Morning Walks Could Be Better Than Drugs At Lowering Blood Pressure

According to a new study published in the journal Hypertension, just half-an-hour of walking in the morning could be as effective as medication at lowering blood pressure.

Researchers at the University of Western Australia found that 30 minutes of walking on a treadmill in the morning improved participants' blood pressure readings for the rest of the day. They say that for some individuals, the morning walking could replace the need for medication.

According to the charity Blood Pressure UK, about one-third of adults have high blood pressure, which is defined as a reading of more than 140/90 mmHg and, in Britain, about 12 million people take medication for the condition.

For the study, Michael Wheeler and colleagues assessed 67 overweight and obese men and women (aged 55 to 80) who engaged in three different 8-hour daily routines.

The first routine involved sitting continuously for eight hours. The second involved sitting for one hour before walking for 30 minutes at moderate intensity on a treadmill, followed by sitting for a further 6.5 hours.

The third routine involved sitting for one hour before 30-minute treadmill walking and then sitting for 6.5 hours, but with this interrupted every 30 minutes with 3 minutes of light intensity walking.

The results showed that blood pressure was significantly lower when participants engaged in the routines that involved walking, compared with the sitting-only routine.

Wheeler says that the magnitude of the blood pressure reduction approached that of what may be expected when this population group take anti-hypertensive medication.

Commenting on the study, the British Heart Foundation added that half-an-hour of morning exercise is also good for people's mental health.

Cardiac nurse at the British Heart Foundation, Chris Allen, says the findings add to a huge body of evidence showing that regular exercise can help to lower blood pressure and reduce the risk of heart attacks and strokes: "It can also give both your body and mind a boost, which is why 30 minutes of activity in the morning is a great way to set yourself up for the day."

As the proportion of those who are overweight with higher blood pressure increases with age, adopting a strategy of combining exercise with breaks in sitting may be important to control and prevent the development of high blood pressure." - Professor Michael Wheeler, Lead Author.

Wheeler, M., J., et al. 2019 Effect of Morning Exercise With or Without Breaks in Prolonged Sitting on Blood Pressure in Older Overweight/Obese Adults. Hypertension.

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Radical Parkinson's Treatment Tested in Patients

A radical Parkinson's treatment that delivers a drug directly to the brain has been tested in people.

Patients in the trial were either given the drug, which is administered via a "port" in the side of the head, or a dummy treatment (placebo).

Both groups showed improved symptoms, meaning it was not clear if the drug was responsible for the benefits.

However, scans did find visual evidence of improvements to affected areas of the brain in those given the drug.

The study's authors say it hints at the possibility of "reawakening" brain cells damaged by the condition.

Other experts, though, say it is too early to know whether this finding might result in improvements in Parkinson's symptoms.

Researchers believe the port implant could also be used to administer chemotherapy to those with brain tumours or to test new drugs for Alzheimer's and stroke patients.

Parkinson's causes parts of the brain to become progressively damaged, resulting in a range of symptoms, such as involuntary shaking and stiff, inflexible muscles.

About 145,000 people a year in the UK are diagnosed with the degenerative condition, which cannot be slowed down or reversed.

For this new study, scientists gave patients an experimental treatment called glial cell line-derived neurotrophic factor (GDNF), in the hope it could regenerate dying brain cells and even reverse the condition.

Participants underwent robot-assisted surgery to have four tubes placed into their brains, which allowed GDNF to be infused directly to the affected areas with pinpoint accuracy, via a port in their head.

After an initial safety study of six people, 35 patients took part in a nine-month "blinded" trial, where half were randomly assigned to receive monthly infusions of GDNF and the other half dummy infusions.

Dr Alan Whone, principal investigator, said patients in the trial had, on average, been diagnosed eight years previously, but brain scans of those given the drug showed images that would be expected just two years after diagnosis.

He said: "We've shown with the Pet [positron emission tomography] scans that, having arrived, the drug then engages with its target, dopamine nerve endings, and appears to help damaged cells regenerate or have a biological response."

'I Feel it Brought Me Time'

Tom Phipps, 63, from Bristol, said he had noticed an improvement during the trial and had been able to reduce the drugs he takes for his condition.

Since it ended, he has slowly increased his medication but is continuing to ride his bike, dig his allotment and chair his local branch of Parkinson's UK.

"My outcome was as positive as I could have wished for," he said.

"I feel the trial brought me some time and has delayed the progress of my condition.

"The best part was absolutely being part of a group of people who've got a similar goal - not only the team of consultants and nurses but also the participants.

"You can't have expectations - you can only have hope.

Following the initial nine months on GDNF or placebo, all participants had the opportunity to receive GDNF for a further nine months.

By 18 months, when all participants had received GDNF, both groups showed moderate to large improvements in symptoms compared with their scores before they started the study.

But the authors say the results need to be treated with caution because of the possibility of the placebo effect - when a patient feels better despite taking a medicine with no active ingredient.

Researchers hope that further trials could look at increasing the doses of GDNF or the duration of treatment.

'A New Horizon'

Dr Arthur Roach, director of research at Parkinson's UK, which funded the study, said: "While the results are not clear-cut, the study has still been a resounding success.

"It has advanced our understanding of the potential effects of GDNF on damaged brain cells, shown that delivering a therapy in this way is feasible and that it is possible to deliver drugs with precision to the brain."

Prof K Ray Chaudhuri, from the Institute of Psychiatry, Psychology and Neuroscience, King's College London, who was not involved in the study, said it was "disappointing" that the difference in symptoms was not significant.

But he said the study was still of "great interest and should point towards a new horizon and direction to restoration-based treatments".

The findings from the trials are published in the medical journals Brain and the Journal of Parkinson's Disease.

The study also features in a two-part BBC Two documentary series, The Parkinson's Drug Trial: A Miracle Cure? on 28 February and 7 March, at 21:00.

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'Know Your Cholesterol Like You Know Your Pin Code'

People are being encouraged to know their cholesterol and blood pressure numbers as well as they know their bank Pin code - because it could save their life.

These numbers flag up early signs of cardiovascular disease, which can lead to heart attacks and strokes.

Forty health organisations have teamed up to urge more people to go for a routine NHS health check.

Doctors should also identify and treat at-risk patients better, they say.

Cardiovascular disease (CVD) causes one in four deaths in England, the equivalent of someone dying every four minutes, according to Public Health England and NHS England.

Poor heart and artery health can also lead to heart failure, kidney disease, arterial disease and vascular dementia.

So, health bodies are leading efforts to improve the detection and treatment of three conditions that contribute to CVD - atrial fibrillation, high blood pressure and high cholesterol - over the next 10 years.

These conditions often have no symptoms, which is why health experts are recommending people aged over 40 take up a free NHS health check.

These can be booked at GP surgeries. They are also available at some local pharmacies and shopping centres.

PHE recommends checking your local area to find out where they are being offered.

People over 30 are being urged to take the Heart Age Test.

'I Had to Give Up Work'

Keith Wilson, from Liverpool, had a heart attack out of the blue at 37.

"I had no symptoms and no reason to believe I was sick in any way," he says.

His father had died of heart disease in his late 60s so he assumed it was something that happened to older people.

"I just didn't consider I was going to get it. I was complacent," he says.

After a second heart attack, Keith spent the next three to four years in and out of hospital receiving treatment.

He had to give up work and this really affected his family and young son.

Now 60, Keith is mindful of his health and keeps a close eye on how much he drinks and exercises. He gave up smoking straight after his heart attacks.

What is high cholesterol?

Cholesterol is carried in your blood by proteins. It can build up in the artery walls, restricting blood flow to the heart, brain and rest of the body. It can be measured with a blood test.

Total cholesterol levels should be:

• 5mmol/L or less for healthy adults
• 4mmol/L or less for those at high risk
• You are at high risk if you have a family history of heart disease, heart attacks or strokes, are overweight or have high blood pressure.

What is high blood pressure?

Blood pressure is recorded using two numbers - the systolic pressure at which the heart pumps blood around your body and the diastolic pressure which measures resistance to blood flow in the blood vessels.

• high blood pressure is usually 140/90mmHg or higher
• ideal blood pressure is usually between 90/60mmHg and 120/80mmHg
• low blood pressure is lower than 90/60mmHg

Most cases of CVD are preventable and, alongside free health checks, PHE recommends people should:

• stop smoking
• eat healthily
• keep to a healthy weight
• drink at safe levels

The report also calls on health professionals to improve the way they manage patients at risk of CVD.

By 2029, PHE and NHS England want:

• 80% of people with high blood pressure detected and treated - up from 57% currently
• 75% of 40- to 74-year-olds having cholesterol levels measured - fewer than 50% currently take up the free health check
• 45% of 40- to 74-year-olds at high risk of CVD treated with statins - up from from 35% currently
• These targets will help meet the commitment to prevent 150,000 heart attacks, strokes and cases of dementia, as set out in the government's long-term plan for the NHS.

But there is no new funding for these new targets.

'Needlessly at risk'

Duncan Selbie, chief executive of Public Health England, said: "We know our Pin numbers but not the numbers that save our lives.

"Thousands of heart attacks and strokes can be prevented by more people knowing their blood pressure and cholesterol numbers and by seeking help early."

Prof Stephen Powis, NHS medical director, said reducing health inequalities was also a priority, with people in the most deprived communities four times more likely to die prematurely from CVD than those in the most well off.

England's Health Secretary Matt Hancock said: "Almost half of those with high blood pressure are going about their daily lives without it being detected or treated.

"Millions of people are needlessly at risk of heart attacks or strokes when it could be prevented.

"So, I want to help more people take the time out to protect their future health and get checked."

Five million people are estimated to have undiagnosed high blood pressure in England.

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What Diet is Best for Older Adults?

A new study has revealed that a diet rich in protein and low in calories can help older adults with obesity lose more weight while maintaining muscle mass and improving bone density.

Losing weight as an older adult presents some challenges.

Older adults often lose bone density and muscle mass when they concentrate on shedding weight.

This unwanted bone and muscle loss can result in mobility issues and can even increase a person's risk of injury.

A recent study, which Wake Forest University in Winston-Salem, NC, is the lead on, has shown that a high-protein, low-calorie diet can help adults avoid these problems.

Several peer-reviewed journals, which include Journals of Gerontology: Medical Sciences and American Journal of Clinical Nutrition have accepted four research papers from the study for publication.

The researchers randomly selected 96 adults over 65 years of age and assigned them to one of two groups.

They put the first group on a 6-month, low-calorie meal plan that was also high in protein - more than 1 gram (g) of protein per kilogram (kg) of body weight. They assigned the other group to a weight-maintenance plan that included 0.8 g of protein per kg of body weight.

High-protein, Low-calorie

Those in the high-protein, low-calorie diet group experienced the most weight loss, but more revealing was that those in this group maintained their muscle mass. They also lost weight on the stomach, hips, thighs, and rear, which can decrease the risk of certain medical conditions, including diabetes and stroke.

Furthermore, the researchers found that the participants in the high-protein group improved their bone quality, and they gained 0.75 points on their Health Aging Index scores, involving longevity and mortality biomarkers.

Kristen Beavers, assistant professor of health and exercise science at Wake Forest and lead investigator of this study, led earlier, smaller studies where she scrutinized the planning and preparation of the participants' meals. For this study, though, with its greater number of participants, she wanted to find a more cost-effective method.

Consequently, the study asked those in the weight-loss group to use four meal replacements every day and to prepare two meals of lean protein and vegetables each day. The team allowed each participant one healthy snack per day to wrap up a low-calorie, high-protein meal plan. Those in the other group were instructed to maintain their regular diet and usual activities.

Older Adults and Nutrition

Older adults have unique nutritional needs and may need to make changes to their diets as the years go by. Muscle mass can decrease as a natural part of aging, and people do not burn calories at the same rate as they do during their younger years.

Targeting nutrient-dense foods is essential for older adults, and avoidance of high-calorie foods that lack vital nutrients is crucial.

Beneficial foods include fruits, vegetables, whole grains, lean meats, seafood, poultry, eggs, legumes, and low-fat dairy. Portion control may also be necessary - for older adults especially - as people may eat more food than they need.

It can be challenging to cook for a smaller family, so experts sometimes suggest cooking ahead and freezing portions to eat later when cooking is less appealing.

The particulars of this latest study seem to mirror the nutritional needs of older adults. However, the authors suggest that the addition of more protein may be the key to avoiding some of the unhealthful pitfalls that can take place when an older adult loses weight.

"This study suggests that a diet high in protein and low in calories can give seniors the health benefits of weight loss while keeping the muscle and bone they need for better quality of life as they age." - Lead investigator Kristen Beavers.

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How Exercise Can Counter the Effects of Jet Lag

New research in The Journal of Physiology suggests that exercising at certain times of the day can alter the circadian rhythms, potentially offering a new therapy for jet lag and shift work.

Jet lag can lead to insomnia and fatigue, but exercise may help alleviate such disruptions to a person's body clock.

Circadian rhythms, which are "physical, mental, and behavioral changes that follow a daily cycle," regulate our bodies.

Light and darkness are the main factors that affect our circadian rhythms.

A cluster of nerve cells in the brain receives information about the amount of light through the optic nerves, "telling" our brains to make us sleepy by releasing the sleep hormone melatonin.

However, when we travel to a different time zone or work the night shift, we disrupt these circadian rhythms. Some of the adverse effects of such disruptions include insomnia and fatigue, trouble focusing, headaches, and gastrointestinal problems.

There are currently no treatments for the adverse effects of jet lag or shift work, so researchers are trying to devise novel therapies. For instance, one recent study has found that the retina contains some cells that secrete vasopressin, another hormone that helps regulate circadian rhythms.

Altering the vasopressin signaling pathway may one day lead to the manufacture of eye drops that could offset the effects of jet lag, but such treatments are still far from becoming a reality.

However, what if it was possible to treat jet lag without drugs? What if light was not the only factor that affects circadian rhythms?

Shawn Youngstedt, from the College of Nursing and Health Innovation and the College of Health Solutions at Arizona State University in Phoenix, and his colleagues asked themselves these questions.

Their research found that exercise may counter the negative effects of circadian rhythm disruption.

Exercise Delays or Advances the Body Clock

Youngstedt and his colleagues examined the effects of exercise on 51 "aerobically fit" participants aged 59-75 years and 48 study participants aged 18-30 years. They measured the participants' circadian rhythms and how exercise affected them for a period of 5.5 days. Specifically, the 99 volunteers all did 1 hour of moderate treadmill exercise for 3 consecutive days at one of eight different times during the day or night.

The scientists determined the participants' baseline body clock by analyzing their urine samples and determining their levels of melatonin.

The body releases melatonin in different amounts at different times of the day: The hormone peaks in the evening and drops in the morning. By taking samples from the volunteers every 90 minutes, the researchers identified the precise time when their melatonin rose and fell throughout the day.

Exercising at 7 a.m. or between 1 p.m. and 4 p.m. shifted the circadian rhythm to an earlier time, while engaging in exercise between 7 p.m. and 10 p.m. pushed the body clock back. Age or sex did not affect these results.

On the other hand, exercising between 1 a.m. and 4 a.m. or at 10 a.m. did not affect their melatonin levels.

Youngstedt comments on the findings, saying: "Exercise has been known to cause changes to our body clock. We were able to clearly show in this study when exercise delays the body clock and when it advances it."

"This is the first study to compare exercise's effects on the body clock, and could open up the possibility of using exercise to help counter the negative effects of jet lag and shift work." - Shawn Youngstedt.

However, the study authors caution that because the participants had higher fitness levels than the general population, the results may not extend to people who are less fit.

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Psychiatric Care Saved Me Says Richard Coles

Pop star-turned-vicar the Reverend Richard Coles has credited a mental health hospital for saving his life when he was 17.

The former Communards keyboard player said he was an inpatient at St Andrew's Healthcare in Northampton when he had an episode of clinical depression.

Mr Coles said he was coming to terms with his sexuality and "as a gay man in Kettering in 1978" at the time.

The care he received "literally saved my life", he said.

The former Strictly Come Dancing celebrity contestant said: "There really wasn't much sense of a life rich in possibilities.

"It was a much less tolerant world then than it is today and that was a real struggle. Coming here (St Andrew's) made a big difference to me."

Mr Coles, a broadcaster on BBC Radio 4's Saturday Live programme, visited St Andrew's Healthcare as part of LGBT (Lesbian, Gay, Bisexual and Transgender) History Month.

He said the care he received from two psychiatrists there helped put a stop to "all that internalised self-loathing" and gave him a sense that "this is an identity that's not necessarily a negative identity".

"I became determined, I wasn't going to live the narrow, mean and constrained life that was the best on offer.

"And I ran away to London and formed a new life and became an activist," he said.

Through access to media and music he said he "caught that rising tide of change".

Mr Coles was ordained into the Anglican priesthood in 2005 and is the vicar of Finedon in Northamptonshire.

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Celebrity Ads for Diet Aids Should Be Banned, Says Top Doctor

Social media companies should ban "damaging" celebrity-endorsed social media ads promoting weight loss aids, England's top doctor has said.

Some celebrities with large followings are promoting products such as diet pills and detox teas on social media.

Prof Stephen Powis, NHS medical director, argues these products have a damaging effect on the physical and mental health of young people.

He is also urging influential celebrities to act "responsibly".

Prof Powis said: "If a product sounds like it is too good to be true, then it probably is.

"The risks of quick-fix weight loss outweigh the benefits, and advertising these products without a health warning is damaging.

"Highly influential celebrities are letting down the very people who look up to them, by peddling products which are at best ineffective and at worst harmful.

"Social media companies have a duty to stamp out the practice of individuals and companies using their platform to target young people with products known to risk ill health," he said.

'Fires lit by other people'

Some influential celebrities have promoted weight loss aids for payment on social media, and this type of advertising is growing as brands realise how influential their posts are with young people.

The Competition and Markets Authority recently announced a clampdown on celebrities who do not clearly label their posts as being paid-for advertisements, but there are few rules around what they can promote.

NHS England's national mental health director Claire Murdoch told BBC Breakfast that the intention was not to "suppress business or comment on what good business looks like".

However, she expressed concern over the influence these celebrities had over young people at an "impressionable" stage in their lives.

"Both the celebrities themselves and these social media companies themselves should be more responsible," she added.

'A toxic influence'

Kim Kardashian West, who has 126 million followers on Instagram, was criticised for advertising appetite-suppressing lollypops last year. She later deleted the post.

In January, she posted an ad promoting meal replacement shakes.

Katie Price (1.9 million followers) has advertised an appetite suppressant on her Instagram page, as did Vikki Patterson (4.2 million followers) of TV shows Geordie Shore and Loose Women.

Lauren Goodger of The Only Way is Essex has also advertised diet aids.

Actress Jameela Jamil, who campaigns for body positivity, has described Kardashian West as a "terrible and toxic influence on young girls", and a meal replacement shake as "laxative teas."

Ms Jamil is the founder of the I Weigh social media campaign on Twitter and Instagram - where she encourages women to measure their value beyond their weight and looks.

Research from the National Citizens Service shows that at least one in four young people say that their appearance was the most important thing to them, with over half of girls feeling the pressure to be thinner, and a third of boys thinking they should be more muscular.

"Taking any substance which impacts the body, without proper medical advice and support, is a risk" said Prof Powis.

"Cosmetic treatments and get-thin-quick products which are readily and increasingly available and promoted, can be harmful if not used correctly."

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Is Breakfast Always a Good Idea?

Breakfast may be the most important meal of the day, but eating it won't help you lose weight, research suggests.

Those who ate breakfast consumed 260 more calories per day and gained 1lb more than those who skipped it, a review of previous studies found.

But experts say a healthy breakfast can be a good source of calcium and fibre.

It has also been shown to improve concentration and attention levels, particularly in children.

Breakfast gives you energy, stops you snacking later in the day and supplies essential nutrients - so we are told.

Its reputation as the nutritional backstop to our day stems from observational studies showing a positive link between people eating breakfast and having a healthy weight.

But this new Australian research in the BMJ, which reviewed the results of 13 separate trials on breakfast eating, weight change and energy intake, found little evidence for those views.

The findings of the Monash University research team suggest that skipping breakfast might in fact be a good way to reduce total daily calorie intake.

They found that breakfast eaters consumed more calories overall and breakfast skippers did not have a greater appetite in the afternoon.

And they say caution is needed when recommending breakfast for weight loss in adults - because it could have the opposite effect.

However, the researchers added that there were limitations to their study.

What is a Healthy Breakfast?

• For an energy boost - try an "apple pie" porridge, with cinnamon, or baked beans on wholemeal toast
• For protein - try scrambled eggs with spinach on toast or low-fat Greek yoghurt with fruit and nuts
• For a light bite - make a smoothie from tinned fruit, banana and spinach or mash avocado on toast

The participants in the studies were only followed for short periods - from between two and 16 weeks - and the difference in calorie intake between breakfast eaters and skippers was small.

The researchers concluded that working out the long-term effect of skipping or adding breakfast to diets still needed more research.

Calcium and Fibre Boost

Prof Kevin Whelan, dietetics expert and head of King's College London's nutritional sciences department, says we should not get too hung up on calorie intake first thing in the morning.

"This study does not say breakfast is bad for the health," he said.

"Breakfast is important for nutrient intake, such as cereals and milk which are good for calcium and fibre."

But the BMJ research did not look at this aspect of breakfast.

"We are not talking about breakfast being the cause of obesity," he said.

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Dentist 'Unfair' Fines Investigated by Watchdog

The public spending watchdog is to investigate whether hundreds of thousands of people going to the dentist have been unfairly fined.

The National Audit Office is holding an inquiry into NHS penalty charges in England - applied to people alleged to be wrongly claiming free treatment.

The BBC had revealed many vulnerable people were being fined £100.

The British Dental Association (BDA) has warned that this is scaring poor families from going to the dentist.

The dentists' organisation says almost 430,000 penalty fines were issued last year - which they say is often "simply for ticking the wrong box on claim forms".

'Low Incomes and Elderly'

Many of the people facing fines, the dentists say, are "on very low incomes, the elderly, and those with learning difficulties".

The BDA says that when these fines for wrongfully claiming free treatment are challenged, about nine in 10 are overturned.

But dentists are worried that many people are so worried about the risk of being fined that they do not get dental treatment.

The BBC highlighted the concerns of many families who found that elderly relatives, or people with dementia or learning difficulties, were getting fined, even though they were entitled to free treatment.

The growing scale of the problem has begun to emerge - and also the impact on poorer patients.

According to the BDA, the number of dental visits from those entitled to free treatment has fallen by almost a quarter in the past four years.

Compared with five years ago, there has been a tenfold increase in the number of fines.

'Hostile Environment'

The National Audit Office is to examine how the NHS penalty charge system is being operated - how many are issued, entitlement to exemptions and the revenue generated from fines.

Charlotte Waite, the BDA's chair of the community dental services committee, welcomed the investigation - and said a simple error in an application form should not mean a £100 fine.

"The government's approach to penalty charges has hit hundreds of thousands of vulnerable patients, and encouraged millions more to miss out on care.

"Yes, we need a system to protect taxpayers' money, but that does not mean constructing a hostile environment for patients, many of whom have complex needs," said Ms Waite.

The Department of Health and Social Care has argued that everyone should have free NHS dental treatment if they are eligible.

But it has said that it is right for it to seek to recover money from anyone who wrongly claims free services.

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