Call to halve target for added sugar.

Sugar: There are growing concerns about sugar and healt

People need to more than halve their intake of added sugar to tackle the obesity crisis, according to scientific advice for the government in England.

A draft report by the Scientific Advisory Committee on Nutrition (SACN) says sugar added to food or naturally present in fruit juice and honey should account for 5% of energy intake.

Many fail to meet the old 10% target.

The sugar industry said "demonising one ingredient" would not "solve the obesity epidemic".

The body reviewed 600 scientific studies on the evidence of carbohydrates - including sugar - on health to develop the new recommendations.

One 330ml can of fizzy pop would take a typical adult up to the proposed 5% daily allowance, without factoring in sugar from any other source. 

Coca Cola Europe boss James Quincey confronted by Newsnight's Jeremy Paxman in November 2013

Prof Ian MacDonald, chairman of the SACN working group on carbohydrates, said: "The evidence that we have analysed shows quite clearly that high free sugars intake in adults is associated with increased energy intake and obesity.

"There is also an association between sugar-sweetened beverages and type-2 diabetes.

"In children there is clear demonstration that sugar-sweetened beverages are associated with obesity.

"By reducing it to 5% you would reduce the risk of all of those things, the challenge will be to get there."

The target of 5% of energy intake from free sugars amounts to 25g for women (five to six teaspoons) and 35g (seven to eight teaspoons) for men, based on the average diet. 

 'Silver bullet'

Public Health England will now reconsider its recommendations on fruit juice and smoothies in its five-a-day campaign.

The current advice from the NHS is that juice counts as a maximum of one portion a day, while a smoothie may count as more than one portion, depending on how it is made.

It will also investigate measures to protect children from food advertising while online and whether a sugar tax would have any merit.

Dr Alison Tedstone, the chief nutritionist at Public Health England, said: "We are very concerned around sugar intakes in England.

"It doesn't mean having a completely different diet from today, it is thinking about swapping high sugar foods for a lower sugar alternative.

"Instead of fizzy drink, have water or low-fat milk, instead of a chocolate bar, have a piece of fruit."

 Analysis

By James Gallagher, Health editor, BBC news online

 

There's something noticeably missing from a call to halve added sugar - how would you go about doing it?

This group was set up to assess the science and determine what we should be eating. Its role was not to come up with policies.

The target of 5% is a huge challenge when teenagers are currently getting 15% of their calories from added sugar.

One option that doctors have called for is a tax on sugary drinks. The measure is being tried in Mexico, although there is still little evidence on its impact.

The tough decisions are all still to come - what measures will the public accept and how can we be encouraged to eat less sugar without driving us back into the arms of saturated fat and salt?

BBC News: Five foods surprisingly high in sugar

BBC News: The family that gave up sugar

The SACN advice echoes an announcement by the World Health Organization in March.

Its draft guidelines reiterated that sugars should constitute no more than 10% of energy intake and that people and governments should be aiming for 5%.

The limits would apply to all sugars added to food, as well as sugar naturally present in honey, syrups, fruit juices and fruit concentrates.

The Food and Drink Federation, which represents manufacturers, said: "SACN's comprehensive analysis of the evidence on carbohydrates has looked at the role of carbohydrates, including sugars and fibre in the diet. We will look at the content of the report and its recommendations over the next few weeks with the intention of engaging in the consultation process and related discussions."

Dr Julian Cooper, head of food science at AB Sugar, said targeting sugar was not a "silver bullet" and people should balance their calorie intake against how much they exercise.

'Fantastic'

The campaign group, Action on Sugar, said the development was "fantastic" news.

The group's chairman Prof Graham MacGregor argued: "Health Secretary Jeremy Hunt must start by setting targets for reducing sugar in soft drinks this summer and move responsibility for nutrition to an independent body such as the Food Standards Agency so that the soft drinks and food industry are given a level playing field, with the threat of regulation to ensure the whole of the food industry comply.

"Before another million British kids become obese."

Public Health Minister for England, Jane Ellison, said: "We know eating too much sugar can have a significant impact on health, and this draft advice confirms that.

"We want to help people make healthier choices and get the nation into healthy habits for life. This report will inform the important debate taking place about sugar."

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Big jump in Mers cases reported.

 

More than 100 more cases and 34 deaths from the new respiratory disease Mers-coronavirus have been reported by officials in Saudi Arabia.

The cases date back to February and came to light after an analysis of hospital records.

The World Health Organization says there have now been 820 cases of Mers and 286 deaths.

The exact source of the novel infection is still uncertain, but camels are a prime suspect.

The virus is from the same family as the common cold, but can lead to kidney failure and pneumonia.

It was first detected in June 2012.

The update from the Saudi authorities said there were 113 additional cases - 76 of the patients recovered, three are still in hospital and 34 have died. 

Cases have also been confirmed in Jordan, Qatar, the United Arab Emirates, France, Germany, Italy, Tunisia, Egypt, the UK and the US - usually after travel to Saudi Arabia.

Source?

  

Researchers believe the coronavirus that causes the infection crossed over from animals.

Earlier this month, a report in the New England Journal of Medicine found "identical" Mers viruses in camels and their owner.

However, the link had not been conclusively proven and some researchers argue there may be another source.

The figures do show that nearly half of the cases were spread between people. It seems to have spread after close contact with family member or medical staff.

The World Health Organization does not recommend restrictions on trade or travel, but does warn people to avoid raw camel milk, camel urine and to ensure meat is properly cooked. 

 What is Mers?

• Acronym for Middle East Respiratory Syndrome

• A type of coronavirus which causes respiratory infections
• First death recorded in 2012 in Saudi Arabia
• Camels are suspected to be the primary source of infection for humans

The mystery virus with no known cure

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Antidepressant suicide warnings 'may have backfired'

US warnings about the risk of suicide in young people prescribed antidepressant medication may have backfired, research suggests.

A study, in the British Medical Journal, showed a sudden fall in antidepressant prescriptions and a rise in suicide attempts after media reports of the connection.

The team at Harvard Medical School said the unintended effect was "disturbing".

Experts said similar changes had been seen in other countries.

In 2003, there were concerns about an increased suicide risk from some antidepressants. It led to the US Food and Drug Administration changing the medicine warnings and widespread media reports.

However, there was concern that the reports were exaggerated and missed out the benefits of antidepressants.

Big fall

The study, which followed 2.5 million teenagers and young adults between 2000 and 2010, showed an immediate impact of the warnings.

Prescriptions fell by a third in teenagers and by a quarter in young adults. 

 The number of suicide attempts increased by 22% in teenagers and 34% in young adults. Overall it led to an additional 77 attempts, the researchers estimated. 

 

The report concluded: "It is disturbing that after the health advisories, warnings and media reports about the relation between antidepressant use and suicidality in young people, we found substantial reductions in antidepressant treatment and simultaneous, small but meaningful increases in suicide attempts."

One of the researchers, Prof Stephen Soumerai, said: "This is an extraordinarily difficult public health problem, and if we don't get it right, it can backfire in serious ways.

"These drugs can save lives. The media concentrated more on the relatively small risk than on the significant upside."

'Powerful impact'

Prof Keith Hawton, the director of the centre for suicide research at the University of Oxford in the UK, said: "The results of this study are important.

"Such findings illustrate the powerful impact that such announcements can have on clinician behaviour.

"Until now there has not been convincing evidence that such changes in practice have affected suicidal behaviour.

"The US study suggests that this may have happened, although fortunately without evidence of an increase in actual suicides."

Dr Christine Lu, of Harvard, told the BBC: "There are several lessons for us to consider. Drug risk communication is a big field and we need to be better next time. Any communication can have intended and unintended consequences. 

"And I think a key message is to remind ourselves not to consider only the new evidence on any drugs, but also consider its risk and the benefits, and undertreating the original condition itself."

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Sunbathing 'may be addictive' warning

 

Spending time basking in the sun's warming rays may have addictive properties, claim researchers in the US.

Their study, published in the journal Cell, showed that sunlight led to the production of endorphins in the skin.

The Harvard Medical School team said their experiments on mice showed repeated UV exposure led to addiction in the animals.

Other scientists said describing it as "addiction" was a step too far.

There have been previous suggestions that people can get addicted to the sun.

A study of university students using tanning salons suggested around one in three met the definition for addiction.

Other trials showed withdrawal symptoms could appear, including nausea, jitteriness and shaking, when enthusiastic tanners were given a drug used to treat addiction.

 Happy chemical

Researchers at Massachusetts General Hospital and Harvard Medical School were exploring how such addiction might occur.

 

Mice with a shaved back were exposed to the equivalent of half an hour of midday Florida sun every day for six weeks.

They showed UV radiation led to the production of a protein in the skin called proopiomelanocortin. This is broken down into the pigment melanin, which gives you a tan, but the team showed pleasure chemicals, or endorphins, were also produced.

The chemicals act on the same systems in the body as other opioids such as heroin and morphine.

Giving the mice drugs to block opioids, which are used in rehab clinics, led to withdrawal symptoms including shaking and tremors.

The mice then started to avoid the place where the drugs were being administered, which the researchers said was a hallmark of addictive behaviour.

But their experiments do not show the mice actively seeking out the UV light in the same manner as a drug addict. 

 

Dr David Fisher, one of the researchers from Massachusetts General Hospital, told the BBC: "I would say at this stage, with reasonable confidence, that this pathway really does exist and is probably present in everybody.

"People who may have no intention of using any drugs may just think they're going out to enjoy a great day outdoors and may be becoming addicted and exposing themselves and their children to UV in a fashion which could elevate their risk of developing skin cancer.

"It sounds like a cruel joke to be addicted the most ubiquitous carcinogen in the world, it is plausible that there is an evolutionary advantage and we suspect that may relate to vitamin D."

However, other scientists are not convinced.

'Not supported'

Dr David Belin, who researches addiction at the University of Cambridge, said: "I'm not disregarding the interest of looking into addiction to UV light, I think this is a very interesting field and their study is going to be seminal even though their conclusions are not supported by their results."

He said UV-addicted mice would show a preference for spending time under a UV lamp to the expense of everything else, even eating - something the researchers do not report.

If people were sun-addicted then: "You would have people giving up their family lives to get access to sunshine, you would have people who lose their jobs because they spend their day on the beach, people would maintain UV-seeking behaviour to the detriment of their everyday life.

"British people would go on holiday to the south of France and would never come back."

He added that other tan-is-beautiful social pressures may be behind addict-like behaviour in some people using sun beds.

However, he said the study itself was "outstanding" and showed that "lying on the beach recruits your opioid system and on its own it might be something you really like."

Dr Clare Stanford, a reading in experimental psychopharmacology at University College London, said: "This study does not provide the sort of evidence needed to show addiction to UV light in mice and it is even less certain that the work predicts addiction in humans.

"This would require testing whether the mice preferred UV light or non-UV light, which was not done in this paper."

 Ouch

 

Dr Fisher said he was motivated by the "remarkable embarrassment" of rising rates of skin cancer in the US despite widespread knowledge of the dangers of UV radiation.

He said using a suncream which blocked both UVA and UVB would probably prevent addiction.

However, he did say there should be more thought about tanning salons.

His report concluded: "It may be necessary to more proactively protect individuals, including teens, from the risks of an avoidable, potentially life-threatening exposure and to view recreational tanning and opioid drug abuse as engaging in the same biological pathway."

'Fake it'

Sarah Williams, a senior health information officer at Cancer Research UK, said: "With most cases of skin cancer linked to too much exposure to UV from the sun and sun beds, it's important that people know the dangers and how to protect themselves.

"While we all need some sun for strong and healthy bones, when the sun is strong it's important to spend time in the shade and cover up with clothing.

"Sunscreen with at least SPF15 and a high star rating can help protect the parts you can't cover and avoid using sun beds. 

"We'd like to see more people celebrating their natural skin tone, but if you really want a tanned look, it's safer to fake it."

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Bird flu 'danger zones' mapped.

The "danger zones" in Asia which are vulnerable to a deadly bird flu have been mapped by scientists. 

The virus, called H7N9, has infected 433 people mostly in China and has killed 62.

The study, published in Nature Communications, showed parts of Bangladesh, India and Vietnam could easily sustain the virus.

The research group said those areas should monitor poultry to ensure any threat is detected.

The H7N9 virus spread from birds to people and was first detected in March 2013 in China.

New viruses are always a concern because of their unknown potential to spread round the world as a deadly pandemic.

Data from the H7N9 outbreak was used to build a computer model of other at-risk areas in Asia.

It involved mapping 8,000 live-poultry markets and assessing how close together they needed to be to spread the infection.

Threat zones.

  

The higher the peaks the greater the potential risk for H7N9 bird flu.

The map does not show where the virus will end up next, just those areas where conditions are suitable to sustain the virus if it managed to get there.

Bangladesh, northern India, the Mekong and Red River deltas in Vietnam and isolated parts of Indonesia and Philippines were identified as at-risk areas.

Thailand was not a risk zone due to cultural differences, which mean live-poultry markets are not common. It is also noticeable that the whole of China is not equally at risk.

H7N9 is not deadly in birds so there is no "body count" to help track the spread of the disease.

Dr Tim Robinson, a senior spatial analyst at the International Livestock Research Institute in Nairobi, told the BBC: "It is a risk map showing, if the virus arrived to an area, how likely it would be to spread and continue from there.

"H7N9 can spread very quietly throughout the poultry population.

"The main use of the maps is to target surveillance, I think these maps can show areas where there's a high chance of the disease flaring up if it arrives."

  

Chinese health workers inoculating chickens at a farm in Shangsi

What is missing from the maps is how the virus is likely to spread.

The researchers want to factor in data on how poultry are traded in Asia.

Dr Simon Hay, from the University of Oxford, said: "H7N9 is confined to China at the moment and all the neighbouring countries are worried about when their chicken industry might be infected."

"The maps are a prediction if you dropped a new infection in that location would it stick and hold as a disease."

He said the tools developed could be quickly applied to other bird flus making the the jump to people in the future.

Yet the great fear in novel avian influenza is that the virus starts to spread rapidly between people.

"I think the maps become redundant at that point," Dr Hay added.

"It's a very different disease process then, if it does jump to human-to-human transmission then you would use a classical influenza model using the proximity of people, volume of air flights and the amount of people moving between cities." 

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Iraq formally asks US to launch air strikes against rebels.

Alleged ISIS militants in the town of Baiji in recent days.

 

   

Shia women in the city of Najaf show their willingness to join Iraqi security forces in the fight against ISIS

Iraq has formally called on the US to launch air strikes against jihadist militants who have seized several key cities over the past week.

"We have a request from the Iraqi government for air power," confirmed top US military commander Gen Martin Dempsey in front of US senators.

Earlier the Sunni insurgents launched an attack on Iraq's biggest oil refinery at Baiji north of Baghdad.

Iraqi PM Nouri Maliki earlier urged Iraqis to unite against the militants.

Government forces are battling to push back ISIS (Islamic State in Iraq and the Levant) and its Sunni Muslim allies in Diyala and Salahuddin provinces, after the militants overran the second city, Mosul, last week.

US President Barack Obama met senior Congress members on Wednesday to discuss the Iraq crisis. The White House said Mr Obama had "reviewed our efforts to strengthen the capacity of Iraq's security forces to confront the threat from ISIL [ISIS], including options for increased security assistance".

Ahead of the briefing Senate leader Harry Reid, a Democrat, said he did not "support in any way" getting American troops involved in the Iraqi "civil war".

But Gen Dempsey told a Senate panel that it was in America's "national interest to counter [ISIS] wherever we find them".

In other developments:

• UK Prime Minister David Cameron told Parliament in London that ISIS was also plotting terror attacks on Britain
• India confirmed that 40 of its citizens had been kidnapped in the violence-hit Iraqi city of Mosul
• Saudi Foreign Minister Saud bin Faisal warned that Iraq faced the risk of civil war
• Turkey is investigating reports that 15 Turkish builders were abducted by ISIS on Tuesday; 80 Turks were kidnapped in Mosul last week

ISIS eyes lucrative Iraqi resources

A detailed look at what ISIS says about itself, in two annual reports, is very revealing.

Get past the gruesome audit of violence - the numbers of people they claim to have killed through car bombs, suicide attacks and even "apostates run over" - and a picture emerges of an "increasingly structured organisation", in the words of an analysis by the Institute for the Study of War (ISW).

The statistics show a major ISIS focus, over the past two years, on Nineveh province, which may help to explain the Iraqi army's headlong flight from Mosul last week. More than 30% of ISIS attacks in both 2012 and 2013 were focussed on Nineveh, with a particular emphasis on threats against members of the Iraqi military and intimidation of local journalists.

But the reports suggest ISIS has nationwide ambitions, to take over large parts of the country. In the absence of a considered strategy, warn the authors of the ISW study, ISIS "will become a permanent fixture in the Middle East".

Microwave helmet 'can spot a stroke'.

The prototype device is still undergoing modification and needs larger tests.

Scientists say they have devised a helmet that can quickly determine whether a patient has had a stroke.

It could speed diagnosis and treatment of stroke to boost chances of recovery, the scientists say.

The wearable cap bounces microwaves off the brain to determine whether there has been a bleed or clot deep inside.

The Swedish scientists who made the device plan to give it to ambulance crews to test after successful results in early studies with 45 patients.

Race against time.

 

 A weak blood vessel can rupture and cause a haemorrhagic stroke.

 

When a person has a stroke, doctors must work quickly to limit any brain damage.

If it takes more than four hours to get to hospital and start treatment, parts of their brain tissue may already be dying.

Continue reading the main story

“Start Quote

Time lost is brain lost”

Dr Shamim Quadir Stroke Association

But to give the best treatment, doctors first need to find out if the stroke is caused by a leaky blood vessel or one blocked by a clot.

A computerised tomography (CT) scan will show this, but it can take some time to organise one for a patient, even if they have been admitted as an emergency to a hospital that has one of these scanners.

Any delay in this "golden hour" of treatment opportunity could hamper recovery.

Vital window

To speed up the process, researchers in Sweden, from Chalmers University of Technology, Sahlgrenska Academy and Sahlgrenska University Hospital, have come up with a mobile device that could be used on the way to hospital.

The helmet uses microwave signals - the same as the ones emitted by microwave ovens and mobile phones but much weaker - to build a picture of what is going on throughout the brain.

Tests with an early prototype - a refashioned bicycle helmet - found it could accurately distinguish between bleeds (haemorrhagic stroke) and clots (ischaemic stroke), although not 100% of the time.

They have since built and tested a custom-made helmet to better fits skulls of different shapes and sizes, and they have tested it out with the help of nurses and patients at a local hospital ward.

Ultimately, they want to fit it into the pillow the patient rests their head on.

The researchers say their device needs more testing, but could be a useful aid in the future.

Doctors would probably still need to use other diagnostic methods too, they told Transactions on Biomedical Engineering journal.

Investigator Prof Mikael Persson said: "The possibility to rule out bleeding already in the ambulance is a major achievement that will be of great benefit in acute stroke care."

Dr Shamim Quadir, of the UK's Stroke Association, said: "When a stroke strikes, the brain is starved of oxygen, and brain cells in the affected area die. Diagnosing and treating stroke as quickly as possible is crucial.

"While this research is at an early stage, it suggests that microwave-based systems may become a portable, affordable, technology that could help rapidly identify the type of stroke a patient has had, and get them treated faster.

"By diagnosing and treating stroke as early as possible, we can minimise the devastating impact of stroke, secure better outcomes for patients and, ultimately, save lives. Time lost is brain lost."

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