The UK's first independent badger vaccination project has proved that the technique is "viable and affordable", according to the charity running it.
The Gloucestershire Wildlife Trust vaccinated 35 badgers during the summer against the bacterium that causes tuberculosis (TB) in cattle. The government wants to fight cattle TB in England through culling, but animal groups see vaccination as preferable. The trial did not look for any impact on disease in badgers or cattle. Instead, the idea was to see how feasible it would be to train staff and vaccinate the animals, and how much it might cost. "We are delighted with the results (which prove) that there is an affordable alternative to the proposed cull," said Gordon McGlone, the trust's chief executive. "Bovine TB is a big problem, but local culling of one of our much-loved native animals is not the answer. "Scientists have spent the last 12 years investigating whether killing badgers will halt this serious disease in cattle, and the answer they are getting is that it could well make the problem worse." The UK's so-called "Krebs Trial", the largest investigation of badger culling undertaken in any country, found that culling can reduce the incidence of bovine TB in the target area. But if it is not done thoroughly and consistently over a large area, it can actually increase the disease burden, as badgers roam further from their setts when others die, taking bacteria to other farms. Trial series Conservation groups argue that vaccination does not carry this risk.
The 'Krebs Trial'
30 areas of the country selected, each 100 square km
10 culled proactively, 10 reactively, 10 not culled
Badgers culled through being caught in cage and then shot
Incidence of bovine TB measured on farms inside and outside study areas
Reactive culling suspended early after significant rise in infection
Trial cost £7m per year
More than 11,000 badgers killed
Latest follow-up studies equivocal on whether benefit of proactive culling is maintained
But the Gloucestershire experience suggests it might be more expensive than culling, with the wildlife trust reporting an average cost of £51 per hectare.
The true cost of culling will not be known unless and until it happens, but farmers' leaders believe it may be in the region of £20 per hectare. The Gloucestershire Wildlife Trust hopes it will never happen. They, and other conservation groups, argue that a combination of tighter restrictions on farmers and vaccination will be more effective, and that in any case, badgers should not be killed as a matter of principle. The National Trust has also begun an implementation trial, at its property at Killerton in Devon. Other wildlife trusts are expected to begin similar projects now that the Gloucestershire group has reported its positive experience. The UK government, meanwhile, is midway through a second consultation period on its culling proposals for England. It is not against vaccination, but believes the approach will have much more success when an edible formulation becomes available to supplant the existing injectable dose, which could take another four to five years. In Wales, plans are on hold following May's election of a Labour government.
Too many hospitals in England are falling short in the most basic care they are giving elderly patients, inspectors say.
The Care Quality Commission carried out unannounced visits at 100 hospitals to assess dignity and nutrition standards.
It identified concerns in 55 cases, describing the findings as "alarming".
Common areas of concern included a lack of support for those who needed help eating, poor hygiene and curtains not being closed properly.
Health Secretary Andrew Lansley said he would encourage whistle-blowers to highlight any concerns they had about the standard of hospital care for the elderly.
He said: "We expect that staff across the NHS, if they see examples of poor care they blow the whistle on that, which is precisely why we have introduced changes to the staff contract."
The inspections were ordered by Mr Lansley after several highly critical reports by campaigners, including the Patients Association.
The 100 sites inspected - representing more than a third of the total number in England - were chosen through a combination of random selection and because previous research had flagged up concerns about standards.
'Major problem'
In total, 45 were judged to be fully compliant, 35 met both the official standards on dignity and nutrition although there was room for improvement and 20 were failing on one or both.
In two cases - Sandwell General in West Bromwich and Alexandra Hospital in Worcestershire - the problems were judged to represent a major problem to patients.
In the case of Sandwell, this led to the closure of the ward where there were the most problems, while a follow-up visit to the Alexandra showed measures had been put in place to rectify the issues.
At another - James Paget in Great Yarmouth - moderate problems were identified, but when a return visit was made and the issues had not been resolved the hospital was issued with a warning notice, meaning if swift improvements are not made it could face sanctions including prosecution or closure of services.
During the inspections, the regulator identified a series of common problems.
These included call bells being placed out of the reach of patients, staff speaking in a condescending or dismissive way and curtains not being closed properly.
In terms of nutrition, some people who were judged to need help eating were not getting it, while interruptions meant that not all meals were being finished by patients.
The regulator also said that in too many cases patients were not able to clean their hands before meals.
The report identified three main reasons for the failures - a lack of leadership, poor attitude among staff and a lack of resources.
'Shocking complacency'
CQC chair Dame Jo Williams said: "The fact that over half of hospitals were falling short to some degree in the basic care they provided to elderly people is truly alarming and deeply disappointing. This report must result in action."
Michelle Mitchell, charity director of Age UK, agreed.
"This shows shocking complacency on the part of those hospitals towards an essential part of good healthcare and there are no excuses."
Janet Davies, of the Royal College of Nursing, accepted there could be "no excuse", but added the squeeze in finances was making it harder to keep standards high on wards.
"Evidence shows that patient safety and quality of care is improved when you have the right numbers and the right skills in place on wards," she added.
Both the government and the NHS Confederation, which represents managers, said examples of poor care were "unacceptable".
Mr Lansley added: "Everyone admitted to hospital deserves to be treated as an individual, with compassion and dignity. We must never lose sight of the fact that the most important people in the NHS are its patients."
OCD, bipolar, schizophrenic and the misuse of mental health terms
Terms like "bipolar", "autistic" and "schizophrenic" are often used in jest to describe character traits. But how harmful is it to bandy the names of such conditions about?
It's a common form of hyperbole.
The neighbour who keeps his house tidy has Obsessive Compulsive Disorder (OCD). A socially awkward colleague is autistic. The weather isn't just changeable, it's bipolar.
Such analogies are so familiar they surely qualify as cliches. They are also inaccurate and, to many, deeply offensive.
Campaigners are targeting what many say is an increasingly common practice - deploying the language of clinical diagnosis to describe everyday personality traits.
Using these terms metaphorically is just a joke, not to be taken seriously, argue some. Others, however, warn that this serves to further obfuscate conditions that are widely misunderstood and stigmatised.
Either way, you don't have to look hard for evidence of such terminology being deployed in this manner - even from sources you might not anticipate.
In December 2010 the Observer newspaper apologised for describing TV presenter Gok Wan's dress sense as "schizophrenic". The International Monetary Fund's September 2011 World Economic Outlook, characterised a volatile global economy as "bipolar". In an article for the Sunday Times, the writer Robert Harris described Gordon Brown and Richard Nixon as displaying "political Asperger's syndrome".
The mental health metaphor also has the distinction of having been deployed by that noted savant of the English language, Katie Price. During a court appearance in which she insisted she had been spraying scent rather than using her mobile phone while driving, the glamour model said: "I am quite OCD about my perfume habits, all my friends know that I'm always spraying perfume."
Research suggests these are far from isolated examples. A 2007 study of the terms "schizophrenia" and "schizophrenic" in the UK national press found that 11% of references were metaphorical, with broadsheet papers more likely to deploy such phrasing than tabloids. By contrast, cancer was only used in this manner in 0.02% of cases.
Gordon Brown and Richard Nixon were compared to those with Asperger's
If anything, the UK is less prone to this tendency than other developed nations. Separate surveys in the United States, Germany and Switzerland found respectively that 28%, 58% and 31% of references to the condition were metaphorical.
Nonetheless, Arun Chopra, a consultant psychiatrist at Queen's Medical Centre in Nottingham and the author of the British research, believes the tendency has a negative impact on the treatment of patients.
He argues that deploying terms in such a way contributes to public misunderstanding - for instance, reinforcing the false notion that schizophrenia is a "Jekyll and Hyde" illness related to split personalities.
Moreover, he says it can be deeply upsetting to patients and their families, and recalls seeing a woman whose son was diagnosed with the condition bursting into tears when she read a newspaper article which described the weather as "schizophrenic".
"The use of the word as a metaphor is tremendously damaging," Chopra adds. "It's part of the process of creating a stigma around mental illness.
It doesn't offend me when people trivialise it - it's almost a vehicle ”
End QuoteBryony Gordon
"You would never hear it used in relation to a physical condition. You wouldn't hear someone being described as a bit diabetic."
As such, he says he would like the Oxford English Dictionary to remove its secondary definition of schizophrenic: "With the implication of mutually contradictory or inconsistent elements".
Of course, deploying medical language to describe character traits is hardly a new phenomenon. Words like cretin and lunatic were originally formal terms to describe specific conditions before they more commonly came to be used pejoratively.
However, not all those affected by frequently misapplied conditions object to their use in this manner.
The Daily Telegraph columnist Bryony Gordon, who has been diagnosed with OCD, says she frequently has to point out that her disorder involves more than simply cleaning her house.
But she feels that attempting to clamp down on this kind of use of the term veers close to political correctness - and, moreover, that she is grateful the condition is, at least, widely discussed.
"It doesn't offend me when people trivialise it," she says. "It's almost a vehicle to talk about it.
"In a way it's a good thing because people acknowledge it exists. You're stuck in your own head and to see other people making light of something makes you think, 'Ah, this is what's happening.' It makes you feel better about it."
Definitions
Schizophrenia is a diagnosis given to some people who have severely disordered beliefs and experiences. It's used to describe a wide range of symptoms. During an episode of schizophrenia, a person may lose touch with reality, see or hear things that are not there, hold irrational or unfounded beliefs, and appear to act strangely.
OCD is a common form of anxiety disorder involving distressing, repetitive thoughts. Obsessions are distressing or frightening repetitive thoughts which come into your mind automatically. Compulsions are actions people feel they must repeat to feel less anxious or stop their obsessive thoughts.
Bipolar disorder is a mood disorder characterised by swings in a person's mood from high to low - euphoric to depressed. People in a high phase can get themselves into difficulties they would normally avoid - they may spend money they don't have or give away all their possessions. In a low phase, people feel hopeless, despairing and lethargic, become full of self-blame and self-doubt and have difficulty concentrating.
Source: Mental Health Foundation
Most advocates for such conditions disagree, however.
Andrew McCulloch, chief executive of the Mental Health Foundation, argues that using a clinical diagnosis to describe minor personality traits can only serve to fuel misunderstanding.
"The upside is that we have moved on from a fear of mentioning these things at all, but it is a tiny step forward," he says. "The trouble is these terms all come to mean the same thing. Then they become as unpleasant as describing someone with schizophrenia as a lunatic.
"The reality is we still have a long way to go when it comes to educating people about mental health. People might use these terms more frequently now but the stigma of having a mental illness is as bad as it has ever been."
Still, attempts by some mental health service users to reclaim pejorative labels under the banner of so-called "mad pride" demonstrate that there is unlikely to ever be consensus about the best way to respond.
The flippant use of such terms nowadays may offend some and not bother others. But such a dynamic is part of the words' evolution, says Joel Rose, director of OCD Action.
"Five years ago people wouldn't have known what you were talking about if you mentioned OCD," he says. "Now they have a sense of what it is about and use it, but don't really fully understand it. The next five years will be about working to fully educate people.
"What we want people to understand is how serious and debilitating OCD can be. We're talking about people who might clean a floor repeatedly for eight hours or someone who can't leave the house. It's not having a tidy house or arranging the tins of food in your cupboard. We also want to get across that it is treatable."
Indeed, many of those diagnosed with the condition have successfully learned to manage it. Overcoming its metaphorical use, however, may prove more difficult
People who are genetically susceptible to heart disease can lower their risk by eating plenty of fruit and raw vegetables, a study suggests.
It says five or more daily portions should be enough to counteract culprit versions of a gene on chromosome 9, thought to be possessed by a fifth of people of European ancestry.
Healthy diets appeared to weaken its effect.
The US researchers investigated more than 27,000 people for their work.
The findings were published in Plos Medicine journal.
These participants came from from around the globe, including Europe, China and Latin America.
The results suggest that individuals with high risk 9p21 gene versions who consumed a diet packed with raw vegetables, fruits and berries had a similar risk of heart attack as those with a low-risk variant of the same gene.
Dried fruit, such as currants, dates, sultanas and figs
Tinned or canned fruit and vegetables
Fruit and vegetables cooked in dishes such as soups, stews or pasta dishes
A glass (150ml) of unsweetened 100% fruit or vegetable juice
Smoothies
Beans and pulses; these only count as one portion a day, no matter how many you eat
Researcher Prof Sonia Anand, of McMaster University, said: "Our results support the public health recommendation to consume more than five servings of fruits or vegetables as a way to promote good health."
The scientists, who also included staff from McGill University, say they now need to do more work to establish how diet might have this effect on genes.
Judy O'Sullivan of the British Heart Foundation said the findings should serve as a reminder that while lifestyle and genes could increase heart risk, the way the two interacted with each other was also very important.
"The relationship between the two is often very complicated and we don't yet have all the answers, but the message appears to be very simple - eating lots of fruit and vegetables is great news for our heart health."
Chancellor George Osborne says emissions reductions must not harm UK industry
The government's "schizophrenic attitude" to climate change is undermining investor confidence in low-carbon industries, MPs have warned.
The UK is committed to cutting emissions in half by 2025 but has said it will review that goal in 2014.
Climate Change Minister Greg Barker said a review was needed to ensure UK industry was not losing out by cutting much faster than the rest of Europe.
But the Environmental Audit Committee warned against sending mixed messages.
David Cameron says he wants his to be "the greenest government ever", but last week Chancellor George Osborne sparked anger among environmentalists when he told the Conservative Party conference the UK would cut emissions no faster than others in Europe, and environmental measures would not be taken at the expense of British business. 'Stroke of a pen'
Earlier this year, the government signed up to the fourth in a series of tough "carbon budgets" - for the period 2023 to 2027.
Labour MP and committee chairwoman Joan Walley said the move suggested the UK really was determined to switch to a greener economy.
"Unfortunately, the government's somewhat schizophrenic attitude to climate change seems to be undermining that confidence," she said.
“Start Quote
Getting the rest of Europe to go further and faster in providing certainty to green investors is vital”
End QuoteGreg BarkerClimate Change Minister
"The chancellor's comments last week show that five years on from the Stern report, the Treasury still doesn't get climate change - or the risk it poses to global stability and economic prosperity."
Zac Goldsmith, a Conservative committee member, said policymakers must recognise "that with the stroke of a pen, they can make a good investment bad".
"Unless they provide real long-term certainty, the transition to a low-carbon economy will be slower and bumpier than it needs to be," he added.
Nick Molho, head of energy policy at WWF-UK, said: "Failing to clearly endorse the fourth carbon budget now will not only slow down urgent action on addressing climate change, it will also seriously undermine investment certainty in the UK's low-carbon sector and result in the UK missing out on the opportunity of creating hundreds of thousands of UK jobs in low-carbon manufacturing."
Mr Barker said the UK was doing more than any other nation to provide long-term certainty for those investing in the low-carbon economy.
"At the same time, it's right that we review progress towards the EU emissions goal in 2014 so that we're not disadvantaging British industry which would simply result in emissions being shipped overseas.
"Getting the rest of Europe to go further and faster in providing certainty to green investors is vital, which is why we're not letting up in pushing the EU to up its emissions reduction target to 30%."
About nine million hospital meals - almost 8% - are returned uneaten across England each year, data suggests.
The analysis of the snapshot figures from 200 NHS trusts by SSentif suggests wastage could be costing the NHS millions every year.
Hospital trusts are responsible for their own catering provision and there is no government guidance on the issue.
But a health minister said trusts with higher levels of waste should learn from those with better records.
The analysis comes ahead of a Care Quality Commission report to be published later this week which will look at poor NHS practice over nutrition for the elderly.
The NHS should adhere to the government's protected mealtimes policy, which says wards should be free of visitors and non-emergency medical activity at mealtimes, and that patients should be encouraged to eat - as and when staff are available to helping them. Mealtimes 'a priority'
The SSentif analysis looked at Estate Returns Information Collection (Eric) data - which all trusts have to provide on a particular day - on costs per patient per day, the percentage of meals requested and the percentage of meals returned untouched.
It found Ipswich Hospital NHS Trust had the worst record, with 29% of meals returned uneaten, while 25% go uneaten at the University Hospital of South Manchester NHS Foundation Trust.
In a statement, the Ipswich trust said: "At the time of our most recent Eric return, based on a one-day snapshot, waste was indeed at 29%, but since then the trust has been working with its hotel services contractor to reduce that figure which will now be considerably lower."
A spokeswoman for the Manchester trust said it had had a high percentage of meals returned.
But she added: "We discovered that staff on the ward, responsible for ordering food for our patients, were being over generous in the food quantities they ordered to create more choice and more menu options on the ward, particularly for our at-risk patients."
She said this no longer happened.
Those hospitals with high levels of waste should be looking to learn from the ones that don't.”
End QuoteSimon BurnsHealth minister
However, other trusts did have much lower figures. Less than 1% of meals are returned uneaten at Buckinghamshire Healthcare NHS Trust, Oxford Health NHS Foundation Trust (a mental health trust) and Barnet and Chase Farm Hospitals NHS Trust.
Judy Aldred, managing director of SSentif, said: "Trusts have responsibility for their own catering budgets and with no minimum standard set by government, the result seems to be huge discrepancies between organisations.
"Food waste in the NHS is also a big concern, as although some waste is inevitable in any catering environment, untouched meals in a healthcare situation have more worrying implications for patient health and nourishment."
Michelle Mitchell, charity director of Age UK, said: "Protecting hospital mealtimes needs to be a priority on every ward to ensure that patients have the help they need at mealtime with staff able to provide proper support to those who need it.
"Often, older patients require more support to eat a meal, especially after an operation or whilst receiving treatment, and this is often not taken into account.
"Hospitals must make nutritional care a top priority, so that older people don't go needlessly hungry."
Health minister, Simon Burns, said: "Those hospitals with high levels of waste should be looking to learn from the ones that don't.
"All hospitals should also make sure that every patient gets the help they need to eat properly, and offer good quality nutritious food. This is an essential part of hospital care."
When it comes to vitamins, it appears you could have too much of a good thing, say researchers who report a link between their use and higher death rates among older women.
Experts have suspected for some time that supplements may only be beneficial if a person is deficient in a nutrient.
And excess may even harm, as the study in Archives of Internal Medicine finds.
All of the women, in their 50s and 60s, were generally well nourished yet many had decided to take supplements.
Multivitamins, folic acid, vitamin B6, magnesium, zinc, copper and iron in particular appeared to increase mortality risk.
The researchers believe consumers are buying supplements with no evidence that they will provide any benefit.
Based on existing evidence, we see little justification for the general and widespread use of dietary supplements”
End QuoteThe study authors
They are quick to stress that their study relied on the 38,000 US women who took part in it recalling what vitamins and minerals they had taken over the previous two decades.
And it is difficult to control for all other factors, like general physical health, that might have influenced the findings.
But they say their findings suggest that supplements should only be used if there is a strong medically based cause for doing so because of the potential to cause harm.
"Based on existing evidence, we see little justification for the general and widespread use of dietary supplements," Dr Jaakko Mursu of the University of Eastern Finland and his research colleagues said.
Less is more
In the study, iron tablets were strongly linked with a small (2.4%) increased death risk, as were many other supplements. The link with iron was dose-dependent, meaning the more of it the individual took, the higher their risk was.
Too much can be toxic and it is easy to inadvertently take more than the recommended daily amount”
End QuoteHelen Bond of the British Dietetic Association
Conversely, calcium supplements appeared to reduce death risk. However, the researchers say this finding needs more investigation and they do not recommend that people take calcium unless advised to by a doctor in order to treat a deficiency.
Drs Christian Gluud and Goran Bjelakovic, who review research for the Cochrane Database of Systematic Reviews to evaluate best evidence, said: "We think the paradigm 'the more the better' is wrong."
They say dietary supplementation has shifted from preventing deficiency to trying to promote wellness and prevent diseases, and caution: "We believe that for all micronutrients, risks are associated with insufficient and too-large intake."
Helen Bond of the British Dietetic Association said some people, like the elderly, might need to take certain supplements. For example, vitamin D is recommended for people over the age of 65.
But she said that generally, people should be able to get all the vitamins and minerals they needed from a healthy, balanced diet.
She said some took supplements as an insurance policy, wrongly assuming that they could do no harm. "But too much can be toxic and it is easy to inadvertently take more than the recommended daily amount."
Drivers have cut their petrol consumption by more than 15% since the credit crunch and the recession.
The AA has calculated that petrol sales in the first six months of 2011 were 1.7bn litres less than in the same period three years ago. The AA says the drop in petrol sales is a direct result of record fuel prices. Many drivers are struggling to make ends meet in any case, so the high cost of petrol leaves them with no option but to try to use less. And businesses have been cutting back as well. The cut in fuel purchases, comparing the first six months of this year with pre-recession levels, is equivalent to 40,000 delivery rounds by fully-laden petrol tankers. One result has been lower emissions of potentially damaging exhaust fumes. Another, says the AA, is that the fall in sales has deprived the Treasury of nearly £1bn in fuel duty between January and June this year. Supermarkets have tried to attract drivers looking for bargain fuel, but hundreds of other petrol stations have gone out of business. However, Tesco reported on Wednesday that high petrol prices had hit people’s spending power so far this year.
Hindu groups have said the two child policy should be imposed as there are limited resources
Several Christian parishes in the Indian state of Kerala have begun offering incentives to couples who produce more children, officials say.
One church of the Syro-Malabar denomination in Kerala's Wayanad district has offered 10,000 rupees ($200) for a couple's fifth child. The move comes after a report submitted to Kerala's chief minister proposed imposing a strict two-child policy. But church groups have aired concerns about dwindling numbers of Christians. Census statistics show that the number of Christians has been in steady decline. Unofficial estimates say they could slip below 18% of Kerala's population in the latest census. But the figures also show that the Hindu population in Kerala may be declining faster than the Christian one. Muslims are increasing in numbers. The state's Hindu and Christian populations declined by 1.48 and 0.32 percentage points respectively, while Muslim numbers increased by 1.7 percentage points between 1991 and 2001. Nevertheless church groups have expressed considerable concern about the trend. "Our campaign is for responsible parenthood but the decision on how many children a couple should have is personal. We are not against family planning," said Fr Paul Thelakkat, a spokesman for Syro-Malabar Church, which is advocating the policy of rewarding procreation. Although the church hasn't announced rewards statewide, Fr Thelakkat says individual parishes have been offering incentives to have more children. Some have even offered free treatment at their hospitals for large families. Kerala's Catholic church has also mounted campaigns promoting larger families. But a recent 12-member panel for the Commission of Rights and Welfare of Women and Children submitted a report to the government last month recommending harsh punishments, such as three months in prison or a 10,000 rupee fine, to any father expecting a third child. Christian and Muslim groups condemned the report, saying it encroaches upon their religious freedom. But the leader of the Hindu United Front in the state said "the two-child norm should be strictly enforced in India as we have limited resources to share among us". Kummanam Rajashekharan added that the spate of church campaigns encouraging procreation only serve to create tensions between the religious communities.
The men who ate the most eggs were at a higher risk
“Eating just three eggs a week increases chance of men getting prostate cancer,” reported the Daily Mail. The story went on to say: “Experts in the US claimed that men who consume more than two-and-a-half eggs on a weekly basis were up to 81% more likely to be killed by the disease.”
This research examined the association between eating red meat, poultry and eggs and the risk of developing lethal prostate cancer (which the researchers defined as either dying from the disease or having metastatic disease that had spread to other organs). The study was in a large group of 27,607 healthy men, of whom 199 developed lethal prostate cancer over 14 years of follow-up. The researchers calculated that the men who ate the most eggs were at a significantly higher risk than those who ate fewer eggs. No significant association was found with any other food item.
This large cohort study has some strengths, such as its large size and the fact that information on the participants’ diet was continually updated over the course of the study. However it also has several limitations, and only a small number of lethal cancers actually occurred, which could suggest that this association is due to chance. Furthermore, these results are inconsistent with previous research, which found no significant association between eggs and prostate cancer. The findings will need to be confirmed in more robust studies before any firm conclusions can be drawn.
Where did the story come from?
The study was carried out by researchers from the Harvard School of Public Health, the University of California in San Francisco, Brigham and Women’s Hospital and Harvard Medical School. Funding was provided by the US National Institute of Health.
The study was published in the peer-reviewed medical journal, Cancer Prevention Research.
The media generally reported the study accurately. However, the Daily Mirror’s suggestion that “a clear link between eggs and prostate cancer” has been found may be misleading, as the researchers say that their results contradict previous findings into the association and that more research is needed. But the Mirror does point out that men in the study who ate the most eggs differed from the rest of the participants in important ways, such as weight and smoking status.
What kind of research was this?
This was a prospective cohort study that investigated whether there is an association between eating red meat, poultry and eggs and the risk of developing lethal prostate cancer in healthy men. A subgroup analysis was carried out afterwards in the men from this cohort who went on to develop prostate cancer. The researchers wanted to see whether eating habits after a prostate cancer diagnosis were associated with the risk of the disease progressing and becoming fatal.
The researchers’ theory was based on the findings from previous research, which found:
an increased risk of developing lethal prostate cancer in healthy men who ate red meat
an increased risk of progression to lethal disease in men with prostate cancer who ate eggs and skin-on poultry after their diagnosis
Participants were recruited from an ongoing cohort study that began in 1986. This study was comprised of American male health professionals who were between the ages of 40 and 75 in 1986. Men in this study completed a questionnaire every two years with information on their medical conditions, physical activity, weight, medications and smoking status. They provided information regarding their eating habits every four years.
Prospective cohort studies are an appropriate design for answering this type of research question. Assessing eating habits at the beginning of a study reduces the risk that people will inaccurately recall their dietary habits, which can arise when you ask people to remember what they ate over a long period of time. It also ensures that the exposure (eating certain foods) precedes the outcome (developing and dying of prostate cancer).
What did the research involve?
In 1994, the researchers recruited 27,607 men from the existing cohort study in the US. The men did not have prostate or other forms of cancer (except non-melanoma skin cancers, which are rarely aggressove). They had also had a prostate specific antigen (PSA) test (PSA screening is not performed in the UK, as higher PSA levels can indicate cancer but are not specific for it. For example, raised levels can also occur with benign enlargement, infection or inflammation).
In this study:
Information on the men’s eating habits was collected every four years.
Information regarding prostate cancer diagnosis was collected every two years.
From men who had been diagnosed with prostate cancer, information of treatment and disease progression was collected every two years.
The researchers defined lethal prostate cancer as disease that had spread to distant organs (metastatic cancer) or death due to prostate cancer during the study’s follow-up period (1994 to 2008).
The researchers followed up the cohort for 14 years and analysed the associations between eating different amounts of red meat, poultry and eggs and the risk of developing lethal prostate cancer. The researchers grouped each participant according to the average amounts of each type of food they ate per week. For red meat, the subgroups included (per week):
less than three servings
3 to 4 servings
5 to 7 servings
over 8 servings
For poultry, the subgroups were defined as (per week):
less than 1.5 servings
1.5 to 2.5 servings
2.5 to 3.5 servings
over 3.5 servings for week
For eggs, the subgroups were:
less than half an egg
0.5 to 1.5 eggs
1.5 to 2.5 eggs
over 2.5 eggs
To determine which subgroup each participant would be allocated to, the researchers averaged their responses from all of the dietary questionnaires the participants had completed up until their diagnosis, or until the end of the study (for those who were not diagnosed).
To determine the amount of each food eaten, the researchers averaged the reported amounts over all of the questionnaires that were completed before diagnosis. During the analysis, the researchers controlled for possible confounding factors such as age, amount of food eaten, body mass index (BMI, which is an indicator of obesity), smoking status and physical activity levels.
The researchers also analysed the risk of dying from prostate cancer in the men who were diagnosed with it during the course of the study, based on their eating habits after diagnosis. The researchers only included men who were diagnosed with localised cancer (cancer that had not spread beyond the prostate). During the analysis, they controlled for possible confounding factors such as age at diagnosis, time since diagnosis, disease stage, treatment type, BMI, activity level, smoking status and pre-diagnosis diet.
What were the basic results?
Of the 27,607 men included, 199 died of prostate cancer during the study. When the researchers analysed the association between eating habits and risk of lethal prostate cancer when using data up to the point of initial diagnosis, they found that:
Men who ate an average of 2.5 or more eggs per week had an 81% higher risk of lethal prostate cancer compared to those who ate an average of less than half an egg per week (Hazard Ratio [HR] 1.81, 95% CI 1.13 to 2.89, p=0.01).
The association between average amount of eggs eaten per week and risk of lethal prostate cancer became non-significant when the researchers analysed data collected up to the point of development of a lethal form of the disease (that is, disease progression or death).
There was no significant association between the average amount of red meat eaten and the risk of lethal prostate cancer.
Men who consumed more red meat or eggs tended to exercise less and have a higher BMI, and were more likely to smoke and have a family history of prostate cancer.
Of the 3,127 men who developed prostate cancer during the course of the study, 123 died of it during follow-up. Further analysis of the men who died found no significant association between eating habits after diagnosis and risk of the disease progressing from localised prostate cancer to lethal prostate cancer.
How did the researchers interpret the results?
The researchers conclude that: “Eating eggs may increase risk of developing a lethal form of prostate cancer among healthy men,” and that although “additional large prospective studies are needed, caution in egg intake may be warranted for adult men”.
Conclusion
This was a large prospective cohort study that examined the impact of lifestyle on the risk of developing and dying of advanced prostate cancer.
In addition to its large size, another strength of the study is that the information regarding exposure (eating habits) and possible confounders (medical conditions, activity levels, weight, medications and smoking status) were continually updated over the study’s course. However, updating information on eating habits every four years may still introduce a significant level of recall bias, and accurately remembering what you ate over the previous four years is likely to be difficult.
The study and data analysis also has several limitations. First, the number of deaths and cases of lethal prostate cancer were small (only 199 out of 27,607 men in the whole cohort, and 123 out of 3,127 in the case-only cohort [those who initially developed localised disease]). This small number increases the likelihood that the results are due to chance. Second, the researchers say that the group of men included in the study generally ate low amounts of the foods of interest, which limits the "power" (or ability to detect a difference) of the analysis.
Furthermore, while the researchers controlled statistically for a number of possible confounders, it is difficult to say whether other factors could account for this relationship. The researchers say that men in the study who consumed more red meat or eggs tended to have a higher BMI, exercise less and were more likely to smoke and have a family history of prostate cancer. Additionally, it is probably difficult to control completely for other dietary effects and focus the analysis on a single component of a person’s diet.
This study points to possible associations between diet and risk of prostate cancer. The aforementioned limitations, however, weaken the strength of these conclusions, along with the fact that previous research has looked at this question and found no association. While an 81% increased risk sounds like a high and definitive figure, it is probably best to wait for more conclusive research before cutting eggs out of your diet. There are existing dietary and lifestyle guidelines for reducing cancer risk, such as limiting your consumption of energy-dense foods such as meat and increasing your consumption of fruits, vegetables and wholegrains.
Fair-skinned people who are prone to sunburn may need to take supplements to ensure they get enough vitamin D, say experts.
It appears that those with pale skin, while not deficient, may still be lacking in the essential vitamin that the body makes from sunlight.
The Cancer Research UK-funded team say that even with a lot of sun exposure, those with fair skin may not be able to make enough vitamin D.
And too much sun causes skin cancer.
Clearly, for this reason, increasing sun exposure is not the way to achieve higher vitamin D levels in the fair-skinned population, say the researchers. But taking supplements could be.
Fair-skinned individuals who burn easily are not able to make enough vitamin D from sunlight and so may need to take vitamin D supplements”
End QuoteProf Julia Newton-Bishop
Supplements are already recommended for groups at higher risk of deficiency. This includes people with dark skin, such as people of African-Caribbean and South Asian origin, and people who wear full-body coverings, as well as the elderly, young children, pregnant and breastfeeding women and people who avoid the sun.
Based on the latest findings, it appears that pale-skinned people should be added to this list.
Vitamin D is important for healthy bones and teeth.
A level less than 25nmol/L in the blood is a deficiency, but experts increasingly believe that lower than 60nmol/L are suboptimal and can also be damaging to health.
Most people get enough vitamin D with short exposures to the sun (10 to 15 minutes a day). A small amount also comes from the diet in foods like oily fish and dairy products.
But people with fair skin do not seem to be able to get enough, according to Prof Julia Newton-Bishop and her team at the University of Leeds.
Part of the reason might be that people who burn easily are more likely to cover up and avoid the sun.
But some fair-skinned individuals also appear to be less able to make and process vitamin D in the body, regardless of how long they sit in the sun for.
Prof Newton-Bishop said: "It's very difficult to give easy advice that everyone can follow. There's no one-size-fits-all.
"However, fair-skinned individuals who burn easily are not able to make enough vitamin D from sunlight and so may need to take vitamin D supplements."
Hazel Nunn, of Cancer Research UK, said: "It is about striking a balance between the benefits and harms of sun exposure.
"People with fair skin are at higher risk of developing skin cancer and should take care to avoid over-exposure to the sun's rays.
"If people are concerned about their vitamin D levels, they should see their doctor who may recommend a vitamin D test."
She said it was too soon to start recommending supplements, but said most people could safely take 10 micrograms a day of vitamin D without any side-effects.
Injection of sulphate aerosols is designed to mimic the cooling effect of volcanic eruptions
A pioneering test of a climate "tech fix" planned for October faces a six-month delay as scientists discuss the issues it raises with their critics.
The test is part of the UK-based Stratospheric Particle Injection for Climate Engineering (Spice) project. It would use a balloon and a kilometre-long hose to spray water into the upper atmosphere - a prelude to spraying climate-cooling sulphate particles. But the funders believe that more talks about the social aspects are needed. The project is supported to the tune of £1.6m by UK research councils, including the Engineering and Physical Sciences Research Council (EPSRC), whose independent advisory panel recommended the delay last week. The test would have put the UK at the forefront of practical climate engineering research. Dr Matt Watson of the UK's Bristol University, who leads the overall project, said he endorsed the decision, although his team had been "taken aback" when they first heard the news. "We're talking about a pressure washer you could buy in a hardware shop, a long hose, and two bathloads of water, so you couldn't have a more benign experiment," he told BBC News.
“Start Quote
There is a very big difference between being keen to research geoengineering and being an advocate for deployment”
End QuoteMatt WatsonBristol University
"But in the end it's the social context that's important - and we realise there's no point in having the (ESPRC independent panel) process unless we're going to work with it."
The initial deployment, due to take place from an abandoned airfield in Sculthorpe, Norfolk, will almost certainly not take place before April. If and when it does happen, the balloon will be allowed to rise to an altitude of 1km, tethered to the ground with reinforced hosepipe. The pressure washer will pump water from the ground and spray it from the end of the hosepipe. Researchers will use the set-up to investigate practicalities such as how the balloon and the pipe react to high winds. A planned series of further trials is envisaged, eventually answering the question of whether it would ever be practical to put large quantities of sulphate aerosols into the stratosphere this way. The principle behind the idea is that high-altitude aerosols would cool the planet's surface by reflecting solar energy back into space, mimicking the effect of huge volcanic eruptions. The 1991 eruption of Mount Pinatubo in the Philippines, for example, ejected at least five cubic kilometres of ash and gas which rapidly spread around the globe, decreasing the average global temperature by 0.5C.
The postponed test would pump water droplets 1km above the ground
Climate engineering - or geoengineering, as it is often known - is a highly controversial subject. As well as aerosol injection, ideas include devices to absorb carbon dioxide from the air, giant sunshields in space, and changing the reflectivity of land through planting different crop strains. Proponents say research is needed into these technologies because humanity will probably need them one day, as society is unlikely to keep greenhouse gas emissions low enough to avoid dangerous impacts of climate change.
Deployment of a giant sunshield in space to reflect solar energy is another geoengineering idea
The Spice team - drawn from a number of universities as well as Marshall Aerospace - calculates that 10 or 20 giant balloons at a 20km altitude could release enough particles into the atmosphere to reduce the global temperature by around 2C. But opponents argue that even testing could have harmful impacts, that there are questions of ethics and international law that remain unanswered, and that even raising the prospect of geoengineering distracts from initiatives to curb emissions. Helena Paul, co-director of environment group EcoNexus, said she was "really pleased" at the latest news. "We are certainly not ready to carry out experiments, and this project should not just be delayed, but should be cancelled immediately," she told BBC News. "This is particularly important because while the scientists involved keep saying that reducing emissions is the primary necessity, they risk distracting attention from that necessity at a crucial moment." At last year's UN Convention on Biological Diversity meeting, governments agreed that geoengineering projects should not have an adverse impact on biodiversity. But that was one of very few attempts to regulate the issue internationally, which opponents argue is a big missing ingredient given that large-scale deployment of technologies in one country could have significant impacts in others. Research shows that the UK public share some of these concerns; in surveys, very few people were unconditionally positive about the concept of geoengineering. Over the next six months, the Spice team will engage with stakeholder groups, discussing the ethical, social and legal issues surrounding their project. The details have yet to be worked out, but discussions are sure to involve opponents such as EcoNexus. However, Dr Watson said there was a need to divorce the concept of researching these technologies from their actual deployment as a climate "fix". "My personal framing of this is that there is a very big difference between being keen to research geoengineering and being an advocate for deployment," he said. "I am not in any way an advocate for deployment."
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