Tuesday, 16 December 2014

grains

Why do Americans love ancient grains?


Quinoa farmer in Bolivia
Would you like to taste the health-giving grain found in the tomb of King Tutankhamun? Or feast on the unprocessed kernels said to have been stored on the ark by Noah? Or how about a vodka made from traditionally farmed Bolivian quinoa? If any of this whets your appetite, you are not alone.
In the past five years there has been an explosion in popularity of so-called "ancient grains" in the American food market.
There is no comprehensive list of "ancient" grains, but the category is generally agreed to include amaranth, barley, bulgur, buckwheat, kamut, millet, spelt, teff and quinoa.
Many of these grains - Bolivian quinoa and Ethiopian teff, for example - have been planted and harvested in the same way for thousands of years.
"It's been a positive perfect storm for these ancient grains," says Cynthia Harriman, director of food and nutritional strategies at the non-profit organisation, the Whole Grain Council.
"They fit with our desire to look for a super-food, a magic bullet we should be eating," she says.
Ancient grains are perceived as the opposite of modern wheat, which is the descendant of three ancient strains of wheat - spelt, einkorn and emmer - and often heavily refined.
They are seen as more healthy, more natural and better for us, providing more vitamins, minerals, fibre and protein than modern wheat - partly because they are rarely eaten in processed form.
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Ancient grains
Ancient grains
• Amaranth - a grain, used by the Aztecs, which is both gluten and wheat-free and is a source of vitamin C
• Barley - an excellent source of fibre, manganese, selenium, and thiamine
• Bulgur - a quick-cooking form of whole wheat which is high in manganese
• Kamut - has a nutty flavour and is high in fibre, protein and several minerals, including selenium and manganese.
• Millet - a small, whole grain is a staple in many Asian and African countries but thought of mostly as bird food in the United States
• Spelt - commonly eaten in medieval times, spelt is part of the wheat family and is high in protein and fibre
• Teff - common in Ethiopia, this grain has the highest calcium content
• Quinoa - perhaps the best known ancient grain, quinoa is a complete protein since it has all nine essential amino acids
Source: Today's Dietitian
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Many of the grains are also gluten-free, or at least low in gluten, tapping into a growing demand from consumers.
Part of the popularity of these grains are the stories that surround them, says Harriman.
"We're drawn to the idea that kamut comes from King Tutankhamun's tomb, the story draws our attention," she says.
"It's a revolt against processed food. It's the opposite of modern."
Cheerios with ancient grains box
Other nutritionists agree.
"Aztec, Indian, African," says Vandana Sheth, nutritionist and spokesperson for the Academy of Nutrition and Dietetics.
"People might be more interested in trying these grains because of their place of origin, history and the culture," she says.
One of the first references to ancient grains as a health food was in an article in the New York Daily News in 1996.
Since then they have seen a steady surge in popularity, with a huge increase in consumption over the past five years, particularly in the last year.
According to figures released by the US Whole Grains Council, sales of kamut rose 686% in the year from July 2013, while sales of spelt rose by 363% and amaranth by 123% - all, admittedly, from a low base.
Such growth figures have spurred the processed food industry to take notice, especially against a backdrop of falling sales of breakfast cereals.

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The gullible consumer is going to buy more if it sounds healthy”
Hemi WeingartenFooducate
"In the past year ancient grains saw a 50% growth across all categories, and a 44% growth in the cereal category," says Alan Cunningham, marketing manager for new products for the food giant General Mills.
The company has announced it will be launching a new line of its successful breakfast cereal, Cheerios, with ancient grains next year.
"It's a way to bring this product into the mainstream," Cunningham says.
"Consumers may feel that the barrier to eating ancient grains is that they're not convenient, so we figured a way to deliver them in a bowl of cereal."
But this will also mean including five times as much sugar as in the original Cheerios recipe - 5g of sugar per 28g serving, instead of just 1g - though, as Cunningham points out, about half as much as in the company's best seller, Honey Nut Cheerios.
"We feel great about the health profile of this Cheerios," he says.
But the addition of sugar and heavy processing has led some to accuse companies like General Mills of cynically making money from the "health halo" surrounding ancient grains.
"Like any grain they can be used in a healthy or unhealthy way," says Hemi Weingarten, founder and CEO of the food blog site Fooducate.
"The gullible consumer is going to buy more if it sounds healthy," he says.
Nutritionists argue that consumers should look at carefully at nutrition labels before buying processed food, to check for the amount of whole grains, and of added ingredients, such as sugar.
"I have heard industry analysts talking about taking advantage of the ancient grains trend," says nutritionist Cynthia Harriman.
"With ancient grains on the label, you could increase the price by 50-300%," she says.
The main barrier standing in the way of incorporating more ancient grains into the American diet is a shortage in supply.
There are also concerns that the exploding market for the grains could have an adverse effect on populations that have eaten them for centuries, the quinoa-growers of Bolivia, for example.
But experts do not see this as a passing fad.
"By incorporating ancient grains, we'll benefit by not only getting more whole grains but enjoying a wider array of flavours, textures and nutritional profiles," says Vandana Sheth.
"Although they are currently thought of as a hot trend, I believe that ancient grains are here to stay."

Wednesday, 10 December 2014

Nearly 50% take prescription drugs

Nearly 50% take prescription drugs


Drugs

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Half of women and 43% of men in England are now regularly taking prescription drugs, according to the comprehensive Health Survey for England.
Cholesterol-lowering statins, pain relief and anti-depressants were among the most prescribed medicines.
The report, by the Health and Social Care Information Centre (HSCIC), showed an average of 18.7 prescriptions per person in England in 2013.
The cost to the NHS was in excess of £15bn-a-year.
More than a fifth of men and nearly a quarter of women were taking at least three prescriptions.
All the figures exclude contraceptives and smoking cessation products.
Nearly a third of prescriptions were for cardiovascular disease with more than 65 million prescriptions for tackling high blood pressure, heart failure or cholesterol levels.
Simvastatin - which lowers cholesterol - was the single most prescribed item with 40 million prescriptions.
Heart
Dr Jennifer Mindell, one of the report's authors at University College London, said: "This is the first nationally-representative study to report on the use of prescribed medicines taken by people in the community, not just those within the healthcare system.
"That half of men over 65 are taking cholesterol-lowering medicines reflects the high risk of cardiovascular disease in this group.
"Stopping smoking, being a healthy weight, eating more vegetables and fruit, and being physically active reduce people's risk of these diseases, for people who want to avoid taking medicines."
Pills and tape measureWeight was strongly linked with the number of pills being popped.
Antidepressants were taken by more than one in 10 women - double the figure for men.
The drugs were most commonly taken by middle-aged women and those from deprived areas - 17% of the poorest women took antidepressants compared with 7% of the richest.
Dr Sarah Jackson, at University College London, commented: "It's well known that rates of depression are much higher among women than men, so I am not surprised to see that antidepressant use follows the same pattern in this study.
"People with depression are less likely to be in regular employment, and people who are unemployed or in low paid jobs are more likely to have depression."
Obesity
The heavier people were, the more likely they were to need prescription drugs.
More than half of severely obese people in England reported taking at least one prescribed medicine and a third took at least three.
Sue Faulding, a pharmacist and programme manager of prescribing and primary care services at the HSCIC, said: "Obesity is often associated with high cholesterol, high blood pressure, joint pain and depression.
"Lifestyle changes are always recommended in the first instance, but medicines can help to address the symptoms and this study shows that medicine use increases steadily with body mass index."

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Saturday, 6 December 2014

NHS Devon surgery restriction for smokers and obese plan revealed

NHS Devon surgery restriction for smokers and obese plan revealed

An overweight child can't do up his trousersMorbidly obese people and smokers in Devon will be refused routine surgery until they have lost weight

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Smokers and the morbidly obese in Devon will be denied routine surgery unless they quit smoking or lose weight.
Patients with a BMI of 35 or above will have to shed 5% of their weight while smokers will have to quit eight weeks before surgery.
The NHS in Devon has a £14.5m deficit and says the cuts are needed to help it meet waiting list targets.
The measures were announced the same day government announced an extra £2bn of annual NHS funding.
'Urgent and necessary'

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The Northern, Eastern and Western Devon Clinical Commissioning Group (NEW Devon CCG) organises most NHS treatment in the area.
It announced a range of cost-cutting measures on Wednesday including only providing one hearing aid, instead of the normal two, to people with hearing loss.
Shoulder surgery will also be restricted.
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What is morbid obesity?
  • People with a body mass index (BMI) of 35 or more are considered morbidly obese by medical professionals
  • BMI is calculated by dividing weight in kilograms by height in metres, then dividing the answer by height again
  • Women of average height, 1.62 metres (5ft 3ins), are considered morbidly obese if they weigh more than 91.5kg (14st 6lb)
  • Men of average height, 1.75 metres (5ft 9ins), are considered morbidly obese if they weigh more than 108kg (17st)
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In November, the CCG said it would take "urgent and necessary" measures to prioritise major treatment.

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The CCG has a legal duty to live within its financial resources and the prioritisation of services is helping us to do that”
Dr Tim BurkeNEW Devon CCG
That included delaying hip and knee operations for the morbidly obese, but Wednesday's announcement applies to all routine procedures.
NEW Devon CCG said it would not restrict IVF treatment or caesarean sections carried out on medical grounds.
A statement said all the decisions were "interim commissioning positions" and would require further consultation.
Patients with a date for surgery will not be affected but will be offered weight management or quit smoking support.
Dr Tim Burke, Chair of NEW Devon CCG, said: "All of these temporary measures relate to planned operations and treatments, not those which must be done as an emergency or to save lives.
"We recognise that each patient is an individual and where their GP or consultant feels that there are exceptional circumstances we will convene a panel of clinicians to consider the case."
NEW Devon CCG said it would announce another round of cost-cutting measures "in due course".
"We don't under estimate how difficult it will be for some people to lose weight or stop smoking and we will continue to support them," said Dr Burke.
"The CCG has a legal duty to live within its financial resources and the prioritisation of services is helping us to do that."
In a statement the Royal College of Surgeons said it was "concerned" by the move and warned the region was merely storing up "greater pressures" for the future.
It said: "The need for an operation should always be judged by a surgeon based on their clinical assessment of the patient and the risks and benefits of the surgery - not determined by arbitrary criteria.
"Losing weight, or giving up smoking is an important consideration for patients undergoing surgery in order to improve their outcomes, but for some patients these steps may not be possible.
"A blanket ban on scheduled operations for those who cannot follow these measures is unacceptable and too rigid a measure for ensuring patients receive the best care possible."

GP 'disgust' at watchdog errors

GP 'disgust' at watchdog errors

Stethoscope

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GPs have told the BBC their reputations have been "tarnished by incompetence" from the health watchdog.
The Care Quality Commission has been forced to apologise to hundreds of GPs for giving incorrect patient safety risk assessments.
A BBC investigation found serious errors in the calculations used by the CQC.
The British Medical Association is calling for the whole banding system to be withdrawn.
Around 60 practices have been taken out of the highest risk categories and four low-risk surgeries need early inspection.
John Flather, a GP in Hadleigh, Suffolk, said his practice had been incorrectly banded as high risk.
He said he was "totally disgusted by the process" and that a formal complaint had been made.
He told the BBC: "Our reputation, which has been built over many years, has been tarnished by incompetence that they purport to eradicate.
"If they had only given us a chance to view their ratings we could have pointed out their errors and avoided this mess."
Dr Chris Cullen, from Ipswich, said: "My practice was rated for highest risk despite being one of the very high achieving practices in the country.
"The CQC claim we gave flu jabs to 24% of our patients, in fact it was over 96%.
"Our true rating should be for lowest risk, but the CQC aren't interested and have not returned our calls."
Bad data
Practices were judged on 38 indicators of performance, ranging from how easily patients managed to get appointments to how good doctors were at picking up conditions such as dementia.
Practices were graded in six bands, with Band 1 being the highest concern, and Band 6 the least risky.
The majority were of low concern, but 11% were rated in the highest risk band.
The BBC discovered that for one indicator, whether patients were able to get an appointment with a GP or nurse the last time they tried, the calculations were so flawed that the CQC has been forced to remove the indicator altogether.
A further four indicators had to be refined based on revisions to data provided to the CQC by NHS England.
Hundreds of practices will now be assigned a different band.
In its initial register, published two weeks ago, the health watchdog ranked 7,276 practices out of the total 7,661 in England, and placed 864 practices in the "highest concern" category.
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Original rankings
GP survey
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As a result of the recalculations, around 60 practices will be lifted out of the two "highest concern" categories, and four that were previously deemed low-risk have been found to be in need of early inspection.
The CQC says 519 practices will move bands, but most were between the lowest risk bands.
The CQC register was set up to help target inspections, and the watchdog said it did not necessarily indicate poor GP surgery performance.
Sir Mike Richards, chief inspector of hospitals for the CQC, told the BBC: "We will make them a big apology. This only became apparent when we ran the data on the thousands of practices rather than just the hundreds that we tested them on."
He defended the publication of the risk bands in the interest of transparency.
He said: "We are using the data to help us know where we might go first. Our judgement comes from a combination of data and inspection. The main thing that is going to matter is that we are going to be inspecting every practice."
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Poor data
Measures removed
  • Whether patients were able to get an appointment with a doctor or nurse last time they tried
Measures recalculated
  • Coronary heart disease incidence
  • Chronic obstructive pulmonary disease (COPD) incidence
  • Unnecessary A&E admissions
  • Dementia diagnosis rates
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The British Medical Association said mistakes by the CQC risked "doing serious harm" to the reputation of good surgeries.
Its GP committee chair, Dr Chaand Nagpaul, said: "The banding system as a whole needs to be withdrawn.
We warned at the time that simplistic targets would fail to take into account the enormous pressures GP practices are facing, and that skewed and limited information does not tell us about the quality of care.
"These failings have the potential to seriously undermine the trust in the system and patients' confidence in their GP and it is only right that all of those practices affected are now contacted and receive a full apology."

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Text messaging service 'helps people take their pills'

Text messaging service 'helps people take their pills'

PillsOne third of patients do not take their medicine as directed, research suggests

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A text messaging service could help people remember to take the medicines they have been prescribed, say researchers.
A test scheme, which involved heart patients, cut the numbers who forgot or just stopped taking their pills.
One in six was helped to continue their treatment, reducing their risk of heart attack and stroke.
It has been estimated that the NHS spends more than £500m on wasted medicines and avoidable illness.

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In general, patients really valued the text messages and were disappointed when they stopped”
Prof David WaldQueen Mary University of London
Other research has shown around a third of patients do not take their medicine as directed.
Study leader Prof David Wald said text reminders could be used by GPs, hospital doctors and pharmacists for a range of different conditions, including diabetes, TB and HIV.
Professor David Wald said the service helped identify and help people who stopped taking their medication
In the study, published in Plos ONE, 300 patients who were already on blood pressure medicines or statins were either sent daily texts for two weeks followed by a fortnight of alternate days, then weekly texts for six months, or no texts at all.
Participants had to reply to say whether they had taken their medication, whether the message had reminded them to take it if they had forgotten, or whether they had simply not taken it.
Telephone support
Anyone who had not taken their medicine was flagged up by a computer and received a telephone call to offer advice.
Of those who did not receive texts, 25% stopped taking their medicine completely, or took less than 80% of it.
In the text group, that figure was 9% - 14 out of 150 patients.
There were only three patients who did not start taking the medicine again after receiving advice.
Prof Wald, consultant cardiologist at Queen Mary University of London, said there was a range of reasons why people stopped taking their medicine, including uncertainty over the need for treatment and concerns over potential side-effects, often prompted by negative reports of statins they had read in the media.
"In general, patients really valued the text messages and were disappointed when they stopped."
David Taylor, emeritus professor of pharmaceutical and public health policy at University College London, said text messaging could be coupled with each relevant prescription and prevent several thousand heart attacks and strokes in the UK annually.
It could also be used for other diseases, he said.
Maureen Talbot, senior cardiac nurse at the British Heart Foundation, added that the study was small but encouraging.
"It's crucial that heart patients take prescribed treatments to control their blood pressure and cholesterol as it helps reduce their risk of having a heart attack or stroke.
"Carrying out a larger study over a longer period would help establish the full extent of the benefits of sending this type of reminders to patients."

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