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Friday, 25 August 2017

10-minute walk a day app to tackle 'inactivity epidemic'

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"Health bosses say 45 per cent of over-16s are so sedentary they do not manage the health-boosting ten-minute walk," the Daily Mail reports.

The headline comes after data compiled by Public Health England (the government body tasked with improving the nation's health) found that more than 6.3 million adults aged 40 to 60 failed to achieve just 10 minutes of continuous brisk walking per month.

This is of concern as physical inactivity directly contributes to one in six deaths in the UK.

Due to this, as part of their ongoing One You campaign, Public Health England (PHE) has launched an app called Active 10, designed to encourage at least 10 minutes brisk walking a day.

While this is below the current minimum guidelines of 150 minutes of moderate exercise per week, 10 minutes per day can still bring health benefits and may serve as "baby steps" along a road that leads to more exercise and better health.

Read more advice about taking up walking as a hobby and exercise.

What is the basis for the news reports?

PHE has released evidence relating to physical activity, reinforcing the advice to do 150 minutes of moderate exercise a week. This level of activity can improve both physical and mental health as well as reduce the risk of long-term conditions such as type 2 diabetes.

Health benefits from exercise tend to increase in a dose-response relationship, meaning the more exercise, the more benefits. PHE has provided evidence that a (reduced) health benefit can still be achieved by engaging in a minimum of 10 minutes moderate exercise per day, for example by going for a brisk walk.

The report is based on the premise that there are still a huge number of adults who are physically inactive and 150 minutes a week might seem unachievable. Encouraging just 10 minutes of brisk walking a day, whereby heart rate is increased, can be a step in the right direction and still result in some health benefits compared to doing nothing at all.

PHE has launched an app called Active 10 to help achieve this goal, by setting targets, automatically seeing achievements and tracking progress over time.

Why is mid-life being targeted and what are the benefits of walking?

Adults in midlife (aged 40 to 60) are being targeted in particular, as increasing activity in this age group has a range of potential benefits, including:


  • developing positive habits as physical activity begins to decline due to ageing
  • preventing and helping to manage a range of health conditions at a period of high risk
  • for those who are parents – influencing their children's activity levels

Walking is an activity that is both accessible and acceptable and has the potential to increase physical activity in adults. For adults aged 40-60 in the UK, walking is the most common of all physical activities, with 79% of all adults spending some time walking every month.

There are many benefits of brisk walking, including improved fitness, finding it easier to perform everyday physical activities, improvements in mood, improvements in quality of life, a healthier weight and an overall 15% reduction in risk of early death.

An individual can tell if they are briskly walking or engaging in other moderate activity as they will feel more breathless, warmer and have an increased heart rate.

PHE suggests walking could have a particularly important impact in those aged 40-60 who are also of a lower socioeconomic group. It estimates that if one in 10 in this group took up walking 10 minutes a day, 251 deaths per year could be prevented and a saving of £310m per year made in terms of preventable health costs.

However, over the past few decades, the amount of brisk walking has declined as has the length of time people spend walking. There is a need to encourage people who are walking to walk at a brisk pace, to increase how regularly people walk and to encourage those who do not walk to develop a walking habit.

How does this evidence affect you?

Current recommendations for physical activity for adults include engaging in both aerobic and strength exercises. You should still aim for the recommended minimum amount of 150 minutes of moderate exercise per week such as brisk walking or cycling and strength exercises on two or more days per week working all major muscles. Alternatively, a minimum of 75 minutes of vigorous exercise such as running or singles tennis, or a mixture of moderate and vigorous exercise, plus strength exercises twice a week is recommended.

However, if you feel this advice might be unachievable to start with, aiming for 10 minutes moderate exercise a day, such as a brisk walk, is a good start.

You can download the app to help you increase your physical activity levels and improve your health.

Links To The Headlines

Britain's laziness epidemic: How half of adults don't even go for a brisk walk once a month... with over-40s most at risk. Daily Mail, August 24, 2017

6 million middle-aged people take no exercise. The Guardian, August 24 2017

Four in ten adults fail to manage even one brisk 10 minute walk a month. The Daily Telegraph, August 24, 2017

Millions fail to walk briskly for 10 minutes a month. Sky News, August 24, 2017

Six million Brits facing health time bomb as they fail to walk even 10 minutes a MONTH. Daily Mirror, August 24, 2017

reposted from: http://www.nhs.uk/news/2017/08August/Pages/10-minute-walk-a-day-app-launched-to-tackle-inactivity-epidemic.aspx

Friday, 9 December 2016

'Not enough over-50s' taking aspirin to prevent heart disease

reposted from: http://www.nhs.uk/news/2016/12December/Pages/Not-enough-over-50s-taking-aspirin-to-prevent-heart-disease.aspx
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December 1 2016

You shouldn’t take daily aspirin unless a doctor advises you to.

Aspirin can help prevent blood clots.

"Aspirin a day could dramatically cut cancer and heart disease risk … study claims," the Mail Online reports.

U.S. researchers ran a simulation of what might happen if all Americans over 50 years old took aspirin on a daily basis. Their results found that people would live about four months longer on average, adding 900,000 people to the US population by 2036.

More info from NHS.uk.

The study was designed to demonstrate the possible long-term effects of more people taking aspirin to prevent cardiovascular disease.

It should be pointed out that there is an important difference between UK and US guidelines. In the UK low-dose aspirin is usually recommended for people with a history of heart disease or stroke. In the US this advice is extended to people who are at risk of cardiovascular disease but don't have it yet.

We already know that aspirin reduces the risk of heart disease and strokes caused by blood clots (ischaemic stroke). There's some evidence it may reduce some types of cancer. However, aspirin also increases the risk of stroke caused by bleeding (haemorrhagic stroke) and increases the chances of bleeding in the stomach or gut.

So should you be taking low-dose aspirin? Without knowing your individual circumstances it is impossible to provide an accurate response. You need to ask your GP.

Where did the story come from?

The study was carried out by researchers from the University of Southern California and a company called Analysis Group. The authors received no funding for the study.

The study was published in the peer-reviewed journal PLOS One, on an open-access basis so it's free to read online.

The Mail Online reports the study as if the findings about aspirin reducing cardiovascular disease and potentially extending lifespan were new, while they have actually been known for some time.

The report says taking aspirin "would save the US $692 billion in health costs," which seems to be a misunderstanding. Health costs would actually increase, because of people living longer.

However, the researchers assigned a value of $150,000 to each additional year of life lived, which is how they arrived at the $692 billion figure.

What kind of research was this?

This was a "microsimulation" study, which used a modelling system to project possible outcomes under different scenarios, using information from health surveys. This type of modelling can throw up some interesting possibilities, but because it relies on so many assumptions, we have to be cautious about taking the results too literally.

What did the research involve?

Researchers used data from cohort studies to predict average life expectancy, cardiovascular events, cancers, disabilities and healthcare costs for people in the US aged 50 and over. They predicted what would happen with the current numbers of people taking aspirin, then with everyone currently recommended to take aspirin doing so, then with everyone over 50 taking aspirin.

They compared the results of their modelling, to see what effect it would have on average lifespan, the US population, costs and benefits.

Cohort studies providing data included the National Health and Nutrition Examination Survey (NHANES), Health and Retirement Study of Americans, Medical Expenditure Panel Survey and Medicare Current Beneficiary Survey.
The model included an assumption that more people would have gastrointestinal bleeding as a result of taking aspirin. It also modified the results using quality of life measures, so that additional life years were adjusted for quality of life.

What were the basic results?

The researchers found that, if everyone advised by US guidelines to take aspirin did so, the:
  • numbers of people with cardiovascular disease would fall from 487 per 1,000 to 476 per 1,000 (11 fewer cases, 95% confidence interval (CI) -23.2 to -2)
  • numbers with gastrointestinal bleeding would rise from 67 per 1,000 to 83 per 1,000 (16 more cases, 95% CI 3.6 to 30)
  • years of life expectancy at age 51 would rise from 30.2 years to 30.5 years, an additional four months of life (0.28 year, 95% CI 0.08 to 0.5)
  • life expectancy without disability would rise from 22.8 years to 22.9 years, an additional one month of life (0.12 year, 0.03 to 0.23)
The model found no reduction in the numbers of strokes or cancers.

The model shows there could be an additional 900,000 people (CI 300,000 to 1,400,000) alive in the US in 2036, who would otherwise have died.

Using the figure of $150,000 per quality-adjusted life year to represent benefits, the researchers say the value of extra life gained by 2036 would be $692 billion.

How did the researchers interpret the results?

The researchers said: "Expanded use of aspirin by older Americans with elevated risk of cardiovascular disease could generate substantial population health benefits over the next twenty years, and do so very cost-effectively."

Conclusion

This study doesn't really tell us anything we didn't already know. Aspirin has been used for many years to prevent heart attacks and strokes in people with cardiovascular disease. Aspirin's wider use is controversial, because of the potential side effects.

What this study does add is an estimate of what might happen if all people in the US who were advised to take aspirin under US guidelines, actually did so. (The researchers say that 40% of men and 10% of women advised to take aspirin don't take it).

The study assumes that people would get the same benefits as those seen in clinical trials of aspirin. This is unrealistic, because most studies find that people tend to do better in clinical trials than when being treated in the real world.

The average results – showing an additional one month of disability-free life for every 1,000 people – may sound trivial. However, it's important to remember that averages don't work like that in real life. Many people will get no benefit from aspirin, while a smaller group will avoid a heart attack or stroke, and so live many more months or possibly years, as a result of taking aspirin.

If you've already had a heart attack or stroke, or if you have angina or another heart or circulation problem, your doctor has probably prescribed low dose aspirin. There's good evidence that aspirin (or similar drugs, for those who can't take aspirin) can help prevent a second heart attack or stroke.

Find out more information about aspirin.
Analysis by Bazian. Edited by NHS Choices. Follow NHS Choices on Twitter. Join the Healthy Evidence forum.
Analysis by Bazian
Edited by NHS Choices

Links to the headlines

Aspirin a day could dramatically cut cancer and heart disease risk - and even extend lifespan, study claims. Mail Online, November 30 2016

Links to the science

Agus DB, Gaudette E, Goldman DP, Messali A. The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older. PLOS One. Published online November 30 2016

Tuesday, 29 November 2016

Review questions recent official vitamin D guidance

reposted from: http://www.nhs.uk/news/2016/11November/Pages/Review-questions-recent-official-vitamin-D-guidance.aspx
crabsallover highlightskey pointscomments / links.

Wednesday, 14 September 2016

Statins are 'safe, effective and should be used more widely'

reposted from: http://www.nhs.uk/news/2016/09September/Pages/Statins-safe-effective-and-should-be-used-more-widely.aspx

"Large-scale evidence from randomised trials shows that statin therapy reduces
the risk of major vascular events (ie, coronary deaths or myocardial infarctions, strokes, and coronary revascularisation procedures) by about one-quarter for each mmol/L reduction in LDL cholesterol during each year (after the first) that
it continues to be taken." Source: http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)31357-5.pdf