Anger at ‘missed TB opportunity’
Anger at ‘missed TB opportunity’
London has become Europe’s TB capital because primary care trusts are failing to adopt measures drawn up four years ago, MPs and health campaigners say.
Just 55% of PCTs in England routinely screen new immigrants, according to a poll by the All-Party Parliamentary Group on Global Tuberculosis.
One PCT with a very high TB rate had even scrapped its screening programme.
PCT representatives argued resources were finite and that decisions were taken on the basis of local needs.
TB is continuing to rise in the UK, and last week the first case of a form resistant to many drugs was diagnosed.
Globally, drug resistant TB is becoming a major problem.
Some 101 PCTs out of 152 responded to the survey sent out by the All-Party Parliamentary Group on Global Tuberculosis (APPG) and British Thoracic Society, the body which represents specialists in respiratory disease.
Only half had appointed an individual to be responsible for leading action on TB, while 41% said they were not actively raising awareness of the disease.
Both measures are laid out in the “TB Toolkit”, which was drawn up by the Department of Health.
The picture of the disease varies across the country, with cities with large immigrant populations much more likely to see a multitude of cases.
London, now Europe’s TB capital, accounts for half of the cases nationwide.
Rising numbers
Levels of TB have been increasing year-on-year in the UK since the late 1980s and the latest available figures from 2006 showed the number of cases increased 17% from three years previously.
KEY POINTS OF 2004 ACTION PLAN
- Better screening programmes
- Multi-lingual and culturally sensitive information
- Higher vaccination coverage of babies in high-risk groups
- Stronger TB surveillance in prisons
- DNA bacterial screening to track the disease
- More research into drugs and vaccines
Last week, doctors in Glasgow confirmed they were treating Scotland’s first diagnosed case of the drug-resistant XDR strain in an man who had come to the UK from Somalia.
The majority of PCTs predict that the number of TB cases in their region is set to rise.
Julie Morgan, chairman of the AAPG, said: “Our findings are deeply worrying.
“The Action Plan was published almost four years ago, and yet clearly very little has been achieved.”
She added: “TB is clearly not getting the attention it deserves. There should therefore be a properly-funded national TB awareness campaign, tailored to local circumstances, aimed at healthcare professionals as well as the general public.”
Professor John Macfarlane, chairman of the British Thoracic Society, said: “This report confirms the experience of our members trying to tackle TB in hospitals, who are not being provided with the tools and resources they need to effectively manage TB.”
“It clearly shows that PCTs must as a matter of urgency identify and commission TB services. Action one needs to be the appointment of a TB lead in every PCT.”
David Stout, director of the PCT Network, which is part of the NHS Confederation, said:”PCTs have the difficult job with finite resources of making decisions on local priorities.
“All PCTs are currently undertaking local needs assessments which will include an assessment of local rates of TB and will prioritise action accordingly.”
<P
Source: news.bbc.co.uk
School-gate junk food ban urged
School-gate junk food ban urged
Schools and councils are being urged to make it harder for children to swap their school meal for a takeaway.
Rising levels of obesity are being fuelled by the ready availability of junk food, said the School Food Trust.
It wants schools to close their gates at lunchtime and councils to stop new fast food outlets opening nearby.
But the Local Government Association said it could not force schools to shut their gates and that food retailers could challenge licence refusals.
Dinner money
The trust has issued a “league table” of the local education authority areas with the most takeaway and sweet shops per secondary school.
"At the moment school canteens have to compete with a myriad of take-aways, chippies, and sweet shops for pupils’ dinner money"Judy Hargaddon
School Food Trust
Seaside towns – with dozens of outlets aimed at tourists – and inner city areas, fare the worst.
Topping the list is Brighton and Hove, with 46 per school, closely followed by Blackpool and Hull.
School Food Trust chief executive Judy Hargaddon said: “At the moment school canteens have to compete with a myriad of take-aways, chippies, and sweet shops for pupils’ dinner money.
“We all know that some children will go for chips five times a week if they are allowed to.
“The problem is that this is damaging their long-term health, and is also threatening the viability of school lunch services.”
Burger ban
She is backed by a dietician from London’s Great Ormond Street Hospital.
10 WORST LEA AREAS- 1 Brighton and Hove 46.11 outlets per secondary school
- 2 Blackpool 40.63
- 3 Kingston upon Hull 40.00
- 4 Reading 39.17
- 5 Middlesbrough 38.33
- 6 Manchester 36.95
- 7 City of Bristol 36.94
- 8 Inner London 36.66
- 9 Newcastle upon Tyne 36.21
- 10 Gateshead 35.00
Source: School Food Trust
Paul Sacher said: “Children face daily temptation from junk foods and many find them hard to resist.
“These foods play a big part in weight gain, have little nutritional value and contribute to health problems later in life.”
Some councils and schools are taking steps to try to restrict the ability of children to buy fast food during school hours.
Leicester City Council is drawing up plans to ban mobile burger vans from areas around schools, and some schools already operate policies which stop children from leaving at lunchtime.
Licence fight
Dr Sacher encouraged other local authorities and schools to take steps to protect child health by restricting the number of new licences issued for fast food outlets in the areas around schools.
However, the Local Government Association said this could be hard to enforce, and any refusal to grant a licence could be challenged.
A spokesman said: “Councils are up for using all the powers at their disposal, including planning, to play their important part in tackling this weighty issue.
“It is wrong to imply that planning laws that ban junk food outlets around parks and schools are a potential ’silver bullet’.
“Local authorities have to base their decisions on good evidence of potential harmful impacts, and the matters they are allowed to take into account by law.”
She said that while education authorities could encourage schools to adopt “stay in” policies, they could not be compelled to do so.
Source: news.bbc.co.uk
Gay men risk of HIV ’still high’
Gay men risk of HIV ’still high’
Gay men are being urged to get HIV tests more regularly and practise safe sex in a bid to halt the high numbers of new cases in the UK.
The Health Protection Agency made the warning after new diagnoses among gay men topped 2,600 for the third year.
But the figures do seem to have begun to plateau after a surge at the turn of the century.
Overall, the number of new cases hit an estimated 6,840 in 2007 – a fall of 1,400 from the previous year.
"Gay men continue to be the group most at risk of acquiring HIV within the UK"
Dr Valerie Delpech
The HPA said this was mostly due to a decline in cases among those infected heterosexually in Africa.
But experts said the new cases among gay men was still at worrying levels.
There were 2,630 diagnoses – a slight fall on previous years, but much higher than the annual figures in the 1990s which tended to hover around 1,500.
HPA head of HIV surveillance Dr Valerie Delpech said: “Gay men continue to be the group most at risk of acquiring HIV within the UK.
“We need to reinforce the safe sex message for gay men that the best way to protect yourself from contracting HIV is practising safe sex by using a condom with all new and casual partners.”
She also urged more regular testing so treatment could be started earlier and to reduce the risk of transmission to partners.
The figures are only provisional as they also take into account the expected delays in diagnosis.
Genevieve Clark, of the Terrence Higgins Trust, said it was “good news” that the figures for gay men seemed to be levelling off.
But she warned the number of cases was still too high and called for easier access to testing as some places had long waits for access to sexual health clinics.<P
Source: news.bbc.co.uk
Caution call on pharmacist drugs
Caution call on pharmacist drugs
Raising the number of drugs that can be bought at pharmacies may affect safety and cut effectiveness, specialists say.
Writing in the British Medical Journal, two doctors say drugs such as statins could be less effective because over-the-counter doses are lower.
They warn some powerful painkillers available without prescription have potentially harmful side-effects.
But the National Pharmacy Association said its members treated newly classified medicines with caution.
Inquests
The government is keen to see some widely used drugs more easily available, to improve the health of people with long-term conditions and potentially cut the bill to the NHS.
"Given the concerns, it would be wise to avoid any wholesale rush to reclassify medicines"Dr Robin Ferner
West Midlands Centre for Adverse Drug Reactions
However, West Midlands Centre for Adverse Drug Reactions director Robin Ferner and Keith Beard, from the Victoria Infirmary Glasgow, believe that the benefits need to be closely measured against the risks.
They highlighted two recent deaths in which codeine-based painkillers were implicated at inquests.
They said it was far more difficult for the potential side-effects to be explained to patients in their local pharmacy.
“Certainly, pharmacists can provide clinical advice to minimise the risk of misuse of pharmacy only drugs, but supervision by a busy community pharmacist in the UK may be perfunctory,” they wrote.
Patients who misdiagnose their symptoms then try to treat themselves using over-the-counter drugs could delay a vital trip to their GP surgery, they added.
‘Trusted profession’
The medicines safety watchdog – the Medicines and Healthcare Products Regulatory Authority (MHRA) relies on reports of side-effects, primarily from doctors, to alert them to any new concerns.
It recently extended its reporting scheme to make it easier for patients to contact them.
However, Dr Ferner and Dr Beard are not convinced that this is enough to ensure their safety.
“Given the concerns, it would be wise to avoid any wholesale rush to reclassify medicines,” they said.
“Whole communities might lose out in the long run if indiscriminate overuse of widely available medicines were to lead to large numbers of avoidable but irreversible adverse effects.”
A National Pharmacy Association spokesman, which represents community pharmacists, said that its members tended to err on the side of caution when handling newly reclassified medicines.
“When a medicine is available over the counter for the first time, it is generally only dispensed by the pharmacist themselves.
“In fact, when people were surveyed about sources of good quality health advise, as many said they would go to a pharmacist as said they would visit their GP.
Source: news.bbc.co.uk
TV crew denies giving flu to Peru
TV crew denies giving flu to Peru
A British TV production company has denied allegations that its researchers spread a fatal flu to an isolated indigenous tribe in Peru.
Indigenous rights activists, Peruvian government officials and a US scientist say four members of the tribe died after the TV producers visited.
A spokesman for the TV company, Cicada Films, said its team did not visit the isolated area in question.
Cicada was in Peru last year scouting locations for a new reality TV show.
The company makes a series called World’s Lost Tribes, which airs on the Disney Channel.
‘No evidence’
The production company said a producer and his guide had been given official permission to enter all the areas they visited in Manu National Park.
The team “travelled only a short distance from the large town Yomibato, and only at the invitation of local people,” Cicada said in a statement.
“There is no evidence that the researcher introduced illness to the areas they visited.
“The researcher and his guide did not visit the area where the deaths are said to have occurred and no deaths occurred amongst the individuals they met.”
Furthermore, Cicada said, the groups lodging the complaint against them had the wrong dates for their visit.
‘Too Westernised’
But the Peruvian government’s protected areas department said: “The Cicada team entered [remote headwaters] which are part of the strictly protected zone.”
A regional rights organisation, Fenamad, also said the Cicada team ignored warnings and travelled upriver to very isolated villages.
An American anthropologist who met the TV team in Peru has also said they complained the first tribal area they visited was “too Westernised” and looked for a more remote location.
The Cicada team is said to have visited the Matsigenka people, who live in the isolated Amazonian Cumerjali area of south-eastern Peru.
Four members of the tribe are reported to have died and others have been seriously ill since the TV team’s alleged visit.
Anthropologists believe there are about 15 isolated groups of indigenous people living without contact with the outside world, says the BBC’s Dan Collyns in Peru’s capital, Lima.
Their isolation means their immune systems have not built up the capacity to deal with illnesses common in less remote regions.
Peru’s indigenous communities often complain that timber companies and oil prospectors encroach on their land and spread disease among their members
Source: news.bbc.co.uk
Salmonella given to baby by snake
Salmonella given to baby by snake
A three-month-old baby contracted salmonella from her family’s pet snake.
It took four days before Amanda Vry’s daughter, Gabriella, was diagnosed with the potentially fatal bacteria and she said she feared she may lose her.
She found out from research on the internet it can be contracted from reptiles and is now looking for a new home for Reg, a Columbian Rainbow Boa.
Ms Vry, from Birmingham, said she thinks her son may have touched Reg then played with his sister.
"When they said it was salmonella I just didn’t know how she could have caught it"
Amanda Vry
Reg was bought as a present for her son’s ninth birthday and the family carried out research on keeping reptiles beforehand as Ms Vry was heavily pregnant at the time.
But when Gabrielle was 14 weeks old she suddenly fell ill and had a temperature of 40 degrees.
“When they said it was salmonella I just did not know how she could have caught it,” Ms Vry told BBC News.
“I went to the hospital’s information centre and typed in ’salmonella’ and it said it can be caught quite easily from reptiles.
“We were all shocked after we had carried out the research before.
“If I had been given this information before we bought it, we would never have bought it and my daughter would never have been ill and my family would not have gone through this.”
Symptoms of salmonella include diarrhoea, nausea and vomiting, headaches, stomach cramps and fever.
Bob Laurence, a warden at West Midlands Safari Park, said hygiene is the most important thing to remember when handling pets.<P
Source: news.bbc.co.uk
Anger at ‘missed TB opportunity’
Anger at ‘missed TB opportunity’
London has become Europe’s TB capital because primary care trusts are failing to adopt measures drawn up four years ago, MPs and health campaigners say.
Just 55% of PCTs in England routinely screen new immigrants, according to a poll by the All-Party Parliamentary Group on Global Tuberculosis.
One PCT with a very high TB rate had even scrapped its screening programme.
PCT representatives argued resources were finite and that decisions were taken on the basis of local needs.
TB is continuing to rise in the UK, and last week the first case of a form resistant to many drugs was diagnosed.
Globally, drug resistant TB is becoming a major problem.
Some 101 PCTs out of 152 responded to the survey sent out by the All-Party Parliamentary Group on Global Tuberculosis (APPG) and British Thoracic Society, the body which represents specialists in respiratory disease.
Only half had appointed an individual to be responsible for leading action on TB, while 41% said they were not actively raising awareness of the disease.
Both measures are laid out in the “TB Toolkit”, which was drawn up by the Department of Health.
The picture of the disease varies across the country, with cities with large immigrant populations much more likely to see a multitude of cases.
London, now Europe’s TB capital, accounts for half of the cases nationwide.
Rising numbers
Levels of TB have been increasing year-on-year in the UK since the late 1980s and the latest available figures from 2006 showed the number of cases increased 17% from three years previously.
KEY POINTS OF 2004 ACTION PLAN
- Better screening programmes
- Multi-lingual and culturally sensitive information
- Higher vaccination coverage of babies in high-risk groups
- Stronger TB surveillance in prisons
- DNA bacterial screening to track the disease
- More research into drugs and vaccines
Last week, doctors in Glasgow confirmed they were treating Scotland’s first diagnosed case of the drug-resistant XDR strain in an man who had come to the UK from Somalia.
The majority of PCTs predict that the number of TB cases in their region is set to rise.
Julie Morgan, chairman of the AAPG, said: “Our findings are deeply worrying.
“The Action Plan was published almost four years ago, and yet clearly very little has been achieved.”
She added: “TB is clearly not getting the attention it deserves. There should therefore be a properly-funded national TB awareness campaign, tailored to local circumstances, aimed at healthcare professionals as well as the general public.”
Professor John Macfarlane, chairman of the British Thoracic Society, said: “This report confirms the experience of our members trying to tackle TB in hospitals, who are not being provided with the tools and resources they need to effectively manage TB.”
“It clearly shows that PCTs must as a matter of urgency identify and commission TB services. Action one needs to be the appointment of a TB lead in every PCT.”
David Stout, director of the PCT Network, which is part of the NHS Confederation, said:”PCTs have the difficult job with finite resources of making decisions on local priorities.
“All PCTs are currently undertaking local needs assessments which will include an assessment of local rates of TB and will prioritise action accordingly.”
<P
Source: news.bbc.co.uk
Hospital deep clean target missed
Hospital deep clean target missed
The NHS is likely to narrowly miss its target to deep clean all the hospitals in England by the end of March.
Ministers have said they expect 93% of trusts to have completed the process by the end of Monday.
They said the remainder had all started the cleans and would finish soon.
But the Tories said it was a shambles as hospitals have had to dip into their funds as not all the money promised to cover the costs has materialised.
Latest figures show £60m has been spent on the deep cleaning of all 1,500 acute, district general and community hospitals in the country.
But data obtained under the Freedom of Information Act by the Tories showed that just £15.6m has been released by regional health authorities to help hospitals pay for the cleaning.
"Deep cleans are immensely popular with patients, the public and hospital staff"
Ben Bradshaw, health minister
News of the financial shortfall comes amid mounting criticism of the programme since it was announced last year by the prime minister.
Infection control experts have dubbed the programme a gimmick, claiming it will only have a short-term impact on hospital infections such as MRSA.
And cleaning firms have said the government should instead have properly funded day-to-day cleaning.
But health minister Ben Bradshaw has hailed the exercise as a success.
“Deep cleans are immensely popular with patients, the public and hospital staff.
“Far from being a ‘gimmick’, they are one of a series of initiatives we have delivered to make our hospitals cleaner and safer.”
Strategy
Extra infection control nurses and MRSA screening also form part of the government’s strategy to fight infection.
Andrew Large, of the Cleaning and Support Services Association, which represents the firmsresponsible for carrying out the deep cleaning, said there were two main reasons for hospitals missing the deadline.
“Some have had a problem freeing up wards of patients to allowing the cleaning to take part.
“However, some others have actively decided not to rush the process. They will all get there in the end, I am sure.”
But shadow health secretary Andrew Lansley branded the programme a “shambles”.
“It is appalling that Gordon Brown has broken his promise to fund it and now the local NHS has ended up footing the bill,” he said.
He also questioned how effective it would be in the long run.
<P
Source: news.bbc.co.uk
Alcohol ban advised for pregnancy
Alcohol ban advised for pregnancy
Women should not drink any alcohol during pregnancy, NHS adviser the National Institute for Health and Clinical Excellence (NICE) has said.
It says if they must drink, they should not do so in the first three months and should limit consumption to one or two units once or twice a week afterwards.
It brings NICE in line with government advice and replaces previous guidance saying small daily amounts were fine.
However, NICE concedes there is no evidence to support the change.
Not everyone agrees with such a tough approach, but research into the impact of alcohol is patchy.
The Royal College of Obstetricians and Gynaecologists said there was no evidence that a couple of units once or twice a week would do any harm to the baby – but could not categorically rule out any risk.
"Unfortunately not all women are getting the support they need at the moment"Dr Gillian Leng
NICE deputy chief executive Q&A: Alcohol and pregnancy
NICE, which is responsible for the promotion of good health in England, Wales and Northern Ireland, decided to tighten its guidance partly because of concern that people are now drinking more than in the past.
Previous draft guidance suggested pregnant women could drink a unit of alcohol a day.
NICE deputy chief executive Dr Gillian Leng said people, and in particular women, were drinking more and the NHS advisory body wanted to send a “clear message”.
“I think it reinforces the advice which came out last year. Women should be advised not to drink.”
The Department of Health in England revised its guidance last year, calling for no drinking while pregnant or while trying to get pregnant.
Professor Sir Liam Donaldson, Chief Medical Officer for England, welcomed the new guidance from NICE, stressing that it was particularly important not to drink at the beginning of pregnancy, when the risk of miscarriage was highest.
Drinking heavily in pregnancy can cause foetal alcohol syndrome, which can leave children with features like small heads, widely spaced eyes and behavioural or learning problems.
Supplements
NICE also made a number of other recommendations for the care of women in England and Wales who were pregnant or planning to get pregnant.
It said vitamin D and folic acid supplements should be offered by health staff to help ward off conditions such as rickets and spina bifida.
And screening for sickle cell diseases by week 10 and Down’s syndrome between 11 and 14 weeks using the most up-to-date methods should be available.
Officials also called for local health bosses to ensure peer support schemes where mothers encourage new parents to breastfeed are set up.
Much of what NICE is recommending is already happening although provision is patchy and officials said they wanted to make sure women got “gold standard” care.
Dr Leng added: “Unfortunately not all women are getting the support they need at the moment.”
NICE also called for improvements in the care of pregnant women with diabetes.
About 20,000 pregnancies each year are affected by diabetes and, therefore, carry higher risk of miscarriage, birth defects and still birth.
The guidance said women should get access to advice and support, in particular to achieve good blood sugar control, before they get pregnant.
During pregnancy, access to specialist multi-disciplinary teams of doctors, nurses and midwives was essential, it added.
UNITS FOR ALCOHOLIC DRINKS
| Drink | Volume | Strength | Units |
| Normal beer/lager/cider | |||
| half pint | 284ml | 4 | 1 |
| large can/bottle | 440ml | 4.50% | 2 |
| Strong beer/lager/cider | |||
| half pint | 284ml | 6.50% | 2 |
| large can/bottle | 440ml | 6.50% | 3 |
| Table wine | |||
| small glass | 125ml | 12.50% | 1.5 |
| medium glass | 175ml | 12.50% | 2 |
| large glass | 250ml | 12.50% | 3 |
| bottle | 750ml | 12.50% | 9 |
| Spirits | |||
| single shot | 25ml | 40.00% | 1 |
| bottle | 750ml | 40.00% | 30 |
| Alcopops | |||
| bottle | 275ml | 5.00% | 1.5 |
| Office for National Statistics | |||
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Gay men risk of HIV ’still high’
Gay men risk of HIV ’still high’Gay men are being urged to get HIV tests more regularly and practise safe sex in a bid to halt the high numbers of new cases in the UK.
The Health Protection Agency made the warning after new diagnoses among gay men topped 2,600 for the third year.
But the figures do seem to have begun to plateau after a surge at the turn of the century.
Overall, the number of new cases hit an estimated 6,840 in 2007 – a fall of 1,400 from the previous year.
"Gay men continue to be the group most at risk of acquiring HIV within the UK"
Dr Valerie Delpech
The HPA said this was mostly due to a decline in cases among those infected heterosexually in Africa.
But experts said the new cases among gay men was still at worrying levels.
There were 2,630 diagnoses – a slight fall on previous years, but much higher than the annual figures in the 1990s which tended to hover around 1,500.
HPA head of HIV surveillance Dr Valerie Delpech said: “Gay men continue to be the group most at risk of acquiring HIV within the UK.
“We need to reinforce the safe sex message for gay men that the best way to protect yourself from contracting HIV is practising safe sex by using a condom with all new and casual partners.”
She also urged more regular testing so treatment could be started earlier and to reduce the risk of transmission to partners.
The figures are only provisional as they also take into account the expected delays in diagnosis.
Genevieve Clark, of the Terrence Higgins Trust, said it was “good news” that the figures for gay men seemed to be levelling off.
But she warned the number of cases was still too high and called for easier access to testing as some places had long waits for access to sexual health clinics.<P
MMR doctor to begin his defence
The doctor who first linked the MMR vaccine to increased risk of autism is due to defend his reputation at a General Medical Council hearing.
Dr Andrew Wakefield, along with two colleagues, is charged with serious professional misconduct.
His research paper, published in the Lancet in 1998 but since disowned by the journal, sparked widespread fears that the MMR triple jab was unsafe.
The current hearing focuses on alleged irregularities in his research methods.
Dr Wakefield is accused of violating ethical guidelines, and of acting against the clinical interests of the children who took part in his trial.
It is alleged that he took blood samples from children at a birthday party while offering financial inducements.
He is also accused of acting dishonestly in failing to disclose to the Lancet that he was advising solicitors acting for parents who had alleged their children had been damaged by MMR.
A further charge relates to his alleged failure to disclose his involvement in a patent application for a potential single measles vaccine.
The GMC hearing will not examine the safety of MMR, designed to protect against measles, mumps and rubella.
The scientific community has repeatedly stressed that the vaccine is safe, and several large authoritative studies have comprehensively dismissed any link between MMR and autism.
However, a crisis of public confidence in the vaccine in the wake of Dr Wakefield’s original research saw vaccination levels fall, with experts warning that children were being exposed to a raised risk of measles.
Although the infection is usually mild, it can be serious, and in rare cases life threatening.
If found guilty of serious professional misconduct, Dr Wakefield faces being struck off the medical register.
Also facing professional misconduct charges are Professor John Walker-Smith, and Professor Simon Murch
Large waist ‘an Alzheimer’s risk’
A big waistline in your 40s could almost triple the threat of dementia in old age, according to US research.
Obesity is a known risk factor for Alzheimer’s, but scientists found even those of normal weight were more at risk if they had a large waist.
However, the study of 6,500 people, published in the journal Neurology, found obesity and bulging stomach was still the most dangerous combination.
An obesity expert said waist size was a good guide to future health problems.
"Where one carries the weight, especially in midlife, appears to be an important predictor for dementia risk"
Dr Rachel Whitmer
Kaiser Permanente Research Calculate your BMI
Research linking obesity to dementia does not reveal precisely why being overweight can affect your ageing brain, but many specialists believe that associated problems such as high blood pressure, diabetes and high cholesterol levels may contribute.
Thickness of fat around the waist is thought to correspond closely with its presence around the major organs of the body.
The latest study suggests that while the standard measure of obesity – body mass index – can help predict those at risk, the lifestyles which produce large bellies may have a closer relationship with the long-term causes of dementia.
Researchers working for Kaiser Permanente, one of the biggest healthcare providers in the US, looked at 6,583 people aged between 40 and 45, measuring their abdominal fat levels with calipers.
They then followed all of these people into their 70s to see who became ill, and who managed to maintain relatively good health.
They found the 20% of people with the largest waistlines had a 270% greater risk of dementia than those with the smallest waists.
Even those reckoned to be normal weight using body mass index calculations had approximately an 90% increased risk of dementia if they had a large rather than a small waist.
People who were measured as overweight or obese using body mass index, but who didn’t have a large belly, had an 80% increase in dementia risk but a combination of all these factors led to a bigger overall increase.
Being overweight and with a large waist raised the risk by 230%, but those who were large-waisted and were so overweight they could be officially classed as obese recorded a 360% rise in dementia risk compared to small-waisted people who met guidelines on normal weight.
Reliable measurement
Dr Rachel Whitmer, who led the research, said: “It is well known that being overweight in midlife and beyond increases risk factors for disease.
“However, where one carries the weight, especially in midlife, appears to be an important predictor for dementia risk.”
She said that autopsies suggested that the changes in the brain characteristic of Alzheimer’s disease started to appear decades before any symptoms became apparent.
Tam Fry, from the National Obesity Forum, said that waist size was potentially a far better way to predict future illness than body mass index.
“Many doctors are now coming around to the idea that this is a more reliable indicator.
“The problem is that waist measurements have to be carried out very precisely, in exactly the right spot, so this is something that is better done by your doctor or practice nurse.
“So while calculating your body mass index at home might give you a clue that something is wrong, this could be confirmed by your doctor measuring your waist size.”
Professor Clive Ballard, of the Alzheimer’s Society, said: “This new study highlights that having a large abdomen, regardless of weight, also significantly increases your risk.
“This is an important piece of research but the results are not that surprising as a large stomach is associated with high blood pressure, cholesterol and diabetes – all major risk factors for dementia. “
We are learning more and more that what is good for your heart is also good for your brain.”
Rebecca Wood, of the Alzheimer’s Research Trust, called for further studies to confirm the findings – and reveal how dementia develops
Coma attack doctor suspended
A doctor who beat a paramedic into a coma has been suspended by the General Medical Council (GMC) for 12 months.
Nik Mann was told his assault on Stephen Mason in Nuneaton, Warks, in August 2006 was contrary to the aims and ideals of the medical profession.
But the fitness to practice panel said it was not in the public interest to strike off Mann.
He was told to do 200 hours’ community service after admitting grievous bodily harm at Warwick Crown Court last June.
Former soldier Jake Roe, of Polesworth, also admitted the same offence and was told to complete the same punishment.
‘Deeply remorseful’
Their trial heard Mann and Roe had been drinking and had beaten Mr Mason after claiming he had hit Mann’s fiancee.
But the GMC hearing was told several doctors had given references for Mann, saying his attack was out of character.
His lawyer told the hearing Mann was “deeply remorseful” for the “indefensible” attack.
Mr Mason, who was in a coma for 12 hours and off work for nearly four months after the attack, said he was “infuriated” by the GMC’s decision.
He said: “(Mann’s) been to A&E before, he’s had people come up to him who’ve been assaulted and had to treat them and he came back to the scene after I was knocked out and further stamped on my head.
“How can someone do that How can someone be given a trustworthy job as a doctor or as a GP
“It just infuriates me. If he’s done it once, he’ll probably do it again.”
Mann will be assessed by the GMC panel before he is allowed back on the register
Salmonella given to baby by snakeA three-month-old baby contracted salmonella from her family’s pet snake.
It took four days before Amanda Vry’s daughter, Gabriella, was diagnosed with the potentially fatal bacteria and she said she feared she may lose her.
She found out from research on the internet it can be contracted from reptiles and is now looking for a new home for Reg, a Columbian Rainbow Boa.
Ms Vry, from Birmingham, said she thinks her son may have touched Reg then played with his sister.
"When they said it was salmonella I just didn’t know how she could have caught it"
Amanda Vry
Reg was bought as a present for her son’s ninth birthday and the family carried out research on keeping reptiles beforehand as Ms Vry was heavily pregnant at the time.
But when Gabrielle was 14 weeks old she suddenly fell ill and had a temperature of 40 degrees.
“When they said it was salmonella I just did not know how she could have caught it,” Ms Vry told BBC News.
“I went to the hospital’s information centre and typed in ’salmonella’ and it said it can be caught quite easily from reptiles.
“We were all shocked after we had carried out the research before.
“If I had been given this information before we bought it, we would never have bought it and my daughter would never have been ill and my family would not have gone through this.”
Symptoms of salmonella include diarrhoea, nausea and vomiting, headaches, stomach cramps and fever.
Bob Laurence, a warden at West Midlands Safari Park, said hygiene is the most important thing to remember when handling pets.<P
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