Early diet 'shapes heart health'

What we eat as a child has long-term effects on our heart, say researchers Continue reading the main storyRelated StoriesWestern diet 'raises heart risk' Growing up starved of calories may give you a higher risk of heart disease 50 years on, research suggests.

Researchers in The Netherlands tracked the heart health of Dutch women who lived through the famine at the end of World War II.

Those living on rations of 400-800 calories a day had a 27% higher risk of heart disease in later life.

It's the first direct evidence early nutrition shapes future health, they report in the European Heart Journal.

The Dutch famine of 1944-45 gave researchers in Holland a unique opportunity to study the long-term effects of severe malnutrition in childhood and adolescence.

A combination of factors - including failed crops, a harsh winter and the war - caused thousands of deaths among people living in the west of The Netherlands.

The women, who were aged between 10 and 17 at the time, were followed up in 2007.

The team, from the University Medical Center Utrecht and the University of Amsterdam, found those who were severely affected by the famine had a 27% greater risk of developing heart disease than those who had had enough to eat.

Diet impact

Lead author Annet van Abeelen told the BBC: "The most important message is that it is good to realise that disturbing the development of children through acute malnutrition can have implications for later adult health.

"It's not only the short-term direct consequences that matter. Even 50 years later, there is still a higher risk of adult coronary heart disease."

Victoria Taylor, senior heart health dietitian for the British Heart Foundation, said: "This study showed a link between children and young adults experiencing famine and the likelihood of them developing heart disease later on in life.

"Although it wasn't clear exactly what changes occurred in the body to increase the risk, this highlights how our environment can have a long-term impact upon our heart health.

"Fortunately, the problems of famine seen in other countries have not been an issue in the UK in recent times. But that doesn't make this study irrelevant for us.

"It adds to the importance of providing a healthy diet for children and young people because of the way it can shape their future heart health."

Too few tonsillectomies 'risks health'

Doctors are seeing more cases of tonsillitis There has been a significant fall in the number of people having their tonsils removed in the UK over recent years, partly as a backlash against the procedure's overuse and, more recently, as a cost-saving exercise for the cash-strapped NHS.

But in this week's Scrubbing Up, consultant ENT surgeon Andrew McCombe, honorary secretary of ENT UK, warns the cuts have gone too far and patients are paying the price.

Tonsillectomy - cutting out the two lumps of lymphoid tissue found at either side of the back of the throat - is an operation that was described first over 3,000 years ago.

Its popularity grew throughout the ages and became so favoured in the UK that in the 1950s over 200,000 were performed in any given year.

Certainly, this rate was too high and surgeons set about refining the indications for carrying out this potentially risky operation, reserving it only for those patients most likely to benefit.

However, over the last 15 years the rate of tonsillectomy has continued to fall, so much so that we are now in danger of too few procedures being carried out.

Out of vogue

In 1994-95 some 77,600 tonsillectomies were carried out in the UK. By 2009 this had dropped by 37% to 49,000.

At the same time, we are seeing increasing rates of diseases and conditions that tonsillectomies can prevent or cure, like infections, and even cancer, of the tonsils.

The number of people who develop cancer of the tonsils is still small, but it has certainly jumped significantly.

In 2000-01, there were 30,942 tonsil-related admissions for emergency medical treatment. By 2008-09, the figure had risen to 43,641, an increase of over 41% in 8 years.

The economic impact of tonsillitis is considerable. Overall, 35m days are lost from school or work each year due to sore throats in the UK.

UK 'lags behind Europe on health'

The UK is one of the unhealthiest nations in Europe for some health indicators, data suggests.

Figures from the Association of Public Health Observatories reveal the UK is the fattest EU member and has one of the highest rates of teen pregnancies.

The UK also performs badly on female cancer survival and infant deaths.

But life expectancy figures in the UK are slightly better than for EU counterparts and the nation also excels at treating heart disease.

And our early action on smoking has had a very positive impact on health outcomes, the report authors say.

They compared all regions across 27 countries in Europe using 37 health indicators in 2006.

Hot spot

The UK as a whole scored particularly badly on obesity, being the fattest nation of all.

And within the UK it was the West Midlands that had the highest percentage of obese adults at 29% - nearly double the EU average of 14% and much higher than the 19% rate seen in Greater London.

The UK's female death rates from cancer were also among the worst in Europe.

Deaths in south-east England were the highest at 185 per 100,000, followed by Scotland at 179 per 100,000 and north-east England at 174. This compares with the European average of 139.5 per 100,000.

All parts of the UK had more teenage mothers than in most other European countries - but the North East of England came out the worst.

The researchers acknowledge the picture may have changed slightly since the data was collected, but they say their snapshot should be a warning to public health experts.

Continue reading the main story“Start QuoteI'm appalled by the figures and feel ashamed as a GP working in the West Midlands that this area has the highest percentage of obese adults in Europe”

End QuoteProfessor Steve FieldChairman of the RCGP Dr Claire Bradford and Professor John Wilkinson, who compiled the report, said the information could help the UK improve its track record.

Dr Bradford said: "This type of data allows us to compare not just between countries but within countries and to look at what is going well and what is not.

"People that are able to influence which way we are going as a nation should look at this to decide on priorities and actions.

"Our problem with obesity might be a good place to start."

Commenting on the data, public health expert, Professor Sir Michael Marmot said the report highlighted "stark differences" in health across the EU.

"The causes of health inequalities are socially determined," he said.

"The behaviours that lead to obesity and teenage pregnancy, for example, arise from social conditions.

"This knowledge informs what we as a society can do at a local, regional, national and international level to create the conditions for greater health equity."

'Appalled'

Professor Steve Field of the Royal College of General Practitioners said: "I'm appalled by the figures and feel ashamed as a GP working in the West Midlands that this area has the highest percentage of obese adults in Europe.

"Obesity is a major problem and predictor of ill health throughout a patient's life, causing serious illnesses.

"I hope we will be able to do more in the future to get people to take responsibility for their own health and take more exercise and eat sensibly."

A Department of Health spokesman said: "The government has made it clear that tackling health inequalities is a priority as part of its commitment to fairness and social justice.

"Action to tackle health inequalities is at the centre of our approach to public health.

"We will aim to use the least intrusive approach necessary to achieve the desired effect.

"We will seek to use approaches that focus on enabling and guiding people's choices wherever possible."

Kilimanjaro climbers 'risking health'

The study found drugs or rest days did not have a major effect on whether people fell ill Climbers scaling Mount Kilimanjaro are taking unnecessary risks with their health, experts have warned.

Travel firms have seen an increase in bookings following the successful summit by nine celebrities for last year's Comic Relief campaign.

But Edinburgh University scientists warned many climbing Africa's tallest peak "know little or nothing" about high altitude, which can be fatal.

Scientists camped out to test altitude sickness in more than 200 climbers.

The researchers camped for three weeks on the mountain at a height of 4,730m - not far below the 5,895m summit.

Continue reading the main story“Start QuoteUndertaking an acclimatisation trek before attempting to summit Mount Kilimanjaro offers climbers the best chance of a safe, successful summit”

End QuoteStewart JacksonEdinburgh University academic They assessed climbers using the Lake Louise consensus scoring system, which records symptoms such as headache, sickness and fatigue.

The academics found almost half, or 47%, of those who had climbed Kilimanjaro, were suffering from altitude sickness before they reached the summit and most were ascending too high, too quickly.

Signs of sickness include vomiting, headaches, difficulty sleeping and sometimes problems with co-ordination.

Effects can be felt from as low as 2,500m above sea level and 75% of people will have mild symptoms at 3,000m or higher, the study said.

Reserachers said the best way to acclimatise was to climb slowly and some trekkers incorporate acclimatisation rest days.

Some also opt for anti-sickness drugs, although there is controversy in the mountaineering community about whether they are effective.

However, the experts found that neither altitude-sickness drugs nor rest days had a major effect on whether people got ill.

Continue reading the main storyALTITUDE SICKNESS SYMPTOMS Headache Tiredness Nausea or vomiting Loss of appetite Dizziness Sleeping difficulties They concluded that climbers were going up so rapidly, the drugs could not protect against the harmful effects of altitude.

It also did not matter which route people took, suggesting "the rate of ascent on any itinerary is sufficiently fast to cause acute mountain sickness in a large proportion of climbers".

However, climbers who had managed to acclimatise beforehand on nearby high mountains were less likely to suffer from sickness, the research said.

Risk dying

Stewart Jackson, who conducted the study, published in the journal High Altitude Medicine and Biology, said: "We found that many climbers knew little or nothing about altitude sickness and did not have previous experience of being at high altitude.

"This research emphasises the need to increase awareness of the risks of altitude sickness and the importance of taking your time to acclimatise.

"Undertaking an acclimatisation trek before attempting to summit Mount Kilimanjaro offers climbers the best chance of a safe, successful summit."

Severe altitude sickness can lead to serious complications, including shortness of breath at rest, inability to walk, decreasing mental alertness and a build up of fluid on the lungs which can result in a "gurgling" sound when breathing.

People with these symptoms must descend the mountain quickly or risk dying.

High altitude cerebral oedema and high altitude pulmonary oedema are rare, but deadly. In both cases, the lack of oxygen results in leakage of fluid into either the lungs or the brain.