Is double blind drug testing really a ‘gold’ standard?

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Most adults are aware of the placebo effect, where the belief in some medical benefit can enhance that effect. But few know that there are twists to the placebo effect that have a significant impact on drug testing. It is the existing ‘gold standard’ drug trial, as characterised by the following main attributes, which is impacted:

  1. One set of patients receives no treatment.
  2. A second set of patients receives the drug being tested
  3. A third set of patients receives a sugar pill (placebo) that looks like the drug
  4. The trial is double blind – neither the patients nor the administers of pills know who is receiving the drug or the placebo
  5. The trial is randomised – the patients are randomly assigned into these groups

The key to the double blind aspect is that patients should not be able to differentiate between the placebo and the drug. Recent research with anti-depressant drugs showed that this is not always the case. It appears that many patients were able to work out if they were receiving the drug, because they could detect the side-effects of the drug. They could sense that they were taking an active substance as opposed to a placebo pill. Research was carried out to try to cancel this detection process by using an alternative drug instead of an inert placebo tablet. The drug would be one that generates similar side effects to the drug under test, but not any anti-depressant effect. The net effect was that the drug was no longer demonstrably more effective than placebo. Minimising the flaw of drug detection (that had negated the vital double blind aspect of drug testing), showed the drug to be much less effective as an anti-depressant.

placebo effect

To explain this, it appears that by being able to detect that a drug rather than placebo was being administered, the patient’s expectations of healing would be elevated. Conversely, a patient that knew he was taking a placebo would have a reduced expectation, and hence lowered placebo effect. There is a profound conclusion to be drawn from this: that drugs shown in scientific studies to outperform placebo may actually have been operating by virtue of the placebo effect in addition, or in place of any biochemical effect. The existing gold standard drug trial is not as sound as it is made out to be.

There is another twist to reveal, courtesy of ‘New Scientist’ magazine. Researchers discovered that the effect of the anxiety reducing drug Diazepam virtually vanished when it was administered unknowingly. Likewise, it was discovered that morphine could be provided at fairly high levels to patients in pain with no effect on that pain if administered without the patient’s knowledge. This too was a telling discovery. Morphine is an extremely well established and effective treatment for pain, effective in most people. Yet, it seems, a part of this very efficacy is due to the placebo effect. This links in well with the placebo detection problem – anti-depressant drugs being barely any more effective than placebo when the placebo used was indistinguishable from the drug. Continue reading →

Regaining your body after pregnancy

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I’ve heard since my childhood how having children ruins a ladies body, how the weight gain after pregnancy will just not shift, how it is just so unfair and been amazed by the extent to which some ladies will go to lose this extra weight. As a man I never really took into consideration that whole spectrum of changes made during pregnancy, whether it be physical, mental or emotional. Since my career as a health and fitness professional started that has changed a huge amount, not least in my appreciation of the turmoil that having a baby can create.

Being a proud father and step-father, I have seen how pregnancies can be life changing for both the mother and partners concerned. But if I could explode one myth within my career it would be that ‘babies ruin bodies’ because they don’t. Though it is very true that we add maternal body fat to our frame and there are significant physiological changes that are undergone during pregnancy in preparation for the birth, it still remains that babies do not ruin our bodies. The amount of body fat we add is largely dependant on a combination of the following; stress, health, diet, activity and experience.

pregnancy

Many women feel greatly pressured to regain their figures, looks and posture quickly after giving birth. A lot of my clients have said that the most hurtful images are those of scantily clad models in commercials advertising shower gels, body lotion etc and that these feelings are also heightened greatly by the whole phenomena of celebrities reclaiming their pre-pregnancy figures and not only are they getting the bodies back in shape but they are apparently doing it really quickly.

But before you rush out and sign up for the forthcoming ‘celebrity mom workout video’ –you know it must be on its way. There are many things to consider here before leaping on the same wagon as the celebrities. Many of the celebrities can afford and do employ personal trainers and nutritionists like myself to tailor make exercise programs and push them as far as they need to make, quick noticeable progress. Celebrities also employ nannies; so no more nappy changes and night time feeds and most importantly they can afford to take the time out to make real changes to their lives and bodies. So all of these factors should be taken into account before trying to achieve the same weight loss goals in the same ‘supposed’ time frame.

Are breakfast cereal bars as healthy as we think?

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We are constantly bombarded with advertisements for breakfast cereals, breakfast bars, this brand and that. But are they healthy choices? Well I’ve taken the liberty of doing some shopping to find out how health these products are.

Ingredients

Sugar, Glucose syrup, sweetened condensed milk, invert sugar syrup, fructose (fruit sugar), glycerol, sorbitol (artificial sweetener), Lactose (milk sugar) – Would you believe all these sweeteners are in the same bar? They certainly want this bar to taste good, almost addictively good.

Hydrogenated vegetable oil – Cheap steam cleaned, bleached vegetable oil which has hydrogen forced into it at high temperature, rendering all nutritional value null and void. Its make up is more that of a plastic than an oil – totally unknown in nature and of no use to the body. Very harmful to health! Otherwise known as a Trans fat

Nutritional breakdown for a 25g bar.

Calories 103 Kcal
Protein 1.5 g 6%
Carbohydrates 18 g
 - of which sugars 11 g 44%
 - of which starch 7 g 28%
Fat 3 g 12%
 - of which saturates 2 g 8%
Fibre 0.4 g 1.6%

 

As you can see the nutrient content within this bar are pitiful. How can we hope to gain useful nutrition from this? These bars are aimed at children and I’m sure you’ll agree that one of these bars would not satisfy a child – maybe three or four? An alternative to a good breakfast? Depends on how good the breakfast is but on the whole NO.

Conclusion

Very little protein, which will not supply the essential amino acids required by children and adults alike. Huge amount of sugar – just look at the different types included. Are they trying to disguise types? Nearly half of the bar is sugar. Relatively high in fat at 12%. But contains Trans fat, which is very detrimental to health. Did you know that if Hydrogenated vegetable oil was discovered now opposed in the 1940’s the food oil industry would not be allowed to use it.

Middle Age Doctors Are The Safest

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So are you set to have an operation in the not too distant future? If you are, you may want to have a look at your surgeons birth certificate as, according to a study, Middle-aged surgeons in their late 30s and 40s and are the safest.

Although inexperience is an obvious disadvantage, if a surgeon has been in the profession for decades it is not a good thing. The small study, was undertaken by bmj.com. The analysis looked at more than 3,500 operations carried out by 28 surgeons. The link they found between what age a surgeon is and complication rates was irrespective of how complex the operation was.

The study came to the conclusion that patients that has surgery (thyroid gland removal) were more prone to have some sort of complications if either an inexperienced surgeon or a surgeon who had been in the job for more than two decades.

The researchers chose to look thyroidectomy due to the fact that the procedure is, basically, carried out in the same way and has not changed that much over the past 30 years

A surgeon at the end of his career will most likely be undertaking a completely different range of operations than at the beginning of his career taking into account of the pace of change in medical developments.

Many experts in the field have gone on record as saying that the studies are in no means conclusive and further investigation is needed. Factors contributing to poor performance in older and experienced surgeons need to be investigated much further.

Medical negligence professionals encounters loads of cases where patients have been treated by younger healthcare professionals, and errors have occurred. This problem is a symptom of the wider failings of the NHS system.  It is the case that these inexperienced surgeons are not supported properly by senior staff members.

Patients undergoing surgery should not worry if the surgeon is in the “risky” age scale. There are other factors which are more important such as the wider hospital environment, how well it is managed and how well resourced the hospital is.

Full body MRI – Why do it?

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There are a number of reasons why people should at least consider professional health screening tests. With advances in medicine and technology, we have never been closer to the prevention and cure of certain diseases. However, the reality is that one would seek medical help only if there are tangible symptoms of an illness. Unfortunately, there are a number of deadly diseases that can develop without symptoms and are often “picked up” at an advanced stage, when the chances of successful treatment are drastically reduced. Such diseases are commonly called “silent killers” and can cause death if not treated. “Silent killers” include various types of cancer (for instance, renal cell and pancreatic cancer), Hepatitis B and C infections, heart and cardiovascular diseases, diabetes and kidney infections to name just a few.

Heart and cardiovascular disease is the number one “silent killer” and it causes over 50,000 premature deaths a year in the UK (Source: BHF). Smoking, a sedentary lifestyle, raised cholesterol or hypertension are some of the main risk factors that contribute to the development of heart disease. (Source: BHF). Approximately one in three adults in England and Scotland are hypertensive and almost half of them are not receiving treatment. Diabetes is yet another “silent killer” that can go unnoticed for most of ones life. The World Health Organisation states that almost 6% of the world’s adult population has diabetes. Many of those affected might not even be aware of it.

Full body MRI

The chances of curing or preventing the development of some of these deadly diseases increase significantly if they are discovered at an early state. Our health screening offer is not only directed towards people who are at risk of developing a certain condition; anyone who is over 40 years of age and is concerned about their health should seriously consider having a professional health check-up. Affordable yet advanced medical check-ups are designed to screen for a number of conditions. Let them help you!

The full body MRI offered in most packages helps to discover the following:

Stages of inflammation in organs
Post-traumatic changes
Early cancer signs
Size and function changes of key organs
Bone changes (that can lead to leukemia, osteoporosis etc)
Unknown birth defects

 

Reducing high blood pressure the natural way!

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For many hypertension suffers, it has been seen that altering their daily eating habits and including different fruit, vegetables, vitamins and minerals into the diet has a very beneficial and significant effect on the blood pressure. So wouldn’t it be great if we could actively lower our blood pressure naturally, reducing the need to take hypertensive drugs.

Now I’m not saying the following list will solve the problem of hypertension or that you will not need the advice of your doctor, but the following foods will definitely have a positive effect on your body and certainly help lower or prevent the early onset of hypertension. They are also natural products which are tasty and healthy, so it would be a shame not to include them within our diet anyway.

Firstly potassium rich foods.

Potassium is well known for its ability to control and prevent blood pressure, so it would be of great benefit to include potassium rich foods within our daily diet.

Apricots Prunes Bananas Orange juice Peaches
Pumpkin Spinach Sweet potatoes Green beans Potatoes
Lean pork Lean veal Flounder Trout Catfish
Milk Yoghurt

Secondly Magnesium rich foods

It has been shown that a large majority of high blood pressure sufferers have magnesium deficiency. And clinical trials have proven that a magnesium deficiency can definitely affect blood pressure adversely.

Beans Okra Spinach Broccoli Chard
Plantain Tofu Soy milk Nuts / Seeds Wholemeal bread
Oysters Scallops Mackerel Sea bass

Thirdly Calcium rich foods

Many studies have shown that those suffering from hypertension would benefit from the added calcium to their diets. Most sufferers tested show that they are low in calcium and consume far less calcium in their diets. Of course many sources of calcium is from dairy products which can have a high fat content. But it is very easy to select the skimmed or low-fat varieties and still maintain a health intake of this important mineral.

Broccoli Turnip greens Spinach
Perch Salmon Mackerel
Cheese Yogurt Milk

Of course one of the many benefits of adding such foods to your diet is that these foods are generally low in calories and will definitely help you lose weight when incorporated into a carefully structured diet. They also add variety which is always a bonus when buy food and planning meals.

Reduce your blood pressure the natural way – Eat right! Exercise right!

The causes of hypertension

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Over 95% of all patients diagnosed with high blood pressure or ‘hypertension’, have ‘essential hypertension’. In other words the cause of the hypertension is not known and is likely that inherited genetic factors as well as environmental factors such your lifestyle, diet and daily exercise play a important role in influencing the symptoms of hypertension.

In each person these factors can have a different affect, and we still have a lot to learn about the genetic factors that cause hypertension, many of which are still being researched. So you can see how it is easy to have the ‘essential hypertension’ label.

As we mentioned earlier some 95% of all hypertensive are ‘essential’ so what about the remaining 5%? Well for these patients there is a specific cause and they are considered to have ‘secondary hypertension’. Such causes of this are kidney failure, hormonal conditions and a narrowing of the arteries to the kidneys. In most cases a G.P can detect these causes or there may be a referral to a nephrologist.

high blood pressure

Are you at greater risk of high blood pressure with age?

Increased systolic blood pressure in more common as we get older.

Is high blood pressure genetic?

There is no single gene that is inherited from our parents that is solely responsible for hypertension. It would be more likely that many different genes are reacting with each other, combined with environmental factors that attribute to hypertension. So you can inherit a greater chance of developing hypertension, but this chance may only increase with the previously mentioned environmental issues.

What is the truth about hypertension and salt?

Many doctors do not believe that salt is the sole cause for many cases of hypertension, but they would all admit that it plays a very important role. It has been seen in cultures where there is a high amount of salt in the populations diet that there are increased numbers of hypertension and cases of heart attacks, strokes etc. But again if you take salt as a major player in the cause of hypertension and then add in the genetic and environmental factors we are already creating a potent recipe for hypertension.

Stress

Your blood pressure can be elevated short term by stress especially emotional stress. So stress can be ruled out as causing hypertension as it doesn’t cause persistent elevation of blood pressure. There are many ways to beat and reduce stress and in-turn reduce the short term affects on your blood pressure. Continue reading →

Corrective Eye Surgery

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What is the best corrective eye surgery for me?

Medical procedures involving corrective eye surgery have made considerable advances and are now both routine and convenient. This has resulted in many more people becoming eligible and ideal candidates for poor vision correction.

There are several different types of corrective eye surgery and the type you will receive will depend on the eye problems you have and how severe those problems are. Many people know only about LASIK corrective eye surgery because it is the one most talked about and most popular. Many patients are also ideal candidates for refractive surgery. A close study of the different types of corrective eye surgery will help you decide which one is most beneficial for you.

Lasik Corrective Eye Surgery

LASIK – which stands for Laser-Assisted In Situ Keratomileusis successfully, treats farsightedness, nearsightedness, and some astigmatism. The severity of your astigmatism will determine if LASIK corrective eye surgery is the best procedure for your condition.

A laser is used by the surgeon to remove material from under a flap cut in the stroma. This surgery normally takes less than one minute for each eye.

Lasek Corrective Eye Surgery

LASEK – which stands for Laser Epithelial Keratomileusis is similar to LASIK corrective eye surgery except the surgeon makes the flap cut in the epithelium instead of the epithelium and the stroma. This surgery is mainly used for people with thin or flat corneas. They are normally suitable candidates for the LASIK surgery because of the condition of their corneas. There are drawbacks to this surgery, a longer healing time, and slightly more discomfort than LASIK surgery.

Corrective Eye Surgery

PRK Corrective Eye Surgery

Photo-refractive Keratectomy is a laser surgery that will successfully treat nearsightedness, mild farsightedness, and some astigmatism problems. This procedure is quick taking less than one minute for each eye. There is no flap cut into the eye as there is with LASIK surgery.

Epi-Lasik Corrective Eye Surgery

Epi-Lasik Corrective Eye Surgeryis where the doctor only cuts a flap in the epithelium and does not use either a surgical blade or alcohol. Alcohol used with eye surgery creates more discomfort than this surgery.

All-Laser Lasik Corrective Eye Surgery

All-Laser Lasik Corrective Eye Surgery an extra laser beam is used instead of a surgical blade in creating the flap in the front of the eye to correct the problem. After the flap is lifted, the second laser beam is used to correct and reshape the eye.

An alternative choice of corrective eye surgery is the nonexcimer laser procedure. This surgery consists of placing artificial lenses in the eye and then reshaping the eye with low heat radio waves, or laser energy. Cutting into the eye surface is also part of this procedure.

For those who have astigmatism, there is a corrective eye surgery called Astigmatic Keratotomy (AK) that will correct a mild astigmatism. Astigmatism of the cornea happens when the cornea is shaped like a football instead of a natural curve. The cornea is reshaped by taking out the bulges affecting the normal curvature of the cornea.

Corrective eye surgery – is ideal for those candidates who have eye problems that are treatable with any type of eye surgery. Some patients with severe eye astigmatisms may not be suitable candidates for corrective eye surgery.

Is weight loss the same as fat loss?

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It seems that the subject of weight loss is almost everywhere; in every magazine, book or television advert. All proudly proclaiming that if you are such and such a height or dress size then you are either the ideal weight or you are OVERWEIGHT. My first real question to all this hype and pressure behind weight loss would be; how can so many body types and shapes possibly fit into the same sizing criteria?

I mean come on now, you can’t tell me a guy who weighs 13 stones and doesn’t exercise, watches the television all day is as healthy as some guy who is 13 stones and the same height and exercises on a regular basis?

Or we could look at this from a different angle. What if we took the same two men and analysed their body composition? Would they be of identical make up if they both weigh the same and are the same height? Highly unlikely, but that is what the media is telling us with statements like ‘You need to be 8 stones in weight if you are 5’ 4″ tall.’ Or ‘To fit into the latest fashion you’ve just got to be a size 10 or less’

Okay so let’s put these guys on the scales and do some analysis. Low and behold there is a difference, a large difference. True they are both the same weight, height and age for that matter, but their body composition is very different. The sedentary man is 35% body fat, on the other hand the man who exercises on a regular basis is 20% body fat, this tells us that of those same 13 stones, man number one is carrying and extra 27 lbs of body fat – that’s nearly two stones more.

weight loss

Easy to see which one is the healthier of the two. But body fat is not just the fat that you can see; around the waist, thighs, bottom and chest. It is also around your internal organs and in your blood stream. Not really the recipe for a good healthy long life is it.

Now lets say that our sedentary man has taken the hint, crumbled under the pressure put on him from all around and decided to go on a crash diet. He’s put up photos of guys with six packs and sworn that he will achieve the same masculine physique in a number of weeks. To do this he shall follow the common guidelines of starving yourself and denying any treats, for the total duration of the diet.

Where has he got this information from? From those readily available magazines that we all love to read. You’ve seen them ‘Lose dress size in a week’ or ‘Lose a stone in 14 days’. Any qualified and knowledgeable nutritionist or personal trainer will tell you that this kind of advice is wrong and can be very damaging to one’s health. And if that is not a good enough not to follow their advice – the long term success rates of these diets are very low. Continue reading →

Do diets work for everyone?

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Diets, healthy eating, weight loss, fat loss, size reduction, call it what you like it’s everywhere. It’s either magazines giving so called expert advice or television adverts proclaiming the latest low fat spread to be the healthiest yet. But they are all trying to impose upon us this ‘one size fits all’ way of thinking, eating and living. We are individuals, just remember that.

If I were to round up ten people of all different shapes, sizes, weights and get them to wear the same one size of clothes. How many of them would actually suit the size of clothes that I had given them? 30%, 40% Maybe more, maybe less. But this is what we are doing when we prescribe the ‘one size fits all’ way of giving diet advice.

You’ve seen it, the food pyramid where there should be x amount of servings of vegetables and fruit per dairy, x amount of servings of dairy and so on and so forth. Do they tell how big each serving is? No they don’t, I know because I’ve studied the subject. But have you noticed how many people this approach actually works for, certainly not everyone. For one reason or another these people are either not helped or fully satisfied by the diet and end up either gaining weight or regaining any weight that they may have lost. After all this is a very boring and restrictive way of living. We can all see that by looking at the next person we are not identical in any way, so why would this be any different when it comes to eating and how much we should eat?

Then we have the ‘low carb’ diets that are all the rage and were all the rage years ago before the ‘low fat revolution’. Why are they so popular? Well great marketing, celebrity testimonials and the promise of weight loss, whether or not it maybe detrimental to your health. I mean most overweight people would tell you they would rather be slim than healthy, crazy if you ask me but vanity is cunningly persuasive animal. So why do these low carbohydrate diets work well for some, bringing out the best in them and filling them with energy and confidence and others report feeling lethargic, grumpy and depressed? It just proves even more that some diets just don’t work for everyone, they can’t do because we are individuals with individual needs.

The most effective way of long term healthy weight loss I have found within my career has been the method of ‘metabolic typing’. The client first has a health assessment to address any current health problems or concerns such as hypertension, high cholesterol, allergies etc. Then they complete a detailed and comprehensive questionnaire about their eating habits and how certain foods affect them. From this method a persons metabolic type can be accurately identified and with it what food types they should include or avoid.

But at the same time, common sense must prevail. As nutritionist it is apparent that all my clients can benefit from eating a diet that is rich in fruit, vegetables, fibre and natural oils. But from the metabolic typing method I am able to see what fruit, vegetables, oils and fibre sources are not suitable for a given client and prescribe a few alternatives.

Then there is the theory surrounding the ‘bad day’, where a client is allowed to eat and drink what ever they like on a given day once a week. Then for the rest of the week they act all saintly; eat and drink only the products that they are allowed. I personally favour the ‘bad day’ along with metabolic typing. It has great results and after all, what fun would there be if you weren’t allowed have a treat now and again? If it didn’t achieve results I’d be out of a job, instead of being a highly sort after health and fitness professional.

I know for a fact when I’ve been on one of my own diets, I’ve longed for the bad day to come along and when it does you almost feel guilty eating all this great tasting, fat laden food. So you end up only eating a fraction of what you initially planned to do.

At the end of the day, do you want to share a diet with the rest of the world? That has very little chance of succeeding? No of course you don’t, you want to lose any required weight in a smart, healthy way. So do yourselves a favour and visit a professional, get a personalised plan and rid yourself of the media stupidity that is all around us. Ever stopped to have a look at the cover pages of these magazines and read their slogans? ‘Lose a stone in a month’ or ‘Drop two dress sizes in two weeks’ absolute garbage! Then have you noticed that after the two weeks or the month, a new diet appears, promising even better results. How can that be, the one you were just offering was supposed to be the best. It is a bit like the best wash powder ever that’s just been improved, but that a whole new rant.

At the end of the day you can’t make bad advice any better can you, it is still going to be bad advice. Where would these magazines be if they gave you the best diet ever? Bankrupt, either that or very thin of topics.