Monthly Archives: December 2022
The more we know about this subject, the better. I have had the first 2 Pfizer jabs, but none since then. I have not had Covid (to my knowledge) but have been exposed to Covid many times, at work and elsewhere. I assume I have now got natural immunity, which is why I have done so well. (so far). Of course, I am not making any recommendations for what any of you should do, but information about the subject is vital to get around all the misinformation that exists. This Dr John Campbell has a number of interesting You-Tube videos similar to the above, which are worth watching. I do not make any apologies for promoting these recent posts because this is an important topic for all of us, as we have to make decisions about what is right for us and our families.
By Will Jones
A leading figure in the British Heart Foundation is suppressing evidence that the Covid vaccines cause heart damage, MP Andrew Bridgen has said.
Speaking in the House of Commons, Mr. Bridgen, the Conservative MP for North West Leicestershire, said:
You can watch this part of Mr. Bridgen’s speech here.
The transcript of Andrew Bridgen’s speech in Parliament is reproduced in full below.
Three months ago, one of the most eminent and trusted cardiologists, a man with an international reputation, Dr. Aseem Malhotra, published peer-reviewed research that concluded that there should be a complete cessation of the administration of the Covid mRNA vaccines for everyone because of clear and robust data of significant harms and little ongoing benefit. He described the roll-out of the BioNTech-Pfizer vaccine as “perhaps the greatest miscarriage of medical science, attack on democracy, damage to population health, and erosion of trust in medicine that we will witness in our lifetime”.
Interestingly, there has so far not been a single rebuttal of Dr. Malhotra’s findings in the scientific literature, despite their widespread circulation and the fact that they made international news.
Before I state the key evidence-based facts that make a clear case for complete suspension of these emergency use authorisation vaccines, it is important to appreciate the key psychological barrier that has prevented these facts from being acknowledged by policymakers and taken up by the U.K. mainstream media. That psychological phenomenon is wilful blindness. It is when human beings – including, in this case, institutions – turn a blind eye to the truth in order to feel safe, reduce anxiety, avoid conflict and protect their prestige and reputations. There are numerous examples of that in recent history, such as the BBC and Jimmy Savile, the Department of Health and Mid Staffs, Hollywood and Harvey Weinstein, and the medical establishment and the OxyContin scandal, which was portrayed in the mini-series “Dopesick”. It is crucial to understand that the longer wilful blindless to the truth continues, the more unnecessary harm it creates.
Here are the cold, hard facts about the mRNA vaccines and an explanation of the structural drivers that continue to be barriers to doctors and the public receiving independent information to make informed decisions about them. Since the rollout in the U.K. of the BioNTech-Pfizer mRNA vaccine, we have had almost half a million Yellow Card reports of adverse effects from the public. That is unprecedented. It is more than all the yellow card reports of the past 40 years combined. An extraordinary rate of side effects that are beyond mild have been reported in many countries across the world that have used the Pfizer vaccine, including, of course, the United States.
Those who feel that they have been damaged by the vaccine should of course have the full support of their elected Members of Parliament and the NHS. Only a couple of weeks ago, I was interviewed by a journalist from a major news outlet who said that he was being bombarded by calls from people who said that they were vaccine-harmed but unable to get the support they wanted from the NHS. He also said that he thought this would be the biggest scandal in medical history in this country. Disturbingly, he also said that he feared that if he were to mention that in the newsroom in which he worked, he would lose his job. We need to break this conspiracy of silence.
It is instructive to note that, according to pharmaco-vigilance analysis, the serious adverse effects reported by the public are thought to represent only 10% of the true rate of serious adverse events occurring within the population. The gold standard of understanding the benefit and harm of any drug is the randomised controlled trial. It was the randomised controlled trial conducted by Pfizer that led to U.K. and international regulators approving the BioNTech-Pfizer mRNA vaccine for administration in the first place.
Contrary to popular belief, that original trial of approximately 40,000 participants did not show any statistically significant reduction in death as a result of vaccination, but it did show a 95% relative risk reduction in the development of infection against the ancestral, more lethal strain of the virus. However, the absolute risk reduction for an individual was only 0.84%. In other words, from its own data, Pfizer revealed that we needed to vaccinate 119 people to prevent one infection. The World Health Organisation and the Academy of Medical Royal Colleges have previously stated and made it clear that it is an ethical responsibility that medical information is communicated to patients in absolute benefit and absolute risk terms, which is to protect the public from unnecessary anxiety and manipulation.
Very quickly, through mutations of the original strain – indeed, within a few months – Covid fortunately became far less lethal. It quickly became apparent that there was no protection against infection at all from the vaccine, and we were left with the hope that perhaps these vaccines would protect us from serious illness and death. So what does the most reliable data tell us about the best-case scenario of individual benefit from the vaccine against dying from COVID-19? Real-world data from the U.K. during the three-month wave of Omicron at the beginning of this year reveals that we would need to vaccinate 7,300 people over the age of 80 to prevent one death. The number needed to be vaccinated to prevent a death in any younger age group was absolutely enormous.
Of course, it is important that the Government justify why they are rolling out a vaccine to any cohort of people, particularly our children. He will recall that, in the Westminster Hall debate, we questioned the validity of vaccinating children who have minimal risk, if a risk at all, from the virus when there is a clear risk from the vaccine. I will again report on evidence from America later in my speech about those risks, particularly to young children.
In other words, the benefits of the vaccine are close to non-existent. Beyond the alarming Yellow Card reports, the strongest evidence of harm comes from the gold standard, highest possible quality level of data. A re-analysis of Pfizer and Moderna’s own randomised controlled trials using the mRNA technology, published in the peer-reviewed journal Vaccine, revealed a rate of serious adverse events of one in 800 individuals vaccinated. These are events that result in hospitalisation or disability, or that are life changing. Most disturbing of all, however, is that those original trials suggested someone was far more likely to suffer a serious side effect from the vaccine than to be hospitalised with the ancestral, more lethal strain of the virus. These findings are a smoking gun suggesting the vaccine should likely never have been approved in the first place.
In the past, vaccines have been completely withdrawn from use for a much lower incidence of serious harm. For example, the swine flu vaccine was withdrawn in 1976 for causing Guillain-Barré syndrome in only one in 100,000 adults, and in 1999 the rotavirus vaccine was withdrawn for causing a form of bowel obstruction in children affecting one in 10,000. With the covid mRNA vaccine, we are talking of a serious adverse event rate of at least one in 800, because that was the rate determined in the two months when Pfizer actually followed the patients following their vaccination. Unfortunately, some of those serious events, such as heart attack, stroke and pulmonary embolism will result in death, which is devastating for individuals and the families they leave behind. Many of these events may take longer than eight weeks post vaccination to show themselves.
An Israeli paper published in Nature’s scientific reports showed a 25% increase in heart attack and cardiac arrest in 16 to 39-year-olds in Israel. Another report from Israel looked at levels of myocarditis and pericarditis in people who had had covid and those who had not. It was a study of, I think, 1.2 million who had not had Covid and 740,000 who had had it. The incidence of myocarditis and pericarditis was identical in both groups. This would tell the House that whatever is causing the increase in heart problems now, it is not due to having been infected with COVID-19.
It was accepted by a peer-reviewed medical journal that one of the country’s most respected and decorated general practitioners, the honorary vice-president of the British Medical Association and the Labour party’s doctor of the year, Dr. Kailash Chand, likely suffered a cardiac arrest and was tragically killed by the Pfizer vaccine six months after his second dose, through a mechanism that rapidly accelerates heart disease. In fact, in the U.K. we have had an extra 14,000 out-of-hospital cardiac arrests in 2021, compared with 2020, following the vaccine rollout. Many of these will undoubtedly be because of the vaccine, and the consequences of this mRNA jab are clearly serious and common.
Ministers may understandably wish to defer the responsibility for a decision such as withdrawing vaccines from the population to regulators such as the Medicines and Healthcare products Regulatory Agency, or in America the Food and Drug Administration. Historically, when undertaking the approval of any drug, the regulators ultimately end up relying on the summary results from the drug companies in their sponsored trials, where the raw data is kept commercially confidential. Furthermore, the MHRA has a huge financial conflict of interest, receiving 86% of its funding from the pharmaceutical industry it is supposed to regulate. In effect, we have the poacher paying the gamekeeper.
In a recent investigation by the BMJ into the financial conflicts of interest of the drug regulators, the sociologist Donald Light said: “It’s the opposite of having a trustworthy organisation independently and rigorously assessing medicines. They’re not rigorous, they’re not independent, they are selective, and they withhold data.”
He went on to say that doctors and patients “must appreciate how deeply and extensively drug regulators can’t be trusted so long as they are captured by industry funding”.
Similarly, another investigation revealed that members of the Joint Committee on Vaccination and Immunisation had huge financial links to the Bill and Melinda Gates Foundation running into billions of pounds. Ministers, the media and the public know that the foundation is heavily invested in pharmaceutical industry stocks.
Unfortunately, the catastrophic mistake over the approval, and the coercion associated with this emergency-use authorisation medical intervention, are not an anomaly, and in many ways this could have been predicted by the structural failures that allowed it to occur in the first place. Those shortcomings are rooted in the increasingly unchecked visible and invisible power of multinational corporations – in this case, Big Pharma. We can start by acknowledging that the drug industry has a fiduciary obligation to produce profit for its shareholders, but it has no fiduciary obligation to provide the right medicines for patients.
The real scandal is that those with a responsibility to patients and with scientific integrity – namely, doctors, academic institutions and medical journals – collude with the industry for financial gain. Big Pharma exerts its power by capturing the political environment through lobbying and the knowledge environment through funding university research and influencing medical education, preference shaping through capture of the media, financing think-tanks and so on. In other words, the public relations machinery of Big Pharma excels in subterfuge and engages in smearing and de-platforming those who call out its manipulations. No doubt it will be very busy this evening.
It is no surprise, when there is so much control by an entity that has been described as ‘psychopathic’ for its profit-making conduct, that one analysis suggests that third most common cause of death globally after heart disease and cancer is the side-effects of prescribed medications, which were mostly avoidable. Because of those systemic failures, doctors often receive biased information, deliberately manipulated by the pharmaceutical industry, which exaggerates the benefits and the safety of their drugs. Furthermore, the former editor of the BMJ, Richard Smith, claims that research misconduct is rife and is not effectively being tackled in the U.K. institutions, stating: “Something is rotten in… British medicine and has been for a long time.”
It has also been brought to my attention by a whistleblower from a very reliable source that one of these institutions is covering up clear data that reveals that the mRNA vaccine increases inflammation of the heart arteries. It is covering this up for fear that it may lose funding from the pharmaceutical industry. The lead of that cardiology research department has a prominent leadership role with the British Heart Foundation, and I am disappointed to say that he has sent out non-disclosure agreements to his research team to ensure that this important data never sees the light of day. That is an absolute disgrace. Systemic failure in an over-medicated population also contributes to huge waste of British taxpayers’ money and increasing strain on the NHS.
We need an inquiry into the influence of Big Pharma on medications and our NHS. That is been called for many occasions and by some very influential people, including prominent physicians such as the former president of the Royal College of Physicians and personal doctor to our late Queen, Sir Richard Thompson. On separate occasions in the last few years those calls have been supported and covered in the Daily Mail, the Guardian and, most recently, the i newspaper.
We are fighting not just for principles of ethical, evidence-based medical practices, but for our democracy. The future health of the British public depends on us tackling head-on the cause of this problem and finding meaningful solutions. In 2015 a commentary by Richard Houghton, Editor-in-Chief of the Lancet, suggested that possibly half of the published medical literature “may simply be untrue”. He wrote that “science has taken a turn toward darkness”, and asked who is going to take the first step to clean up the system.
That first step could start this evening with this debate. It starts here, with the Vaccine Minister and the Government ensuring in the first instance an immediate and complete suspension of any more Covid vaccines with their use of mRNA technology. Silence on this issue is more contagious than the virus itself, and now so should courage be. I would implore all the scientists, medics, nurses and those in the media who know the truth about the harm these vaccines are causing to our people to speak out.
We have already sacrificed far too many of our citizens on the altar of ignorance and unfettered corporate greed. Last week the MHRA authorised those experimental vaccines for use in children as young as six months. In a Westminster Hall debate some weeks ago, I quoted a report by the Journal of the American Medical Association studying the effect of the COVID-19 mRNA vaccination on children under five years of age. It showed that one in  had an adverse event that resulted in hospitalisation, and symptoms that lasted longer than 90 days.
As the data clearly shows to anyone who wants to look at it, the mRNA vaccines are not safe, not effective and not necessary. I implore the Government to halt their use immediately. As I have demonstrated and as the data clearly shows, the Government’s current policy on the mRNA vaccines is on the wrong side of medical ethics, it is on the wrong side of scientific data, and ultimately it will be on the wrong side of history
This is a favorite topic of mine, which many of my long term patients would know. Two I am particularly are concerned about is the over prescription of Statins (See “The Truth about Statins”on a previous blog) and PPIs like Nexium and others for Reflux. Type in “PPI”in the search engine of my web-site for the reason to get off PPIs. I am well aware of the points he makes below, and this whole last 3 years of Covid is a good example of Pharmaceutical companies doing what they do best. I am restricted in what I can say without being sued, but you can work it out for yourselves. I have given plenty of hints over the last 2 years.
This is my last working day until 9th of January, when I return to work. Have a lovely and blessed Christmas and New year.
Cheers from me for now.
The disease guidelines industry: How independent is it, really?
24 October 2022
Australian Doctor recently reported on an expert-written guideline urging Australian GPs to inform patients with mild dementia that a multivitamin supplement had been shown to help.
In the guideline, the product is twice referred to by its generic name Fortasyn Connect, but is sold as Souvenaid.
The wording of the guideline refers to the findings of an RTC involving the supplement and specifically says patients “should be informed of these results and the availability of Fortasyn Connect in Australia”.
You can read the full wording yourself at the end of this article.
The cost of the supplement is not cheap — about $1500 a year. And there are no PBS subsidies given, as I will explain, the paucity of evidence for its efficacy.
But the important point here is that the manufacturer of the product was the sole sponsor of these guidelines and paid for the article’s medical writer.
One of the authors of the guideline, an associate professor at Austin Health, defended the recommendation, telling Australian Doctor: “We were happy to receive the money from the company, Nutricia, but I do not believe there was any influence on the guidelines or the workshop outcomes.”
Authors can and do say that.
I’m not alleging anything deliberately untoward in the creation of this guideline. I don’t have any evidence to say whether there was or not.
But if I had a dollar for every time I heard the same claim, I could afford to sponsor a guideline myself.
After 25 years as a medical editor, I do more claim-checking than most. I have developed a ‘Spidey sense’ for picking statements that stand out as being unusually positive towards a particular medication.
In general, the authors of guidelines are often unaware of their own biases.
They are experts in their field, but for years, they have chosen to upskill themselves surrounded by a sea of pharmaceutical-company-influenced colleagues, on boards, working groups and guideline panels. Like all cultures, it shapes you.
Arguably the most influential guidelines in the world emanate from the US, where 75% of authors declare pharmaceutical conflicts of interest, many of them receive six-figure sums over a career.1
Most of those guidelines expand disease definitions and suggest we aren’t diagnosing often enough.
Not one of the 16 major guides includes a rigorous assessment of potential harms of overdiagnosis.1
The sponsoring company pays for everything and everyone, from go to whoa.
They would typically invite a specialist who is on their advisory board to run the show. That chair then helps select co-authors they are familiar with — rarely straying from the small pool of other specialists who inhabit the same pharma-sponsored world.
Typically, co-authors will have career-long relationships with a number of companies rather than just having received a grant for research.
Occasionally, they include a non-conflicted GP or representative of a patient advocacy group.
Very rarely is anyone from ‘outside the tent’ invited; no doctor, epidemiologist or health economist with a history of independent scepticism, who could have drawn the panel’s attention to evidence countering medication-friendly recommendations. This is a missed chance to improve the guidelines for the end users: patients.
Little time (often no page space) is spent considering the harms or costs of medication or the population groups where medication is not recommended.
Add in a professional medical writer and — bingo! — you have a very publishable paper with plenty of useful information, but one that recommends GPs diagnose more and prescribe more.
The article on mild dementia contains much that is useful, yet its very design is unambiguously conflicted.
Both specialists who collated the recommendations are paid members of the advisory board of the sponsor.
Of the eight doctors on the author list, five list multiple pharmaceutical conflicts of interest.
However, when I looked up the Disclosure Australia database (where pharma is mandated to name doctors whom they pay), two of the other three had also received payments from pharmaceutical companies that they chose not to disclose.
That leaves a grand total of one independent GP.
None of that makes the guideline wrong or unethical, yet to me, it sends the strong message that GPs are failing to diagnose up to a million Australians who have mild dementia.
And once we diagnose them, we should discuss the evidence (based on a single small company-sponsored study with a high dropout rate) promoting the sponsors’ particular brand of multivitamin.
The double-blinded trial involved 311 patients aged 55-85 who either received Souvenaid (153) or a same-tasting placebo drink (158); however, only 45 participants remained in the active group by the end of the three-year follow-up.
The authors concluded that the drink slowed cognitive decline and brain atrophy in patients with prodromal Alzheimer’s disease.
For me, that sort of study would be unlikely to be included, let alone highlighted, by an independent group.
Yes, the guideline may be worded in a way that doctors are expected only to discuss the evidence for this product rather than actively recommend its use.
But when a doctor mentions any possible therapeutic options in a consult, patients are influenced by an unspoken subtext that the doctor thinks those options are worth following.
Nowhere does the guideline mention cost, number-needed-to-treat or the potential impact of diverting time and resources.
The extent to which conflicts of interests distort expert advice is an age-old chestnut.
But there is a simple fix.
I would like to see all national guidelines that advise doctors about prescription decisions make a substantial shift towards independence, away from the companies that profit from those prescriptions and the specialists they employ.
We owe that to our patients.
Lifestyle prescription for mental health – 9 strategies for GPs
/ Lifestyle prescription for mental health – 9 strategies for GPs
Jonah Hill’s Netflix documentary, Stutz, is an insightful journey into the mind of his therapist, renowned psychiatrist Phil Stutz. Hill delves into Stutz’ model of care, creatively using visual depictions of key concepts and “tools” drawn by Stutz himself.
This model is founded upon one’s relationship with their physical body. When he’s discussing the importance of health behaviours like exercise, diet and sleep, Stutz estimates 85% of the initial gains to someone with mental health concerns commencing therapy can come from focusing on these “lifestyle” factors. Surprised, Hill says in the film:
When I was a kid, exercise and diet was framed to me in like, ‘there’s something wrong with how you look’. But never once was exercise or diet propositioned to me in terms of mental health. I just wish that was presented to people differently. Because for me, that caused a lot of problems.
So, is Stutz right?
What does the latest evidence tell us?
While the 85% figure is debatable, there is now good evidence therapies targeting lifestyle factors can be a critical part of treating psychiatric conditions such as depression. A recent meta-analysis (which brings together results from different research studies) shows exercise may be as powerful as anti-depressant medication for depression.
Our own research shows a modified Mediterranean diet can substantially improve symptoms and functioning of people living with moderate to severe depression.
The mental health benefits of these interventions occur independent of weight loss, can be used in combination with medications (such as antidepressants or antipsychotics) and are cost-effective because of societal gains such increased workplace productivity.
And the benefits of these approaches can be be experienced relatively quickly, with effects evident in as little as three weeks.
Lifestyle changes can reduce the risk of common conditions such as heart disease and diabetes, which contribute to the 20-year life expectancy gap for those experiencing mental illness.
The principal organisation representing the medical specialty of psychiatry, the Royal Australian and New Zealand College of Psychiatrists, now recommends lifestyle modification should be considered the first step in treating depression.
Despite all of this, this approach has not been comprehensively taken up by mainstream mental health-care providers in Australia or in the setting of the Stutz documentary, the United States. https://www.youtube.com/embed/UKCmefQdplI?wmode=transparent&start=0‘You have to give somebody the feeling they can change right now.’
The use of lifestyle therapies is a reasonably new area to psychiatry compared to other treatments such as antidepressant medication or talk therapy with psychologists. Our randomised control trial showing diet can be a treatment strategy for depression mentioned previously was the first of its kind and was only completed in 2017.
There are various barriers to its translation in mental health care: training, funding, access and variability in quality given the historical absence of guidelines.
In October, we published the first international guidelines that can be used across any clinical setting – from general practices, to specialist mental health care and by dietitians – in any country. They cover nine established and emerging lifestyle “pillars” to support whole-of-person care. These are:
1. physical activity and exercise – improving aerobic and resistance training, yoga, reducing sedentary behaviours
2. relaxation techniques – such as guided breathing exercises
3. engaging (or re-engaging) with employment or volunteering
4. getting enough sleep
5. mindfulness-based therapies and stress management (including coping skills)
6. healthy diet that includes intake of a wide variety of plant-based whole foods and minimises highly processed foods
7. quitting smoking
8. improving social connections
9. interaction with nature – in green spaces such as forests and parks, and blue spaces like the ocean or creeks and rivers.
Clinicians can shape their approach in four key ways:
- increase lifestyle and social assessments. Our guidelines contain a list of recommended tools to capture changes in a patient’s health behaviours across the course of therapy as well as social screening tools to help understand their socioeconomic backdrop (such as stable housing, access to resources)
- get input from allied health professionals (such as dietitians or exercise physiologists), patients’ support networks including other health professionals, community, family, carers and peers. It’s important to know, for example, how someone’s household or neighbourhood may shape their ability to give up smoking
- identify behavioural change strategies. Each individual will have a different mindset in terms of their openness to changing their behaviours. Clinicians can use the guidelines to identify the best strategies for different individuals
- help reduce stigma and/or assumptions that lifestyle is a choice. Instead, understand and explain to patients how individual, social and commercial factors can play a role and make it harder for them to make changes. This can make it feel less like a personal responsibility or fault and help navigate realistic changes.
Still more to understand
While these guidelines and resources are an important first step, there are key questions in this field that remain unanswered.
These include how to best personalise treatments using a person’s unique physiology, genetics, demographics, background and individual preferences.
We need to examine how this approach compares to gold-standard care such as psychotherapy, especially for more severe depression. We are currently testing this question and recruiting participants for a national trial.
It is important to note medication and other therapies can play an important role in mental health treatment. Medications should not be ceased or changed without consulting a medical professional. We have also created a course for health professionals who want additional support.
For now, our guidelines provide a way for health professionals to begin addressing Jonah Hill’s point – that lifestyle factors should be presented to people as critical to their mental health.
The dangers of ‘bikini medicine’
By Alistair Gardiner
- The term “bikini medicine” refers to the mistaken belief that women’s health only differs from men’s in the parts of the body that a bikini would cover. Research has debunked this theory.
- Healthcare may be failing women due to outdated practices based on such beliefs. Research indicates many physicians still prescribe the same doses of cardiovascular medication for men and women, even though women are more than twice as likely to experience adverse reactions. Sex also affects the diagnosis of mental illnesses, including attention deficit/hyperactivity disorder.
- Female patients with stroke tend to present with certain symptoms that male stroke patients don’t experience. And as the pandemic data accrues, research is uncovering sex-specific differences in the impact of SARS-CoV-2.
Healthcare historically has taken a one-size-fits-all approach to diagnosis and treatment. Here’s one reason why: Men have historically had far greater representation in clinical studies than women—and evidence suggests that this under-representation leads to poorer outcomes for female patients.
Sex differences lead to underdiagnosis or diagnostic delay in more than 700 diseases for women, compared with men, according to an article published by the University of Colorado’sLudeman Family Center for Women’s Health Research.
The outdated and sexist idea that men and women should be cared for similarly has been dubbed “bikini medicine,” a nod to the mistaken belief that women’s health only differs from men’s in the parts of the body that a bikini would cover.
Research has debunked this theory. As noted in a study published in Nature, sex and gender are essential considerations for precision medicine (sex defined as the biological component; gender as a social construction).
Study authors pointed out that conditions such as cardiovascular disease, osteoporosis, and autoimmune diseases affect men and women differently.
Study authors pointed out that conditions such as cardiovascular disease, osteoporosis, and autoimmune diseases affect men and women differently.
What’s more, some diseases affect both sexes at similar rates, yet women tend to be underdiagnosed.
In light of this, here’s a brief overview of some of the ways that routine healthcare may be failing women, due to outdated practices and beliefs.
Sex affects many aspects of cardiovascular diseases, from how symptoms present to how the body interacts with medications. For example, research cited in the aforementioned University of Colorado article indicates that women taking cardiovascular medication are more than twice as likely to experience adverse reactions than men taking the same meds.
Despite this, many physicians continue to prescribe the same dose for men and women.
A study published in Circulation in February of this year presents another consideration. For decades, the normal upper limit for adult systolic blood pressure (SBP) has been 120 mm Hg—but researchers concluded that the sex-specific definition of optimal SBP for women may need to be lowered.
The study included a cohort of 27,542 individuals with standard SBP, 54% of whom were women. Analyzing 28 years of participant health data, researchers found that cardiovascular disease risk and incidence increased at the lower thresholds of SBP for women compared with men.
They posited that this disparity may be due to sex-specific differences in vascular anatomy and physiology—women tended to have smaller arterial diameters compared with men, after normalizing for body size, for example. They concluded that the physiologic range for SBP should be reassessed on a sex-specific basis, because using the same range could lead to missed cardiovascular disease diagnosis in women.
Mental illness and mental health
Sex also affects the diagnosis of mental illnesses, including attention deficit/hyperactivity disorder (ADHD), according to a study published in the Nordic Journal of Psychiatry in November 2020.
Researchers examined health data on 50 boys and 50 girls under the age of 18 with a diagnosis of ADHD. The researchers focused on referral reason, diagnostic process, and treatment.
They found that, on average, female patients visited the clinic more frequently before receiving a diagnosis, and that the female patients were more likely to have been prescribed non-ADHD medication (typically for emotional symptoms) before and after diagnosis.
Female patients were more likely to be referred to a clinic for suspected emotional problems, researchers noted, while boys tended to be referred with symptoms of a neurodevelopmental disorder.
Female patients were more likely to be referred to a clinic for suspected emotional problems, researchers noted, while boys tended to be referred with symptoms of a neurodevelopmental disorder.
Researchers posited that ADHD symptoms in girls may not be recognized by teachers and/or parents until they are older—and by this point, patients may have increased emotional problems as a result of living with undiagnosed ADHD. Hormonal differences and societal perception of gendered behaviors could also be explanations.
A study published in BMJ Open Sport & Exercise Medicine in March of this year found evidence of other sex-specific differences in mental health symptoms.
Researchers examined a cohort of 523 professional athletes, 56% of whom were women, and found that female athletes tend to report higher rates of mental health symptoms, and lower rates of mental well-being. Researchers noted various social factors, including the gender pay gap and public social media abuse, as possible reasons for this.
In some cases, knowing sex-specific differences in symptoms can become a matter of life and death. For example, female patients with stroke tend to present with certain symptoms that male stroke patients don’t experience, according to materials provided by Northwestern Medicine.
During a stroke, men and women typically report numbness or weakness in the face, arm, or leg; confusion; trouble speaking or seeing; difficulty walking; dizziness or loss of balance; or severe headache. The following symptoms are, however, specific to women: hiccups, nausea, chest pain, fatigue, shortness of breath, and a racing heartbeat.
Women tend to have more risk factors for stroke (including prescriptions for birth control pills, current pregnancy, diagnosed atrial fibrillation, and others), and one in five women will have a stroke in their lifetime.
As the pandemic data accrues, research is uncovering sex-specific differences in the impact of SARS-CoV-2.
In a Journal of Women’s Health study from March of this year, which used data from 1.4 million patients, collected between January 1 and May 1, 2020, researchers found that headache, anosmia, and ageusia were significantly more frequent in females.
Ear, nose, and throat symptoms were also more common in women. Chest X-ray and blood tests were performed less frequently in females, and women were hospitalized and admitted to the ICU less frequently, the data showed.
Researchers concluded that “women were more heavily impacted by COVID-19 than men (specifically teenagers and young adults)” and they recommended further research “to identify and close the gender gap in the diagnosis and treatment of COVID-19.”
Outdated beliefs such as the “bikini medicine” theory can impact how physicians care for men and women. According to research, such misconceptions can affect how women are treated for cardiovascular disease, mental illness, stroke, and SARS CoV-2. Be mindful of the anatomical differences between the sexes in your treatment of patients to ensure their care isn’t compromised due to such beliefs.
We’re told to ‘eat a rainbow’ of fruit and vegetables. Here’s what each colour does in our body
Published: November 25, 2022 9.42am AEDT
- Evangeline Mantzioris Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
Evangeline Mantzioris is affiliated with Alliance for Research in Nutrition, Exercise and Activity (ARENA) at the University of South Australia. Evangeline Mantzioris has received funding from the National Health and Medical Research Council, and has been appointed to the National Health and Medical Research Council Dietary Guideline Expert Committee.
We believe in the free flow of information
Nutritionists will tell you to eat a rainbow of fruit and vegetables. This isn’t just because it looks nice on the plate. Each colour signifies different nutrients our body needs.
The nutrients found in plant foods are broadly referred to as phytonutrients. There are at least 5,000 known phytonutrients, and probably many more.
So what does each colour do for our body and our overall health?
Red fruits and vegetables are coloured by a type of phytonutrient called “carotenoids” (including ones named lycopene, flavones and quercetin – but the names aren’t as important as what they do). These carotenoids are found in tomatoes, apples, cherries, watermelon, red grapes, strawberries and capsicum.
These carotenoids are known as antioxidants. You will have heard this name before, but you might not remember what it means. It has something to do with “free radicals”, which you’ve also probably heard of before.
Free radicals are formed naturally in our body as a byproduct of all our usual bodily processes such as breathing and moving, but they also come from UV light exposure, smoking, air-pollutants and industrial chemicals.
Free radicals are unstable molecules that can damage proteins, cell membranes and DNA in our body. This natural but damaging process is known as oxidation or oxidative stress. This contributes to ageing, inflammation and diseases including cancer and heart disease.
Importantly, antioxidants “mop up” the free radicals that form in our body. They stabilise the free radicals so they no longer cause damage.
Increasing antioxidants in your diet lowers oxidative stress and reduces the risk of many diseases including arthritis, type 2 diabetes, heart disease, stroke and cancer.
Orange fruits and vegetables also contain carotenoids, but slightly different ones to red veggies (including alpha and beta-carotene, curcuminoids, and others). These are found in carrots, pumpkins, apricots, mandarins, oranges and turmeric.
Alpha and beta-carotene are converted to vitamin A in our bodies, which is important for healthy eyes and good eyesight. Vitamin A is also an antioxidant that can target the parts of your body made of lipids (or fats) such as cell membranes.
The vitamin A targets the free radicals building up around our cell membranes and other areas made of lipids, reducing the risk of cancers and heart disease.
Yellow fruit and vegetables also contain carotenoids, but they also contain other phytonutrients including lutein, zeaxanthin, meso-zeaxanthin, viola-xanthin and others. These are found in apples, pears, bananas, lemons and pineapple.
Lutein, meso-zeaxanthin and zeaxanthin have been shown to be particularly important for eye health and can reduce the risk of age-related macular degeneration, which leads to blurring of your central vision.
These phytonutrients can also absorb UV light in your eyes, acting like a sunscreen for the eyes and protecting them from sun damage.
Green fruits and vegetables contain many phytonutrients including chlorophyll (which you probably remember from high school biology), catechins, epigallocatechin gallate, phytosterols, nitrates and also an important nutrient known as folate (or vitamin B9). These are found in avocados, Brussels sprouts, apples, pears, green tea and leafy vegetables.
These also act as antioxidants and therefore have the benefits as described above for red veggies. But this group also provides important benefits in keeping your blood vessels healthy, by promoting something called “vasodilation”.
These phytonutrients help make our blood vessels more elastic and flexible allowing them to widen or dilate. This improves blood circulation and reduces blood pressure, reducing our risk of heart and other vessel complications and disease.
Folate is recommended before pregnancy because it helps reduce the risk of neural tube defects (such as spina bifida) in babies. Folate helps the development of the foetal nervous system during the first few weeks of pregnancy, as it has been shown to promote healthy cell division and DNA synthesis.
Blue and purple
Blue and purple produce contain other types of phytonutrients including anthocyanins, resveratrol, tannins and others. They are found in blackberries, blueberries, figs, prunes and purple grapes.
Anthocyanins also have antioxidant properties and so provide benefits in reducing the risk of cancer, heart disease and stroke, as explained under red fruit and veg.
More recent evidence has indicated they may also provide improvements in memory. It is thought this occurs by improving signalling between brain cells and making it easier for the brain to change and adapt to new information (known as brain plasticity).
Brown and white
Brown and white fruits and vegetables are coloured by a group of phytonutrients known as “flavones”, this includes apigenin, luteolin, isoetin and others. These are found in foods such as garlic, potatoes and bananas.
Another phytonutrient found in this colour of vegetables, particularly in garlic, is allicin. Allicin has been shown to have anti-bacterial and anti-viral properties.
Most of this research is still at the lab-bench and not many clinical trials have been done in humans, but lab-based studies have found it reduces microorganisms when grown under laboratory conditions.
How can I get more veggies in my diet?
Coloured fruit and vegetables, and also herbs, spices, legumes and nuts provide us with a plethora of phytonutrients. Promoting a rainbow of fruit and vegetables is a simple strategy to maximise health benefits across all age groups.
However most of us don’t get the recommended amount of fruit and vegetables each day. Here are some tips to improve your intake:
1. when doing your fruit and vegetable shopping, include a rainbow of colours in your shopping basket (frozen varieties are absolutely fine)
2. try some new fruit and vegetables you haven’t had before. The internet has tips on many different ways to cook veggies
3. buy different colours of the fruit and vegetables you normally eat like apples, grapes, onions and lettuces
4. eat the skins, as the phytonutrients may be present in the skin in higher amounts
5. don’t forget herbs and spices also contain phytonutrients, add them to your cooking as well (they also make vegetables more appealing!)
Yesterday’s blog certainly stirred up some interest. When I said it may offend some I was generally referring to politicians and some in the medical profession. The general public have more commonsense and understand these issues better.
Why am I bloated? Here are some possibilities to consider
Published: November 15, 2022 10.51am AEDT
- Saman Khalesi Postdoctoral Fellow of the National Heart Foundation & Senior Lecturer and Discipline Lead in Nutrition, School of Health, Medical and Applied Sciences, CQUniversity Australia
- Chris Irwin Senior Lecturer in Nutrition and Dietetics, School of Health Sciences & Social Work, Griffith University
Dr Khalesi was supported by a Postdoctoral Fellowship (Award No. 102584) from the National Heart Foundation of Australia.
Chris Irwin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
If your tummy seems to feel full or stretched and is rumbling all the time, you’re not alone. Up to 30% of people of all ages experience bloating, with symptoms such as gassiness, a sense of fullness and pressure.
This can be with or without distention (a visible increase in abdominal girth).
So what might be behind your bloating?
Get news curated by experts, not algorithms.
The role of gas
Bloating is in fact a complex condition that can be caused by several direct and indirect factors. Gas often plays a role.
Gas production in the digestive system is part of the normal digestion process, and is released through the mouth (burps) or anus (farts).
On average, our gas expulsion is around 600–700 millilitres per day, resulting in around 14 farts a day. That said, there isn’t a set number for the normal amount of gas or expulsions; each body is different.
Bloating can occur as a result of retained gas, excess gas production, altered gas transit (changes in the speed and movement of gas), or intestinal hypersensitivity.
An imbalanced gut microbiome can lead to the overproduction of gas. What is the human microbiome?
We have more than 40 trillion microbes living in and on our body. They can be helpful or harmful. The balance between these helpful and harmful microbes plays an important role in our immune response, metabolism and health.
These bacteria need food to survive. Their food comes from fermenting carbohydrates such as dietary fibre from the plants we eat.
One of the byproducts of this fermentation process is hydrogen gas.
Most of these microbes live in the lower parts of our intestine (colon). The upper parts of the intestine (small intestine) have far fewer microbes.
But if an excessive number of microbes colonise the small intestine (a condition known as small intestine bacterial overgrowth), more gas is produced in the small intestine.
This can lead to bloating, abdominal discomfort, diarrhoea and nausea.
Could it be IBS, lactose issues or FODMAPs?
Some disorders of the intestine and colon can affect the amount of gas and severity of bloating symptoms.
For example, in constipation, movement of stools is reduced, allowing more time for the bacteria to ferment the stool content, increasing gas production.
Bloating is also very common in people with irritable bowel syndrom (IBS).
Changes in gut muscle tone and greater sensitivity to gas contribute to bloating in IBS sufferers.
Bloating may also occur because of poor digestion and malabsorption of some carbohydrates.
Lactose malabsorption (in those with lactose intolerance) is a common issue.
Symptoms may also occur with other digestive resistant short-chain carbohydrates known as FODMAPs (fermentable oligo-, di-, monosaccharides and polyols).
FODMAPs are found in a wide variety of foods, including certain fruit and vegetables, grains and cereals, nuts, legumes, lentils and dairy foods.
While these are good foods for our gut bacteria, they can add to gas production and trigger bloating symptoms, especially in people with digestive disorders (like IBS). They can also cause water to be drawn into the intestines, causing distension. This can contribute to bloating.
Other factors: salt, hormones or swallowing air
There are of course other factors that could be behind bloating.
For example, consuming too much sodium or salt in your diet causes water retention, resulting in abdominal distention. But this may also alter the gut microbiome and influence gas production.
For many women, bloating can be linked to the menstrual cycle phase. This is most common at the onset of bleeding, when peak fluid retention occurs, but is also related to underlying hormonal changes.
Swallowing too much air, especially when eating, can also increase the amount of gas entering the gastrointestinal tract and lead to bloating.
Talking while eating, eating in a rush, and carbonated beverages can also increase the amount of air swallowed.
How can I reduce bloating?
Dietary strategies can be effective ways of managing bloating. While foods that trigger symptoms can be different for everyone, you could try to:
- eat fewer gas-producing FODMAP foods such as onion, cabbage, brussels sprouts, cauliflower, dried beans and lentils
- eat fewer foods containing lactose, like milk, ice-cream and some yoghurts (there are lactose-free alternatives for people with intolerance)
- replace carbonated drinks such as soft-drinks with water, and drink less alcohol
- consume more probiotics (such as yoghurt or certain fermented foods)
- do more exercise, as mild physical activity enhances intestinal gas clearance and can reduce symptoms of abdominal bloating
- eat and drink more slowly; taking your time means you can enjoy your food, but will also help you swallow less air.
See an accredited practising dietitian for personalised advice on managing symptoms using dietary strategies.
When to see a GP
Most of the time, bloating goes away soon enough and is no cause for concern. But consider seeing a doctor if:
- your gas is persistent and severe and it’s impacting your quality of life
- your gas is associated with other symptoms such as vomiting, diarrhoea, constipation, unintentional weight loss or blood in the stool.
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