In July, the Healthy London Partnership launched NHS Go, a new website and mobile phone app aimed at young people. These new digital resources aim to:
Give young people greater control over their health;
Enable young people to make healthier choices;
Provide trusted advice and information on a range of health issues.
The app is aimed at 16-26 year olds after young people stated that they wanted better and easier access to health and wellbeing information. In creating the app and website the NHS worked with young people at all stages of development. They have also recruited well-known YouTube vloggers to not only promote the app but raise awareness of a number of health issues.
One of the YouTube vloggers supporting this campaign is the very popular hair vlogger Laila whose YouTube channel, Fusion of Cultures, has over 179,000 subscribers. As well as creating a promotional video with other vloggers, Laila has also discussed mental health touching on anxiety, suicide and depression.
Black Health is Covered in NHS Go
NHS Go has a section on black health. This section starts with diabetes, explaining how young people can reduce their risk of developing diabetes. There is a also a personal story from diabetic Brian Hunte, a Trinidadian who lives in London and was diagnosed with diabetes 24 years ago. He shares his story telling of how diabetes affects his daily life
“When I was diagnosed with diabetes, it was a surprise. I didn’t feel unwell, but I had been losing weight and I felt thirsty all the time. I was drinking lots of water and going to the loo more often. I had to get up twice in the night to urinate, which wasn’t normal for me.” – Brian Hunte, diabetic
Another black health issue that NHS Go covers is vitamin D. Black people are more likely to have a vitamin D deficiency because melanin blocks the sun’s UV rays and therefore reduces our skin’s ability to make vitamin D. The NHS Go app gives young people advice on how to get enough vitamin D discussing diet and safe levels of sun exposure.
The app also touches on prostate cancer with a moving testimony from Darcus Howe, high blood pressure, stroke, skin-lightening, mental health and keloid scars.
Useful App
The NHS Go is a useful resource for young people and if you’re a young person and have a general question about your health please do make use of the app. If you think you have a serious health issue or have symptoms that you are concerned about please make an appointment to visit your GP.
Saturday was a really exciting day for us as we hosted our first fibroids conference, Fibroid Focus. The theme of the conference was treatment and we aimed to provide an in-depth look at all treatment options including natural options.
The day started with an introduction by our founder, Abi Begho, who welcomed everyone, explained the aim of the day and briefly summarised the work we’ve been doing on fibroids. This work has included conducting a survey to understand the needs of black women with fibroids, forming an expert panel, developing a booklet and organising awareness events.
You can watch a clip of Abi talking about the event here
Exercise and Fibroids
We first heard from Lillian Lartey the founder and CEO of I Want My Body Back. Lillian discussed exercise and fibroids and we learnt that exercise has been shown to be beneficial in reducing the risk of developing a number of hormone-dependent conditions such as breast cancer and hence we expect that it will also be beneficial in preventing fibroids but also in improving symptoms as part of a healthy lifestyle. Lillian explained that stress is an important factor as any benefits of exercise are cancelled out if we are experiencing persistent stress in our lives. Finally, Lillian reminded us that we should be aiming for 30 minutes of moderate exercise a day and that we shouldn’t consistently take part in long bouts of exercise as this can put pressure on our body. Lillian ended with three suggestions on how to move forward:
Check your lifestyle – how will exercise be a part of your life?
Choose the right type of exercise for you and avoid stress-induced exercise
Manage your stress – this is more than just resting but managing your thoughts.
You can watch a clip of Lillian’s talk here, download her presentation in the section below this blog piece, listen to her full presentation here and you can read our blog on fibroids and exercise here.
Diet and Fibroids
Next we heard from Leah Salmon, The Naturally You Coach, who spoke about diet and fibroids. Leah stressed that food is more than something that we eat three times a day because it tastes nice, food is medicinal. To reap the benefits of food and to fight disease we need to have a solid foundation of nutrients for our body to build on. To achieve this Leah advised that we make at least 50% of our diet unprocessed foods. Leah explained that fibroids have been linked to a number of nutritional deficiencies such as vitamin D, magnesium and essential fatty acids. Leah stated that we can use our diet to prevent the deficiencies that lead to the fibroids or, if we have fibroids, use nutrition to re-balance the deficiencies, build and repair the body and stop the fibroid tumours from growing. Leah then recommended nine foods that can achieve this:
Irish Moss and sea weed
Bone broth and oily fish
Evening Primrose Oil
Molasses
Tumeric
Garlic
Green smoothies and vitamin C rich food
Vitamin D
Water
Leah also warned us about six foods we should avoid:
Xenoestrogens (growth hormones in commercially reared animals and can thus be found in red meat, poultry and eggs and also BPA, found in some plastics)
Alcohol and caffeine
White sugar
Processed grains
Trans and hydrogenated fats
Finally, Leah stated that success in this area is all about our mindset and we need the willingness to change, the stamina to commit to a healthy lifestyle and patience.
You can download Leah’s slides below this blog, watch clips of Leah’s talk here and here, listen to her full presentation here and you can read more about diet and fibroids here.
Medical Treatment and Fibroids
We also heard from Rajiv Varma, a consultant gynaecologist at the Nuffield Hospital, who presented on the medical management of fibroids. Mr Varma first described some of the effects of fibroids such as challenges with fertility, problems during pregnancy and a number of symptoms that affect a woman’s quality of life, but he did stress that most women with fibroids do not experience these problems.
Mr Varma explained the treatment options available and these include:
Doing nothing (watchful waiting)
Drug treatments – mainly used to shrink fibroids before surgery or to relieve symptoms
Procedures
Uterine Artery Embolisation (UAE) – cuts off blood supply to the fibroids
Surgery – to remove the fibroids
Mr Varma then gave us some really good insight and advice on a number of issues:
NHS treatment vs. private treatment: He stated that in an ideal world there would be no difference between NHS and private treatment but unfortunately there can be some issues with NHS care such as: lack of choice, long waiting times and limited treatment options. There are a number of benefits though which include: the NHS is better equipped to deal with complex cases, easy access to supportive services (such as blood transfusions and intensive care), the consultant is present and other specialists are available.
Second opinions: Mr Varma explained that we are entitled to get a second opinion and the situations where he would advise that a woman seeks a second opinion are: if you are unhappy with the treatment and management options that have been presented to you; if you lose confidence in your doctor; and if there is poor communication between yourself and your doctor.
Finding the right doctor: he stated that the most effective way of finding the right doctor is to have insider information and nurses are the best people to get information on who the best doctors are.
Herbal Remedies and Fibroids
Patricia Ferguson, a Medical Herbalist and a member of the College of Practitioners of Phytotherapy, then discussed herbal remedies that have been shown to be effective in treating fibroids. These remedies either contribute to shrinking the fibroid or are effective at managing some of the symptoms. They are as follows:
Vitex Berries (or agnus cactus) – act on the pituitary gland and depress oestrogen and progesterone (both of which can stimulate the growth of fibroids).
Shepherds Purse – can be effective in treating heavy menstrual bleeding
Red raspberry leaf – can help control heavy menstrual bleeding and can help shrink fibroids
Nettle leaves- can be effective in reducing heavy bleeding
Yarrow – helps to stop the growth of fibroids
Thuja – helps to stop the growth of fibroids
Burdock Root – can improve liver function and may inhibit the growth of fibroids
Milk Thistle – improves liver function and therefore can help the live control oestrogen levels
It was also noted that before taking any of these herbal preparations women should seek advice from a medical herbalist as some of the above shouldn’t be taken if a woman is pregnant or if she is on certain medication.
You can download a copy of the handouts to this presentation below this blog and read about some research on complementary and alternative medicine and fibroids here.
Managing the Emotional Impact of Fibroids
Finally, Olivia Haltman discussed the emotional impact of fibroids and how to manage this. Olivia explained that women may experience a number of emotions when going through their fibroid journey. This starts before the diagnosis with some women experiencing fear of the unknown due to symptoms. There can be a significant amount of anxiety whilst waiting for results and after receiving results, there can be a feeling of loss of control and hopelessness where you feel like you can’t control the outcome. Additionally, the vaginal examination can cause a significant amount of stress particularly for women who have had a traumatic sexual experience in the past.
Once a woman has received a confirmed diagnosis she may feel a fear of the growth of her fibroids and experience some unease about how her employers may respond, for example, missed days from work due to symptoms. Additionally, she may have anxiety over her fertility and then feel overwhelmed by the treatment decision.
The emotional impact may also include loss of focus, mood swings, panic attacks, lack of self-esteem, irrational emotions, fears regarding relationships and severe premenstrual syndrome.
So, fibroids can have a significant emotional impact on women which, in many cases, go unrecognised. These issues need to be addressed so that women can heal and move on.
Olivia provided some tips on how to start dealing with the emotional impact and these were:
Educating yourself about fibroids – this can be empowering allowing you to make informed decisions about treatment
Relaxation and breathing techniques
Ground techniques
Writing as therapy
Positive thinking techniques
Talking to your partner, friends and family
Talking therapy
Healthy eating
Holistic lifestyle
Olivia finished by summarising tips from HysterSisters which were:
Don’t play the blame game
Don’t dwell on the what if’s
Don’t compare yourself to others
Give yourself time to heal emotionally as well as physically
Don’t underestimate how much your hormones affect your emotions
Don’t do it alone
Do move on
Conclusions
The event ended with a really good summary from The Lake Foundation’s trustee, Fadzai Marange, who shared a little of her personal experience with fibroids, summarised the talks and appealed to women to follow Leah Salmon’s advice regarding the watchful waiting option i.e. if you have been diagnosed with fibroids and your doctor says: ‘ let’s watch and wait’, don’t be passive during this time, act – adopt a healthy lifestyle and see what you can do naturally. Finally, Fadzai encouraged women to visit their doctor and check whether they have a vitamin D deficiency as this is strongly linked to fibroids.
Provided information on the support available for women affected by fibroids;
Provided information on health and well-being programmes;
Sold health and well-being books;
Sold natural feminine hygiene products; and
Sold natural hair and skin care products.
We also had ‘Meet the Exhibitor’ sessions on the agenda giving attendees the opportunity to hear organisations talk about their work.
Thank you
We had a great day and would like to thank everyone who attended, shared their story and for being a fantastic, engaged audience. We’d also like to thank all the speakers for their thought-provoking, informative presentations and all the exhibitors for attending and sharing their information, services, products and knowledge.
The report revealed that people are twice as likely to survive at least 10 years after being diagnosed with cancer than they were if they were diagnosed at the start of the 1970s. It is thought that this improvement in survival is due to earlier diagnosis and better treatment. Whilst there is good news generally there are some cancers where survival rates are still very low and these include lung and pancreatic cancer. Macmillan states that the survival rates for these two cancers have not changed over the past 30 to 40 years.
When it comes to treatment Macmillan’s report reveals that treatment has improved significantly since the 1970s. Treatments now have a greater precision and are thus more effective. Techniques that are used in surgery, radiotherapy and chemotherapy have been refined so that there are less side effects. In surgery, new techniques that use robotics have allowed previously inoperable tumours to become operable. Radiotherapy has become less crude and new methods can more accurately focus on the cancer. There are more chemotherapy drugs now than ever before and there is a greater understanding of how to manage the side effects. Newer types of treatments have been developed since the 1970s these include biological therapies which use our body’s immune system to target cancer cells.
Whilst Macmillan’s report celebrates the advances in cancer survival they do highlight that the disease continues to be very devastating affecting a person long after their treatment comes to an end. Many people will experience long-term side effects such as chronic fatigue, incontinence, disability and general poor health. Thus the need for an effective after-care plan.
When comparing after-care over the last 30 to 40 years, Macmillan’s report explains that in the 1970s and 80s support for patients wasn’t commonplace. Now there are several organisations that offer comprehensive cancer support programmes ensuring that patients are catered for and their needs are met.
Finally, Macmillan’s report looked at end of life care and how that has changed over the years. They state that in the 70s end of life care lacked planning and expertise, but this area has now become a “highly developed field of practice that increasingly puts the patient’s needs and compassion at its heart”
This report was very interesting highlighting the progress that has been made in the treatment, diagnosis and support provided to patients.
The Lake Foundation has been playing its little part through its cancer support group. For more information about our support group please email us
There are several medical procedures used to treat fibroids. Some of these result in infertility and because of this, as well as unease with these procedures, many women are seeking less invasive more “natural” options. But, are these effective?
One area that has been explored is the use of green tea extract which has been used for a variety of medical reasons with some success.
What research has been done?
To explore this area we’ll be looking at a research paper published in the International Journal of Women’s Health in 2013 – ‘Treatment of symptomatic uterine fibroids with green tea extract: a pilot randomised controlled clinical study.’
Why green tea extract?
In the research paper, the investigators described why they decided to look at green tea extract. They explained that green tea contains epigallocatechin gallate which has been shown to have useful biological effects. These include: anti-inflammatory, anti-proliferative (stops cells from growing) and antioxidant effects.
They stated that a study conducted by the US Department of Agriculture reported that great tea has an anti-cancer effect. Additionally, they quoted further research that showed that green tea stops the growth of tumours. From these studies, it is safe to conclude that as fibroids are benign tumours green tea extract may be an effective treatment.
Furthermore, at the time of conducting their research, there were no effective drug treatment for fibroids. So there was a need to explore this area to explore the possibility of developing the first drug treatment.
The researchers had also conducted some preliminary work, not on humans but on fibroid cells grown in their lab and in a mouse model of fibroids. This was very promising with their experiments on the fibroid cells showing that green tea extract caused the cells to stop growing and die. Whilst in the mouse model they saw a significant amount of fibroid shrinkage.
What did they do?
The researchers conducted a small clinical study which included 33 women with fibroids. Twenty-two women were given green tea extract and eleven women were not. To ensure the outcome of the study wasn’t compromised, the women taking part and the study staff didn’t know who was receiving the extract and who wasn’t (double blind study). The treatment lasted for four months and women were followed up monthly.
The aim of the study was to determine whether treatment with green tea extract could:
reduce the size of a patient’s fibroids;
reduce the severity of symptoms; and
improve quality of life.
What were their findings?
When looking at those women who were given green tea extract the researchers determined that, on average, the size of their fibroids decreased by 32.6%. Meanwhile those women who didn’t receive the extract actually experienced an average increase in the size of their fibroids of 24.2%.
The researchers then looked at the severity of symptoms and a similar trend was seen. In the women given green tea extract there was a significant decrease in the severity of their symptoms, but there was an increase in symptom severity in those not treated.
Next, the researchers analysed quality of life. They found that the overall average increase in the quality of life score in women treated with green tea extract was 20.7 (i.e. their quality of life improved significantly). But in women not treated with green tree extract there was only a 2.19 increase in their quality of life score.
Finally, the study looked at menstrual bleeding and they were able to show that green tea extract caused a significant decline in average blood flow, there was no such effect seen in women not treated.
Conclusions
Based on their findings the researchers concluded that:
“… green tea extract has a significant positive effect on the reduction of uterine fibroid burden and symptoms severity. Thus, administration of green tea extract could possibly be an effective oral treatment.”
The Limitations of this Research
It is worth bearing in mind that this was a very small study with only 33 women taking part. This study needs to be repeated on a larger scale to confirm this finding and ensure its accuracy.
To find out more about this study you can read the full paper below.
This week the UK’s Scientific Advisory Committee on Nutrition published their report on vitamin D and health. This was an interesting report that provided some useful background on vitamin D. This included the benefits of vitamin D, an analysis of whether people in the UK are getting enough vitamin D and recommendations on how to ensure that we all have sufficient levels.
Background
The report stated that vitamin D is important in regulating the amount of calcium and phosphorus in the body and is made in the skin upon exposure to sunlight that contains sufficient levels of UVB radiation. Sunlight is the main source of vitamin D for most people but it can also be obtained from our diet and supplements.
Dietary sources and supplements become important during the winter months when UVB radiation is limited, in people who spend a lot of time indoors and in people who cover their body when they go outdoors.
Previous Guidance On Recommended Levels of Vitamin D Were Not Sufficient
In 1991, Dietary Reference Values (DRVs) for vitamin D were set by the Committee on Medical Aspects of Food Policy (COMA). These values were only based on preventing rickets in children and osteomalacia in adults.
A Reference Nutrition Intake(RNI) for vitamin D was not set for people with regular exposure to sunlight. This is because it was felt that the exposure to sunlight in the summer would balance out the lack of exposure in the winter. Therefore RNIs were set only for people at risk of a vitamin D deficiency. This included infants aged 0-3 years old; pregnant and breastfeeding woman; those over 65 years old; those with limited sunlight exposure; and Asian women and children.
The Need for this Current Report
There was a need for new guidance because previous guidance was not extensive and a significant amount of research has been conducted on vitamin D since publishing the previous guidance. Therefore the Scientific Advisory Committee on Nutrition carried out a review with the aim of exploring the Dietary Reference Values for vitamin D and to make recommendations. This work started in 2010 and the findings were published this week.
The Committee’s Findings
The committee looked at a range of health outcomes to determine whether these could help determine what the Dietary Reference Values for vitamin D should be.
They first explored muscle and bone health outcomes and then reproductive health, cancer, cardiovascular disease, hypertension, infectious diseases, oral health and other health comes. They wanted to see if there was a clear link between these health outcomes and vitamin D supplementation and levels of vitamin D. So, they were looking at what levels of vitamin D could positively affect these health outcomes.
They found that the only reliable data they could use to determine what the Dietary Reference Values should be were those related to muscle and bone health outcomes. These outcomes included rickets, osteomalacia, falls, muscle strength and muscle function.
For the other health outcomes the data was inconsistent so further work is needed to determine whether vitamin D has a beneficial effect on these conditions.
Recommendations
Based on their findings the committee made the following recommendations:
To protect musculoskeletal health, the serum 25(OH)D – a marker of vitamin D status- of individuals in the UK should not fall below 25nmol/L at any time of the year.
Those at risk of having serum 25 (OH) D below 25nmol/L are: those who spend the least amount of time outdoors (frail and institutionalised people), those that wear clothing that covers most of their skin when they are outdoors and those from ethnic groups with dark skin.
A Reference Nutrition Intake (RNI) for vitamin D of 10ug/d is recommended for the UK population aged 4 years and above. This includes pregnant and lactating women and population groups at risk of having low levels of vitamin D. A separate RNI is not required for these groups as was advised previously.
RNI should be applicable throughout the year, as a precautionary measure, to cover population groups in the UK identified to be at risk of having low vitamin D levels.
The RNI refers to all intakes from dietary sources: natural food sources, fortified foods and supplements. (They note that it is difficult to achieve the RNI with natural food sources alone so the government needs to develop a strategy for the UK population to achieve the RNI of 10ug/d).
This was a very informative report and one the black community in the UK should take note of as we are at risk of having low levels of vitamin D. This is because the melanin in our skin doesn’t absorb as much UV radiation. This means that we have to ensure that we obtain vitamin D from dietary sources and we should be aiming for the 10ug/d the report suggests.
For more information you can download the full report below.
Yesterday, Public Health England published its guidance on how to get adults more active. In their report they state the benefit of physical activity – it improves the physical and mental wellbeing of individuals. Then they explain how much activity adults should take part in. They recommend that adults should aim for at least 150 minutes of moderate-intensity physical activity each week, in bouts of 10 minutes or more.
They describe moderate-intensity activities as anything that causes you to get warmer and breathe harder and gets your heart rate up, such as cycling or a brisk walk.
It is also recommended that adults aim to be active daily. Additionally, adults should include a muscle-strengthening activity on at least two days of the week to prevent loss of muscle mass.
Finally, their guidance stresses the importance of minimising the amount of time spent sitting for extended periods of time. This increases the risk of a number of health conditions.
They suggest the following to reduce the amount of time sitting:
Reducing the time spent watching TV, using a computer or playing video games
Reducing the amount of time sitting during work
Walking part of the way on a long bus or car journey
Research has shown that many of the UK’s minority ethnic groups have lower rates of physical activity participation and do not achieve the recommended levels of physical activity. Therefore it’s very important that the black community takes notice and becomes more active. The Lake Foundation through its cycling club is aiming to get our community more active. Please do join us for a fun way to get some exercise. For more information email events@thelakefoundation.com
On 14th July 2016, Public Health England launched a fourteen week campaign to raise awareness of the symptoms of lung cancer, lung disease and heart disease. The campaign will focus on the symptoms of persistent cough and inappropriate breathlessness stressing that a sign of lung cancer or other lung disease could be a cough lasting more than three weeks and/or getting out of breath while doing everyday tasks such as vacuuming.
Additionally, it’s important to note that breathlessness could be a sign of heart disease.
If you, or anyone that you know, are experiencing these conditions please visit your GP and finding these conditions early makes them easier to treat.
Professor Kevin Fenton, PHE National Director for Health and Wellbeing said:
“The estimated number of people with undiagnosed lung cancer, lung disease or heart disease, is deeply concerning. If diagnosed early, these diseases can be managed and treated successfully. This campaign will help people recognise the symptoms and encourage them to seek help, potentially saving lives from what are 3 of the biggest causes of death in England.”
For more information about this campaign, lung cancer and lung disease please click here
One of its aims is to understand how they can better join up services to treat fibroids to offer the best care to their patients. As part of this work they conducted a focus group which identified that more needed to be done to empower, inform and support women with fibroids. Therefore they started a patient support group and this week we had the pleasure of being invited to attend.
TOHETI’s patient support group started in March 2016 and meets every two months. It is facilitated by a specialist nurse and aims to provide women with a safe, informal setting to share their experiences, ask questions, meet other women with fibroids, understand treatment options and learn about how best to manage their situation.
We attended the support group to learn more about TOHETI’s project and to understand how we could collaborate with them.
The women who attended the support group session told very similar stories to women we have met in the work that we’ve been doing. They explained that it took several years for them to be diagnosed and that they didn’t feel well-informed about fibroids or their treatment options. Additionally, attendees explained that fibroids significantly affect their quality of life, including their relationships and emotional wellbeing. They also felt that no one was listening to their concerns. We also briefly discussed diet with one attendee stating that when she adopted a healthy lifestyle this significantly improved her symptoms but the challenge was maintaining this lifestyle.
Also in attendance were representatives from Gedeon Richter, the pharmaceutical company that developed the drug ESMYA® which is used to treat fibroids. They were able to answer questions on treatment, particularly on ESMYA®, its benefits and how it works.
This was an interesting session that highlighted the need for more support for women with fibrioids and we look forward to working with TOHETI to address this.
The next session will be on Wednesday 5thOctober at the McNair Centre at Guy’s Hospital. If you’d like to attend please contact Yvonne Akande (yvonne.akande@kcl.ac.uk).
The UK’s Change For Life programme has once again teamed up with Disney for the 10 Minute Shake Up campaign. This campaign aims to get children active over the summer by encouraging them to do 10 minute bursts of moderate to vigorous activity throughout the day every day, so they meet the recommended 60 minutes of physical activity that children need.
The 10 Minute Shake Up was launched in July 2014 and is back this year. The campaign is inspired by Disney Pixar’s Finding Dory and it uses Disney characters like to get kids involved in a range of fun activities such as swimming, dancing and ball games.
To find out more visit their website here and for resources to get you started click here
Hi there, my name is Samantha and I’m writing this blog about the exciting cycle journeys with the Lake Foundation.
I joined the Lake Foundation cycling club after deciding to up my fitness levels and try out my new bike that I had brought. I found out about the club through my local leisure centre. It had been years since I rode a bike and at first, I lacked motivation getting back onto a bike but finding a group of like-minded people inspired me
By riding with the Lake Foundation twice a month my confidence has boosted, It’s the best way to progress your cycling. You learn how to ride safely and efficiently in a group with trained instructors and it’s far easier to head out for a training ride knowing you’ll be with a group of mates rather than on your own. Cycling really helps you feel physically stronger, it is a great stress buster and I always feel refreshed and relaxed after a ride even if my legs ache a bit.
The best part is that when I first started, I barely could cycle very far but after a few months of cycling with the club, I was able to cycle 20-23 miles. Now I can cycle around 11-13 mph. In May 16, My friend asked me to join her team to cycle London to Brighton 54 miles. I knew that it would be a big challenge for me but with all of the cycling with the group, I felt confident that I could achieve my goal.
I made it to Brighton in 8 hours. It was hard and gruelling work. At some points, I wanted to give up but I kept going! I’m still feeling the pain now. The first time you see Brighton in front you of is shortly after Ditchling Common it is an amazing sight. I used my GPS to track my journey as I went along and the steepest section was a 30.6% gradient. I prepared in advance for the Beacon by training in the gym alongside the cycling. I’d say that at least 80% of the people I saw on the incline had resorted to walking. Although it was hard work I just kept pushing on, and as I got closer to the top I was rewarded with the most amazing views. Then before I knew it the gradient reduced and I had conquered the Beacon! The best feeling ever! and knowing that it was downhill from there. I had an amazing day of cycling and I loved doing it as part of a team. I would definitely ride it again in the future.
I would most defiantly recommend taking up cycling and joining the Lake Foundation cycling club as it is an amazing way to get to places and when it’s a challenging ride it feels like a real good achievement. You’ll need a reasonable level of fitness but you definitely don’t need to be a super fit racer. It is much more fun riding as a group and there’s sometimes a café stop on the journeys.
