Have you heard of the expression: ‘don’t do things by halves’?  It normally means that people shouldn’t do things without putting maximum effort into it. So for example – if you are doing an exam you may wake up in the early hours of the day to study and revise. If you have an interview – you read up about the role and company until the point of saturation.  If you’re going out for a New Year celebration, you may select your outfit and venue (and maybe even hairstyle!)  well in  advance.  But for me, doing things ‘by halves’ can take on a different meaning.  It can mean achieving your goal ‘piece by piece’ i.e. piecemeal.  So instead of exhausting yourself to achieve a goal, you could achieve it by breaking it down into manageable chunks or ‘half- measures’

So what has this got to do with the New Year?

Well, every year millions of people make a pledge to be healthier and fitter. But six months down the line – the pledges are largely forgotten and definitely not achieved. Perhaps if we make small changes or ‘half-measures’ our goals would be easier to achieve.

So how can we break down key health and fitness activities into manageable chunks?

1.   Eating more fruit and vegetables

This is a common goal for most people. You don’t have to consume large plates of vegetables or fruits in one go.  Vegetables can easily complement many meals. Why not add some slices of fresh cucumber to your already prepared jollof rice?  Or add scoops of avocado or finely chopped mushrooms to your rice and peas?

2.    Increasing exercise
Do you find gym membership too expensive?  Is it too cold to go for walks outside? Jogging on the spot at home whilst watching your favourite soap for just 30 minutes could burn at least 100 calories! You could start off by jogging through one programme and then slowly build up to two. Do you love exercising to music? Why not find some old school Rnb tunes on YouTube, switch it on and dance while you are doing the dishes?

3.   Reduce fried food intake
Fried food isn’t great for many reasons including the fact that it is high in calories because it absorbs the fat from the oil. But many people find fried chicken irresistible! If you are one of those then why not alternate between fried and grilled food to begin with?  You could have fried chicken on one day then the next time you have chicken make it grilled or roasted. You could do the same thing with other meats.

4.   Reduce alcohol intake
Did you overdo the Baileys or the rum punch at Christmas? Next time you’re out for the evening or even at home and you feel like a drink – why not pour yourself two drinks? One of the drinks could be your favourite tipple and the other could be a glass of water.  You could alternate between the two drinks, sips from one then another.  You would ultimately end up drinking less alcohol.

So hopefully you now have the gist of ‘doing things by halves’ to achieve your goals.  What other ideas can you come up with?

A recently published study has thrown new light on the links between dietary sugar and breast cancer. The study authors investigated the effect of different types of diets on the development of tumours in mice. The authors found that just 30% of mice on a starch-based diet had measurable tumours, whereas 50 to 58 percent of the mice on sucrose-enriched diets had developed mammary or breast tumours. The study also showed that numbers of lung metastases (secondary cancer growths) were significantly higher in mice on sucrose- or a fructose-enriched diet, when compared with mice on a starch -based diet.  This implies that sucrose and fructose have the ability to promote tumour growth through specific pathways.

 Although it’s difficult to compare mice with humans,  the mice in this study received amounts of sugar (relative to their size) that were similar to amounts found in western diets. This raises questions about the presence of sugar in the western diet and its influence on breast cancer. The diets of people of African and African-Caribbean descent are often high in sugar. It is also the case that young UK based Black women (under the age of 40) have poorer outcomes in relation to breast cancer when compared with their non-black counterparts.  Further research into the effects of dietary sugar on breast cancer in humans (particularly young Black women) is certainly warranted.

You can find more information about the studies here , here and here.

In our new blog series, Inspirational People in Healthcare, we’ll be recognising people in healthcare who are making a significant difference in their field. We hope you’ll enjoy reading this blog series and please do email us the details of anyone in healthcare who inspires you and we’ll include them in this series. In this our first blog in the series, we focus on the Nigerian doctor Dr Bennet Omalu.

Dr Bennet Omalu is a Nigerian forensic pathologist based in the US. He was the first to identify, describe and name Chronic Traumatic Encephalopathy (CTE) in American football players in 2005. He has continued to conduct research in this area and discovered the same condition in war veterans.

Over the years Dr Omalu has tirelessly campaigned for further work to be carried out to protect football players from CTE and to raise awareness of this condition which causes those affected to suffer from memory loss, aggression, confusion and depression. He has testified twice before the US congress and took on the NFL who tried to discredit his work, but later in 2009 the NFL publically acknowledged the link between CTE and football. In 2013, the NFL reached a settlement with 4500 former football players who stated that the NFL failed to properly educate them of the dangers of professional football.

Dr Omalu’s story was recently told in the 2015 film ‘Concussion‘ starring Will Smith and this led to the formation of the Bennet Omalu Foundation. You can view the trailer for Concussion below.

Dr Omalu has made a significant difference in this field and we salute him for his determination, integrity and bravery.

The Lake Foundation would like to wish you all a very merry and happy Christmas.

You can still indulge today whilst being healthy. Remember to include lots of vegetables with your Christmas dinner – try Brussel sprouts, parsnips, carrots, sweet potatoes and  baked/grilled plantain – and for dessert try a lovely vegan cashew cheese cake.

Additionally, select white meat and fish instead of red meat and keep active – try taking a walk regularly throughout the two week Christmas and New Year period.

A new study published this week suggests that women with high levels of both oestrogen and testosterone at midlife are at a higher risk of developing fibroids than women with low levels of hormones. This finding is important because this is the first time that testosterone has been linked to fibroids.

In this study 1412 women aged 45 -52 were monitored over 13 years with each woman having an annual check-up where their hormone levels were measured. It was found that women with high levels of testosterone in their blood were 1.33 times more likely to develop fibroids than women with low levels of testosterone, and women with high levels of both oestrogen and testosterone had an even greater risk , they were 1.5 times more likely to develop fibroids.

Dr Jennifer Lee, one of the researchers explained the importance of these findings by stating that:

“The research opens up new lines of inquiry regarding how fibroids develop and how they are treated. Given that managing uterine fibroids costs an estimated $34.4 billion in annual medical expenditures nationwide, it is important to identify new ways to better treat this common condition.”

You can read more about this research here

As the year draws to an end it’s the perfect opportunity to reflect on the work that we’re doing. As a result of all your support and encouragement we have been very productive and have made significant progress in working towards our mission of improving the health and well-being of the black community.

We are delighted to share our achievements for 2015 with you. Over the past year we have:

1. Continued to run our African Caribbean Cancer Support Group which meets monthly  and were delighted to have been awarded a grant by Macmillan to help us increase its membership.

2. Published our new fibroids booklet which aims to be a one-stop-shop for anyone with questions or concerns about fibroids

3. Continued to offer support to women through our Fibroids Ask the Expert which provides women with questions or concerns about fibroids with access to experts in the field that can provide them with accurate reliable information

4. We welcomed a new member to our Fibroids Ask the Expert, Dr Nigel Hacking

5. We continued with our summer cycling sessions  as part of our ‘Keep Active’ work. These sessions had double the number of people attending compared to the previous year.

6. Delivered a range of health awareness presentations to the  community

7.  Recruited new trustees

8. Our founder was presented with an award for her contribution to improving the health and wellbeing of the black community

9. Published the results from Prostate Cancer Engagement and Empowerment pilotthat we conducted with funding from Prostate Cancer UK

10. We were featured on radio and in AfroRetro magazine

11. We were offered a grant from Sport England to run a cycling club for a year and hope to begin this project in January 2016

12. We teamed up with Black History Walks, Amanda Epe and Dr Sydney Dillard to run a fibroids awareness event with over 200 women attending.

13. We became a member of the Croydon BME Forum

14. We piloted ‘AfroFit’ as part of our ‘Keep Active’ work

This week the UK’s Chief Medical Officer Prof Dame Sally Davies published her annual health report which focused on women’s health. We were very happy that the report had this focus as many of the health issues that affect women can often be ignored,  not talked about or are felt to be too trivial to be of any importance to society. The report communicates this sentiment by stating that:

“Problems ‘below the waist’ are not generally seen as attractive topics for public or political discourse. Women are often reluctant to seek help for conditions that are common, disabling and taboo…”

The report covers a number of women’s health issues including gender-based violence, FGM, eating disorders, pre-conception health, prenatal screening, perinatal mental health, post-pregnancy care, menopause, incontinence, prolapse and women’s cancers. They make 18 recommendations on how to address the challenges associated with these issues and you can read about these here

We were disappointed to see that fibroids weren’t mentioned in this report despite fibroids being very common and having a significant effect on quality of life. It would have been very relevant for fibroids to be have been explored in a report on women’s health and we feel that this was a missed opportunity to explore the impact of fibroids and begin to develop a national strategy to support women.

The authors highlighted the fact that obesity tended to be a common theme in all of the health issues they explored and stressed that action is needed to prevent obesity. Therefore the report made the recommendation that the Government should include obesity in its national risk planning.  This led to the many media headlines this week stating that “Obesity is the biggest threat to women’s health” and that “obesity is as dangerous as our terror threat”.

We were very happy that the Chief Medical Officer’s report focused on women’s health, a very important area and hope that her recommendations are taken forward to ensure that we improve the health and wellbeing of all women. We were disappointed that key issues such as fibroids were excluded from this report and we’ll continue our work in this area.

You can download her full report below.

This week the UK’s Health Committee published their report on childhood obesity setting out what action needs to be taken to tackle this ever increasing problem.  The report states that the scale of the problem requires “bold and urgent action from the Government.”

From the report we learn that a fifth of children in the UK are overweight or obese when they begin school and by the time they leave primary school a third will be overweight or obese. They also noted that deprived children are twice as likely to be obese than the least deprived children and therefore obesity is a significant contributor to health inequality.

The report also highlights the cost of obesity. Treating obesity and its consequences costs the NHS £5.1bn every year. Obesity is the main risk factor for a number of disease including diabetes and the cost of diabetes to the NHS is  £8.8bn a year.

Through their research into this area, the committee found that there are very few interventions aimed at overweight or obese children. They state that the evidence shows that healthy living campaigns tend to help those who are already making healthy choices and are not reaching those that need them.

The health committee have made a number of recommendations that focus on changing our food environment because evidence suggests this is where the most attention is needed. Their nine recommendations include:
–  Strong controls on price promotions of unhealthy food and drink
–  Tougher controls on marketing and advertising of unhealthy food and drink
–  A centrally led reformulation programme to reduce sugar in food and drink
–  A sugary drinks tax on full sugar soft drinks, in order to help change behaviour, with all proceeds targeted to help those children at greatest risk of obesity
–  Labelling of single portions of products with added sugar to show sugar content in teaspoons
–  Improved education and information about diet
–  Universal school food standards
–  Greater powers for local authorities to tackle the environment leading to obesity
–   Early intervention to offer help to families of children affected by obesity and further research into the most effective interventions

We are in support of the above recommendations as obesity is a significant problem in the black community and by taking these actions we can begin to change our community’s behaviour and improve our health.

You can download the full report below.

At the end of last year we conducted a prostate cancer engagement pilot project as part of a large piece of work funded by Prostate Cancer UK to determine the most effective method of reaching the black community with the key messages about prostate cancer.

Local charities were invited to apply for funding to carry out small projects over 3-4 months and we applied for funding to focus on black churches to determine whether, in reality, this is an effective and practical environment to raise awareness of prostate cancer.

Targeting black churches has two main advantages. Firstly, if we take London as an example, a large number of London’s black population attends church regularly. The London Church Census, covering the time period 2005-2012, found that 48% of inner London’s church goers and 21% of outer London’s church goers were black¹.  Based on their figures this equates to 238,158 people from the African and African Caribbean community. This means that by targeting black churches we can reach a significant proportion of the African Caribbean community.

The second advantage of targeting churches is that it provides a very structured environment where a large number of people meet regularly. This, in theory, makes it a convenient environment to deliver health awareness messages. Additionally, many churches have developed their institutions beyond just preaching on a Sunday. Many churches have Men’s Fellowships, Young Professional Networks, Women’s Fellowships, Over 50’s Clubs, Men’s Conferences, Women’s Conferences and social functions. This means that there is the opportunity, in some churches, to select a sub-population within a church that would most benefit from a particular health message.

Whilst there are advantages to targeting black churches there are some logistical challenges. Firstly, churches tend to have a busy programme of events that will have been planned months in advance making it difficult to fit additional events into their schedule. Secondly, the ideal situation would be to deliver a presentation on a Sunday where there is access to the entire congregation, but many churches may not be able to accommodate this.  This means that awareness presentations would have to be delivered on a Saturday or during the week where only a small percentage of the congregation is likely to attend.  Through a flexible approach, being creative with the methods of engagement  and developing  long term relationships with churches it is possible to overcome some of these challenges.

The Lake Foundation being based in Croydon, where there is a diverse population and a significant number of black churches, decided to work locally and target churches in Croydon and the surrounding area.  In our pilot we worked with two churches and explored the best strategy for working with churches to raise awareness amongst their congregations.

From our pilot we  found that:

1. Engaging with black churches can be an effective way of reaching the African Caribbean community with the key messages about prostate cancer because of the potential of reaching large numbers.
2. To reach large numbers in a church setting requires the development of a long-term bespoke engagement programme.
3. There is a need to understand the structure of individual churches to ensure the best strategy is implemented to reach as many of their members as possible.
4. Engaging with churches may include targeting Sunday services for maximum reach and/or organising awareness sessions on a weekday/Saturday to ensure members have a more in-depth knowledge of prostate cancer.

 Recommendations

Overall The Lake Foundation recommended that Prostate Cancer UK explores developing a structured awareness program for African Caribbean churches in the UK or contracting this work out to community organisations. Whilst this may require significant time, personnel and resources we believe it is an effective way of reaching the black community.

Our specific recommendations:

Target Sunday Services

This pilot has shown that targeting Sunday services would ensure large numbers of people are reached but with limited information because of the time constraints of fitting into the Sunday service’s programme

Targeting churches successfully on a Sunday would require two approaches:

• A short presentation during all their Sunday services
• Setting up an information table throughout the day on a Sunday

Specific recommendations:

• Develop a  5-7 minute presentation that could be used for Sunday services
• Develop an easy method to measure the impact of delivering short presentations at a Sunday service
• Be flexible and persistent

Target churches outside of a Sunday service to achieve depth of knowledge

If the aim is to deliver in-depth information about prostate cancer to church goers and if this isn’t possible through a Sunday service due to time constraints then an additional approach will need to be taken.

The pilot has shown that targeting churches through a one-off event (not on a Sunday) is not the most effective method of reaching the largest number of people, this  only reaches a small percentage of a church’s congregation.  Therefore a regular engagement programme is needed.

Specific recommendations:

• Work with individual churches to understand their structure and how best to reach their members
• Identify groups, departments, events and forums within individual churches that can provide an effective environment to raise awareness
• Organise regular events with the same church throughout the year
• Make good use of churches’ communication platforms – social media, website, newsletters, bulletins, TV stations, YouTube channels etc.

We believe that by taking a long-term, flexible and creative approach in targeting churches a significant impact can be made and we’re delighted to learn that Prostate Cancer UK will be launching a new Faith Based Outreach Project using what we learnt from this pilot. We wish them all the very best in this project and hope that is makes a significant difference in increasing cancer outcomes by facilitating early diagnosis and we’d like to thank Prostate Cancer UK for giving us the opportunity to conduct this pilot.

You can download our full report below.

---

References

1.       Brierley Consultancy, London Church Census and London City Mission, 2013. London’s Churches are Growing.Kent: Brierley Consultancy

We were absolutely delighted to be interviewed on Croydon Radio once again about the work of our charity. We featured on Worker’s Playtime this week where we discussed our mission to improve the health and wellbeing of the African and African Caribbean community and also talked about some of the support we’re offering with our cancer support group.

You can listen to a recording below,  our interview starts about an hour into the show.