This week, an article in the Daily Record encourages everyone to take a look at the Japanese diet and lifestyle if we are serious about improving the health and wellbeing of our families. They stated that The Lancet has found that Japanese children are the healthiest in the world and this is down to their lifestyle.
The article highlights a new book by husband and wife team William Doyle and Naomi Moriyama, Secrets of the World’s Healthiest Children. This book is based on Doyle and Moriyama’s research into why Japan is the world leader when it comes to health. The key reasons why this is so include:
– The Japanese eat foods high in nutrients, including fruit, vegetables and whole grains.
– They don’t rely on processed foods
– The Japanese only consume sugar or salt in small quantities
– Meat is usually treated as a garnish or side dish rather than the main part of any meal
– The Japanese eat moderately, they serve only moderate sized portions of food
– The Japanese are physically active
Let’s follow Japan’s example and adopt some of their habits to ensure that we too can enjoy good health.
Last week, we attended Croydon Clinical Commissioning Group’s (CCG) Annual General Meeting. This was an interesting meeting that gave us the opportunity to learn more about the work of the CCG and what health challenges residents of Croydon face.
What are Clinical Commissioning Groups (CCGs)?
For those of you who might not be familiar with Clinical Commission Groups they are groups of GPs who work together to plan and develop local health services in England. They do this by buying health and care services such as planned hospital care, urgent and emergency care, community health services and mental health and disability services. CCGs are a fairly new concept and were established in 2012 partly replacing Primary Care Trusts. There are 211 CCGs in England covering the 8,000 GP practices across the country.
Connecting with the Public Through their AGMs
Each CCG holds an annual general meeting (AGM), which is open to the public, to provide an overview of their work during the previous financial year. We decided to attend Croydon CCG’s AGM to get a feel for what health conditions need a bit of focus and to understand if The Lake Foundation can address any of the challenges that might exist.
Croydon CCG’s AGM
Croydon CCG’s annual general meeting began with a welcome by Dr Tony Brzezicki, the clinical chair of the CCG, and this was followed by short presentation from Paula Swann, the Chief Executive, who gave an overview of the CCG’s achievements and performance for the 2014/2015 year. From Ms Swan’s presentation we learnt that the CCG has been focusing on community and mental health services and has been transforming the way that care is delivered in Croydon by developing new care pathways for cardiology, COPD, diabetes, musculoskeletal and falls. Additionally they have provided better access to care for people with mental health problems through a range of new initiatives and have supported patients with diabetes through their diabetes management course. Furthermore patients with heart problems are now seen and treated more quickly in community clinics and children with asthma have better support through Croydon’s paediatric asthma service.
Ms Swan stated that the areas that need focus include improving waiting times in A&E, ambulance response times and the quality of care for people with learning disabilities.
The focus then switched to mental health and this was a very interesting and eye opening session that highlighted the extent to which Croydon residents are affected by mental illness. Firstly we heard from a patient who talked about her long journey with mental illness, she spoke of her ups and downs and commended that great work that local charities have played in providing her with support. She specifically mentioned Mind In Croydon whose many services have helped her manage her condition and “live well with my mental health needs.” This really inspired us and clearly demonstrated the significant impact that local charities can have.
We then heard from Dr Bobby Abbot a GP and the CCG’s clinical lead for mental health. He provided an overview of the impact of mental health in Croydon stating that 1 in 6 Croydon (67,000 people) residents have a mental health problem at any one time, half of all lifetime mental health problems begin before the age of 14 and that poor mental health affects a person’s physical health, education, employment, relationships, finances and housing. When he discussed who was most at risk it made for grim reading (or should I say listening) for the black community. He stated that the black community are seven times more likely to be affected by psychosis. Additionally he mentioned that anxiety and depression are the most common mental health issues in Croydon and these problems are projected to increase by 5% over the next couple of years.
To address the aforementioned mental health problems a number of services are being developed or expanded and these include: Personality Disorder Service, Early Detection Service, Primary Care Mental Health Support and Extension Home Treatment, just to name a few.
Finally we heard about the CCG’s work on Out of Hospital and Integrated Care. This work included developing or improving the following: co-ordinated care, roving GPs (for fast support), rapid response, rapid acute medical unit (for integrated care), end of life care and the pharmacy discharge pathway.
Our Thoughts
This was a very interesting meeting giving a good overview of some of the health issues facing residents in Croydon. It once again highlighted the need to address mental health in the black community and we’re now going to go away and think about this and explore what approach we can take on this matter.
You Can Get Involved
You can get involved in the work of the CCG and help shape the way that health and social care is delivered in Croydon. The CCG has a Patient and Public Forum which meets regularly. We encourage you to attend to ensure that the views of the African and African-Caribbean community are represented as services are being developed. For more information please email getinvolved@croydonccg.nhs.uk
This week WHO published its European Health Report 2015. The report shows that whilst many European countries are making great progress in improving the health of their nations there is still much work to do. Great improvements were noted in tackling premature mortality and therefore improving life expectancy but high levels of tobacco and alcohol consumption coupled with the rise in obesity could mean that life expectancy for future generations may fall. Furthermore inequalities do exist with the gap in life expectancy at birth between the highest and lowest countries being 10 years.
This report is an interesting look at the health of Europe and shows, to a certain extent, that the health challenges are lifestyle related. Therefore by more people making different personal choices Europe can significantly improve its health.
The Lake Foundation specifically encourages the black community to make these changes as we are more likely to develop conditions like high blood pressure, stroke and diabetes which can be prevented by being more active and eating a healthy diet.
For more information you can read WHO’s report here
This week the UK government has announced a key part of its plan to improve cancer care in England. In order to improve the care that patients receive, NHS England will introduce a target to ensure that patients are given a confirmed diagnosis or all-clear within four weeks of being referred by their GP.
The target the government is aiming for is that by 2020 95% of patients will receive a confirmed diagnosed within four weeks. To achieve this the NHS has to invest £300M a year until 2020 and train 200 extra staff to perform diagnostic tests for certain cancers.
This 95% target by 2020 was recommended by the independent cancer taskforce and the plans to achieve this will be piloted in five hospitals before being rolled out nationally. It is hoped that achieving this target will save 11,000 lives a year by increasing the number of cancers diagnosed at an early stage.
Jeremy Hunt, the UK’s Health Secretary said:
“For people who are worried they may have cancer, waiting for that all important test result is a nerve-wracking time. We have a duty to make sure this period of uncertainty is as short as possible. For those who get the all-clear, they will have peace of mind sooner. Those who sadly have cancer will get treatment much quicker and we will save thousands of lives as a result.”
September is Sickle Cell Awareness Month in the US and this gives us the perfect opportunity to focus a bit of attention on this condition which is more common in the black community. In this week’s blog we provide a quick introduction.
What is Sickle Cell?
Sickle cell anaemia is an inherited condition where the red blood cells which carry oxygen around our body develop into an abnormal shape. Instead of being round they form into a sickle shape i.e. a semi-circle. These abnormally shaped blood cells are sticky and stiff and they can block blood flow into your tissues and organs. The reduction in blood flow to your organs can cause pain, organ damage and increase a person’s chance of developing infections.
What Causes Sickle Cell?
It is caused by faulty gene which will have been inherited from the patient’s parent. The person would have inherited one copy of the gene from their father and another copy of the gene from their mother. If you only inherit one of the faulty genes you will not develop full-blown sickle cell, you will be a carrier of the gene, but you can pass this gene down to your children.
If you are a carrier of the sickle cell gene you have enough normal blood cells to ensure that your blood flows adequately throughout your body but as a carrier you do have to be careful in situations where oxygen levels are low like when mountain climbing and scuba diving.
Complications of Sickle Cell
People with sickle cell may experience a number of symptoms and complications; everyone is different so each individual will have a different experience with sickle cell. You may experience any of the following:
Episodes of pain (Sickle cell crisis)
This is the most common complication of sickle cell and occurs when sickle shaped blood cells block the blood vessels that supply a particular tissue. This means oxygen is unable to get to that tissue and it becomes starved of its energy source. This causes tissues to become damaged – this causes the pain. Repeated episodes eventually lead to organ damage. The episodes can affect your ribs, spine, pelvis, abdomen, chest, legs and arms.
Anaemia
Anaemia is a decrease in the number of red blood cells in the body. Sickle cells do not live for a long time and when they die they are not replaced quickly enough so sickle cell sufferers will have a low red blood cell count which can lead to:
· Shortness of breath
· Feeling tired all the time
· An irregular heart beat
Infections
Children with sickle cell are prone to developing infections such as pneumonia, bone infections and meningitis. If your child has sickle cell they may need to have some additional vaccinations or be given antibiotics as a precaution.
Jaundice and Gallstones
The rapid break down of the sickled cells can lead to the build up of a yellow waste product called bilirubin. This causes the yellowing of the skin and the whites of the eye, this is called jaundice. The bilirubin can also solidify forming gallstones.
Stroke and Acute Chest Syndrome
If sickle cells block the blood flow to the brain this can lead to a stroke, and if it blocks the blood flow to the lungs this can result in acute chest syndrome where patients experience chest pain and difficulty breathing.
Treating Sickle Cell
Sickle cell cannot be cured and a treatment plan is developed to help sickle cell sufferers manage their disease. The aim of any treatment is to:
· Prevent episodes of pain
· Relieve pain
· Minimise any complications
· Treat any other symptoms
Diagnosing Sickle Cell
Sickle cell is diagnosed through a blood test. When a person has sickle cell this will become apparent when they are a child. If you are worried that your child has sickle cell you can arrange for them to have the blood test by making an appointment to see your GP. For couples who are expecting a baby and may be concerned that their baby may inherit sickle cell, your unborn baby can be tested from eleven weeks into your pregnancy. You can speak to your GP or obstetrician about this.
More Information
For more information on sickle cell please visit the Sickle Cell Society’s website
The Institute of Health Metrics and Evaluation (IHME) has found that unhealthy eating contributes to more deaths globally than any other factor. This is because unhealthy eating plays a role in increasing risk of heart disease, stroke and diabetes. They also found that high blood pressure was another big cause of premature death across the world.
The IHME’s conclusions are based on data from 108 countries from 1990 to 2013.
This study is very important as it adds to the evidence base that shows the extent to which our diet affects our health and wellbeing. It also shows that we can significantly improve our health by making very simple changes to our lifestyle.
Researchers at the National Institute of Ageing have published the results of their study exploring the relationship between weight at midlife and Alzheimer’s Disease.
In their study they found that being obese or overweight at midlife (at age 50) may put people at increased risk of developing early onset Alzheimer’s Disease. They found that for each unit of increase in BMI at age 50 accelerated onset of Alzheimer’s by nearly 7 months in those who developed the condition.
Although more work is needed to confirm this relationship between body weight and Alzheimer’s, this work suggests that maintaining a healthy weight could be an option for delaying the development of Alzheimer’s.
Our cycling group have had a great time over the past two months building up their confidence to cycle on the road, learning cycling techniques, getting some exercise and discovering new and interesting places in Croydon.
Since our last update where we shared our experience cycling from Croydon to Catford we’ve had quite a few cycling adventures. We started off with a lovely 16.3km ride through South Norwood, Beckenham and Crystal Palace. This route saw the group take on quite a few hills and busy roads as well as beautiful parks like Crystal Palace Park where we discovered the park’s Darwin and the Dinosaurs trail, a collection of life-size dinosaur models created by leading scientist Richard Owen.
Our second cycling adventure was a 16.4km route from Croydon Arena to Central Croydon and then on to Lloyd Park, Addiscombe and South Norwood Country Park. This was a really lovely route taking us through some beautiful, quiet neighbourhoods and along a number of green spaces.
Our most recent adventure was a 14km ride to West Wickham this was a challenging and sometimes dramatic ride as we battled scary roundabouts , rush hour traffic, and numerous buses.
These last three cycling sessions were great fun. Altogether we cycled 46.7km and burnt about 600 calories and we look forward to next week’s adventure.
High blood pressure is a major challenge for the black community in the UK with 33% of black adults having high blood pressure compared to 16% of white adults. When we look at the actual numbers, to understand the scale of the problem, the black community makes up 3.3% of the UK’s population so a staggering 625,503 black people in the UK are known to have high blood pressure; we have to do something about this.
What is high blood pressure?
Blood pressure is a measure of how much force (pressure) our blood exerts on our blood vessels (our arteries and veins). High blood pressure, medically known as hypertension, occurs when the force our blood exerts on our vessels is consistently higher than what is considered to be a healthy level, which is generally 120/80mmHg. If a person has several blood pressure measurements, on separate occasions, which are 140/90mmHg or higher then they are considered to have high blood pressure. This is a major concern because it is associated with a number of health complications with people suffering from high blood pressure being twice as likely to have a heart attack or stroke. This is because the high pressure can damage our arteries affecting the blood supply to our heart or brain.
What causes high blood pressure?
The exact cause of high blood pressure is unknown but there are a number of factors that increase a person’s risk of developing high blood pressure and many of these factors are associated with lifestyle and these include: lack of physical activity, an unhealthy diet (especially a diet high in salt), being overweight or obese, drinking too much alcohol, stress and smoking. Furthermore, your risk of developing high blood pressure increases as you get older, and you’re at a higher risk if you have a family history of high blood pressure, are from the black community and suffer from sleep apnoea. Additionally there are a number of health conditions that increase a person’s risk of developing high blood pressure so for example people who have diabetes, kidney disease and adrenal and thyroid disorders are at increased risk of developing high blood pressure.
Why is the black community at higher risk of developing high blood pressure?
We know that the black community in the UK are twice as likely to develop high blood pressure as their white counterparts and are more likely to develop it at a younger age, but the question is: why? Research suggests that there may be several reasons for this and here are just four key reasons:
Salt Sensitivity
We now know that people respond to salt differently so some people who consume large amounts of salt will not go on to develop high blood pressure whilst others will. This has led to a term called salt sensitivity which is a measure of how a person’s blood pressure responds to salt. A person who is salt sensitive is likely to develop high blood pressure from consuming salt whilst a person who is salt resistant is unlikely to develop high blood pressure from consuming salt.
Sodium (salt is sodium chloride), blood pressure and fluid balance are controlled by the renin-angiotensin-aldosterone system in our body. In this system hormones control the absorption of sodium by the blood and therefore control our blood pressure. People who are salt sensitive have genetic variations in some of the genes involved in the renin-angiotensin-aldosterone system which makes them less able to handle salt and maintain a normal blood pressure.
Members of the black community are more likely to be salt sensitive particularly black Americans and black Caribbeans who are thought to have inherited the aforementioned genetic variations.
“The majority of salt consumed by people of black African descent is from salt added in cooking and/or at the table. This is in contrast to the rest of the UK population (and indeed the Western world) where 75% of salt intake comes from processed foods. A health survey in England found that 83% of black men and 85% of black women added salt in cooking. Over a quarter (28%) of the same population add salt at the table. Salted meats and fish like salt-fish and salt-beef, and heavily seasoned meats such as fried chicken, stews and curries can contain a lot of salt.”
This suggests that the black people may consume more salt than their white counterparts and when this is coupled with the salt sensitivity phenomena this is a recipe for disaster when it comes to high blood pressure.
Increased Risk of Diabetes
Diabetes is a key risk factor for high blood pressure with about 80% of type 2 diabetics suffering from high blood pressure. When we look at how diabetes affects the black community data suggests that the black community is three times more likely to develop diabetes than their white counterparts, and this will mean that as a result of diabetes black people will be more likely to develop high blood pressure. Again, if we put this into numbers, to understand the scale of the problem, it is estimated that 5.3% of the UK’s black population have type two diabetes compared to 1.7% of the white population which means that 50,000 black people in the UK are affected by diabetes and hence are at a higher risk of developing high blood pressure.
Lifestyle
We also know that the black community are at increased risk of high blood pressure due to other lifestyle factors, for example black African women in the UK have been found to have the highest prevalence of obesity and obesity is a risk factor for high blood pressure. Additionally, the black community are less likely to be physical active with NICE reporting that:
“African-Caribbeans aged 16 to 74 years, 62 per cent of men and three quarters of women do not participate in enough physical activity to benefit their health* (HEA 1995a), compared with the general population (59 per cent of men and 68 per cent of women (HEA 1995b).”
Physical inactivity is a key risk factor for high blood pressure and the above shows that many black people are not achieving their recommended level of physical activity putting us at a higher risk of developing high blood pressure.
What can we do?
In order to tackle this problem we clearly need to make some changes to our diet and lifestyle. We can make a significant difference by looking at our salt intake. The government recommends that adults consume no more than 6g of salt a day. To achieve this we have to:
Avoid adding salt to our food and use herbs and spices to season our food
Avoid processed foods
Ask restaurants to prepare low-salt versions of the dishes on their menu
For some great tips on how to reduce your salt intake visit Consensus Action on Salt and Health’s website
Additionally we have to get more active and aim to do 30 minutes of physical activity every day and we have to tackle diabetes. We can reduce our risk of developing diabetes through lifestyle changes, – a healthy diet, being active and maintaing a healthy weight.
Finally, there needs to be collaboration between the government, the food industry, the public and charities to ensure that it is easy for all of us to achieve a healthy lifestyle or else this problem of high blood pressure will not go away.
References
Ageymang C & Bhopal R. Is the blood pressure of people from African origin adults in the UK higher or lower than that in European origin white people? A review of cross-sectional data. Journal of Human Hypertension. 2003; 17(8). 523-534
Blood Pressure UK.
D Lane, D G Beevers and G Y H Lip. Ethnic differences in blood pressure and the prevalence of hypertension in England Journal of Human Hypertension (2002) 16, 267-273. DOI: 10.1038/sj/jhh/1001371
Diabetes UK. Diabetes: Facts and Stats (2014)
Diabetes UK. Diabetes in the UK 2011/2012: Key Statistics on Diabetes. Diabetes UK, 2011
Fuchs FD. Why Do Black Americans Have Higher Prevalence of Hypertension? An Enigma Still Unsolved. Hypertension.2011; 57: 379-380
Gatineau M, Mathrani S. Obesity and Ethnicity. Oxford: National Obesity Observatory, 2011
NICE. Promoting Physical Activity Among Black and Minority Ethnic Groups
Scarborough P, Bhatnagar P, Kaur A, Smolina K, Wickramasinghe K and Raynew M.Ethnic Differences in Cardiovascular Disease. Oxford: University of Oxford/British Heart Foundation, 2010
Sullivan JM.1991. Salt sensitivity. Definition, conception, methodology, and long-term issues. Hypertension. 17(1 Suppl):I61-8. PMID:1987013.
The Stroke Association. Stroke in African Caribbean People. London: The Stroke Association, 2012
Last week, Diabetes UK reported that the number of people living with diabetes has risen by a staggering 60% over the past 10 years. They stated that 3.3 million people in the UK have some form of the condition which is up from 2.1 million in 2005.
About 90% of diabetes cases are type II which is strongly linked to lifestyle (diet and obesity) therefore we can reverse this trend by encouraging the UK’s population to change their lifestyle and adopt a healthy lifestyle.
The black community is three times more likely to develop diabetes and hence it is important that we take note of these statistics and make a concerted effort to do something about this.
As a community we have to look at our diet, make changes and get more active in order to beat this condition.
