The Christmas and New Year break are over and although I enjoyed it, I felt strangely relieved.  I think that’s because although it’s normally a really enjoyable time of year- it can also be highly stressful.  We know stress has an effect on general health. But how much do we know about how stress affects particular conditions associated with the Black community?  Black women have the highest risk of developing fibroids (non-cancerous growths in or around the womb). They can lead to heavy periods, period pain and pregnancy challenges (amongst other things). It is useful to know if stress plays a part in the existence of fibroids since we can control the way we handle stress.

A basic search of the literature doesn’t reveal many studies focused on the link between stress and fibroids.  One study did note that the increase in stress hormone cortisol can cause fluctuations in oestrogen and progestogen. Low levels of these hormones are linked to a reduction in fibroid growth.  This particular US study actually investigated the links between major-life event stress and fibroids in both Black and White women.  The authors reported  that the greater the number of ‘major life events’ the female experienced, the more likely she was to have fibroids. The pattern was evident among white women who had experienced all levels of stress yet only obvious  among  very highly stressed  Black women.  The authors of another study looked at 22,002 premenopausal  US Black women.  They reported that high levels of self-reported racism increased the risk of fibroids.  However, a study on Chinese women did not find any link between stress and the presence of fibroids. You can find out more about these studies here, here andhere.

Due to the small number of studies which investigate the link between fibroids and stress, it is difficult to say whether there is a true link- more work needs to be done in this area.  However, some people do find that they discover their fibroids after a period of stress in their lives. Have any of you had this experience?

A new report about the burden of obesity in the UK, has delivered shocking predictions about future cancer rates. Based on today’s trends the report predicts that nearly 3 in 4 adults will be overweight or obese by 2035 and this would lead to an additional 670,000 cases of cancer.

Rising obesity may lead to increased cancer rates for several reasons. High amounts of fat in the body change the levels of hormones such as oestrogen and testosterone which may raise the risk of cancer. Raised levels of fat can also alter the quantities of chemical messengers in the body and possibly have cancer related effects.

 Black people are at already very high risk for particular forms of cancer.  Black men have the highest risk of developing prostate cancer amongst all other ethnicities. Young Black women have worse breast cancer outcomes compared with white women.

The report (co-authored by Cancer Research UK and the UK Health forum) also suggests a variety of strategies which may help reduce obesity rates and consequently cancer rates. These recommendations appear to be sensible and practical but may not be sufficient for members of the UK population at high risk of obesity e.g. Black men and women. According to a 2014 report, Black men and women have the highest rates of obesity in England. Furthermore, it has been reported that Black and other ethnic minority children have higher rates of obesity when compared to White children in the UK. Further investigation into the obesity challenges faced by the Black community is needed.

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

Comfort Momoh is a  Female Genital Mutilation/Public Health Specialist at Guy’s and St Thomas’ NHS Foundation Trust in London and  is the founder of the African Well Woman’s Clinic, a service that provides counselling, support, information and surgical reversal to women and girls who have undergone FGM.  

She was an advisor to the World Health Organisation, represented the UK at the UN Commission on the Status of Women in 2001, is the Chairperson for  Black Women’s Health and Family Sport,  is the vice-president of the European Network on FGM and is a member of the UK’s FGM National Clinical Group.

 In 2003, she was awarded the first ever nurse/midwife of the year award by Guy’s and St Thomas’ Foundation Trust , in 2014 she was the recipient of the Nigerian Centenary Awards’ 100 Outstanding Nigerians past and present who have lived in the UK over the past 100 years and in 2008 she was awarded an MBE for her services to women’s health.

[Photo credit: Top Forma]

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.