On 1^st October, we attended the Fibroid Forum. This was an excellent informative event organised by a group of ladies affected by fibroids.  In our previous blog we discussed the first half of the event and in today’s blog we’ll summarise the second half of the event.

The final part of the fibroid forum focused on treatment and we heard from two speakers on this topic, Dr Raj Das, Consultant Diagnostic and Interventional Radiologist at St Georges and Professor Isaac Manyonda, Consultant Obstetrician and Gynaecologist at St Georges.

Uterine Artery Embolisation

Dr Raj Das focused his presentation on uterine artery embolisation (UAE), an established procedure which has been used by doctors since the 1990s to treat fibroids; it involves cutting off the blood supply feeding the fibroid.  Dr Das spoke about the evidence that demonstrated the benefits of UAE. The benefits include patients having a good clinical outcome, patients reporting a good outcome themselves, lower blood loss, a shorter hospital stay and a quicker return to work than  some other procedures.  He also added that for UAE the rate of infection is less than 5% and that after the UAE procedure the fibroids are still there and what they are looking for is symptom improvement rather than disappearance of the fibroids, but in 3-5% of cases the fibroids do clear themselves. He stated that UAE is a viable treatment for those wishing to retain fertility.

Dr Das also mentioned that UAE can be used when women with fibroids have any of the following: severe heavy bleeding,  painful periods, anaemia and pressure on the bladder or bowel.  He also touched on aftercare and suggested that women take 1-2 weeks off work after the procedure, avoid driving for five days and only engage in light activities at home during the recovery period.

Surgical and Medical Treatment

Following Dr Das’ presentation we then heard from Prof Isaac Manyonda. Prof Manyonda discussed surgical and medical interventions for treating fibroids and started by explaining that it is very important that doctors optimise the care that women receive because of the changing demographics of childbirth – women are delaying pregnancy until later in life when fibroids are more common and more likely to be symptomatic.  He said the old adage “babies, then fibroids, then hysterectomy” no longer works.

 Prof Manyonda focused his talk on two areas:

• The surgical removal (myomectomy and hysterectomy)
• The medical management (drug treatment – ESMYA)

With regards to surgical removal, Prof Manyonda stated that a myomectomy is more complex than a hysterectomy (removal of the womb) and there can be more blood loss. He mentioned that for the same sized fibroid it takes 40 minutes to perform a hysterectomy compared to  sometimes 150 minutes for a myomectomy. He also described the benefits of a hysterectomy which are: it provides a definitive cure, there is no possibility of a recurrence of the fibroids and it has one of the best outcomes  in terms of quality of life, but it does remove all fertility potential.  Prof Manyonda talked about the recovery period saying that a hysterectomy requires a 3-4 night hospital stay and an 8 week recuperation period with a phased return to work.

Prof Manyonda then discussed a myomectomy which is the removal of the fibroids while preserving the womb so there is the possibility of pregnancy in the future.  He explained that it requires a 4 night hospital stay and, like a hysterectomy, women will need an 8 week recuperation period with a phased return to work.  He also advised that women wait 6 months before attempting pregnancy. He did warn that whilst one of the main benefits of a myomectomy is to preserve fertility it can actually compromise the very same fertility that it is intended to preserve due to the formation of scar tissue, so it needs to be done carefully. Furthermore he explained that with a myomectomy we’re dealing with the fibroids that are there and it doesn’t tackle the cause so new fibroids can develop. He also said that it’s best that all the fibroids are removed and none are left behind to give women the best chance of a good outcome long-term.

He mentioned that many women are only offered a hysterectomy because it is felt they are too old for child-bearing or their fibroids are too large, too many or in the wrong place, but research has shown that women should also be offered a myomectomy and age, size, number nor location of fibroids should be a barrier.

Finally Prof Manyonda touched on the medical management of fibroids with the drug ESMYA. He stated that we need as many weapons as possible to fight fibroids as not everyone is suited for surgery or UAE. ESMYA is a drug that initially was licensed to be used 3 months prior to surgery but now it can be used as a standalone therapy. Research has shown that it can reduce the size of fibroids and improve a number of fibroids-related symptoms. He said whilst it is promising we have to exercise caution as its unclear what the long-term impact of this treatment will be. He said ESMYA is a good option for older women or for those who are not keen on surgery.

This was a really informative event which ended with an open discussion where women were able to ask Prof Manyonda and Dr Das questions and share their personal stories.

We’d like to thank the House of Bread for organising this much-needed conference and we were very pleased to have been given the opportunity to have a stall at this event.

Today is World Mental Health Day and this year’s theme is psychological first aid and the support people can provide to those in distress.

Watch our video clips below to learn what you can do support someone with a mental health challenge.

Abi Begho, Founder of The Lake Foundation

Abi Begho- from Aniku Ltd on Vimeo.

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Baffour Ababio, Psychoanalytic Psychotherapist

About Me: Baffour Ababio

Baffour WMHD-_2 from Aniku Ltd on Vimeo.

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Know What Support Services Are Available

Baffour WMHD- from Aniku Ltd on Vimeo.

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Reach Out and Be Inclusive

Baffour WMHD-_1 from Aniku Ltd on Vimeo.

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Olivia Haltman, Accredited Integrative Humanistic Counsellor and EMDR Therapist

About Me: Olivia Haltman

Olivia WHMD Intro from Aniku Ltd on Vimeo.

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Be Informed

Olivia WHMD_1 from Aniku Ltd on Vimeo.

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Don’t Give Up

Olivia WHMD_2 from Aniku Ltd on Vimeo.

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Ask if They’re OK

Olivia WHMD_3 from Aniku Ltd on Vimeo.

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Janet McNish,  Counsellor and Trainer

About Me: Janet McNish

Janet #wmhd Intro from Aniku Ltd on Vimeo.

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Take Care of Yourself

Janet WMHD from Aniku Ltd on Vimeo.

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Remember the Good Times

Janet WMHD_1 from Aniku Ltd on Vimeo.

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In Conclusion: Validate their experience and provide a listening ear

JanetOliviaBaffour WMHD from Aniku Ltd on Vimeo.

Last Saturday, we had the pleasure of having a stand at the Fibroid Forum. This was an event organised by a group of ladies from the House of Bread who have all been affected by fibroids.

The event brought together clinical experts, organisations working on various aspects of fibroids and women affected fibroids  to discuss this health issue and its treatment. There was also an open forum with an expert panel giving women the opportunity to share their experiences and ask experts questions.

In this blog we’re going to summarise the first half of the event which covered an introduction to fibroids, personal stories and an overview of the NICE guidance.  In our next blog we’ll summarise the second half of the event which covered surgical treatment, radiology treatment, aftercare and the open forum.

An Introduction to Fibroids

The event started with a welcome and opening prayer by Dawn Martin who also shared her story and stressed that fibroids are not just physical but emotional and it’s something that affected every aspect of her life including her relationships, work, what she wore and even planning her holidays.

This was followed by a short film that provided an overview of what fibroids are and then we heard from our first main speaker, Audrey Skervin, who talked through some facts and figures  as well as the symptoms.

We then heard from Yvonne Maye who discussed how fibroids have affected her. She stated that she was happy that we’ve now reached an age where women can speak openly about fibroids as when she was diagnosed many years ago issues like fibroids were not spoken about meaning that many women suffered in silence. Another interesting point she raised was the pressure that women felt at the point of diagnosis to have baby. Many doctors, and this was confirmed by other attendees, placed women under a lot of pressure to start having a family without understanding their personal situation and this added to their distress.

Fibroids Research Update: New NICE Guidelines on Heavy Bleeding

Next on the agenda was Christine Clewlow, Medical Scientific Liaison Manager at Gedeon Richter. She gave an update on interesting fibroids news focusing on the NICE guidelines.

NICE or the National Institute of Health and Care Excellence is the organisation that produces evidence-based guidance that is used by the NHS to decide what treatment should be made freely available on the NHS.

NICE has guidance on heavy menstrual bleeding which is very relevant to many women affected by fibroids, as this is one of the main symptoms. The NICE guidance on heavy bleeding was first written in 2007 and a summary version is available here. The parts of the guidance that are relevant to patients are:

• Any interventions [to treat heavy menstrual bleeding] should aim to improve quality of life measures
• A women with heavy menstrual bleeding referred to specialist care should be given information before her outpatient appointment
• Ultrasound is the first-line diagnostic tool for identifying structural abnormalities (e.g. fibroids)
• A women with heavy menstrual bleeding should be given the opportunity to review and agree any treatment decisions. She should have adequate time and support from healthcare professionals in the decision-making process

Christine highlighted the importance of these guidance  stating that they are designed to ensure that patients are being treated appropriately and women shouldn’t be afraid to challenge doctors if they aren’t following the guidance.

Christine also informed attendees that the guidance is being updated and the new guidance should be published in August 2017

In the discussion following Christine’s presentations there were some really useful recommendations put forward for women who have symptoms they are concerned about:

1. Before visiting your GP make a list of all your symptoms
2. Do your research so you arrive at your appointment with your GP prepared
3. Make a note of all your questions so you can have a constructive discussion with your GP
4. If you think you may have fibroids, be aware of the guidance so you can have an informed discussion with your GP about next steps.

This ended the first half of the event which was a good introduction into fibroids, providing attendees with a good foundation for the next half which was more clinical and this will be covered in our next blog. Stay tuned!

This blog is the second in a two-part series discussing alternative feminine hygiene products. This follows on from our blog on menstrual cups and this series is a result of a discussion at our recent fibroid focus conference that got us thinking about the fact that many women with fibroids experience heavy and prolonged periods. This means they use large quantities of tampons and pads and we want to ensure that women who use these products more frequently than most are aware of all the options out there so they use the best products for them.

What’s the Problem?

Over the last few years there has been quite a bit of focus on the chemicals in feminine hygiene products and these chemicals have raised concerns about their possible health effects.

Research has shown that chemicals like dioxins are found in trace amounts in tampons and pads. These chemicals are by-products of the bleaching process and whilst they are in small quantities and cause no harm after just a one-off exposure, women use these products very frequently and it’s not clear if the frequent exposure could lead to an accumulation of dioxins in the body. The WHO states that long-term exposure to dioxins  is “linked to impairment of the immune system, the developing nervous system, the endocrine system and reproductive functions.”

Additionally, testing has found detectable amounts of pesticides in five out of eleven of the products tested and long-term exposure to pesticides may affect the liver, brain and reproductive system and has been linked to autism and some types of cancer.

Furthermore many manufacturers don’t list all the chemicals in their products making it hard for women to make an informed choice about the products they use. This led to a petition calling for companies to list all the components of their feminine hygiene products which has been signed by over 250,000 people.

The Solution

In order to avoid the chemicals in tampons and pads a number of companies now manufacture organic feminine hygiene products to give women a more natural alternative.

Companies producing organic feminine hygiene products tend to used certified organic cotton as their absorbent material rather than synthetic absorbent material. They also don’t use harsh bleaching agents so their products are chlorine free and won’t have traces of dioxins.  They are also plastic free, fragrance free and many consider the environment and make their products biodegradable.

These organic products are a good alternative to the synthetic products that are widely available and it is worth searching them out.

Where Can I get Organic Feminine Hygiene Products?

One of the most well-known manufacturers of organic tampons and pads is Natracare, they have been producing these products for almost 30 years and have a wealth of experience. Their products are plastic free, certified organic, animal friendly, don’t result in fibre loss and are recommended by gynaecologists.  To find out where you can purchase their products click here.

Other organic feminine hygiene products include:

• Organyc
• NatraTouch
• Naty Nature Women Care
• The Honest Co. Feminine Care

For a convenient one-stop-shop that sells a few different brands, then you can try Be Prepared.Period who sell a range of organic feminine hygiene products.

If you’re looking for a more natural alternative when it comes to tampons and pads then why not give the  above mentioned organic products a try.

Do you use any of these products? What are your thoughts? We’d be interested in hearing what you think about this topic. Is using organic feminine hygiene products important to you? Leave a comment below.

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References

A question for women’s health: chemicals in feminine hygiene products and personal lubricants. Environ Health Perspect. 2014 Mar; 122(3): A70-5.

Feminine Protection Products: What do they consist of? 60 Million Consumers, 23^rd Feb 2016

Tampax tampons and Always sanitary towels among feminine hygience products that contact toxic chemicals.  The Independent, 25^th Feb 2016.

This weeks’s blog post is a guest post from Nadene Clarke, the founder of  a new organisation, Voices for Autism. Nadene tells us about why she started Voices for Autism,  provides some background to this condition and shares her personal experience with autism. 

My name is Nadene and I am the founder of Voices for Autism. Voices for Autism is a non-profit organisation which supports parents/carers who care for a young person with Autism living in London. It was created for parents/carers to help spread awareness as well as create a community for parents/carers to feel a part of.

Autism is quite common in the UK affecting approximately 70,000 people. It is a lifelong developmental disability that affects how a person sees the world. It also affects how a person communicates with, and relates to other people. It is a spectrum condition which means people with Autism have a range of difficulties in common but it affects everyone differently.

Voices for Autism was born out of my personal experience with the condition. My son was diagnosed with Autism when he was 11 years old. When he was diagnosed, I felt that there was not enough support out there post-diagnosis in and around my community and whilst trying to deal with our new hurdle, I spent some time thinking of ways to build up the Autism community as it is a very sensitive subject.

My son was born prematurely so we were informed that he would have some difficulties in his childhood and it was not until he reached secondary school age that I felt I needed to do more as he was moving into a new setting so I requested for him to be assessed by a neurological team. Mainstream primary school was fantastic with all of the right support he needed but I knew it would be very different in secondary school……and I was right!

As parents we had never considered a special setting and went ahead with the mainstream secondary setting but this was a terrible experience in my eyes. He moved into a special setting soon after joining secondary school and we have not looked back.

At Voices for Autism we are striving to create a haven where we can come together to share advice, ideas, strategies etc. We want to echo the message that young people with Autism are unique and deserve the same opportunities as those without a disability.

I have been hosting coffee mornings on a monthly basis since the beginning of 2016 and they are proving so useful and are growing. We are a friendly bunch and can see that there is not enough support available for us parents/carers. The coffee mornings are set in a relaxed, informal environment where we are building strong, positive relationships and our group feels like one big family.

As a parent, it is important for me to empower and motivate others with the journey that myself and my son have been on, what a journey, but we are stronger because of it. It is vital for us to remember that we are our child’s biggest advocates and if we do not speak up for them, nobody will.

Let’s build a community, let’s build a voice!

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The Lake Foundation would like to say a big thank you to Nadene Clarke for sharing her experience with autism and introducing us to the great work that Voices for Autism is doing. If you would like more information about the support that they provide please visit their website: http://www.voicesforautism.co.uk or email info@voicesforautism.co.uk

The Eve and Grace Wellness Centre in Battersea opened its doors to the public on Saturday 10^th September 2016. This is a lovely space that aims to connect the community and promote healthy behaviours by providing education, support and wellness services to all. The services that the centre will offer will include yoga, reiki, massage,  pre and postnatal care and much, much more.

Our founder, Abi Begho, attended the launch of the wellness centre and said:

“We were delighted to attend the opening of the Eve and Grace Wellness Centre. This is a lovely space that will offer much-needed services to the community and play an important role in improving the health and well-being of its service users. We fully support this organisation, wish them all the best and look forward to exploring opportunities for collaboration”

The centre will start its activities with taster sessions from Monday 19^th September. To find out more and register an interest to attend please visit www.eveandgrace.co.uk

Sheila is The Lake Foundation’s Cycling Club Coordinator and since joining us in March she has done a fantastic job in managing our cycling club. In this blog Sheila discusses her role and what she enjoys most about it.

Tell us about your role as the cycling club coordinator.

The aim of the cycling club is to give people an opportunity to be more active. So we organise a 2-hour bike ride every 2nd and 4th Saturday of the month. Once a year we organise a 4-hour ride taking us a bit further into the countryside and a social where we will have a meal. The social is usually around Christmas.

Organising the rides involves liaising with our wonderful instructors from Cycle Instructor. They will suggest routes and lead the group on the day. I manage bike reservations and organise our participants. I update them on what we are doing and about cycling opportunities in the local area and beyond. I also spread the word about the cycling club using leaflets, writing and social media.

What do you enjoy most about your role?

London can be both lonely and stressful. This can take its toll on us in the long term. There are physical and mental benefits of people coming together and people doing exercise. So it’s rewarding to know the cycling club is doing its part to promote well-being. The group is fun and positive. You can also chat as much or as little as you want for example. Everyone is welcome and everyone seems to be him or herself.

What has been your favourite cycling route and why?

I like cycling in any green space. There are lots of green spaces in Croydon and I’ve enjoyed discovering them.

What advice would you give to someone who is thinking of joining the club but is a bit nervous?

Cycling Instructor is a helpful resource. They offer free one-to-one and group sessions. They will instruct you in how to cycle on roads and public spaces and teach you techniques. You can do one of their courses before joining The Lake Foundation Cycling Club and can also have a refresher with them at any time. The Lake Foundation Cycling Club members are supportive. In this atmosphere we find that new riders grow in confidence.

Do people have to be super fit or an experienced cyclist to join the club?

Our cycling club members are mixed in ability and fitness. People tend to be less confident if they feel they can’t keep up. So we encourage people to maintain regular exercise outside of the club and to practice cycling where possible. One of our members went on to do the London to Brighton ride and another ride after that. Another couple of riders did a 10k run for Cancer Research UK. London is a great city for charity and fun fitness challenges and the club members seem to inspire each other to take advantage of these opportunities.

Do you have to have your own bike to be a part of the club?

We have a few cycles and helmet sets that people can reserve, this way people can try cycling without taking the lead of buying a bike first. One regular member has since purchased his own bike.

What do you enjoy most about cycling?

I like the fact that I’m being active. I think you experience our city in a different way on a bike than if you were in a bus, car or on the tube. I like the freedom it gives and it’s an efficient way to get around town. I cycled more when I was living closer to central London, which is more cycle friendly these days.

What advice would you give to anyone new to cycling in terms of technique, equipment and building confidence?

I would do a course with Cycle Instructor. Go to a good and reputable cycling shop and get kitted out with a well fitted helmet, good lights, a good lock etc. Be super safe, sensible and make sure you keep hydrated. There are lots of helpful resources out there.

When you’re not cycling what do you do for fun?

I enjoy dancing, walks and cycles in the country, cinema, theatre, cultural events and hanging out with folk.

How can people join the cycling club?

The best way is to drop us an email today at events@thelakefoundation.com. Also stay in touch with The Lake Foundation on twitter and Facebook!

Many years ago before I even knew what endometriosis or fibroids were I knew the sudden stabbing pains I felt in my side weren’t right. My periods were often heavy and ‘clotty’ but I was too embarrassed to discuss it with anyone and so I suffered in silence.

Some years later I was living in England and when the pain recurred I went to see my GP who disappointed and shocked me with his response when I described my symptoms to him. My GP asked me whether I was planning to have children. I was 22 then and not ready. He replied, ‘well there are a lot of people who don’t have children’. I left the clinic stunned. I wasn’t very assertive then so didn’t answer him back.

Fortunately, I did have my son a couple of years later and all was well. I remember though that the pains would come and go but I just bore it. During a trip to Ghana, I woke up to stabbing pains in my right side again which had me doubled up in pain. When I got back home I saw my GP who referred me to a Consultant who happened to be the one to travel this journey with me. She sent me to carry out some tests which revealed I had endometriosis and fibroids. I was given tablets to help and the pain subsided. By then my son was 5/6 years old. At one of my check-ups my Consultant asked me whether I wanted any more children and advised me to do it ‘sooner rather than later’.

A year later, on Valentine’s Day, I went for another check-up, my Consultant was about to prescribe some more medication for me when I told her I might be pregnant. We did a test which was positive!

Whilst pregnant and after my daughter’s birth there were no symptoms and my doctor told me many women find the fibroids and endometriosis disappear during pregnancy.

Eight years ago I felt the pains and discomfort again. The same Consultant I had seen over 12 years earlier was still working at the hospital which I considered a blessing as she knew my history. She sent me off for a scan. I knew there was a problem when the lady carrying out the scan stopped joking and suddenly had a serious look on her face. I asked whether everything was alright, she told me my Consultant would be in touch.

I received an appointment. It was a different Consultant this time who asked me to have some blood tests done. I asked him whether I should have them done at my local hospital, he said no and that I had to have the blood tests done straight away!! As I walked to the department to have the tests done I opened the letter and saw the letter C scribbled amongst other medical jargon. I knew straight away I was being sent to test for some form of cancer. And I was on my own!

I got home and looked the medical term up on the internet which confirmed my fears, it was a test for cancer!

Another appointment came and my husband accompanied me. Thankfully it was my regular Consultant. She gave me the results and explained the scan showed a very large cyst on my right ovary which they thought could have been cancerous. The blood tests had however come back clear.

My Consultant went on to say she felt I needed to have a hysterectomy as soon as possible because I had a ‘diseased womb’. My husband and I were shocked and we tried to ask for other options. She told us that this time I didn’t have a choice and that on top of my problems with fibroids, endometriosis and the cyst on my ovary I also had an ‘enlarged womb’! Gosh, the list just gets bigger! She then booked an appointment whilst we were in her office for my surgery in 2 weeks’ time!

I had the surgery by this Consultant in September 2006 and thank God all was well. No cancer found. I however had to undergo a ‘total hysterectomy’ which meant losing my ovaries, womb, tubes and cervix. I guess the risk of cancer was great and she wanted to eliminate any possibility.

I cried for a while to think I had lost my ‘womanly bits’ but my husband sternly told me to be grateful to be well and alive. That shook me up and I started to take a positive approach. I had two healthy children, one of whom I didn’t think I would be able to have. I used to call her my ‘little miracle’.

After my surgery I had to go on HRT which I didn’t want to because it made me ‘feel old’. I soon went on it though when I had a sudden surge of heat through my body and quickly stuck my head in the freezer! My family watched me do this in amazement, confusion and amusement!

I have been on HRT patches for 8 years now and feel fine. I have put on a lot of weight but I’m not sure whether that has anything to do with the HRT or the lovely cakes people keep bringing in to work!!

Two months ago a friend mentioned HRT caused her to put on a lot of weight. She came off it and used another form of medication which is made from natural minerals. I have started using it too and have taken myself off the HRT. I have weighed myself and found I have lost a little weight. I need to cut out the cakes and do some walking and I will be back in shape.

I am thankful for my life and have learned it is good to talk, share our fears and experiences; you can learn from someone else and they can learn from you! Let’s be aware and educate ourselves.

Well done on setting up this website!

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The Lake Foundation would like to say a big thank you to Naa for sharing her experience with fibroids and endometriosis, we hope that through her experience you have gained some insight into these conditions.

To learn more about fibroids download our booklet below  and for more information about endometriosis visit Endometriosis UK’s website

Disclosure: this post contains an affiliate link. Find out more here.

A study published in the British Journal of Cancer has found that the effect of combined hormone replacement therapy (HRT) in increasing a women’s risk of developing breast cancer is likely to have been underestimated in previous studies.

HRT is used to treat the symptoms of menopause (hot flushes, mood changes etc) by replacing the oestrogen that is lost during a woman’s menopause. There are two type of HRT, oestrogen only HRT and combined HRT which is mixture of oestrogen and progestogen.

Over the years studies have identified that women using HRT have an increased risk of developing breast cancer but this was only felt to be a slight increase with many stating that the benefits of taking HRT outweigh the risks.  This new study has found that combined HRT actually has a bigger effect on breast cancer risk than was previously thought.

This New Study

This new  piece of work was part of the Breast Cancer Now Generations Study which was set up in 2004 to understand the causes of breast cancer. The full Generations Study is following 113,000 women in the UK for 40 years.

 For this research into the effect of HRT, 39183 women from the Generations Study were selected who were at menopausal age. These women had  been monitored for 6 years through questionnaires which asked a number of questions including questions about their HRT use.

After the six years of monitoring it was found that 775 of the 39,183 women had developed breast cancer. Statistical analysis revealed that women using combined HRT were 2.7 times more likely to develop breast cancer than those who had not used HRT. This applied to use of HRT for a median length of time of 5.4 years and when they explored longer use of HRT, so 15+ years of use, this increased to women being 3.27 times more likely to develop breast cancer. No overall increase in breast cancer risk was observed in women who used oestrogen only HRT.

They also found that the increase in risk returns to almost normal once combined HRT use is stopped. Researchers noted that after a year and also two years of ceasing to take combined HRT there was no significant increase in breast cancer risk.

How Did Other Studies  Result in an Underestimation of Risk?

The underestimation by previous studies occurred because of the way the studies were carried out. Previous studies didn’t comprehensively follow-up with women and document their use of HRT  (e.g. did some women  stop using HRT over the course of the research) nor did they determine the age at which women went through the menopause.  These oversights caused inaccuracies.

What Does this Mean for Women Considering Taking Combined HRT?

Baroness Delyth Morgan, the Chief Executive of Breast Cancer Now said:

“Whether to use HRT is an entirely personal choice, which is why it’s so important that women fully understand the risks and benefits and discuss them with their GP. We hope these findings will help anyone considering the treatment to make an even more informed decision.

“On balance, some women will feel HRT to be a necessity. But in order to minimise the risk of breast cancer during treatment, it is recommended that the lowest effective dose is used for the shortest possible time.

“The good news is that the increased risk of breast cancer begins to fall once you stop using HRT. “If anyone is at all worried about either HRT or breast cancer, we’d highly encourage you to speak to your GP.”

The Lake Foundation believes that women considering using the combined HRT should have a discussion with their doctor about the pros and cons and make an informed decision about whether to proceed with treatment. If you can avoid combined HRT we would recommend that you do so.

You can download the full research paper below.

Yesterday, the UK Government published its childhood obesity action plan which sets out its strategy to significantly reduce obesity levels in children over the next ten years.

Childhood obesity is a major problem in the UK with nearly a third of children being obese or overweight. There are a number of factors that have contributed to this and these include behaviour, our environment, culture and genetics.

The government’s action plan makes an important observation which is that obesity levels are highest in children from low-income families.  Research has shown that 5 year olds in the poorest  families are twice as likely to be obese than their affluent counterparts and by the age of 11 they are three times more likely to be obese. We need to address this inequality.

The government’s action plan aims to provide a good balance of reducing childhood obesity whilst respecting the public’s freedom of choice when it comes to food selection. They also clearly state that this action plan is a starting point rather than a complete final plan.

A Summary of the Action Plan

Introducing a sugar levy (the sugar tax)

Soft drinks companies will pay a levy on drinks with added sugar. This will apply to drinks with a total sugar content above 5 grams per 100 ml. A higher rate will be applied to drinks with more than 8 grams per 100 ml.  The levy won’t be applied to milk-based drinks or fruit juices.  The levy will come into effect from April 2018.

Soft drinks manufacturers will have two years to reduce the sugar content of their drinks so they won’t be taxed if they are successful. The government states that there has already been some success with some manufacturers already reducing sugar in their drinks.

The money raised from the sugar levy will be used to double the funding available to primary schools for PE and sports programmes. The government has estimated the sugar levy will raise £320 million a year for primary schools to support healthier more active lifestyles in children. The funding will not only go towards expanding PE and sports programmes but to also expand breakfast clubs in primary schools ensuring that children have access to a healthy breakfast every week day.

The idea behind the sugar levy is a good one. It’s hoped that the levy will incentivise the soft drinks industry to reduce the amount of sugar in their products, helping the public consume less sugar. The money raised will go towards helping children get more active and healthy and thus tackle our high rates of childhood obesity.  So, from a public health point of view the sugar levy is a win-win.

Taking out 20% of sugar in products

The government will be slowly reducing the sugar content in everyday products  and will launch a sugar reduction programme to reduce sugar in products that are popular with children.  All sectors in the food and drinks industry will be challenged to reduce the sugar in their products by 20% by 2020, this will include a 5% reduction in year one. Their recommendations to the food and drinks industry are to:

• Reduce sugar in their products
• Reduce portion sizes
• Use lower sugar alternatives

The sugar reduction programme will focus on nine areas: breakfast cereals, yoghurts, biscuits, cakes, confectionery, morning goods (such as pastries), ice cream and sweet spreads. They will then move on to other foods and drinks such as milk-based drinks and they will ensure that they focus on ranges that target babies and young children.

The government will monitor progress and publish reports every six months to determine if manufacturers are on track to achieve the 20% reduction.

The action plan also makes the point that sugar reduction should also mean calorie reduction and manufacturers should not increase the saturated fat content of their products.

We like the sugar reduction programme with its clear targets and hope that the manufacturers will comply and work with the government to achieve this. The issue we see is that manufacturers have no strong incentive to take part in this programme and may continue as is.  Also, we know some manufacturers don’t appreciate the government interference in the way they do business and may not comply out of principle – they think it will set a nanny state precedent.

Supporting innovation to help businesses make healthier products

The action plan summarises how the government is supporting businesses in making healthier products. This includes: a £10millon investment to support research that explores new processes and products to increase the availability of healthy food choices; the formation of the Agri-Food Technology Council to provide leadership in health, nutrition and consumer acceptability; and the formation of the Food and Drink Innovation Network which brings together the food and drinks industry, researchers and innovation support to enable greater take up of world-leading R&D.

Updating the nutrient profile

The current nutrient profile which gives foods a score based on their sugar, fat, salt, vegetables, nuts, fibre and protein content is 10 years old and needs updating. It does give parents a view on how healthy their food is and enables them to make healthier choices, but work is needed to update it so it is in line with today’s scientific advice.

The government will therefore work with academics, the food and drinks industry, charities and other stakeholders to update the nutrient profile.

Making healthy options available

The action plan talks about the potential of the public sector to make a significant contribution to reducing childhood obesity.  They state that every public space from leisure centres to hospitals should serve healthy food.  The government has committed to working with their local government colleagues to ensure that this will happen.

Helping low-income families in purchasing healthy foods

The government will continue with their Healthy Start Scheme which provide vouchers to low-income families, these can be exchanged for fruit, vegetables and milk. The scheme also provides vitamins during pregnancy and early years.

Encouraging children to take part in one hour of physical activity every day

The government aims to support schools in using the funding raised by the sugar levy on sports programmes that have the maximum impact possible and guidance will be developed on how best to implement school PE, sports and healthy lifestyle programmes. Support will also be given to schools to ensure they have access to high quality sports and physical activity programmes. Additionally the government will continue to invest in making it safe for children to walk and cycle to school.

Encouraging healthy eating in schools

The government will introduce a voluntary healthy rating scheme to recognise the work being done in schools to ensure that children are eating healthy and getting active. There will be a focus on continuing to improve school meals through the School Food Standards and breakfast clubs will continue to provide children with a healthy start to the day.

Other measures

Other areas the government will focus on are:  clearer food labels, making use of technology in the form of apps and other digital resources, for example the sugar smart app and exploring how health professionals can support families.

Conclusions

We are very happy to see the government publish its childhood obesity action plan, and we see it for what it is: a starting point.

We believe that it is a good starting point and are particularly happy to see the sugar levy; the sugar reduction plan; the investment being made in research and development to support businesses in making their food healthier; the support given to schools to ensure kids are active and healthy during school time; and the support given to low-income families.

We hope that everyone will play their part so that this plan is successful and we hope that the government will continue to develop its strategy to ensure that all areas are addressed.

You can download the full report below.