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.

At our recent Fibroid Focus conference an interesting question was raised: “Has anyone used the Mooncup?” There were a few blank stares, which came from us too, and then an attendee answered: “Yes, and it is so much better than tampons and pads.”

This little exchange got us thinking.

Many women with fibroids experience heavy prolonged periods meaning they use large quantities of pads and tampons. Over the last few years there has been quite a bit of focus on the chemicals in these products and this has raised concerns about possible health effects. This led to the formation of a number of companies who now manufacture organic feminine hygiene products to give women a natural alternative.

But are women with fibroids aware of all the options available when it comes to feminine hygiene products and are they aware of alternatives like the Mooncup (a menstrual cup made by Mooncup Ltd)? This is particularly important for women with fibroids, who are likely to need to use large quantities of pads and tampons, and may be concerned about their prolonged exposure to the chemicals in these products.

In this blog series we are going to introduce you to a selection of feminine hygiene products starting with the menstrual cup today.

What is a Menstrual Cup?

A menstrual cup is a small flexible cup usually made of silicone, but can also be made of rubber, that is inserted into the vagina and collects menstrual blood. Depending on the amount of flow the cup is removed every 4-8 hours, emptied, washed and reinserted. At the end of a woman’s period the cup can be sterilised and the same cup used again every month. The shelf life of menstrual cups is fairly long with manufacturers recommending that they be replaced, on average, every 5 years.

Many companies make menstrual cups and these include:

• Mooncup Ltd
• DivaCup
• Lunette
• IrisCup
• MeLuna

Are Menstrual Cups New?

The menstrual cup was invented by Leona Chalmers in the 1930s and she patented her design in 1935. So the menstrual cup is over 80 years old and has been used for decades.

Is it Safe to Use?

Research has shown that the cup is safe to use with only a very small number of issues reported.

There has been just one case of toxic shock syndrome linked to the use of a menstrual cup, making this a very rare occurrence.  Additionally, one research paper reported that a woman may have developed adenomyosis and endometriosis  after using a menstrual cup for four years and the Endometriosis Research Centre in the US has called for more research to determine if there is link between the use of the menstrual cup and endometriosis.

Several studies have shown that, provided the cup is used properly and is kept clean, the risk of infection is low.  Also, for those worried about allergic reactions the majority of cups are made from medical grade silicone and silicone sensitivity is very rare. For those with a latex allergy they just need to ensure that they use a cup that is made entirely of silicone and does not contain rubber.

The Benefits

There are many benefits of using a menstrual cup. These include:

• Environmentally friendly – one cup can be used for 5 years which means there is less waste created than if tampons or pads are used
• Cost effective – menstrual cups costs about £20 and last for up to 5 years so this works out much cheaper than pads which are estimated to cost about £80 per year and tampons about £43 per year.
• No exposure to toxic chemicals – menstrual cups do not contain the bleaches, pesticides and other chemicals that the majority of pads and tampons contain
• Doesn’t cause dryness –tampons and pads can cause vaginal dryness because they are made of absorbent material, the cup simply collects fluid and isn’t drying
• Less leaks

The Drawbacks

There are some disadvantages associated with the menstrual cup:

• Inserting and removing the cup can be challenging
• Emptying the cup can be quite messy
• Women with certain conditions may not find a cup that fits properly. This has been reported for women with a dropped uterus and certain types of fibroids
• The cup needs to be kept clean to avoid infection so it requires some maintenance every month and needs to be sterilised after each cycle

Conclusion

If you’re looking for an alternative to tampons and pads a menstrual cup is an option you can explore. It may take some time to get used to it, but we recommend that you give it a few months before you make a judgement.

Saturday was a really exciting day for us as we hosted our first fibroids conference, Fibroid Focus. The theme of the conference was treatment and we aimed to provide an in-depth look at all treatment options including natural options.

The day started with an introduction by our founder, Abi Begho, who welcomed everyone, explained the aim of the day and briefly summarised the work we’ve been doing on fibroids. This work has included conducting a survey to understand the needs of black women with fibroids, forming an expert panel, developing a booklet and organising awareness events.

You can watch a clip of Abi talking about the event here

Exercise and Fibroids

We first heard from Lillian Lartey the founder and CEO of I Want My Body Back. Lillian discussed exercise and fibroids and we learnt that exercise has been shown to be beneficial in reducing the risk of developing a number of hormone-dependent conditions such as breast cancer and hence we expect that it will also be beneficial in preventing fibroids but also in improving symptoms as part of a healthy lifestyle. Lillian explained that stress is an important factor as any benefits of exercise are cancelled out if we are experiencing persistent stress in our lives. Finally, Lillian reminded us that we should be aiming for 30 minutes of moderate exercise a day and that we shouldn’t consistently take part in long bouts of exercise as this can put pressure on our body. Lillian ended with three suggestions on how to move forward:

• Check your lifestyle – how will exercise be a part of your life?
• Choose the right type of exercise for you and avoid stress-induced exercise
• Manage your stress – this is more than just resting but managing your thoughts.

You can watch a clip of Lillian’s talk here, download her presentation in the section below this blog piece, listen to her full presentation here and you can read our blog on fibroids and exercise here.

Diet and Fibroids

Next we heard from Leah Salmon, The Naturally You Coach, who spoke about diet and fibroids. Leah stressed that food is more than something that we eat three times a day because it tastes nice, food is medicinal. To reap the benefits of food and to fight disease we need to have a solid foundation of nutrients for our body to build on. To achieve this Leah advised that we make at least 50% of our diet unprocessed foods. Leah explained that fibroids have been linked to a number of nutritional deficiencies such as vitamin D, magnesium and essential fatty acids.  Leah stated that we can use our diet to prevent the deficiencies that lead to the fibroids or, if we have fibroids, use nutrition to re-balance the deficiencies, build and repair the body and stop the fibroid tumours from growing. Leah then recommended nine foods that can achieve this:

• Irish Moss and sea weed
• Bone broth and oily fish
• Evening Primrose Oil
• Molasses
• Tumeric
• Garlic
• Green smoothies and vitamin C rich food
• Vitamin D
• Water

Leah also warned us about six foods we should avoid:

• Xenoestrogens (growth hormones in commercially reared animals and can thus be found in red meat, poultry and eggs and also BPA, found in some plastics)
• Alcohol and caffeine
• White sugar
• Processed grains
• Trans and hydrogenated fats

Finally, Leah stated that success in this area is all about our mindset and we need the willingness to change, the stamina to commit to a healthy lifestyle and patience.

You can download Leah’s slides below this blog, watch clips of Leah’s talk here and here, listen to her full presentation here and you can read more about diet and fibroids here.

Medical Treatment and Fibroids

We also heard from Rajiv Varma, a consultant gynaecologist at the Nuffield Hospital, who presented on the medical management of fibroids.  Mr Varma first described some of the effects of fibroids such as challenges with fertility, problems during pregnancy and a number of symptoms that affect a woman’s quality of life, but he did stress that most women with fibroids do not experience these problems.

Mr Varma explained the treatment options available and these include:

• Doing nothing (watchful waiting)
• Drug treatments – mainly used to shrink fibroids before surgery or to relieve symptoms
• Procedures
  • Uterine Artery Embolisation (UAE) – cuts off blood supply to the fibroids
• Surgery – to remove the fibroids

Mr Varma then gave us some really good insight and advice on a number of issues:

 NHS treatment vs. private treatment:  He stated that in an ideal world there would be no difference between NHS and private treatment but unfortunately there can be some issues with NHS care such as: lack of choice, long waiting times and limited treatment options. There are a number of benefits though which include: the NHS is better equipped to deal with complex cases,  easy access to supportive services (such as blood transfusions and intensive care),  the consultant is present and other specialists are available.

Second opinions:  Mr Varma explained that we are entitled to get a second opinion and the situations where he would advise that a woman seeks a second opinion are: if you are unhappy with the treatment and management options that have been presented to you; if you lose confidence in your doctor; and if there is poor communication between yourself and your doctor.

Finding the right doctor: he stated that the most effective way of finding the right doctor is to have insider information and nurses are the best people to get information on who the best doctors are.

Herbal Remedies and Fibroids

Patricia Ferguson, a Medical Herbalist and a member of the College of Practitioners of Phytotherapy, then discussed herbal remedies that have been shown to be effective in treating fibroids. These remedies either contribute to shrinking the fibroid or are effective at managing some of the symptoms. They are as follows:

Vitex Berries (or agnus cactus) – act on the pituitary gland and depress oestrogen and progesterone (both of which can stimulate the growth of fibroids).
Shepherds Purse – can be effective in treating heavy menstrual bleeding
Red raspberry leaf – can help control heavy menstrual bleeding and can help shrink fibroids

Nettle leaves- can be effective in reducing heavy bleeding
Yarrow – helps to stop the growth of fibroids
Thuja  – helps to stop the growth of fibroids
Burdock  Root – can improve liver function and may inhibit the growth of fibroids
Milk Thistle – improves liver function and therefore can help the live control oestrogen levels

It was also noted that before taking any of these herbal preparations women should seek advice from a medical herbalist as some of the above shouldn’t be taken if a woman is pregnant or if she is on certain medication.

You can download a copy of the handouts to this presentation below this blog and read about some research on complementary and alternative medicine and fibroids here.

Managing the Emotional Impact of Fibroids

Finally, Olivia Haltman discussed the emotional impact of fibroids and how to manage this. Olivia explained that women may experience a number of emotions when going through their fibroid journey. This starts before the diagnosis with some women experiencing fear of the unknown due to symptoms. There can be a significant amount of anxiety whilst waiting for results and after receiving results, there can be a feeling of loss of control and hopelessness where you feel like you can’t control the outcome. Additionally, the vaginal examination can cause a significant amount of stress particularly for women who have had a traumatic sexual experience in the past.

Once a woman has received a confirmed diagnosis she may feel a fear of the growth of her fibroids and experience some unease about how her employers may respond, for example, missed days from work due to symptoms. Additionally, she may have anxiety over her fertility and then feel overwhelmed by the treatment decision.

The emotional impact may also include loss of focus, mood swings, panic attacks, lack of self-esteem, irrational emotions, fears regarding relationships and severe premenstrual syndrome.

So, fibroids can have a significant emotional impact on women which, in many cases, go unrecognised. These issues need to be addressed so that women can heal and move on.

Olivia provided some tips on how to start dealing with the emotional impact and these were:

• Educating yourself about fibroids – this can be empowering allowing you to make informed decisions about treatment
• Relaxation and breathing techniques
• Ground techniques
• Writing as therapy
• Positive thinking techniques
• Talking to your partner, friends and family
• Talking therapy
• Healthy eating
• Holistic lifestyle

Olivia finished by summarising tips from HysterSisters which were:

1. Don’t play the blame game
2. Don’t dwell on the what if’s
3. Don’t compare yourself to others
4. Give yourself time to heal emotionally as well as physically
5. Don’t underestimate how much your hormones affect your emotions
6. Don’t do it alone
7. Do move on

Conclusions

The event ended with a really good summary from The Lake Foundation’s trustee, Fadzai Marange, who shared a little of her personal experience with fibroids, summarised the talks and appealed to women to follow Leah Salmon’s advice regarding the watchful waiting option i.e. if you have been diagnosed with fibroids and your doctor says: ‘ let’s watch and wait’, don’t be passive during this time, act – adopt a healthy lifestyle and see what you can do naturally. Finally, Fadzai encouraged women to visit their doctor and check whether they have a vitamin D deficiency as this is strongly linked to fibroids.

The Exhibitors

At this event were a  number exhibitors including:

• Gedeon Ricther
• I Want My Body Back
• Nearer Nature
• Noire Wellness
• Pure Goodness
• The Naturally You Coach
• TOHETI
• Wisdom of Osun

Together they:

• Provided information on fibroids;
• Provided information on the support available for women affected by fibroids;
• Provided information on health and well-being programmes;
• Sold health and well-being books;
• Sold natural feminine hygiene products; and
• Sold natural hair and skin care products.

We also had ‘Meet the Exhibitor’ sessions on the agenda giving attendees the opportunity to hear organisations talk about their work.

Thank you

We had a great day and would like to thank everyone who attended, shared their story and for being a fantastic, engaged audience. We’d also like to thank all the speakers for their thought-provoking, informative presentations and all the exhibitors for attending and sharing their information, services, products and knowledge.

Finally, we’d like to thank Black History Walks, Natracare and Noire Wellness for their support.

There are several medical procedures used to treat fibroids.  Some of these result in infertility and because of this, as well as unease with these procedures, many women are seeking less invasive more “natural” options. But, are these effective?

One area that has been explored is the use of green tea extract which has been used for a variety of medical reasons with some success.

What research has been done?

 To explore this area we’ll be looking at a research paper published in the International Journal of Women’s Health in 2013 – ‘Treatment of symptomatic uterine fibroids with green tea extract: a pilot randomised controlled clinical study.’

Why green tea extract?

In the research paper, the investigators described why they decided to look at green tea extract.  They explained that green tea contains epigallocatechin gallate which has been shown to have useful biological effects. These include: anti-inflammatory, anti-proliferative (stops cells from growing) and antioxidant effects.

They stated that a study conducted by the US Department of Agriculture reported that great tea has an anti-cancer effect. Additionally, they quoted further research that showed that green tea stops the growth of tumours. From these studies, it is safe to conclude that as fibroids are benign tumours green tea extract may be an effective treatment.

Furthermore, at the time of conducting their research, there were no effective drug treatment  for fibroids. So there was a need to explore this area to explore the possibility of developing the first drug treatment.

The researchers had also conducted some preliminary work, not on humans but on fibroid cells grown in their lab and in a mouse model of fibroids. This was very promising with their experiments on the fibroid cells showing that green tea extract caused the cells to stop growing and die. Whilst in the mouse model they saw a significant amount of fibroid shrinkage.

What did they do?

The researchers conducted a small clinical study which included 33 women with fibroids.  Twenty-two women were given green tea extract and eleven women were not. To ensure the outcome of the study wasn’t compromised, the women taking part and the study staff didn’t know who was receiving the extract and who wasn’t (double blind study). The treatment lasted for four months and women were followed up monthly.

The aim of the study was to determine whether treatment with green tea extract could:

• reduce the size of a patient’s fibroids;
• reduce the severity of symptoms; and
• improve quality of life.

What were their findings?

When looking at those women who were given green tea extract the researchers determined that, on average, the size of their fibroids decreased  by 32.6%. Meanwhile those women who didn’t receive the extract actually experienced an average increase in the size of their fibroids of 24.2%.

The researchers then looked at the severity of symptoms and a similar trend was seen. In the women given green tea extract there was a significant decrease in the severity of their symptoms, but there was an increase in symptom severity in those not treated.

Next, the researchers analysed quality of life. They found that the  overall average increase in the quality of life score in women treated with green tea extract was 20.7 (i.e. their quality of life improved significantly). But in women not treated with green tree extract there was only a 2.19 increase in their quality of life score.

Finally, the study looked at menstrual bleeding and they were able to show that green tea extract caused a significant decline in average blood flow, there was no such effect seen in women not treated.

Conclusions

Based on their findings the researchers concluded that:

“… green tea extract has a significant positive effect on the reduction of uterine fibroid burden and symptoms severity. Thus, administration of green tea extract could possibly be an effective oral treatment.”

The Limitations of this Research

It is worth bearing in mind that this was a very small study with only 33 women taking part. This study needs to be repeated on a larger scale to confirm this finding and ensure its accuracy.

To find out more about this study you can read the full paper below.

This week the UK’s Scientific Advisory Committee on Nutrition published their report on vitamin D and health. This was an interesting report that provided some useful background on vitamin D. This included the benefits of vitamin D, an analysis of whether people in the UK are getting enough vitamin D and recommendations on how to ensure that we all have sufficient levels.

Background

 The report stated that vitamin D is important in regulating the amount of calcium and phosphorus in the body and is made in the skin upon exposure to sunlight that contains sufficient levels of UVB radiation. Sunlight is the main source of vitamin D for most people but it can also be obtained from our diet and supplements.

Dietary sources and supplements become important during the winter months when UVB radiation is limited, in people who spend a lot of time indoors and in people who cover their body when they go outdoors.

Previous Guidance On Recommended Levels of Vitamin D Were Not Sufficient

In 1991, Dietary Reference Values (DRVs) for vitamin D were set by the Committee on Medical Aspects of Food Policy (COMA). These values were only based on preventing rickets in children and osteomalacia in adults.

A Reference Nutrition Intake(RNI) for vitamin D was not set for people with regular exposure to sunlight. This is because it was felt that the exposure to sunlight in the summer would balance out the lack of exposure in the winter. Therefore RNIs were set only for people at risk of a vitamin D deficiency. This included infants aged 0-3 years old; pregnant and breastfeeding woman; those over 65 years old; those with limited sunlight exposure; and Asian women and children.

 The Need for this Current Report

There was a need for new guidance because previous guidance was not extensive and a significant amount of research has been conducted on vitamin D since publishing the previous guidance. Therefore the Scientific Advisory Committee on Nutrition carried out a review with the aim of exploring the Dietary Reference Values for vitamin D and to make recommendations. This work started in 2010 and the findings were published  this week.

The Committee’s Findings

The committee looked at a range of health outcomes to determine whether these could help determine what the Dietary Reference Values for vitamin D should be.

They first explored muscle and bone health outcomes and then reproductive health, cancer, cardiovascular disease, hypertension, infectious diseases, oral health and other health comes. They wanted to see if there was a clear link between these health outcomes and  vitamin D supplementation and levels of vitamin D. So, they were looking at what levels of vitamin D could positively affect these health outcomes.

They found that the only reliable data they could use to determine what the Dietary Reference Values should be were those related to muscle and bone health outcomes. These outcomes included rickets, osteomalacia, falls, muscle strength and muscle function.

For the other health outcomes the data was inconsistent so further work is needed to determine whether vitamin D has a beneficial effect on these conditions.

Recommendations

Based on their findings the committee made the following recommendations:

1. To protect musculoskeletal health, the serum 25(OH)D – a marker of vitamin D status- of individuals in the UK should not fall below 25nmol/L  at any time of the year.

2. Those at risk of having serum 25 (OH) D below 25nmol/L are: those who spend the least amount of time outdoors (frail and institutionalised people), those that wear clothing that covers most of their skin when they are outdoors  and those from ethnic groups with dark skin.

3. A Reference Nutrition Intake (RNI) for vitamin D of 10ug/d is recommended for the UK population aged 4 years and above. This includes pregnant and lactating women and population groups at risk of having low levels of vitamin D. A separate RNI is not required for these groups as was advised previously.

4. RNI should be applicable throughout the year, as a precautionary measure, to cover population groups in the UK identified to be at risk of having low vitamin D levels.

5. The RNI refers to all intakes from dietary sources: natural food sources, fortified foods and supplements. (They note that it is difficult to achieve the RNI with natural food sources alone so the government needs to develop a strategy for the UK population to achieve the RNI of 10ug/d).

This was a very informative report and one the black community in the UK should take note of as we are at risk of having low levels of vitamin D. This is because the melanin  in our skin doesn’t absorb as much UV radiation. This means that we have to ensure that we obtain vitamin D from dietary sources and we should be aiming for the 10ug/d the report suggests.

For more information you can download the full report below.

Transforming Outcomes and Health Economics Through Imaging (TOHETI) is a three year Guy’s and St Thomas’ Charity funded programme. It includes NHS partners across Lambeth and Southwark who are developing a vision of imaging with patient experience at its core.

One of its  aims is to understand how they can better join up services to treat fibroids to offer the best care to their patients. As part of this work they conducted a focus group which identified that more needed to be done to empower, inform and support women with fibroids. Therefore they started a patient support group and this week we had the pleasure of being invited to attend.

TOHETI’s patient support group started in March 2016 and meets every two months. It is facilitated by a specialist nurse and aims to provide women with a safe, informal setting to share their experiences, ask questions, meet other women with fibroids, understand treatment options and learn about how best to manage their situation.

We attended the support group to learn more about TOHETI’s project and to understand how we could collaborate with them.

The women who attended the support group session told very similar stories to women we have met in the work that we’ve been doing. They explained that it took several years for them to be diagnosed and that they didn’t feel well-informed about fibroids or their treatment options. Additionally, attendees explained that fibroids significantly affect their quality of life, including their relationships and emotional wellbeing. They also felt that no one was listening to their concerns. We also briefly discussed diet with one attendee stating that when she adopted a healthy lifestyle  this significantly improved her symptoms but the challenge was maintaining this lifestyle.

Also in attendance were representatives from Gedeon Richter,  the pharmaceutical company that developed the drug ESMYA® which is used to treat fibroids. They were able to answer questions on treatment, particularly on ESMYA®, its benefits and how it works.

This was an interesting  session that highlighted the need for more support for women with fibrioids and we look forward to working with TOHETI to address this.

The next session will be on  Wednesday 5^thOctober at the McNair Centre at Guy’s Hospital. If you’d like to attend  please contact Yvonne Akande (yvonne.akande@kcl.ac.uk).

Hi there, my name is Samantha and I’m writing this blog about the exciting cycle journeys with the Lake Foundation.

 I joined the Lake Foundation cycling club after deciding to up my fitness levels and try out my new bike that I had brought. I found out about the club through my local leisure centre.  It had been years since I rode a bike and at first, I lacked motivation getting back onto a bike but finding a group of like-minded people inspired me

By riding with the Lake Foundation twice a month my confidence has boosted, It’s the best way to progress your cycling. You learn how to ride safely and efficiently in a group with trained instructors and it’s far easier to head out for a training ride knowing you’ll be with a group of mates rather than on your own. Cycling really helps you feel physically stronger, it is a great stress buster and I always feel refreshed and relaxed after a ride even if my legs ache a bit.

The best part is that when I first started, I barely could cycle very far but after a few months of cycling with the club, I was able to cycle 20-23 miles. Now I can cycle around 11-13 mph.  In May 16, My friend asked me to join her team to cycle London to Brighton 54 miles. I knew that it would be a big challenge for me but with all of the cycling with the group, I felt confident that I could achieve my goal.

I made it to Brighton in 8 hours. It was hard and gruelling work. At some points, I wanted to give up but I kept going! I’m still feeling the pain now. The first time you see Brighton in front you of is shortly after Ditchling Common it is an amazing sight. I used my GPS to track my journey as I went along and the steepest section was a 30.6% gradient. I prepared in advance for the Beacon by training in the gym alongside the cycling. I’d say that at least 80% of the people I saw on the incline had resorted to walking. Although it was hard work I just kept pushing on, and as I got closer to the top I was rewarded with the most amazing views. Then before I knew it the gradient reduced and I had conquered the Beacon! The best feeling ever! and knowing that it was downhill from there. I had an amazing day of cycling and I loved doing it as part of a team. I would definitely ride it again in the future.

I would most defiantly recommend taking up cycling and joining the Lake Foundation cycling club as it is an amazing way to get to places and when it’s a challenging ride it feels like a real good achievement. You’ll need a reasonable level of fitness but you definitely don’t need to be a super fit racer.  It is much more fun riding as a group and there’s sometimes a café stop on the journeys.

This month is Black Music Month giving us an opportunity to highlight the contribution that black people have made to the music industry.  As I think about all the great music out there, I wonder, can music have a serious role in improving our health and well-being?

We know that music has a huge impact on our emotions. The right song at the right time can be inspiring, make us happy, motivate us to take action and cause us to reflect

So, by extrapolation we could say music must be good for our health because it can make us feel good. But, what does research tell us about the effect of music on our health?

There have been a number of studies exploring the effect of music on our health and they have found that music has a beneficial effect on both our physical and mental health.

Stress and Music

One of the most obvious benefits of music is its effect on anxiety and stress. We’ve all turned to music when we’ve had a particularly stressful day and have needed to create a peaceful calming environment.   Research has shown that the calming effect of music is real with scientists demonstrating that music prevents stress-induced increases in subjective anxiety.

Researchers looked at measures of anxiety (heart rate, blood pressure and cortisol levels) and found that in a stressful situation these measures were increased in people not exposed to music but not so for those people exposed to music; subjects exposed to music were not anxious and were better able to deal with the stressful situation.

Other studies have confirmed this showing that music can relieve anxiety in a number of situations. These include:

• Improving anxiety levels in cancer patients
• A reduction in pain and anxiety in children undergoing medical and dental procedures
• A reduction in psychological distress during gastrocopic examination

 Mental Health and Music

As well as music being beneficial in alleviating stress and anxiety, music has a role to play in treating mental health conditions.  It can help with the symptoms of depression, improves a person’s ability to carry out cognitive tasks and helps people express emotions.

Furthermore an interesting study looking at the effect of religious music found that listening to religious music regularly was associated with a reduction in death anxiety and an increase in life satisfaction, self-esteem and a sense of control, leading scientists to conclude that listening to religious music promotes psychological well-being

The video below provides a great example of the power of music in improving our mental health

Physical Health and Music

Music also improves our physical health with studies showing that music can help patients with conditions such as heart disease, stroke, cancer and dementia, and can  help us cope better with pain.

When it comes to heart disease researchers found that joyful music improved blood vessel function and can therefore improve the health of our heart. In addition, music has also been shown to improve stroke recovery helping with memory and attention and as mentioned previously music has been shown to be beneficial to cancer patients by reducing anxiety levels but it also has been shown to alleviate pain and improve the quality of life of patients.

So, music is not just about entertaining it can be good for our health and well-being meaning we have a very easy way to improve the quality of our life at our finger tips.  Happy listening!

This month thousands of riders set out at too-early-o’clock on the legendary London to Brighton charity bike ride. Among them was The Lake Foundation cycle club member Sam.

Sam is a regular at our bi-monthly rides. Sam announced her goal to complete the London to Brighton ride on our WhatsApp group back in May:

“Guess what everyone I’m doing the London to Brighton [bike run]”.

In our cycle club fashion, the group began to send messages to cheer Sam on when she decided to keep us informed on WhatsApp about her training.

Training included regular on-road cycling and cycling in the gym. Her team, Cor Correya once rode to Biggin Hill through Sanstead and Warlingham over country lanes and hills. Sam messaged the WhatsApp group, “Only 19 days to the big event. Still time to join me if you want to.” Maybe next year!

As well as training Sam invested in a pump, a puncture repair kit and took her bike in for a maintenance check. This was a good way to avoid any mechanical mishaps on the day.

The big day came and Sam wrote to the group including hashtags #L2B and #HeartRiders, which we then tweeted in support of her. Sam kept up the conversation between her start at Clapham Common and arrival in Brighton. Members responded encouragingly:

“Keep going Sam. Keep up the pace and effort luv”