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”

Back in March we worked with Black History Walks to organise a fibroids awareness event at the University of Westminster. This was a very well-attended event with over 150 women attending. Our speakers provided an overview of fibroids and its treatment, and shared personal stories of the effect of fibroids.

During the event we were absolutely delighted to meet Yvonne Akande, Senior Project Manager at Transforming Outcomes and Health Economics Through Imaging –TOHETI. It was wonderful to learn of all the great work they’ve been doing to raise awareness of fibroids and support women who have been affected.

TOHETI is a three year Guy’s and St Thomas’ Charity funded programme, working with NHS partners across Lambeth and Southwark to develop a vision of imaging with patient experience at its core. The programme has been working to understand how they can better join up services to treat fibroids to offer the best possible care to their patients.

In June 2015 they conducted a series of focus groups which helped identify how they could improve the information provided to patients. This resulted in the development of their new patient information leaflet and video.  You can download their leaflet here and view their video here.

Additionally, TOHETI has been hosting patient support groups and their next sessions will be held on Wednesday 13^thJuly and Wednesday 5^thOctober at the McNair Centre at Guy’s Hospital. If you’d like to attend one of these sessions please contact Yvonne Akande (yvonne.akande@kcl.ac.uk).

We’re really happy to see fibroids getting a lot more attention as this is an area that women, from our survey in 2013, felt needed a lot more focus.

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The Lake Foundation will be hosting a half day fibroids seminar on 30^thJuly 2016. At this event we will be focusing specifically on treatment including natural ways of managing symptoms. For more information and to book a place please click here

Last month we were delighted to have been interviewed on Gill Manly’s Worker’s Playtime show on Croydon Radio. This was a joint interview with Kinetic Root Services where we discussed trauma in the black community and the work that both our organisations are doing to support the black community through traumatic experiences.

You can listen to the interview below which starts at about an hour and 15 minutes into the show.

The Lake Foundation Cycling Club sprung forward this season with a cycle through South Norwood Country Club and Beckenham Palace Park.  Cycling Instructors Jo and Selena navigated the group along some surprising quiet Croydon back routes.

The level paths of South Norwood Country Park was a stark contrast to the hilly terrain of Beckenham Palace Park. Muscles got a good workout and riders were thankful for the snack and water breaks after climbs.

 The cycling group is made up of people at different cycling proficiency and fitness levels. It was good to see members practice tips they learnt on how to cycle up hills. By way of a reminder you can check watch the British Cycling Federation video on climbing technique.

Meanwhile we were pleased to learn that one of our regular riders booked a free one-to-one session with Cycle Instructor Selena before the session. “Doing the class made me more confident riding in the roads with traffic, especially coming up to Junctions”.

Cycle Instructor is a great resource for the community of Croydon and beyond. They provide one-to-one and group training sessions where you will learn practical skills and gain an understanding of how to cycle on today’s roads. To book a session go to the Cycling Instructor website, http://www.cyclinginstructor.com

Our next ride is on Saturday 28 May 2016. Email events@thelakefoundation.com to join.

A couple of weeks ago we listened live to Harvard Medical School’s Mini Med seminar on ageing. This was a very informative  event featuring experts in the field Amy Wagers Professor of Stem Cell Regenerative Biology; Sharon Inouye, the Director of the Hospital Elder Life Program and Professor of Medicine; and  Bruce Yanker, the Co-Director of the Paul F. Glenn Centre for the Biology of Ageing. Together they explained how the body ages and how we can keep it young and healthy.

The event started with an introduction by Amy Wagers who explained that ageing is a collection of physical and behavioural changes that take place as an individual gets older. She stated that ageing is the biggest risk factor for many diseases and the challenge that the medical field faces is how to promote healthy ageing.

When thinking about aging it was stressed that we have to think of a person’s health span as opposed to their life span. A person’s health span is the number of healthy years of life they experience and currently the general population’s life span has increased but their health span is relatively short and we need to do more research to determine how we can effectively increase a person’s health span; we don’t want people to have a long life span but have a poor quality of life because their health span is short.

Amy stated that we need to understand the cellular, biochemical and molecular basis of ageing and therefore understand how age-related diseases develop so that we can target these diseases. Amy stressed the importance of identifying predisposition to age-related diseases as there has been an explosion in these diseases over the past 15 years, mostly because we have more elderly than ever before.

Amy explained that ageing is a complex process where many biological mechanisms interact, these include loss of protein function, reduction in the communication between organs, the loss of the ability to regenerate cells after injury, metabolic dysfunction and DNA defects, just to name a few.  She said that there is hope that we can target the biological causes of ageing to prevent and reverse age-related disease.  Amy stressed that there are two very important factors in preventing age related diseases and these are: diet and exercise.

We then heard from Sharon Inouye who explored the clinical aspects of ageing. She stated that some of the main issues with ageing are: illness, disease and medications affect older adults differently; older adults are more likely to have multiple health conditions; we’re in a stressful society and stress results in a reduction in our physiological reserve so our body is less able to deal with ageing; falls are the leading cause of death in the elderly; many eldery experience a significant decline in brain function and finally we don’t have enough geriatricians to treat older people. Due to all of these issues we need to find ways to ensure that people age well. She stated that an important part of addressing these issues is ensuring that older people maintain their cognitive health by: encouraging people to be physically active (this is the most important), reducing cardiovascular risk factors, looking at medication management,  keeping the elderly socially and intellectually active and ensuring they get enough sleep.

Finally we heard from Bruce Yankers who spoke about brain function in the elderly. He wanted to answer the question: how do people who are healthy lose neurons? He stated that many older people retain memory and cognitive function but others lose this, why? He explained that biological processes in the brain decline with age and there are a number of genes involved in this process. REST is a gene regulator that appears in the ageing brain and disappears in people with Alzheimer’s Disease. REST controls many genes involved in memory. It keeps cells alive and regulates genes involved in neuron function. REST proteins are protective against Alzheimer’s Disease and thus prevent loss of neurons. He explained that some people can withstand Alzheimer’s lesions and do not go on to develop dementia, why? It seems to be REST proteins that are protective in these situations.

Finally Bruce explained that research has suggested that the strength and quality of relationships dictate how well people age. It was found that how happy people are is important in ageing healthily. Specifically how happy people are in marriage by 50 seemed to be a good indicator of how well they will age. Therefore it’s important that people control their stress levels and strive to be happy.

This was a very interesting seminar and gave us a lot to think about with regards to how to promote healthy ageing. A key theme of each talk was the power of exericse and we’ll continue to encourage the public to keep active.

We’d like to thank Harvard Medical School for organising this seminar series and making it as accessible as possible by broadcasting it live on the internet. You can find out more about this seminar series, read the lecture notes and watch

This week it was reported that Johnson and Johnson, the company that produces talcum powder, has lost a second court case where another woman has claimed that she developed ovarian cancer after using talcum powder for feminine hygiene reasons.

The company has been instructed by a jury to pay a settlement of $55M to the claimant. This case follows a case in February of this year where the family of a women who died from ovarian cancer was awarded $72M after it was claimed that she developed ovarian cancer after using talcum powder for many years.

Johnson and Johnson will be back in court and may face a long stretch of court appearance as it faces 1,200 lawsuits accusing the company of not adequately warning women of the risks associated with using talc-based products.

The question is: is there a risk of developing ovarian cancer from the use of talcum powder? The short answer is, we don’t know.

Cancer Research UK says the following:

“Scientists are trying to see if this is the case, but for now the evidence is still uncertain. However, even if there is a risk it is likely to be fairly small.

“Cosmetic body and talcum powders often contain a mineral compound called talc. Several studies have looked at talcum powder use and ovarian cancer. While on the whole the studies have seen a modest increase in the risk of ovarian cancer in women who use talc on their genitals, the evidence isn’t completely clear. So we can’t be sure whether or not talc itself could cause ovarian cancer”

The Chief Executive of the UK’s leading ovarian cancer charity, Ovarian Cancer Action,  has said the following on this issue:

“If you’re currently using talc, don’t panic. Given evidence is inconsistent we do advocate a ‘better safe than sorry’ attitude and advise that women using talc on their genitals stop doing so. But it’s important to remember that the suggested increased risk from using talcum powder is very small.

“While the relative increase of a third suggested by some studies sounds significant, the absolute risk of getting ovarian cancer still remains very low. We’re talking about the difference between a 2% risk and a risk of 2.5%.”

This sentiment about using talcum powder for personal hygiene reasons is echoed by the NHS who say:

“Most gynaecologists recommend using plain, unperfumed soaps to wash the area around the vagina (the vulva) gently every day, as opposed to talc or perfumed soaps, gels and antiseptics.” 

The take home message is that there isn’t yet clarity on whether talcum powder increases risk of ovarian cancer and while this uncertainty remains it’s probably better to avoid using talcum powder on the genital area.