American women are more likely to not properly take their medications – or take them at all – compared to women in other countries, a new study suggests.
Researchers found that women in the US were almost twice as likely to skip their prescriptions compared to Canadian women and three times more likely than Australian women.
What’s more, 25 percent of younger women said they couldn’t adhere to their medication schedules due to the cost.
The team, from Columbia University Mailman School of Public Health in New York City, says this is not only likely because women take more prescriptions than men do but, if it continues, it could create future sex-related disparities.
A new study has found one in four US women from ages 18 to 64 said they weren’t taking their prescriptions due to cost compared to one in seven men in that age bracket (file image)
For the study, published in Health Affairs, the team looked cost-related non-adherence among younger women (ages 18 to 64) and older women (ages 65 or older) in 11 high-income countries.
These countries include Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the US.
Results showed that the largest disparities for non-adherence were among younger US women compared to men at 54 percent.
This was much higher than the disparity between women and men in Canada at 33 percent and in Australia at 17 percent.
One in four younger women said they weren’t taking their drugs due to cost compared to one in seven younger men.
Comparing 11 countries, the largest disparities for not taking medication were among American women ages 18 to 64 compared to men at 54% (above)
This large disparity still held true even after the researchers adjusted for factors such as age, income and chronic conditions.
However, there were no significant female-differences among older adults in any of the 11 studied countries.
The team says it believes the sex-related inequality is likely due to women’s higher health needs and higher overall prescription use.
From 2015 to 2016, 41 percent of US males reported receiving one or more prescription drugs compared to 50 percent of females.
For patients, especially those with chronic conditions, not taking prescribed medication due to cost is a common problem, says senior author Dr Jamie Daw, an assistant professor of Health Policy and Management at Mailman.
If women choose to not fill or delay refilling prescriptions, skip doses or split pills, they may risk not getting the full benefit for their treatment.
‘Prescription drug coverage systems – like those in the US and Canada – that rely on employment-based insurance or require high patient contributions may disproportionally affect women, who are less likely to have full-time employment and more likely to be lower income,’ Daw said.
‘The disparities we found in access to medicines may produce health disparities between men and women that should be further explored.’
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Are the additives in our food making us ill?
Our lives are being cut short by the toxic effects of our ‘ultra-processed’ diet, according to new research buried by the attention on Covid-19.
Ultra-processed food products — which studies suggest now make up to 60 per cent of the average diet in the UK — are invariably high in fat or sugar (or both) and contain a cocktail of food additives.
Although all factory-produced foods contain at least some artificial preservatives, the new generation are packed with additives such as artificial sweeteners, colourings, emulsifiers to mix ingredients that would not naturally combine, preservatives to ensure foods don’t discolour and have months of shelf life — plus a variety of chemicals to disguise the sour or bitter taste of other additives.
Ultra-processed food products — which studies suggest now make up to 60 per cent of the average diet in the UK — are invariably high in fat or sugar (or both) and contain a cocktail of food additives [File photo]
Scientists estimate that Britons, on average, now consume 8 kg (18 lbs) a year of chemical additives.
The theory is that the body struggles to process these foods, leading to chronic — and harmful — inflammation, which is already linked to serious conditions, including type 2 diabetes, heart disease and cancer.
Nor is swapping to ‘healthier’ food products necessarily the answer, say experts, because those who have switched to vegetarian or vegan diets may also be increasing their health risks by consuming the highly processed meat substitutes now widely available.
These health risks have been highlighted in the latest results from NutriNet-Santé, the world’s biggest ongoing study of the effect of food on health, which is monitoring the food intake of up to 500,000 people.
Results show that even in France, the home of haute cuisine, processed food consumption has become normal.
In a study involving more than 100,000 people, the researchers found that those eating the highest levels of ultra-processed food radically increased the risk to their health.
How we consume 8kg of chemical additives a year in everyday dishes
Ultra-processed foods — and their cocktail of additives — might now represent up to 60 per cent of the average diet in Britain, according to surveys reported by the British Medical Journal last year.
Other research suggests that the average Briton ingests 8 kg (1 8 lbs) of non-food chemicals every year.
A report in the journal Nature earlier this year said more than 330 chemical additives are approved for use in food manufacture.
Additives linked to health risks — including heart disease, diabetes and cancer — are in the top 50 most used chemicals in food products, as listed in journal Nature Medicine. The top 50 include:
- Sodium nitrate: To make processed meat look pink.
- Potassium nitrate: Also known as saltpetre, a meat preservative.
- Carrageenan: A thickener, used in ice cream.
- Monosodium glutamate: Flavour enhancer, used in foods such as stock cubes.
- Sulphite ammonia caramel: Colouring in beer, tea and desserts.
- Acesulfame Potassium: Sweetener used in soft drinks.
- Sucralose: Sweetener in confectionery, breakfast bars and soft drinks.
- Mono/diglycerides of fatty acids: Texture improvers found in bread, frozen meals and mayonnaise.
- Potassium sorbate: Preservative used in wine, cheese and yoghurt.
- Cochineal: Red colouring for desserts and wine.
- Potassium metabisulfite: Wine preservative.
- Sodium alginate: Emulsifier (mixing aid) in prepared salads, cheese and jam.
- Bixin: Colouring in butter and cheese.
Over a ten-year period, for every ten per cent increase in ultra-processed food in the diet, there was a 12 per cent increase in the number of people with heart disease and an 11 per cent increase in strokes.
Processed food is hardly new — we have been curing, smoking and pickling for centuries, and even canning foods is a relatively old technique (first introduced more than 200 years ago).
The difference with ultra-processed foods (UPFs) is that they contain few, if any, recognisable intact food ingredients, as you can see on their labels. The range of UPFs is vast, from savoury snacks to breakfast cereals, meat substitutes and baked goods.
There is no strict definition of a processed as distinct from an ultra-processed food — but a label on cheese, for example, will generally list recognisable food ingredients such as milk or cream first. A UPF will often list something called ‘crème’ to disguise an ingredient derived from pig lard.
The latest findings from the NutriNet-Santé project, reported earlier this year in the journal Nature, showed that more than 330 chemical additives have now been approved for use in foods across Europe, including Britain, and, worryingly, that have been linked to health problems, were all among the top 50 most frequently used.
So what is inflammation?
Inflammation is our body’s way of responding to damage from injuries and infections. It floods the area with white blood cells and hormones in order to repair the damage.
This response usually lasts a few hours or days, as the body releases the chemicals that can deal with the problem and help it recover.
But sometimes the inflammatory response remains switched on, causing low-grade chronic inflammation which is linked to a wide range of diseases including type 2 diabetes, heart disease, dementia and cancer.
Chronic inflammation means the body is also less able to deal with infections such as Covid-19.
Causes of this chronic inflammation include pollution, lifestyle factors including diet, smoking, stress, excess alcohol, autoimmune conditions, unresolved infection and injury.
‘Food manufacturers use studies that are based on laboratory animals to show these products are safe but it’s not the same, because we are talking about long-term exposure in humans via all the food and drink we consume over many years,’ says Dr Bernard Srour, an epidemiologist at the Institute of Health and Medical Research in France, who is one of the leaders of the NutriNet- Santé project.
‘We are seeing more and more ultra-processed products with messages about how healthy they are. The food industry is trying to demonstrate that its products are low in sugar and salt and fat but it is replacing sugar with artificial sweeteners, for example, which may cause all sorts of other problems,’ he says.
‘The cocktail effect of all these additives has also never been investigated. They may generate a health effect that doesn’t happen when the additives are used individually.’
Specialists now agree that while inflammatory processes are triggered by obesity and type 2 diabetes themselves, there is growing evidence that food additives may also be making things worse.
‘It is now recognised that inflammation is involved in heart disease along with every other disease process,’ says Dr Scott Murray, a consultant cardiologist at Wirral University Teaching Hospital in Liverpool and former president of the British Association for Cardiovascular Prevention and Rehabilitation.
‘Heart disease is driven by changes in the way your body handles fat because of excess processed food intake, plus malfunction in the over-stressed fat cells,’ he says. ‘That, in turn, causes inflammation as the body struggles to adjust its regulatory processes.’
Normally, the hormone insulin is released to mop up excess sugar in the bloodstream but this regulatory system starts to fail.
Dr Murray adds: ‘When calorific intake from processed, energy-dense foods gets too high, spare energy is carried from the blood into the fat cells. Fat cells multiply and swell to store this spare energy.
‘This process begins to break down when it becomes impossible for sufficient blood to reach these abnormal swollen fat cells and there is also no more room at the fat cell motel.
‘Spare energy remains in the blood, causing a variety of toxic effects elsewhere in the body and leading to a cascade of further inflammation. New fat cells then form in abnormal places around the liver, heart and pancreas.
‘Abnormal fats and glucose [i.e. sugar] continue to circulate in the blood, causing chronic and worsening inflammation, which also means the body is less able to deal with infections such as Covid-19.’
At the moment, scientists don’t know the extent to which food additives contribute to inflammation.
‘It’s difficult to answer how much of the problem of inflammation is coming from obesity itself and how much is coming from food additives,’ Dr Srour tells Good Health.
‘The data and scientific literature we have right now don’t tell us and we are working to find the pathways involved.’
One suggestion from the NutriNet-Santé scientists is that emulsifiers, the chemical compounds used to make incompatible processed food components to mix together, appear to allow toxic bacteria to escape from the digestive system. This, in turn, causes inflammation in the abdomen as the body’s defences mobilise to destroy them.
This theory chimes with a report published last year in the Nutrition Bulletin, which was carried out by a group led by scientists at the University of Liverpool and the Rowett Institute in Aberdeen.
They calculated that the average Briton’s total annual intake of non-food chemicals amounts to about 8 kg (18 lbs). Their report also highlighted how a commonly used emulsifier called polysorbate 80 (added to foods such as ice cream) has been shown in studies of human intestinal tissue to leak out of the digestive system and into the body.
The researchers believe it may also disturb or destroy natural bacteria in the digestive system. ‘This raises the possibility that dietary emulsifiers might be factors in conditions such as coronary artery disease, type 2 diabetes and Crohn’s [inflammatory bowel] disease,’ they wrote.
At the moment, scientists don’t know the extent to which food additives contribute to inflammation. ‘It’s difficult to answer how much of the problem of inflammation is coming from obesity itself and how much is coming from food additives,’ Dr Srour tells Good Health [File photo]
If you think swapping to healthier alternatives avoids the problems, Dr Srour is clear — even people following dietary guidelines to reduce or eliminate meat consumption might risk triggering inflammatory processes by consuming high quantities of ‘healthy’ ultra-processed foods.
‘Soya steaks are sold targeting vegetarians or vegans, but people assume they’re not eating anything unhealthy as we know that reducing consumption of animal products is better,’ he says. ‘The trap people are falling into is that they are not substituting meat products with unprocessed foods. Ultra-processed vegan food could be a problem in the long-term.’
He says the healthiest option is to cook from scratch without using cook-in sauces, packets or anything containing synthetic food additives. If you must use processed products read ingredient lists carefully and opt for those with the maximum proportion of whole food ingredients.
‘We don’t really know the real nutritional quality of lots of ultra- processed foods . . . It’s important to do detailed studies of different food additives, then we can investigate how each might be associated with chronic diseases.’
To measure the impact of these additives, the NutriNet-Santé scientists are looking at biomarkers in blood and urine, as well as analysing faecal material to see if food additives are having an effect on ‘good’ natural bacteria in the digestive system.
But, as far as Professor David Haslam, a specialist in obesity management at Luton & Dunstable Hospital, is concerned, there is already enough evidence. ‘The chemical additives and excess carbohydrate [sugar] we consume multiplies up to a complete disaster,’ he says.
‘The message is absolutely clear. There are people who get this and people who don’t. We are screaming our heads off to get this message through.’
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Trump hints that PFIZER’s coronavirus vaccine could be first approved
‘Pfizer’s doing really well,’ Trump said in a Fox News interview.
‘Johnson & Johnson…they’ll probably be a little later.’
Also on Monday the same day, the White House’s vaccine czar, Dr Moncef Slaoui said that the most vulnerable Americans could be vaccinated against COVID-9 by December, with ‘most of the elderly’ and frontline workers getting shots in January.
Dr Slaoui told Squawk on the Street that he and Operation Warp Speed could have vaccines to others by April.
That does not quite fit with the timeline laid out by the CDC last week, which suggested that, if a vaccine was approved, states should be ready to distribute it, for free, to Americans by January.
President Trump said on Monday that Pfizer’s coronavirus vaccine is ‘looking really good,’ hinting that it could be the first approved in the US (pictured: a self-swab kit to test Pfizer trial participants for the infection; file)
Last month, the CDC sent guidance to US states and territories that advised them to be prepared for the arrival of one of two unnamed COVID-19 vaccines by the end of October.
When the documents were leaked to the New York Times, health officials scrambled to temper that promise without contradicting it.
Several, including Dr Slaoui, top US infectious disease expert Dr Anthony Fauci and Centers for Disease Control and Prevention (CDC) director Dr Robert Redfield, said that it was possible, but not likely that a vaccine would be available that soon.
Trump only pressed the timeline harder, hinting subsequently that the a vaccine could get approved by ‘a very special day’ – meaning the November 3 election.
His intent was to promise the public that the best hope to end the pandemic was on the horizon, and linked to his reelection campaign.
Trump is pushing for a vaccine to be ready ahead of the November 3 election (file)
Vaccine czar Dr Moncef Slaoui said the most ‘susceptible’ Americans could get vaccinated by January with health care workers and the elderly coming next (file)
But public trust in the safety of vaccines only fell further, prompting nine lead vaccine manufacturers to promise they would not seek FDA approval they had enough data to tell them the shots were safe.
Among those companies were Pfizer, Moderna, Johnson & Johnson and AstraZeneca.
AstraZeneca’s was dubbed the most promising vaccine candidate by the World Health Organization – but just after signing the pledge to vaccine safety, a spinal cord issue reported in one of its UK trial participants triggered a hold on its late-stage global trials.
Trials have now resumed in most locations, including the UK, but are still on hold in the US as National Institutes of Health (NIH) and FDA regulators conduct their own investigation.
Pfizer and Moderna have now both published detailed descriptions of their trial methodologies. Pfizer’s CEO said the firm expects to have enough data to know whether their shot works by October. Moderna’s CEO said the most plausible scenario for the company to know whether its vaccine is safe and effective would be a November deadline – though it’s possible they could reach that point by October.
Last week, the CDC publicly released its ‘playbook’ for rolling out free COVID-19 to the public, nationwide, by January.
The guidance still listed the end of October as the hopeful arrival of one of two unnamed shots.
With Trump’s Monday comments, it seems all but certain that Pfizer’s is one of those two vaccines, although that has not been revealed by the CDC.
Dr Slaoui’s timeline, however, suggests that those in greatest need will only just getting the shot by the end of the year, a timeline more closely matching what CDC director Dr Robert Redfield has detailed, than the optimism of the president.
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Is this the cure for sleepless nights? Scientists believe ear zapper could help banish insomnia
Ear clips that stimulate a nerve in the ears could help treat insomnia. New research suggests that using the clips for just 30 minutes before you go to bed can improve sleep quality and reduce daytime drowsiness.
Scientists believe it works by stimulating the release of the sleep-inducing hormone melatonin.
One in three people in the UK suffers with insomnia at some point (insomnia is defined as the inability to fall asleep or stay asleep at night).
New research suggests that using the clips for just 30 minutes before you go to bed can improve sleep quality and reduce daytime drowsiness [File photo]
The most common causes include stress or anxiety, and shift work (which can disrupt natural sleep patterns). Alcohol and caffeine consumption are also factors: these can disrupt sleep as they act as a diuretic, making us want to urinate in the night, as well as relaxing muscles and causing heavy snoring.
An estimated one in ten people with insomnia ends up taking sleeping tablets, either prescribed or bought over the counter from a pharmacist.
Stronger drugs prescribed by GPs include so-called ‘Z’ drugs (the three main ones are zopiclone, zolpidem and zaleplon), which work by slowing the brain’s activity so it is easier to nod off.
However, long-term use of the drugs has been linked with worrying side-effects, including drowsiness (which raises the risk of falls and road traffic accidents), memory loss and aggression.
Patients can also suffer withdrawal problems when they come off them.
Now, scientists at Peking University in Beijing, China, believe the ear clips could offer a drug-free way to improve sleep.
The clips are connected by a wire to a small power pack about the size of a mobile phone.
When this is switched on, an electric current passes through the clips and into the ears to stimulate the vagus nerve. This is a major nerve that runs up through the chest and neck and into the brain and is involved in controlling a wide range of functions, including our sleep and wakefulness.
The clips are attached to the auricular concha — the shell-like entrance to the ear that leads towards the ear canal, where a branch of the vagus nerve can be found just beneath the skin.
In a trial, the scientists tested the clips on 63 volunteers with insomnia. Half were told to attach the clips to the auricular concha, the rest to the outer-edge of the ear where the vagus nerve does not pass near the skin.
Each person used the device for 30 minutes before bed for a month and kept diaries of their sleep patterns.
The results, in the journal Evidence Based Complementary and Alternative Medicine in August, showed that those who received vagus nerve stimulation had fewer problems nodding off by the end of the trial and were less drowsy in the day.
In just four weeks, their average scores fell by around two points on the Epworth Sleepiness Scale, which measures drowsiness.
Independent sleep expert Dr Neil Stanley, says: ‘This study is of interest but the number of patients involved was small. We need larger, better quality studies to show positive results before this can be used as a treatment.’
Insomnia should be a recognised risk factor for type 2 diabetes, new research suggests. Scientists at the Karolinska Institute in Sweden examined 1,360 studies on risk factors for type 2 diabetes and concluded those with insomnia were 17 per cent more likely to develop the condition than those without.
Researchers suggest it could have something to do with the effect poor sleep has on lifestyle choices. ‘Short and poor quality sleep [are] associated with less healthy eating and irregular meal patterns,’ they reported.
Bells & Whistles vegan cakes are just 120 calories per slice and free of the major allergens gluten, dairy and wheat.
Pack of four slices, £1.80, sainsburys.co.uk
Cancer drug to stop allergic reactions
A new pill could stop life-threatening anaphylactic reactions in people with drug or food allergies.
Research from Northwestern University in the U.S. found that drugs that block an enzyme called Bruton’s tyrosine kinase (BTK) — used to treat some blood cancers — also block immune cells released during severe allergic reactions.
Further studies are needed, but, if successful, this would be the first known treatment to prevent anaphylaxis, reports the Journal of Clinical Investigation. ‘This pill could quite literally be life-changing,’ says researcher Bruce Bochner, a professor of medicine.
Gut bacteria linked with multiple sclerosis
Certain types of gut bacteria may worsen the symptoms of multiple sclerosis (MS), suggests a study at the RIKEN Centre for Integrative Medical Sciences in Japan.
MS occurs when the body’s own immune cells attack nerve coatings. This interrupts the messages between the nerves and muscles, leading to symptoms such as numbness and difficulty walking.
A study on mice revealed that two specific gut bacteria make the immune cells that attack these nerve coatings more active.
New blood thinners for surgery patients
Scientists have discovered blood thinners that avoid a key problem with current drugs — bleeding after an injury or surgery because the blood doesn’t clot enough.
Blood thinners or ‘anticoagulants’ are commonly prescribed for patients suffering from thrombosis (a blood clot that prevents normal circulation of blood) or stroke.
These drugs work by blocking enzymes that help stop bleeding, but can leave patients vulnerable after injury.
Scientists in Switzerland and in the U.S. have found the first synthetic inhibitor of a different enzyme (called FXII), without these complications, according to the journal Nature Communications.
How exercise can boost children’s memory skills
Getting children to be physically active can help improve their ability to learn, according to a study from Kobe University in Japan.
Previous research has shown that physical exercise improves the activity in parts of the brain critical to learning. In the latest study, scientists analysed data from three trials that looked at the effects of physical activities, such as ball games, on cognition, including the child’s ability to focus, memorise facts and switch between tasks.
The research showed most improvement was seen in children whose skills had been lowest.
Eating soup regularly lowers the risk of being obese by 15 per cent, according to a study of more than 40,000 people reported in the journal Physiology & Behavior.
Soup is generally low in calories but a significant volume, and it is thought that this increases fullness, reducing additional food intake.
Weak hand grip may point to type 2 diabetes
The stronger your grip, the lower your risk of type 2 diabetes, a study from the University of Bristol and the University of Eastern Finland has found.
The research, published in Annals of Medicine, looked at almost 800 people without a history of diabetes over 20 years.
Participants had to squeeze a dynamometer (an instrument that measures hand grip) hard with their dominant hand for five seconds.
Results showed that for every unit of strength, the risk of type 2 diabetes was reduced by 50 per cent.
The researchers say hand grip may be a good way to identify who is at risk of the condition.
Veg patch medicine
Health wonders that lie in your larder. This week: Spinach to ward off dementia
In a study, people who ate more green leafy veg, such as spinach, saw a significant reduction in the rate of cognitive decline, found scientists at Rush University in Chicago.
They tracked the diets and cognitive abilities of nearly 1,000 older adults for an average of five years.
Published in Neurology, the 2017 study found people who ate one to two 80g servings a day had the cognitive ability of someone 11 years younger than those who ate none.
Scientists believe the vitamin K in greens such as spinach, broccoli and kale is involved in maintenance of the myelin sheath that helps nerve cells communicate with one another.
Research has shown that patients with recently diagnosed Alzheimer’s had lower intakes of vitamin K.
Did you know?
Naturally occurring lithium in drinking water could help to stabilise mood and reduce rates of suicide, according to the British Journal of Psychiatry. Lithium, which is used in the treatment of bipolar disorder, was found to be beneficial after a review of 15 studies comparing regional suicide rates with lithium concentrations in water.
Missing in action
We look at neglected parts of the body — and how to make them stronger. This week: Your calves
‘No one ever comes to me and asks for strong, defined calves — but they should,’ says Kira Mahal, a personal trainer who runs MotivatePT in London.
‘The calf muscles are the powerhouse for lifting your heel off the ground when you walk and run, and ankles and feet need them for stability. Spending time on strengthening your calves helps prevent injuries in the lower leg.’
Do this exercise while you’re waiting for the kettle to boil: press the balls of your feet into the floor and rise up on to your tiptoes. Lower and repeat three sets of 15 repetitions.
Raise the intensity by doing them one leg at a time, or with your toes on a step so your heel drops lower than it.
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