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‘Body clock gene’ diabetes clue


Article Source: Health And Fitness Journal

The workings of our internal body clock appear to be directly connected to our risk of diabetes, researchers claim.

International research published in the journal Nature Genetics found faults in a key ‘clock gene’ were linked to blood sugar levels and type II diabetes.

Some scientists already believe that our circadian rhythms (body clock) have a role to play in the condition, which affects millions worldwide.

But one expert said more evidence was needed, before a link was proved.

"Our research demonstrates that abnormalities in the circadian rhythm may partly be causing diabetes and high blood sugar levels – we hope it will ultimately provide new options for treating people"
Professor Philippe Froguel
Imperial College

Scientists say that unravelling the links between obesity, type II diabetes, and circadian rhythms could point the way towards new strategies to control or prevent the illness.

The fact that humans work on a rough 24-hour cycle, sleeping at night, and waking to be more active during the day, is controlled partly by hormones released by the body.

One, in particular, called melatonin, released by the pineal gland in the brain, is involved in drowsiness and the lowering of body temperature.

The researchers, from a variety of universities in the UK and abroad, scanned the genomes of thousands of people looking for associations between particular genetic variations and type II diabetes.

A team including scientists from Imperial College London found one genetic “variation” which appeared to be linked to a 20% increase in the risk of type II diabetes.

Another, including Oxford and Cambridge University scientists, discovered a second variation which could be linked to naturally higher blood sugar levels and diabetes risk.

However, it was the location of these variations on the human genome which suggested the connection to the internal body clock.

Both were connected to MTNR1B, a gene which helps control the action of melatonin on different parts of the body.

Bad sleepers

Professor Philippe Froguel, from Imperial College, said that the findings fitted with earlier research linking sleep problems with obesity, which increases the risk of type II diabetes.

“For example, we know that obese children tend to sleep badly and that people become more obese if they are not having enough sleep.

“Our research demonstrates that abnormalities in the circadian rhythm may partly be causing diabetes and high blood sugar levels – we hope it will ultimately provide new options for treating people.”

Professor Nick Wareham, the director of the MRC Epidemiology Unit in Cambridge, said: “This observation provides important clues about the possible mechanisms linking genes to diabetes risk.”

However, sleep and circadian rhythm researcher Dr Jim Horne from the Sleep Research Centre at Loughborough University said it was too early to be suggesting that problems with the body clock might actually be responsible for obesity and diabetes.

He said: “There are other explanations for the link between obesity and sleep disturbance – people who eat too much may have disturbed sleep, or be drowsy or sleep during the day, and obese people may suffer from sleep apnoea which can disturb sleep.

“The evidence linking insufficient sleep with these changes is very contentious, and we should be cautious about drawing the wrong conclusions.”

Separate research by researchers at Leeds University suggests that children with diabetes living in poorer households are less likely to have their blood sugar levels under control.

They looked at blood sugar levels in 1,742 Yorkshire children, mostly with the type I form of the disease, and found that fewer than 15% were reaching National Institute for Clinical Excellence targets.

Those from lower-income families were less likely to hit the target than those from more affluent families.

This article is from the BBC News website. © British Broadcasting Corporation

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Health message ‘needs more power’


Article Source: Health And Fitness Journal

The NHS needs to use more sophisticated marketing techniques to convince people of the benefits of a healthy lifestyle, a leading think tank says.

Copying strategies usually employed by commercial advertisers is just one of a range of tactics needed to tackle bad habits, a King’s Fund report warned.

NHS staff also need more training in promoting healthiness, the report said.

Unhealthy behaviour such as smoking and obesity is thought to cost the NHS in England more than £6bn a year.

The latest report is the conclusion of a year-long investigation into the effectiveness of different programmes to tackle smoking, alcohol misuse, poor diet and lack of exercise.

It found that the behaviours are “deep-rooted social habits” that cannot be easily changed.

And although the Department of Health invests heavily in publicity campaigns to promote healthy lifestyles – £50m in 2007/08 – providing information on its own has little effect, the King’s Fund said.

Marketing

Social marketing techniques and data analysis tools like geodemographics should be used to identify, target and communicate messages designed to motivate people to change how they live.

And public health programmes should not rely on just one approach – such as information campaigns or financial incentives – as the evidence shows the most effective interventions employ a variety of tactics.

"Obesity and the health problems associated with smoking and excessive alcohol are the biggest challenges facing the 21st-century NHS"
Dr Anna Dixon, King’s Fund

Successful strategies highlighted by the report include a “Chill Out Cabin” set up by a health trust in Liverpool outside a nightclub for young people to get health advice, non-alcoholic drinks, and alternative therapies such as massages.

And a “Food Dudes” scheme, available in schools throughout England and Wales, which has significantly boosted children’s fruit and vegetable intake through a superheroes-style cartoon characters.

The report added that frontline NHS staff should be better trained in promoting healthy habits to patients – a goal which should be underpinned by contracts and incentives.

Innovation

Dr Anna Dixon, director of policy at the King’s Fund, said the health services needs to be more innovative.

“Obesity and the health problems associated with smoking and excessive alcohol are the biggest challenges facing the 21st-century NHS.

“The methods used to promote public health need to be more modern, using the most advanced techniques and technologies.”

She added that more evidence was needed on the interventions that worked so money was not wasted.

Professor Alan Maryon-Davis, president of the Faculty of Public Health, said he wholeheartedly agreed with the report conclusions.

“We need social marketing techniques to target messages and understand what will make changes worthwhile for people but also we need to make sure the healthy choices are the easy choices.

“The NHS needs to work with other organisations, such as local councils, to make sure the environment is right – for example in terms of physical activity we have to have safe places to walk and cycle.”

This article is from the BBC News website. © British Broadcasting Corporation

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NHS bosses oppose election plan


Article Source: Health And Fitness Journal

By Andrew Black
Political reporter, BBC Scotland news website

What does your NHS board think about direct elections
Most of Scotland’s NHS authorities are either opposed to or have serious concern about plans for direct elections to their health boards.

Some health bosses have raised concern that the proposals could destabilise boards by pulling them into party politics.

Health Secretary Nicola Sturgeon told BBC Scotland the concerns were not well-founded.

She also insisted the scheme was “massively popular”.

Direct health board elections, a key SNP election manifesto pledge, was brought forward by the party in government to improve public confidence in the health system.

Ministers have cited concern that health authorities had not always properly listened to local views, but several NHS boards disagreed.

It has emerged that five of Scotland’s 14 health authorities – Highland, Tayside, Ayrshire and Arran, Lothian and Grampian – have opposed direct health board elections outright.

"Any institution facing a quite radical change might be resistant to that change"
Nicola Sturgeon
Scottish health secretary

A further five – Shetland, Forth Valley, Lanarkshire, Greater Glasgow and Orkney – have expressed doubts about the plans.

They include concerns about the “politicisation” of boards and being flooded with single-issue candidates with no interest in overall policy.

Critics also pointed out that councillors already sat on health boards, which were accountable to ministers and parliament.

But Ms Sturgeon said ordinary people should be given a say in the running of the health service which they paid for, adding: “It’s also massively popular and I think it’s the right thing to do.”

She went on: “I don’t think democracy is ever a bad thing.

“I understand and am aware of some of the concerns health boards have. I don’t agree that those concerns are well-founded.”

The Scottish Government hopes to pilot direct health board elections, probably with two NHS authorities, in a Bill currently going through parliament.

Test concerns

However, opposition parties are sceptical towards the plan, and could vote the legislation down.

One NHS board – Fife – backed the bill, while NHS Western Isles said it had not discussed the plans and Dumfries and Galloway declined to comment until after the pilot.

Ms Sturgeon said she was not surprised by the health boards’ reservations, but said she was confident they would eventually come round.

“Any institution facing a quite radical change might be resistant to that change, but what convinces me this is the right thing to do is that the public think it’s right and I believe it’s right, because the NHS is a public service and it’s right that it should be influenced in terms of what the public think.”

The health secretary added: “In any event, if the bill passes, we will have pilot elections to test out some of these concerns in practice and then parliament would have to decide before health board elections could be rolled out further.”

One of the earliest acts of the SNP in government was to reverse decisions by the previous administration to close accident and emergency units at Ayr hospital and Monklands in Lanarkshire, which had caused a local outcry.

HEALTH BOARD VIEWS ON DIRECT ELECTIONS

NHS BORDERS

“NHS Borders operates within the context of governmental policy and, therefore, comments submitted following the call for written evidence did not represent the views of our board, but reflected the opinions of a number of individuals.”

NHS HIGHLAND

“Although there is a spectrum of views across NHS Highland board members, overall we are strongly opposed to the principle of direct elections. The majority view of NHS Highland is that the existing arrangements for the appointment of public members to NHS boards work well.”

NHS ORKNEY

“NHS Orkney sees no benefits in having additional elected members on its board under the system highlighted in the Bill. In small, rural areas there is a real risk that those who are elected are members of groups with particular issues, rather than having the wider interest across the whole range of health board priorities.”

NHS LOTHIAN

“We believe we can demonstrate delivery of robust internal accountability through our current non-executive members. We suspect that further, wholesale change to the current system has the potential to destabilise boards.”

NHS DUMFRIES AND GALLOWAY

“NHS Dumfries and Galloway understands that the proposals under the Health Boards (Membership and Elections) Bill are to be piloted elsewhere in Scotland. Until the outcome of the pilot arrangements have been made known and our board has the opportunity to consider its position, NHS Dumfries and Galloway has no other comment.”

NHS FIFE

“Ministers have set out the policy directions and NHS Fife fully supports their Bill. When the government was considering policy earlier this year via a consultation document, NHS Fife expressed agreement with the starting premise that the public does not believe NHS boards have taken sufficient account of the views of local people.”

NHS TAYSIDE

“Tayside NHS Board does not believe that the limited attempt to democratise health boards by electing some members to boards will do much to enhance the concept of mutuality. For the board, mutuality emphasises participation much more than representation.”

NHS AYRSHIRE AND ARRAN

“NHS Ayrshire and Arran would not support the introduction of this Bill. It would change and confuse, rather than increase, accountability, it would be likely to undermine the operation of a national NHS [and] there is no evidence that it would increase the quality of decision-making.”

NHS GRAMPIAN

“The current local authority membership of both NHS boards and Community Health Partnerships provides a significant, democratic input to the working of these bodies. To expand directly elected health board members as proposed in the Bill would only lead to confusion and conflict between members from different ‘electoral’ systems.”

NHS FORTH VALLEY

“Elected members are unlikely to have the mechanisms in place to enable them to seek the views of the electorate and, therefore, would be elected on the basis of their manifesto. It would be difficult, therefore, for them to truly represent the local population and the risk to boards is that their input is based on particular issues and a lack of understanding about the broader health board issues.”

NHS LANARKSHIRE

“There are already a substantial number of mechanisms in health and in local authorities, and through health and local authority partnership arrangements, for the needs and views of local communities to be heard effectively.”

NHS GREATER GLASGOW AND CLYDE

“There could be possible tensions between locally elected council members on NHS boards and those appointed through the direct elections process and tensions between non-executive members appointed through an open and competitive process and, again, the members appointed by the direct election process.”

NHS WESTERN ISLES

“The matter of direct elections to health boards has not been discussed by Western Isles Health Board.”

NHS SHETLAND

“The board would strongly object to diverting current resources from patients to support elections, but the cheapest method must be adopted, and the cost met nationally without detriment to patient services, either in money or staff time.”Return to top

This article is from the BBC News website. © British Broadcasting Corporation

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