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How hacking your metabolism can help you burn fat and prevent disease

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Hacking your metabolism to help your body burn fats and carbs more efficiently may be key to helping you lose weight, run for longer and reduce the risk of conditions like type two diabetes



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4 October 2022

Spencer Wilson

MY FAMILY holidays in France are synonymous with one thing: bread. But this year, as everyone else sits down to their croissants and baguettes, my plate is bare. Before even my first sip of coffee, I have to take a long, slow inhalation through a handheld device resembling a sleek electronic cigarette, hold my breath for 10 seconds, then exhale through the mouthpiece. Instantly, an app on my phone delivers the verdict as a score from 1 to 5. Today, it is a 1, and I am elated. For the first time in weeks, I have woken up in “fat-burn mode”. I have taken my first steps to hacking my metabolism.

Usually, I would be the first to roll my eyes at any gizmo associated with weight loss and healthy eating. You don’t need an app to tell you which foods are good or bad. Or do you? Evidence has been mounting that suggests the one-size-fits-all advice on nutrition is drastically failing us, and that we have been thinking about metabolism – the chemical reactions in your cells that change food into energy – all wrong. Against this backdrop, many new technologies are hitting the market, claiming to reveal what your metabolism is doing as you go about your day – and giving tips on how to improve it. Make the right tweaks and you could find it easier to manage your weight, ward off disease, sleep better, and more. I wanted to understand how much of a difference such changes could make and whether ignoring the new science might be leading me to metabolic meltdown.

Dietary advice used to be straightforward: …

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Navigating the NHS: How patients are affected by delays | NHS

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Patients are facing increased delays at almost every stage of their NHS treatment, as the health system struggles to find the resources to deal with demand.

The latest data shows waiting lists across England have surpassed record highs every month for two years running, one of many major challenges currently facing the NHS.

“There is not one area of NHS provision that isn’t really struggling,” Alastair McLellan, the editor of Health Service Journal, told the Guardian in August. “There is literally nowhere where it isn’t bad, and in some cases really bad.”

But what impact does this have on ordinary people trying to access the NHS in 2022?

Through a combination of interviews with health professionals and analysis of official data, the Guardian has plotted the journeys of four fictional patients through their NHS journey and how waiting times have changed at each stage of their treatment and recovery.

We look at how the crisis affects the day-to-day lives of four patients: someone with breast cancer, someone requiring cataract surgery, a patient with heart issues and one with a hip fracture. These case studies have been created in consultation with health experts and represent realistic patient pathways that a person with one of these conditions could expect.

The Head of Policy at Macmillan Cancer Support, Minesh Patel, said that delays existed prior to the pandemic, but Covid “has made these much worse and led to backlogs.”

“Hardworking cancer professionals are doing the best they can to treat people, but vast gaps in the workforce have been growing for years, leaving NHS staff exhausted and burnt out, and too many people left in limbo waiting to be seen.”

Mr Patel warned that “these excruciating waits can significantly affect people’s physical and mental health”.

Daniel Hardiman-McCartney MBE, Clinical Adviser from the College of Optometrists, said that the “rapid increase in the number of [independent NHS-funded] clinics has destabilised traditional eye care provision in some areas and has exacerbated problems related to the shortage of ophthalmologists”.

The lack of eye doctors in NHS trusts has “resulted in longer delays in some areas for people with chronic eye conditions” such as glaucoma or people with comorbidity or complex problems, which can increase the number of people affected by preventable sight loss.

For Mr Hardiman-McCartney, eye care could be improved by better supporting local ophthalmologists’ departments with optometrists. While there are some areas in England with successful examples, this “frustratingly remains a post code lottery, with the main barrier being local systems’ reluctance to fully utilise the optometric workforce.”

Professor Antony Johansen, consultant orthogeriatrician in Cardiff and clinical lead at the National Hip Fracture Database, told the Guardian: “Hip fracture care is losing the momentum that was so successfully maintained during the pandemic, and a patient’s chance of next-day surgery has fallen lower than we’ve seen for a decade.

“This may reflect poorer population health, as well as strain on ambulance services, emergency departments, hospital beds and operating theatres. Delayed surgery will worsen these pressures by increasing patients’ risk of complications and prolonging their time in hospital.”

Professor Ioakim Spyridopoulos, an honorary Consultant Interventional Cardiologist at Newcastle’s Freeman Hospital, told The Guardian that while the NHS response to acute life-threatening conditions is “still excellent”, urgent or elective care such as valve replacements “lags behind other leading European nations.”

For patients who require urgent treatment for a heart condition, “the cause for delays for urgent patients is mainly due to hospital staffing issues and bed capacity.

“As a consequence [of longer waiting times], these patients have a higher risk of dying while waiting for treatment, and even the general outcome is much worse when treated too late.”

In a statement released to coincide with the release of several of the metrics covered here, NHS England said the service was contending with its busiest October ever, including for the most serious ambulance callouts.

NHS medical director, Prof Sir Stephen Powis said there was “no doubt October has been a challenging month for staff who are now facing a tripledemic of Covid, flu and record pressure on emergency services”.

“Pressure on emergency services remains high as a result of more than 13,000 beds taken up each day by people who no longer need to be in hospital. But staff have kept their foot on the accelerator to get the backlog down with 18-month waiters down by three-fifths on last year.”

The service said that recent NHS analysis found that the service was diagnosing more patients with cancer at an earlier stage than ever before.

Notes

While patient pathways vary depending on geography, the patient and the severity of the case, each scenario has been verified by a health professional as a reasonable care pathway someone could expect. The majority of the data used in this piece was from the NHS England and NHS Digital, however some data was also sourced from the Royal College of Physicians, the Royal College of Ophthalmologists and the British Heart Foundation. MacMillan, the Health Foundation, the Royal College of Nursing, the College of Optometrists and Heart Research UK were consulted in the development of accurate patient journeys. Our cataract operation scenario refers to Leicester City CCG as equivalent national figures were not available.

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Readers sound off on union representation, rat relations and fare hikes – New York Daily News

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Manhattan: Re “A surgical intervention” (editorial, Nov. 26): You got this all wrong. Yes, two courts decided Administrative Code 12-126 was interpreted correctly by my organization, the NYC Organization of Public Service Retirees. We earned and paid for the benefits we currently have and any changes should be negotiated by unions for their members, not for retirees they no longer represent. The court was clear with its interpretation of how retirees should be treated after years of committed service to this city.

We expressed more than only two concerns about Medicare Advantage. Many of our physicians would never accept it, and its prior authorizations will become barriers to care for older or disabled retirees. How about not being able to coordinate insurance for drug coverage? You suggested the city could use its “institutional weight to keep private providers in line.” Why haven’t they done this already? This is the New York taillight guarantee. No thanks.

We would like the city to develop a supplemental plan that uses the Center for Medicare and Medicaid Innovation programs’ federal funding. It can consolidate union welfare funds, conduct eligibility reviews of the entire plan and put out a request for proposals for the supplemental plan and all other plans. You would be surprised by what you would find. Also, when those RFP responses come in, share them publicly. The city has positioned itself to be more transparent with its process, so why not be transparent with the retirees? No more deals in the dark and on the backs of the people who need real healthcare and not false promises. Marianne Pizzitola, president

Manhattan: I agree with Voicer Marie Richardson’s assessment of Mayor Adams and am also very disappointed in his performance. A mayor’s job shouldn’t be all about bluster, which he has in spades, but also about compassion. It’s something he’s obviously lacking, as we see with his positions: kill rats, ignore the carriage horse issue and mishandle the mentally ill. When a poll showed 71% of registered New York voters supported a ban on horse-drawn carriages, his office chose to ignore the collapse and death of Ryder the carriage horse. Elizabeth Forel

Manorville, L.I.: To Voicer Marie Richardson: It’s been mankind against rats since the dawn of civilization. The plus side to this, for people who love animals, is that humans have befriended many kinds of wild animals to help them against a plague of rats. They’ve allowed many kinds of mammals, birds and reptiles to live in villages to catch and kill rats. They have domesticated cats and bred dogs to kill rats. During the Middle Ages in Europe, people harassed and killed domestic cats, causing a huge increase in the population of rats and helping to cause the deaths of millions of people from the bubonic plague, which rats and their fleas transmit. If you have rats, you have to get rid of them, pronto — and rats breed much faster and more prolific than humans. Oh, but you are right about the garbage problem. Paul Melnik

Bronx: I recognize the need for speed cameras and support the basic idea of them. It seems the city has gone to great lengths recently to ambush drivers. New cameras are popping up in locations designed to catch motorists unaware and trigger a summons. They are now setting them up immediately after a highway exit ramp with little to no opportunity for drivers to decelerate in a normal and safe fashion. The city has also stretched the definition of “school zone” to its limits by setting up a speed camera across a major highway from a school. A student would have to scale a fence, navigate four lanes of highway, climb over two sets of guardrails, navigate four more lanes of traffic and climb another fence to get to the camera near Veterans Park in Throgs Neck. Every truck or car traveling to and from the Throgs Neck Bridge on I-695 would be violating a school zone. Bill Reddan

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Bronx: They should not raise the transit fares. They have to police the fare-beaters. It’s a disgrace how many people walk on without paying their fare. It’s a total disgrace. People just walk on buses without paying. This must be adjusted. Ralph Canzone

Brooklyn: Fare hikes for mass transit could be avoided if fares are paid. Select Bus Service is a disaster. Passengers get on the back and don’t pay. Riders get on and say they have no money. Turnstiles are jumped by some consistently. Where is the enforcement? Additionally, people are afraid to ride the subway due to the increase in attacks in the subway system. We want to feel safe going to our destination. Fare increases will turn us away. I guess I will be walking more and will finally learn to ride that two-wheeler. Harrolyn Murphy-Conway

Brooklyn: The MTA has a 5.5% fare hike on the table for 2023. They think this will help get back the $2 billion deficit they are facing. How about facing the facts of why you have the deficit? COVID hurt everyone. More people are working from home these days. There’s nothing you can do about that, but raising the fare will only keep them home. How about cleaning up the subways and working with the NYPD to get a much bigger police presence in the subways? If crime goes down, you will get people to ride the trains again. People are going out but they are taking Uber, and you can’t blame them. The subways are not safe and now they have an added incentive not to ride them thanks to a possible 5.5% fare hike. John De Angelo

Manhattan: It’s December! How did that happen? I’m on alert once more, concerned about the holidays and income tax prep is nipping at my heels. Then I ran across a possible solution: Paying attention to other people makes loneliness less harsh — yes, consciously tending to the needs of others. Reaching out in simple exchanges at the grocery store or at the library, saying, “Isn’t it a beautiful day?” or, “I loved that book,” can bring a friendly and healthy response. Interactions that acknowledge the reality of other human beings make us happier. James A. Fragale

Brooklyn: I really cannot understand the appeal of “The View.” It’s a female cast with hate-filled hosts. They are not educated about the Constitution. Well, maybe Sunny Hostin (who’s never sunny) knows a bit. She’s a law school grad — she tells us every chance she gets. Smart does not equal kind or humble. Joy Behar is keeping Trump alive. Whoopi makes mistakes every day and needs to apologize. As for the others, I’m not sure who they are. They should all kiss Barbara Walters’ ass. Without her, I would not bother writing this. Mariann Tepedino

Manhattan: Gov. Hochul’s cashless bail law and the proposed Clean Slate Law make sense to me, save for one glaring pitfall: Both give softer treatment to those charged with or convicted of (often pled down to) misdemeanors. Because many violent crimes get classified as misdemeanors under our wacky justice system, both Hochul’s law and the Clean Slate Law are far less palatable. In my view, violent criminals should be treated by society as the pariahs they are and not afforded any further special treatment than they are afforded in sentencing. Take the guy who got out recently under Hochul’s law after beating his wife because they classified it as a misdemeanor, then went home and murdered his wife. Both laws would be more palatable if they simply changed “misdemeanor” to “nonviolent misdemeanor.” A simplistic misdemeanor-versus-felony distinction just doesn’t cut it. Ken Blomster

Monroe, N.J.: As reported, desperate-for-power Kevin McCarthy negotiated with Republicans for their votes as he bargained to become speaker of the House of Representatives. Just think of what we are in for — more vindictiveness and a puppet regime. Katherine A. Moloney

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Charity urges Matt Hancock to do more to raise dyslexia awareness | Matt Hancock

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A charity has called on Matt Hancock to renew his efforts to raise awareness about dyslexia after apparently only fleetingly addressing the issue on I’m a Celebrity.

The former health secretary defended his decision to take a break from Westminster and sign up for the ITV reality show in the Australian jungle by claiming he wanted to use it as a platform to raise the profile of his dyslexia campaign.

In the end it was mentioned three or four times, according to Kate Griggs, the founder and CEO of Made By Dyslexia, who said it was “a shame” there was not more about dyslexia in the show.

“For us, yes, it would have been fantastic if there had been a really big focus on dyslexia,” said Griggs. “What matters most is what he does now he is out of the jungle.”

Writing in the Sun after he was announced as one of the contestants, Hancock said politicians should embrace popular culture. “Reality TV is a very different way to communicate with the electorate – it’s both honest and unfiltered.

“For example, while most people will know me for being the health secretary during the pandemic, what you probably won’t know is that I am dyslexic and I’ve been campaigning for better identification and support for dyslexic children.”

Hancock added: “I want to raise the profile of my dyslexia campaign to help every dyslexic child unleash their potential – even if it means taking an unusual route to get there … via the Australian jungle. I’m a Celebrity   … is watched by millions of Brits up and down the country. I want to use this incredible platform to raise awareness, so no child leaves primary school not knowing if they have dyslexia.”

Viewers claimed it was not until two weeks into the show that Hancock finally raised the issue of dyslexia, when he discussed being diagnosed at university while in conversation with the comedians Seann Walsh and Babatunde Aléshé.

“It’s a reality TV show. It was not particularly surprising there was not a huge focus on one particular issue,” said Griggs, who conceded that more might have been cut out in the editing process. “It’s what happens now that’s really going to determine how effective Matt’s campaigning is.”

On Friday, there will be a second reading of the dyslexia screening and teacher training bill, a private member’s bill tabled by Hancock to provide universal screening for dyslexia in primary schools and improve teacher training on the issue.

A spokesperson for Hancock, who lost the Tory whip over his jungle adventure, said: “Matt’s bill in front of parliament on Friday is incredibly important. By Matt going on I’m a Celebrity he was able to raise and discuss the vital issue of dyslexia in front of millions of people.”

Griggs said: “This bill is way, way overdue. It’s crazy we are not screening every child. It’s quite frankly a disgrace every teacher is not given the skills they need to help and empower these children. Now Matt is not tied to a party, I hope he is really, really able to champion the cause and put things right for dyslexic children. Let’s see what Matt does now.”

Chivonne Preston, the interim chief executive of the British Dyslexia Association, said: “We are grateful when public figures like Matt use their platforms to draw attention to the barriers and challenges that the dyslexia community faces. Dyslexia is misunderstood and despite being incredibly common is often hidden; many people in our community feel like their struggles are unseen. We welcome opportunities to shine a light on dyslexia and inspire people to seek help and support.”

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