Butter unlikely to harm health, but margarine could be deadly

a block of butter 
Butter is not likely to kill you 

Saturated fat found in butter, meat or cream is unlikely to kill you, but margarine just might, new research suggests.

Although traditionally dieticians have advised people to cut down on animal fats, the biggest ever study has shown that it does not increase the risk of stroke, heart disease or diabetes.

However trans-fats, found in processed foods like margarine raises the risk of death by 34 per cent.

 “For years everyone has been advised to cut out fats,” said study lead author Doctor Russell de Souza, an assistant professor in the Department of Clinical Epidemiology and Biostatistics, at McMaster University in Canada.

“Trans fats have no health benefits and pose a significant risk for heart disease, but the case for saturated fat is less clear.

“That said, we aren’t advocating an increase of the allowance for saturated fats in dietary guidelines, as we don’t see evidence that higher limits would be specifically beneficial to health.”

Saturated fats come mainly from animal products, such as butter, cows’ milk, meat, salmon and egg yolks, and some plant products such as chocolate and palm oils.

In contrast Trans unsaturated fats or trans fats – are mainly produced industrially from plant oils for use in margarine, snack foods and packaged baked goods.

Guidelines currently recommend that saturated fats are limited to less than 10 per cent, and trans fats to less than one per cent of energy, to reduce risk of heart disease and stroke.

However the new research which looked at 50 studies involving more than one million people found there was no evidence that saturated fat was bad for health.

It backs up recent research from the University of Cambridge that found saturated fat in dairy foods might protect against diabetes.

Cheese counter at a shop
Cheese and other saturated fats are unlikely to be harmful to health   

Last year leading heart scientist Dr James DiNicolantonio of Ithica College, New York, called for health guidelines on saturated fats to be changed in an article in the British Medical Journal.

The “vilification” of saturated fats dates back to the 1950s when research suggested a link between high dietary saturated fat intake and deaths from heart disease.

But the study author drew his conclusions on data from six countries, choosing to ignore the data from a further 16, which did not fit with his hypothesis, and which subsequent analysis of all 22 countries’ data.

Nevertheless the research stuck and since the 1970s most public health organisations have advised people to cut down on fat.

However the new research found no clear association between higher intake of saturated fats and death for any reason, coronary heart disease, cardiovascular disease, ischemic stroke or type 2 diabetes.

In contrast, consumption of industrial trans fats was associated with a 34 per cent increase in death, a 28 per cent increased risk of death from coronary heart disease, and a 21 per cent increase in the risk of cardiovascular disease.

Despite the research British health experts cautioned against changing to a diet which was high in saturated fat.

Prof Tom Sanders, Emeritus Professor of Nutrition and Dietetics, King’s College London, said: “It would be foolish to interpret these findings to suggest that it is OK to eat lots of fatty meat, lashings of cream and oodles of butter.

“Death rates from CVD have fallen in the UK by about 55 per cent since 1997 despite the rise in obesity for reasons that remain uncertain but this may in part be due to changes in the food supply particularly fewer trans and more omega-3 fatty acids.”


Victoria Taylor, Senior Dietitian, British Heart Foundation, added: “While saturated fats were not robustly associated with total or deaths from CHD, this does not mean we should all go back to eating butter – the studies that this review is based on can’t show cause and effect.

“Rather, it highlights how difficult it is to understand the true relationship between diet and our health.

“Diets high in saturated fat are linked to raised cholesterol levels, a risk factor for CHD. But when one nutrient is reduced it will be replaced by another and, depending on what this is, it can have positive or negative health consequences.”

Source: British Medical Journal.

Never mind free tampons – what schoolgirls need is education about periods.

No other area of school life relies on free samples or branded teaching resources. So why, when it comes to menstruation, have we ceded control to companies?

Schoolgirls using iPads during a lesson at a comprehensive secondary school
‘Donating free tampons for ever is a nice idea, but it’s a short-term solution that benefits multinational corporations as much as it helps kids.’ 

Iwoke up this week to the news that we were being urged to buy tampons for a worthy cause again. According to the charity Freedom4Girls, a school in Leeds has reported that girls are missing school because they can’t afford to buy menstrual products. In response, individuals and charities are donating disposable menstrual products, and calling for them to be provided free in all schools.

Donating free tampons for ever is a nice idea, but it’s a short-term solution that benefits multinational corporations as much as it helps kids, if not more so. Austerity and food poverty (including household toiletries poverty, which includes disposable menstrual products) have highlighted a bigger problem that was masked by the relative financial comfort in the UK a decade or so ago. The menstrual taboos were always there, though. It’s time to acknowledge that we need to start working on medium- and long-term solutions, such as improving menstruation education, removing branding from school resources and eradicating the period taboo for ever.

The news from Leeds was greeted with some very privileged “surely this can’t happen here” handwringing. But this isn’t even a recent development in the UK – it’s just the first time mainstream media has covered it; for those who research school absence, it’s nothing new.

In a letter published in the British Medical Journal in 2010, Dr Daniel Hindley noted that in a Bolton NHS foundation trust study, “menstruation problems” was listed as the fifth most common school absence reason among 251 primary and secondary pupils referred to the trust. He concluded: “It is essential that preventive and early intervention should be seen as the cornerstone of multi-agency working to ensure pupils’ right to education and to protect their health and wellbeing.”

But that didn’t happen seven years ago, and it’s not happening now. If these interventions and recommendations had been followed up, we wouldn’t have kids deciding to truant rather than feel they had the knowledge to manage menstruation themselves or the confidence to talk to parents or teachers.

And as a “Lass war” protester, I need to be clear that this doesn’t just happen in the north of England. And it doesn’t just happen just in the global south. Please don’t come back to me in five years’ time with a news story about someone in the home counties skipping school because of periods. That’s certainly already happening.

If we can’t throw tampons at the problem for ever, what do we do instead? Now that it looks like sex and relationships education is finally going to be made compulsory, we actually have the opportunity to change things and make them stick.

We need to stop leaving lesson plans to companies that are in any way linked to the menstrual product industry. There are market research and projection reports up to 2020 telling the industry that they need to solicit schools to gain young, brand-loyal customers, and that advice hasn’t changed in a century.

Schools need to deal with this better themselves. They’re schools. What are they playing at? No other school subject relies on free samples or branded teaching resources. We need to keep brands away from national curriculum planning for menstruation education, and include experts.

So, policymakers: don’t tell schools to give out free disposables without teaching about reusables in equal measure and legislate against branded resources.

Schools: provide different brands of disposable pads and tampons in the toilets – especially during exams. Ensure school toilets are unlocked and accessible all day long, not just at break times, and that they’re clean and have hot water, soap, dryers and bins. Teach about puberty before it starts, and don’t single out early menstruators. Remove all outer packaging and complain to any companies that send you branded resources, or better still use unbranded, factually accurate, menstruation education resources, and vet everything with an expert on menstruation for quality.

And finally, since the girls from Leeds were confident enough to share their concerns, it’s most appropriate to direct some advice straight to them: if a company sells menstrual products, profit is always going to be their first priority, no matter how they dress it up, and the designs they use on the lesson plans or web content will look just like the product packaging. Don’t let yourself be bought and sold.

Don’t let teachers skip an important part of your education just because someone skipped it for them. Demand better, because you deserve better. Don’t be afraid to keep talking about it. And don’t accept a bunch of free tampons as the best solution for menstrual management – or austerity. There are more options out there, and you have a choice.

Demand to know about reusable menstrual products. You don’t have to spend all your money buying expensive disposables if you don’t want to or can’t. You can use menstrual cups or cloth pads too, or instead – they’re good for the environment and your wallet.

Oh, and take it from someone who got teased for leaking on their period at a slumber party while trapped in a blizzard at the age of 13: leaks are not the worst thing in the world. Stick together. I’m proud and impressed that you’re talking about this. And everyone else? Buying tampons for people only lasts for a certain period. It doesn’t address the taboos or end poverty – it feeds right into the rampant capitalism and disposable culture that got us here in the first place.


Doctors confirm 200-year-old diagnosis

John Hunter

Doctors have confirmed a diagnosis made more than 200 years ago by one of medicine’s most influential surgeons.

John Hunter had diagnosed a patient in 1786 with a “tumour as hard as bone”.

Royal Marsden Hospital doctors analysed patient samples and case notes, which were preserved at the museum named after him – the Hunterian in London.

As well as confirming the diagnosis, the cancer team believe Mr Hunter’s centuries-old samples may give clues as to how cancer is changing over time.

“It started out as a bit of fun exploration, but we were amazed by John Hunter’s insight,” Dr Christina Messiou told the BBC News website.

Mr Hunter became surgeon to King George III in 1776 and is one of the surgeons credited with moving the medical discipline from butchery to a science.

He’s also rumoured to have given himself gonorrhoea as an experiment while writing a book about venereal diseases.

His huge medical collection is now housed at the Hunterian Museum at the Royal College of Surgeons.

It includes his colourful notes describing a man who arrived at St George’s Hospital, in 1786, with a hard swelling on his lower thigh.

“It appeared to be a thickening of the bone, it was increasing very rapidly… On examining the diseased part, it was found to consist of a substance surrounding the lower part of the thigh bone, of the tumour kind, which seemed to originate from the bone itself.”

Mr Hunter amputated the man’s leg and he recovered briefly for four weeks.

“From this time he began to lose flesh and sink gradually, his breathing more and more difficult,” the notes continued.

The patient died seven weeks after the operation and an autopsy discovered bony tumours had spread to his lungs, the lining of the heart and on the ribs.

More than 200 years later, the samples fell under the gaze of Dr Christina Messiou.

She said: “Just looking at the specimens, the diagnosis of osteosarcoma came very quickly to me and John Hunter’s write up was amazingly astute and fits with what we know about the behaviour of the disease.

“The large volumes of new bone formation and the appearance of the primary tumour are really characteristic of osteosarcoma.”

She went to get a second opinion from her colleagues at the Royal Marsden in central London.

And in an out-of-hours session at the hospital they used modern day scanning technology to confirm the centuries old diagnosis.

Dr Messiou, whose speciality is sarcoma, told the BBC: “I think his diagnosis is really impressive and in fact his management of the patient followed similar principles to what we would have done in the modern day.”

But she says the exciting stage of the research is still to come.

They are now going to compare more of Hunter’s historical samples with contemporary tumours – both microscopically and genetically – to see if there are any differences.

Dr Messiou told the BBC: “It’s a study of cancer evolution over 200 years and if we’re honest we don’t really know what we’re going to find.

“But it would be interesting to see if we can link lifestyle risk factors with any differences that we see between historical and current cancers.

“So we’ve got big ambitions for the specimens.”

Writing in the British Medical Journal, the Royal Marsden team apologised for delay in analysing the samples from 1786 and the obvious breach of cancer waiting times, but point out their hospital was not built until 1851.

Benefits of statins outweigh risks, says medicines regulator

MHRA says evidence from clinical trials shows statins can save lives by reducing risk of heart attacks and need for surgery
Statin pills
Statin pills. 

Millions of people prescribed cholesterol-reducing statins should continue to take them because the benefits outweigh the risks, Britain’s medicines regulator said on Friday. The Medicines and Healthcare products Regulatory Agency (MHRA)issued a safety update following a row over the frequency of side effects from the drugs. It said evidence from large clinical trials showed statins could save lives by reducing the risk of heart attacks, strokes and the need for heart surgery.

Its advice to health professionals said at least 450 deaths from heart attacks, stroke or vascular failure would be prevented for every 10,000 patients treated, if patients with a 20% risk or more of suffering such a cardiovascular event over a 10-year period took statins for at least five years.

The update came after the British Medical Journal(BMJ) commissioned an independent panel to report on how claims that 18-20% of people on statins suffered adverse events were published in the journal last year .

The verdict is expected by the end of July. The authors of two articles using the figure, John Abramson, from Harvard medical school, and Aseem Malhotra, a UK cardiologist, have withdrawn statements on the frequency of side effects following a charge from Prof Sir Rory Collins of Oxford University that the information was inaccurate and could endanger lives.

Collins, a leading advocate of statins, has argued that both articles should be withdrawn completely, saying they had caused uncertainty in patients. He suggested they could lead to far more harm than the scare over the MMR vaccine caused by the now discredited Andrew Wakefield.

Statins are currently being taken in Britain by about 7 million people who have at least a 20% risk of a heart attack or stroke in the next 10 years. The National Institute for Health and Care Excellence (Nice) recommended in February that statins should be given to people at only 10% risk – a move that could dramatically increase the number of people taking them.

Public Transportation Commutes May Be Long, But They Promote Better Health In Americans: The Health Consequences Of Driving

Whether you walk, cycle, take public transportation, or drive your way to work, most people dread their morning commute that adds up to 25.5 minutes each way for the average American. UK researchers from the University of London weighed out the benefits of commuting to work and published their findings in The British Medical Journal on Tuesday.

Driving To Work Has A List Of Health Consequences

Health repercussions, both good and bad, come from commuting, but research has proven time and again when people drive to work every day, they tend to gain more weight than those who choose an alternative route. There’s a significant difference in the health between commuters who weave their way through traffic and those who hitch a ride on the subway line. What is it about driving for hours every day through traffic that harms our physical and mental health?

Researchers analyzed 7,534 participants from the United Kingdom Household Longitudinal Study and found correlations with how they commute to work and their body mass index (BMI) and body fat percentage. A large majority of men and women commute to work through private motor vehicle transportation, with a total of 76 percent of men, and 72 percent of women, respectively. Compare that to the 10 percent of men and 11 percent of women who report using public transportation on a daily basis, and it starts to make sense how the country is experiencing an obesity epidemic and environmental crisis with carbon monoxide pollution from vehicles.

Women who commuted through any mode of transportation besides a private vehicle had a BMI score 0.7 lower than drivers, and they weighed 5.5 pounds less than the average woman. Non-car commuting men were an entire 1.0 lower than their counterparts and weighed 6.6 pounds less than the average man. BMI is a commonly used scale to evaluate the health range a man or woman falls into depending on their height and weight. Generally, a person with a BMI of 18.5 to 24.9 is within healthy range, while a person lower than 18.5 indicates they’re underweight and any number above 25 indicates a person may be overweight, and above 30 indicates obesity.

Aside from commute-related weight gain, traffic can be stressing, your neck can be straining, and you’re stuck in a seated position that can be hurting your spine. Driving just 10 miles or more each way to work is associated with high blood sugar and high cholesterol, according to a study published in the American Journal of Preventive Medicine. High blood glucose levels can lead to pre-diabetes and diabetes. Those same commuters are also more susceptible to depression, anxiety, and social isolation, along with lower levels of cardiovascular fitness and physical activity.

Commuting by car may be faster and easier than grabbing a bike or aligning your schedule up with the local bus route, but it’s the long-term health risks commuters must keep in mind. The short-term oftentimes does not outweigh the long-term risks and benefits, especially when convenience comes into play. If you work over an hour away, try going for a 10-minute walk or run to clear your mind and prepare your body for the sedentary ride you have ahead of you. Before you head home from work, find a gym at your mid-way point and release some tension and awaken your muscles with 30 to 60 minutes of well-deserved exercise.

Researchers said the differences between people who drove their car every day and people who took alternative routes, were “larger than those seen in the majority of individually focused diet and physical activity interventions to prevent overweight and obesity.” If communities and cities made alternative routes more accessible for commuters to get to work each day, obesity prevention campaigns could encourage people to choose healthier routes. “It is crucial that the public health community, including health care professionals, provide strong and consistent messages to politicians and the public, which frame these measures as positive public health actions,” researchers said.

Obesity has rapidly plagued the world over the last 30 years, and although intervention strategies are being implemented in small ways every day, there are still 34.9 percent of obese American adults living today and a growing number of obese children, according to the Centers for Disease Control and Prevention. Walking, cycling, and public transportation “should be considered as part of strategies to reduce the burden of obesity and related health conditions,” the authors wrote. “[Further research] is required in order to confirm the direction of causality in the association between active commuting and body weight.”

Source: Sacker A. Associations between active commuting, body fat, and body mass index: population based, cross sectional study in the United Kingdom. The British Medical Journal. 2014.

Toilet Issue: Anthropologists Uncover All the Ways We’ve Wiped.


The last time I visited Boston’s Museum of Fine Arts was in 2004 to see a Rembrandt exhibition. But I might have wandered away from the works of the Dutch master in search of an ancient Greek artifact, had I known at the time that the object in question, a wine vessel, was in the museum’s collection. According to the 2012 Christmas issue of the BMJ (preacronymically known as the British Medical Journal), the 2,500-year-old cup, created by one of the anonymous artisans who helped to shape Western culture, is adorned with the image of a man wiping his butt.

That revelation appears in an article entitled “Toilet Hygiene in the Classical Era,” by French anthropologist and forensic medicine researcher Philippe Charlier and his colleagues. Their report examines tidying techniques used way back—and the resultant medical issues. Such a study is in keeping with the BMJ‘s tradition of offbeat subject matter for its late December issue—as noted in this space five years ago: “Had the Puritans never left Britain for New England, they might later have fled the British Medical Journal to found the New England Journal of Medicine.”

The toilet hygiene piece reminds us that practices considered routine in one place or time may be unknown elsewhere or elsetime. The first known reference to toilet paper in the West does not appear until the 16th century, when satirist François Rabelais mentions that it doesn’t work particularly well at its assigned task. Of course, the ready availability of paper of any kind is a relatively recent development. And so, the study’s authors say, “anal cleaning can be carried out in various ways according to local customs and climate, including with water (using a bidet, for example), leaves, grass, stones, corn cobs, animal furs, sticks, snow, seashells, and, lastly, hands.” Sure, aesthetic sensibility insists on hands being the choice of last resort, but reason marks seashells as the choice to pull up the rear. “Squeezably soft” is the last thing to come to mind about, say, razor clams.

Charlier et al. cite no less an authority than philosopher Seneca to inform us that “during the Greco-Roman period, a sponge fixed to a stick (tersorium) was used to clean the buttocks after defecation; the sponge was then replaced in a bucket filled with salt water or vinegar water.” Talk about your low-flow toilets. The authors go on to note the use of rounded “fragments of ceramic known as ‘pessoi’ (meaning pebbles), a term also used to denote an ancient board game.” (The relieved man on the Museum of Fine Arts’s wine cup is using a singular pessos for his finishing touches.) The ancient Greek game pessoi is not related to the ancient Asian game Go, despite how semantically satisfying it would be if one used stones from Go after one Went.

According to the BMJ piece, a Greek axiom about frugality cites the use of pessoi and their purpose: “Three stones are enough to wipe.” The modern equivalent is probably the purposefully self-contradictory “toilet paper doesn’t grow on trees.”

Some pessoi may have originated as ostraca, pieces of broken ceramic on which the Greeks of old inscribed the names of enemies. The ostraca were used to vote for some pain-in-the-well-you-know to be thrown out of town—hence, “ostracized.” The creative employment of ostraca as pessoi allowed for “literally putting faecal matter on the name of hated individuals,” Charlier and company suggest. Ostraca have been found bearing the name of Socrates, which is not surprising considering they hemlocked him up and threw away the key. (Technically, he hemlocked himself, but we could spend hours in Socratic debate about who took ultimate responsibility.)

Putting shards of a hard substance, however polished, in one’s delicate places has some obvious medical risks. “The abrasive characteristics of ceramic,” the authors write, “suggest that long term use of pessoi could have resulted in local irritation, skin or mucosal damage, or complications of external haemorrhoids.”

To quote Shakespeare, “There’s a divinity that shapes our ends.” Sadly, for millennia the materials used to clean our divinely shaped ends were decidedly rough-hewn.

Source: Scientific American.