Saving Lives Through Changing Behaviour

Fresh food, more exercise and no smoking.  These are some of the choices we need to make in order to lead a healthy lifestyle, which is sustainable in the long term.

The Royal Society for Public Health (RSPH) http://www.rsph.org.uk/ has responded to the Government’s White Paper, by developing a suite of training programmes on Behaviour Change designed specifically to support health and well being professionals to deliver these messages effectively as part of their behaviour change strategy. 

Professor Richard Parish, Chief Executive of RSPH comments:

“It is our belief that spreading skills and knowledge in this area will have a direct effect on driving behaviour change and reducing health inequalities, resulting in healthier communities across the country.”

Rises in obesity, diabetes, heart disease and sexually transmitted infections (STIs), alongside problems associated with unhealthy eating, drinking and smoking habits, have placed our health service under huge pressure.  As many health conditions are both preventable and avoidable, we have a responsibility to ensure that we intervene and steer people towards healthier lifestyle choices.  This not only positively impacts the wellbeing of the individual but also their communities.

Preventing avoidable conditions is better for both the patient and the health service, but the approach differs depending on the time available, the skill of the individual and the nature of the contact.

The programmes are tailored to help everyone and range from a short introduction for frontline staff right through to strategic planning for leaders and managers.

Influencing Behaviour Change

An introduction to communication and sign-posting

This one day workshop for front-line staff explores the potential improvements they could make to community health by influencing changes to behaviour. Drawing on motivational interviewing techniques and a variety of communication styles, participants will gain a clear understanding of how they can increase the impact of everyday contact with their community.

Making Every Contact Count

An introduction to the Behaviour Change competence framework

This half day programme introduces participants to the competence framework which has been developed by NHS Yorkshire and The Humber. It is designed for use at all levels of experience and provides a common approach against which skills can be assessed, either within a single programme or for an entire workforce. This will enable individuals to identify gaps in their knowledge, Commissioners to address weaknesses in their provision, and Service Providers to offer exactly what is needed.

To find out more about RSPH’s programmes on Behaviour Change please contact Gina Mohajer on gmohajer@rsph.org.uk 020 7265 7327or visit http://www.rsph.org.uk/en/training-solutions/index.cfm

Cutting out the Fat....

The relationship between fatty foods and developing type 2 diabetes

As levels of obesity continue to rise, posing as a serious threat to public health, conditions of type 2 diabetes has also increased.  Evidence has suggested a strong link between obesity and developing type 2 diabetes, however, scientists have now discovered how a high fat diet can cause type 2 diabetes.  Researchers believe this discovery will not only help explain the relationship between fatty foods and obesity, but it may lead to finding a cure for the disease.   

This week the Daily Mail and BBC Health News reported the findings.

The study published in the peer-reviewed journal Nature Medicine, was carried out by researchers from the University of California and the RIKEN Advanced Science Institute in Japan.  The study sought to investigate whether a high-fat diet might contribute to causing type 2 diabetes, by looking at its effect on the insulin producing cells of the pancreas on mice, and on the response of cells to insulin.  The scientists investigated their findings further on human pancreatic cells in the laboratory.

The Science bit

In type 2 diabetes, the cells in the pancreas that normally produce insulin – called beta cells – gradually stop working over time.  These cells respond to increased levels of sugar in the blood by producing insulin, but this ability is lost in type 2 diabetes.  The cells of the body become less responsive to insulin (insulin resistance) and fail to take up the sugar in the blood stream.  This then causes high levels of sugar circulating around the body, which is detrimental to cells and tissues.   

The Research

Scientists looked at what effect a high-fat diet had on the activity of certain genes and proteins in the cells that are thought to help the beta cells function. Particular focus was placed on a protein called GnT-4a glycosyltransferase.  In healthy pancreatic cells this protein helps in the detection and response to glucose in the blood stream.

The researchers found that when they fed mice a high-fat diet, the genes encoding the GnT-4a protein and one of the glucose sensing proteins (called Slc2a2) became less active in the mice’s pancreatic cells.

The scientists also genetically engineered mice to have a form of GnT-4a that was always active in the beta cells. They then looked at how these mice responded to the high-fat diet.  The theory was that if dietary fat had its effects by stopping these proteins working, then these genetically engineered mice should be less susceptible to the effects of a high-fat diet.

The Findings

It was found that high-fat diets in mice affected the insulin-producing cells, reducing their ability to correctly respond to the presence of glucose.  As such, there were high levels of glucose circulating in the bloodstream and a reduced ability of certain tissues to respond to insulin and take up sugar.   Tests on pancreatic tissue from people with type 2 diabetes suggested that similar changes may be occurring in humans.

However, in mice genetically engineered to have GnT-4a work constantly in the beta cells, the high-fat diet had less of an effect on blood sugar levels and the ability of the cells to respond to insulin, even though the mice became fat.  This enhanced understanding of the effects of fat on pancreatic cells, provides a possible biological explanation as to why high fat diets can lead to type 2 diabetes. Researchers believe this will also aid the development of possible new treatments for type 2 diabetes.

However, human research is a lengthy process and finding a cure for type 2 diabetes may take years.  Thus, the best current advice to prevent type 2 diabetes, is to maintain a healthy weight, do exercise and eat a healthy diet.  For further information on this research please visit NHS Choices

What You Can Do?

At RSPH Training Solutions we take health seriously and we believe that through education and training, people can learn to make better lifestyle choices and positively influence people around them.  The level 2 Award in Understanding Health Improvement provides knowledge and understanding of the benefits of good health and well being, and of the barriers to making a change of lifestyle.  This qualification is specifically designed for people who work with the public in a healthcare environment and those who have an interest in developing public health skills.  For further information on the course please click here or contact Nicolette Boustaoui   or by phone 020 7265 7325. 

Breast Health

World Breastfeeding Week

This week from 1^st to 7^th August the World Alliance for Breastfeeding Action (WABA) has been celebrating World Breastfeeding Week (WBW).  WBW is carried out in 170 different countries and this is the 19th year it is running.  This year's theme is “Talk to Me! Breastfeeding – a 3D experience”.

Spreading the Message

World Breastfeeding Week provides the opportunity to highlight the many health benefits of breastfeeding and to encourage everyone to support mothers who want to breastfeed.  This year however, WABA are determined to raise awareness outside of the health care sphere and encourage young people to get involved to help spread the message.

In association with the United Nation’s International Year of Youth, WABA commissioned a group of dedicated young people to partake in the United Nation’s call for action and help create awareness, mobilise and engage, connect and build bridges across generations, different cultures and religions.

In a press release, a spokesperson for WABA stated: “Youth account for about 18 percent of the world’s population and are therefore an invaluable sector to ally with in any public health movement” 

The “3D” theme is about looking at the dimensions of our lives and ensuring that communication is filtered throughout all channels so that it speaks to everyone. A young advocate from WABA YOUth stated that “as a young person I want to contribute to the global breastfeeding movement! Not only do I learn more about breastfeeding, but I need to make sure I talk to my friends and family when needed”.

Breastfeeding - The Statistics

Data published in the NHS The Information centre for health and social care, revealed that in 2005, 76 percent of mothers breastfed their babies compared with 69 percent in 1995.  Evidence shows that globally breastfeeding is on the rise, but more needs to be done to ensure that the correct health message reaches everyone and that support and information is offered to mothers to help them make choices. 

The Benefits

We are told that breastfeeding is the best way to feed your baby, but let us now look at why this is the case?

Breast milk is considered to be rich in nutrients and antibodies which protects your baby from diseases and infections and also stimulates the baby's immune system. 

Studies have compared the health of children who were breastfed as babies and children who were given formula milk.  The results highlighted that breastfeeding substantially decreased the risk of illness and that the longer babies were breastfed, the greater the health benefits.  

The World Health Organisation and the Department of Health, Social Services and Public Safety recommend breastfeeding with no other food or drink until around six months of age.    

The NHS Choices website advocates the many positive reasons why breastfeeding is good for baby, mother and society.  Aside from being the only natural food designed for babies, breast milk is available whenever, wherever and at the right temperature.  Let us not forget it is free! 

Benefits for baby

Less chance of:

1. Diarrhoea, upset tummy and gastroenteritis

2. Coughs and colds

3. Ear and chest infections

4. Urine infections

5. Allergies, asthma and eczema

6. Childhood diabetes and obesity in later life

It is also recognised that breastfeeding helps to strengthen the emotional and physical bond between mother and baby.

Benefits for Mother

Less Chance of:

1. Breast cancer

2. Ovarian cancer

3. Osteoporosis (Bone thinning)

Breastfeeding also helps mothers to get back to their pre-pregnancy weight more easily, as it naturally uses 500 calories per day.

Society also benefits from breastfeeding, not only are babies healthier, but it means less demand on the health service.  Mothers are healthier, which means less time off work, saving employers money and making family life less stressful.  Lastly, breastfeeding is environmentally friendly because there is no pollution, manufacturing, packaging or waste involved!

For further information on breastfeeding, please click on the NHS Choices website

What are you views?

We are interested to hear your views on breastfeeding and open up a discussion. 

Do you feel you have gained any benefits from breastfeeding?
Have you encountered any difficulties breastfeeding? Have you felt pressure to breastfeed and been unsuccessful?  Has working life prevented you from breastfeeding?
Were you given the right information and support?

Getting Sporty – The Benefits for Body and Brain!

It is widely accepted that exercise has many beneficial effects on the body.  However, a new review article entitled “Exercise, Brain and Cognition Across the Lifespan” published in the Journal of Applied Physiology, highlights that the positive effects of exercise also extends to the brain, influencing cognition.  The article draws upon recent evidence which identifies physical activity as positively affecting the body and also the mind.     

Michelle W. Voss, from the University of Illinois at Urbana-Champaign and her colleagues affirmed that both aerobic exercise and strength training play an essential role in maintaining brain and cognitive health throughout life.  However, they also highlighted that this area of research still needed to be explored into understanding how certain aspects of exercise influence brain physiology and function.   

The Results

The article used the findings from 111 studies to demonstrate the effects of aerobic exercise and strength training on humans from children through to the elderly. 
It was found that aerobic exercise was crucial for getting a head start during childhood on cognitive abilities.  It suggested that physical inactivity was associated with poor academic performance, whereas, exercise programs could help to improve memory, attention and decision making.  These effects, it was argued, extend to both young and elderly adults. 

There was strong evidence that showed aerobic training benefitted executive functions, including multi-tasking, planning and inhibition, as well as improving memory.  This is particularly evident for high-intensity and high load training for older adults.  More research needs to be carried out on the effects of strength training on brain health for children. 

Animal studies, which examine the influence of aerobic exercise has found that physical activity appears to change the brain structure, promoting the growth of new nerve cells and blood vessels.  It is also recognised as increasing the production of neurochemicals, such as BDNF and IGF-1 which help to promote growth, survival and repair of brain cells. 

Clearly, the studies identify the positive effects of exercise on the brain, but the article also made clear that there were gaps in the scientific literature and more needed to be done to examine how exercise type might promote different effects on brain health and cognition at different ages. 

"It is increasingly prevalent in the print media, television, and the Internet to be bombarded with advertisements for products and programs to enhance mental and physical health in a relatively painless fashion through miracle elixirs, computer-based training, or gaming programs, or brief exercise programs," the authors say. "Although there is little convincing scientific evidence for such claims, there have been some promising developments in the scientific literature with regard to physical activity and exercise effects on cognitive and brain health."

For more information on how to get active and the recommended physical activity guidelines please visit the NHS Choices website by click here. 

RSPH – Sport for Health

Sir Liam Donaldson, Chief Medical Officer stated that:

“The potential benefits of physical activity to health are huge.  If a medication existed which had a similar effect, it would be regarded as a ‘wonder drug’ or ‘miracle cure’.

RSPH Training Solutions, recognises the importance of how sport can play a vital role in improving ones overall health and wellbeing.  However, the problem stems in that so many people avoid sport and thus ignore one of the cheapest and most effective ways to improve health.  Sport for Health is a programme which has been designed for people who work in sport, either in a professional or voluntary role.  It aims to help them increase the level of physical activity amongst people by understanding how an active lifestyle promotes good health and also understanding the barriers people face and ways to overcome them.

Through the Mayor’s Legacy Fund, applicants can apply for funding which entitles them to 75% off the cost of the course.  For more information on Sport for Health please click here or email sportforhealth@rsph.org.uk

Rises in Cancer Rates: 17,000 more middle-aged people are diagnosed with cancer every year, compared to a generation ago

Yesterday's news articles reported the subsequent rises in cancer rates over the past two decades.  The Daily Telegraph, the Daily Mail and the Sun, pointed out that cancer rates in the middle-aged have increased “by almost a fifth in a generation”.  The articles highlighted that the rise was mainly a result of better detection of cancer, but also the rise in obesity and unhealthy lifestyles.

Cancer Research UK (CRUK) – The Findings

Figures from Cancer Research UK compared the rates of cancer in Great Britain in 1979 and 2008.  The statistics found that new cancer diagnoses increased by 16 percent in men and 34 percent in women in Great Britain between the 1977-1979 and 2006-2008 reporting periods.  This equated to a rise from 368.3 to 416.7 cases per 100,000 men and from 273.9 to 365.7 cases per 100,000 women.

The increases in cancer rates between 1979 and 2008 varied across age groups, however, the main focus was the rates of cancer in middle-aged individuals (40-59 years old) which saw new diagnoses rise from 329.1 per 100,000 in 1979 to 388.1 per 100,000 in 2008.  It was reported that in 1979 44,000 people in this age group were diagnosed with cancer in Britain and this figure rose to 61,000 in 2008.

The statistics revealed that among 40-59 year olds, prostate cancer rates have risen six fold in 30 years and breast cancer rates have increased by 50 percent.  In comparison, cases of lung cancer in men of this age have dropped from 6,300 to around 2,700 in the same period.  For a break down of all the cancer figures, please visit the Cancer Research UK website by clicking here.

Despite the upward trend, CRUK say that the number of people surviving cancer has almost doubled since the 1970s.  In 1979 in Great Britain there were 215.2 deaths from cancer per 100,000 people, which decreased to 174.4 deaths from cancer per 100,000 people in 2008. 

Why the Increase?  

Although the exact causes for the increases were not directly investigated, CRUK claim that the rises could be contributed to higher detection due to the NHS breast cancer screening programme and the PSA test for prostate cancer.  However, it has also been suggested that these rises are due to modern changes in lifestyle, with people eating more unhealthily and living a sedentary lifestyle, compared to people in the past decades.

Evidence demonstrates that certain lifestyle factors do influence risk of cancer and that smoking, obesity, poor diet, alcohol consumption can be hazardous for our health and may increase the possibility of cancer. 

Therefore, by taking responsibility for our health, by exercising, maintaining a healthy weight and diet, not smoking and reducing our alcohol consumption we can help to limit the risk of cancer.  For further information on cancer prevention, please visit the NHS Choices website by clicking here.

Sporting Advice

Today the Department of Health launched new advice on how to maintain fitness levels and stay or get healthy, for people of all ages.  The UK-wide physical activity guidelines by the four nations’ Chief Medical Officers, is intended to help people understand the benefits of physical activity and also promote the simple steps that people can take to incorporate activity into their everyday lives.

Although the guidelines build on previous advice about the positive outcomes of physical activity, they also highlight that being more active can dramatically reduce the risk of serious diseases such as heart disease, stroke and diabetes.

Key New Elements of the Guidelines Include:

How to incorporate physical activity into busy lives.  Adults can get their 150 minutes of activity a week in sessions of ten minutes or more and should aim to be active every day. 30 minutes five times a week is just one way this can be achieved.

·         Greater emphasis on vigorous activity and muscle strengthening through, heavy gardening, group sports, such as volleyball and basketball or swimming. There is good evidence this stimulates bone formation and maintains muscle mass;

·         Advice tailored to every age group including - for the first time - guidance for parents for under-fives;

·         Reducing and minimising periods of sedentary behaviour.

·         The guidance has a renewed focus on being active everyday and spells out the recommended minimum levels of activity for each age group:

The Recommendations:

Under Fives

180 minutes - three hours - each day, once a child is able to walk

Children and young people (5-18 year olds)
60 minutes and up to several hours every day of moderate to vigorous intensity physical activity. Three days a week should include vigorous intensity activities that strengthen muscle and bone. Adults (19-64 years old) and older people (65+) 150mins - two and half hours - each week of moderate to vigorous intensity physical activity (and adults should aim to do some physical activity every day). Muscle strengthening activity should also be included twice a week.

England's Chief Medical Officer Sally Davies said:

"Being active has enormous health and well being benefits. It protects against many of the biggest causes of early death like heart disease, and stroke, and can promote good mental health.
"The latest figures show that almost a quarter of adults are obese and on current trends by 2050 it means 9 in 10 adults will be overweight or obese. We know that more than 60 per cent of adults are not active enough which is why today the UK Chief Medical Officers are launching the first UK-wide guidelines that draw on the latest science to inform weekly levels of physical activity - whatever your age. "But it's not just about health. Cycling and walking more can save on transport costs, reduce congestion and pollution."

Robin Gargrave, Director of Innovation and Development at Central YMCA said:
"In terms of health benefits, we know that the duration, intensity and type of physical activity for a young person is very different to that required for an older adult. Most people know they can improve their health by being more active, but face barriers, which prevent them from doing so.

"This advice addresses these barriers by recognising the limitations of a 'one size fits all' approach to physical activity - it speaks directly to people at different stages of their lives and is flexible in its approach. For providers such as Central YMCA, this advice will enable us to develop and target physical activity interventions more effectively."

To access the guidelines, click here and to view the press release, click here

RSPH – Sport for Health: Bringing Sport into People’s Lives.

Sport for Health is a two part programme specifically for people who work in sport, either in a professional or voluntary role. It is designed to help them increase the level of physical activity amongst people who do not normally take part in sport.  It provides an understanding of how an active lifestyle promotes good health, and a practical approach to understanding the barriers people face and ways to overcome them.

Through the Mayor’s Legacy Fund, applicants can attend the courses at a 75% discount on the normal rate (ie the trainee fee is £50 per day as opposed to the normal £200).   In order to qualify for the discount applicants need to commit to 20 hours of voluntary work in the London area – either in sports or in encouraging others to take part in physical activity.
To find out more about this course, available funding and other programmes offered by RSPH, please click here call Nicolette Boustaoui on 020 7265 7325 or email sportforhealth@rsph.org.uk. 

Planning for healthy communities: Joint Strategic Needs Assessment

Reforms to our health and social care services are rarely out of the news, but one common theme is the importance of a local approach to healthcare provision, which takes into account the needs of the whole community. The framework for planning the future healthcare provision for our communities is known as the Joint Strategic Needs Assessment (JSNA), and a new step by step briefing on this process has just been launched. 

The Royal Society for Public Health (www.rsph.org.uk) has been working with the NHS Confederation and Local Government Improvement and Development to develop this briefing, so that all the parties involved in the new health and wellbeing boards will have a common understanding of how to identify their community’s needs.

The JSNA pulls together all the relevant information about a community, including population data, levels of smoking, housing quality, and importantly, the views of its residents. This picture is then used to plan future provision, to ensure that the community has the health and social care services which it needs.

Professor Richard Parish, Chief Executive of RSPH, comments “The importance of effective planning for local communities cannot be overstated, and it is vital that a strong partnership is developed between the health and social care professionals, and the representatives of hard to reach groups. The JSNA process provides a vital tool which will allow everyone to contribute effectively to the development of healthy communities.”

PCTs have been using the JSNA process since 2007, but in future, health and wellbeing boards will have responsibility for providing the health and social care services for their communities. These groups will include members of the health professions, locally elected representatives and the Local Authority Directors of Children’s Services and Social Care. And the Directors of Public Health will play a vital role in providing technical advice.

It is particularly important that the voluntary sector and local community groups take an active part in the JSNA process, because they often have the best understanding of what their community needs, and can provide specialist services to support particular groups of people. By making contact with their local health and wellbeing board, and taking an active part in the JSNA, the third sector can ensure that the needs of every part of the community are considered.

According to John Wilderspin, the National Director, Health and Wellbeing Board Implementation, "JSNAs should not be seen as dry documents to sit on your shelf gathering dust - they should provide a comprehensive "picture of place" for all decision makers to use to prioritise action, and evaluate what they have achieved.  Combined with the new joint health and wellbeing strategy they are the foundation stone for effective planning and commissioning undertaken within health and wellbeing boards."

RSPH will also be offering a range of tailored seminars for health professionals and third sector organisations to support them as they develop their JSNAs. For further information contact Nicolette Boustaoui at nboustaoui@rsph.org.uk or visit www.rsph.org.uk/jsna.