Are we drinking too much? New report shows rises in death due to Liver Disease

Today a new report warns that the number of people dying from liver disease in England is on the increase, with the most common factor for mortality being attributed to unhealthy lifestyles and consequently preventable.

The report “Deaths from liver disease: Implications for the end of life care in England” the first ever national report on the statistics published by the National End of Life Care Intelligence Network, shows that between 2001 and 2009 there has been a 25 percent rise in liver disease deaths (from 9,231 to 11,575 people).

Figures indicate that although the numbers of deaths from cancer, vascular and respiratory disease still remain significantly higher, liver disease disproportionately kills people at a much younger age.

Alarmingly 90 percent of people who die from liver disease are under 70 years old and more than 1 in 10 are in their 40s.  The report also highlights that more men (60 percent) than women (40 percent) die from liver disease.

Lifestyle and Liver disease

Although there are many reasons for liver disease, the most common cause is alcohol related.

The British Liver Trust says that a healthy liver should contain little or no fat.  Fatty liver, where the liver contains too much fat, is regarded as the most common forms of liver disease.  The effects of having fat in the liver over a long duration of time may lead to inflammation causing swelling (hepatitis) and then scarring (fibrosis).  Where the condition may be the result of excess alcohol, it is referred to as alcoholic liver disease.

Alcoholic liver disease is the most common and preventable type of liver disease.  It accounts for over a third of all liver disease deaths and kills 3,880 people annually.  The figure for men is considerably higher at 2,588 deaths compared to that of women 1,292 deaths.  Regionally, the report demonstrates that alcoholic liver disease death is most prevalent in the North West, South East and West Midlands.  However, for both male and female the highest mortality rate is in the North West, approximately double that of the lowest in the East of England.

The Chief Executive of Alcohol Concern, Eric Appleby, said: "This report shows that loss of life through alcoholic liver disease remains as big a problem as ever, with a worrying tendency for those with the highest deprivation to suffer most, leading to a distinct north/south divide.

Cause for Concern

Liver disease is regarded as a challenging area for public health.  With over 70 percent of people with liver disease dying in hospital, patients tend to be younger, from poor socio-economic backgrounds (although this is not always the case) and often come from either isolated or ethnically diverse subcultures.  Those dying of alcoholic liver disease may have mental health problems drug dependency issues, which could further isolate them socially.  Additionally, people may feel stigmatised by their disease because of its degenerative nature.

Professor Martin Lombard, National Clinical Director for Liver Disease, said: "The key drivers for increasing numbers of deaths from liver disease are all preventable, such as alcohol, obesity, hepatitis C and hepatitis B. We must focus our efforts and tackle this problem sooner rather than later."

What can you do?

One of the key objectives of the Government’s White Papers Liberating the NHS and Healthy Lives, Healthy People, was to reduce mortality in people under 75 years of age.

The report shows that death from liver disease can affect any one of us and is largely the result of our lifestyle.  Rises in alcohol consumption and obesity are clearly huge areas for concern.  Therefore, in order to tackle the issues and reduce mortality rates, advocates believe we need to address the underlying causes of liver disease.  It becomes essential that we help to educate people about the consequences of unhealthy living and ways to improve their lives, as well as, reaching out to the most deprived and isolated people in society.

Prof Julia Verne, lead author of the report and clinical lead for the National End of Life Care Intelligence Network, said: "It is crucial that commissioners and providers of health and social care services know the prevalence of liver disease in their local areas, so that more people can receive the care they need to allow them to die in the place of their choosing."

RSPH Training Solutions offer a number of low cost training programmes on health improvement, JSNA’s, and provide training on key aspects of health to help you, help others and people in your community to lead longer and healthier lives.  For more information click here.

Health Warnings Over Rises in Shisha Bars

Today is No Smoking Day, and several newspapers have highlighted the growing concern of the rise in shisha cafes and the lack of health awareness of the harm they can cause.

Data from the Freedom of Information (FoL) taken from 133 local authorities in major cities around the UK shows that the number of shisha cafes/bars have increased by 210 percent since 2007.

Smoking shisha has become a fashionable pastime for many young people falsely believing it to be safer and less harmful than smoking cigarettes.  However, strong evidence suggests that a typical one hour session of smoking shisha is equivalent to inhaling the same amount of smoke as from more than 100 tobacco cigarettes. 

The Medical Director of the British Heart Foundation Dr Mike Knapton said that waterpipe smokers should not be “duped by the sweet and wholesome sounding fruity flavours, if you use shisha you are a smoker and that means you’re putting your health at risk.”

Shisha smoking is linked to the same kinds of diseases as cigarette smoking including heart disease, cancer, respiratory disease and problems during pregnancy.  However there are added risks because you often smoke it for a greater length of time than you would a cigarette and you are also exposed to toxins from the wood or charcoal used to burn the tobacco. 

Worryingly, statistics demonstrate that more than one in ten UK Adults (13 percent) continue to think that are no health harms from using shisha.  This could explain the subsequent rises in shisha users and the increase of shisha cafes around the UK.

Tobacco consumption has been linked to a high death rate worldwide with 5 million deaths each year and is considered to be the second major cause of death in the world that is completely preventable.

 

No Smoking Day is a great opportunity for anyone who smokes to try and quit.  However, thousands of quitters could be putting their health at risk by using shisha as an alternative.  More information needs to provided to people so they become educated and clued up on the high health risks associated with shisha.  

For further reading on the harmful affects of shisha smoking click here

If you are interested in quitting smoking or for further advice on the steps to help you stop smoking visit the NHS Choices Website  

RSPH report: the future for public health learning and development

"Paving the Way"

The Royal Society for Public Health has commissioned an in-depth report into the future learning and development landscape for the wider public health workforce.

Although the broad context for health improvement is well established, its architecture is undergoing a radical shift, from a health led service towards a public health system that is local authority led.

The report is based on interviews with people in a wide range of public health roles; in both practice and learning settings, Local Authorities, the NHS, and the third and the independent sectors.

The findings highlight the complexity of developing effective education and learning to support health improvement and the changes that will be needed to ensure that the workforce can operate effectively in the new environment. In particular:

·         ‘Health Improvement’ is still not a clearly understood term, and it is used to mean different things by various parts of the workforce.

·         Each area of the workforce has a different culture and uses specialist terminology in their work. This causes difficulties as they start to work together.

·         The traditional format of training is no longer appropriate, and new approaches are needed to support learning for the new public health workforce.

This report informs future education and learning in the light of the forthcoming Public Health Workforce Strategy. RSPH wants to share the learning from this work with practitioners and policy makers to stimulate, inform and shape ongoing discussions and bridge the gap between the policy and practice. The intention is to create an ongoing dialogue recognising that the best solutions are co-created.

For a copy of the final report contact Gina Mohajer on gmohajer@rsph.org.uk or download it from the RSPH website here>

Celebrating International Women's Day

- Remembering the importance of health and well-being

March 8th is International Women’s Day , a global day celebrating the economic, political and social achievements of women past, present and future.    Today not only signifies the great work that women are carrying out, it also highlights the struggles and barriers that women face around the world, and why the search for change and equality continues.

  

To coincide with International Women's Day, RSPH Training Solutions has developed a one day programme on Women’s Health and Well-being to highlight the importance of women's health, whilst educating participants on how to empower women to live longer, healthier and happier lives.

All to often, in our busy lifestyles we forget the importance of looking after our health. But our health and mental well-being not only affects us, it has an impact on our family, friends and our wider community.  Therefore, although today is a celebration of women's achievement, we believe that maintaining good health should be a priority and practised everyday.    

The Women's Health and Well-being programme will examine the five essential elements of health and wellbeing – eat well, sleep well, play well, relax well, and move well, particularly as they relate to female hormonal changes at different stages of life.  Each is important for protection against certain conditions such obesity, diabetes, heart disease and osteoporosis.

After attending this day you will be equipped to play your part in improving the health of your community by identifying opportunities to improve women’s health and wellbeing, and evaluating what works best.

Anyone who works in a voluntary organisation, education or health and social care, with responsibility for health education, well-being, exercise, nutrition or personal care, will benefit from this new programme. For further information on the programme and to book your place please click here or contact Gina Mohajer

Rare Disease Day!

 

February 29^th is Rare Disease Day, an annual event co-ordinated by EURORDIS at the international level and National Alliances of Patient Organisations at the national level.

The main purpose of the day is to highlight and raise awareness to the public and decision makers about rare diseases and their impact on patients’ lives

Rare Disease Day was first launched by EURORDIS and its councils of National Alliances in 2008.  With more than 1000 events taking place over the past four years, the publicity and media attention that has been generated, has enabled information to reach hundreds of thousands of people, including patients and patient representatives, as well as targeting policy makers, politicians, public authorities, researchers and anyone who is interested in rare diseases. 

The political momentum resulting from the day has also served for advocacy purposes and consequently has led to the advancements of national plans and policies for rare diseases in a number of countries where health inequalities may also be prevalent. 

What is a rare disease?

Information from the EURORDIS website describes a rare disease, also referred to as an orphan disease, as a disease which affects a small proportion of the population, that is less than 1 in 2000 citizens (Orphan Drug Regulation 141/2000). 

Most rare diseases are known to be genetic, chronic, degenerative, life threatening and where there is no existing effective cure.

It is estimated that there are between 6,000 and 8,000 rare diseases and each disease can be so broad and diverse that even symptoms and suffering levels for the same disease can vary from patient to patient.  In many cases, where symptoms are not always immediately evident, or where symptoms are common, can often lead to misdiagnosis and further pain.

For many rare diseases, there is often a lack of scientific and quality knowledge of the disease, which not only delays access to the appropriate diagnosis and medical procedures, but it is also detrimental for the patients’ health and wellbeing.    

The evidence shows that around 75% of rare diseases affect children and that 30% of rare disease patients die before the age of five.

Bring About Change

Advocates believe that by developing appropriate public health policies and implementing a comprehensive approach to rare disease, will help to eradicate many of the existing hurdles experienced by patients and their families.  Similarly by increasing international cooperation in scientific knowledge, and the sharing of knowledge of rare diseases, will subsequently lead to faster and new diagnosis as well as therapeutic procedures.      

Undeniably people with rare diseases often experience high level of pain and suffering, which impacts on their surrounding family and friends.  It is hoped that with worldwide growing interest in rare diseases and the need for further research and awareness, one of the objectives of the day is for WHO to recognise the last day of February as the official Rare Disease Day.  For further information on the events and the day please visit the official RareDiseaseDay website and the EURORDIS homepage 

Drinking Water can improve our Moods

We are continually being reminded to drink water and keep hydrated.  Experts and health advisors claim that drinking water is essential for maintaining your health and general well-being.  It helps keep our skin looking fresh, aids digestion and removes toxins from the body.  However, recent research has now found that dehydration has a correlation with our moods and cognitive ability. 

Two recent studies, conducted at the University of Connecticut’s Human Performance Laboratory, found that being even mildly dehydrated could alter a person’s mood, energy levels and ability to think clearly.

The results from the study highlighted the importance of staying properly hydrated at all times and not just during exercise or extreme heat.  It found that regardless if a person had just walked forty minutes on a treadmill or was resting, the adverse affects from mild dehydration were equal.  Mild dehydration is defined as an approximately 1.5 percent loss in normal water volume in the body.   

Lawrence E Armstrong, one of the lead scientists for the study and an international expert on hydration says that, “our thirst sensation doesn't really appear until we are 1 or 2 percent dehydrated. By then dehydration is already setting in and starting to impact how our mind and body perform,"

Armstrong also highlighted that dehydration affects everyone and staying adequately hydrated is just as important for those who work all day at a computer as it is for those who are exercising. 

The Research

The study, which was published in The Journal of Nutrition, consisted of separate tests for young women and young men.  Twenty-five women aged around 23 and twenty-six men with an average age of 20 were selected for the research.  All the participants were considered to be healthy and active individuals.

The participants were required to walk on a treadmill to induce dehydration, and all of the subjects were hydrated the evening before the tests began.  As part of the research, each participant was put through a number of tests that measured vigilance, concentration, reaction time, learning, memory and reasoning.

The results were then compared against a separate series of tests, whereby the individuals were not dehydrated. 

The research found that the young women who had mild dehydration suffered from headaches, fatigue and consequently had difficulty concentrating and carrying out certain tasks. 

Similarly the study showed that the young men who were mildly dehydrated, experienced difficulty with mental tasks, particularly in the areas of vigilance and working memory.  It was also noted that the same group of men also suffered from fatigue, tension and anxiety. However, the study pointed out that these adverse changes in mood were notably more prevalent in females than males, both at rest and during exercise.

Harris Lieberman, the studies’ co-author, stated that, “even mild dehydration that can occur during the course of our ordinary daily activities can degrade how we are feeling – especially for women, who appear to be more susceptible to the negative affects of low levels of dehydration than men”

Lieberman explains that is very important for both sexes to keep hydrated throughout the day because, as the study demonstrates, mild dehydration can negatively impact mood and de motivate someone to engage in moderate exercise and interfere with daily activities.    

It is unclear why women are more affected by dehydration than men, and this is an area of research that requires further exploration.  However, other studies have pointed to the idea that neurons in the brain detect dehydration and consequently signal other parts of the brain regulating mood. This process has been identified as part of an “ancient warning system” to protect humans from more dire consequences, by alerting them to the need for water to survive.

Recommendation

Experts suggest that in order to stay hydrated, people should be consuming around two litres of water a day, that is eight glasses of water.

For further information on the benefits of keeping hydrated and tips to make sure you are drinking enough water, please visit the Water Aid website  

International Childhood Cancer Day

Today, February 15^th is International Childhood Cancer Day.  The International Society of Paediatric Oncology (SIOP) and the International Confederation of Childhood Cancer Parent Organizations (ICCCPO) are launching a health advocacy campaign to help educate the public in recognising the early warning signs for childhood cancer. 

Worldwide, 175,000 children are diagnosed with cancer each year and it is estimated that more than half (90,000) will die from the disease.  Clearly, these high death figures give cause for concern considering the fact that seventy percent of all childhood cancers are curable when diagnosed and treated early.

Statistics reveal that cancer is the second leading cause of death among children in developed countries.  The most common type of cancer in Europe, Americas and East Asia is Acute Lymphoblastic Leukaemia.  

One of the issues surrounding late detection of the disease is because symptoms of cancer often get interpreted as common childhood ailments, as Dr Gabriele Calaminus, President of SIOP points out.

Kenneth Dollman, President of ICCCPO says “By dinner time tonight, someone’s son, daughter, sister or brother, an estimated 440 children, will have been diagnosed with cancer, while 250 children from around the world would have succumbed to it”  

Figures from Cancer Research UK shows that 1,550 children are diagnosed with Cancer each year, of which around 260 children, under the age of 15, die as a result.

It has been acknowledged that children in wealthier countries have an eighty percent cancer survival rate, however, this figure is reversed for those living in poor socio-economic settings.  It is estimated that around eighty percent of children with cancer die due to late detection and limited access to appropriate treatment.     

"Delayed diagnosis significantly diminishes survival rates.  While in resource-rich countries, 8 out of 10 children survive, only 2 to 3 out of 10 children will survive in low and middle-income countries" explained Dollman. 

Today SIOP and ICCCPO, with its members from around the world will be reaching out to communities, schools, hospitals and the public to disseminate critical information about childhood cancer. 

For further information about childhood cancer, awareness, symptoms and support please visit the Be Child Cancer Aware at http://www.bechildcanceraware.org/.