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Tim Peake is the first official British astronaut to walk in space. The former Army Air Corps officer has spent a month in space, after blasting off on a Russian Soyuz rocket to the International Space Station on December 15 last year, but the spacewalk will doubtless be his most gruelling test.

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Quality : HD
Title : Fifty Shades Darker
Director : James Foley.
Writer :
Release : 2017-02-08
Language : English.
Runtime : 118 min.
Genre : Drama, Romance.

Synopsis :
Movie Fifty Shades Darker was released in February 8, 2017 in genre Drama. James Foley was directed this movie and starring by Dakota Johnson. This movie tell story about When a wounded Christian Grey tries to entice a cautious Ana Steele back into his life, she demands a new arrangement before she will give him another chance. As the two begin to build trust and find stability, shadowy figures from Christian’s past start to circle the couple, determined to destroy their hopes for a future together.

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When you think about body fat, it’s probably white fat that comes to mind. That’s where our bodies store excess calories, and it’s the stuff you want to get rid of when you are trying to lose weight.

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‘Lion’ is great film tell story about A five-year-old Indian boy gets lost on the streets of Calcutta, thousands of kilometers from home. He survives many challenges before being adopted by a couple in Australia; 25 years later, he sets out to find his lost family. This film have genre Drama and have 118 minutes runtime.

Cast
Nicole Kidman as Sue Brierley, Sunny Pawar as Young Saroo, Abhishek Bharate as Guddu, David Wenham as John Brierley, Dev Patel as Saroo Brierley, Rooney Mara as Lucy.

Production
The Director of this movie is Garth Davis. The film Lion is produced by The Weinstein Company, Screen Australia, Sunstar Entertainment, See-Saw Films, Aquarius Films and released in November 24, 2016

Similar Movie
Lion have some similar movie, Nerve, Strangerland, Fifty Shades Darker, Forrest Gump, Wake in Fright, Walkabout

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  • A Cure for Wellness (2017)

  • Duration
    146 mins
    Genre
    Drama, Horror, Mystery, Thriller.
  • In Cinemas
    February 15, 2017
    Language
    English, Deutsch.
  • Country
    Germany, United States of America.
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Plot For A Cure for Wellness

‘A Cure for Wellness’ is a movie genre Drama, was released in February 15, 2017. Gore Verbinski was directed this movie and starring by Dane DeHaan. This movie tell story about An ambitious young executive is sent to retrieve his company’s CEO from an idyllic but mysterious “wellness center” at a remote location in the Swiss Alps but soon suspects that the spa’s miraculous treatments are not what they seem.

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Gore Verbinski.

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Gore Verbinski, Arnon Milchan, David Crockett.

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Studio Babelsberg, Regency Enterprises, New Regency Pictures, TSG Entertainment, Blind Wink Productions.

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Explainer: why is it so hard to lose weight?

We are designed to seek food – our drive to do so is essential to our survival and we have a complex system to control this.

The new you: harder than it sounds www.shutterstock.com

We are designed to seek food – our drive to do so is essential to our survival and we have a complex system to control this. Recent research shows that following weight loss, levels of circulating hormones which affect our appetite tend to promote over-eating and weight regain.

Indeed, the Minnesota experiment published in 1950 showed that we tend to overeat after a period of energy restriction until fat mass has returned to or exceeded initial levels. And although we might consider fat a simple energy reserve, during periods of food shortage fuel partitioning is not straightforward – muscle protein is just as readily converted to energy which protects fat stores.

Blame the hunter-gatherers

It can be surprising to hear that excess fat is rigorously defended by our own bodies. However, a moment’s thought explains why this should be. Our physiology has been shaped over millennia by evolutionary processes which make us suited to a hunter-gatherer lifestyle – which necessitates high levels of physical activity and likely periods of famine and feast.

Those with thrifty metabolic adaptations, which favoured storage of excess energy as fat would have been more likely to survive and pass on their genes. During periods of famine, the ability to hold on to stored fat would also have been advantageous. These adaptations which were once useful, are now causing unprecedented levels of obesity across all populations that lead a lifestyle characterised by low levels of physical activity and an abundance of food. In short, we are designed to store fat, and to keep it once we have it.

Designed for fat

To understand our physiology, we must understand homeostasis whereby biological systems are regulated mostly via negative feedback systems. Changes to a monitored condition (such as body fat) produce responses that oppose the change until the monitored condition returns to a “set point”. This seems to be the case for weight loss. A reduction of fat tissue results in changes in levels of hormones that typically lead to a return to the original level of fat.

Crucially however, this does not seem to be the case when dealing with weight gain. Our biological systems seem insufficiently powerful to return us to our set-point. Perhaps the environment is too overwhelmingly obesogenic? Or perhaps our physiology has always relied on an external event, such as famine or high levels of physical activity, to regulate body weight?

As long as the environment remains obesogenic, the problem of obesity will remain. We can no longer rely on our instinct to regulate body fat – we must now rely on our intellect.

Matthew Haines does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com

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Director : M. Night Shyamalan.
Writer : M. Night Shyamalan.
Producer : Mark Bienstock, Jason Blum, M. Night Shyamalan.
Release : January 19, 2017
Country : United States of America.
Production Company : Universal Pictures, Blumhouse Productions, Blinding Edge Pictures.
Language : English.
Runtime : 117 min.
Genre : Horror, Thriller.

‘Split’ is a movie genre Horror, was released in January 19, 2017. M. Night Shyamalan was directed this movie and starring by James McAvoy. This movie tell story about Though Kevin has evidenced 23 personalities to his trusted psychiatrist, Dr. Fletcher, there remains one still submerged who is set to materialize and dominate all the others. Compelled to abduct three teenage girls led by the willful, observant Casey, Kevin reaches a war for survival among all of those contained within him—as well as everyone around him—as the walls between his compartments shatter apart.

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Celebrity chef Jamie Oliver’s campaign to introduce a sugar tax on fizzy drinks and snacks has been gaining momentum. Oliver has a history of trying to persuade the British public to eat more healthily, with mixed results – his campaign for healthier school dinners led to some parents feeding their children chips through the school railings.

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Director : Martin Koolhoven.
Writer : Martin Koolhoven.
Producer : Els Vandevorst, Uwe Schott.
Release : January 12, 2017
Country : United Kingdom, United States of America, Netherlands, France, Germany, Belgium, Sweden.
Production Company : X-Filme Creative Pool, Film i Väst, Prime Time, Illusion Film & Television, Backup Media, N279 Entertainment, FilmWave.
Language : Nederlands, English.
Runtime : 148 min.
Genre : Mystery, Thriller, Western.

Movie ‘Brimstone’ was released in January 12, 2017 in genre Mystery. Martin Koolhoven was directed this movie and starring by Guy Pearce. This movie tell story about In the menacing inferno of the old American West, Liz is a genuine survivor who is hunted by a vengeful preacher for a crime she didn’t commit.film download

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Director : D.J. Caruso.
Writer : Chad St. John, F. Scott Frazier.
Producer : Neal H. Moritz, Jeff Kirschenbaum, Joe Roth, Samantha Vincent, Vin Diesel.
Release : January 13, 2017
Country : United States of America.
Production Company : Paramount Pictures, Original Film, Revolution Studios, One Race Films.
Language : English.
Runtime : 107 min.
Genre : Action, Adventure, Crime, Thriller.

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When it comes to an athlete’s weight, a few grams can make a vital difference to their chances of winning. In some sports, an athlete’s body mass puts them within a strictly defined weight classification.

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Offering smaller portions is one way of encouraging people to eat less. But while a single, smaller portion does lead to less consumption, having multiple smaller portions on offer can encourage some people – notably the diet-conscious – to eat more.

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Release : March 22, 2017
Country : United States of America.
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Language : English.
Runtime : 84 min.
Genre : Science Fiction, Animation, Action.

Movie ‘Teen Titans: The Judas Contract’ was released in March 22, 2017 in genre Science Fiction. Sam Liu was directed this movie and starring by Stuart Allan. This movie tell story about Tara Markov is a girl who has power over earth and stone; she is also more than she seems. Is the newest Teen Titan an ally or a threat? And what are the mercenary Deathstroke’s plans for the Titans?

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As Sierra Leone waits for Ebola all-clear, its emotional scars will take longer to heal

Sierra Leone has just reported one week of zero confirmed Ebola infections – the first time since the deadly virus reached its border in May 2014.

United Nations Photo, CC BY-NC-ND

Sierra Leone has just reported one week of zero confirmed Ebola infections – the first time since the deadly virus reached its border in May 2014. If there are no more infections for 42 days after the country’s last Ebola patient was discharged, the outbreak will be declared over. But the race to end West Africa’s Ebola epidemic is not just about getting to zero infections. It’s also about how the three countries most affected can deal with the broad humanitarian crisis the virus has left, which impacted livelihoods and led to food shortages, loss of education, widespread fear and mistrust in communities.

Ebola has caused further limitations to an already poorly resourced health and social care system. In Sierra Leone, there is just one trained psychiatrist for a population over 6m people. Recent research I’ve worked on and visits to Sierra Leone to pilot a mental health intervention with nurses there have illuminated the severe lack of mental health services available – and the devastating impact that Ebola has had on those already scarce services.

Devastated communities

A nurse in Makeni, Sierra Leone’s fourth largest city, was brought to tears as she described the vulnerability of orphans, especially young girls, who cannot afford to go to school and are left without family or community support. The charity Street Child estimates that over 12,000 children have lost at least a primary caregiver due to Ebola. Following training we delivered in April, this nurse is establishing connections in the local community to support these young girls to get back to education or find jobs.

The disease was particularly influenced by cultural and behavioural practices at household and community levels. Much of West Africa still relies heavily on traditional healthcare practices. The care for a sick relative is first done in the home by family members and further treatment is often sought from traditional healers rather than in the poorly resourced government health facilities. Fear and mistrust of modern health services have existed in Sierra Leone for some time. This stopped many people from seeking medical care for Ebola and caused them to instead flee or hide from authorities. One can imagine how distressing it might be to have people enter the village, fully covered in personal protective equipment and to recognise that when they took a family member he or she was not likely to return.

Any interventions to address psychosocial needs must therefore be adapted for cultural sensitivity while also maintaining salient public health messages around Ebola. For example, when comforting a loved one we often express emotion physically, by holding hands or giving a hug, but across Sierra Leone the public health message was “ABC: Avoid Body Contact” to reduce the spread of the virus. So when training nurses, the images we portrayed needed to reflect supportive relationships absent of physical touch.Watch Full Movie Online Streaming Online and Download

The highly infectious nature of Ebola coupled with crowded living conditions meant that entire families and villages were infected. For example, we heard from one of the nurses working with a survivor group in the Eastern Provinces, where the virus first entered the country, of a survivor who had lost 54 members of his family. All of his possessions were burnt when he was infected with the disease and he was left excluded from the community by people were fearful he would bring Ebola back to the village. This social exclusion has a long-term impact on the individuals involved and on wider society.

The harsh stigmatisation of healthcare workers, survivors and family members of those infected with Ebola is not dissimilar to the treatment of people with mental health problems and the nurses who care for them.

Weight of mental illness

In Sierra Leone, Ebola hit a post-conflict country still dealing with a recent history of trauma and mental illness. After the country’s decade long civil war which ended in 2002, the Ministry of Health and Sanitation conducted a survey of mental health needs and found prevalence rates to be roughly 13% of the population – nearly four times higher than the global prevalence of severe mental illness, estimated at 4%. Twelve years later the Ebola epidemic hit Sierra Leone, but there is still no current data on the prevalence of mental illness in the country.

Exposure to an emergency situation of any kind, be it a natural disaster, conflict situation or an infectious disease outbreak, has a devastating effect on the psychological and social well-being of people involved.

There is international consensus around the need to establish mental health services in developing countries that are community-based, family-focused and culturally sensitive. The World Health Organisation (WHO) has established guidelines for training primary care workers in mental health and recently published a toolkit for assessing psychosocial needs in humanitarian settings. However, to date very few social interventions have been developed and piloted in places with low resources.

Despite the devastation Ebola has caused to the communities in West Africa, there is also an opportunity to “build back better”, as international organisations such as the WHO and International Medical Corps bring human capacity and funding to support survivors, rebuild communities and enhance their health and social care systems. A recent meeting in the Liberian capital Monrovia emphasised the ways that the three most affected countries (Sierra Leone, Liberia and Guinea) can learn from one another and co-ordinate future mental health efforts.

It is possible to take a cost-effective approach to re-establishing communities and support networks in Sierra Leone. Existing resources need to be mobilised and mental health workers trained to strengthen the social support of individuals diagnosed with a mental health problem as well as those experiencing emotional distress and grief. Ultimately this will allow us to turn a terrible situation into a long-term solution by taking the opportunity to install a more comprehensive mental health network in Sierra Leone.

Meredith Fendt-Newlin receives funding from the American Association for University Women (AAUW). The research project mentioned in this article has been partially funded by the following sources: the Wellcome Trust through the Centre for Chronic Diseases and Disorders (C2D2) at the University of York; the Maudsley Charity; the International Centre for Mental Health Social Research (ICMHSR) and the Centre for Teaching and Learning at the University of York.

Read the Original Article at TheConservation.com

Breast milk is best for new babies but it’s not the ‘pure’ food we thought

A Harvard University researcher last week suggested western women stop breastfeeding after a couple of months to reduce the risk of passing potentially harmful toxins on to their infants via breast milk.

Breastfeeding reduces the risk of infections in early life. Harald Groven/Flickr, CC BY-NC-SA

A Harvard University researcher last week suggested western women stop breastfeeding after a couple of months to reduce the risk of passing potentially harmful toxins on to their infants via breast milk.

But while babies may receive chemicals and allergens in breast milk, it doesn’t mean breastfeeding is unsafe. For most women, breast milk is the best food for new babies.

Benefits of breast milk

Breastfeeding is the natural way to feed human infants. After all, infant formula is made with cow’s milk, and our babies are not little cows. The World Health Organization (WHO) recommends:

Exclusive breastfeeding … up to six months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond.

These guidelines are estimated to save up to 800,000 lives a year in low-income, developing countries.

The first breast milk, known as colostrum, contains antibodies, live immune cells and anti-bacterial proteins and is very important for the new baby’s immune system.

When a baby is born, the immune system is immature and the baby is at risk of contracting infections, especially respiratory viral infections. Breastfeeding reduces the risk of infections in early life and may reduce the risk of long-term diseases such as asthma, excess weight and obesity, and type 2 diabetes.

There is increasing evidence that vaccinating pregnant women against infections that threaten infant’s lives, such as whooping cough and influenza, may be the best way of protecting very young infants against these diseases. The precise mechanism underlying this protection is not known, but the immunological benefits of colostrum are likely to be involved.

But while the protection breastfeeding confers on infants in low-income developing countries against death from lower respiratory illnesses is indisputable, the same situation does not exist in high-income developed countries.

Some women are not able to breast feed, for reasons that are beyond the scope of this article, and the current focus on breastfeeding in countries such as Australia can leave these women feeling guilty that they have “failed” their babies.

Is breast always best?

Breast milk is produced by the mother’s body and, as such, is subject to the condition of her body. Infections such as HIV can be passed to infants via breast milk.

However, the WHO breastfeeding guidelines suggest that that HIV-infected women should breast feed, provided that they are on adequate anti-retroviral treatment. Indeed, substantial progress has been made in high-prevalence countries such as South Africa in reducing infant HIV infection while allowing the benefits of breastfeeding.

There is no doubt that breast milk is also likely to contain the same range of external or “xenobiotic” substances that exist in the mother’s body, including many prescribed and illicit drugs and environmental chemicals.

We used to think that that the placenta protected the developing fetus from maternal exposures and that breast milk was a “pure” and uncontaminated substance. Unfortunately neither of these beliefs is true. For practical purposes, the developing fetus is exposed to what the mother is exposed to and the breastfeeding infant is exposed to contaminants in the mother’s body.

Chemicals and allergens

Since the “chemical revolution” of the mid-to-late 20th century, hundreds of thousands of chemicals have been introduced into use with minimal to no testing to demonstrate their safety.

The Centres for Disease Control and Protection in the United States monitor the population for 212 environmental chemicals and report that almost all Americans have these chemicals in their body; many of which, especially those that are soluble in fat, are likely to pass into breast milk.

There is no such population biomonitoring program in Australia. Many of the environmental chemicals have activities that mimic hormones and are collectively known as endocrine-disrupting chemicals.

One of the most controversial recently is bisphenol-A, which has been banned from products designed for babies in several countries but not in Australia.

A new report from a group of Danish and American researchers investigated levels of water- and stain-proofing chemicals, known as perfluorinated alkylate substances, or PFASs, in children from the Faroe Islands. The babies who were exclusively breastfed had levels 20-30% higher, which gradually fell after weaning.

While data on this class of chemicals is new, the problem is not. Breastfed infants receive “doses” of many chemicals from their mother, including flame retardants, pesticides, plasticizers, and many long-lived persistent chemicals that are no longer in use.

It is not only chemicals that can pass into breast milk. Food proteins are also likely to be present and can increase the risk of food allergy. The infant feeding guidelines of the Australasian Society of Clinical Immunology and Allergy encourages breastfeeding but also state that early introduction of solid foods, around four to six months of age, may help prevent food allergy.

Benefits and risks

Does the fact that babies receive chemicals and allergens in breast milk mean that breastfeeding is unsafe?

No, it clearly does not. While the chemicals in breast milk can be associated with adverse health effects, there is not a good understanding of what levels of such chemicals are unsafe or when, if ever, the potential adverse effects outweigh the benefits of breastfeeding. Balancing the pros and cons of breastfeeding would not be a trivial undertaking and, to my knowledge, has not been attempted.

There is a relatively new methodology, known as integrated environmental health impact assessment that could be used to tackle this complex issue. This methodology is designed to incorporate the complexities of real world problems and to include views of stakeholders in framing the assessment scenario and in interpreting the results.

In the case of breastfeeding, this assessment would need to include views from a wide cross section of health care professionals, toxicologists and the general public. The results of such assessments would also be specific to the location in which they were undertaken, with potentially different conclusions reached in low-income and high-income countries.

The bottom line is that breast milk is the best food for new babies but that it is not the “pure” food it was assumed to be. For the vast majority of women and babies, breastfeeding, provided that it is possible, is best.

At this stage, it is not possible to provide accurate advice to Australian women about when, if ever, breastfeeding should be limited because of increased risks posed by chemical levels in the milk. Further research in this area is definitely needed.

Peter Sly does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com

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Game your way to weight loss, thanks to new research

There are many different ways which people try to lose weight. After a long day in the office some people manage to drag themselves to the gym and squeeze in that all-important cardio session.

New goals Shutterstock

There are many different ways which people try to lose weight. After a long day in the office some people manage to drag themselves to the gym and squeeze in that all-important cardio session. Others may regularly find themselves forgoing the gym to head home and relax. And there are a huge range of diet plans, many of which require significant effort to change your daily routine and eating habits. But what if there was a way to change your attitude to food from the comfort of your living room sofa?

Researchers from the University of Exeter have developed a simple computer game that aims to help people to control their snacking impulses and lose weight. They trialled the game with adults who had a body-mass index that indicated that they were overweight and/or who reported unhealthy snacking habits. The intervention lasted for one week and participants completed up to four training sessions using the online computer game.

The game works by asking people to avoid pressing on pictures of certain images (including calorie-dense foods such as biscuits), whilst responding to other images (including healthy foods such as fruit, and unrelated items such as clothes). The online training lasts for just 10 minutes and is designed to be easily managed in everyday life.

The game is based on the “go/no-go” principle in psychology. Players are led to associate the “go” category of healthy foods with motor impulses, the signals the nervous system use to tell our muscles to move (in this case using our arm and hand to press a button). The “no-go” (stop) category of high-calorie foods is linked to the desire to withhold motor responses (in this case not pressing the button).

Putting unhealthy food out of reach
Shutterstock

Repeating this process is designed to lead players to associate high-calorie foods with stopping motor activity. In other words, the idea is that when trained individuals see unhealthy foods they will no longer feel the ingrained need to reach for them. They may even no longer associate such foods with a feeling of reward.

To test the effectiveness of the game, researchers asked 41 participants to spend 10 minutes playing it on four occasions in one week. Players were also weighed and asked to complete food rating tasks and food diaries one week before and one week after the training. A follow-up was also made six months after training.

Another 42 volunteers formed a “control” group that was asked to play a similar game that only featured non-food objects. Those playing the food game lost an average of 0.7kg during the training week and consumed an average of around 220 fewer calories per day – while the control group on average gained weight. The active group also reported liking the unhealthy snack foods they were trained to stop reaching for less than they had when they started. And the further weight loss they self-reported six months later indicates the training effects may persist over longer periods.

Changing your mind

Cognitive brain-training apps that promise to easily improve our intellect or change our behaviour have become a multi-million pound business in recent years. Companies such as Nintendo and Luminosity have developed a wide range of user-friendly neuroscientific puzzles. These apps typically aim to provide a mental workout and often promise to improve memory, IQ or cognitive abilities such as spatial awareness or verbal reasoning. Brain training apps have even become associated with the ability to delay the onset of dementia.

In reality, the scientific proof for these grand claims is fairly limited. A 2010 study reported that individuals actually get better at the specific tasks set in the brain training games through familiarity, but showed no overall improvement in memory or general IQ.

The activities in brain training apps usually take up mere minutes of your long day. Is this really enough time to counteract a lifetime of bad habits, or even our very regular exposure to advertisements endorsing all things unhealthy? Intelligence and behaviours such as eating habits are developed over our entire lifetime. It is possible to form new neural pathways in the brain representing new patterns of thought or behaviour. But for us to favour these over long-established pathways we will likely need much more effort than that required to play a ten-minute computer game every day.

Exeter’s research shows such brain training techniques show promise in helping people control problematic and undesirable behaviour like overeating. Other recent research suggests similar internet-based “go/no-go” tasks can be particularly helpful in training those most vulnerable to overeating. Plus, the fact that such games can fit easily into our often busy daily lifestyles suggest it might be easier to convince people to use them than traditional diets.

But despite the success of these efforts, we should regard the results of this research with some caution. There is no quick-fix solution to losing weight. It is likely that the participants who volunteered to enter these studies were already motivated individuals with an existing desire to change their eating habits. That means that this kind of brain-training game may have less success with those are unconcerned with or unwilling to change their diets in the first place.

Kira Shaw is a member of the Sheffield NeuroGirls (@Shef_NeuroGirls)

Read the Original Article at TheConservation.com

Do kids born by C-section have a higher risk of chronic disease? A new study looks at the evidence

In many parts of the world, rates of cesarean delivery are too high, and growing. In the UK, for instance, about one-quarter of babies are born by cesarean.

With c-sections becoming so common, it’s time that we started to investigate what that means for child health. Baby via www.shutterstock.com.

In many parts of the world, rates of cesarean delivery are too high, and growing. In the UK, for instance, about one-quarter of babies are born by cesarean. In the US, the rate is one-third, and in Brazil, it is one-half. The World Health Organization recommends that no more than 15% of deliveries be by cesarean.

The reasons behind these variations and growing numbers are complex, and beyond my scope here. Whatever the reason, more and more babies are entering the world surgically. We need to understand the potential consequences.

The high C-section rate is an emerging global health issue

Cesarean can be a medical necessity, or even an emergency. Decision-making can be fraught, with doctors and soon-to-be parents discussing risks and benefits during labor. Let’s put that aside.

Instead, let’s talk about the kind of information that clinicians and parents want to weigh in cooler moments, when cesarean is neither a medical necessity nor an emergency.

There has been much media attention of late to cesarean delivery on maternal request. It appears that this is rare in the US. One source estimates that 2.5% of births are cesareans requested by mothers. But it appears much more common in other parts of the world. For example, in southeast China, 20% of births were recorded as cesareans on maternal request in 2006. In some middle-income countries, skyrocketing elective cesareans have become a pressing public health matter.

In the US, there’s another setting that is more relevant. Many women who have had previous cesareans are able to go on to have vaginal births, from a medical perspective. But fewer than 10% of births to women who have had prior cesareans are vaginal deliveries. Repeat cesareans are a health concern worldwide, as more women receive a cesarean with their first birth.

The bottom line is that both of these settings – maternal request in low-risk pregnancy, and prior cesarean – offer a clear opportunity for a cool, deliberative weighing of risks.

What do we know about the long-term effects of C-sections?
Baby via www.shutterstock.com.

Weighing risks and benefits for the child

In the short term – the hours and days surrounding birth – different modes of delivery bring different risks. For instance, parents might want to know that babies born by cesarean are more likely to need a brief stay in the newborn intensive care unit, while children born by vaginal delivery are more likely to have serious bruises under the scalp, requiring a short course of light therapy.

But when it comes to potential long-term health risks from C-section delivery, there is less information available. To date, discussions about delivery risks have tended to focus on long-term health problems with vaginal delivery. These include the very small risk of brain damage, injury to the the nerves of the arm (from shoulder dystocia), and other conditions.

This is changing, with growing evidence that delivery by cesarean may come with an increased chance of obesity, asthma and diabetes during childhood. In a piece that appears this week in the British Medical Journal, I discuss and evaluate this evidence, along with my colleague Jianmeng Liu of Peking University.

Evidence of long-term child health risks

The gold standard for evidence in medical science is the study where two treatments are compared in groups of volunteer patients whose treatment is determined by a coin flip. This is called a randomized study. Reviewing the published literature, we found six randomized studies comparing cesarean and vaginal delivery. All were conducted in scenarios where the optimal delivery choice was unclear (for example, delivery of twins and babies coming feet first, or “breech”).

These randomized studies mostly focused on the benefits and risks for mothers’ health. Only one of the studies followed children beyond the newborn period. The Term Breech Trial found that children in the cesarean group were in worse general health than those in the vaginal delivery group at two years of age. While the researchers didn’t go into great detail about the kinds of health problems that the children had, this finding was striking. Unfortunately, the children were not followed up later in life.

We also reviewed the summary evidence from over 50 nonrandomized studies that compared the health of groups of children delivered by the two methods. Those generally find a correlation between cesarean delivery and increased likelihood of childhood obesity, asthma and diabetes.

Using the summary data and extrapolating the findings to the US population, my coauthor and I estimated a childhood obesity rate of 15.8% for children delivered vaginally versus a 19.4% rate for children delivered by cesarean, a childhood asthma rate among children delivered vaginally of 7.9% versus a 9.5% rate for children delivered by cesarean, and a childhood type 1 diabetes rate of 1.79 cases per 1,000 children versus a rate of 2.13 per 1,000 for children delivered by cesarean. Again, these are just estimates, helping to translate the statistics into accessible numbers.Watch movie online The Transporter Refueled (2015)

But importantly, correlation isn’t causation: women who have cesareans may be less healthy, and so their children might also be less healthy, regardless of how they are delivered. As it turns out, some correlational studies suffer from this limitation more than others. I believe that we can still get useful information about risks by focusing on the strongest of these correlational, nonrandomized studies.

As always, better data and further research are needed. I’ll have more to say about that later.

We need more research to better understand potential long-term consequences.
Babies via www.shutterstock.com.

Why might cesarean be linked to long term health risks?

Stepping back, why might delivery matter? One theory says that it has to do with intestinal bacteria, which are important in food uptake and fighting infections. During vaginal birth, babies swallow maternal vaginal bacteria, and those bacteria are early colonizers of the babies’ intestines. Cesarean-born babies miss this exposure. It is possible that the resulting early differences in resident gut bacteria result in differences in health, later on.

Another theory focuses on the healthy, positive stress of labor and delivery, and the ways that stress “programs” a baby’s genes. According to this theory, the key programmers are levels of hormones such as oxytocin, cortisol and adrenalin. These give rise to so-called epigenetic changes that in turn determine the risk of disease later in life.

What do the experts say?

In medicine, expert advice is often delivered in the form of written clinical guidelines that summarize the evidence for clinicians and make recommendations for treatment. Recently, two influential groups – one in the US, and the other in the UK – issued guidelines for Cesarean Delivery on Maternal Request (CDMR). These guidance documents were pieces of advice to inform decisions in this very specific nonemergency situation.

After reviewing evidence, both groups concluded that vaginal delivery should be recommended for healthy women with low-risk pregnancies. In that group, requests for cesarean should be honored, after a women receives counseling about resources that are available, including pain control. Women requesting cesarean should also understand the risks and benefits of their choice. Strikingly, neither of the two documents mentioned the relatively new evidence on long-term risks to child health, such as obesity, asthma and diabetes.

Time to talk it over

It’s time for that evidence to enter the wider conversation. A good way to start would be to review and critically assess the evidence in updated guidelines. This would educate doctors and midwives, allowing them to present fuller information to their patients.

Make no mistake: the evidence linking cesarean to worse child health outcomes is far from airtight. We look forward to getting better evidence in future clinical trials, or cleaner correlational studies.

Again: cesarean is sometimes medically indicated, and is sometimes even an emergency. But in the US, and in many nations around the world, the high cesarean rate isn’t just a question of medical need. Patients, midwives and doctors are making choices, and those choices should be as informed as possible.

The evidence isn’t perfect. But then, it rarely is.

Jan Blustein received funding from NYU CTSA grant UL1TR000038 from the National Center for the Advancement of Translational Science (NCATS), NIH.

Read the Original Article at TheConservation.com

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Calories in, calories out – obesity and the energy imbalance gap

The prevailing notion about obesity is that if we just work out harder and eat a little bit better, then perhaps the obesity trend will subside in a few years.

Balanced? Scale via Olivier Le Moal/Shutterstock

The prevailing notion about obesity is that if we just work out harder and eat a little bit better, then perhaps the obesity trend will subside in a few years. However, the key to really making a difference is food – the number of calories we eat is the most important factor in obesity. But changing the way people eat will take a very long time.

Things like individual routines, menus, food access and affordability, and cultural practices all influence how we live and eat. All of these things can influence the energy imbalance gap (EIG). The EIG is essentially how many calories you consume versus how many calories you burn in a day. It controls the speed of change in body mass and is at the core of understanding obesity.

Think of the EIG like a gas pedal in a car. If you push the pedal, the gap is positive and obesity trends speed up. If you push the brake, then the gap becomes negative and we would have fewer obese people. A zero gap is like cruise control with a steady obesity prevalence. For example, an EIG of about 10 calories a day leads to weight gain of approximately one pound per year.

Measuring the energy imbalance gap

In a recent study, my colleagues and I applied system dynamics, a simulation method for understanding complex socio-technical systems, to estimate EIG trends in the US.

Measuring EIG directly is complex – even a 1% error in measuring daily energy intake would render the EIG values unreliable. And in typical, self reported calorie intake logs, the main EIG direct measure applicable to large groups, have errors in excess of 10%. In fact few previous studies provided reliable EIG estimates for large populations. So we developed a method to reverse engineer the EIG trends based on weight data, just as you can estimate acceleration rates from data on the speed of a car at different times. This method separates the contribution of EIG to population weight profile from other factors such as differential mortality rates due to obesity.

Based on weight data from National Health and Nutrition Examination Survey (NHANES) our research looked at changes in the EIG over the past four decades in representative samples of three different population groups: Non-Hispanic Whites, African-Americans, and Mexican-Americans. We found significant differences among these three population groups as well as between genders within each group.

10 extra calories a day can lead to 1 lbs of weight gain a year.
Label via Ekaterina_Minaeva/Shutterstock

For Non-Hispanic Whites, the largest group in the survey (and the largest population group in the US), we found that the average EIG has been positive over the last four decades. That means that this group has been gaining weight consistently, a trend reflected in the current obesity epidemic. But our model shows that the gap is actually shrinking. Once the gap reaches zero, the obesity rate will have stabilized (meaning it is not growing nor shrinking) – and for this population we may be already at that point. This doesn’t mean that the problem of obesity is solved for this group, but it does mean that the problem is no longer getting worse.

We see a different story for African-Americans and Mexican-Americans. For African-Americans, the rate of obesity is growing and the EIG is still not close to zero. The average gap is positive, around 15 extra calories per day, which is a powerful engine behind continued obesity trends. The good news for African-Americans is that the energy gap has started to shrink. Based on current trends we may expect the gap to stay positive for at least another decade before it begins to close. This means that in the future we’ll see more challenges with obesity in the African-American community, which may peak in a decade or so.

The situation for Mexican-Americans is more critical. Not only is the gap positive, at approximately 20 calories a day, it is above the estimates for any other population group. And the EIG is growing at an alarming rate. Not only this group faces a obesity epidemic today, but also the situation is getting worse at an accelerating rate. This population group needs much more attention to turn the tide of the obesity epidemic.

As for gender, our most notable finding pertains to African-American females, who generally have had higher EIGs than African-American males. This means that obesity has been getting worse for females faster than for males. More recently Mexican-Americans show a similar gender gap, with higher EIG for females in the last few years. For Non-Hispanic Whites, the energy gaps are bigger for males than females, thus obesity trends are growing faster for men than women. From food and activity environment to social norms, various factors may explain these differences across population groups, and more research is needed to pin down the exact contribution of each factor.

Where do we go from here?

We know obesity is an epidemic so these findings aren’t that surprising. However what is remarkable is the differences among ethnicities. There are numerous programs and policies that target obesity with varying success. Focusing on the ones that research finds cost-effective and targeting population groups most at risk would best leverage the limited available resources in controlling future obesity trend and its costs.

Hazhir Rahmandad receives funding from National Institutes of Health.

Read the Original Article at TheConservation.com

Health Check: how to get kids to eat healthy food

Hippocrates said circa 400BC that “food should be our medicine and medicine should be our food”. He would probably turn in his grave if he saw the amount of highly processed, sugary food and drinks marketed to children today.

Children will learn to like vegetables if they’re regularly exposed to them from a young age. Zadorozhnyi Viktor/Shutterstock

Hippocrates said circa 400BC that “food should be our medicine and medicine should be our food”. He would probably turn in his grave if he saw the amount of highly processed, sugary food and drinks marketed to children today. This food can be as addictive as cocaine or heroin. And it’s difficult for parents to counteract its appeal.

One in four Australian children and 63% of adults are overweight or obese. This is contributing to unprecedented levels of preventable obesity-related disease such as diabetes, heart disease, and liver and kidney failure.

Unhealthy diets also contribute to poor mental health and lower IQ in children. Just like our body, our brain needs essential nutrients and a healthy environment free from inflammation, oxidation and excess glucose to work properly.

What can we do?

Public health groups are tackling junk food marketing with a multifaceted approach akin to the painfully gradual change that reduced tobacco advertising and smoking. In the meantime, parents can have a very important influence on their child’s health and eating choices.

A healthy diet at any age is high in plant foods such as fruit, vegetables, legumes, nuts, seeds and wholegrains as well as fish and healthy oils such as extra virgin olive oil. And it’s low in processed, high-fat, high-sugar foods and red meat.

It’s important to enjoy a variety of foods from each of the core food groups in order to get a broad range of essential nutrients.

A variety of foods will give children a broad range of nutrients.
Alpha/Flickr, CC BY-NC-SA

So, for starters, breastfeeding for 12 months gives children a healthy immunity and has multiple benefits for their health and for their cognitive development. It can also impact on their taste preferences by exposing them to multidimensional flavours – and they can develop taste preferences for foods that mum eats too (healthy or otherwise).

The best time to gradually start introducing solids is around six months of age, when children are developmentally ready and start needing extra calories and some extra nutrients such as iron. But even the most well-meaning parents can struggle to get toddlers and children to eat healthy food, especially vegetables.

Convincing toddlers

Children will learn to like healthy food such as vegetables if they are regularly exposed to them from a young age. Where you can, cook baby foods yourself from fresh ingredients, and avoid adding sugars and salt.

Children’s taste preferences are established in early life. It is best to keep it simple – introduce new vegetables and fruit one at a time so they can learn to appreciate the individual flavours.

Young children naturally tend to develop neophobia, fear of unknown food, at around the age of two. Therefore, continued exposure to healthy foods, rather than pandering to fussiness, will help to mitigate this and their willingness to try novel foods will naturally increase over time.

Research shows it can take ten to 14 exposures to a previously unliked vegetable for children to like it and choose to eat it. So don’t give up. It’s important for this exposure to be neutral, without any pressure, rewards or bribes. Make it a positive family occasion free from distractions such as TV, other media and toys.

Research has shown that even exposing children to vegetables in story books from a young age can further strengthen the likelihood that they will eat vegetables.

Let kids explore the textures and flavours.
Nongbri Family Pix/Flickr, CC BY-NC-ND

Most importantly, make it fun and let children play with their food to explore all of the colours, flavours and textures.

The “parent provide, child decide” model can make this process a little easier. This is where parents provide healthy options within firm boundaries and allow the child to decide what, and how much to eat. Keep the unhealthy options out of the house.

Forcing children to eat vegetables does not work – you might win the battle but will lose the war. Avoid negative associations with healthy food, as these can put them off.

Nor does using bribes or rewards work, as children will learn to prefer the reward and not learn to enjoy healthy food for its own intrinsic taste.

Children will eat when they are hungry; their appetite will vary so don’t panic if they don’t want to eat. Let them learn to listen to their bodies and their innate hunger cues.

They will also copy you. So if you want healthy children, you need to be a good role model and eat well too.

Encouraging older children

As children get older, other children, parties and school can influence their eating behaviours. However, the family food environment still plays an important role in influencing healthy eating – in particular, the mother’s role modelling behaviour and the food that is available in the home.

Other things that parents can do is involve children in shopping, cooking, gardening. School projects have shown that if children are involved in growing, picking and cooking vegetables they are more likely to eat them.

Involve children in shopping, cooking and gardening.
Eric Peacock/Flickr, CC BY-NC-SA

Children of all ages whose families eat together at home – free from distractions such as television – have been shown to have healthier diets. So make it a priority to eat together. This is also a great time for conversation and bonding.

And don’t despair if you or your child is struggling. The good news is that food addictions and taste preferences can be changed. There are infinite healthy, tasty recipes that are simple and affordable to make.

In sum, create a warm, positive, healthy food and meal environment free from distractions when eating, and be a good role model. Children will learn to enjoy good food as it is meant to be enjoyed, and flourish in the process.

Natalie Parletta is supported by National Health and Medical Research Council Program Grant funding (# 320860 and 631947) and has previously received research funding from the Australian Research Council as well as food and nutritional supplements for research purposes from industry partners.

Read the Original Article at TheConservation.com

Health Check: how to work out how much food you should eat

Dietary guidelines broadly recommend a daily intake of 10,000 kilojoules (2,400 calories) for men and 8,000 kilojoules (1,900 calories) for women. But what do these figures mean in the context of the number of kilojoules or calories you personally need to consume to attain and maintain a healthy body weight?

Daily kilojoule requirements are based on many variables, and no two people are the same across all of these parameters. Sarah Horrigan/Flickr, CC BY-NC

Dietary guidelines broadly recommend a daily intake of 10,000 kilojoules (2,400 calories) for men and 8,000 kilojoules (1,900 calories) for women. But what do these figures mean in the context of the number of kilojoules or calories you personally need to consume to attain and maintain a healthy body weight?

I’m going to stick with kilojoules in this article because kilojoules – not calories – are the metric unit for measuring energy, just as kilograms – not pounds – are the metric unit for measuring body weight.

Daily kilojoule requirements are based on many variables, and no two people are the same across all of these parameters. It makes sense then that if we all followed the same prescriptions for kilojoule intake, some of us would gain weight while others might lose some. That’s because any excess or deficit between the number of kilojoules you consume and the number your body uses results in weight gain or loss.

So how can you know what you need to maintain your energy balance? There are two options: the mathematical approach, which requires kilojoule counting, and the instinctive approach, which involves “listening” to your body (my personal preference).

Both approaches take some trial and error.

The mathematical approach

One way to estimate how many kilojoules you need is to use an online calculator that takes into account major factors regulating energy requirements. These include your sex, weight, age and activity levels. Some calculators also take height into account.

Such calculators are based on prediction equations that estimate true energy requirements – as measured in a laboratory – from readily available parameters.

Processed foods make it harder for the body’s automatic weight-management system to do its job.
Michael Johnson/Flickr, CC BY

While some prediction equations may be slightly better than others, none of them can tell you exactly how many kilojoules you need to consume to maintain your weight. That’s because no prediction equation can take your genetic make-up, which may impact how fast or slow you churn through kilojoules, into account.

Nor can they account for things like whether you have more or less lean mass or fat on your body than the average adult. Or that you may have spent the last few months on a weight-reducing diet that has dropped the amount of energy you need to maintain your weight by a few thousand kilojoules per day.

Despite these limitations, once you have a ballpark figure of your energy requirements, you can roughly work out how much you need to eat and drink based on the kilojoule content of the foods and beverages you consume.

For this you will need a comprehensive kilojoule counter (I recommend CalorieKing, which has extensive data bases for Australia and the United States) and a way to track your food and beverage intake throughout the day (MyFitnessPal comes highly recommended). Numerous other programs and apps are available for both.

The instinctive approach

We also have the ability to maintain a healthy body weight without any regard for kilojoule counting; the human body is endowed with a remarkable system that enables us to attain and maintain an optimum weight instinctively.

Eating minimally processed food is best for using your body’s appetite signals to control weight.
Ron Dauphin/Flickr, CC BY-NC

This system works by controlling your appetite. When your body needs more kilojoules, you may feel hungrier more often. And you may need to eat and drink a greater number of kilojoules in order to feel satisfied.

When your body needs fewer kilojoules, you may not feel hungry enough to eat all the meals and snacks you normally eat in a day. When you do eat, it may take much less than usual to satisfy your hunger.

Provided you heed your body’s appetite signals by eating when you are hungry – and only when you are hungry – and eating enough to feel satisfied but not too full, then you will be able to attain and maintain an optimum body weight.

Sounds simple, doesn’t it? It is when you eat a diet of foods that are close to the form they appear in nature – that is, food that’s minimally processed.

Processed foods, which have many added ingredients such as fat and sugar to make them palatable, make it harder for the body’s automatic weight-management system to do its job. That’s because diets high in fat, or high in fat and sugar, change the balance of natural chemicals in the brain that control this system.

Using trial and error to get there

If your clothes are getting tighter, then you’re consuming more kilojoules than your body needs.
bark/Flickr, CC BY

Regardless of how you estimate the amount you need to eat, the current obesogenic environment prevailing in most countries, which pushes us to gain weight, means you will need to use some trial and error to determine exactly how much to eat.

If you are gaining weight, or you find your clothes are getting tighter, then you’re consuming more kilojoules than your body needs, period.

To prevent further weight gain, you need either to cut your energy intake or to increase the number of kilojoules you burn via physical activity – or both. Do this by becoming mindful of the kilojoule content of the foods and drinks you consume. Drinks are particularly important, especially alcohol, because they sneak into your day and may not be accounted for.

Or you need to keep a written hunger-and-satiety diary to ensure you’re eating only when hungry and only until you feel satisfied. And that your food choices are as close to natural as possible.

In today’s obesogenic world, attaining or maintaining a healthy body weight doesn’t just happen naturally for most people. It usually requires conscious attentiveness to how much and what you’re eating. The good news is that you can do this using external signals such as kilojoule counting, or via your body’s own internal signals.


If you live in the Sydney metropolitan area and would like to find out about participating in weight-management trials involving mathematical or instinctive approaches to eating, please e-mail tempo.diet@sydney.edu.au or click here for more information.

Amanda Salis receives funding from the National Health & Medical Research Council (NHMRC) of Australia, in the form of research project grants and a Senior Research Fellowship. She is the author of The Don’t Go Hungry Diet (Bantam, Australia and New Zealand, 2007) and Don’t Go Hungry for Life (Bantam, Australia and New Zealand, 2011) and owns shares in a company (Zuman International Pty Ltd) that sells these books

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Cap sugar, fat and salt, three hours of exercise a day: Labour’s plan for unhealthy kids

The NHS is 67 years old, on its knees and struggling, and its patients are not doing much better. Launching the Labour Party’s new plans for public health today – it’s an election year after all – the shadow health secretary, Andy Burnham, argued that the solution was a combination of patient responsibility and government intervention: a perfect positioning of Labour between personal choice (the Tory favourite) and a nanny state (the domain of Labour’s political roots).

Have another go. Nutrition by Shutterstock

The NHS is 67 years old, on its knees and struggling, and its patients are not doing much better. Launching the Labour Party’s new plans for public health today – it’s an election year after all – the shadow health secretary, Andy Burnham, argued that the solution was a combination of patient responsibility and government intervention: a perfect positioning of Labour between personal choice (the Tory favourite) and a nanny state (the domain of Labour’s political roots).

But is this enough? And can this approach not only solve the modern problems of obesity, diabetes and other behaviour-related conditions but also revitalise the NHS and get it off its knees?

Personal responsibility

Food does not get eaten unless you put it in your mouth, exercise doesn’t happen if you stay on the sofa and cigarettes have to be bought, unwrapped and lit in order to be smoked. At the end of the day, people behave in unhealthy ways because at some level they choose to.

But people in my profession would be out of a job if that was it. Childhood, learning, beliefs, emotions, parenting, friends, the media, expectations and habit all lead to a sense that there’s not much choice at all and at that moment of thinking “cake now or health in the future”, cake pretty much always wins out. So it is right to call for more personal responsibility, but it would help if someone would take the cake away.

Burnham (along with Luciana Berger, who holds the shadow public health brief) wants to see more intervention and more responsibility – or empowerment as Burnham calls it. Among other things, he wants to see half the population taking up recommended activity levels, and for children in particular two hours of PE a week plus up to a further three hours a day of further activities through breakfast and after-school clubs in extended school hours. It’s a fortuitous focus given the finding of a new study from Cambridge researchers that suggests that a lack of exercise is responsible for twice as many deaths as obesity. They argue that just 20 minutes of walking a day could cut the risk of early death by 30%.

Commercial responsibility

But if we’re all taking on more responsibility, it is therefore also right for the government to intervene in the activities of the commercial world. Plain packaging should stop smokers being walking adverts for their favourite brands and may make the habit less attractive to those who haven’t yet started.

Labour is proposing to cap the levels of sugar, fat and salt sold in children’s food – something that has been notoriously difficult to achieve against a strong food lobby, who have still yet to find voluntary consensus for the traffic light system on food packaging, another focus for Burnham. Any taxes on sugar and fat have been ruled out in favour of “making food healthier in the first place,” Berger said.

Health dependencies

Limiting fat, salt and sugar in foods for children would of course help parents make better choices (without even knowing it), and lowering alcohol levels may help with the teenager determined to binge drink. But is that really all that is needed to make a new generation of children the healthiest so far and to save the NHS and save us from these modern problems?

I think that both the demise of the NHS and the rise of both obesity and diabetes reflect a much more fundamental problem beyond either patient responsibility or the nanny state; a culture of health dependency.

Some 200 years ago doctors used leeches, bled their patients and blistered their feet. Today, we have drugs; we’re encouraged to take more medication and that medicine can cure our every ailment. But much as we are told that things are better now, we are not told that far from working for everyone, these drugs only work for some of the people, for some of the time and that even if they do work benefits are often minimal. What about all those for whom the treatment didn’t work, who experienced side effects, or even got better on their own? We never hear about that in the media. Instead there’s a pill for every ill and doctors can and should manage our every ailment.

And nor are we told that all drugs have side effects and that there are no drugs for the coughs, colds, fatigue, tummy aches and wind that so often end up at the doctor. As doctor Angus Wallace recently wrote: people turn to nurses to clean grazes or wounds rather than do it themselves these days.

The emphasis on early detection through screening, symptom detection and health checks is a good thing but symptoms such as bowel changes (colon cancer?), bloatedness (ovarian cancer?) and indigestion (heart disease?) are so commonplace that the doctor’s waiting room fills up, outpatient departments are swamped and our beloved NHS starts to creak. Better health information for patients, and crucially, how to critique it may be one way forward for the NHS.

The shadow health secretary wants to save the NHS and make people healthier. But this is more than just about patient responsibility and the nanny state. Until all parts of society start to take responsibility; until we can see the limits to medicine and where we can start to look after ourselves, know when to seek help and when to wait, the NHS is destined to stay on its knees.

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China’s ‘white gold’ infant formula rush comes at a public health cost

Alongside this week’s announcement of a free trade deal between China and Australia came reports of Gina Rinehart’s investment in a Queensland dairy operation to supply infant formula to China.

Alongside this week’s announcement of a free trade deal between China and Australia came reports of Gina Rinehart’s investment in a Queensland dairy operation to supply infant formula to China. Australia’s richest woman built her fortune on iron ore, but Rinehart’s A$500 million investment makes her a major player in Australian milk formula exports.

Infant formula sales in China have increased more than ten-fold over the last decade and will double again in the next three years, according to Euromonitor. As foreign-produced infant formula can sell for close to A$100 a tin, investors have been scrambling to get a share of the predicted “white gold rush”.

But why the boom? Commentators point to relaxation of China’s one-child policy, the melamine poisoning scandal in 2008 and the rising affluence of a growing middle class. But the often hidden truth is that escalating formula sales are driven by a lack of access to maternity leave and the unethical – even corrupt – marketing of infant formula through the maternity care system.

Although maternity leave is available on paper in China, in practice many new mothers cannot get it. Separation of mother and baby, because of unaccommodating workplaces or employment arrangements, can necessitate formula feeding.

Aggressive marketing of infant formula is also a key factor. Recent research identified that 40% of new mothers in China were contacted directly by infant formula sales staff after the birth of their babies and given samples of formula. Sales representatives walk the halls of hospitals to find mothers and recruit doctors and midwives as salespeople.

Advertising exploits the desire of families to promote the prospects of their child. With many babies now an only child of only children, four grandparents plus two parents may believe the future of their family depends on the success of this one precious baby. So marketing that promotes infant formula products (falsely) as enhancing brain development and ensuring academic success has real traction.

Regulatory capacity and social protection policies are lagging behind the emerging needs of the population, especially women, due to extraordinarily rapid economic development. Comparing China with India, a country also experiencing rapid development and urbanisation, an industry report by Euromonitor observed that “the huge disparity in the retail value of milk formula sales between China and India is mainly due to the significant differences between their official regulatory regimes”.

The consequences of “white gold mining” are threefold: for public health, the economy, and women’s rights.

Most important are the effects of a precipitous decline in exclusive breastfeeding from over 60% to less than 30% over the past decade.

Formula feeding increases infection risk. Some assume this is a result of dirty water, but in fact the formula itself helps to facilitate and maintain infection. Even in highly developed countries, babies that are fully formula fed are three to five times more likely to be hospitalised with infections than their fully breastfed counterparts.

Higher rates of formula feeding mean that overburdened Chinese hospitals face higher costs to treat more seriously ill babies and young children. And infant lives are at stake: diarrhoea and respiratory tract infections are responsible for more than half of all infant deaths in China. Formula feeding is also implicated in other high-cost health problems, such as obesity.

The economy suffers from declining breastfeeding. Breast milk has economic value. In Australia, the value of current human milk production levels exceeds A$3 billion a year. In China, Chinese mothers produced about 2.3 billion litres of breast milk in 2012; if all Chinese mothers breastfed in line with WHO recommendations, the country’s annual production value would be US$778 billion, nearly US$530 billion a year higher.

However, the economic value of human milk is presently uncounted in economic statistics. Like other unpaid work that women do, it is invisible and therefore taken for granted by policymakers. Its value is rarely acknowledged, or protected.

Indeed, when formula feeding increases, and breastfeeding declines, measured GDP is seen to go up. Nonetheless, through the provision of high-quality food and preventative health care to infants, breast milk contributes to economic production.

So, the third consequence is that by expanding sales of formula, governments can avoid addressing the needs and human rights of women and children in China. This includes mothers who need to combine paid employment and a career with their role as mothers, such as by breastfeeding. Underfunded and poor-quality maternity care can continue unaddressed.

There is much rhetoric about the benefits to Australia of the latest trade agreement, but this particular dairy milk boom is far from costless.

It raises questions such as who is profiting from this “white gold boom” and who pays its costs? Does Australia not have a duty of care for selling formula to China’s mothers and babies? And will the Australian government take responsibility for ensuring that Australian companies do not unethically exploit the regulatory weaknesses of our neighbours in Asia?

Julie Smith has received funding from the Australian Research Council and the National Health and Medical Research Council.

Karleen Gribble does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond the academic appointment above.

Read the Original Article at TheConservation.com