Penicillin doses for children need to be reviewed to take account of the fact youngsters are getting heavier meaning they may not be getting an adequate dose doctors have said.Dosing guidelines have remained unchanged for almost 50 years and are mostly based on children’s ages.

But experts argue that the dose a child needs is determined by their weight – and the average weight of children has increased.

It means that children may not be receiving a big enough dose of antibiotics to combat their infection.

Giving inadequate doses also encourages bacteria to become resistant to antibiotics making them harder to treat in future, it was warned.

The average weight today of a five-year-old is 21kg and a 37kg for a 10-year-old – up to 20% higher than in 1963, researchers at King’s College London sad.

The study, led by a team at King’s College London and St George’s, University of London, said they were “surprised at the lack of recent evidence” to support current dosing recommendations for penicillins.

Writing in the British Medical Journal (BMJ), they said ‘fractions’ of adult doses are calculated instead of basing the dose on the weight of the child who needs treatment.

The article said: “The widely used doses are still based on the original dosing principle of a big child = half an adult, small child = half a big child, baby half a small child.”

The team analysed the actual dose that would be received today based on age bands recommended in the 2010/11 British National Formulary for Children and the current weights of children based on 2009 Health Survey for England data.

The results showed doses could be strikingly low.

The authors also pointed out that many infections do not need treatment with antibiotics.

“Many of the five million children in England who receive oral penicillins each year may not need them, but those who do should receive them in an effective dose.”

Dr Paul Long, senior lecturer in pharmacognosy at King’s College London, said: “We were surprised at the lack of evidence to support the current oral penicillins dosing recommendations for children, as it is such a commonly used drug.

“Children’s average size and weight are slowly but significantly changing, so what may have been adequate doses of penicillin 50 years ago are potentially not enough today.

“It is important to point out that this study does not provide any clinical evidence that children are receiving suboptimal penicillin doses that lead to harm, and we want to reassure parents of that.

“But what we are saying is that we should ensure that children with severe infections who need these antibiotics the most are still receiving an effective dose.”

Up to 24,000 people with diabetes are dying unnecessarily every year, according to a new report.Most deaths could be avoided if they received better NHS care and if their condition was better managed, it said.

The report into death rates, from the National Diabetes Audit for England, found that women with diabetes are nine times more likely to die young than those without the condition.

Among women aged 15 to 34 with diabetes, death rates are up to nine times higher than the average for this age group.

And the report also found that two young people of both sexes aged 15 to 34 may be suffering an avoidable death every week.

An estimated 70,000 to 75,000 people with diabetes die in England every year – accounting for about 15% of all deaths.

Most deaths are related to the actual condition – diabetes can cause serious heart and kidney problems, as well as amputation of limbs and loss of eyesight.

The report said people are dying too early due to poor management of their condition.

This includes not receiving basic diabetic health checks on the NHS, having unhealthy lifestyles and not taking medication properly or understanding how to take it.

It argues that educating people in managing their condition reduces the risk that they will suffer dangerously high or low blood sugar, which increases the risk of complications but can also lead directly to death.

The gap in death rates between people with diabetes and those without become more extreme in younger age groups.

About one in 3,300 of all women will die between the ages of 15 and 34, but this risk increases nine-fold among women with Type 1 diabetes to one in 360.

Type 1 diabetes usually develops in childhood and patients need to take insulin injections.

Among women with Type 2 diabetes – linked to unhealthy lifestyles and obesity – the risk increases six fold to one in 520.

Men aged 15 to 34 in the general population have a risk of dying of one in 1,530, but this risk increases four-fold for those with Type 1 diabetes to one in 360, and by just under four-fold among those with Type 2 to one in 430.

Earlier this year the National Diabetes Audit found almost 450,000 children and younger adults (aged up to 54) with diabetes have high-risk blood sugar levels that could lead to severe complications.

The audit is managed by the NHS Information Centre and commissioned by the Healthcare Quality Improvement Partnership (HQIP).

The report also found a strong link between deprivation and increased mortality rates.

Among under-65s with diabetes, those from deprived backgrounds are twice as likely to die as those from more affluent areas.

Diabetes UK has compiled a list of 15 essential health checks and services and there are nine checks recommended on the NHS by the National Institute for Curbing Excpenditure (Nice).

These nine checks include blood sugar control, cholesterol, blood pressure, body mass index (BMI) and eye and foot examinations to check for diabetic complications.

The National Diabetes Audit has found that only around half of people (53%) with Type 2 diabetes and less than a third (32%) with Type 1 diabetes receive all nine checks.

Some 290,000 people in the UK have Type 1 diabetes and another 2.6 million are diagnosed with Type 2.

It is also estimated there are 850,000 other people with undiagnosed Type 2 diabetes.

Women can lower their risk of breast cancer by 40 per cent by following a two day ‘life saver diet’ it has been claimed.Researchers at the University Hospital in South Manchester are claiming that observing a strict two day diet, rather than trying to constantly cut calories, is a more effective way to loose weight.

The study, lead by Dr Michelle Harvie, and presented at the San Antonio Breast Cancer Symposium, found that women who followed a diet for just two days of the week lost more weight than those practising a full time diet.

The researchers put 100 overweight female volunteers on one of three diets.

The first diet consisted of consuming just 650 calories a day for several days of the week, with carbohydrates such as potatoes and bread cut out. For the remaining five days of the week the participants, whilst encouraged to eat healthily, could consumer whatever they liked.

Although volunteers on the second diet were also banned from eating carbohydrates for two days in a week, they were not set a specific calorie limit.

They were also allowed to eat as much as they wanted for the remainder of the week. The third and final group followed a more conventional diet, which included avoiding high-fat foods, alcohol and sticking to approximately 1,500 calories every day.

The results of the study showed that after three months the women on the two day diets had lost an average of nine pounds, compared to five pounds of those on the full time diet.

Volunteers who had followed the two day diet had lost nearly twice the amount of weight of those on the more traditional full time diet, and recorded significant improvements in three key areas linked to breast cancer. Their levels of hormone leptin dropped by 40 per cent.

Research professor Gillian Haddock, who also took part in the study herself, has said she would recommend the diet to friends and that she found it an easier diet option.

Mrs Haddock said: “I used to follow the 650 calorie diet on a Monday and Tuesday and it was great because I knew that by Wednesday I would be eating normally.

“It really suited me, I did it on my busiest work days and I would mainly have the milky drinks while I was at work so I didn’t have to worry about shopping or taking in a specially prepared packed lunch.”

The research, conducted at the Genesis Breast Cancer Prevention Centre at UHSM, was published in the International Journal of Obesity.

Pamela Goldberg, chief executive of the Breast Cancer Campaign said: “There are many breast cancer risk factors that can’t be controlled, such as age, gender and family history – but staying at a healthy weight is one positive step that can be taken.

“This intermittent dieting approach provides an alternative to conventional dieting which could help with weight loss, but also potentially reduce the risk of developing breast cancer.”

The diet that the women followed for only two days a week:

• Breakfast: Fruit tea and a banana, or mug of milky coffee.
• Mid-morning: Can of diet cola, or cup of tea and plum.
• Lunch: Carrot and coriander soup and half pint of milk, or salad, glass of squash and half pint of milk.
• Mid afternoon: Glass of squash, or glass of sparkling water and Satsuma.
• Dinner: Soy sauce and ginger stir-fry with two vegetables and glass of water, or vegetable curry with two vegetables, half pint of milk and cup of tea.
• Supper: Pint of milk, or hot milk with cinnamon and sweeteners.

Almost half of cancers are caused by an unhealthy lifestyle that could be avoided by quitting smoking, losing weight, exercising and drinking less alcohol, the most comprehensive study of its kind has found.Around 134,000 cancers each year are the result of a poor lifestyle, Cancer Research UK has found.

In the most wide reaching study yet conducted into the issue, it was found that 14 different lifestyle factors ranging from smoking, to lack of exercise, eating too much salt, not having babies, drinking too much and being overweight contributed to four in every ten cancers diagnosed in the UK.

The findings expose the myth that developing cancer is ‘bad luck’ or down to your genes, the researchers said.

Previous studies had suggested around 80,000 cancers a year could be prevented but they did not take into account occupational exposures to things like asbestos, infections that can cause cancer and sunburn as the latest research has.

In a complex set of research studies, scientists calculated how many cancers and of what type could be attributed to each of the 14 lifestyle factors.

The findings of the research The Fraction of Cancer Attributable to Lifestyle and Environmental Factors in the UK were published in the British Journal of Cancer.

Smoking was the biggest factor, causing nearly one in five of all cancers.

But Harpal Kumar, chief executive of Cancer Research UK, said most people would not know that a quarter of all breast cancer cases could be prevented along with half of colorectal cancers.

He added: “Leading a healthy lifestyle doesn’t guarantee that someone will not get cancer but doing so will significantly stack the odds in your favour.”

Dr Kumar said tackling unhealthy lifestyle factors linked to cancer would also reduce the risk of a host of other killer diseases such as heart disease, respiratory problems, kidney disease and others.

The study found that alcohol was responsible for 6.4 per cent of breast cancers and almost one in ten liver cancers.

Three quarters of stomach cancers could be avoided, mostly by not smoking, eating too much salt and consuming more fruit and vegetables.

Red meat consumption led to 2.7 per cent of cancers, almost 8,500 cases. Obesity was linked to more than five per cent of cancers or almost 18000 cases, including a third of womb cancers.

Lack of breastfeeding was linked to 3.1 per cent of breast cancers and 17 per cent of ovarian cancers.

The study did not examine how many cancer deaths would be prevented with a healthier lifestyle.

Sara Hiom, director of information at Cancer Research UK, said: “We know, especially during the Christmas party season, that it is hard to watch what you eat and limit alcohol and we don’t want people to feel guilty about having a drink or indulging a bit more than usual. But it’s very important for people to understand that long term changes to their lifestyles can really reduce their cancer risk.”

The World Cancer Research Fund did a similar exercise in 2007 coming up with recommendations to individuals on how to reduce their cancer risk by eating less red meat, taking more exercise and staying slim.

Dr Rachel Thompson, Deputy Head of Science for World Cancer Research Fund, said: “This adds to the now overwhelmingly strong evidence that our cancer risk is affected by our lifestyles.

“We hope this new study helps to raise awareness of the fact that cancer is not simply a question of fate and that people can make changes today that can reduce their risk of developing cancer in the future.”

Professor Stephen Bloom, from Imperial College London who is described as an “outstanding clinical academic” and pioneer in the field of obesity and diabetes research has received a knighthood in the New Year’s Honours list.Prof Bloom is currently leading a research group investigating appetite control systems and gut hormones.

Their discovery that oxyntomodulin reduces appetite offers a potential new treatment for obesity.

Prof Bloom said he was delighted by his knighthood.

“This is a testament to the efforts of a great many colleagues with whom I have worked over the years. This is a unique period in the history of scientific research when we are at last able to work out the details of how the body functions and therefore contribute to the prevention of disease. I am proud that the units are helping patients. I get letters from them all the time.”

Professor Sir Keith O’Nions, rector of Imperial College London, said Prof Bloom’s research was “pioneering” and had changed the approach to treating obesity, for the benefit of everyone in society.

A large variety of vocations are also honoured in health and medicine.

They include MBEs for six GPs, five nurses, a physiotherapist, two pharmacists, a dentist and a volunteer ambulance driver.

John Wallwork, professor of cardiothoracic surgery and director of transplantation at Papworth Hospital in Cambridge, is the recipient of a CBE.

Julie Moore, chief executive of University Hospital Birmingham NHS Foundation Trust becomes a Dame. Her personal involvement in the development and staffing of the military managed ward concept at Selly Oak Hospital has been recognised.

Christine Mills, founder of Hope for Tomorrow charity, receives an MBE for launching the first UK mobile chemotherapy unit.

She founded the charity after her husband died from cancer of the spine and wanted to alleviate the suffering of people travelling long distances to and from hospital to receive chemotherapy treatment.

She raised enough money to build the world’s first mobile chemotherapy unit, which can treat 12 to 20 cancer patients a day on the road, complete with two dedicated nurses.

Children with low vitamin D levels are more likely to be at risk of developing Type 2 diabetes, according to a study suggesting a deficiency could help trigger the disease.Researchers found those with lower vitamin D levels were more likely to be obese and have higher degrees of insulin resistance, when the hormone becomes less effective at lowering blood sugar.

Dr Micah Olson, lead author of the study Diabetes & Metabolic Syndrome: Clinical Research & Reviews , published in the Journal of Clinical Endocrinology and Metabolism, said: “Although our study cannot prove causation, it does suggest that low vitamin D levels may play a role in the development of Type 2 diabetes.”

He added: “Future studies are needed to determine the clinical significance of lower vitamin D levels in obese children, the amount and duration of treatment necessary to replenish vitamin D levels in these children and whether treatment with vitamin D can improve primary clinical endpoints such as insulin resistance.”

The skin helps manufacture vitamin D, but only when exposed to strong sunlight. In the winter and early spring the body’s reserves can drop to low levels, particularly if a person has had insufficient exposure in the summer months.

Vitamin D can also be derived from certain foods, such as oily fish, eggs and fortified breakfast cereals.

Therefore, lack of vitamin D could simply be a sign of a generally unhealthy lifestyle: not getting out for enough exercise in the fresh air, and not eating a good diet.

Children who sit in front of the television for most of the day, snacking on fatty foods, are therefore likely to have lower vitamin D levels and be overweight as well. The two factors might not be biologically related.

Nonetheless, Dr Iain Frame, director of the charity Diabetes UK, said the study “adds to growing evidence of a link between low levels of vitamin D and an increased risk of Type 2 diabetes.”

He went on: “However, as the authors note, the exact causes of vitamin D deficiency and its role in the development of Type 2 diabetes are still unclear.

“Diabetes UK is currently funding research at the University of Glasgow to help establish if people with Type 2 diabetes might benefit from vitamin D supplementation.

“Until we know more, it is not possible to recommend vitamin D supplements to reduce the risk of Type 2 diabetes and people should not see this as an easy fix.

“Maintaining a healthy weight by keeping to a healthy diet and undertaking regular physical activity is still the best way to reduce your risk of developing Type 2 diabetes.”

Living an unhealthy lifestyle could make you look older because high blood sugar causes the face to age more quickly, new research has found.People whose blood sugar levels are higher than average look older than those with low levels, experts said.

Blood sugar, which can rise as a result of an unhealthy diet or lack of exercise, was already known to cause ill health but the study is believed to be the first to link high levels to appearance.

Researchers found that every additional millimole per litre increase in blood sugar, which in healthy people is usually between five and six mmol/l, adds five months of ageing to their facial features.

They measured the blood sugar of 602 people, while a group of 60 independent assessors studied two photographs of their faces to come up with a “perceived age” score.

Healthy people with low blood sugar typically looked a year younger than those with high readings, and a year-and-a-half younger than diabetics, the study published in the Age journal found.

The ageing could be caused by a build-up of sugar which sticks to collagen – a protein in the skin which keeps it supple – and is difficult for the body to remove.

Alternatively, the glucose could hamper insulin production which is believed to play a central role in ageing, researchers said.

David Gunn, who led the Unilever study, said: “The higher glucose people had, they started looking older. Diabetics looked older again, and they have had the worst exposure to high glucose levels.

“This adds extra evidence that there is another reason to have a healthy lifestyle – because it is going to affect your appearance as well as your health.”

Diana van Heemst, of Leiden University in the Netherlands, who contributed to the paper, said: “The results from this study further underscore how important regulation of blood glucose levels is for wellbeing and health in advanced middle age.

“The associated benefit of looking younger might provide an extra motivation to bring about healthy lifestyle changes in 50-to-70 year olds.”

From:  http://www.telegraph.co.uk/High-blood-sugar-speeds-up-ageing

British women are the most overweight in Europe, according to official figures.Between the ages of 18 and 74, almost one woman in four is so fat their health is suffering.

The figure is far worse than most other countries.

By comparison, 12.7 per cent of Frenchwomen are overweight, 14.4 per cent of Spaniards and just 9.3 per cent of Italians.

Experts from the European Commission, which compiled the figures for the year 2008/9, are concerned at the number of young British women who are obese.

Across most of Europe, very few 18- to 24-year-olds are obese but in Britain 16.6 per cent of young women are too fat.

The data comes from the European Health Interview Survey (EHIS) published by Eurostat, the EU’s statistical office- Overweight and Obesity BMI Statistics.

The statistics showed British men are not far behind, with 22.1 per cent being classed as overweight, coming second only to Malta.

They found the share of overweight and obese people increases with age in all of the 19 member states for which data was available.

The figures also show the proportion of women who are obese or overweight falls as the educational level rises.

The high levels of obesity in the UK are in stark contrast to those in countries such as Romania, where just 8 per cent of women were classed as obese along with 7.6 per cent of men.

Obesity is defined as having a Body Mass Index of over 30. BMI is calculated by dividing one’s weight in kilograms by the square of one’s height in metres.

Earlier this year, a report by the World Health Organisation found that British men were among the fattest in Europe and that, as a nation, we do less exercise than almost every other.

The study ranked British men as the third fattest in Europe, with 67.8 per cent of males aged 15 or older either overweight or obese – only Greece (77.5 per cent) and Malta (73.3 per cent) were fatter.

The report also found that Britain is the ninth least active nation in the world, with 63.3 per cent of adults taking less than 30 minutes of moderate exercise five times a week.

Cardiovascular disease is Britain’s number one killer, accounting for more than 191,000 deaths every year.

A new drug which destroys blood supply to fatty tissue could help people lose a tenth of their body weight in just one month, a study indicates.Obese rhesus monkeys lost on average 11 per cent of their body weight after four weeks of the experimental treatment.

Body mass index (BMI) and waistline also were reduced, while all three measures were unchanged in untreated control monkeys.

Imaging studies also showed a substantial decrease in body fat among treated animals.

A research team led by scientists at The University of Texas MD Anderson Cancer Centre carried out the study.

Co-senior author Professor Renata Pasqualini, at the David H. Koch Centre for Applied Research of Genitourinary Cancers, said: “Development of this compound for human use would provide a non-surgical way to actually reduce accumulated white fat, in contrast to current weight-loss drugs that attempt to control appetite or prevent absorption of dietary fat.”

She said previous attempts to treat obesity have predominantly focused on drugs aimed at suppressing appetite or increasing metabolism, but these efforts have been hampered by their toxic side-effects.

The MD Anderson group designed a new drug, which includes a homing agent that binds to a protein on the surface of fat-supporting blood vessels and a synthetic peptide that triggers cell death.

Their blood supply gone, fat cells are reabsorbed and metabolised.

Co-senior author Professor Wadih Arap, said: “Obesity is a major risk factor for developing cancer, roughly the equivalent of tobacco use, and both are potentially reversible.”

In earlier preclinical research, obese mice lost about 30 per cent of their body weight with the drug, now called Adipotide.

The drug acts on white adipose tissue, the scientific name for the unhealthy type of fat that accumulates under the skin and around the abdomen, and is a disease and mortality predictor.

Prof Pasqualini said: “Most drugs against obesity fail in transition between rodents and primates.  We’re greatly encouraged to see substantial weight loss in a primate model of obesity that closely matches the human condition.”

The primate model also shares other physiological features associated with human obesity, such as metabolic syndrome, characterised by an increased resistance to insulin, which can lead to the development of type 2 diabetes and cardiovascular disease.

Adipotide-treated monkeys showed marked improvements in insulin resistance – using about 50 per cent less insulin after treatment.

Now the research team are preparing for a clinical trial in which obese prostate cancer patients would receive daily injections of Adipotide for 28 consecutive days.

Prof Arap said: “The question is, will their prostate cancer become better if we can reduce their body weight and the associated health risks?”

He said some prostate cancer treatments, such as hormone therapy, cause weight gain.

Greater weight can lead to arthritis, which in turn causes inactivity that leads to more weight gain.

Fat cells also secrete growth hormones that cancer cells thrive on.

Weight, BMI and abdominal circumference all continued to drop for three weeks after treatment ended before turning back up during the eighth week of the study.

Treated monkeys’ abdominal fat levels fell by 27 per cent during the study. Fat levels increased slightly in the control group.

Lean monkeys did not lose weight in a separate study to test for potential effects of the drug in non-obese animals, indicating that the drug’s effect may be selective for obese subjects.

Monkeys in the studies remained bright and alert throughout, interacting with caretakers and demonstrating no signs of nausea or food avoidance.

This is potentially an important finding since unpleasant side-effects have limited the use of approved drugs that reduce fat absorption in the intestines.

The principal side effects were noted in the kidneys.

Study first author Dr Kirstin Barnhart, a veterinary clinical pathologist said: “The renal effect was dose-dependent, predictable and reversible.”

The results were published in the journal Science Translational Medicine.

An ingredient found in red wine can combat the harmful effects of obesity and reduce the risk of disease in the elderly, a clinical trial has shown for the first time.When taken regularly a natural compound known as resveratrol, found in red wine and grapes, mulberries and peanuts, can offer similar benefits to low calorie diets and endurance training.

As well as lowering the metabolism – meaning the body needs less food to generate enough energy – it can reduce levels of liver fat, blood pressure and blood sugar.

The compound also improves the rate at which the muscles burn fat, lessens insulin resistance and could protect against certain age-related diseases like Type 2 diabetes and cancer, experts said.

Unfortunately, to consume the amount of resveratrol given to patients in the study a wine-drinker would need to work their way through more than 13 bottles a night, doing far more harm than good!

But researchers said the 150mg dose could easily be taken as a daily capsule with water, or incorporated into existing food supplements.

Prof Patrick Schrauwen of Maastricht University in The Netherlands, who led the study, said the benefits of resveratrol for obese people were small but significant.

He said: “I think the positive thing is that they were very consistent, they cause a small difference on a lot of different parameters.

“Also, we only gave it to patients for 30 days and we do not know what would happen if we gave it for longer. Metabolic changes can take a while before they start to appear so it is quite possible the effects could be larger.”

Dr Andrew Murray, of Cambridge University, who was not involved in the study, said it provided the first real evidence that resveratrol could have a significant effect in humans.

He said: “Although the effects are slight they could make all the difference to people with metabolic complications like obesity.

“What is very exciting about this is that there are many problems related to obesity and the onset of diabetes, and what this study seems to show is that it is not going to make people thin again but it could slow down all the problems associated with lifelong obesity.”

The researchers gave daily injections of resveratrol to 11 obese male patients for a month and found it altered their metabolism in a similar, although weaker, way than extreme dieting or endurance training.

The treatment lowered systolic blood pressure by 5mmHg and reduced the amount of energy participants used by two to four per cent, indicating that their metabolism had slowed down.

Biologically speaking this is healthy because it means we require less energy and need to eat less, but the researchers admitted that burning fewer calories may not be desirable for obese patients.

Prof Schrauwen said: “In our society with so much obesity people want to have a high metabolism because it is easier to lose weight.

“But the lowering of your energy metabolism is actually a good thing because it means that you become more efficient.”

Because the eleven patients tested in the study, published in the Cell Metabolism journal, were all obese men it is not clear whether slimmer people would benefit in the same way.

Prof Schrauwen said: “I can imagine it will work better in people who already have some disturbances in their metabolism – if your blood pressure and blood glucose are normal, then it might not be lowered.”

From: http://www.telegraph.co.uk/Red-wine-holds-key-to-better-health-for-obese-patients