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Can exercise offset some of the harms of regular drinking?

NHS Choices - Behind the Headlines - Fri, 08/09/2017 - 17:28

"Adults who booze regularly but exercise for five hours a week are no more likely to die than teetotallers," the Mail Online reports.

A study suggests exercise may compensate for some, but certainly not all, of the harms associated with excessive alcohol consumption. This latest study looked at deaths from cancer and cardiovascular disease, as well as premature death in general (usually judged to be dying before the age of 75).

Researchers looked at around 10 years' worth of national survey data from UK adults aged over 40. Unsurprisingly, they found links between all-cause and cancer mortality in inactive people. But they also found increasing levels of physical activity generally removed the association with drinking habits. In fact, occasional drinking was associated with a significant reduction in all-cause mortality for the most active of people.

Although the study had strengths in its large sample size and regular follow-up, we can't be sure that any links observed were solely down to the interaction between alcohol and exercise. For example, people who are physically active may also avoid smoking and consume healthy diets. It is difficult to completely control for such influences when analysing data like this.

While regular exercise may mitigate against some of the harms associated with excessive alcohol consumption it certainly won't make you immune. Many world-class sportspeople, such as George Best and Paul Gascoigne, have had both their careers and lives blighted by drinking.

 

Where did the story come from?

The UK-based study was carried out by an international collaboration of researchers from Canada, Australia, Norway and the UK. The health surveys on which the study was based were commissioned by the Department of Health, UK. Individual study authors also reported receiving funding from the National Health and Medical Research Council and University of Sydney. 

The study was published in the peer-reviewed British Journal of Sports Medicine. 

The media coverage around this topic was generally overly optimistic, highlighting that by exercising, individuals can completely undo the harm caused by excessive alcohol consumption, which is untrue.

In particular, the Mail Online claimed "Adults who booze regularly but exercise for five hours a week are no more likely to die than teetotallers" which could send out the wrong message to the public.

 

What kind of research was this?

This cohort study analysed data from British population-based surveys: Health Survey for England (HSE) and the Scottish Health Survey (SHS) to investigate whether physical activity is able to moderate the risk between alcohol consumption and mortality from cancer and cardiovascular diseases.

Cohort studies like this are useful for assessing suspected links between an exposure and outcome. However, there are potentially other factors that have a role to play in such associations and therefore the study design doesn't allow for confirmation of cause and effect.

 

What did the research involve?

The researchers collected data on 36,370 men and women aged 40 or above from Health Survey for England (1994; 1998; 1999; 2003; 2004; and 2006) and the Scottish Health Survey (1998 and 2003). Among other things, the participants were asked about their current alcohol consumption and physical activity.

Alcohol intake was defined by six categories (UK units/week):

  • never drink (lifetime abstainers)
  • ex-drinkers
  • occasional drinkers (haven't drank anything in past seven days)
  • within (previous) guidelines: <14 units (women) and <21 units (men)
  • hazardous: 14-15 units (women) and 21-19 units (men)
  • harmful: >35 (women) and >49 (men)

Frequency and type of physical activity in the past four weeks was questioned and converted into metabolic equivalent task-hour (MET-hours, which are an estimate of metabolic activity) per week according to national recommendations:

  • inactive (≤7 MET-hours)
  • lower level of active (>7.5 MET-hours)
  • higher level of active (>15 MET-hours)

The surveys were linked to the NHS Central Register for mortality data and the participants were followed up until 2009 (HSE) and 2011 (SHS). There were 5,735 recorded deaths; deaths from cancer and cardiovascular disease were of most interest for this study.

The data was analysed for associations between alcohol consumption and the risk of death from all-causes, cancer and cardiovascular disease. The results were then analysed according to levels of physical activity.

Potential confounders (such as sex, body mass index and smoking status) were controlled for.

 

What were the basic results?

Overall, the study found a direct link between all levels of alcohol consumption and risk of cancer mortality. It also found that increasing levels of physical activity reduced this association with cancer mortality, and also reduced the link with death from any cause.

  • In individuals who reported inactive levels of physical activity (≤7 MET-hours), there was a direct association between alcohol consumption and all-cause mortality.
  • However, in individuals who met the highest level of physical activity recommendations a protective effect of occasional drinking on all-cause mortality was observed (hazard ratio: 0.68; 95% confidence interval (CI): 0.46 to 0.99). It should be noted that this result just skimmed the cut-off point for statistical significance.
  • In this high activity group, there was no link between all-cause mortality and alcohol consumption within guidelines, or even hazardous amounts, but the risk was still increased for those drinking harmful amounts.
  • The risk of death from cancer increased with the amount of alcohol consumed in inactive participants, ranging from a 47% increased risk for those drinking within guidelines to 87% increased risk for those with harmful drinking.
  • In people with higher activity levels (above 7.5 MET hours) there was no significant link between any amount of alcohol consumption and cancer mortality.
  • No association was found between alcohol consumption and mortality from cardiovascular disease, although a protective effect was observed in individuals who reported the lower and higher levels of physical activity (>7.5 MET-hours) and (>15 MET-hours) respectively.

 

How did the researchers interpret the results?

The researchers concluded "we found evidence of a dose–response association between alcohol intake and cancer mortality in inactive participants but not in physically active participants. [Physical activity] slightly attenuates the risk of all-cause mortality up to a hazardous level of drinking."

 

Conclusion

This study aimed to explore whether physical activity is able to moderate the risk between alcohol consumption and mortality from cancer and cardiovascular diseases. It found that increasing levels of physical activity reduced the association for death from both all-causes and cancer.

This study has strengths in its large sample size, comprehensive assessments and long duration of follow-up. The findings are interesting, but there a few points to bear in mind:

  • As the authors mention, cohort studies such as this are unable to confirm cause and effect. Though the researchers have tried to account for various potential health and lifestyle confounding variables, there is the possibility that others are still influencing the results. A notable one is dietary habits which weren't assessed. Also, for example, the former drinkers may have quit due to other health issues which may have introduced bias.
  • The study was unable to look at binge drinking levels of alcohol consumption which would have likely had important health implications.
  • Additionally, there is always the possibility with self-reported surveys that the participants either under or over-reported their drinking habits which can increase the chance of misclassification bias.
  • Though having a large sample size, fewer people reported harmful drinking levels, so links within this category may be less reliable.
  • The study has only looked at the link between alcohol and actually dying from cancer or cardiovascular disease. Links may be different if they looked at associations between alcohol and just being diagnosed with cancer or heart disease, for example.
  • The study is also only representative of adults over the age of 40.

Overall, maintaining a healthy lifestyle seems to be the best bet for reducing the risk of any chronic disease, be it through physical activity, balanced diet or reasonable alcohol consumption.

Current alcohol recommendations for both men and women are to drink no more than 14 units per week.  

Links To The Headlines

How exercise undoes the harm from drinking: Adults who booze regularly but exercise for five hours a week are no more likely to die than teetotallers. Mail Online, September 8 2016

Two hours a week of exercise could offset the dangers of alcohol. The Daily Telegraph, September 8 2016

Exercise can cut risk from alcohol-related diseases, study suggests. The Guardian, September 8 2016

Links To Science

Perreault K, Bauman A, Johnson N, et al. Does physical activity moderate the association between alcohol drinking and all-cause, cancer and cardiovascular diseases mortality? A pooled analysis of eight British population cohorts. British Journal of Sports Medicine. Published online August 31 2016

Categories: NHS Choices

Revealed: the tricks packaging designers use to make us spend

Newmarket Journal - Sun, 25/09/2016 - 06:00
Celebrity endorsements, pseudo-science and fancy boxes are among the tricks retailers are using to part us from our cash.
Categories: Local Press

Feeding egg and peanuts to young infants “reduces allergy risk”

Newmarket Journal - Sat, 24/09/2016 - 06:00
Feeding babies with egg and peanut at a young age – rather than waiting until they are older – may prevent them developing an allergy to the foodstuffs, according to a major new study.
Categories: Local Press

Why does Earl Soham needs its village green preservation society?

Ely Standard - Fri, 23/09/2016 - 19:22

It is the proud centrepiece of many an English village - but in one Suffolk community it is disappearing by the day.

Categories: Local Press

Fitness trackers 'don't help you lose weight'

NHS Choices - Behind the Headlines - Fri, 23/09/2016 - 17:28

"Fitness trackers may not help weight loss," reports Sky News on a new trial which investigated whether using wearable technology helped people lose more weight compared to standard weight-loss programmes.

Researchers tracked 470 overweight or obese people aged 18 to 35, for 24 months. Everyone in the study was put on a low-calorie diet, given an exercise plan and invited to regular group counselling sessions.

After six months, half the group was given a wearable device to track activity and feed it into a computer programme that also allows people to record their diet.

The other half were simply told to continue the weight loss programme and monitor their exercise and diet by themselves.

The group using the Fit Core tracker lost an average of 3.5kg over two years, compared with an average 5.9kg in the self-monitored group.

The spread of obesity across the globe has been increasing rapidly in recent years and public health bodies continue to struggle with tackling the issue.

Along with the usual weight-loss diets, the use of wearable technologies promoting fitness, such as FitBit and Jawbone, is also on the rise.

The study authors say there are many possible explanations for their surprising finding but, as yet, no proof.

BBC News quotes lead researcher Dr John Jakicic saying: "People have a tendency to use gadgets like these for a while and then lose interest with time as the novelty wears off.

"And we did see a drop off in the usage data as the study went on."

Although the study's findings are interesting, it may be the case that the use of fitness trackers and other devices may be more effective for some people than others.

Until more conclusive research is available, the best advice for losing weight is to follow a calorie-controlled diet combined with regular exercise.

Where did the story come from?

The study was carried out by researchers from the University of Pittsburgh in the US. It was funded by a grant from the National Institutes of Health and the National Heart, Lung and Blood Institute.

Interestingly, the researchers were affiliated with Weight Watchers International.

The findings from the trial were published in the peer-reviewed medical journal JAMA. It is free to read online.

Generally, media coverage around this topic was accurate.

What kind of research was this?

This was a randomised controlled trial (RCT) which aimed to compare the effectiveness of a wearable technology weight loss intervention (fitness tracker) with standard weight loss strategies to see which would result in greater weight loss.

RCTs such as this are one of the best ways to investigate the effectiveness of public health interventions.

In such trials there is the possibility that the individuals' knowledge of being monitored by the wearable technology could influence their diet, activity and weight loss. This is known as being non-blinded to the intervention group, which can normally be a potential source of study bias. However, in this case it's probably just part of the way the intervention was intended to work.

What did the research involve?

The 24-month Innovative Approaches to Diet, Exercise and Activity (IDEA) randomised controlled trial at the University of Pittsburgh recruited 471 participants (aged 18-35) with a body mass index (BMI) between 25.0 and 40.0.

Participants were randomised to one of two treatment groups: a standard behavioural weight loss intervention and a weight loss intervention enhanced by using wearable technology.

For the first six months both groups received the same behavioural weight loss intervention and were instructed to self-monitor dietary intake and their physical activity in diaries. This information was given to the study staff who offered feedback.

At six months, the standard behavioural weight loss group started self-monitoring their diet and physical activity via an website designed for the trial. No feedback was given. At this time, the enhanced intervention group were given their wearable technology device which had access to education materials via a web-based interface (BodyMedia FIT Core). This monitored their diet and physical activity.

During months 7-24, both groups also received telephone counselling sessions, text message prompts and access to online study materials.

The main outcome of the study was to assess weight change at 24 months. Participants were also assessed at months 0, 6, 12 and 18, and received monetary compensation for completing each assessment. The researchers analysed the findings between both treatment groups.

What were the basic results?

Overall, there was significant weight change over time in both treatment groups. However, there was greater weight loss in the standard behavioural intervention group compared with the technology-enhanced intervention.

  • The average weight loss between baseline and 24 months in the standard behavioural intervention group was 5.9kg (95% confidence interval (CI): 5.0 to 6.8).
  • In the technology-enhanced intervention group, the average weight loss over the same time was 3.5kg (95% CI: 2.7 to 4.5).
  • The difference between the two groups was 2.4kg (95% CI: 1.0 to 3.7).

Additionally, there was a greater decrease in body fat (%) in the standard behavioural intervention group compared with the technology-enhanced intervention.

  • The average loss of body fat (%) between baseline and 24 months in the standard intervention was 3.5% (95% CI: -4.0 to –3.0).
  • The enhanced intervention group lost on average 2.4% body fat (95% CI: -3.0 to -1.9).
  • The difference between the two groups was -1.1% in body fat (95% CI: -1.9 to -0.3).
How did the researchers interpret the results?

Researchers concluded: "Among young adults with a BMI between 25 and less than 40, the addition of a wearable technology device to a standard behavioural intervention resulted in less weight loss over 24 months. Devices that monitor and provide feedback on physical activity may not offer an advantage over standard behavioural weight loss approaches."

Conclusion

This trial aimed to compare the effectiveness of a wearable technology weight loss intervention (fitness tracker) with standard weight loss strategies to see which would result in greater weight loss at the end of 24 months.

It found the addition of a wearable technology device did not aid weight loss, and participants in the standard behavioural intervention group lost more weight when compared to the technology group.

This was an interesting study with a reliable study design. However there are a few things to note:

  • As the authors mention, the participants were all young adults (mean age 30) and 77.2% were women so these findings are not representative of the general population.
  • Although this trial showed weight loss over a 24 month period, the greatest weight loss was achieved in the first six months and this was not fully sustained over the long-term. Therefore, the challenges of maintaining weight loss continue to exist.
  • The adoption of the wearable technology device was started six months into the intervention so the findings may have been different had the participants started using them at baseline.

Links To The Headlines

Fitness trackers offer no weight-loss benefit and can make users fatter, says study. The Daily Telegraph, September 21 2016

'No proof' fitness trackers promote weight loss. BBC News, September 20 2016

Fitness trackers may not help weight loss. Sky News, September 21 2016

Fitness trackers may not aid weight loss, study finds. The Guardian, September 21 2016

Study finds fitness trackers don't pull their weight. The Daily Mail, September 21 2016

Links To Science

Jakicic JM, Davis KK, Rogers RJ et al. Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss: The IDEA Randomized Clinical Trial. Published September 21 2016

Categories: NHS Choices

In a spin: the Marquettes’ baton twirling brilliance guides them to regional title

Ely Standard - Fri, 23/09/2016 - 11:48

A team from Ely was crowned champions after their baton twirling brilliance impressed at a regional competition.

Categories: Local Press

What to do if you’re one of the 500m hacked Yahoo users

Newmarket Journal - Fri, 23/09/2016 - 11:16
Internet giant Yahoo has admitted to a data breach affecting as many as 500 million user accounts, pointing the finger at a “state-sponsored actor”.
Categories: Local Press

KD Theatre Productions hoping to take you to a whole new world with Pantomime production of ‘Alladin’ this Christmas

Ely Standard - Fri, 23/09/2016 - 10:09

KD Theatre Productions are gearing up for the Pantomime season and will be returning to the Maltings for their fourth triumphant year with their offering of ‘Alladin.’

Categories: Local Press

Three men charged with two burglaries in Burwell and Sutton - within 24 hours of each other

Ely Standard - Fri, 23/09/2016 - 09:51

Three men have been charged in connection with two burglaries that happened within 24 hours in the East Cambs district.

Categories: Local Press

Toys “R” Us reveal must-have Christmas toys

Newmarket Journal - Fri, 23/09/2016 - 09:20
Toy experts at Britain’s biggest toy store, have unveiled their very own list of 14 Superstars, which are expected to dominate kids’ Christmas lists this year - and it’s going to be a hard-fought battle between tech toys versus popular collectibles and characters.
Categories: Local Press

‘Stop the airbase houses’

Newmarket Journal - Fri, 23/09/2016 - 06:42
A parish councillor has called on the people of West Row to have their say about plans for RAF Mildenhall that he fears could ‘swamp’ the village.
Categories: Local Press

GM chemicals in cleaning products are 'potent allergens'

NHS Choices - Behind the Headlines - Thu, 22/09/2016 - 17:28

"GM enzymes used in household products 'are potent allergens'," reports The Daily Mail following research on the potential for genetically modified enzymes to cause allergies.

Researchers took blood samples from 813 workers routinely exposed to genetically modified (GM) enzymes from working in the food, drinks, chemicals, detergents and pharmaceutical industries.

They found antibodies – proteins produced in response to the presence of the GM enzymes – in just under a quarter of those tested. 

The most commonly detected antibodies were derived from exposure to alpha amylase, stainzyme, and pancreatinin, which are predominantly used in detergents and home care products.

However, just having antibodies doesn't prove a person has an allergy.

The researchers examined a subgroup of 134 workers and found around a third of them had possible allergic symptoms such as runny nose, eye irritation or shortness of breath.

One-off tests on these workers do not give conclusive proof that exposure to these enzymes causes allergies.

Also, these workers are likely to have a higher level of exposure through their occupation than the average person may have just by using such products.

Therefore the findings do not give immediate cause for concern for the general public.

Nevertheless, if these findings are verified, further regulation around products containing such enzymes may be required.

Where did the story come from?

The study was carried out by researchers from the University Medical Center Hamburg-Eppendorf. There was no mention of a source of funding for this study.

The report was published in the peer-reviewed journal Occupational & Environmental Medicine and is free to read online.

The media reported on this study accurately. The Guardian provides a good summary of the research and findings, rightfully pointing out limitations of the research such as the possibility of selection bias in the subgroup analysis.

What kind of research was this?

This was a cross sectional study which aimed to investigate genetically engineered enzymes – such as those used in manufacturing fragrances, detergents and food flavourings – as potential allergy-causing substances (allergens).

As this was a cross sectional study, taking one-off allergy tests in staff in the workplace, it cannot prove causation. However, this type of study is useful for providing links for further investigation.

A cohort study, assessing allergic response in people before they started working in these industries, and then following them up over time to see how their allergic response changes, would give better indication of cause and effect.

What did the research involve?

The researchers took blood samples from 813 workers exposed to genetically modified enzymes. Most of the workers were from the food, chemical, detergent and pharmaceutical industries. Two-thirds were men aged 20 to 60 years.

The blood samples were screened for antibodies related to enzyme exposure in their workplace. The specific enzyme antibodies were:

  • phytase
  • xylanase
  • glucanase
  • cellulose
  • savinase and/or alpha-amylase

The workers were exposed for between three months and 10 years to two to four enzymes in their workplaces.

For a subgroup of 134 workers at two workplaces, clinical data was collected, including their medical histories, physical examination and lung function testing.

What were the basic results?

Just under a quarter (23%) of all exposed workers had IgE antibodies related to workplace-specific enzymes. These are the antibodies the immune system produces as an allergic response.

The most common antibodies were against the enzymes derived from alpha-amylase (44%), followed by stainzyme (41%) and pancreatinin (35%).The highest individual antibody levels were detected in workers exposed to phytase, xylanase and glucanase.

Alpha amylase, stainzyme, and pancreatinin are predominantly used in detergents, cleaning products and home care products.

The sub group analysis found that 64% were symptom free, 19% had a runny nose and/or conjunctivitis, and 17% had wheezing and/or shortness of breath.

How did the researchers interpret the results?

The researchers conclude: "Our data confirm the previous findings showing that genetically engineered enzymes are potent allergens eliciting immediate-type sensitisation. Owing to lack of commercial diagnostic tests, few of those exposed receive regular surveillance including biomonitoring with relevant specific IgE [tests]."

Conclusion

This cross sectional study aimed to assess the potential for allergy caused by genetically modified enzymes which are abundant across the manufacturing industry.

The researchers showed that such enzymes can cause increased levels of the related antibodies, causing sensitisation for some of those that come in contact. However, just having antibodies to something you've been exposed to doesn't necessarily equate to allergic symptoms such as dermatitis or asthma.

A notable limitation of this study is that it examined and reviewed the medical history of only a small subgroup of people. The majority of these people had no allergic symptoms, despite the high prevalence of antibodies. As these people were only selected from two sites, and were not a randomly selected sample of all workers tested, the possibility of selection bias can't be ruled out.

Another important limitation is that this type of study is unable to prove cause and effect. A prospective cohort study would be the best way of assessing whether non-allergic people subsequently develop allergic sensitivity upon working in environments where they are exposed to these enzymes.

It is also likely that the level of exposure for these workers is higher than for the general public using these products. So the implications for the general population are probably minimal.

Another drawback to the research, acknowledged by the authors, is that commercial secrecy limited access to data, preventing them from gaining access to the chemical formulations used.

Nonetheless, should these findings be verified and suggest that these enzymes lead to allergies, further regulation around products containing such enzymes may be required. 

Links To The Headlines

Enzymes used in cleaning products and food 'are potent allergens', warns study. The Guardian, September 22 2016

GM enzymes used in household products 'are potent allergens'. The Daily Mail, September 22 2016

Links To Science

Budnik L, Scheer E, Sherwood Burge P et al. Sensitising effects of genetically modified enzymes used in flavour, fragrance, detergence and pharmaceutical production: cross-sectional study. Published September 21 2016

Categories: NHS Choices

Overturned vehicle blocking A14 near Newmarket

Newmarket Journal - Thu, 22/09/2016 - 16:58
An overturned vehicle is blocking one lane of the A14 near Newmarket this afternoon, Thursday September 22.
Categories: Local Press

March woman Lauren Lyon graduates with a 2:1 degree and speaks out about mental health issues that blighted her time at university

Ely Standard - Thu, 22/09/2016 - 16:22

Lauren Lyon, the girl whose birth hit the national headlines when her mum became the oldest woman in Britain to give birth, has graduated from university.

Categories: Local Press

World War One hero Herbert remembered 100 years after his death with ceremony

Ely Standard - Thu, 22/09/2016 - 14:44

Residents, members of the Royal British Legion, Cambridgeshire Army Cadets and members of the Cambs 876 Remembered Project paid their respects to World War One hero Private Herbert Low, who died 100 years ago last week.

Categories: Local Press

Charities, schools and community groups in Cambridgeshire are invited to be one of 50 to get financial support from a business

Ely Standard - Thu, 22/09/2016 - 14:15

Anglian home Improvements is marking its 50th anniversary by launching an appeal to find 50 worthy community projects that need new windows or doors or financial support.

Categories: Local Press

VIDEO: Company launches ‘selfie sticks’ for dogs

Newmarket Journal - Thu, 22/09/2016 - 12:29
The ultimate in pet pampering has arrived in the form of a selfie stick for your dog.
Categories: Local Press

Outpatients clinics at Princess of Wales Hospital and Doddington Hospital secured

Ely Standard - Thu, 22/09/2016 - 12:27

The future of outpatients clinics at the Princess of Wales Hospital in Ely and Doddington Hospital have been secured.

Categories: Local Press

‘I was a walking ticking time bomb’ says Soham woman who is raising money after heart transplant

Ely Standard - Thu, 22/09/2016 - 12:15

“I was a walking ticking time bomb,” says a Soham woman who underwent open heart surgery earlier this year and is holding a fundraising event next month.

Categories: Local Press

New trains to bring a ‘touch of pampering’ as part of nine-year plan

Ely Standard - Thu, 22/09/2016 - 12:02

A nine year plan of promises for better train travel for passengers across the Fens, Ely and beyond will make people feel “a touch pampered” - providing it happens, says a rail users campaign group.

Categories: Local Press

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