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Tuesday, February 21, 2012

Workouts May Not Be the Best Time for a Snack

 
Andrew Burton/Associated Press
A few weeks ago, a friend showed up for a run with a CamelBak — one of those humplike backpacks with a tube that allows you to sip liquid — and a belt containing food to eat along the way. Every 20 minutes or so as we ran, he stopped to eat and drink, sprinting afterward to catch up.
Now that is unusual, I thought. Does it really help to eat so often during a 16-mile run?
 The Science Times Podcast: The fight against AIDS, and should you eat on the run?

Certainly a lot of athletes believe they need constant nourishment. My friend and running partner Jen Davis, who has entered more races and run more than I ever have, once went on a 30-mile training run with a guy wearing a CamelBak and bearing snacks. He stopped every 20 minutes along the way and then, about halfway through the run, pulled out a turkey sandwich.
“I’m not sure if he ever actually ran an ultra race,” Jen said. “He may have gotten injured after carrying that heavy pack on those long runs.”
There is no end to the crazy foods people will eat at endurance events. At the J.F.K. 50-Mile in Maryland, boiled potatoes and chicken broth are provided at aid stations. At the Rocky Raccoon Endurance Trail Run in Texas, runners can choose rice and beans or pasta, along with snacks like pretzels, cookies and candy.

At a 100-mile bike ride my husband and I have done several times, pumpkin pie is offered about 25 miles from the finish line. (My husband tried it one year and felt ill the rest of the ride.)
For the athlete determined to munch on the go, there are shelves worth of prepackaged “energy gels” and bars, even jelly beans, promising to raise performance.
But most athletes are not running 30 or 50 or 100 miles, nor are they doing the equivalent amount of exercise in another sport, like cycling or swimming or skiing. So most of us really do not need to keep eating during a race to maintain energy and stamina, said Nancy Rodriguez, a sports nutritionist at the University of Connecticut.
Dr. Rodriguez reviewed published studies on nutrition and performance as part of a group of experts who wrote a position paper on the topic for the American College of Sports Medicine. Runners, for example, competing in a 5- or 10-kilometer race, she said, “don’t need the CamelBaks and don’t need to have that Hershey bar or Powerade or Clif shot.”
Even athletes who are fast and competitive may not always need to eat during a workout. There’s no set rule on what they should eat and drink before, during and after exercise, said Melinda M. Manore, a sports nutritionist at Oregon State University who was an author of the position paper.
“People have gotten the message that they have to eat something,” Dr. Manore said. They guzzle an energy drink or eat a sports bar, but that doesn’t help. And for the many who are trying to lose weight, the habit just adds extra calories.
What they need depends on what they ate before they started and how hard their workout is going to be, among other things, she explained. “If you can run six-minute miles or five-minute miles and you are going out for an hour, you do not need to be eating an energy bar during the workout,” Dr. Manore said.
Moderate athletes need to eat and drink after the workout, she said, but a healthy meal with plenty of fluids is sufficient. Indeed, for most of them, the most common error is to eat too much.
Dr. Manore follows her own advice. She hikes for an hour in the hills every morning, four to five miles. All she has before she goes out is a cup of tea with milk.
But anyone exercising for two hours or more does need to get carbohydrates, the muscles’ fuel, according to the position statement. That means eating before, and perhaps during, the workout.
Those who try to skimp can end up with a poorer performance, said Dan Benardot, a sports nutrition researcher at Georgia State University. A long workout, like a run that lasts more than two hours, is “an enormous drain on blood sugar,” he said.
If the body runs out of glucose for fuel, it will start breaking down muscle, which is counterproductive. Dr. Benardot’s research indicates that athletes do best when they never let themselves have more than a 400-calorie deficit during the day. That is, if you expend 1,500 calories on a two-hour run, you offset it with at least 1,100 calories in food that day.
That means it is a disadvantage to eat most of the day’s calories at one time — at night, for example. But athletes should make dietary changes gradually so their bodies can adapt to more frequent fueling, he said. Those who try sudden changes sometimes pay a price.
Dr. Benardot tells the story of a distance runner who was doing well and felt great the morning of a big marathon. Before the race began, she saw her chief competitor put packs of a sugary gel into her running bra to eat during the race.
The distance runner did the same, even though she had never before eaten during races or long runs. It was a disaster: She had diarrhea during the event.
The gels “were anything but a competitive advantage,” Dr. Benardot said.
“You have to let your body adapt,” he added. “And you have to find out what works for you.”

Sunday, February 19, 2012

Tate that: Singer Jason Orange and unlikely lover Catherine Tate end their whirlwind romance




They raised eyebrows when they first started dating late last year.
But now it appears one of showbiz's most unlikely couples has split up.
Funnywoman Catherine Tate and Take That singer Jason Orange have gone their separate ways after a whirlwind romance which lasted just several months.
New couple: Catherine Tate and Jason Orange have apparently been enjoying a secret romanceNew couple: Catherine Tate and Jason Orange have apparently been enjoying a secret romance
Parted ways: Jason Orange and Catherine Tate have ended their budding romance after just a few months of dating
The pair have decided to return to being just friends after cracks emerged following their romance being made public.
 

Jason first met the comedienne when they both took part in a sketch for Comic Relief last March.
Catherine dressed up as the singer for spoof band Fake That alongside James Corden, Alan Carr, John Bishop and David Walliams, who made up the other fatter members of the band.
Double act: Jason Orange and Catherine met on the set of Comic Relief
Double act: Jason Orange and Catherine met on the set of Comic Relief when she dressed as him in a spoof boyband called Fake That
The pair hit it off and were again reunited six months later when they both turned out to support Walliams during his charity swim along the River Thames.
But as the press and fans picked up on their blossoming relationship, it reportedly caused friction between them.
And things came to a head when they spent New Year apart.
Spot the difference: Catherine (second from left) as Jason in Fake That, and the real article (second from right) in Take That
Spot the difference: Catherine (second from left) as Jason in Fake That, and the real article (second from right) in Take That
Jason, 41, reportedly saw 2012 in during a detox holiday to Thailand, while 43-year-old Catherine stayed in Britain.
A source tells The People: 'Jason is a very private person and after it came out that he and Catherine were getting closer together it did affect their relationship.
'There was a lot of pressure on them and it caused them to go their separate ways for a bit but they are still very good friends.'
After getting together they were reportedly spotted on a string of dates to the cinema, the National Theatre and at a coffee shop near Jason's flat in West London.
Enlarge   Caught by fans! First pictures of Catherine Tate and Take That singer Jason Orange spending time together away from work
Caught by fans! First pictures of Catherine Tate and Take That singer Jason Orange spending time together away from work in October
You can't get away that easy! Take That singer Jason had avoided being pictured with Catherine but beamed at the camera when three fans descended on him
You can't get away that easy! Take That singer Jason had avoided being pictured with Catherine but beamed at the camera when three fans descended on him
And rumours about their love life heightened when they were spotted enjoying a romantic break in Stratford-Upon-Avon in October.
They spent time watching the Royal Shakespeare Company's A Midsummer Night's Dream.
And photos emerged of them by fans who had spotted them in the area.
As Catherine posed for a picture with the group of fans, Jason was seen sitting on a bench in the background.
Keeping a safe distance: Jason and Catherine watch on in David Walliams hotel room during his River Thames swim for Sport Relief
Keeping a safe distance: Jason and Catherine watch on in David Walliams hotel room during his River Thames swim for Sport Relief
But the pair have never spoken out to confirm their romance and they were last seen together in November during a day out shopping in London.
Catherine has a daughter with her former partner Twig Clark, while Jason, who is notoriously private about his love life, has never been married but has been romantically linked to singer Lulu, TV presenter Jenny Powell and model Kathy Lloyd.
Representatives for both Catherine and Jason are yet to respond to the reports.

Round two! Amanda Holden hits back in the BGT style wars with eye-catching neckline after Alesha Dixon stole spotlight


There is undeniably more pressure on the female contingent when it comes to the style stakes of the Britain's Got Talent judging panel.
And Alesha Dixon outshone fellow judge Amanda Holden as they arrived at the ICC Arena in Birmingham yesterday, wearing a tiny patterned mini dress which put her cleavage and legs on full display.
However Amanda, who has already snapped back to her pre-pregnancy figure only three weeks after giving birth, hit back today with a plunging neckline and tiny skirt that made the most of her svelte physique.
But though the star has clearly thrown herself back into her judging role, Amanda has reportedly said that she is planning to take a break after this series of Britain's Got Talent.
Still got it! Amanda Holden worked a sexy red and silver Mini dress as she turned up to the Britain's Got Talent audition at the ICC Birmingham this afternoon
Still got it! Amanda Holden worked a sexy red and silver Mini dress as she turned up to the Britain's Got Talent audition at the ICC Birmingham this afternoon
Taking turns: Alesha was more demure after baring both her cleavage and legs yesterday, while Amanda went for a more revealing look
Taking turns: Alesha was more demure after baring both her cleavage and legs yesterday, while Amanda went for a more revealing look
Taking turns: Alesha was more demure after baring both her cleavage and legs yesterday, while Amanda went for a more revealing look
Sources told The People: 'After this series Amanda will be taking an extended break from everything showbiz. She has decided family comes first.'
'She loves doing Britain's Got Talent, but she will just be spending time with Chris and the girls.'
'Last year she did BGT, Shrek in the West End then back to BGT before having Hollie last month.'
Amanda and her husband 38-year-old Chris Hughes also have a six-year-old daughter called Lexi.
Nevertheless, while Amanda might be intending to give the world of glamour a rest soon, she's certainly throwing herself into the job for the time being.
Snapped into shape: Amanda showed off an incredible physique considering she gave birth less than a month ago
Snapped into shape: Amanda showed off an incredible physique considering she gave birth less than a month ago
Snapped into shape: Amanda showed off an incredible physique considering she gave birth less than a month ago
Amanda accentuated her slender legs with black and white leopard print heels as she arrived today, and showed off toned bare arms- though she must have been freezing in the February chill.
Yesterday former Mis-Teeq star was dressed in a barely there sleeveless pink number that skimmed the top of her thighs and had a plunging neckline.
Meanwhile Alesha, though she had her legs on display again, covered up with a high-necked purple top and pale pink blazer jacket as she greeted the crowds.
She teamed the revealing number with a pair of bright yellow pumps.
Time for a holiday? Amanda is reportedly planning to take a break after this series of Britain's Cot Talent
Time for a holiday? Amanda is reportedly planning to take a break after this series of Britain's Cot Talent
Meanwhile Amanda, 41, was a a little more understated in a white long-sleeved mini dress with nude heels and a large red bag.
Both ladies were the star attraction as the second day of auditions kicked off.

Also making his way into the ICC Arena was David Walliams, 40, who was happy to pose for pictures with one wheelchair-bound fan - in a recreation of his Lou character from Little Britain.
BGT
BGT
Yesterday: Alesha bared all in a tiny pink and white number, while Amanda covered up in a high necked dress
Amanda recently gave birth to second daughter Hollie Rose, but was left in intensive care due to complications during the birth.
Thankfully she has made a swift and full recovery, returning to work just two weeks after her scare.
Meanwhile, according to reports, Britain’s Got Talent judge Simon Cowell was reprimanded by David Walliams at auditions last week after he suggested like the likes of Cheryl Cole and Alesha Dixon can’t sing.
BGT
BGT
Where do you find the energy? Amanda must be shattered juggling BGT with taking care of a new baby
The music mogul made a sly dig at the pair of popstars, saying: 'Most girls who haven’t got good voices end up in girlbands.'
But Little Britain funnyman David was quick to stand up to Simon, defending Alesha.
He apparently said: 'You’re so mean to Alesha, making her sit beside me and not you. You always have the person you fancy next to you. We feel left out.'
Ladies man: David Walliams posted a picture of Amanda and Alesha pulling a Charlie's Angel pose
Ladies man: David Walliams posted a picture of Amanda and Alesha pulling a Charlie's Angel pose

Thursday, February 16, 2012

Migraine victims could get Botox on the NHS: Anti-wrinkle jabs 'halve effects of pain'


Thousands of migraine sufferers could benefit if an official review gives the go-ahead for Botox jabs on the NHS.
Results of clinical trials suggest the injections, used as an anti-wrinkle treatment, can halve the effects of chronic migraine.
The therapy, which uses a purified version of botulinum toxin A, blocks overactive nerve impulses which trigger excessive muscle contractions.
Relief: Research suggests Botox injections can halve the effects of chronic migraine
Relief: Research suggests Botox injections can halve the effects of chronic migraine
It can act as a preventive treatment, breaking the cycle of chronic headaches. Botox, made by Allergan, was licensed for use on migraines almost two years ago.
Patients pay £400-£600 a time for private treatment, according to the charity Migraine Action.
But it has not yet been approved for funding by the NHS rationing body, the National Institute for Healthcare and Clinical Excellence.
 
A review being conducted by NICE says there is 'insufficient evidence' so far to approve NHS funding.
Yesterday it revealed it wants Allergan to provide more evidence on the value of the drug before giving the green light for widespread NHS use.
Joanna Hamilton-Colclough, director of Migraine Action, said using Botox for her headaches had 'absolutely transformed my life'.
Botox, which is used as an anti-wrinkle treatment, has not yet been approved for funding by the National Institute for Healthcare and Clinical Excellence
Botox, which is used as an anti-wrinkle treatment, has not yet been approved for funding by the National Institute for Healthcare and Clinical Excellence
She said: 'I've been having chronic headaches for 40 years – I wake up every day with a headache. After my first Botox treatment I woke up the next day feeling ill.
'At lunchtime I realised that I felt different because I didn't have a headache. I've been able to work without a headache and sleep properly for the first time.'
She admitted it did not work for everyone but added that clinical trials also suggested a 50 per cent reduction in migraine days for some patients.
A vial of the drug costing around £300 should be given as 31 injections in the forehead, temples, neck and shoulders. One treatment might  break the cycle of pain, or top-ups might be required every three months.
Mrs Hamilton-Colclough said: 'We don't think the treatment is expensive when you take into account the cost to the economy from people needing time off work for migraine and to the NHS from A&E treatment.'
Professor Anne MacGregor, a migraine expert at St Bartholomew's Hospital, London, said she was concerned Botox might be used as a 'quick fix' for chronic headaches.
She added: 'It's not a blanket treatment but it might be appropriate for a small number of patients.'
A decision from NICE is expected  in June.

Seven in ten British adults and almost half of under 35s now have high blood pressure due to lifestyle


Seven in ten adults are at greater risk of stroke or heart attack because their blood pressure is too high, a study has found.
Senior doctors said unhealthy lifestyles were to blame. Desk jobs, lack of exercise and feasting on salty fast foods have contributed to the problem, even among the young.
Almost half of under-35s have blood pressure above healthy limits and a third are in the high  to very high range, figures from LloydsPharmacy show.
Office workers are amongst those most likely to have high blood pressure
Office workers are amongst those most likely to have high blood pressure
Results of the more than 100,000 blood pressure tests it has carried out since 2003 show that 70 per cent of all adults are in the unhealthy range.
Leslie Hamilton, a consultant cardiac surgeon at the Freeman Hospital in Newcastle, said: 'These figures are a real concern and a stark reminder that high blood pressure is a major issue in the UK.
 
'The number of people suffering from high blood pressure is increasing and the age at which people develop it is getting ever younger.
'In my job as a heart surgeon, I see the effects of high blood pressure and heart disease every day.
'High blood pressure can lead to debilitating strokes and fatal heart attacks.
'Many people put their heart problems down to genetics, but your blood pressure is one area that you can control with lifestyle changes and medicine.
'It can be caused by smoking, salty diets, being overweight, not taking enough exercise, high cholesterol and diabetes.
Exercising is seen as a good way to combat the increase in blood pressure levels
Exercising is seen as a good way to combat the increase in blood pressure levels
'Although less people now smoke, modern lifestyles mean people are eating more high-salt junk food and doing less exercise.
'By making positive changes, people can help combat high blood pressure.
'However, the condition is known as the silent killer because people do not report any symptoms and it is only detectable by measurement.'
Blood pressure is reported as two numbers - the first when the heart is contracting, known as the systolic pressure, and the second when the heart is releasing, known as the diastolic pressure.
It is measured in millimetres of mercury, or mmHg.
Shafeeque Mohammed, heart health expert at LloydsPharmacy, said a blood pressure of 120/80 was good.
He added: 'Anybody with a blood pressure of more than 140/90 should be concerned and needs to make lifestyle changes.
'Modern lifestyles are largely to blame for the upward trend in people suffering from high blood pressure.
'Many people have sedentary jobs, work long hours and leave little time to eat healthily or take exercise.
'However, it is important people are educated to the risks so they can do something about it.
'If nothing is done, it could become a massive burden on the NHS, especially with an ageing population.'

Want to avoid an op? Then follow our simple tips to keep swivelling those hips

Want to avoid an op? Then follow our simple tips to keep swivelling those hips




Every year around 73,000 Britons undergo a hip replacement. In most cases, this is because the cartilage — which cushions the hip joint — has worn away through wear and tear.
More than half those aged over 50 will have some degree of this damage. Many will resort to non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, but taken long term, these carry a risk of gastric bleeding and ulcers — they may also increase the risk of heart disease.
‘Our aim is to help people maintain joint function and keep them away from surgery for as long as possible,’ says Dr Rod Hughes, a rheumatologist at the Ashford and St Peter’s Trust in Surrey. ‘But we also want to encourage patients not to take strong conventional painkillers for long periods.’
King of the swingers: Follow our tips and you could be moving your hips like Elvis
King of the swingers: Follow our tips and you could be moving your hips like Elvis
So are there any alternatives? One hope is that the patient’s own stem cells — which have the capacity to turn into different cells in the body — could soon be used to regenerate cartilage in the joints.
 
Human trials are already under way at the new £6 million Arthritis Research UK Tissue Engineering Centre at Newcastle University.
In the meantime, what else can you do to tackle hip pain — and try to postpone the need for an op? We asked the experts . . .

SHELLFISH

One of the most popular remedies for joint health is glucosamine, a dietary supplement usually derived from mussel shells.
Glucosamine is often combined with chondroitin, a substance found naturally in cartilage, but manufactured from animal sources such as bovine cartilage.
Laboratory studies have shown that it nourishes cells — the theory is this helps preserve cartilage in the body. Glucosamine is also thought to act as an anti-inflammatory. Vegetarian varieties are available for those allergic to shellfish.
DOES IT WORK? In a study reported in the New England Journal in 2002, glucosamine was shown to reduce the speed at which damage to knee joints develops.
The six-month trial involved patients taking 1,500 mg daily, and this was found to be more successful in reducing arthritic pain in knee joints than a placebo or paracetamol.
Another more recent U.S. trial found that it helped reduce pain in some patients with severe arthritis, but made no difference to those with mild to moderate arthritis. Then in 2010 a review of studies on hip and knee arthritis found glucosamine made no difference.
EXPERT COMMENT: ‘Anecdotal support for its benefits is strong,’ says Dr Hughes. ‘The trouble is that glucosamine supplements are less predictable than conventional medicines, but they could play a role in a balanced programme of treatment that also includes weight-loss and exercise.’
New lease of life: Glucosamine could have you back on your feet if supplements are combined with exercise
New lease of life: Glucosamine could have you back on your feet if supplements are combined with exercise

COLLAGEN

Collagen is the most common protein found in our bodies and it is the loss of this with age that leads to wrinkles. However evidence is emerging to show it helps keep our connective tissue flexible, enabling our bones and cartilage to bear weight.
DOES IT WORK? Taking collagen hydrolysate (a form of collagen supplement) appears to slow collagen loss, according to some studies. A German review of 16 studies involving 2,000 people with osteoarthritis of the hip and knee found that taking collagen hydrolysate a day for at least three months reduces pain and improves mobility.
EXPERT COMMENT: ‘There’s evidence from a small number of studies that taking collagen hydrolysate orally can slow down the progression of osteoarthritis,’ says Professor Greg Whyte, a physiologist from the School of Sports Sciences at Liverpool John Moores University and also an adviser to the British Olympic team. He recommends collagen hydrolysate capsules to athletes in his care.

JOINT INJECTIONS

Shock absorber: Hyaluronic acid, which is found naturally in joint fluid, can be injected to treat joint pain
Shock absorber: Hyaluronic acid, which is found naturally in joint fluid, can be injected to treat joint pain
Hyaluronic acid, which is found naturally in joint fluid, is increasingly used to treat joint pain. A synthetic form is injected into the joint to lubricate and act as a shock absorber. Doctors believe in osteoarthritis, the molecules of hyaluronic acid become smaller and their concentration is reduced.
Injecting it into the joint replaces what has been lost and helps slow the progression of the disease. The jabs need repeating every six to 12 months.
DOES IT WORK? After examining 76 trials of varied size and quality, the respected Cochrane Collaboration, based in Oxford, supported its use in the treatment of knee osteoarthritis. Pain relief comes on slowly but can, in some cases, last up to six months.
Although the Government’s health watchdog the National Institute for Health and Clinical Excellence (NICE) has found the injections have a small beneficial effect in treating osteoarthritis, from a cost-effectiveness point of view the efficacy of the injections would have to be three to five times greater before it would recommend their use on the NHS. For this reason the injections are only available in the UK privately, costing around £200.
EXPERT COMMENT: ‘These injections may have a beneficial effect in early arthritis, but it isn’t clear yet whether they postpone the need for joint replacement,’ says Sudheer Karlakki, an orthopaedic surgeon at the Robert Jones and Agnes Hunt Orthopaedic Hospital.
He points out that injecting a hip joint ‘is more complex than injecting a knee because the joint is much deeper’. ‘You have to use X-ray or ultrasound to ensure the hyaluronic acid gets right into the joint.’
Dr Hughes adds: ‘These injections are in widespread use in private medicine and anecdotally they work well for some patients, but others are disappointed and, occasionally, the injections can cause flare-ups.’

ROSEHIPS

Encouraging results: Rosehips have been shown to reduce joint pain
Encouraging results: Rosehips have been shown to reduce joint pain in studies
The active compound found in some rosehips is thought to have an anti-inflammatory effect, helping to reduce joint pain.
DOES IT WORK? More than 80 per cent of participants in one study, reported in the Scandinavian Journal of Rheumatology in 2005, experienced pain relief in three weeks, and 40 per cent were able to cut the number of painkillers they were taking.
A more recent review, published in the journal Osteoarthritis and Cartilage, looked at three rosehip studies and concluded that the traditional remedy had a ‘small-to-moderate short-term effect’ in reducing pain in people suffering with osteoarthritis compared with a placebo.
EXPERT COMMENT: ‘The data, especially where knee pain is concerned, is very encouraging,’ says Dr Hughes. ‘As yet, there are no specific studies on hip pain but there’s no reason to suppose this extract will work any differently on that.’

HIP CLEAN-OUT

Hip arthroscopy is a form of keyhole surgery used to ‘smooth out’ the hip joint by trimming or removing loose cartilage or bone to reduce pain and delay the need for full joint replacement.
Knee arthroscopy has been used since the Seventies and is now one of the most commonly performed orthopaedic operations. Hip arthroscopy is a newer technique and fewer orthopaedic surgeons are performing it.
The technique is particularly helpful for those who suffer persistent groin pain as a result of hip impingement — also known as Femoro Acetabular Impingement.
This is caused by bony projections from the leg bone pinching the soft tissue in the joint and can go on to cause osteoarthritis.
The condition affects around one in ten adults and usually first strikes between the ages of 20 and 40.
Hip arthroscopy means patients can have minor repairs done before they go on to develop arthritis.
During a one-hour-long keyhole operation, done under general anaesthetic, the bony projections are cut away and the area around the socket is smoothed out.
DOES IT WORK? A study last year in the British Journal of Sports Medicine found that using hip arthroscopy to treat athletes with Femoro Acetabular Impingement helped protect the hip joint’s surfaces and reduced the risk of early osteoarthritis.
EXPERT COMMENT: ‘There’s evidence that this minimally invasive procedure may delay the need for patients to undergo hip replacement,’ says Mr Karlakki.

COD LIVER OIL

Daily dose: Osteoarthritis sufferers may benefit from taking cod liver oil
Daily dose: Osteoarthritis sufferers may benefit from taking cod liver oil
Fish oil has long been used as a natural treatment for arthritis. It’s now thought the omega-3 fats it contains could reduce the inflammation that causes pain and swelling.
DOES IT WORK? A study by Dundee University three years ago compared the effects of cod liver oil in 97 patients with rheumatoid arthritis who were already taking NSAIDs.
Forty-nine were also asked to take two teaspoons of cod liver oil daily. The remainder took a placebo. After nine months nearly 40 per cent of those taking cod liver oil were able to reduce their dosage of anti-inflammatory drugs by over 30 per cent.
Only ten per cent of those in the placebo group were able to do this.
EXPERT COMMENT: ‘Good-quality evidence to support the use of fish oils is scarce, and most studies have been on people with rheumatoid arthritis,’ says Dr Hughes. ‘But we believe osteoarthritis sufferers may also benefit from taking cod liver oil.’

Why full disclosure is healthy


Do British people know enough about the financial interests of those writing health articles? Time to toughen editorial codes
LAST year, the BBC News website published an article that questioned if psychological therapies were enough to tackle the rise of depression in the UK. "Is it time," asked the author, "to question our seeming obsession with talking treatments? I want to stand up for the very important role medication can play in the treatment of mental illness."
What stood out for me was not just the pro-pill stance, but an endnote that its author, Richard Gray, a professor in nursing research at the University of East Anglia, Norwich, had "given lectures on behalf of a number of pharmaceutical companies". It did not state he had been paid for them, or that he had received fees and honoraria from antidepressant manufacturers, including AstraZeneca and Eli Lilly, for consultancy work.
This kind of omission happens all the time, so why single out this case? Primarily because the site is run by the BBC, a global media corporation. And the thousands reading the article could not judge its impartiality because they did not know about the payments.
After trying to get a comment for some time, the BBC agreed to amend the endnote. But at medical journals such as The Lancet failure to disclose payments would have breached editorial codes. In the UK, we rely on codes, in the US, media outlets are legally obliged to declare potential vested interests.
Sophie Corlett of Mind, a UK mental health charity, thinks we should take this seriously. "People experiencing mental health problems look to professionals... for many, this includes information that filters through the media. The responsibility to inform readers of issues which may affect the impartiality of a published piece lies with... news outlets and contributing authors. Mind has long campaigned for medical information to be conveyed in an open and balanced manner... we encourage... disclosure of interests."
This is happening at a time when concern is mounting over industry influence on psychiatric research and practice, and on public opinion. Trials of antidepressants are mostly funded, and often analysed and directed, by pharmaceutical companies. Some 60 per cent of the task force behind DSM-IV (the psychiatrists' diagnostics handbook) received money from pharma, as have most research centres and many heads of psychiatry schools. Of the 29 experts writing DSM-5, 21 received honoraria, consultancy fees or funding from pharma.
The BBC defends its coverage: "It's common for the BBC to speak to people with expertise in a particular subject. We do so under clear editorial guidelines that contributors associated with a particular viewpoint or with a commercial interest in a subject should be clearly signposted... Nothing has been put to us which suggests that there has been any conflict of interest."
So the BBC aims to ensure articles are signposted. In this case one slipped through the net and was duly amended. But it must be more alert to contentious topics and conflicts of interest. Perhaps its code needs tightening - or we should consider a law.
James Davies is a senior lecturer in social anthropology and psychotherapy at the University of Roehampton, London