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Press releases Saturday 15 October 2005
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(1) BIG AND FAST GROWING INFANTS AT GREATER RISK OF LATER OBESITY
(2) KENNETH CLARKE’S TOBACCO INDUSTRY LINKS MAKE HIM UNFIT FOR PARTY LEADERSHIP
(3) IS COMPLEMENTARY MEDICINE COST EFFECTIVE?
(4) UK LIVER SERVICES NEED URGENT IMPROVEMENT
(5) BIOTECHNOLOGY HAS FAILED TO LIVE UP TO ITS PROMISES
(1) BIG AND FAST GROWING INFANTS AT GREATER RISK OF LATER OBESITY
Online First
(Being big or growing fast: systematic review of size and growth in
infancy and later obesity)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38586.411273.E0
Large infants, and those who grow rapidly during the first two years of life, are at increased risk of obesity in childhood and adulthood, a study published online by the BMJ today (14 October 2005) has found.
There is an urgent need to tackle rising levels of obesity in the population. However it is not clear how early in life prevention could begin. This study examines the relation between infant size and growth and later obesity.
Researchers analysed 24 studies which assessed the relation between infant size and growth and the development of obesity at any later age. They found that the heaviest infants, those with the highest body mass index, and those who gained weight rapidly during the first and second year of life, were more likely to be obese in childhood, adolescence, and early adulthood than other infants.
The authors believe that factors during or before infancy that are related to infant growth probably influence the risk of later obesity.
They suggest that future studies need to investigate what determines these patterns of growth, and to explore whether interventions to alter infant growth could be associated with other benefits or harms.
It will also be important to assess whether factors influencing infant growth are amenable to change, to establish which strategies might alter infant growth, and to find out whether these are acceptable to parents, they conclude.
Contact:
Dr Janis Baird, Research Fellow,
MRC Epidemiology Resource Centre, University of Southampton, Southampton
General Hospital, UK
Email: jb@mrc.soton.ac.uk
(2) KENNETH CLARKE’S TOBACCO INDUSTRY LINKS MAKE HIM UNFIT FOR PARTY LEADERSHIP
(Personal View: Why Kenneth
Clarke is unfit to be Tory leader)
http://bmj.com/cgi/content/full/331/7521/912
Prospective candidate for the Tory party leadership, Kenneth Clarke, is “unfit” for the role because of his continued connection with the tobacco industry, says a contributor to this week’s BMJ.
MP Kenneth Clarke, deputy chairman of British American Tobacco (BAT) which holds one sixth of the global tobacco market, has been a leading supporter of the industry for well over thirty years, says Mike Daube, a Professor of Health Policy and campaigner for tobacco control.
While he was minister for health in the eighties his Government was criticized for its “cosy relationship” with the tobacco industry, and Clarke was accused by the Observer newspaper of writing a letter “pressurising the Chairman of the government-funded Health Education Council ‘to soften its line on low tar cigarettes and actively to promote their use.’”
Throughout his ministerial career Clarke maintained contact with BAT and other tobacco companies, and accepted an invitation from tobacco giant Philip Morris to the Formula One Grand Prix saying at the time that he was “happily opposed to the advertising and sponsorship ban being proposed by the [European] Commission” and “I will certainly do my best to ensure that our Government maintains its opposition”.
Clarke is in no doubt about the dangers of smoking to health and has even acknowledged the “rather feeble attempts to dispute the scientific evidence”. Yet he “has been actively involved in BAT’s efforts to undermine the tobacco control work of organisations such as the World Health Organisation and the European Union”, says Professor Daube.
The herald of modern Conservative values Benjamin Disraeli wrote that “the first consideration of a minister should be the health of the people”, says Professor Daube. As deputy chairman of BAT, a company which “can already be credited with upwards of three quarters of a million deaths every year”, Kenneth Clarke is not fit for the office of party leader, he concludes.
Contact:
Mike Daube, Professor of Health
Policy, Curtin University of Technology, Perth, Western Australia
Email: m.daube@curtin.edu.au
(3) IS COMPLEMENTARY MEDICINE COST EFFECTIVE?
(Cost effectiveness of complementary
treatments in the United Kingdom: systematic review)
http://bmj.com/cgi/content/full/331/7521/880
BMJ Volume 331, pp 880-1
(Editorial: Complementary
therapies and the NHS)
http://bmj.com/cgi/content/full/331/7521/856
BMJ Volume 331, pp 856-7
More doubts are cast over the cost effectiveness of complementary medicine in this week’s BMJ.
The cost-effectiveness of using complementary treatments in the United Kingdom has been the subject of much speculation and controversy.
For instance, a report commissioned by the Prince of Wales last week said that complementary therapies should be given a greater role in the NHS, while others believe that more studies are needed before they are made widely available.
As an example of how poor the evidence is, researchers carried out a systematic review of cost effectiveness analyses of complementary treatments. They found only five studies done in the UK before April 2005, one of acupuncture for headache and four of spinal manipulation for back pain.
They conclude that these treatments represent an additional cost to usual care with questionable clinical benefit.
In an accompanying editorial, two senior doctors and general practice researchers suggest that complementary medicine should be considered for inclusion in national clinical guidelines despite limited evidence of cost effectiveness.
They believe that the integration into the NHS of specific complementary therapies for chronic conditions would be beneficial to patients, but that each therapy needs to be considered on its merits, including cost-effectiveness.
Contacts:
Paper: Peter Canter, Research Fellow,
or Edzard Ernst, Director of Complementary Medicine, Peninsula Medical School,
Universities of Exeter and Plymouth, UK
Email: peter.canter@pms.ac.uk
Editorial: Gene Feder, Professor
of Primary Care Research and Development, Queen Mary’s School of Medicine
and Dentistry, London, UK
Email: g.s.feder@qmul.ac.uk
(4) UK LIVER SERVICES NEED URGENT IMPROVEMENT
(Editorial: Services for
liver disease in the United Kingdom)
http://bmj.com/cgi/content/full/331/7521/858
Liver services in the United Kingdom need better funding and better staffing, argues a senior doctor in this week’s BMJ.
Mortality from liver disease is increasing in the UK. In 2000 liver disease killed more men than Parkinson’s disease and more women than cancer of the cervix. Deaths from alcoholic liver disease has doubled in the past 10 years, while liver disease arising from hepatitis C infection is expected to treble by 2020.
Evidence also suggests that the standard of care may vary widely from place to place.
But are there enough specialist staff and facilities in the UK to manage these projected increases in liver disease, or even the current workload, asks the author?
He conducted a survey on the staffing and facilities of liver centres at 28 English hospitals. Relatively few were able to provide a full range of liver services and there were serious shortages of staff at all levels.
Lack of dedicated beds was one of the most common problems, while waiting times for outpatient appointments were often unacceptable, with only seven hospitals able to offer an urgent appointment within two weeks. An earlier survey also showed the need for a substantial increase in consultant liver specialists (hepatologists).
Recent initiatives to improve teaching and specialist training are a step forward, says the author, but liver services need better funding as well as better staffing.
Increasing the number of transplant centres would be one way to provide liver services more widely in the United Kingdom, he suggests. At present, large areas of the country currently lack a transplant centre, and it was once estimated that a patient living in Cornwall was four times less likely to be referred for a liver transplant than someone in Leeds.
Clearly, specialised services for liver disease and transplantation will have to improve substantially to meet the considerably increased burden of liver disease that is predicted for the next 20 years, he concludes.
Contact:
Roger Williams, Director, The UCL
Institute of Hepatology, Royal Free & University College Medical School,
London, UK
Email: roger.williams@ucl.ac.uk
(5) BIOTECHNOLOGY HAS FAILED TO LIVE UP TO ITS PROMISES
(Disappointing biotech)
http://bmj.com/cgi/content/full/331/7521/895
Promises of cheaper and better drugs using biotechnologies have not been met, say researchers in this week’s BMJ.
They assessed biotech products approved by the European Medicine Evaluation Agency between 1995 and 2003.
Of 61 products licensed for therapeutic use, only 15 were for diseases without effective treatment, more effective than existing treatment, or active in patients resistant to current treatment.
A further 22 offered limited advantages over existing products, and 24 were copycat drugs, many of which have failed to offer new options for patients and provide no cost advantage, say the authors.
Furthermore, evaluation of these substances was not always based on rigorous methodological criteria, suggesting that commercial priorities come before the sound development of drugs in the interest of patients.
The promises of biotechnology substances to be more effective and less toxic than conventional drugs have been only partially fulfilled, they add. Many of the substances produced so far are analogues of existing drugs and have contributed little to innovation in medicine.
Nevertheless, biotechnology has made it possible to make available drugs that would otherwise be impossible to obtain in large amounts or research tools that are useful for discovering new drugs. “Let us hope that in future biotechnology will better live up to its promises.”
Contact:
Silvio Garattini, Director, Mario
Negri Institute for Pharmacological Research, Milan, Italy
Email: garattini@marionegri.it
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