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We’ve been warned repeatedly about the health perils of being out-of-sync with our body clocks. Are we eating in the right way for these circadian rhythms, and could changing our mealtime habits boost our health and help us lose weight?
‘Breakfast like a king’
What did you eat this morning for breakfast or lunch?
The chances are it wasn’t steak and chips, chickpea curry or anything else you might normally have for dinner.
Yet some scientists believe eating more of our daily calories earlier in the day – and shifting mealtimes earlier in general – could be good for our health.
One study found women who were trying to lose weight lost more when they had lunch earlier in the day, while another linked eating later breakfasts to having a higher body mass index.
“There’s already a very old saying, eat breakfast like a king, lunch like a prince and dinner like a pauper, and I think there’s some truth in that,” says Dr Gerda Pot, a visiting lecturer in nutritional sciences at King’s College London.
Now scientists are trying to find out more about what’s driving those results and are looking at the relationship between eating and our body clocks, dubbed “chrono-nutrition” by some, for answers.
When you eat
You may think of the body clock as being something that determines when we sleep.
But in fact there are clocks in virtually every cell in the body.
They help prime us for the day’s tasks, such as waking up in the morning, by regulating blood pressure, body temperature and hormone levels, among other things.
Experts are now looking at whether our eating habits – including irregular mealtimes and eating too late – are far from optimal for our internal rhythms.
Dr Pot, who studies chrono-nutrition, said: “We have a body clock that determines that every 24 hours each metabolic process has an optimal time when something should happen.
“That suggests that having a large meal in the evening is actually, metabolically speaking, not the right thing to do because your body is already winding down for the night.”
Dr Jonathan Johnston, reader in chronobiology and integrative physiology at the University of Surrey, said although studies suggest our bodies are less good at processing food in the evening it was not yet understood why this is.
One theory is that it’s linked to the body’s’ ability to expend energy.
“There’s a little bit of preliminary evidence to suggest that the energy you use to process a meal – you use more of it in the morning compared with if you eat in the evening.”
Properly understanding the link between when we eat and our health is important, Dr Johnston says, because it could have big implications for helping to tackle the obesity epidemic.
“If we can come up with advice to say, ‘Well actually you don’t necessarily have to change so much what you eat, but if you just change when you eat,’ that little subtle modification might in itself be a really important part of how people can improve health across society,” he says.
Beyond this, the timings of our meals could also have implications for people with disrupted body clocks, such as shift workers, who are estimated to make up about 20% of the workforce, Dr Johnston says.
Animal studies have shown that eating at certain times can help re-set circadian rhythms, and now research is looking at if this applies to people too.
In a study of 10 men, Dr Johnston found that delaying their mealtimes by five hours clearly shifted a biological marker of their body clocks.
While it was a small study, Dr Johnston said it suggested that eating at specific times could form part of a strategy to help people cope with a disrupted body clock, something that has been shown to be particularly harmful for health.
So should we all start eating earlier?
Experts say there are a lot of questions that need answering.
For example, what are the optimum times to eat and avoid food?
How is this affected by our own individual body clock types – be it morning lark, night owl or something in between?
And are there foods that are particularly bad to eat at certain times?
Both Dr Johnston and Dr Pot said the evidence suggested we should be consuming more of our calories earlier in the day, for example by making lunch the biggest meal.
However, Prof Alexandra Johnstone, a nutritionist who is now starting to study in the field of chrono-nutrition, is slightly more cautious.
She says that while there are studies showing that shifting our mealtimes earlier might boost our health, she’d like to see a clearer explanation of what’s causing this.
But she hopes forthcoming research can show this and lead to clear guidance for people around when to eat.
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Researchers say it is a warning to urban societies becoming less in tune with nature.
When David Ferran left school at the age of 17, he was encouraged to learn a trade and become a bricklayer or an electrician.
But that wasn’t for him. He went into nursing, bucking the trend in what is still a female-dominated profession.
David, who works in the dermatology department at the Royal Victoria Hospital, in Belfast, says: “I love the job – and think more men should consider it. But because of the stereotypes surrounding it, they don’t.
“People ask me, ‘Are you a doctor?’ Then when I say, ‘No, I’m a nurse,’ they say, ‘Do you want to become a doctor?’ I have to say, ‘No, this is what I want to do.’ Some people are surprised.
“There’s a gender imbalance – and that’s not good for patients.
“One day when I was on shift, there was an elderly man who clearly looked uncomfortable about the idea of a female nurse providing personal care.
“I was able to do it, but that is not the case always. There are not enough male nurses – only about one in 10 nurses are men.”
‘Male Florence Nightingale’
David has formed a group – Northern Ireland Men in Nursing – which will be going round schools to promote it as a career option for men.
He believes the media could play a role, citing the lack of male nurses in TV roles, with the exception of Charlie Fairhead in the BBC series Casualty.
David led a debate at the Royal College of Nursing’s annual conference in Belfast this week, in which members urged the union to help create male icons to rank alongside Florence Nightingale.
RCN general secretary Janet Davies agrees there is a need to get rid of the stereotyping that creates the perception that nursing is “women’s work”.
“It goes hand in hand with gender equality,” she says. “Men are taking on more of a caring role in society, but we are not seeing that in nursing yet.”
She too would like to see more male nurses appearing on TV. But she says the profession itself also needs to consider its role. And phrases such as “ward sister” and “matron” may be “out-dated”.
“That is something that should be debated. We also need to do more to promote careers in nursing to everyone. Nursing is an incredibly complex, skilled job.”
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A common cause of female infertility – polycystic ovary syndrome (PCOS) – may be due to a hormonal imbalance before birth, researchers have found.
Researchers have been able to cure it in mice, and a clinical trial in human women is due to begin later this year, the New Scientist reports.
PCOS affects up to one in five women worldwide, it says.
It affects how a woman’s ovaries work – symptoms include irregular periods and difficulty getting pregnant.
“It’s by far the most common hormonal condition affecting women of reproductive age, but it hasn’t received a lot of attention,” Robert Norman at the University of Adelaide in Australia told the New Scientist.
What is PCOS?
- irregular periods or no periods, which means ovaries don’t regularly release eggs
- difficulty getting pregnant
- excessive hair growth caused by excess testosterone
- weight gain
- oily skin and acne
More than half of the women affected don’t have any symptoms.
Researchers at the French National Institute of Health and Medical Research (Inserm) have found that the syndrome may be triggered before birth by excess exposure in the womb to a hormone called anti-Müllerian hormone (AMH).
They found pregnant women with PCOS have 30% higher levels of the hormone than normal.
As the syndrome is known to run in families, they wanted to test the idea that the imbalance in pregnancy might induce the same condition in daughters.
Read more about PCOS and infertility
They injected AMH into pregnant mice, and as the offsprings grew up, found that they had many PCOS symptoms, including infrequent ovulation and delays in falling pregnant.
The excess hormone seemed to overstimulate a set of brain cells that raises the level of testosterone.
After treatment with an IVF drug used to control women’s hormones, cetrorelix, the mice stopped showing PCOS symptoms.
“It could be an attractive strategy to restore ovulation and eventually increase the pregnancy rate in these women,” Paolo Giacobini, whose group conducted the research at Inserm, told the New Scientist.
A “vulnerable” bulimic woman suffered the “most distressing” death after taking a toxic slimming aid she bought online, a court heard.
Eloise Parry, 21, from Shrewsbury, died in April 2015 after taking eight diet pills containing Dinitrophenol (DNP).
Albert Huynh, 33, Bernard Rebelo, 30, and Mary Roberts, 32, all deny Miss Parry’s manslaughter.
Prosecutor Richard Barraclough QC told jurors taking the chemical is like “playing Russian roulette”.
Opening the case at Inner London Crown Court, he said “you might survive, you might not”.
Miss Parry, a student at Glyndwr University, Wrexham, started taking the chemical in pill form in February 2015, and soon became addicted.
It is alleged the group were operating from a flat in Harrow, north west London, and made the capsules which they sold online for considerable profits.
Jurors were told how the defendants bought the chemicals in drums from China and two of the defendants had consumed DNP themselves so knew of its dangers.
The defendants “cynically thwarted” authorities such as the Food Standards Agency and Interpol that tried to close down their operations, the court heard.
Describing DNP and its effects, Mr Barraclough said it was a “highly toxic substance when ingested, inhaled or absorbed through the skin”.
He added it causes weight loss by burning fat and carbohydrates, in turn causing energy to be converted into heat.
“The result is that that person’s temperature and metabolic rate all dangerously increase,” Mr Barraclough explained.
In the weeks before her death Miss Parry, who had a history of self-harming, was admitted to hospital numerous times, suffering from the effects of taking the chemical.
She sent desperate messages to her friends telling them she wanted to stop taking the pills but was “psychologically addicted” and knew that feeling her temperature rise meant her fat was burning, jurors heard.
Having driven herself to the Royal Shrewsbury Hospital after feeling unwell, she messaged a friend, saying: “I screwed up big time. Binged/purged all night and took four pills at 4am.
“I took another four when I woke and I started vomiting soon after. I think I am going to die.
“No one is known to survive if they vomit after taking DNP. I am so scared.”
Mr Huynh from Northolt, north-west London, Mr Rebelo and Ms Roberts, both from Gosport, deny two counts each of manslaughter, one count each of supplying an unsafe food, and Ms Roberts faces a single count of money laundering.
The trial continues.
Parents are turning to sleep clinics to help them deal with children who will not sleep through the night.
Lucy Williams suffers from a severe lack of sleep because her son, Carter, wakes up throughout the night.
The mum from Norwich says her inability to help him makes her feel like she is failing the six-month-old.
She plans to attend workshops at Sleep East to find out how to improve the situation.
An epidemic of a laboratory-created cannabis substitute in UK prisons is putting nurses called in to treat inmates at risk, union leaders say.
The Royal College of Nursing said it had members who had been left unwell after treating prisoners who had taken the illegal drug, known as “spice”.
One lost consciousness after inhaling the fumes and had to be taken to an accident and emergency unit.
And in some places 50 inmates were being treated each week, the RCN said.
It comes after a report last year by HM Inspectorate of Prisons raised concern over the widespread use of the drug.
It said inmates were sometimes not diluting it with tobacco, leading to serious medical emergencies.
Nurses and healthcare assistants are often the first on the scene when inmates need emergency care.
They are expected to enter cells before the smoke is clear.
But the union says NHS staff should be allowed to assess the danger of the situation before rushing in and called on the prison service to do more to combat the problem.
‘We’ve given care to 50 people in one week’
One nurse, speaking on condition of anonymity, said: “Recently we’ve had to give medical care to over 50 people in one week.
“Walking back after attending to a patient, I’ve sat in my car in the car park for 50 minutes after work so I feel confident enough to drive.”
RCN general secretary Janet Davies said: “Spice poses a serious threat to nurses, healthcare assistants and prison staff, whose safety and long-term health is being put at risk day in, day out.
“As dedicated health professionals, prison nursing staff are expected to offer high quality care, but they should not be expected to put their own wellbeing on the line to deliver it.
“I have heard some truly shocking stories of nursing staff passing out or being unable to drive after exposure to spice.”
A Prison Service spokesman said: “The best way to keep staff and inmates safe is to keep drugs out of our prisons.
“That is why we have trained more than 300 specialist drug dogs, introduced body scanners and intelligence-led searches and made it a criminal office to possess psychoactive substances in prison.”
Shelley Pearce could tell immediately that the patient she had been asked to care for didn’t like her.
The woman had been admitted to hospital as part of a detox programme.
“She wanted to leave and when I said no, she smashed a piece of plastic and put the sharp piece to my neck. It was terrifying.”
The patient marched Shelley to the lifts. It was only because she was able to press the alarm button in the lift that she was able to alert security.
The situation was defused, but it could have been so different.
“There are some horrendous stories and assaults that staff have had to endure,” says Shelley, who now works as an A&E nurse at a hospital in the south of England.
This was not the only time she has experienced a physical assault.
She says there have been particularly bad occasions, including being head-butted by a drug abuser, that made her question her future.
‘Not in a nightclub’
“I have thought about giving up nursing, but it is a job I love. I just don’t think we should live in fear and under the threat of assault.
“It happens on a daily basis. Sometimes it is just aggression, but it is the sort of thing that would never be tolerated in a nightclub.
“The police would be called and the person would be ejected.”
The situation has got so bad – more than 70,000 NHS staff are assaulted every year – that the nursing profession has even started to consider asking staff to wear body cameras, as police and fire crews do.
The issue was debated at the Royal College of Nursing’s annual conference in Belfast this week.
Stabbed, stalked, gouged
It was proposed by Sarah Seeley, a nurse from Ipswich. She says some places have started trialling it and it has led to a reduction in assaults.
“We need a robust deterrent. Nurses have been stabbed, stalked and even had their eyes gouged.
“Wearing body cameras might make people feel safer and de-escalate situations. Of course, there is a cost, but it is worth considering.”
Would that have helped Shelley? She’s not convinced.
“I can’t see it working and the risk is that it will destroy the patient relationship,” she said.
“We just need proper support so we can raise the alarm and get help from security when we are concerned and good training in how to defuse these situations.
“We have mental health patients coming into hospital in crisis, we have drunk patients and those with head injuries – and some people are just not very nice.
“Nurses need protecting.”
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