Adapted from Westergaard et al Cephalalgia 23 June 2021
People with a history of chronic headache are significantly more likely to have poor social support and loneliness than those without a headache history.
Other chronic illnesses, mental illness and indeed death, are also more common when a person lacks social relationships.
This study was undertaken in Denmark in over 55 thousand people.
2.7% of people reported chronic headache and in 66% of these medication over use was a major factor. Poor social support was cited by 20 % of the participants who did not have chronic headache and in almost 37% of those who did.
Loneliness was reported by almost 8% of the people without headache and in almost 24% of those who did have chronic headache.
Stress was reported by 24% of those with no headache and in almost 61% of those who did.
The researchers did not differentiate between different headache diagnoses such as migraine and tension headaches.
My comment: As a GP, I was surprised that only 2.7% of the population said they had chronic headache, because it feels like a lot more in the surgery. It is a very common presentation to GPs. I can understand why poor social support could make stress more difficult to bear and produce headaches, and I can also see that people with headaches may want to limit social interaction. What doctors don’t tend to do is to look at improving social interaction as a means of ameliorating headache in patients.
Adapted from Zhang Y et al. Frontiers of Cardiovascular Medicine 1 Jan 2021
Just under two hundred thousand participants in the UK Biobank with data on birth weight were studied. Researchers looked at the correlation between birth weight and hypertension as adults. They also looked at the patients’ obesity indexes.
They found that the lower a baby’s birth weight, the higher the risk for hypertension as an adult. The highest risk was for babies under 2.88kg which is 6 pounds 2 oz.
When it came to adult obesity and hypertension risk, those with a BMI of over 30 were at the highest risk.
This is a lot of babies and adults!
They think that a birth weight of between 3.43 kg and 3.80 kg is the most healthy. This is between 7lbs 5 oz and 8 lbs 4 oz.
We can’t really choose our birthweight, but we can do something about our weight as adults, so you will be pleased to see that adult BMI was a lot more influential in producing hypertension than low birth weight.
My comment: I was only 2 pounds 3 oz when I was born, so I was very pleased to make it past babyhood at all. The association between low birth weight and hypertension and metabolic syndrome in adulthood has been studied for many years. Factors that make the baby more likely to survive placental failure unfortunately programme the body to respond less favourably in adulthood.
Adapted from Human Givens No 1 2020 BMC Psychiatry 2020
The less physical exercise students take, the more likely they are to suffer from mental ill health, and think about or attempt suicide, according to a Norwegian study.
Researchers questioned over fifty thousand students to assess frequency, intensity and duration of physical exercise and self reported depression, suicide and self harm. Low frequency, low intensity of exercise and low duration of exercise all had a significant role.
My comment: Lockdown and online classes will have exacerbated these risk factors. Home exercise, VR exercise, online exercise, You tube classes, and getting out to run, walk, take out neighbour’s dogs will all help.
Adapted from Chemotherapy induced cognitive impairment from the forensic medicine perspective: A review of the updated literature. Stefania Turrina et al. Journal of Forensic and Legal Medicine Nov 2020
Chemotherapy treatments for cancer may cause physical weakness due to changes in ability to think clearly and precisely, think and react speedily and may thus impair daily life activities, working memory, and organisational ability.
Chemotherapy induced brain fog has been recognised since the late 1980s, but the neurobiological reasons for it are still poorly understood.
Research has shown that certain drugs are more likely to cause it including: doxorubicin, cyclophosphamide, cytarabine, methotrexate, 5-fluorouracil and cisplatin. The drugs affect the central nervous system causing both physical weakness and mental confusion. The duration can be long or short. 35% of patients have an extended period of brain impairment. This can affect the validity of such legal issues as any will that is changed or undertaken during this period of time.
The sorts of impairments described are similar to those experienced with fibromyalgia and chronic fatigue syndrome.
Older patients seem to be more at risk of post chemo cognitive impairment compared to younger patients. If oestrogen and testosterone are depleted as well, such as with breast and prostate cancer treatments, the mental impairment is worse. Ongoing anxiety and depression also worsen the condition. Previous cancer treatments also have been shown to worsen mental impairment. It is not unusual for patients to have more than one cancer successfully treated. My comment: I had one very fit woman patient in her sixties who had been cured of five different unrelated tumours. As some of the treatments cause brain impairment but don’t cross the blood brain barrier it is thought that peripheral inflammatory cytokines have a role to play as well as other mechanisms.
Studies have found that in colon cancer, the brain impairment starts with the onset of the disease process, is worsened by chemotherapy and is worse the longer the treatment continues. The working memory, verbal learning and speed of information processing are all affected. As with other cancer patients these can go on to affect educational attainment and the ability to do certain jobs. Many countries classify cancer patients as having a disability for which reasonable adjustments need to be taken by the employer.
Legal contracts entered into by someone suffering from brain impairment due to cancer or cancer treatment may not be considered valid. It is up to a person who contests the validity of the agreement or contract to prove that the person was so impaired that they did not understand the implications of what their decision was. Certain age based factors such as appearing a little confused and disoriented cannot be considered symptomatic of testamentary inability, so the burden of proof is with the person contesting the contract.
My comment: We never know what is in front of us, so regular review of Power of Attorney, your will, and financial planning when you are healthy will make it easier for you and your relatives should you or your family be affected by cancer in the future.
Advertisements for unhealthy food and drink will be banned before the 9pm watershed by the end of 2022 in television and on demand programmes in the UK.
Chris Thomas, a research fellow at the Institute for Public Policy would have liked to have seen measures going further, by taxation of these foods. He says that money raised could be used to fund free nutritious food for those who need it. This improves both health and the economy.
In the USA, children get two thirds of their energy intake from ultra processed foods. The proportion of calories from such food is rising steadily. In 1999 it was 61.4% and in 2018 it was 67%. As the amount of wholesome, home cooked food reduces, the levels of childhood obesity increase. Ready meals are responsible for 11.2%, and sweet snacks 12.9%. The trend is now reducing for sugary drinks, sauces and oils.
Diabetes Diet 