Month: Feb 2025

Adapted from Which February 2025

Which recently surveyed their readers about their personal use of the Zoe app. As a reader, I contributed too, but was dissuaded from buying the App as I have wheat intolerance and irritable bowel syndrome, both of which make their food recommendations impractical. I was impressed with their integrity about this, as they could easily have taken my money, and then given me advice that wouldn’t have helped me.

Zoe is a self testing and nutrition plan, headed by Professor Tim Spector. Zoe has signed up more than 120,000 people so far. 241 Which members contributed to their survey about it.

67% said that they wanted to find out about their gut microbiome. 44% wanted dietary advice. 37% wanted to improve their health. 30% wanted to lose weight.

The top five changes that they made to their diets after using the app were:

They ate fewer carbohydrates, ate more protein, ate more nuts and seeds, ate more vegetables, and ate less red meat.

The response was generally very positive with most people getting out of the app what they wanted.

78% had a better idea of what to eat, 48% said their guts worked better, 42% said they felt healthier, and 41% had lost weight.

29% said it was good value for money. 46% said it was reasonable value for money and only 20% said it was poor value for money.

Subscriptions to Zoe costs between £400 for four months and £600 for a year.

When you join up, you have to eat various biscuits that they supply, and then send off faecal samples and blood samples. After this you get feedback on the variability of the bugs in your gut, and how well or not you handle fat and sugar in your body.

For the next stage, you log in all your meals, snacks and drinks. You are advised as to whether they are “green”- go ahead, “amber”- just now and then, or “red” -you really should avoid. One user was advised to eat more avocado, green lentils and olive oil, and to avoid canned chicken soup, rice, white bread and ice cream. She was also advised to add wholegrains, vegetables, nuts and seeds. Reading this, I could understand why I had been advised not to purchase it.

The app contains tutorials, information, recipes, and support groups. To increase meal “scores” you generally need to eat more plant food, less refined carbs, sugar, processed meat and processed food. Such advice is common to many healthy diets, so whether it is truly individualised, is difficult to ascertain.

Although the Zoe app also measures blood sugars, for most people who are not diabetic, this becomes unnecessary, when sugars and starches are restricted, as these are the culprits when it comes to blood sugar spikes.

In general, users are advised to increase the range of plant foods that they eat, such as lentils, pulses, legumes, nuts, wholegrains and seeds. Reduce ultra processed foods. Include fermented foods such as kefir, kimchi, kombucha, cheese, yoghurt, coffee and some teas.

Finally they also advise lifestyle improvements such as being active, managing stress, get enough sleep, and look after your mental health.

Adapted from BMJ 11-18 Jan 2025

Dementia is perhaps the disease we all most dread. It kills you slowly and gradually. You stop being able to learn new things, you forget a lot of your past and relationships, and your personality changes along with your physical abilities.

Bruck CC et al, searched for longitudinal studies on survival and admission to nursing homes, in people who had been diagnosed with dementia. Studies had to include at least 150 people and follow them up for at least a year.

Median survival from diagnosis seemed strongly dependent on age, ranging from 8.9 years, mean age 60 in women to 2.2 years at a mean age 85 for men.

Overall, women survived for fewer years than men, but this was due to them being diagnosed at later ages than men. The mean difference between the sexes was 4.1 years.

Median survival was 1.2 – 1.4 years longer in Asia, than in the US or Europe. My comment: I wonder if this is due to the tendency for older people to be looked after in extended families there.

Survival time with Alzheimer’s disease was 1.4 years longer than with other types of dementia.

One the whole, survival tends to be longer now than it was pre-2000.

The median time to nursing home admission was 3.3 years. 13% of people were admitted in the first year after diagnosis, increasing to 57% after five years. About a third of the time of remaining life expectancy was spent in a nursing home.

These figures are averages, and are potentially helpful when it comes to health and social care planning for governments, health boards and councils. The individual prognosis, however, is highly dependent on personal and clinical characteristics, offering potential for individualised prognostic information and care planning.

My comment: In my work as a GP, I often was consulted by worried relatives about suspected dementia. I would assess the patient, and particularly if I knew the patient well, I could be pretty sure that there had been a definite cognitive deficit, and I would refer to the memory clinic. More often than not, the patient would come back with no diagnosis. 18 months to two years later, I would refer again, and this time the dementia diagnosis would be made. It seems to me that the tests used for diagnosis are not that accurate in getting a diagnosis in the early stages. Dementia symptoms can have a lot in common with other problems such as depression. At the same time, there are still no good treatments for it. There has been a little success with ketogenic diets and ketone supplementation. Meanwhile, what tends to be good for your blood vessels, tends to be good for your brain.

Adapted from BMJ 7 Dec 2024

If given the choice, you will not experience more immunisation side effects if you decide to get a covid-19 vaccine at the same time as a flu shot.

Three hundred people were randomised to receive either vaccine plus a placebo injection or to have both together. The placebo or real vaccine was then given two weeks later. (That was very sporting of the participants!)

Adverse reactions were reported by a quarter of participants but were not more likely when vaccines were administered together or separated by two weeks.

My comment: In my health board area, the vaccines are offered together, probably to improve uptake. I was able to have them both in the same, non- dominant arm. I was given the option of different arms.