Which: Best tinned fish for omega-3

Oct 15, 2026Jun 9, 2026 kaitiscotland1 Comment

*Photo by Karen Lau00e5rk Boshoff on Pexels.com*

Adapted from Which Magazine June 2026

Tinned fish is a simple, affordable way to boost your intake of high quality protein and nutrients including vitamin D and B12. Oily fish are also high in omega-3 fats which are essential for heart, immune and lung health.

Mackerel, sardines, and salmon are the top three fish for dietary omega-3s. From 80 tins of fish, Which researchers found that the best sources seem to be mackerel, then sardines, then salmon. It should be noted that mackerel is being overfished.

Fish in tomato sauce or spring water are lower in calories and salt than those in sunflower oil or brine. Richly sauced options such as sweet chilli flavour, were found to have high amounts of added sugar and salt.

Eating “with bone” varieties give more calcium. Smaller fish species such as sardines naturally accumulate less mercury than bigger fish like tuna.

The UK government recommend at least two portions (140g) of fish a week, one of which should be oily. The NHS advises that girls and women planning a pregnancy should not eat more than two portions of oily fish a week. Everyone else can have up to four portions of oily fish a week.

Which’s top picks are:

Mackerel: Sainsbury’s Taste the Difference smoked Scottish mackerel with black pepper. This contains 4,700mg of omega-3 per 100g and costs £3.20 for a 110g tin.

Sardines: Fish4ever sardines in organic piri piri sauce contains 4,200g per 100g and costs £3.35 for a 120g tin from Ocado.

Salmon: Marks and Spencer’s wild Alaskan red salmon contains 2,000mg of omega-3 per 100g. This costs £.3.65 for a 213g tin and Sainsbury’s wild pacific red salmon contains the same omega-3 and costs £3.50 for a 212g tin.

Preventing cognitive decline as you age.

Oct 9, 2026Jun 7, 2026 kaitiscotlandLeave a comment

Adapted from BMJ 2-9 May 2026

A Japanese study has linked home cooked meals to a reduced risk of dementia.

Among 11,000 adults over the age of 50, those who prepared meals at least once a week were a third less likely to be diagnosed with dementia over six years of follow up. Whether cooking itself is protective or simply indicates a more active and independent life is hard to say. Perhaps those who cook are less dependent on highly processed foods?

Several studies have shown that exposure to green space improves well being, but a randomised study from Zurich, Switzerland, indicates that this is dependent on getting away from traffic noise as well as getting out into a green environment.

Financial insecurity has long term consequences for higher mental function. In a US longitudinal study of more than 7,500 adults aged over 50 years, worsening material circumstances were linked to poorer memory and faster cognitive decline. The associations were strongest in older participants and in those whose circumstances had deteriorated the most.

Grip strength also reflects mental health. In a cross sectional study of more than 500 participants, people who had schizophrenia or depression had lower grip strength than healthy controls.

Strength was lowest in those who had current or past depression and did not fully recover with remission. In schizophrenia, weaker grip correlated with negative symptoms. The researchers think that reduced physical strength may be a marker for impaired motivation and motor function.

Although physical inactivity, hypertension and hyperlipidaemia are well established as risk factors for cognitive decline, a multicentre randomised controlled trial of more than 500 older adults failed to show that dealing with them made much difference.

Neither a programme of aerobic exercise, intensive pharmacological lowering of blood pressure and LDL cholesterol, nor a combination of both interventions, improved global function over 24 months.

My comments: So what can we make of all this? Make healthy home cooked food several times a week. Maybe ask your friends round to share it, and vice versa. Get out for walks in green spaces and say away from the noise and pollution of cars and roads if you possibly can. It will benefit you more. Keep active and balance your walks with strength training. Keep your blood pressure under control, but you don’t need to go great lengths to have the blood pressure of a teenager. And don’t worry too much about your LDL. Low triglycerides and high HDL are much better markers of lipid health and can be achieved by a low carb diet that includes naturally saturated fat.

How much money you have as you age depends on many factors. Did your family have money? What lessons in finance were passed down or learned by you? What was your job and your spouses job? What economic situations have occurred during your lifetime? What are your spending habits? Have you invested carefully? All these things build up over time, and I would say that what you do when you are young to improve your situation is going to matter the most long term. If you are getting on in age, are you getting all of the benefits that you are entitled to?

There are many resources that can help you to manage your money optimally for your circumstances and needs, plan meals, cook, walk and exercise, and particularly if you are young, getting into good habits and sticking with them will reap great rewards later on.

Adoption into loving homes improves life for the children and their offspring.

Oct 3, 2026May 24, 2026 kaitiscotlandLeave a comment

Adapted from BMJ 2-9 May 2026

If a child from parents who have psychiatric or behavioural problems is adopted into a favourable home environment, this has lasting benefits for that child, but also for the children of that child.

Researchers in Sweden used national registers to compare full siblings and half maternal siblings born between 1950 and 1980 who were adopted before the age of ten, compared with their biological siblings who were not adopted. The children of these children were also compared. The outcomes included psychiatric, social, educational, cognitive and non-cognitive measures.

Adopted children showed a lower risk of psychiatric disorders: 29.8% compared to 36.1%.

Fewer criminal convictions: 26.1% compared to 34%

Fewer social welfare recipients: 37.8% compared to 48.5%

Higher mean intelligence scores: 4.5 compared to 3.8

Better cognitive skills scores: 4.8 compared to 3.9.

More likely to attend university: 26% compared to 15.2%.

The measures between the future offspring were less marked but still showed some improvement with higher psychosocial functioning. Regarding psychiatric disorders the figures were 29.6% compared to 32.3%.

The early environment in early life plays a central role in shaping health, educational, and labour market outcomes over the life course. Disadvantaged children who suffer from poverty, poor neighbourhoods, and who don’t get good nursery or maternal care have worse outcomes in adulthood.

Sweden has a particularly good social welfare system so results could be different in other countries. The results do seem to indicate that if a child’s environment can become more stable, and adequate resources and support are given to caregivers, the child’s outcome should improve.

My comments: I wondered how these figures compared with “normal families”. I asked ChatGTP.

Around 25% of working age adults have some form of criminal conviction. This includes minor offences such as motoring offences or not having a television licence. When these are excluded the figures are 25% of men and 10% of women have some sort of conviction.

In the UK 22-23% of adults of working age get some sort of disability or health related support, get benefits due to low income, receive housing assistance or are carers. 10% of UK adults get some sort of health support.

About 50% of UK adults go to university. 40% go immediately after school and the rest go later. More women go than men. 42-46% of working age adults have a higher education qualification such as degrees, HNDs or nursing qualifications.

These figures tend to indicate that children adopted from difficult home circumstances still don’t do as well as “average” children, although the UK is a different country and the times periods are not directly comparable.

Anti-amyloid drugs don’t improve memory in Alzheimer’s patients.

Sep 27, 2026May 23, 2026 kaitiscotlandLeave a comment

*Photo by Mehmet Turgut Kirkgoz on Pexels.com*

Adapted from BMJ 2-9 May 2026

Unfortunately a Cochrane study has revealed that new drugs for dementia that target amyloid protein in the brain, just don’t make a clinical difference to the patient.

Although amyloid beta protein accumulates in the brain in Alzheimer’s dementia, and the drugs do help to clear this up, there is no significant difference to the mental functioning of the patients. In addition the drugs increase the risk of swelling and bleeding in the brain. The findings were reported by Francesco Nonino the lead author, who is a lead author, neurologist and epidemiologist.

The review examined 17 randomised controlled trials, involving 20,342 participants aged 70-74 with mild cognitive impairment or mild dementia from Alzheimer’s disease. Seven different monoclonal antibody drugs were tested and the outcomes assessed against placebo. The drugs all have different mechanisms of action. The studies lasted 18-24+ months. Two of the drugs, donanemab and lecanemab are licenced in the UK.

Disappointingly, there was no difference in cognitive function between the groups. There were small increases in brain swelling and bleeding, but no other side effects.

As as result there could be changes in the prescription guidance of these drugs, particularly as they are very expensive. They can cost up to £32,600 for each patient in the USA per year.

The authors recommend that other pathways be looked at for the development of new drugs and that the amyloid hypothesis be put to rest.

My comment: These drugs, particularly Donezepil, have been prescribed for quite a few years. I did see one man who had a great response to the drug. He was being cared for by his wife. He would hide under the bed thinking that he was back in the war and under attack. He got the drug and his response was fantastic. He was so good that he became her carer when she got dementia. Unfortunately he was the only patient from whom there was any noticeable change when I was a GP. In the UK the drug is only £18-30 per patient per year. I would imagine that a three month trial of the drug may be reasonable and if there is no clinical response it could be stopped. Money would be better spent on social and nursing care. No doubt clinical guidelines will be changed after this important study. Already there are calls to delay the onset of Alzheimer’s and other dementias by recommending population approaches such as measures to prevent obesity, increase exercise, decrease smoking, improve sight and hearing, and encourage social meetings and lifelong learning. If you have diabetes, good control will also reduce your risk.

Public toilets are becoming hard to find in the UK

Sep 21, 2026May 22, 2026 kaitiscotlandLeave a comment

*Photo by Jan van der Wolf on Pexels.com*

Adapted from BMJ 2-9 May 2026

The number of public toilets in England has fallen by 14% in a decade. There are now 15,481 people for each public toilet in England. Let’s hope they all don’t want to go at the same time!

In Scotland the level is 8,500 people per toilet and in Wales it is 6,748.

The shortage is causing people to have to urinate in public, according to the Royal Society of Public Health (RSPH). They say, “Access to a public toilet can be the difference at to whether someone can comfortably leave their house. For others, they can only go out if they deliberately reduce fluid intake.”

Whether councils provide public toilets or not is discretionary. Their funding power has dropped by 26% since 2010 and this has affected spending on public toilets. My comment: In my own area there has been a noticeable drop in activities for young people, libraries, and community hubs for people of all ages matched by increased expenditure on home care for the elderly.

The RSHP wants adequate toilet facilities to be funded centrally. They also want developers to include public toilets when they build non-residential buildings. They say, “We need to give local authorities the resources they need to provide the facilities we all rely on.”

My comment: People who have diabetes or other disabilities can obtain a key to unlock public toilets under the RADAR scheme. These are big blue keys and they cost £7.50. You register for one of them online. Google RADAR. One problem is that there are not that many toilets that are available under the scheme. An App that helps is Where is Public Toilet. This covers most of the world. It’s best to look for available toilets before you leave your home or hotel. Most places that serve food and drink provide toilets and they may let you use their facilities if you pay them, even if you are not a customer.

Your genetic inheritance determines 50% of your life expectancy.

Sep 15, 2026May 20, 2026 kaitiscotland1 Comment

Adapted from BMJ 21-28 March 2026

Estimates of the genetic contribution to human lifespan have been surprisingly low and often show rates of 20% or less.

A re-analysis of Scandinavian twin cohort studies now puts this figure at 50%.

The reason for lower figures is that mortality rates are distorted by external causes that often have a familial effect such as infection, violence and other unintentional harms such as eg road traffic accidents or natural disasters or building collapses.

When these deaths are excluded the heritability of the intrinsic life span rises to around 50%.

This is similar to other complex traits such as body mass index, blood pressure and general cognitive ability.

My comments: Recently a friend who is adept at trawling ancestry sites discovered information about my family tree. There was a great deal of poverty and early death. I added up the ages of death of my parents and grandparents and divided the figure by six. According to this, my heritable life expectancy is 54.8 years. I’ve already lived 12 years longer than this. Here is a list of the ages and causes of death:

Women: Jeannie, my mother’s mother : Age 38 Lobular pneumonia and heart failure due to Pneumococcal Pneumonia – now has effective anti-biotics and vaccination. Ellen my mother: Age 46 Myocardial Infarction due to Ischaemic Heart Disease – now would have substantial chance of success after a stent operation and modern drugs. Sarah my father’s mother : Age 71 Heart Failure due to Pernicious Anaemia- now treatable with vitamin injections and drugs.

Men: Thomas, my father’s father: aged 29 Burns and Pneumonia due to Industrial Accident- chances of this very much reduced now with Health and Safety at Work Legislation. Robert, my mother’s father aged 66. Head injury due to fall from a height at work due to Industrial Accident – chances of this very much reduced due to Health and Safety at Work Legislation and practices around scaffolding. Tommy my father aged 79: Cardiac Failure due to Hypertension. Would still have died of this but modern drugs slow down the progression and he could possibly have added up to a further five years of life, though not without debility.

It’s better to try to lose weight and fail rather than not trying at all.

Sep 9, 2026May 19, 2026 kaitiscotlandLeave a comment

Adapted from The Lancet 19th May 2026

Is weight cycling clinically harmful?

Prof Faidon Magkos, PhD^a Send email to fma@nexs.ku.dk ∙ Prof Norbert Stefan, MD PhD^b,c,dAffiliations & NotesArticle Info

Publication History:

Published May 14, 2026

DOI: 10.1016/S2213-8587(26)00037-9 External LinkAlso available on ScienceDirect External Link

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Summary

Worldwide, approximately half of the general population is actively attempting to lose weight.

However, weight loss is typically followed by substantial weight regain, often leading to repeated cycles of loss and gain of bodyweight. Weight cycling has been suggested to be metabolically harmful, in that it could lead to greater rebounds in fat mass and smaller regains in lean (muscle) mass, thereby promoting sarcopenia, lowering metabolic rate, and exacerbating obesity and its metabolic complications (eg, glucose intolerance).

In this Personal view, we critically evaluate evidence from studies in humans and animals investigating whether weight cycling has adverse effects on bodyweight, body composition, energy metabolism, and metabolic function. We also briefly discuss potential strategies to mitigate weight regain and its consequences.

Overall, the current evidence does not support a causal link between weight cycling per se and clinical harm in people with obesity.

Most of the adverse effects reported are likely circumstantial, possibly because of ageing, unintentional weight loss, reverse causality, earlier onset of obesity, repeated obesogenic exposures, or longer cumulative exposure to obesity.

Available evidence suggests that the benefits of intermittent weight reduction—such as improved metabolic markers, cardiovascular health, and quality of life—outweigh the potential risks associated with weight fluctuation.

New hip joints should last your entire life thesedays

Sep 3, 2026May 16, 2026 kaitiscotlandLeave a comment

Adapted from BMJ 21-28 March 2026

I first heard about hip joint replacements while I was a child watching Michael Barratt on the news programme Nationwide in the late 1960s. There was a brand new operation that could change the lives of those who had hip joint arthritis or hip damage from falls.

In the 80’s, a major new development was a closed air system in the operating environment that reduced the infection risk.

In the 90’s and beyond, as a GP, I told people that they could expect a new hip to last 15 years, and that another hip joint replacement could be expected after that, but that it usually was never as long lasting as the first one. I urged them to keep their weight down and to retain as much mobility as possible to keep their muscle strength up.

Now, the great news, is that modern hip joints should last the user for the rest of their life. 93.6% of new hip joints last at least 20 years. 92.1% are expected to last 30 years or more.

As a general rule, because of the life expectancy of artificial hip joints, orthopaedic surgeons don’t want to replace the joint till a person is over the age of 60. Results of hip joint replacement aren’t as good in patients over the age of 75, mainly due to their lower muscle mass and strength.

For best results, eat sufficient protein, do your best to keep your weight at normal levels, and keep strength training to keep muscle mass up. This gives your hips the best chance of getting the best results from a hip joint operation.

Meanwhile, research on the best footwear to use after hip joint replacement shows no difference in pain whether you use a flat soled stiff shoe or a flexible shoe.

Endothelial damage drives vascular complications in Covid and other infections

Aug 28, 2026May 15, 2026 kaitiscotlandLeave a comment

Adapted from BMJ 2-9 May (Professor Kumar Raina) and 21-26 March (Katharine Lang, Journalist)

Many viral infections such as Covid and Influenza, Dengue Haemorrhagic Fever, and the onset of sepsis from any cause are associated with thrombotic complications.

Pathogen associated molecular patterns in the microbe activate pattern recognition receptors in the endothelial cells that line our blood vessels. This action triggers inflammatory cascades. Tight junctions between cells are weakened, coagulation is triggered and the glycocalyx is damaged. Whether viral proteins, bacterial lipopolysaccharides, or dengue NS1 protein, the blood vessels show the same type of damage.

Endothelial damage causes a diverse range of acute and chronic disease. Understanding this can help us understand the acute and long term effects of some infections.

Covid-19 infection started causing vascular complications such as myocardial infarction right from the onset at Wuhan. Later studies showed that 6% to 30% of patients admitted to hospital had myocardial injury. Although the virus enters the body from the respiratory system, it exerts its systemic effect via the vasculature affecting the lungs, heart, kidneys, and brain. There is damage to the small blood vessels, inflammation and clots, and perfusion of blood to the tissues is affected.

In the acute phase Covid-19 can cause myocarditis, myocardial infarction, and blood clots in the lungs. Those in the earliest wave were affected the most. The risk was equal to having prior coronary artery disease. In the first year after Covid you are more likely to experience stroke, heart rate irregularities, heart disease, peri-carditis, myocarditis and thromboembolism. Even having mild symptoms still increases the risk to some extent.

Hypertension, diabetes, obesity, old age, and pre-existing cardiovascular disease all magnify the risks of Covid infection. The severity of the initial infection matters too. Those admitted to hospital or intensive care units fare the worse.

Long covid is a complex multi-system disorder that can affect nearly every organ system and can be very disabling. In 2024 it affected 400 million people. Neurological, neuro-psychiatric and pulmonary symptoms are the most frequent problems. Then come the cardio-vascular problems.

One characteristic is dysautonomia (the autonomic nervous system doesn’t work correctly) and postural orthostatic tachycardia syndrome. Chest pain, palpitations, breathlessness and fainting are common problems. These are 1.6 times more likely in long covid sufferers compared to those without long covid. The initial severity of the infection, the higher the risk of cardiovascular complications.

Newer variants of Covid and infection in those already immunised don’t carry the same degree of risk compared to earlier waves of the infection. Some anti-viral drugs lessened the risk and others increased it. Vaccination is thought to be the best protection. Influenza vaccination also seems to protect against vascular complications. This is because the systemic inflammatory response is blunted when the person meets the infection.

Maintaining good blood pressure, good lipid control, and regular exercise are also protective.

UK Accident and Emergency Units in crisis

Aug 22, 2026May 14, 2026 kaitiscotlandLeave a comment

Adapted from BMJ 21-28 March 2026

Throughout the UK, Accident and Emergency Departments are in crisis.

A survey by the Royal College of Emergency Medicine was sent a survey to their members in March.

51% of the 80 respondents said that their department was fairly or very unsafe and 28% said that their department was very or fairly safe.

88% said that overcrowding was a daily occurrence. 96% said overcrowding happened several days a week.

Meanwhile in Scotland, Fiona Hunter, the Vice President of the Scottish branch of the Royal College of Emergency Medicine. In 2024 the college showed that 818 excess deaths occurred due to long waits in Accident and Emergency Departments.

The Scottish Liberal Democrats analysis reported that in 2025 there were 871 deaths associated with a wait of 12 hours or more for hospital admission in Accident and Emergency Departments.

My comments: A lot of A and E attendees are people who would be better served by Primary Care than A and E. General Practitioners are under strain, and have limited appointments in weekday and out of hours services by allocating fixed appointments, instead of absorbing the work regardless of ability to provide good care. This is a way of coping and I don’t blame them. The result however, is ever overflowing A and E departments. I know that some areas have GPs on site in hospitals to deal with some patients but this doesn’t happen everywhere.