More physical activity is needed in high income countries

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Adapted from BMJ 4-11 April 2026

A new study in Nature Medicine indicates that when it comes to physical activity, more people achieve physical activity targets through the nature of their work or from their usual mode of travel or commuting. The World Health Organisation population household survey also noted that there were large discrepancies in overall physical activity between genders and nations. The most sedentary were wealthy men in high income countries, and the most active were women in low income countries.

More than 80% of the population in low income countries meet WHO physical activity guidelines. Just over 60% of people in high income countries make this target. Only 40% of wealthy men in high income countries manage this.

About 70% of the population meet this target just from the work they do in low income countries. 40% of the population in high income countries manage adequate activity from work alone. (My comment: not too shabby!)

Just over 60% of the population meet physical activity goals during transport such as walking or biking in low income countries. This fell to 20% in high income countries.

About 7% of the population in low income countries had active leisure pursuits compared with about 25% of the population in high income countries.

Medium income countries performed in between the high and low income countries on all measured outcomes.

My comment: What does this tell us? I think this tells us that what you have to do almost every day regarding physical activity, matters more than what you can do now and again. If you have an active job and an active commute, great for you. You probably don’t need to be a gym bunny, or member of a sports club. or go hillwalking at weekends, and ski in the winter unless you want to. But 60% of us in high income countries don’t have active jobs. (I was surprised it wasn’t higher than this.) 80% of us drive or get to work by other means than our feet or bikes. Only 25% of us bother with active leisure pursuits. Maybe it would be easier overall if we did get more routinised physical activity in every day by getting off a stop earlier, parking further away, or going for a walk at lunch time or after work. Meanwhile governments and councils could do more to make walking or biking safer and more available to the working population.

Which: Best tinned fish for omega-3

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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.

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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.

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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.

Your genetic inheritance determines 50% of your life expectancy.

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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.

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Adapted from The Lancet 19th May 2026

Is weight cycling clinically harmful?

Prof Faidon Magkos, PhDa Send email to fma@nexs.ku.dk ∙ Prof Norbert Stefan, MD PhDb,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

Copyright: © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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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.

UK Accident and Emergency Units in crisis

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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.

More people than ever are surviving cancer

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Adapted from BMJ 21-28 March 2026

Cancer death rates in the UK are their lowest level on record.

This level peaked in 1989 and is now 29%. About 250 in every 100,000 die from cancer each year. This is 11% lower than ten years ago.

Cervical cancer has shown the greatest fall in death rates. Deaths have fallen 75% in the last 50 years. Much of this is due to cervical screening programmes. The progress is likely to continue as there has been a great impact in cervical cancer prevention since the vaccination programme against HPV started in 2008.

New medication for hot flushes

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Adapted from BMJ 21-28 March 2026

NICE has approved an important new pill for menopausal flushes. It is non-hormonal and can be taken by women who can’t take oestrogen based HRT products. This usually means women who have had a previous diagnosis of breast cancer or a high risk of getting it.

The drug is called Fezolinetant and will be marketed under the name of Veoza by Astellas Pharma. It can be used for moderate to severe flushes and sweats and 45 mg is taken once daily.

It is a neurokinin 3 receptor antagonist that blocks nerve pathways in the brain that trigger vasomotor symptoms.

My comment: This is a breakthrough drug which will help a lot of women who have previously been unable to get effective treatment. Because it is non-hormonal, it will treat symptoms, but there won’t be the other bone and vascular protection afforded by oestrogen based HRT. After other surgeries eg for hysterectomy and oophorectomy in a case of endometriosis, the patient is put into an immediate menopausal state, but can’t take oestrogen HRT because it can make the endometriosis grow again. I’m delighted that this drug is now available.

I was asked a question by a reader who wondered if she was suitable for this drug as she was 73 years old. The answer is that I don’t know. This would depend on the licensing indications for the drug and whether local prescribing committees have approved it or not. If flushes are still a problem there is certainly no harm in asking. Another drug that sometimes works is low dose Citalopram.

The first baby advantage starts really early

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Adapted from BMJ 18-25 April 2026

Firstborn children are known to outperform their later born siblings in adulthood regarding earning capacity and IQ. It has now been shown that these differences start really early in babyhood from research published in JAMA.

In Japan, 2,000 sibling pairs were tested regarding cognitive skills and developmental milestones. By six months of age, the older siblings outperformed the younger ones. Some of the differences evened out by the age of 12 months, but deficits in fine motor skills and personal-social areas persisted.

This difference however is paralleled by lower parental engagement for second born and subsequent children. Resources become diluted as families grow.

My comment: I do remember slacking off with my second son compared to my first. The first one got everything done by my Penelope Leitch book.

The second got warmer and more social baths, far fewer photographs taken, was able to decide his own bedtimes, decided when he was ready to get toilet trained, I found him trying to change his own nappy, and I didn’t bother trying to get him to eat vegetables or anything he didn’t immediately like. He also stayed on bottled milk far longer. He was able to get these himself out of the fridge. Unlike baby #1 I didn’t warm up the milk after one month of age and he took it chilled.

I hope my lack of diligence in one side of the equation gave me more time to spend talking to him and playing with him on the other. He did speak far later though.

They have both done very well in adulthood although the limited dietary intake persists. I do think the younger child had a better time of it with a more relaxed parenting style.