Live to 100 with Dr Hilary Jones: Spring 2021 by Magazine

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Welcome

Your Life and Wellbeing Dr Hilary Jones introduces this issue of Live to 100, where we can all learn more about the issues surrounding our health, happiness and future lives

elcome to the latest issue of Live to 100. We’ve all been living through difficult times, where it’s been more important than ever to look after ourselves and each other. There are many valuable lessons to learn from the coronavirus pandemic, and I hope that this magazine will be valuable in dispelling some of the health myths that can be misleading and harmful. No-one could have anticipated at the start of last year that the whole world would be in the grip of a pandemic well into 2021. I don’t think anyone can say that they were well prepared for it, and our NHS has had to perform marvels in combatting the COVID-19 virus. It has exposed just how fragile our health can be, and how even those of us who think of themselves as fit and well can be laid low unexpectedly. This makes it all the more important that we take responsibility for our own health, and understand how basic essentials such as good diet, exercise, sleep and mental health contribute to a long and happy life.

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In this issue we cover many of these subjects, from fitness and nutrition to the importance of vaccination, the proper care of conditions such as diabetes, cancer, heart disease and prostrate problems, and some of the concerns of later life, such as Alzheimer’s and the cost of dying – something we all have to think about eventually. But in all the gloom of the last year, let us end on a note of hope – that medical research is making great advances, and that there is light at the end of the tunnel. When life is back to normal, and it will be soon, we should all be able to enjoy a long, happy and healthy life together. •

Dr Hilary Jones Guest Editor www.drhilaryjones.com

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18 Contents 11 INTERVIEW Britain’s favourite TV Doctor Hilary Jones talks to Chris Jenkins about the coronavirus crisis, what we can do to keep fit and healthy in lockdown, and how our mental well-being is just as important as our physical health

Your Wellbeing 18 COUNTING SHEEP Why is sleep so important to our health, and how can we make sure we get a restful night?

26 YOU, ME AND CBD You will have heard of CBD, but what exactly is it, how does it differ from medical cannabis, and what ailments can it help? We bust a few myths 6 | LIVE TO 100 WITH DR HILARY JONES

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32 IN THE AIR TONIGHT There may be all sorts of nasty pollutants lurking not only in outdoor air, but also in your home. What should you be aware of and what can you do about it?

38 A JAB WELL DONE In the current situation we’re all becoming aware of the vital role of vaccination, but beyond coronavirus, why is it essential that we keep up our programme of jabs?

40 CLEAN AND TASTY Is ‘clean eating’ a diet fad, or is there something to it? We explain how a healthy diet doesn’t necessarily mean having to dump everything that isn’t raw and organic

50 BEST FOOT FORWARD One of the less well-known aspects of the condition diabetes is the harm it can do to our feet. We explain why it happens and how you can monitor the health of your tootsies celebrityangels.co.uk

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Contents

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56 53 A SIGHT FOR SORE LIPS Cold sores can be an unsightly and recurring problem, but what causes them, and is there anything we can do about them?

56 STAND UP FOR YOUR PITS Could we do better for our armpits than spraying them with aerosol deodorants? There’s a move towards natural solutions that may be better for your health and the planet’s

Your Health Care 58 DNA DREAMS It’s the dream of the medical community to cure multiple health issues through a better understanding of our DNA. So how does gene therapy work, and what is its potential?

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62 PREVENTION IS BETTER THAN CURE It’s an old adage but true – many medical conditions could be better treated if we undertook health checks whether or not we have any symptoms

64 DEALING WITH DIABETES Though it’s an increasingly common condition, many people are still unaware of the causes and possible consequences of diabetes. We search out the facts

68 CORONA NATION The world is still in the grip of the coronavirus pandemic. Is this a situation we are going to have to learn to live with?

74 THE RIGHTS OF WOMEN Many health issues are specific to women, but often overlooked when it comes to research and provision of services. How is the situation changing?

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79 THE SUNSHINE VITAMIN Why is Vitamin D so important that’s it’s being given out free? We look at the vital role of this essential organic substance

82 KEEPING UP THE FIGHT AGAINST CANCER With NHS facilities diverted to fighting coronavirus, has cancer care lost its priority? We look at the efforts to keep the condition in the public eye

88 THE HEART OF THE MATTER Coronary Heart Disease is a major cause of death in the UK, but what are the causes and what can we do to avoid it?

91 TOP TRENDS Some of the most exciting and innovative products in the health, wellbeing and care markets

92 GET THE BALANCE RIGHT It can be hard to stick to a routine for losing weight and keeping fit - in fact you can do yourself harm if you get it wrong. Can technology help?

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94 ASK THE PHARMACIST With access to GPs limited during the coronavirus crisis, don't forget that there’s another source of sound advice and prescription services we can rely on both on the High Street and online

98 THE NATURE OF SKIN Skin is sensitive, so perhaps we ought to think more about what we put on it. Here’s a guide to some of the cosmetic ingredients to avoid, and the new natural alternatives

102 THE ESSENTIALS OF SKIN CARE Whatever our age and skin type, there are basics of skin care which can guarantee us firmer, brighter, more elastic skin if we choose the right products

104 PROMINENT PROSTATES The health campaign Men, We Are With You drew attention to prostate problems using the real life experiences of celebrities. What should we all learn from them?

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PUBLISHER & CEO Kevin Harrington EDITOR Chris Jenkins WRITERS Tom Glover, John Renwick, Margo Lane DESIGN Friyan Mehta PRODUCTION DIRECTOR Joanna Harrington PRODUCTION MANAGER Sam Bradford

110 DIFFERENT STROKES Examining the causes, symptoms, and risks for this dangerous condition

114 THE HARD FACTS Atherosclerosis or hardening of the arteries is a major health risk, but lifestyle changes can hold it off

116 ATTENTION ON ALZHEIMER’S Alzheimer's Disease is the most common form of dementia, and distressing for those affected and their loved ones.

Medical Tourism 120 MEDICAL TOURISM: TURKEY Turkey is thriving as a centre for medical tourism – what is it about this beautiful country that attracts more and more health visitors?

Over 60 124 REST IN PEACE When you have the stress of organising a funeral, the last thing you want is the added worry of how to pay for it. Could a pre-paid funeral plan be the answer?

128 INSURE YOUR FAMILY’S FUTURE The subject of life insurance may be a tricky one, but in the current situation it’s something every family ought to think about

130 HYDRATION CONTEMPLATION Do you know the difference between skin moisturisation and hydration? Read here to learn the secrets of fresh and luminous skin celebrityangels.co.uk

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Live to 100 with Dr Hilary Jones Celebrity Angels 143 Caledonian Road, London, N1 0SL Tel: 020 7871 1000 Fax: 020 7022 1694 For sales enquiries call: 020 7871 1000

All material in Live to 100 with Dr Hilary Jones is wholly copyright and reproduction without the written permission of the publisher is strictly forbidden. The views expressed in this publication are entirely those of the authors and do not necessarily represent those of Celebrity Angels. The information in this publication is carefully researched and produced in good faith, however, neither the publisher nor the editors accept responsibility for any errors. The Celebrity Angels Series is published in the UK under licence by Damson Media Limited. Damson Media Limited is registered in England and Wales under registration no. 07869300. Disclaimer: Live to 100 with Dr Hilary Jones has been produced as a family health guide. It does not constitute professional medical advice. In no way does this publication take away your responsibility to seek professional medical advice should you have concerns regarding your health. Please visit your GP should you require professional medical advice.

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Interview

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Healthy Future Britain’s favourite TV doctor, Dr Hilary Jones, talks to Chris Jenkins about the challenges of the coronavirus pandemic, how the health services might respond in the future, and what we can all do to improve our health

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“

When this novel virus arrived in the UK there is no doubt that we were woefully unprepared

“

Q. The coronavirus pandemic has dominated world news this year. How well do you think our government, health services and pharmaceutical industry have reacted to it? What is the outlook for the medium and long-term future? What are the likely effects of ‘Long Covid?’ HJ. The coronavirus pandemic has been the biggest public health challenge for a hundred years. Despite regular warnings from microbiologists and epidemiologists and

even after pandemic planning to prepare for such an event most countries of the world were caught napping. When this novel virus arrived in the UK there is no doubt that we were woefully unprepared. We did not have sufficient PPE, the NHS was already under resourced and overstretched, we did not have an effective testing and trace system and we had porous borders with millions of travellers from overseas bringing more virus in the country. LIVE TO 100 WITH DR HILARY JONES | 11

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Interview

Q. One side-effect of the pandemic has been growing waiting lists for treatments for other conditions. What conditions are the most affected, and how concerned should we be about this? HJ. Other conditions have of course had to take a back seat whilst critical care and intensive care units in hospitals were filling up and preparations were being made for a huge influx of Covid sufferers. Hospitals were separated into Covid and non-Covid areas and many doctors and nurses were redeployed away from their normal activities into coping with the pandemic. Even in general practice each appointment took far longer because of the need to clean rooms and provide PPE. We know that patients suffering from cancer and heart disease were not able to access all the care they might otherwise have had and certainly many of the excess deaths, those indirect harms caused by the coronavirus were due to this. There were fewer hospital beds, there was a reluctance on the part of people to attend for appointments, many cancer and heart specialist were redeployed elsewhere, and much cancer screening was postponed 12 | Live to 100 with Dr Hilary Jones

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or delayed, meaning that diagnosis was also delayed. Mental health took a back seat as well, meaning that even people who had not previously suffered with anxiety and depression felt isolated lonely and desperate. We must never allow ourselves again to be caught by surprise by a similar virus, which is by no means an impossible scenario. Q. Other than coronavirus, how concerned should we be about seasonal infections such as influenza? What is the importance of vaccination generally and how do you respond to the anti-vaccination movement? HJ. Luckily so far this season we have seen very low prevalence of influenza and let us hope it stays that way. We know that should somebody be unfortunate enough to contract both influenza and coronavirus at the same time the risk of serious complications and death is twice that it is of having either infection alone. The worry has always been that during the winter months the number of infections increase leading to greater pressure on the National Health Service.

Viral pandemics remain one of the greatest threats to public health so we must prepare and plan carefully for the future and fully equip the National Health Service with the resources it needs to cope with such eventualities. The two things that have probably most transformed the health of the human race has been clean water and vaccination. During the course of the last century millions of lives have been saved through vaccination and millions would not be here today had their forefathers turned down invitations for inoculation. The anger of the anti-vaccination movement is only matched by their ignorance and dangerous rantings and it is my fervent hope that such misleading information is deleted from social media which otherwise does so much harm. Q. How important is it to have preventative health checks? HJ. One of the reasons preventive health checks are so important is because so many diseases are asymptomatic for such a long time. Coronary heart disease can be present

Images: Dreamstime

We allowed the virus to permeate our care homes and take a terrible toll on our elderly and most vulnerable people. Public health messages have been contradictory and confusing. Having said that, few countries have dealt with the virus much better. The staff of the NHS and other essential workers have worked hard and done a magnificent job for which we should be eternally grateful and hopefully they will be rewarded with more resources in the future. We could not have a normal Christmas last year, but our immediate future will be secure if the majority of people behave responsibly for the next few months. Our long-term future looks much better with several vaccines and rapid accurate tests. â&#x20AC;&#x2DC;Long Covidâ&#x20AC;&#x2122; may pose a problem for thousands of patients however and hopefully clinics will be established dedicated solely to help those people.

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Interview

for years without the patient knowing about it until they have a heart attack. If they survive the victim may still suffer from disability, shortness of breath and chest pain for years to come. Diabetes has reached epidemic proportions and there are tens of thousands of patients who are unaware that their blood sugars are currently out of control. There may be millions with uncontrolled high BP putting them at greater risk of stroke and many people developing tunnel vision because of glaucoma. Osteoporosis is known as the silent killer and there will be many people today who have undiagnosed cancer of the bowel, prostate or breast, or who if they availed themselves of screening tests would have other conditions diagnosed early to give them a better chance of survival. It would also help if we resolved to take a greater interest in mental health and help people talk about their worries and concerns in order to prevent so much suffering and psychological pain. Q. What is the state of research into common conditions such as diabetes, heart disease, Alzheimer’s and prostate cancer? Where can we hope for breakthroughs in the next few years? 14 | Live to 100 with Dr Hilary Jones

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HJ. We’re always looking for a breakthrough

but the miracle cures which often make headlines in the tabloids are few and far between. It is been interesting to see that the coronavirus has proved to be a multiorgan disease affecting amongst other things the pancreas gland. In some people damage to this gland has rendered them diabetic and completely dependent on insulin. It has always been hypothesized that viruses which are recognized as foreign by the body will produce antibodies which in turn recognise the pancreas gland as foreign and destroy the cells which produce insulin. This is known as autoimmune disease and this horrible virus may yet give a research model to see whether we can prevent this happening. Advances such as the technology improving diabetic blood sugar control and making fingerpricking almost redundant such as the Freestyle Libra 2 and 3 are certainly making life easier. There is interesting research into the repair of damaged heart muscle after heart attacks and in the use of stem cells in diseases of the nervous system such as stroke and Parkinson’s disease. It would be lovely to see breakthroughs in research for Alzheimer’s disease and prostate cancer and when we see what can be achieved by scientists working together

as we have done with the pandemic it might happen sooner than we think. Q. What are your tips for dietary health? HJ. It is no secret that we have a massive

problem with obesity in this country and consequently with diabetes, heart disease, liver problems, high blood pressure, cancer and arthritis as a result. We are still consuming far too much energy dense food in the form of fats and carbohydrate and the Government has done far too little in discouraging such high consumption of fast foods and processed foods, when more people could be enjoying fresh fruit and vegetables and limiting portion sizes. Why do we advertise unhealthy food so widely when we know what the consequences are? Generally, the population needs to eat less, eat healthier, exercise more and achieve a good nutritional balance in everything they put on their plate. Q. Why has there been a surge of interest in CBD for self-treatment, and what value do you think it has? HJ. CBD oil has suddenly become the on-trend fashion supplement in recent years with literally hundreds of different companies selling it. The advertising hype almost has no equal.

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Interview CBD oil does contain a number of cannabinoids derived from the cannabis plant but the amount of psychoactive THC within it is almost undetectable and will not produce a ”high”. There are a number of claims about the therapeutic benefits of CBD oil ranging from the treatment of anxiety and depression right through to helping insomnia, pain, headaches and fatigue. But bear in mind that in some products the amount of cannabinoids is tiny and the quality dubious. I’d like to see more randomised clinical trials before I’m convinced of its worth! Q. Why is sleep so important for

“

It would be lovely to see breakthroughs in research for Alzheimer’s disease and prostate cancer

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“

I think there still remains this pervading perception that because it comes from cannabis it will give you a high and make you feel more relaxed. But of course, that is a myth. It is totally different from medicinal cannabis which only has a license to be prescribed by specialists for a very small number of diseases of the nervous system. celebrityangels.co.uk

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health? How can we improve the quality of our sleep? HJ. Shakespeare summed it up nicely: “The innocent sleep. Sleep that knits up the raveled sleeve of care. The death of each days life, sore Labour’s bath, balm of heart minds. Great nature’s second course. Chief nourisher in life’s feast.” I couldn’t have put it better myself! Sleep allows us to restore and replenish and sleep deprivation is so unpleasant it has been used as a form of torture. Without enough good quality restorative sleep we cannot concentrate, energy levels fall and we become grumpy and irritable. To ensure a good night’s sleep avoid having any technology in your bedroom. Get rid of the TV and leave your electronic devices somewhere else. Switch your mind off by relaxing for at least three hours before bed and exercise during the day as this releases growth hormone which promotes sleep. Avoid stimulants like caffeine in the evening do not rely on alcohol, eat early, ensure a comfortable bed and to clear your mind write down any worries that you have which are keeping you awake on a piece of paper which you can refer to the next day.

Q. Are women and the elderly being neglected in health planning? HJ. I think the elderly do get a raw deal as we only have to look at what happened in the pandemic when so many lives were sacrificed on the altar of protecting the NHS. It is also true that the care they receive in the NHS is more likely to be rationed because of their age. I have heard that some have been told they can only have one cataract operated on and I know that waiting lists for orthopaedic operations can be extensive especially at the moment. I do not believe however that women are neglected in health care planning. The majority of appointments with GP’s are with women and it is still the case that more money is spent on research for breast cancer than prostate cancer. One area that really is neglected is mental health and hopefully the Government will fulfil its promise to increase resources so that we can address these issues in the future. Q. What charities, medical campaigns or other activities have you been involved in this year? HJ. I’m sure that in the same way that many other people’s year has been different in 2020 so has mine. I’m still involved in the various charities with whom I work, but not face-toface meeting people. Hopefully this will pick up again next year. There have been a number of medical campaigns which I’ve been involved in however for example for flu vaccination, for lung cancer, for smoking cessation and the usual public-health issues that affect millions. I was delighted to be awarded the MBE in October for work with charities, with public health broadcasting and in the field of medicine. But the vast majority of my time this year has been spent dealing with the pandemic. I have been giving advice almost every day this year on breakfast television and just like everybody else I look forward to a nice holiday in the sun. I wish I could prescribe such a thing for everyone! • Live to 100 with Dr Hilary Jones | 15

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YOUR Wellbeing

Counting Sheep

ven though most of us know how important sleep is to our health, the nature of our 24/7 world means that getting a good night’s sleep continues to be difficult. We are always in front of the blue lights of our laptops, phones, and tablets for every aspect of daily life – be it for news, entertainment, communication, or work. Scientists have long stressed the importance of healthy sleep habits,

18 | Live to 100 with Dr Hilary Jones

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Did you know? Winston Churchill apparently got by on 5-6 hours per night, but ‘power-napped’ during the day, sometimes for an hour or more.

recommending at least seven hours each night, and have linked a lack of sleep to increased risk in numerous health conditions, including diabetes, stroke and cardiovascular disease. Alongside this, a common problem for many of us living in lockdown has been trying to get healthy sleep, as uncertainty and concerns over the health of loved ones made living in the land of nod difficult. So, what are the health effects of a bad night’s sleep, and how can we fix it?

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Why is sleep so important to health, and how can you make sure you get a restful night’s slumber?

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YOUR Wellbeing Sleep loss The pattern of human sleep is determined by what is called the circadian rhythm, an internal biological clock which keeps us alert during the day and prepares us for sleep at night. Due to Coronavirus, many people are going through a period of intense change, working from home and subsequently not going outside for much of the day Circadian rhythm depends on light to keep it healthy, so spending more time indoors means that people receive less natural light exposure, potentially damaging our chances of sleeping well. In addition, young people appear prone to acquiring poor sleeping habits, with heavy nights all week and catching up with sleep at the weekend. This can have many negative health consequences in later life. One sleep study in 2018 found that disorders such as sleep apnoea are common in people at risk of stroke, and another found that compared to people who slept 6-9 hours a night, people who slept fewer than 6 had a 20 % higher risk of heart attack.

time every day will mean that your body comes to recognise the cycle and will work with you. The brain’s pineal gland produces the hormone melatonin on cue from lower light levels – so when dusk falls, the body prepares for sleep. Conversely, when light levels rise in the morning, the circadian system wakes you up ready for another day. That’s why, although having a schedule is important, you can’t rely on it alone. You have to make sure that your body is ready for sleep, and that your sleeping environment is right too. Relaxation is an incredibly important way to prepare the body for sleep. Stimulation of the mind or body late into the evening will disturb your sleep patterns, and as a result, a period of total relaxation is the ideal preparation for falling asleep. Medical experts suggest turning off electronic devices such as phones a couple

of hours before bed, in order for people to ‘wind down’ effectively. Having a hot bath before bed or reading a book for an hour are tried and tested relaxation techniques. The blue light emitted from the screens of televisions, laptops, tablets, and mobile phones confuses the pineal gland and upsets melatonin levels, so watching TV or scrolling through social media before you try to get to sleep is to be avoided. If you often have to get up in the night, keep a small torch by your bed rather than switching on the lights, as this too will affect your circadian rhythm.

Remember One US study suggested that 100,000 road traffic accidents a year are a result of driver fatigue, with over a third of drivers admitting having fallen asleep at the wheel.

These studies also found detrimental effects of sleep deprivation to include: h h Hallucinations, temporary psychosis or symptoms resembling paranoid schizophrenia h h Lethargy and lack of motivation h h Moodiness and depression h h Lack of cognitive ability during the day h h Impaired sex drive h h Premature skin ageing h h A weakened immune system h h High blood pressure h h Certain types of cancer

A perfect night Establishing a regular routine of sleeping and waking is essential for promoting a good night’s sleep, so that you can work with your body’s circadian rhythm. Although you may crave a one-off late night, long lie-in, or daytime nap, this will not help you in the long run. Going to bed and waking at the same celebrityangels.co.uk

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YOUR Wellbeing

What is TMS? Transcranial Magnetic Stimulation (TMS) is a non-invasive and medication-free solution for various conditions including insomnia, depression and anxiety. TMS uses magnetic pulses to stimulate areas of the brain related to insomnia, rather than flooding the brain with chemicals; and unlike medication, there are very few potential side effects. Patients can return to work, drive and continue with daily activities after treatment.

Why choose Smart TMS? ince opening their first clinic in 2015, S Smart TMS has helped hundreds of patients see a huge improvement in their quality of life. For more information visit SmartTMS.co.uk or call 0345 222 5678.

Daytime exercise is another important factor in preparing the body for a good night’s sleep. Not only does it keep you fit, but exercise is also known to relieve stress and reduce anxiety, which are common causes of sleep problems. Anything form of exercise that raises your heart rate will do, so to reduce stress, try five minutes of aerobic exercise. Additionally, you can try relaxation techniques such as tai-chi, yoga, or meditation. They are known to lower blood pressure, calm the nervous system, and reduce levels of the hormone cortisol, which regulates stress. Exercise and weight loss have many more benefits, one of which is an improvement in breathing and a reduction in the severity of sleep apnoea. The more 20 | Live to 100 with Dr Hilary Jones

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Did you know? The ideal bedroom temperature for getting to sleep is 15.6–19.4°C. regular exercise you get, the more it will benefit your sleep patterns. Do remember not to indulge in any heavy exercise within three hours of going to bed. In contrast to the idea that a latenight workout will tire your body out and help you to sleep, it actually disrupts your resting heart rate, leaving you dehydrated and releasing stress hormones.

Environment The environment you are sleeping in is essential to a good night’s sleep. There are

some simple things you can control to help you get to sleep easily. hh C ontrol light and sound. Make sure not to have any electronic devices with standby LEDs in the bedroom. Shut doors to reduce noise from fridges and other electrical items. You may want to play soothing music or environmental sounds to get you to sleep or wake you up. Put up heavy curtains to make sure sunlight doesn’t disturb you, particularly for early sunrises in the summer months. hh Control temperature. The ideal bedroom temperature for getting to sleep is 15.6–19.4°C. Check room temperature with a digital thermometer and adjust heating or air

Images: Shutterstock, Shutterstock Dreamstime

Exercise

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YOUR Wellbeing

Lifestyle Diet and lifestyle are essential elements for getting a good night’s sleep.

DO eat: 99 Cottage cheese, containing muscle repair protein casein 99 Chamomile tea, an herbal drink containing antioxidant flavones, that may offer a variety of health benefits. 99 Tart cherry juice, containing Vitamin A, Vitamin C, manganese, antiinflammatories, and the hormone melatonin which helps to regulate your body clock. 99 M ilk, which includes tryptophan, an amino acid essential to the production of the sleep regulating compound serotonin. 99 Bananas, cheese, eggs, fish, poultry and nuts also contain tryptophan 99 Oatmeal, high in carbohydrates and melatonin and said to induce drowsiness

DON’T eat: 8 8 Smoked meats and cheeses, which contain the stimulant tyramine 8 8 Coffee and dark chocolate, packed with the stimulant caffeine 8 8 Cruciferous vegetables such as broccoli, which contain a large amount of hard-to-digest fibre 8 8 A lcohol, which can have the effect of stimulating drowsiness, but which disrupts REM sleep 8 8 Tomato sauce, because of its high acidity 8 8 Red meat, also high in hard-to-digest protein 8 8 Orange juice, because of its acidity 8 8 Fizzy drinks, because of their high carbohydrate content 8 8 Water. Yes, water. Good for you during the day, but likely to make you need to get up to urinate at night.

conditioning to suit. Sleeping without nightclothes can help you to regulate your sleep temperature. Your mattress and pillow can also affect your temperature when you sleep – modern innovations in fillings can help keep your sleep surface at optimal temperature. hh Replace ticking clocks with digital ones. Choose a digital clock with a dimmable display. hh Keep your bedroom tidy and uncluttered. Don’t use it for anything but sleep and sex. Make sure your bedding and sheets are clean and comfortable. hh Don’t let pets sleep on the bed. As long as the owner and animal are healthy there’s no reason why the animal shouldn’t sleep on (not in) the bed, but of course, if they move around they can disturb the owner’s sleep. Try putting a pet-bed in the room rather than letting them sleep on your bed.

Remember Most adults need between 6 and 9 hours of sleep every night. Quitting smoking, particularly before bed, is one of the most important factors in getting a good night’s sleep. Studies show that smoking reduces the amount of time sleeping generally and particularly the amount of time in REM. Smoking is also a major causative factor in sleep apnoea, increasing inflammation and fluid retention in the upper airways, which leads to the swelling and narrowing of the airways. The real answer to how much sleep we need is however much it takes for us to feel refreshed, alert and vibrant all day. Making these positive changes to your relaxation, lifestyle, exercise, and environment will increase your chances of having a refreshing night’s sleep, which has numerous health benefits. •

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Live to 100 with Dr Hilary Jones | 21

01/02/2021 09:58

The UK’s largest provider of TMS treatment Transcranial Magnetic Stimulation (TMS) is a non-invasive and medication-free solution for conditions such as depression, anxiety, addictions, OCD and insomnia. Not Depressed brain • Normal activity is seen across all areas of the brain. • The areas in yellow show increased activity across the different neural pathways of the brain. • Indicating normal functioning and control of emotions and cognitive function.

Depressed brain • Reduced activity is seen in the area of the brain responsible for the voluntary and automatic control of emotion. • In depression it is believed that connections between the different areas of the brain are effected, leading to reduced activity and lack of emotion, motivation, memory issues and cognition problems

TMS delivers magnetic pulses to areas of the brain to either stimulate or inhibit activity depending on the condition being treated. The treatment restores balance and therefore, reduces the symptoms of the condition.

TMS treatment

‘TMS saved my life!’

“My practitioner was called Ailish, she was amazing, from the start she wasn’t just there to turn on the machine, she talked to me and helped me through any troubles or changes I was facing through treatment! She was able to help me set short small goals to focus on throughout treatment and even after I ﬁnished she would check in to see how I was feeling with life!”

I had suffered badly with PTSD and Depression for years and no treatment was working for me, I started to feel the beneﬁts of TMS around 1/3 of the way through. Since ﬁnishing my treatment I haven’t been struggling to live anymore, I’ve been able to have relationships with people in my life again, I am able to go outside without feeling in constant danger, I don’t have rushes of adrenaline throughout the day anymore! TMS really is the treatment that saved my life!

www.feefo.com/en-GB/reviews/smart-tms

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02/12/2020 10:14

‘Excellent. Highly Recommend.’ Highly recommend this treatment. No side effects. Psychometric questionnaires clearly show if you respond to treatment or not. It is very expensive but compared with other treatments that did not work for me, in the end it is worth the value.

Find out if TMS treatment could help you, call us today

‘Absolutely worth it, I wish more people knew this was a treatment option’ Really pleased that I was in the cohort that responded to the treatment. The technician was great and I felt like they were invested in making sure that the experience was positive. My depression symptoms have dramatically improved and for the ﬁrst time in a decade of mental illness and different treatments I don’t feel completely hopeless

Tel. 0345 222 5678 Smart TMS.indd 2

02/12/2020 10:14

YOUR Wellbeing

Keep Cool, Sleep Sound Why is sleep so essential to our wellbeing, and why is the correct temperature so vital in getting a good nightâ&#x20AC;&#x2122;s sleep?

24 | Live to 100 with Dr Hilary Jones

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YOUR Wellbeing

Images: Shutterstock, Kaymed

here have been over 17,000 medical studies of sleep, many of them linking lack of sleep to health problems including stroke, obesity and heart disease. Most types of life-form show some form of sleep behaviour – certainly all mammals. Sleep patterns are normally tied in with the patterns of nature, so humans tend to be awake in the day and sleep at night, making us ‘diurnal’, while some animals are naturally more wakeful at night, so are known as ‘nocturnal’. The pattern of human sleep is determined by what is called the ‘circadian rhythm’, an internal biological clock which keeps us alert during the day and prepares us for sleep at night. A study in 2018 found that sleep disorders such as sleep apnoea are common in people at risk of stroke, and another found that compared to people who slept six to nine hours a night, people who slept fewer than six had a 20 percent higher risk of heart attack. There are four major types of insomnia, or lack of sleep, each with its own causes and symptoms. Finding it hard to go to sleep in the first place or waking frequently from sleep are known as Onset Insomnia and Maintenance Insomnia. A temporary episode of sleeplessness is knows as Acute Insomnia, and is usually caused by a stressful life event such as a bereavement, change of job or travel. Chronic Insomnia is a long-term pattern of difficult sleeping. Insomnia is usually diagnosed as chronic if the sufferer has difficulty falling asleep or staying asleep for at least three nights per week, for a period of three months or longer. Comorbid Insomnia is a description of sleeplessness that occurs along with another condition.

maintained bedframe, mattress and bedclothes. Temperature control is now understood to be crucial to getting a perfect night’s sleep. If we are too hot or too cold, the body will move unconsciously, with the result that the sleep cycle will be broken, potentially during the critical REM phase. In 2013, Kaymed partnered with a brilliant American inventor who pioneered the concept of regulating the temperature of the sleep surface. This was achieved by basic chemistry, adding a conductive Gel Technology (phase change material or PCM) into the foammaking process. The temperature of the sleeping surface should be optimised, with a mattress that ensures you never sleep too hot or too cold as the active material removes, stores and then releases heat as your body needs it. Today, Kaymed is the exclusive supplier of this technology to the UK market. Kaymed has been in business for

over 100 years and is constantly striving to incorporate new innovations into its mattresses. Kaymed temperature regulating mattresses can be purchased from: Bensons for Beds (iGel), John Lewis (Climate Collection), and Harvey Norman (ThermoPure). • For more information visit: www.kaymed. co.uk or www.kaymed.ie. Read more at www.celebrityangels.co.uk/ how-to-get-the-perfect-nights-sleep

Did you know? Studies in mice show that sleep plays a role in clearing the brain of the metabolic waste product Betaamyloid which is linked to impaired brain function and Alzheimer’s disease.

Beds and mattresses Your bed and mattress are essential elements in getting a good night’s sleep. Yet many people don’t appreciate the importance of a properly designed and celebrityangels.co.uk

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29/01/2021 18:52

YOUR Wellbeing

You, Me and CBD You’ll have heard a lot about CBD products, but what exactly is CBD, and how does it differ from medical cannabis? We bust a few myths…

xtracts from the hemp plant, such as its fibres, seeds and oils, have been used for more than 10,000 years for various purposes. As one of the first plants to be cultivated, hemp was used to make clothing, rope, paper, and shoes, while its seeds and oils were used as food and medicines. Cannabidiol, or CBD, can be extracted from hemp, which is a fibrous, industrial form of cannabis. CBD is one of over sixty compounds found in the cannabis

26 | Live to 100 with Dr Hilary Jones

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(marijuana) plant, and is classified as a natural dietary supplement. It is generally extracted from the resin glands of the marijuana flowers and buds. It’s important to dispel the myth that CBD products have a psychoactive effect – in other words, that they can cause people to become ‘high’. CBD is a quite separate product from medical cannabis, where the compound that creates the high is tetrahydrocannabinol, or THC. This is taken from the same plant, yet it differs wildly in

its effects. There may be miniscule traces of THC in CBD oil, but this is carefully controlled, and in most cases the aim in a CBD products is to eliminate THC altogether. CBD products such as oils have been legal to buy in the UK since 2016. Two years later, in early 2018, Holland & Barrett became the first High Street store to stock CBD oil in the UK. In most cases, CBD is bottled and comes with a dropper. However, you may have celebrityangels.co.uk

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YOUR Wellbeing

Studies claim that CBD can counteract this by helping the body achieve a state of equilibrium, apparently through an antiinflammatory effects. Published research from reputable institutions includes: hh Relieves pain and inflammation, Journal of Experimental Medicine, 2012. hh Antipsychotic effect, The American Journal of Psychiatry, 2017. hh Reduces anxiety, National Institute on Drug Abuse, 2015. hh Regulates nausea, British Journal of Clinical Pharmacology, 2011. hh Fights cancer, British Journal of Clinical Pharmacology, 2012. hh Improves seizures and related neurological conditions, British Journal of Clinical Pharmacology, 2012. hh Promotes cardiovascular health, British Journal of Clinical Pharmacology, 2013. hh Improves Alzheimer’s symptoms, Journal of Alzheimer’s Disease, 2014.

Remember CBD is not addictive. According to a WHO report, “in humans, CBD exhibits no effects indicative of any abuse or dependence potential.”

seen it in a number of different forms in supermarkets and corner shops, from hand soaps, chewing gums, or energy drinks, to vape oil for e-cigarettes.

Images: Shutterstock

Analysis Unlike THC, which has been linked to psychosis, CBD products are believed to be completely safe to consume. But what health properties are they supposed to offer, and what is the evidence for their effectiveness? When buying a CBD product, make sure that you check the EU Food Supplement regulations certificate of analysis on the bottle. This will make clear the celebrityangels.co.uk

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manufacturing process and the source of the ingredients. An increasing number of people are adding CBD into their diets in some form, claiming that they have experienced positive effects with conditions from anxiety to arthritis to insomnia. Research has shown that CBD can have a positive affect on our endocannabinoid system, or ECS, a network of molecular receptors in the body’s cells, including the nervous system, brain, and immune cells. The ECS seems to be partially responsible for regulating our mood, pain, appetite, and memory, and it can quickly be tipped out of balance by ageing and stress.

However, the function of CBD is imperfectly understood, and it has not been studied long enough for anyone to state with authority anything about its long-term effects. Partly for that reason, though the World Health Organisation (WHO) has stated that “no health problems … have been associated with the use of pure CBD”, it cannot be sold as a medical product, or with any very specific claims about its effects. In the USA, the Food and Drug Administration (FDA) has approved only one CBD product, a prescription drug product to treat two rare, severe forms of epilepsy, and it is currently illegal to market CBD by adding it to a food or labelling it as a dietary supplement. Elsewhere, in some cases there is a worrying lack of regulation or standardisation in ingredients, potency, and manufacturing processes that go into each product.

Reactions All types of people are aiming to enhance their quality of life by using CBD oil, either Live to 100 with Dr Hilary Jones | 27

01/02/2021 13:46

E V E RY T H I N G YO U N E E D TO K N OW ABOUT CBD OIL HEARD ABOUT CBD OIL AS A NATURAL REMEDY? UP TO 6 MILLION PEOPLE IN THE UK HAVE TRIED IT ALREADY, AND THE NUMBER’S GROWING. IF YOU’RE THINKING OF TRYING CBD, JERSEY HEMP, THE ONLY BRITISH GROWER OF CBD, HAS PUT TOGETHER A GUIDE TO BUYING AND TAKING BRITISH-GROWN CBD WITH CONFIDENCE.

WHAT IS CBD?

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CBD (or cannabidiol) is an extract of the hemp plant used as a natural remedy. Hemp is a strain of the cannabis plant, but CBD doesn’t have the psychotropic effects of marijuana, so it won’t get you ‘high’. Any minuscule traces of THC (the substance that gets marijuana smokers stoned) are removed during Jersey Hemp’s extraction process to non-detectable levels. All Jersey Hemp CBD products are third party lab tested as standard. CBD with non-detectable levels of THC is legal in the UK.

CBD fits into the body’s endocannabinoid system, helping us to stay balanced. Many people choose to take CBD for conditions like anxiety, depression, sleep problems, pain, inflammation or just to support their overall wellness.

When you choose Jersey Hemp, you’re choosing the leading British-made CBD, from organically-cultivated hemp plants grown at our farm on the beautiful island of Jersey.

Taking CBD as drops of oil is the most common way, just use the bottle’s pipette to place a few drops under the tongue and leave for a few seconds to absorb.

Jersey Hemp’s CBD products are good by nature, gluten-free, vegan and chemical-free and contain no artificial colours or preservatives. Simply high quality British-grown CBD you can trust, made to support your wellbeing naturally.

“WE’RE COMMITTED TO MAKING SURE THAT EVERY SERVING LIVES UP TO OUR PROMISE: 100% PURE AND NATURAL QUALITY FROM PLANT TO PRODUCT.” P R E M I U M B R I T I S H - G R OW N C B D O I L YO U C A N T R U ST. M A D E F R O M O R G A N I C A L LY - G R OW N H E M P I N J E R S E Y.

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YOUR Wellbeing

Did you know? In 2016, the UN International Narcotics Control Board (INCB) found that the UK produced approximately 95 tonnes of legal medical cannabis, accounting for 44 percent of the world total. A significant part of this production goes towards a cannabis-based medicine called Sativex. At present, Sativex is only available on prescription by the NHS in Wales. severity of the condition being treated. CBD products will often have a recommended maximum daily allowance on the labels and packaging.

Results from ongoing medical studies are producing interesting results, but it is important to be wary, as more proof must be obtained before we can deem CBD oil safe and healthy in the long term. The jury is out on possible side-effects. Most people using CBD as a dietary supplement experience no side effects, but others have reported nausea, drowsiness, diarrhoea, dry mouth, bloating, and vomiting. All food supplements can affect different people in different ways, and you should consult your GP or medical practitioner if you are concerned that CBD may affect you in a negative way, such as an allergic reaction. There is also a chance of drug interaction when using CBD alongside common medications. So is CBD the universal wonder drug it is sometimes claimed to be? We won’t know for sure until more is known about its function and long-term effects, but if you want to be part of the experiment, you will be joining an ever-growing band of CBD users. •

Images: Shutterstock

as an alternative to traditional remedies, to supplement conventional treatment, or to improve overall wellbeing. Numerous positive reviews state that CBD can aid sleep quality and digestion and can strengthen the immune system. One of the easiest ways to take CBD is in an oil under the tongue, so it can quickly and directly enter the bloodstream. Using a dropper, place several drops under the tongue and hold for up to five seconds, longer if possible. Some people feel instant results, whereas others find it takes up to a couple of weeks to discover the right dosage for them in order to experience the benefits. Dosage will vary from person to person depending on the reason that they are taking CBD as a dietary supplement. Currently there’s no set limit or recommended daily allowance because of the many variable factors involved. These include the concentration of the CBD product, the individual’s body mass index (BMI) and body chemistry, and the

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Live to 100 with Dr Hilary Jones | 29

29/01/2021 18:55

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02/10/2020 10:45

YOUR Wellbeing

In the Air Tonight

We all know about the dangers of outdoor air pollution, but what about indoors? Find out about the dangers and how you can avoid them

ven before lockdown, we spent around ninety percent of our time indoors. This figure is certainly much higher since the coronavirus pandemic took hold. Now more than ever, it is important to understand the risks of indoor air pollution. There are regular campaigns to improve the air quality of the outdoors, which has resulted in wide public awareness about pollutants and how air pollution affects our

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health. Walking, cycling, and taking public transport instead of driving are well known ways to curb outdoor air pollution. Yet still a national survey from Global Action Plan found that more than a third of adults believe indoor air pollution has no impact whatsoever on their health. Even worse, while we are living our entire lives at home; working, eating, socialising, and sleeping at home, the air quality indoors can be as bad or worse

than outside. Despite this, very few people appear to be knowledgeable regarding the causes, effects, and remedies that surround the issue of indoor air pollution.

Causes Indoor air pollution can be caused by dust, dirt, gases, chemicals or organic matter in the air, and the genesis of these can be the way in which we cook in, clean, maintain, and build our homes. celebrityangels.co.uk

01/02/2021 13:47

YOUR Wellbeing For people suffering from health conditions such as asthma, chronic obstructive pulmonary disorder and lung cancer, quality of indoor air is hugely important. Especially during this pandemic, it is of utmost importance that we make sure our buildings are well ventilated. Additionally, children are more susceptible to indoor air pollution than adults due to their developing lungs, and their narrower airways. Breathing in indoor air that is polluted can lead to respiratory infections, with symptoms such as dry throats, runny noses, sore eyes, and sinuses, to shortness of breath, wheeziness, and in the long term an increased risk of pneumonia, COPD, lung cancer, heart disease and stroke.

The main chemical culprit in indoor air pollution is volatile organic compounds, so-called VOCs, commonly used in household cleaning and decorating materials, or bleach and ammonia used in cleaning compounds.

What are VOCs? Volatile Organic Compounds are chemicals released by common household products, and can be damaging to your health. In our homes, VOCs are released from synthetic paints, cigarette smoke, new furniture and building materials, air fresheners, as well as from natural sources, like fungi and mould. They can cause issues that range from headaches and irritations to major longterm health implications that are linked to cancer. VOCs are most common in the bathrooms, bedrooms, and garages of our homes. The American Thoracic Societyâ&#x20AC;&#x2122;s American Journal of Respiratory and

Critical Care Medicine found regular use of cleaning sprays has a huge impact on lung health, equivalent to smoking a pack of cigarettes every day. The research followed more than 6,000 people over a 20 year period and found that women in particular suffered significant health problems after long-term use of these products. VOCs such as acetone, xylene and formaldehyde are found in detergents, furniture polish, air fresheners, carpet cleaners, oven cleaners, paint strippers, varnishes, glues, pesticides and fungicides, and evaporate into the air and can be inhaled. Chemicals with fragrances are particularly likely to contain VOCs, which studies suggest can cause allergic reactions and asthma.

Did you know? In low income countries, indoor air pollution is the leading risk factor for deaths. (Source: Our World in Data)

Images: Shutterstock

The main causes are: hh Chemicals used in cleaning or decorating hh Materials used in construction such as asbestos hh Tobacco smoke hh Poor ventilation leading to damp and mould

hh Allergies caused by pets or dust mites hh Outdoor pollution getting indoors

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Live to 100 with Dr Hilary Jones | 33

01/02/2021 13:47

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02/09/2020 14:35

The Worldâ&#x20AC;&#x2122;s most informative indoor air quality monitor with the exclusive

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It tells you if the air quality in your home or oďŹ&#x192;ce is promoting or impeding the survival and spread of viruses. Oh, and it also tells you which of six pollutants are in the air too. Nice one! More Information https://www.uhooair.co.uk Or call +44 (0)1636 555 007

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YOUR Wellbeing

Reducing risk So, what can we do to reduce our risk to indoor air pollutant VOCs? hh Ask smokers in the household to smoke outside, or not at all. This will not only be a nicer smoke-free environment for everyone, it will also keep the VOC benzene, that is released from cigarette smoke, out of the house. hh Choose products that are fragrancefree. If you can do this on a daily basis, it will drastically reduce the number of VOC fragrances released into the air. hh Investigate using â&#x20AC;&#x2DC;naturalâ&#x20AC;&#x2122; paints. But be aware paints advertised as water-based or low VOC may still contain some hazardous chemicals. hh When purchasing new flooring or furniture that is not 100 percent natural wood, try to keep the rooms 36 | Live to 100 with Dr Hilary Jones

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well ventilated for the first weeks and months after purchase. hh Keep your home free from damp, as fungi generates natural VOCs which can negatively impact on family health. hh Studies also show that that cleaning professionals who use these chemicals over long periods may sustain lung damage. Carpets, furniture and flooring often contain formaldehyde which can be a lung irritant. To reduce exposure to VOCs you should try to use allergy-free cleaning compounds, and liquids rather than sprays. Make sure your home is well ventilated when you clean, keep children away from cleaning products and dispose of packaging carefully.

Careful Cooking Alongside VOCs, a main source of indoor air pollution is cooking and heating. Cookers, heaters, stoves and open fires are all known to be able to release pollutants into your home, either in the form of particulate matter (PM), as gasses including carbon monoxide, nitrogen oxides and sulphur dioxide, or as microscopic particles of dust. These can be very consequential, with the ability to cause lung and heart disease. Carbon monoxide poisoning can cause headaches, flu-like symptoms and can be fatal in severe cases. To minimise indoor air pollution from cooking and cleaning: hh Make sure you get a professional to service chimneys, cooker and heater flues. celebrityangels.co.uk

29/01/2021 17:07

YOUR Wellbeing Allergies to house dust mites, dead skin flakes and mould spores are common, and may cause breathing problems, especially for those who suffer from asthma. In pillows, mattresses, duvets, carpets and upholstery, dust mite droppings and are hard to get rid of completely. Using mattress covers, vacuum cleaning, having effective ventilation, freezing, washing, air filtration or air ionisers can help you reduce their frequency in your household. If you have pets, pet dander (dead skin flakes) from furred animals and birds can also cause allergic reactions and are hard to dispose of. Unfortunately, there is no easy fix; the only solution seems to be regular cleaning of the home and the animal. You should resist contact with your animal at night and consider not letting your cat or dog sleep on your bed.

Pollutants

Remember

Images: Shutterstock

Each year, close to 4 million people die prematurely from illness attributable to household air pollution from inefficient cooking practices using polluting stoves paired with solid fuels and kerosene. hh D o not burn wood or coal in open fires, and never burn rubbish or packaging. hh Regularly Service cooking and heating appliances. hh You must fit extractor fans above all cooking appliances. hh Fit smoke and carbon monoxide alarms and service them regularly. celebrityangels.co.uk

HJ07 Indoor Air Pollution.indd 37

Although you may be tempted to use candles and incense to improve the atmosphere of your home, in terms of air quality they are to be avoided; both emit particles and other pollutants, incense sticks emit more than 100 times the number of fine particles as candles. Both can emit those troublesome VOCs and formaldehyde, so make sure to never to keep and light a large number of them in a small space. The most significant indoor air pollution chemical health risk from building materials is asbestos. Though since 1999, asbestos hasn’t been used in new buildings, it may still be present in old buildings, and can cause lung disease and cancer if inhaled in particle form. If you do find some in your building, do not disturb it, get it removed by accredited professionals. The same applies to fibreglass insulation. Alongside this, a potential indoor air pollution problem is radon, which is a naturally occurring gas that can accumulate in poorly ventilated buildings. By looking at the website www.ukradon.org, you can find out whether your home is built on a high radon area, and you can then seek help and advice on guarding against it.

Did you know? In recent studies of UK homes it was found that more than one-third of our homes have at a high risk of containing polluted indoor air and 81 percent of the population are at greater risk of respiratory or dermatological conditions because of this. It goes without saying that smoking cigarettes indoors is a major cause and source of poor air quality, is the main cause of preventable illness and death. You should ideally stop smoking altogether, but short of that, you should smoke outdoors, or take up vaping – still not provably harmless, but less harmful than tobacco.

At work Once we all return to our offices, many of the conditions causing indoor air pollution at home can apply at work, and you could also be exposed to other causes of allergic reaction and health risks such as wood dust, spray paint, flour dust, oils, welding by-products, silica dust and industrial agents. Workplace regulations are in place to protect you against these hazards and there should be a risk assessment to identify possible causes of harm. Talk to your health and safety representative or report potential problem to the Health and Safety Executive. It’s important for all of us to have a more informed knowledge of indoor air quality. There are some simple, positive, and consequential steps that we can all take to look after our health and the health of our friends and family. It is simply a case of making more informed, conscious choices so that we are creating a home environment that is both sustainable, enjoyable, and healthy. • Live to 100 with Dr Hilary Jones | 37

29/01/2021 17:08

YOUR Wellbeing Content commissioned by GSK

Amid falling coverage rates, could a rise in vaccine confidence be one upside to the pandemic? COVID-19 has boosted belief in vaccines, but prior to the pandemic, there had been a decline in uptake rates. Greater public awareness and improved access to health services could be vital in reversing the trend.

Interview with Maurine Duchenne, Medical Advisor, GSK

he COVID-19 pandemic has highlighted the value of vaccines in protecting us from infectious diseases. With no vaccine or specific treatment available at the outset of the pandemic, our lives changed as we

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altered our behaviors to avoid infection. To understand what effect the pandemic has had on attitudes towards vaccines, GSK polled 2,500 UK parents of young children1 and found that confidence in vaccines has been boosted. 93% of parents said they were happy for their children to be vaccinated generally, with 29% more likely now, than before the pandemic, to take up vaccinations for their children or themselves. Maurine Duchenne, Medical Advisor at GSK, says this is a positive trend. “It is often only when health is in the news after a virus

outbreak or the release of new data, that we are reminded of the crucial role vaccines play in safeguarding our health. Vaccination has prevented millions of illnesses2 and, in terms of worldwide public health interventions, only clean drinking water is more effective in its ability to save lives3. Any increase in vaccination confidence is welcome.” “It’s also important to remember that vaccines aren’t just for infants. As we age, our immune system does too, so getting the right information and protection at all ages is vital.” celebrityangels.co.uk

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YOUR Wellbeing

factors behind declining rates

CL code: NP-GB-ABX-JRNA-200002. Date of preparation: December 2020.

Worryingly, vaccination rates have been dropping in recent years. One example is MMR (measles, mumps and rubella) immunisation. To ensure 'herd’ or ‘community’ immunity, and to prevent measles outbreaks, the MMR vaccine must achieve a coverage level of 95%. But, in 2019, MMR coverage levels fell to around 87%, and the UK lost its measles-free status.4 “Measles is a very infectious disease, so losing our status is a cause of concern for parents, policymakers and healthcare professionals,” says Duchenne. The reason for the decline in some vaccination rates, for example MMR, is multifactorial. One lesser-considered challenge is practical issues, such as timing, location and availability of appointments. In addition, GSK’s research found that only 27% of parents are now comfortable taking their child to a medical centre for vaccinations – down from 91% pre-pandemic. This is despite the additional safety measures implemented by UK medical centres. A potential solution to these safety concerns and to the wider practical issues could be administering vaccinations

in alternative locations. The parents questioned indicated that they would be open to this, with potential alternatives being a nurse home visit, a drive-through facility, local pharmacy and a mobile medical centre. “The data shows parents’ flexibility. With ease of access to services playing a key role in uptake of vaccinations, now could be a good time to explore innovative and untraditional locations, such as drive-through facilities, for future vaccinedelivery,” says Duchenne.

tacklING a systemwide challenge Duchenne says more must be done to address the general lack of education about vaccination. “Ensuring there is accurate, easily accessible information online is vital. This is where concerned people are likely to look if they can't get answers from their time-strapped clinical practice.” Falling MMR uptake figures include people who received the first dose of a vaccination but didn't return for their succeeding dose. It has to be made clear to patients that they must receive a full vaccination course to experience the full benefit. “It sounds simple, but staff at a clinic,

such as receptionists, can play a crucial role,” says Duchenne. “They're the ones talking to patients and scheduling appointments.” Duchenne says ensuring optimal access to appropriate services is a system-wide challenge. “Clear and precise guidelines for the delivery of vaccines and more accountability across the system, including practices having a main vaccination lead will help.” “Increasing accessibility could include providing interpreters and translations for communities with non-English speaking parents and creating pop-up clinics out of hours for parents and others who can't get time off work. Although all of this can be a logistical challenge,” she adds.

Working together to spread awareness Vaccine manufacturers can help too by supporting public health authorities and patient groups to learn more about barriers to people getting their vaccines. GSK is also studying communities with low MMR coverage and working with local health authorities on how best to advise parents and the public. “I'm optimistic that vaccination rates will rise again,” Duchenne says. “While 2020 was a challenging year, perhaps one small comfort we can take from the pandemic is that vaccine confidence in the UK has been boosted. This could play an important role in the coming years. Now is not the time for people to miss their scheduled immunisations!” For more information, visit the GSK website: vaccinateforlife.com. •

References 1. Data on file, Vaccines in light of COVID-19 market research (2,500 parents of children aged between 9 months and 10 years), May 2020, REF-81763. 2. Walter A. Orenstein & Rafi Ahmed, 2017. Simply put; vaccination saves lives. 3. Plotkin SL & Plotkin SA, 2012. A short history of vaccination. 4. Public Health England, 2019. Measles in England. Accessed online: Mar 2020.

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YOUR Wellbeing

Clean and Tasty What is ‘clean eating’? A fad, a lifestyle or a cure-all? We look at some of the facts and fancies behind the diet trend that’s catching on all over.

he ‘clean eating’ movement is often presented as a transition away from food trends of the modern day – factory farming, processed goods, untrustworthy food chains and the perceived threat of genetic modification – and towards foods that are “whole” and “unprocessed”—it means finding good ingredients, and cooking at home. But is it based on sound nutritional principles? Does it have any real effect on health? And could there be better alternatives? With clean eating, the idea is to just eat “clean” foods, which means choosing foods in their natural state, cooking from scratch, and getting rid of additives such as refined sugar. Some people take the principle to extremes, cutting out gluten, grains and dairy, or even promoting a raw food diet.

Classic clean-eating dishes include homemade soups and salads, smashed avocado, kale smoothies, and a lot of chia seeds and quinoa. So far as larger portions go, dishes such as a sweet potato bake or grass-fed, free range meat, and homemade sweet potato chips are prime examples. The idea has been around for about a decade, fuelled by social media websites such as YouTube and Instagram, where popular vloggers and bloggers have given the scheme widespread appeal. These early influencers inspired A-list celebrities to join the trend, including Gwyneth Paltrow, Katy Perry, Miranda Kerr and Jessica Alba, all reportedly being fans and proponents of the concept.

FOLLOWERS No-one can say for certain how many people follow the ‘clean eating’ doctrine, as unlike, say veganism, it doesn’t have a particular pressure group promoting it. But it has certainly become more of a lifestyle choice than a diet, perhaps appealing broadly to the Instagram lifestyle set,

DID YOU KNOW? The World Health Organisation states that unhealthy diet and lack of physical activity are leading global risks to health. 2.7 million deaths a year are attributable to diets low in fruits and vegetables

Images: Dreamstime

(Source: WHO)

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perhaps mainly teenage girls and women in their 20s. An early feature on the trend in The Guardian states that “it quickly became clear that “clean eating” was more than a diet; it was a belief system, which propagated the idea that the way most people eat is not simply fattening, but impure.” Certainly it seems that ‘clean eating’ is largely the preserve of people with plenty of time on their hands to prepare food – it would be a difficult regime to follow for a working family with children, for example. So what are the truths about the clean eating concept? For one, it’s a misconception that gluten-free and dairy-free recipes are necessarily better for us. The truth is that unless you have intolerances, this isn’t the case. While there are a growing variety of gluten- and dairy-free options on the market, the simple truth is you can still be very healthy on a gluten and dairy diet as long as you monitor your consumption like you would all other foods. Carbohydrates, one of the taboos of clean eating, are in fact essential, though you should try to get them from the best sources, such as fruit and vegetables, beans, nuts, dairy and whole grains. These foods aren’t processed like the betterknown sources of carbs such as bleached grains and sugars—these are the ones that should be avoided. Some clean eating basics, such as flaxseed, have a place in a healthy diet, but are not in themselves adequate to supply compounds such as omega-3s fatty acids in the form of Docosahexaenoic Acid (DHA), which is especially abundant in fish. While flaxseeds contain omega3s, it is in the form of Alpha-Linoleic Acid (ALA), which needs to convert into DHA for any beneficial results. Unfortunately, the conversion ratio from ALA to DHA is very limited. Whole flaxseeds may pass through the intestine undigested so their nutrients remain unabsorbed. It’s essential you have omega-3s in your diet so if you’re looking for a plant-based source of this fatty acid, it 42 | Live to 100 with Dr Hilary Jones

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is recommended to supplement with DHA from algae.

Diet don’ts Eggs sometimes get bad press, but while they do contain a lot of cholesterol, it’s of the good denser variety that in reduces, reuses and recycles its bad counterpart and puts it to use relining the inner walls of blood vessels—in turn helping prevent heart disease. Beyond this, eggs also have a rich variety of nutrients and antitoxins. They are extremely good for you. Another clean eating no-no, gluten is only the enemy if you suffer from coeliac disease. There is a misconception that gluten can break down the microvilli (a very tiny hair-like membrane) in the intestine,

letting food particles pass into your bloodstream. This can be the case, but only if you’re suffering from coeliac disease. The real enemy, as with a lot of these cases, is overindulgence. Equally, it’s untrue that saturated fats are necessarily bad for you, despite a historical belief that they contribute to heart disease. It’s now thought that there is no substantial proof for this, and indeed one of the most popular healthy oils— coconut oil—is in fact high in saturated fats but is still considered a healthy food.

Preparation There are also clean eating rules about how to eat – it’s suggested that eating small meals more frequently throughout the day

Images: Shutterstock

YOUR Wellbeing

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YOUR Wellbeing increases your metabolic rate. But studies have shown you neither burn calories nor lose fat any faster by doing this. The best way to burn calories and lose fat is to focus on eating real foods and avoid consuming more calories than you’re burning. Similarly, the trend for juicing or blending fruits and vegetables may make them easier to consume, but there’s no real evidence that it has any dietary effect different to eating fruit or veg whole – and in fact it may reduce the dietary effectiveness of fibres which are essential for good heart and digestive health. If you like your health kick flavoursome, juice away, but don’t expect significant differences in your health. Regular detox cleanses aren’t necessary because your liver and kidneys already do this on their own. Professor Erdem Yesilda of AlchemLife says that to reset the digestive system you need to stimulate the acidity in your stomach to activate the enzyme pepsin for protein digestion, then bile secretion should be stimulated in the intestines for lipids digestion. The natural way to do this is using oriental spices like Turmeric rhizomes and Ginger rhizomes. A unique combination of their extracts exists in capsule form called PhytoCid. Used after meals, the unique blend of concentrated “Phyto-Actives”act synergistically to solve your indigestion problem and reset your system naturally. Find out more at www.alchemlife.com.

ALTERNATIVES So is there sound evidence for the health benefits of ‘clean eating’? Essentially, the general rule for diets is that the more restrictive they are, the less healthy they tend to be. Some early proponents of extreme 'clean eating' found themselves suffering from hair loss, skin and menstrual issues, and even osteopenia, which is a precursor to the brittle bone disease osteoporosis, normally seen in women after they go through the menopause. This disease can be caused by someone 46 | LIVE TO 100 WITH DR HILARY JONES

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cutting out food groups such as dairy, particularly if it is a lifelong habit. Even the phrase ‘Clean’ eating implies that not following this diet is ‘dirty’ eating, a dangerous idea to put into the impressionable minds of some young people. So what is the sensible alternative to ‘clean eating’? Here are our tips, based on the NHS’s Eat Well Guide.

Base your meals on higher fibre starchy carbohydrates. These should make up over a third of what you eat, including bread, rice, pasta, cereal, and potatoes. To make sure, include at least one starchy food with each main meal.

Eat less salt. Eating too much salt can raise your blood pressure, which can have serious long-term health consequences. Have a look at the labels on the back of your products - more than 1.5g of salt per 100g qualifies as a high salt count and should be avoided.

Get active and be a healthy weight. Exercising regularly is essential to reduce your risk of developing serious health conditions. Exercise is also important for your mental health.

Eat lots of fruit and veg. Regardless of whether you juice or not, getting your five a day is essential for maintaining a healthy diet. It does not matter whether they are fresh, frozen, canned, dried, or juiced.

Eat more fish, a great source of protein, vitamins, calcium and minerals. You should aim to eat at least two portions of fish a week, including a portion of oily fish. Try Brunswick tinned sardines, available in a delicious range of contemporary flavours including mustard, lemon, and hot peppers. See www.brunswick.ca.

You should regulate your alcohol consumption to 14 units per week, that's about six pints of beer or glasses of wine, spread out over three days or more. You don’t have to sacrifice the taste of luxury wines to drink healthily. ThinK Wines Prosecco and Pinot Grigio Sparkling Rosé are 100% vegan, organic and have reduced calories and sugar, ideal for the health conscious individual that still wants a great tasting wine that you associate with the Italian vineyards. See www.thinkwinegroup.co.uk.

7 8

Do not get thirsty. Simply, drink plenty of water, between 6 and 8 glasses a day.

Do not skip breakfast, it's the most important meal of the day. Breakfast sets you up with all the nutrients and energy you need to get up and go! • celebrityangels.co.uk

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YOUR Wellbeing

DID YOU KNOW? You don’t always have to eat fresh fruit and veg to get your ﬁve-a-day. Unless you’re feeding a family, it can be hard to get through a variety of fresh fruit and vegetables before they go oﬀ. Buying tinned or frozen means that you only use what you need, so there’s less waste. (Source: Age UK)

Images: Shutterstock

REMEMBER Most of us still are not eating enough fruit and vegetables. They should make up over a third of the food we eat each day. In 2020, a National Diet and Nutrition Study found that the calcium intake of one in six women under 24 was deemed worryingly low. celebrityangels.co.uk

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Best Foot Forward If you have diabetes is it important that you take care of your feet, particularly as you age. But why is this so important and how can we better care for our feet?

iabetes is a lifelong condition that causes the blood sugar level to become too high. This can have detrimental effects on many different parts of the body and adversely affect quality of life. There are two main types of diabetes: Type 1 and Type 2. Type 1 diabetes is caused when the body's immune system attacks and destroys the cells that produce insulin. This is usually developed from birth or a

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DID YOU KNOW? Though there is variation between countries, worldwide 1 in 7 people with diabetes will develop a foot ulcer. (Source: Annals of Medicine)

young age and is less common than type 2. Type 2 diabetes is a result of the body not producing enough insulin, or the bodyâ&#x20AC;&#x2122;s cells do not react to insulin, meaning glucose stays in the blood and is not converted into energy. The latter is usually associated with obesity, and tends to be diagnosed in older people. Around 90 percent of the 4.7 million people with diabetes in the UK suffer from Type 2 diabetes. This number is rising rapidly in the UK and worldwide, celebrityangels.co.uk

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YOUR Wellbeing Remember Worldwide, 1 in 11 adults has diabetes. In 2017, approximately 425 million people of the global adult population have diabetes. By 2045 this will rise to 629 million.

with many not knowing they even suffer from it. If you have a high blood sugar level, you are likely to feel thirsty and subsequently pass urine more frequently, particularly at night, and can lead to constant tiredness. This can affect your daily life at home and work.

Images: Shutterstock

Outcomes Diabetes can cause serious long-term health problems. It’s the most common cause of vision loss and blindness in people of working age. Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year for diabetic retinopathy. celebrityangels.co.uk

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Diabetes is also responsible for most cases of kidney failure and lower limb amputation (other than accidents). People with diabetes are up to five times more likely to have cardiovascular disease, such as a stroke or a heart attack, than those without diabetes. It is important to look after your feet if you have diabetes. The condition can reduce the blood supply to your feet and cause a loss of feeling known as peripheral neuropathy. You should see a podiatrist at least once a year to check up on this issue. These problems often become more serious in elderly sufferers where cuts, blisters or grazes caused by ill-fitting or rubbing footwear can go undetected and untreated due to the lack of sensation caused by nerve damage, and the person’s physical inability to check their feet on their own due to age-related mobility issues. Around one out of 10 diabetics suffer with foot ulcers. These injuries may begin small, but can grow larger, become infected or fail to heal properly. As they linger, more rigorous treatment may be needed to restore the area back to health. However, these small and helpful tips for foot care will give you peace of mind. hh Keep your feet clean. Go to extra measures, such as having a footbath every evening and drying thoroughly.

hh C ut your toenails. This will reduce the places where bacteria can collect and mean your shoes will fit better. hh Never walk barefoot. Even in your garden on the beach, not walking barefoot will reduce your chances of scrapes, cuts, and ulcers. hh Wear shoes that fit well, and don’t squeeze or rub. By doing this, you will drastically reduce the chances of getting corns and calluses, nail problems, and ulcers.

Footwear Diabetics simply need to wear footwear that fits well. It must be soft, supportive, and forgiving – with ample padding around the rub of the foot, ankle, and toes. You should look for footwear that is seam-free inside, so that it does not rub sensitive feet while walking. For the same reason, you should consider diabeticfriendly socks that have smooth seams around the toes. Particularly, you must ensure that you find footwear that is a wide enough fitting, especially if you suffer from wider than average or swollen feet. Don’t fall for the idea that you can ‘break in’ narrow footwear – it’s more likely that it will simply squeeze your feet, leading to the more serious diabetic foot problems. Correctly fitting footwear will fit and feel comfortable straight away. Hunt down footwear that features removable insoles to adjust the fit to each particular foot as this can ensure the perfect fit, regardless of whether you have diabetes or not. • Live to 100 with Dr Hilary Jones | 51

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YOUR Wellbeing

A sight for sore lips

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Painful and unsightly, cold sores can be a recurring problem, but what causes them and what can be done to treat them?

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YOUR Wellbeing Remember Avoid close contact with children when you have a cold sore. Kissing a baby if you have a cold sore can lead to neonatal herpes, which is very dangerous to new-born babies.

Symptoms A cold sore usually starts with a tingling, itching or burning feeling, after which a blister will appear. The blisters can appear anywhere on the face, small and fluidfilled, before they then burst and scab over, 54 | Live to 100 with Dr Hilary Jones

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forming the painful sore. Whilst the sores usually resolve themselves within 10-14 days, your cold sore will be very contagious throughout this period. What should you do when you get them? Here are some do’s and don’ts when a cold sore appears. Do 99 Eat cool, soft foods. 99 Make sure to wash your hands with soap and water before and after you apply cream to your cold sore. 99 If you are going to be in the sun outside, use sunblock lip balm at SPF 15+ 99 To ease the pain and swelling, take paracetamol or ibuprofen – but do not give aspirin to children under the age of sixteen. 99 Avoid dehydration. Don’t 88 Kiss anyone while you have a cold sore. 88 - Share anything that has come into contact with a cold sore, including towels, sore cream, cutlery, or lipstick. 88 Have oral sex until your sore completely heals, as there would be a chance of giving your partner genital herpes. 88 Touch your cold sore, apart from to

It’s simplex Other than using recommended creams and ointments to treat the uncomfortable and painful symptoms of cold sures, such as itching, tightness, burning, and tingling, you can use a heat device to selfadminister a brief, concentrated burst of high temperature which should prevent the development of the condition and promote faster healing. These devices have been shown to reduce the duration of cold sore blisters by 50 percent, or even preventing the development entirely, if caught and applied early enough. They are suitable for almost anyone including pregnant women, those who suffer from allergies, and the young. The benefit of these heat devices is that they are simple, convenient, and covert. All you have to do is remove the protective cap, place the ceramic contact plate onto the affected area and gently press it against the skin. The plate will heat up to 51 degrees for 3 seconds, before switching off. If symptoms persist, you can treat the same area of skin multiple times, if you leave a gap of at least 2 minutes between applications. You must never apply this treatment more than 5 times in the same area in an hour. Afterward, put the device’s cap back on and get on with your life – don’t let a cold sore ruin your day! •

Images: Shutterstock

old sores are uncomfortable, annoying, painful, and unpleasant. Combine this with feelings of fear, humiliation, awkwardness, and shame caused by social pressures that stigmatise those with visible cold sores, and they can leave you feeling self-conscious and unwilling to leave the house. For children, it can lead to being bullied at school. So what causes them, and why do they keep coming back? Cold sores are a common infection caused by the virus Herpes Simplex. Once you have the virus, it will stay in your skin for the rest of your life. Sometimes it flares up and causes a cold sore. Most people become exposed to the virus in childhood after close skin-to-skin contact, such as kissing, with someone who has a cold sore. It does not normally cause any symptoms until you're older, and there is no way to know if it is in your system unless you get a cold sore. Cold sores can appear after a period of exhaustion, and they have also been linked with menstruation and pregnancy.

apply cream, unless you wash your hands first. 88 Don’t rub cream into the sore, dab it on instead. 88 Don’t eat acidic or salty food if it makes the cold sore feel worse.

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YOUR Wellbeing

Stand Up For Your Pits Conventional deodorants may not be good for your armpits – so does it make sense to move towards natural solutions?

Fragrances Aluminium, found in antiperspirants, is thought to cause “gene instability” in breast tissue, and may lead to the development of tumours or cancer cells. Research shows that over 50 percent of breast cancers start in the upper outer 56 | Live to 100 with Dr Hilary Jones

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quadrant of the breast local to the underarm region, and while this isn’t conclusive, doctors suggest that it may be worth avoiding using antiperspirants containing aluminium, particularly if you shave your armpits. The antibacterial Triclosan is commonly used in aerosol deodorants, and though there are no known human hazards associated with it, it may be worrying that it is so common that it is detectable in most people’s urine. Phthalates, which help the deodorant

adhere to the skin, may interfere with the body’s use of testosterone, and the catchall term ‘fragrances’ covers a whole range of potentially allergenic compounds. While research into many of these compounds is inconclusive, researchers argue that the causes of conditions such as cancers are sometimes hard to pin down, and they prefer to err on the side of caution. Looking for natural deodorants without parabens, Triclosan, aluminium or fragrance may be a start towards treating our armpits better. •

Images: Shutterstock

any of us start the day with a shower and a quick squirt of aerosol deodorant, but should we be putting more thought into what we apply to our armpits? Part of the problem, scientists say, is that the chemicals in aerosol deodorants can enter our bloodstream directly, rather than being broken down by our digestive systems. Heather Patisaul, Ph.D., an associate professor of biology at North Carolina State University, says “When you put something on your skin, there are times when it can enter your bloodstream without being metabolised.” The problem is that some of the chemicals in aerosol deodorants may be ‘endocrine disruptors’, which interfere with the body’s hormonal system. Endocrine disruptors can be stored in the fat cells that surround the armpits, and could also affect hormone receptor cells. Other ingredients commonly found in aerosol deodorants may be carcinogenic, or may interfere with the microorganisms of the gut biome which play a part in digestion. For instance, parabens, used as preservatives in deodorants and other products, may interfere with the regulation of oestrogen and other hormones, and could affect oestrogensensitive tissues in the breast.

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DNA Dreams Is ‘gene therapy’ the solution to all our medical ills? With DNA breakthroughs constantly in the news, it’s time to sort out the facts

ttention-grabbing “scientific breakthroughs” are often in the news, but in reality, medical innovations are a cautious, gradual, slow process with clinical experimentation and continuous improvement until it reaches any patients. After many years of research, gene therapy looks like becoming a routine medical approach to addressing serious unmet medical needs. Live to 100 takes a look at what this exciting method is, what it can treat, and the state of play is the field.

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Gene therapy is the process of introducing DNA, the building-block of genetic information, into a patient to treat a certain genetic disease. The new DNA usually contains a functioning gene to correct the effects of a disease-causing mutation. The concept of gene therapy has been around since 1972, but until recently it has had limited success in treating human diseases. However, with the complete analysis of the human genetic structure or genome, this is slowly changing, and the future for the technique looks bright.

There are main types of gene therapy depending on which types of cells are treated: hh Somatic gene therapy: transfer of a section of DNA to any cell of the body that doesn’t produce sperm or eggs. Effects of gene therapy will not be passed onto the patient’s children. hh Germline gene therapy: transfer of a section of DNA to cells that produce eggs or sperm. Effects of gene therapy will be passed onto the patient’s children and subsequent generations. celebrityangels.co.uk

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Did you know? The first approved gene therapy clinical research started in 1990, at the National Institutes of Health (NIH) in the US, under the direction of William French Anderson.

Another technique that can be used in the fight against cancer can be through the killing of specific cells. This method destroys certain groups of cells; the aim is to insert DNA into a diseased cell that causes that cell to die. This can be achieved in one of two ways - the inserted DNA contains a “suicide” gene that produces a highly toxic product which kills the diseased cell - or the inserted DNA causes expression of a protein that marks the cells so that the diseased cells are attacked by the body’s natural immune system. However, many genetic disorders that can be targeted with gene therapy are extremely rare. Gene therapy therefore often requires an individual, case-by-case approach. This may be effective but may also be very expensive.

State of the art The UK is a leader in global cell and gene therapy clinical trials, it has been found by the Cell and Gene Therapy Catapult (CGT Catapult) – a government-backed agency. Keith Thompson, CEO of CGT said: “The total number of cell and gene therapy clinical trials in the UK has been increasing consistently by an average of 25% year on year since 2013. This has been enabled by the development of the UK’s fantastic ecosystem to support the development and clinical adoption of cell and gene therapies.” In CGT Catapult’s publication of the 2019 UK Advanced Therapy Medicinal Products (ATMPs) clinical trials database, it shows that there are 127 ongoing trials, representing a 45 percent increase compared with 2018. In 2019, there were 90 cell therapy trials recruiting patients, compared with around 55 in 2018, and the data suggest that these trials are quickly moving through planning and regulatory approvals to recruitment stage. These figures are increasing year on year, and the future is looking bright for treating hugely damaging diseases in a number of patients. At the cutting edge of research for the moment then, but in years to come gene therapy may be a route to the elimination of hundreds of medical conditions until now beyond our control. •

Images: Dreamstime, Shutterstock

There is a reason that gene therapies have been described as ‘the future of the healthcare system’, with revolutionary potential. When you consider that 80 per cent of rare diseases have a genetic component, these treatments could transform the prospects of thousands of people living with these conditions, creating a brighter and more sustainable future for them and their families. Gene therapy may be a promising treatment option for some genetic diseases, including muscular dystrophy, cancer, and cystic fibrosis. Gene inhibition therapy, for example, has the potential to address some cancers, infectious diseases, and inherited disease that are caused by inappropriate gene activity. In this case, the aim is to introduce a gene whose products either inhibit the expression of another gene or interfere with the activity of the product of another gene. The basis of this therapy is to eliminate the activity of a gene that encourages the growth of disease-related cells. For example, cancer is sometimes the result of the over-activation of an oncogene (gene which stimulates cell growth). So, by eliminating the activity of that oncogene through gene inhibition therapy, it is possible to prevent further cell growth and stop the cancer in its tracks.

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Long Covid Health Assessment For most people who suffer Covid, their recovery will be quick, resuming their normal lives within a few days. However, for some, the effects of the virus can last for weeks or months. This “long Covid” can cause symptoms such as profound fatigue, breathlessness, anxiety and depression, palpitations, chest pains, joint or muscle pain, difficulty in concentrating and ‘brain fog’. Other issues can involve lung clots, neurological abnormalities and deficits in cardiac, kidney and liver function. In order to minimise the long-term impact of ‘long Covid’ a thorough assessment of such patients is essential in order to devise a structured and personalised management plan. Designed and led by Dr Paul Jenkins who has over 30 years’ experience in the management of patients with post viral fatigue, Echelon Health’s Long Covid Assessment is one of the most comprehensive Assessments available anywhere today.

Core Cancer Health Assessment Lung, Colon and Breast Cancer are unfortunately all too familiar. However, if caught early, are treatable. Early detection is paramount to protect against the biggest killers today. Whilst Echelon Health offers Individual Cancer Assessments focusing on targeted areas, the Core Cancer Assessment includes a wide range at the same time. Offered to both men and woman, this assessment like all of our assessments save lives. Disease does not discriminate against age, gender, or wealth it can attack anywhere anytime. Detecting over 92% of all diseases, we do not guess. We do not base your results on probability or national averages, our assessments are about You, and what is going on inside YOUR body. Echelon Health is here to provide that peace of mind so you can plan-ahead with those you love.

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Women’s Health In 2020 it was reported one million breast screenings were missed or cancelled throughout the UK due to Covid. This alarming figure has resulted in a prediction that 8,600 women may now be living with undetected breast cancer. Due to increased pressures on the NHS this figure is set to rise. With all preventive screening, early detection is paramount for the highest survival rate. At Echelon Health we offer a rapid breast screening assessment utilising the most advanced screening equipment either as a single scan, or as part of our Well Woman Package which includes a Medical Questionnaire, Blood Tests, Ovaries Ultrasound Scan, Digital Mammogram, and your final consultation. The Government guidelines are clear and supportive that Medical Appointments should not be delayed. www.echelon.health/breast-screening-in-london

Monthly Evergreen Membership ‘Whether you are looking for a cost-effective health scanning solution or a life-long programme to give you and your family peace of mind, our Evergreen Membership may be perfect for you. For a one-off activation fee and then ﬁxed monthly fee you will receive a tailored programme of scans, arranged over 3 years, and conveniently scheduled to ﬁt with your busy life. You will receive not only the scans and assessments that would normally only be available with our Platinum Package but also additional annual blood tests, an annual full body mole check and follow up consultations after each set of scans you undertake.

Life saving testimonial ‘The bottom line is that I was diagnosed with a cerebral ﬁstula in my brain, a condition from which I was suffering no symptoms and would have been completely undetectable in a normal medical. Post diagnosis I was referred to one of the best specialists in the country and operated on a few days later thus avoiding a potential brain haemorrhage or quite possibly a life ending trauma. I do hope that others will treat themselves to the full preventative maintenance regime that they and their families deserve’. Nick Finegold, CEO, Curation Corp

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Prevention

is Better Than Cure Can a bespoke approach to health assessment avoid many of the medical conditions we take for granted?

ny doctor will tell you that prevention is better than cure, and that living a healthy lifestyle can stave off many of the conditions which can affect our later lives and sometimes lead to serious problems or premature death. Yet many of us feel we are too busy to pay attention to our health, and neglect it until something goes wrong. Certainly a healthy lifestyle with regular exercise, a balanced diet, moderate use of alcohol and avoidance of smoking is a sensible aim; but some conditions, particularly those with a genetic origin, are harder to avoid.

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In many cases, waiting until disease strikes is leaving it too late â&#x20AC;&#x201C; no matter how much time or money you spend on your health afterwards. This can be particularly tragic for those with young families left devastated by premature death of a parent. Far better, then, to catch potentially harmful conditions before they develop, and can still be treated.

Have a heart Take, for instance, coronary heart disease. Approximately 300,000 people in the UK suffer a heart attack each year. Of those, around 125,000 will die and astonishingly,

for almost half of them, this is their first sign that there is any health problem. The traditional method of assessing cardiac risk, using Framingham scores, dates from the 1960â&#x20AC;&#x2122;s and uses factors such as age, lifestyle and family history to generate a statistical risk. However, 40-50 percent of individuals who suffer a heart attack have no risk factors and are unaware of their hidden risk, and would be missed by the traditional screening algorithms. Advances in scanning technology offer a more accurate assessment. The latest generation of computerized tomography (CT) scanners can image the inside of the celebrityangels.co.uk

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YOUR Healthcare of health or another – and a bespoke health assessment can pick up on a condition which could otherwise be missed.

Examination

heart arteries in incredible detail to spot the earliest signs of ‘furring up’, providing an accurate assessment of an individual’s risk of coronary heart disease. CT scanning also has applications in detecting lung cancers as small as 1-2 mm, a far more sensitive scan than using X-rays which can generally only detect tumours of 10mm in size, and MRI scanning which cannot image the chest at all. Compared to a traditional Framingham assessment, there’s evidence that results from a CT scan lead to better adherence to lifestyle changes and use of medicines such as statins.

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Key issues To be effective, though, a preventative health assessment must take a bespoke approach. Using generalised, populationbased statistics to provide a statistical risk of disease which is frequently inaccurate. A bespoke advanced health assessment will use modern medical imaging to actually see ‘under the bonnet’ to determine the earliest stage of disease and provide a precise individual assessment. World class providers of preventative Health Assessments such as Echelon Health (www.echelon.health) will assess clients who are otherwise asymptomatic, but wish to be sure that they are healthy. Sometimes there is a specific reason for their concern such as a family history of a specific disease. However, more often than not, it is because celebrityangels.co.uk

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they wish to be proactive and find out what, if anything, is going wrong. One client of Echelon Health, Nick, says: “I was diagnosed with a cerebral fistula in my brain, a condition from which I was suffering no symptoms and would have been completely undetectable in a normal medical. Post diagnosis I was referred to one of the best specialists in the country and operated on a few days later thus avoiding a potential brain haemorrhage or quite possibly a life ending trauma. I do hope that others will treat themselves to the full preventative maintenance regime that they and their families deserve”. This sort of proactive approach is sometimes disparaged as being the concern of the ‘worried well’, but even NHS screening programmes depend on people being willing to take responsibility for one aspect

A typical health assessment might include a physical examination, lifestyle questionnaire, and tests of body mass index, blood pressure, PSA (Prostate Specific Antigen), and so on. But this approach risks missing many conditions such as coronary heart disease, colorectal cancer and skin cancer. A comprehensive health assessment would use a range of advanced scanning equipment together with the most skilled radiographers, radiologists, clinicians and specialist consultants and physicians to refer the patient to for treatment if anything of concern is found. Apart from detecting disease that may lead to premature death, this approach also minimises the risk of causing unnecessary concerns by flagging ‘abnormalities’ which are in fact within acceptable ranges. From lung, prostate, pancreatic, breast and prostate cancer, to COVID-19 health assessments, Echelon Health can offer an assessment package tailored around your busy life – you can even sign up for an Evergreen package with regular assessments, follow-up consultations and a GP service. The cost of this level of care is obviously a factor, but you might think it’s one worth paying for peace of mind so you can look forward, plan ahead and ensure more time with those you love. •

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Dealing with Diabetes Though itâ&#x20AC;&#x2122;s an increasingly common condition, many people are still unaware of the causes and possible consequences of diabetes. We search out the facts

iabetes is a lifelong condition that causes blood sugar levels to become too high. This can be detrimental to many different organs and systems and can have severe health consequences.

There are two main types of diabetes: Type 1 and Type 2. hh Type 1 diabetes - This is caused when the body's immune system attacks and destroys the cells in the pancreas that produce the hormone insulin, which breaks down sugars. Often, this type of diabetes is present from birth or an early age, though itâ&#x20AC;&#x2122;s less common than type 2 diabetes. hh Type 2 diabetes This is a result of the body not producing enough insulin, or the bodyâ&#x20AC;&#x2122;s cells failing to respond to insulin, meaning glucose stays in the blood and is not used for energy. Type 2 diabetes is usually associated with obesity, and tends to be diagnosed in older people. Around 90 percent of the 4.7 million people with diabetes in the UK suffer from Type 2 diabetes. This number is rising rapidly in the UK and worldwide, with many not knowing they even suffer from it.

Symptoms People do not often realise they have type 2 diabetes because the symptoms do not necessarily make you feel unwell. 64 | Live to 100 with Dr Hilary Jones

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The symptoms of type one and two are the same, so it is important to go to your GP if these problems persist. They include: hh Feeling very thirsty hh Peeing more than usual, particularly at night hh Feeling very tired hh Losing weight without trying hh Recurring infections such as thrush hh Blurred vision hh Cuts and grazes that are not healing While these symptoms can appear minor, they are the sign of long-term organ damage which can become progressively worse. Diabetes is the most common cause of vision loss and blindness in people of working age, so everyone aged 12 or over should be invited to have their eyes screened once a year for diabetic retinopathy, damage to the back of the eye. Diabetes is also responsible for most cases of kidney failure and lower limb amputation (other than accidents). People with diabetes are up to five times more likely to have cardiovascular disease, such as a stroke or a heart attack, than those without diabetes. Images: Dreamstime, Shutterstock

Treatments It is essential that people with type one diabetes take insulin. Insulin is a hormone manufactured in the pancreas which helps your body use glucose (sugar) for energy. In type 1 diabetes the pancreas no longer makes insulin, so you have to inject it to control your blood glucose levels. There are celebrityangels.co.uk

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different types of injectable insulin, taken at different times. hh Basal insulin - long-acting, background or basal insulin is taken once or twice a day, and gives your body the insulin it needs whether you eat or not. Basal insulin should keep your blood glucose stable overnight and between meals. hh Fact-acting insulin - taken with food or drink, fast-acting, mealtime or bolus insulin helps reduce the rise in blood glucose caused by eating or drinking. You usually take it before a meal, snack or drink with carbohydrates in it. There are many types of medicine for type 2 diabetes, and it can take time to find a medicine and dose that's right for you. You'll usually be offered Metformin first. If your blood sugar levels are not lower after taking Metformin, you may need another medicine or a combination of medicines. Your GP or diabetes nurse will recommend the medicines most suitable for you. Insulin is not often used for type 2 diabetes in the early years, though it may be needed if other medicines fail to work.

Coronavirus It appears that diabetics are no more vulnerable to coronavirus than anyone else, and if they do contract it, regardless of what type of diabetes you have, the majority of people will have mild symptoms and wonâ&#x20AC;&#x2122;t need to go into hospital. However, as with anyone else, there is a small risk of people with diabetes being severely affected by coronavirus, though this is unlikely to happen with children. The problem seems to be that any severe illness can disrupt blood sugar levels, and this is of course crucial for diabetics. The body can try to fight the illness by releasing stored glucose (sugar) into the blood stream to supply energy, and if your body canâ&#x20AC;&#x2122;t produce enough or any insulin to cope with this, so blood sugars levels will rise. For advice on coping with diabetes and up-to-date advice on coronavirus, visit www.diabetes.org.uk. â&#x20AC;˘ Live to 100 with Dr Hilary Jones | 65

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Corona Nation The coronavirus pandemic has dominated world headlines this year. Can we look forward to a cure, or is it going to become a part of our everyday lives?

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s we write, the UK is once again in a general lockdown, having endured a very restricted Christmas and New Year. But there is hope on the horizon; coronavirus vaccines from Pfizer/BioNTech and from Oxford/AstraXeneca have been rolled out after performing well in trials, and Health Secretary Matt Hancock has stated that the NHS is ready to handle a mass program of vaccination throughout the year. Since the pandemic took hold in the UK in March 2020, it’s been impossible to predict how it would spread and which countries would be affected most. Some countries with advanced medical systems such as the USA seem to have found it politically or socially difficult to stop the spread of the virus; while others with less concentrated populations or better border control such as New Zealand seem to have escaped its effects almost entirely. The irony, of course, is that there are many forms of coronavirus in circulation, and have been for decades – the name comes from the ring of protein spikes surrounding the body of the virus, and it’s most commonly found in forms of influenza. COVID-19, the coronavirus responsible for the current pandemic, just happens to be a particularly infectious and potentially dangerous instance of a type of virus we have been living with throughout human history. Unrestricted international travel has been the determining factor in the rapid intercontinental spread of the virus, which

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originated in food markets in Wuhan province, China. Later in 2020 even more infectious variations of the virus developed, and it could be that it will mutate further and develop new features. While international health authorities scrambled to supply enough hospital beds, emergency hospitals, respirators, personal protective equipment and trained staff to fight the pandemic, what really seems to have stymied them is the behaviour of the virus, which has some very unpredictable aspects – such as being more dangerous to older and BAME patients, yet almost harmless to children.

VIGILANCE Though the news of a range of potential vaccines comes as a relief, the Health Secretary has pointed out that this is not the time to relax vigilance, since “This is still a deadly disease, and this is not over yet. Even once we start to roll it out, we still need to look after ourselves, look after our community by following the rules and being careful to stop the spread of transmission.” Until the vaccines have been widely applied, the 'R'-rate, or rate of spread of infection, may remain dangerously high, and local or national lockdown restrictions will still apply. Vaccines are being made available available to different groups in an established order, with the elderly and vulnerable and care workers first in line. The progress of vaccination may also depend on which vaccines prove the most Live to 100 with Dr Hilary Jones | 69

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Staying connected in uncertain times The mobile phone is a lifeline for the older generations If the Covid-19 pandemic has taught us one thing, it is that we all have a need to be connected with loved ones – and we suffer more when that connection is lost or taken away from us. For the older generations, even those who are enjoying a peaceful and positive retirement, there is now a need to evolve and adapt to new and changing communications technology. Mobile phone manufacturer emporia, which specialises in simplifying the usability and design of technology to make it easier for older users to do more and with confidence, conducted extensive research throughout last year. They discovered just how vital mobile devices have become and how important it is that the retirement generation feels comfortable using the technology. At the beginning of 2020, the average amount of time spent on a mobile phone screen, per day, by those over the age of 66 who own a smartphone, was just 12 minutes – compared with four hours per day for 16-24 year olds. Towards the end of the year however, emporia found that 86% of older smartphone users were using their device much more than before. And three in five said their device helped them to feel less disconnected during the national restrictions.

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Developing technology Changes in mobile technology will help people live richer and more fulfilled lives, but, for the retirement generation, the key is to design products which are more accessible, giving the users a better understanding so they are able to get the most from it. This is what drives emporia. The new emporiaSMART.4 mobile combines many of these elements in a straightforward smartphone with a difference. It has a large screen, with easy to understand icons, large text and loud sound. Importantly, the S4 comes with a QR scanner already embedded – perfect for checking into venues as part of the national “track and trace” system. It also has NFC (near field communication) which means that it can be used for contactless payment in a more secure way than just using credit or debit cards – and without the need to touch payment card readers. With front and rear facing

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cameras, the S4 is perfect for staying in touch with WhatsApp video calls. Emporia’s research showed that more than 50% of retirees with a smartphone use WhatsApp regularly and 30% use it to stay in touch with grandchildren directly. The S4 also has a magnifying glass feature which is perfect for reading things if you have left your glasses at home or the light isn’t good.

More than 150 pages of easy-to-follow instructions take new users through everything they need to know, and at their own pace. Users can learn how to pinch and zoom on screen, how to swipe and how to download and access apps. They can learn all about contactless payments and how to keep their phone secure and, of course, how to use WhatsApp to stay in touch. Following these instructions is made easy with the design of the S4 user interface, where large icons point the way for the most used and most useful functions.

Game changer But perhaps the single most impressive thing about the S4 is that every device not only has a standard user manual, but also comes with a unique illustrated training book. Emporia believes this is a game changer in helping older users enter the smartphone world.

Chris Millington, Managing Director of Emporia Telecom in the UK and Ireland said: “A global pandemic with lockdowns, isolation and restrictions has pushed our older generation into a digital journey they perhaps had not foreseen. But simplifying technology is a key enabler in helping them find their way. “But on a more positive note. The changes they embrace in mobile technology now will stay with them for the long term, long after this pandemic is over. Planning holidays, banking online, following the news and much more, making them feel more connected and more confident in their later years.”

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Normal life So when can we expect to get back to normal life without any restrictions on our movement or socialising? It’s hard to say, particularly since we haven’t yet got through the Winter ‘flu season, but Professor Ugur Sahin, BioNTech co-founder, has said that the life could be normal by next winter. "I'm very confident that transmission between people will be reduced by such a highly effective vaccine - maybe not 90% but maybe 50% - but we should not forget that even that could result in a dramatic reduction of the pandemic spread," he said. During the COVID-19 pandemic, older people have been advised to stay at home and limit social contact with others. People showing symptoms of COVID-19 are advised to completely self-isolate. As a result, these people are at increased risk of loneliness and social isolation. Family, friends and neighbours should take steps to support people who are self-isolating. 72 | Live to 100 with Dr Hilary Jones

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Research conducted by mobile phone manufacturer emporia – which specialises in designing user-friendly devices for seniors – showed that as Covid restrictions impacted on our lives in 2020, 86 percent of smartphone users over retirement age used their phone significantly more than before, and three out of five believed their phone stopped them from feeling disconnected. For details of their complete mobile range go to www.emporiatelecom.co.uk. Some measures we could take to help people who are self-isolating include: hh O ffer to go shopping hh Set up regular phone calls with isolated friends and loved ones hh Set up older relatives with a tablet/ laptop/smartphone to enable them to have regular video calls with family hh Deliver a DVD series they might like hh Encourage older people who are still well to stay active and go for walks hh Contact Age UK about local befriending services hh Encourage them to pursue indoor hobbies such as writing, art, reading, organising photos, crafting or puzzles

Long Covid Researchers are warning that even after recovering from coronavirus infection, patients can suffer symptoms for months – so-called ‘long COVID’. Symptoms are diverse and can span respiratory, cardiovascular, neurological, dermatological or renal issues, some

Remember that it is cold season - if you have a cold, it is probably just a cold. As a reminder, the main symptoms of coronavirus are a high temperature, a new, continuous cough and a loss or change to your sense of smell or taste. of which can be serious (e.g. strokes, pulmonary embolisms). More commonly, exhaustion, vomiting, high temperature, chills, muscular aches and insomnia are experiences – and there’s an occasional incidence of purple discolouration of the feet known as ‘COVID toes’. NHS England’s Your COVID Recovery website offers personalised support for all patients recovering from COVID-19. The government has promised new and strengthened rehab centres and community services, and in Wales, community and specialist rehabilitation programmes are likely to be the forum for offering Covid care. The Department of Health in Northern Ireland says it is assessing the long-term needs of Covid patients, while Scotland is planning to provide “high quality personcentred rehabilitation in different settings”. So we’re not out of the woods yet, but many valuable lessons have been learned and the prospect of a COVID-19 free nation is a tantalising one. •

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effective. The Pfizer/BioNTech vaccine uses a piece of viral RNA which stimulates the production of antibodies and killer T-cells, and is claimed to be 90 percent effective, but it has to be stored in extraordinarily low temperatures. The Oxford/AstraZeneca vaccine, normally 70 percent effective, may be up to 90 percent effective if a variant vaccination routine is used. Ideally, the vaccines require two jabs a few weeks apart, but initially it may be more important to get a first jab done for a larger number of people, with the second jab perhaps three months later. The initial Pfizer/BioNTech trials noted no serious side-effects, other than headaches and fatigue in around two percent of test volunteers. In this trial, 42 percent of participants were from diverse ethnic backgrounds and 41 percent aged between 56 and 85 years old. Trials are continuing and will collect data on safety and efficacy of the vaccine for another two years. The vaccine is being tested on people at 150 sites in the US, Germany, Turkey, South Africa, Brazil and Argentina. The companies expect to produce up to 1.3 billion doses by the end of 2021.

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YOUR Healthcare

The Rights of Women Many health issues are specific to women, but often overlooked when it comes to research and provision of services. How is the situation changing?

any medical conditions which affect mainly or only women, such as breast cancer, ovarian and cervical cancer, gynaecological health, pregnancy issues, autoimmune diseases, endometriosis, osteoporosis, post-natal depression, and domestic violence, have been overlooked when it comes to research and provision of services. In fact some recent medical trials have been discredited because they didn’t use an appropriate number of female subjects. Live to 100 is going to focus on three major health issues facing women; breast cancer, endometriosis, and violence against women, and we will be asking some experts why getting effective diagnosis and treatment for these issues has historically been difficult.

BREAST CANCER Breast cancer is the most commonly occurring female cancer in the UK but earlier diagnosis and improvements in treatment are resulting in the majority of women surviving their diagnosis. In the UK, breast cancer survival has improved by around 40 percent over the last 40 years. Eight in ten women diagnosed and treated for breast cancer today in the UK are predicted to survive their cancer for at least ten years. At present, knowledge of all the factors resulting in the development and growth of breast cancer is incomplete. Gene mutations in breast cells are necessary for all breast cancers to be initiated but 74 | LIVE TO 100 WITH DR HILARY JONES

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progression and further development also depends on complex interactions with lifestyle and reproductive risk factors. A small proportion of women are at an elevated risk due to a family history, where the gene mutations are inherited (up to 10% of all breast cancers diagnosed annually in the UK). In most women diagnosed with breast cancer (about 90 percent) the gene mutations resulting in their diagnosis develop during their lifetime. In women at risk, by far the greatest risk factor for being diagnosed with breast is age, which cannot be avoided. In addition, there are some lifestyle and reproductive factors associated with an increased risk of breast cancer diagnosis. It has been estimated approximately 23 percent of all the breast cancers diagnosed in the UK could be prevented by avoiding or reducing exposure to lifestyle-based risk factors. It is currently impossible to predict on an individual basis who might be at risk.

 Risk factors associated with lifestyle and female reproduction, such as prolonged exposure to sex hormones [oestrogen] produced within the body  Early age starting menstrual periods and late age at menopause  Being overweight/obese and postmenopausal.  Exposure to sex hormones [oestrogen and progestogen] taken in the form of medication, such as the use of hormonal contraceptives and hormone replacement therapy (HRT).  Changes to metabolism of female sex hormones, such as through smoking and alcohol use  Not having children or a first full-term pregnancy at a later age or not breast feeding can increase the risk of normal breast cells becoming malignant.  Lack of physical activity  Clearly, with many factors thought to contribute to the likelihood of breast cancer, screening for early detection of the condition is vital.

Factors associated with an increased breast cancer risk include:  Gender (breast cancer diagnosis is overall 200 times more common in women than in men)  Increasing age (most breast cancers are diagnosed in women over 50)  Family history  ‘High risk’ benign breast conditions, which cannot be easily identified, leading many women to never be diagnosed in their lifetime

About one quarter of breast cancers diagnosed annually in women in the UK are done so via the NHS Breast Screening Programme. The remainder are diagnosed in those presenting to their GP with breast symptoms. Currently, with optimal treatment two in three women will survive their disease beyond 20 years. For many women, it is a condition they live with, rather than die from. Female deaths from breast cancer per year in England and Wales (four celebrityangels.co.uk

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Everyone can take steps to lower their chances of getting breast cancer by making small healthy changes and living well now, including drinking less alcohol, maintaining a healthy weight and keeping physically active.

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percent) are much lower than those due to Alzheimer’s disease and dementia (16 percent), heart disease (eight percent) and stroke seven percent). Once a diagnosis of breast cancer is confirmed, management generally involves varying combinations of surgery, radiotherapy, anti-oestrogen hormone therapy, chemotherapy and immunotherapy. Treatment recommendations are based on the individual features of a breast cancer (e.g. the size, grade and stage of the breast cancer), menopausal status and an individual’s general health.

Endometriosis Endometriosis is a condition whereby fragments of cells like the ones in the lining of the womb (the endometrium) develop elsewhere in the body. As the endometrium grows during the menstrual cycle so do the fragments, causing debilitating pain. They then break down and bleed, just like the uterus lining. However, this internal bleeding has no way of leaving the body, and leads to inflammation, pain, and the formation of scar tissue (adhesions). Endometriosis can be hard to diagnose (on average diagnosis can take 7-10 years according to the British Journal of Medical Practice). The condition can have a significant impact on a person's life in a number of ways, including: hh Chronic pain hh Fatigue/lack of energy hh Depression/isolation hh Sexual problems hh Inability to conceive hh Disruption of everyday work and social commitments However, with the right endometriosis treatment, many of these issues can be addressed, and the symptoms of endometriosis made more manageable. It’s important to remember that endometriosis is not an infection, 76 | Live to 100 with Dr Hilary Jones

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contagious, or cancer. The actual cause of endometriosis is unclear, though these may be factors: hh Retrograde menstruation. This occurs when some of the womb lining flows up through the fallopian tubes and embeds itself on the organs of the pelvis, rather than leaving the body as a period. hh Genetic predisposition. Some families may be more susceptible to endometriosis, but the causes of this are unclear. hh Lymphatic or circulatory spread. Endometriosis tissue particles are thought to somehow travel round the body through the lymphatic system or in the bloodstream. This could explain why it has been found in areas such as the eyes and brain.

Domestic violence Our final major women’s health issue may not strictly be a medical one, more a social one, but it is significant, and has relatively recently been treated as a health issue. The phrase ‘Violence Against Women’ is used to describe ‘any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life’ (BMA).

As well as abuse and domestic violence, it also includes rape and sexual abuse, crimes against women and girls based on notions of ‘honour’, forced marriage, forced prostitution and trafficking, female genital mutilation, and sexual harassment. Factors such as age, financial dependence, poverty, disability, homelessness, and insecure immigration status can heighten women’s vulnerability to abuse or entrap them further in it. For example, minority ethnic women may face barriers such as racism and language difficulties and may also fear being accused of bringing shame and dishonour upon the family. Women with disabilities may experience communication or physical barriers to getting help or away from an abuser or be isolated because of their impairment. Young women are at high risk of all forms of abuse, yet often this can be overlooked or minimised, particularly in their teenage years. Experiencing abuse or violence as an adult or when a child can have a huge effect on an individual’s life.

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YOUR Healthcare

Remember Two women are killed by their partner every week in England and Wales. Of all female homicides, 40 percent involve gendered violence. The UK police receive a call every minute about domestic abuse, 89 percent of which are about a woman being abused by a man.

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The impacts can be a combination of physical, psychological, sexual, as well as individually. Other impacts may include financial difficulties and becoming homeless.

The issues Dr Kate Young, public health researcher at Monash University in Australia, says: “For much of documented history, women have been excluded from medical and science knowledge production, so essentially we’ve ended up with a healthcare system, among other things in society, that has been made by men for men.” The author Maya Dusenbery supports this in her 2018 book Doing Harm, The Truth About How Bad Medicine and Lazy Science Leave Women Dismissed, Misdiagnosed, and Sick. She writes: “Observing that women tended to have lower rates of heart disease until their oestrogen levels dropped after menopause, researchers conducted the first trial to look at whether supplementation celebrityangels.co.uk

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Did you know? Around 55,000 women and 370 men are diagnosed with breast cancer every year in the UK. (Breast Cancer Now)

with the hormone was an effective preventive treatment. The study enrolled 8,341 men and no women ... And a National Institutes of Health-supported pilot study from Rockefeller University that looked at how obesity affected breast and uterine cancer didn’t enrol a single woman.” Find out more about issues in women’s healthcare from charities www.women atwish.org.uk, www.womenforwomen.org.uk, www.cancerresearchuk.org and www.health.org.uk. • Live to 100 with Dr Hilary Jones | 77

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The Sunshine Vitamin Why is Vitamin D so important that it’s being given out free? We look at the vital role of this essential organic substance

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itamins are organic compounds needed to sustain the human body; there are 13 main ones, and we need to obtain most of them from food, since we can’t produce any or enough of them internally. However, Vitamin D can be synthesized in the human body, but only with the help of sunlight; without sunlight, particularly in the winter months, we may suffer from Vitamin D deficiency, and may need to take supplements. Vegans and people with lactose intolerance may find it particularly difficult to source enough Vitamin D from their diet. Vitamin D deficiency can also be caused by some specific medical conditions, such as cystic fibrosis, Crohn's disease, and celiac disease which prevent the intestines from absorbing enough vitamin D. Kidney and liver diseases can reduce the amount of an enzyme needed to change vitamin D to a form used in the body, and Vitamin D deficiency is more likely in obese people, as fat cells keep vitamin D isolated so that it is not released. A Body Mass Index greater than 30 is associated with lower vitamin D levels. It’s been NHS advice to take Vitamin D supplements in winter for some time; but during the current coronavirus pandemic, it’s been suggested that Vitamin D should be given free to those on the clinically extremely vulnerable list - the 2.7 million people who were asked to shield during the first lockdown - on the principle that it may boost the immune system.

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Remember NHS advice is that you should take 10 micrograms (400 IU) of vitamin D a day between October and early March to keep your bones and muscles healthy. If your doctor has recommended you take a different amount of Vitamin D, you should follow their advice.

Whether or not taking Vitamin D supplements can help protect against winter infections such as influenza, and even coronavirus, there’s no doubt that Vitamin D is essential to a whole range of bodily functions.

Sunlight Sometimes known by its chemical name of ergocalciferol or cholecalciferol, Vitamin D helps to regulate the amount of calcium and phosphate, nutrients needed to keep bones, teeth and muscles healthy, Live to 100 with Dr Hilary Jones | 79

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Vitamin D is found in oily fish, red meat, liver, egg yolks and fortified foods such as some fat spreads and breakfast cereals. In the UK, cows' milk is generally not a good source of vitamin D because it is not fortified, as it is in some other countries. so a lack of vitamin D can lead to bone deformities such as rickets in children, and bone pain caused by a condition called osteomalacia in adults. It’s also been suggested that Vitamin D deficiency may contribute to heart disease, high blood pressure, diabetes, infections and immune system disorders, colon, prostate and breast cancers and Multiple Sclerosis. 80 | Live to 100 with Dr Hilary Jones

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From about late March/early April to the end of September, most people should be able to get all the vitamin D they need from sunlight, but between October and early March we do not get enough vitamin D from sunlight, so supplements may be needed. hh Babies up to the age of a year need 8.5 to 10 micrograms of vitamin D daily. hh Formula-fed babies should not be given a vitamin D supplement until they're having less than 500ml (about a pint) of infant formula a day, as infant formula is fortified with vitamin D hh Children from one year and adults need 10 micrograms of vitamin D a day. hh Children aged one to four should have a daily supplement containing 10 micrograms of vitamin D hh Everyone (including pregnant and breastfeeding women) should consider taking a daily supplement of 10 micrograms of vitamin D in autumn and winter. Women and children who qualify for the Healthy Start scheme can get free

supplements containing vitamin D. The Department of Health and Social Care recommends that you take a daily supplement containing 10 micrograms of vitamin D throughout the year if you: hh Are rarely outdoors – for example, if you're frail or housebound hh Are in an institution like a care home hh Wear clothes that cover most of your skin when outdoors hh Are dark skinned, for example if you have an African, African-Caribbean or South Asian background

Exposure Do not take more than 100 micrograms (4,000 IU) of Vitamin D a day as it could cause a build-up of calcium. Some medical conditions mean people may not be able to safely take this much. If in doubt, consult your doctor. You can’t overdose on vitamin D through exposure to sunlight, but always remember to cover up or protect your skin if you're out in the sun for long periods to reduce the risk of skin damage and skin cancer. •

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Did you know?

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Keeping Up The Fight

Against Cancer With NHS facilities diverted to combatting coronavirus, has cancer care lost its priority? We look at the efforts to keep the condition in the public eye

he coronavirus pandemic has hit all of society and, predictably, our healthcare system has been badly affected; not that the worries that the NHS would be overwhelmed by coronavirus patients have been justified, or the emergency Nightingale hospitals called into use. But apart from the tragic consequences of the coronavirus pandemic itself, there have been knock-on effects in other areas of care, including clinical research, diagnosis and delivery of treatment, all of which are likely to have long-term effects. So how has the NHS responded in critical areas such as cancer diagnosis and care?

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Screening The NHS continues to offer cervical, bowel, and breast cancer screening programmes to identify those at high risk of these cancers, to enable an early diagnosis and treatment for individuals affected. However, at the pandemicâ&#x20AC;&#x2122;s peak, cancer screening services were paused across the UK, to protect individuals from COVID-19 infection and to enable the redeployment of healthcare professionals to critical areas. It has been predicted that approximately 200,000 people per week across the UK were not screened for cancer, equating to over 2,200 possible missed cancer cases and resulting in waiting lists for screening appointments continuing to grow. The delayed screening times have the potential to have huge effects both celebrityangels.co.uk

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Did you know? In England, there was a 37 percent drop in the number of patients commencing cancer treatment in May 2020 compared with the same period in 2019. economical and psychological, which are expected to increase. There have also been problems getting people to attend GP appointments during the pandemic, combined with public concerns from some GPs about referring patients to hospital. The number of urgent cancer referrals dropped by around 25 percent in England during the early months of Covid-19. For patients who were referred but required non-urgent diagnostic investigations, this often resulted in deferred appointments because only 2-week-wait urgent referrals were eligible for further investigations. Additionally, the introduction of remote GP consultations could have played a part in the decreased number of urgent referrals for cancer screenings. Being remote, doctors do not have the opportunity to physically examine their patients, which can result in missed signs and symptoms that would usually warrant referral; so missed cancer diagnoses are likely to have increased during this time.

Management Patients with cancer are at an increased risk of the symptoms and long-term effects of COVID-19 compared with their healthy counterparts. As a result, decisions regarding the treatment of such individuals have forced practitioners to choose to commence or continue treatment, against the risks of a possible coronavirus infection for their patient. Fortunately, as we write in November, cancer screening programmes have recommenced their services across the UK. As is necessary, important measures have been put in place to ensure that appointments are COVID-19 safe, such as providing personal protective equipment for staff, instructing and requiring patients to wear a mask and performing temperature checks upon patientsâ&#x20AC;&#x2122; arrival at the clinic. However, with COVID-19 cases continuing to rise, itâ&#x20AC;&#x2122;s hard to say how quickly services can return to normal. Since the number of urgent cancer referrals hit their lowest point in April, the numbers of cancer referrals and individuals starting cancer treatment have slowly increased but, unfortunately, these figures are still lower than prelockdown levels. But a survey of 239 researchers by the Institute of Cancer Research in London has found that major advances in cancer research face being delayed by nearly a year and a half due to the pandemic. The effects of lockdown, the closure of laboratories and a shift in research Live to 100 with Dr Hilary Jones | 83

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YOUR Healthcare funding from cancer to Covid-19 have hampered efforts in the fight against the disease. Taking into account broader effects on charity funding and other factors, it’s estimated advances into cancer research are likely to be delayed by an average of 17 months. The biggest problem, according to 90 percent of respondents, was the closure of labs during the first lockdown and restrictions in access to facilities and equipment. The average ICR researcher spent more than half of their working hours in a lab before lockdown, but this dropped to just 5 percent during the shutdown and has since recovered to around a third. ICR’s labs have stayed open during the second lockdown in England, and additional measures are in place to help prevent the risk of spreading the virus.

Delays Professor Paul Workman, chief executive of ICR, said: “It is sobering to see that our researchers are estimating that their own research advances will be delayed by six months – and that the wider impact, because of the interconnectedness of science, is likely to push back major advances for patients by nearly a year and a half. Our survey though does provide solutions to mitigate the impact – in the form of investment in staffing, new technologies and computing power. “For that, we need more of the generous donations we have been receiving to our emergency appeal, along with a commitment from the Government to help fill the funding gap... left by the pandemic.” In the long term, extra funding may be needed to make up for the cancer research time lost to coronavirus. Meanwhile, the NHS is encouraging us to help ourselves. The NHS has launched a campaign called ‘Help Us Help You’ that is urging anyone concerned about cancer to get checked and continue to keep routine appointments. Famous faces have put 84 | Live to 100 with Dr Hilary Jones

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their weight behind this public health awareness drive, including TV chefs Gordon Ramsay and Nadiya Hussein, and actress Emma Thompson. In a survey for the NHS: hh Nearly half (48 percent) of the public said they would delay or not seek medical help at all during the coronavirus pandemic hh 22 percent said they didn’t want to burden the health service during the pandemic hh 22 percent said they were worried about contracting coronavirus and passing it onto others hh 40 percent would leave it longer to get health advice than they normally would have before the coronavirus outbreak Since early diagnosis is vital in the treatment of condition including cancer, delaying treatment can have serious

consequences and there has been an immense effort on behalf of NHS staff to keep cancer services going throughout the pandemic, with almost one million people referred for checks or starting treatment since the virus took hold. The NHS’s Help Us Help You campaign urges people to speak to their GP if they are worried about a symptom that could be cancer, and also remind pregnant women to attend check-ups and seek advice if they are worried about their baby. Additionally, people with mental health issues are also been encouraged to access NHS support. A range of measures have been put in place by the NHS so that people can be treated safely throughout the pandemic including COVID protected cancer surgery hubs, a COVID friendly drugs fund which means fewer trips to hospital and chemotherapy being delivered in more convenient locations. celebrityangels.co.uk

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Symptoms of possible cancer include: hh Changes in bowel habits, including blood in your poo hh Unexplained weight loss hh A lump hh Persistent bloating hh Pain that does not go away Other NHS services being rolled out to help make diagnosis and treatment of a range of conditions easier during the pandemic include chemotherapy buses, and the fast-track rollout of an innovative and life-saving type of radiotherapy.

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Visits Since June, NHS England has been accelerating the use of stereotactic ablative radiotherapy (SABR) which requires fewer doses than standard radiotherapy, cutting the number of hospital visits that potentially vulnerable cancer patients need to make. Rather than a full rollout by 2022, it will now be celebrityangels.co.uk

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available across the NHS by April 2021. SABR is a very precise method using a high dose of radiations requiring only around five outpatient visits, compared to conventional radiotherapy requiring 20 to 30 treatments. By April 2021, every part of the country will be offering SABR treatment for nonsmall cell lung cancer and those with lung, lymph nodes and non-spine bone oligometastatic disease, in radiotherapy units nationwide. Further rollout for other disease types is planned for 2021/22. Local hospitals have also increased treatment outside of hospital including fast-tracking the use of ‘chemo buses’ so people can receive life-saving care without having to travel long distances. Four cancer buses, based in North Middlesex University Hospital in London and Airedale NHS Trust in Yorkshire, have allowed around 60 sessions a day to go ahead. Although some cancer treatments which weaken the immune system have had to be paused until a safer time, frontline staff have pulled out all the stops to ensure people can get cancer care, with almost 30,000 people starting treatment during March.

Did you know? IN November an NHS statement said: "Cancer survival rates are at a record high in England and the number of people being treated for cancer is now back to usual levels of activity. The NHS message to the public has always been clear - do not delay, help us to help you by coming forward for care."

And there is some good news on the way for cancer patients. The Galleri blood test, developed by GRAIL, can detect early stage cancers through a simple blood test, and will be piloted with 165,000 patients in a world-first deal struck by NHS England. The test which checks for molecular changes can identify many types that are difficult to diagnose early, such as head and neck, ovarian, pancreatic, oesophageal and some blood cancers. • Live to 100 with Dr Hilary Jones | 85

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The Heart of the Matter

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Coronary Heart Disease is a major cause of death in the UK, but what are the causes and what can we do to avoid it?

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oronary heart disease (CHD) is the most common type of heart disease, when coronary arteries become narrowed by a build-up of atheroma, a fatty material within their walls. The pain or discomfort felt from such narrowing is called angina and if a blockage occurs it can cause a myocardial infarction (heart attack). The build-up of atheroma makes the arteries narrower, restricting the flow of blood to the heart muscle. This process is called atherosclerosis. Your risk of developing atherosclerosis is significantly increased if you: hh Smoke. As always, smoking is a major threat to your health. It is a key risk factor for coronary heart disease. The smoke contains nicotine and carbon monoxide, which puts a strain on the heart by making it work faster. They also increase your risk of blood clots. Other chemicals in cigarette smoke can damage the lining of your coronary arteries, leading to furring of the arteries. Smoking significantly increases your risk of developing heart disease. hh Do not exercise enough. If you're inactive, fatty deposits can build up in your arteries. If the arteries that supply blood to your heart become blocked, it can lead to a heart attack. If they are affected, it can cause a stroke. hh Have high blood pressure. This puts a strain on your heart and can lead to CHD. hh Have high cholesterol. Whilst cholesterol is essential for healthy cells, too much in the blood is known to lead to CHD. hh Have diabetes. A high blood sugar level may lead to diabetes, which can more than double your risk of developing CHD. Diabetes can lead to

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Did you know? Coronary Heart Disease is the leading cause of death worldwide. An estimated 3.8 million men and 3.4 million women die each year from CHD. (Source: Health Knowledge)

CHD because it may cause the lining of blood vessels to become thicker, which can restrict blood flow. hh Have high lipoprotein (a). Like cholesterol, lipoprotein (a), also known as LP(a), is a type of fat made by the liver. You should routinely have its level measured as it's a known risk factor for cardiovascular disease and atherosclerosis. The level of LP(a) in your blood is partly inherited from your parents. You will also be at risk of developing atherosclerosis if you are obese or overweight, or if you are unfortunate enough to have a family history of CHD.

SYMPTOMS Beating an average of 72 times a minute, your heart pumps oxygen and nutrientrich blood throughout your body, while simultaneously removing the waste products you don’t need. When blood flow becomes limited or stopped, through angina, heart attack, or heart failure, the organs shut down and without urgent intervention – this can be fatal. If your coronary arteries become partially blocked, it can cause chest pain (angina). This can be a mild, uncomfortable feeling similar to indigestion. However, a

severe angina attack can cause a painful feeling of heaviness or tightness, usually in the centre of the chest, which may spread to the arms, neck, jaw, back or stomach. Angina is often triggered by physical activity or stressful situations. Symptoms usually pass in less than 10 minutes and can be relieved by resting or using a nitrate tablet or spray. If your arteries become completely blocked, it can cause a heart attack (myocardial infarction). Heart attacks can permanently damage the heart muscle and, if not treated straight away, can be fatal. Dial 999 for immediate medical assistance if you think you're having a heart attack. Although symptoms can vary, the discomfort or pain of a heart attack is usually similar to that of angina. However, it's often more severe and may happen when you're resting. During a heart attack, you may also have the following symptoms: pain in other parts of the body (it can feel as though pain is travelling from your chest to your jaw, neck, stomach, back, or arms), light-headedness, sweating, nausea, and breathlessness. A heart attack can occur without warning, when you’re resting, at any time. If you are experiencing pain lasting longer than 15 minutes, it could be the start of a heart attack. If you have CHD, it is possible that you could have heart failure. This happens when the heart becomes too weak to pump blood around the body, which causes fluid to build up in the lungs and makes breathing increasingly difficult. There are two types of heart failure; acute, which happens suddenly, or chronic, which happens gradually. Heart attacks are a medical emergency. Anyone experiencing chest pain or other severe, quickly worsening warning signs should seek medical help immediately. Live to 100 with Dr Hilary Jones | 89

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YOUR Healthcare Treatment A number of medications are available to treat CHD and some of its causes, including high blood pressure. Usually, these medications are taken for the long term, and include beta-blockers and ACE inhibitors, which control blood pressure; statins, which reduces cholesterol; nitrates, which dilate the blood vessels; and aspirin, warfarin, and clopidogrel, which prevents harmful blood clotting. Before it comes to medicinal treatment, and you have been diagnosed with CHD, you should make some simple lifestyle changed to decrease the risk of having further cardiac episodes. Eating healthily, doing regular exercise, and especially quitting smoking, will greatly and quickly reduce the risk of having a heart attack in the future. If your symptoms cannot be controlled by medicines, you may need to undergo an interventional procedure to open or

bypass blocked arteries. Let’s look at some of the available procedures. hh Coronary angioplasty. An angioplasty works this way: first, a small balloontipped catheter is inserted inside one or more of the coronary arteries, which have become very narrow. The catheter is then inflated one or more times until the artery is opened wide enough to improve blood flow to the heart. hh Coronary artery bypass graft. This involves taking a blood vessel from the leg, chest or arm and grafting it to the coronary arteries. This improves blood supply to the heart through a detour around the blockage, known as a “bypass”. hh Heart transplant. When the heart has been severely damaged, medicine doesn’t help, or in the case of a heart failure, a transplant may be needed – replacing the damaged heart with a health heart from a donor.

RESEARCH As cardiac conditions are so common, heart research is continuous, and charities such as the British Heart Foundation have done an incredible amount for our understanding and treatment of CHD. Since the BHF was established the annual number of CHD deaths in the UK has fallen by more than half. But a lot of responsibility for the fight against CHD is in our hands – so as always, to prevent high risk of CHD, do not smoke, exercise regularly, keep a balanced diet, keep your diabetes and blood pressure under control, and take any prescribed medicine. •

Did you know? There are 2.3 million people in the UK living with CHD – around 1.5 million men and 830,000 women. (Source: British Heart Foundation)

Remember

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In the UK, one in seven men and one in twelve women die from coronary heart disease. There is an average of one death every eight minutes.

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Top Trends

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ThinK Wine Group offers two luxury sparkling wines: a Prosecco and a Pinot Grigio Sparkling Rosé. Both wines are 100% vegan, organic, with reduced calories and sugar. Despite this, we ensure that there is no compromise on the taste of our wines. To find out more, visit our website at www.thinkwinegroup.co.uk and our Instagram @thinkwinegroup.

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 PRO-VEN PROBIOTICS 50 BILLION SHAPELINE Pro-Ven Probiotics 50 Billion ShapeLine has been shown in two clinical studies to support weight loss when taken daily for six months – with no changes to diet or lifestyle. 50 Billion ShapeLine contains five strains of probiotics, with vitamins C & D and zinc for additional immune support. www.provenprobiotics.co.uk/shop

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Get the

Balance Right

itness professionals are aware of the dangers of setting an exercise routine which concentrates on one desired result at the expense of general wellbeing. For instance, routines like HIIT (High Intensity Interval Training) have become very popular, but if overused, can cause damage to long-term health. More than three HIIT sessions a week, for instance, could cause damage to the nervous system, joints and muscle groups. Crossfit training is another routine which can be overused. In extreme cases, sometimes associated with military bootcamps, this over-exercise can lead to rhabdomyolysis, where the muscles start to break down. Other exercises which concentrate purely on cardio, or one area such as the upper body, may also lack the balance of a tailored exercise programme.

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One solution to the problem is the body composition scale. Thse devices measure your Body Mass Index (percentage of body fat) as your exercise regime progresses. This is just as important as measuring your overall weight, because if you are building muscle, your overall weight may not change.

Ratios A body fat scale will help you to figure out if you have a healthy fat-to-muscle ratio. You simply step on the scale, and the device measures both your body weight and your estimated fat percentage using sensors underneath your feet that use bioelectrical impedance. Many body fat scales will connect to a smartphone app or fitness watch. Other devices can go far beyond measuring your BMI, giving limb-by-limb measurements of muscle mass, water

levels, bone density and metabolic rate. Damage or stress caused to muscle groups can be easily flagged up - for instance inconsistencies in leg muscle mass can indicate one is having to work harder than the other. Advanced models will have different settings for men and women, and for multiple users, so the whole family can use them. And should you advance to ‘elite athlete’ level, there’s even a mode for that, reflecting the change in water-to-muscle ratio seen in elite athletes. Remaining motivated to change your habits for a healthier, happier life isn’t always easy. Research has shown that by regularly monitoring your progress, you are 80% more likely to attain your goal. Tanita Body Composition scales help you to remain motivated and on track by monitoring your progress in the My Tanita App. Find out more at https://tanita.eu. •

Images: Dreamstime

It is possible to exercise too much or in the wrong ways, but new technology makes it easier to monitor your routine

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Start the journey to a healthier you with a single step We all had to dig deep in 2020 to weather the changes, limitations and loss that the year brought. What has become clearer, is that taking steps to have a healthier body helps to strengthen our immune system. This is something we can all embrace; not with drastic changes to your whole lifestyle and unattainable goals that leave us feeling defeated; but with changes to your habits, one step at a time.

Measure your health, not your weight

Rather than focussing just on your weight, why not increase your activity to develop your muscle mass, reduce fat, and get a healthier body composition as well as losing weight?

All the motivation you need to succeed We know it is hard to keep motivated, but research has shown that you are up to 80% more likely to achieve your goals when you track your progress. Here is where the Tanita BC401 and My Tanita app can be your motivational best friend, showing you your progress on your smartphone.

The Tanita BC401 is a scale, but it doesnâ&#x20AC;&#x2122;t just tell you your weight. It measures 10 vital aspects of your health and physical condition, so that you can set the achievable targets which are right for you.

Tanita BC-401

Why wait to get healthier? Take that first step with Tanita today and start your journey to better health for life.

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YOUR Healthcare

Ask the Pharmacist

With GPs’ surgeries under increasing pressure, we should all remember that there’s another source of medical advice and prescription services - our pharmacists

articularly at a time when GPs’ surgeries and A&E departments are working under difficult conditions due to the coronavirus pandemic and the anticipated Winter ‘flu outbreak, it’s important to remember that there’s another source of medical advice and prescription services ready to help you. As qualified healthcare professionals, pharmacists can offer clinical advice and over-the-counter medicines for a range of minor illnesses, such as coughs, colds, sore throats, skin complaints, eye problems, stomach troubles and general aches and pains. At some High Street pharmacists you can even get a ‘flu jab. If symptoms suggest it's something more serious, pharmacists have the right training to make sure you get the help you need. For example they will tell you if you need to see a GP, nurse or other healthcare professional. All pharmacists train for five years in the use of medicines. They are also trained in managing minor illnesses and providing health and wellbeing advice. Many pharmacies are open until late and at weekends. You do not need an appointment. Most pharmacies have a private consultation room where you can discuss issues with pharmacy staff without being overheard. But what do you do if you can’t get to a local pharmacy? You can now access many pharmacy services including free prescription delivery online.

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Online The Co-op Health pharmacist, for instance, allows you to use an online service to order your repeat NHS prescriptions and get them delivered for free. There’s nothing to it - you can register online or by downloading an app. If you are registered with GP in England and have a repeat prescription, the quickest way to get started with Co-op Health is by registering for a NHS login. NHS login is the most secure way to connect to your NHS record and protects your information. The NHS will ask for: hh Confirmation of your email address hh An image of your photo I.D (e.g. passport or driving licence) hh A short facial recognition or video of you to verify your photo I.D You can also connect by visiting your GP surgery to 'register for online services' they'll probably send your codes to you in a letter. If you've already used them to register with Patient Access, you can find their details in your profile. Once you've signed up, because Co-Op Health is securely connected to the NHS, your repeat prescriptions will be retrieved from your GP surgery and from here you can order what you need. You have a choice of delivery methods: free of charge to any UK address, by Royal Mail tracked delivery, or you can choose to collect from over 1000 collection points in the UK. Your prescriptions will be delivered in plain, unbranded packaging. celebrityangels.co.uk

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YOUR Healthcare Using Co-op Health prescription delivery service does not cost you or the NHS anything. If you pay for your prescription, online payment will be requested once your GP has approved your order. If you do not pay for your prescriptions, you’ll be asked to provide your exemption details. Once you’ve ordered your medication, your order is then reviewed by your GP and once approved it will be delivered to your chosen address. You will be informed of your order status by email so you’re always up to date, and you can also select to be reminded when to re-order your medications, making sure you never run out. If you have the highly rated Co-op Health mobile app, there are even more handy options. You can order medication on someone else’s behalf, choose where the medication is delivered to, and get progress updates on the order.

Advice But this isn’t the entire extent of the online services offered by Co-op Health. Online health blogs give advice on a number of conditions, including: hh Migraine – the symptoms and the treatments available hh Insomnia – how can lifestyle changes improve our sleep? hh Blood pressure – How can you manage your blood pressure? hh Asthma – what causes it and how does ‘flu season affect it? hh Alzheimer’s – what can you do to help someone with Alzheimer’s? hh Stroke – what are the signs and what should I do in an emergency? hh Smoking – how does it affect health and what help can you get to quit? hh Antibiotics – how should the use of antibiotics be managed to prevent the development of microbial resistance? Images: Shutterstock

So it’s good to know that if you can’t get to your High Street pharmacist, there’s an online alternative that’s fast, free and secure. You can find out more about Co-op Health and the applicable terms and conditions at coop.co.uk/health-terms. • celebrityangels.co.uk

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Your NHS prescription is just a tap away

Free home delivery Connect securely to your GP When you register with Co-op Health, we connect you securely to your GP. This makes it easier for you, and your surgery too, as you don’t need to contact them to request your repeat prescription.

View your repeat prescriptions Order the medications that you need and we’ll let you know when it has been approved by your GP, and when it’s on its way to you, giving you one less thing to worry about.

Order to your home Our home delivery is at no extra cost to you or the NHS. Just what you’d expect from a brand you can trust.

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Don’t get caught out this winter Get your repeat prescriptions delivered to your home for free

View and order your repeat medicines online

Rated 4.5/5

Our pharmacists receive and check your prescription

Our team prepare your order for despatch

Royal Mail deliver to your home in plain packaging

Order NHS medication for someone else

You can now add up to 5 other adults to your Co-op Health account. This means you will be able to order medication on their behalf and: • Choose where medication is delivered to • Get progress updates on the order • Enjoy free delivery You don’t need to have a repeat prescription yourself.

Google Play and the Google Play logo are trademarks of Google LLC. App Store® is a trademark of Apple Inc.

Only available on the app.

How to get started The quickest way to get started with Co-op Health is by registering for an NHS login via our website or app. NHS login is the most secure way to connect to your NHS record and protects your information. To prove who you are the NHS will ask for:

Because we are securely connected to the NHS, your repeat prescriptions will be retrieved directly from the GP surgery. From here you can order what you need, ready for your GP to approve the request. Then we’ll take care of the rest.

• A photo of your ID (e.g. passport or driving licence) • A short facial recognition or video of you to verify your photo ID

You must be registered with a GP in England to use this service.

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Scan me to download the Co-op Health app or visit coop.co.uk/health to register online Terms and conditions apply, see coop.co.uk/health-terms

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YOUR Healthcare

The Nature of Skin Skin is sensitive, so perhaps we ought to think more about what we put on it. Here’s a guide to some of the cosmetic ingredients to avoid

Elasticity Sacha Inchi oils are said to be good for all sorts of conditions from stretch marks 98 | Live to 100 with Dr Hilary Jones

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and sunburn to wrinkles and scars. They are also suitable for use on babies, to treat conditions such as nappy rash and cradle cap. Omega oils are said to be particularly good at treating stretchmarks (striae), caused by weight gains, growth spurts or pregnancy. By improving elasticity the oils allow the skin to stretch without damage, and reduce the appearance of marks when skin contracts. Dry, leathery, or sun-damaged skin can also be treated successfully with Omega oils, which are also ideal for use on post-surgical scars to reduce inflammation and tenderness. Crucially, skin changes as it matures, losing elasticity as collagen levels reduce. The skin’s barrier functions degrade, increasing water loss. Omega oils also contain fatty acids which infuse the skin and help to improve its condition as we age.

Did you know? Other natural oils available include argan oil, derived from the kernels of the argan tree grown in Morocco; rosehip oil, pressed from the fruit and seeds of the rose plant; and avocado and olive oils, prized for their skin penetration and attractive scent.

So check the ingredients list next time you’re buying cosmetics, try to eliminate the synthetic chemicals, and look for the natural ingredients that work with your skin, not against it. •

Images: Shutterstock

t’s become pretty clear that a lot of the chemicals used in cosmetics aren’t good for us – they might be effective, but in the long term they could cause harm, and aren’t always good for the planet either. Chemicals derived from crops genetically engineered to be pesticidal, fillers such as parabens, artificial colours and fragrances, and even potentially irritant mineral oils are often found in cosmetics. But there are alternatives to these ingredients, and many more natural cosmetics use botanically derived ingredients without these health implications. An alternative to mineral oils, for instance, is the Omega 3 oil derived from the Sacha Inchi plant. This grows in the Peruvian Amazon rainforest, and has been used locally for thousands of years, but has only recently been put to use in cosmetics. Seeds from the Sacha Inchi plant contain 90 percent Omega Fatty Acids, 54 percent of which is Omega 3, and also have high levels of protein and Vitamin E. Unlike mineral oil, which can wrap the skin in a layer which prevents it from ‘breathing’, this natural alternative used to be prohibitively expensive, but is now more widely available through Fair Trade partnerships.

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ADVERTORIAL

100% NATURAL, SPECIALIST SKINCARE FOR THE WHOLE FAMILY.

Omega Oil.

Historically taken as a supplement, Omega Oil is now available as specialist treatment oil to apply directly to your skin. Whether it’s dry and irritated skin, a scar or worry about stretch marks during pregnancy... discover the virtues of this new skin phenomenon. What is Omega Oil? Botánico Vida’s Omega Oil is frequently touted as a cure-all for all of our skin issues, from dry skin to stretch marks. It is an award-winning specialist skincare treatment oil. 100% natural and clinically proven to increase skin elasticity by 45% helping the skin to stretch during pregnancy; and for use after an injury, burn or surgery; to help minimise scarring or to deeply hydrate and soothe dry, red and irritated skin.

What does it contain? It contains Sacha Inchi, the earth’s richest plant source of Omega 3, 6 and 9 with other Omega rich oils: Argan, Avocado and Rosehip Oil infused with Vitamin E and Calendula to deliver a total fatty acid content of 70% directly into your skin.

How does it work? Omega Oil is very high in essential fatty acids in particular the all-important Omega 3, protein and anti-oxidants which have demonstrated their ability to accelerate wound healing and repair the skin’s barrier function. Omegas are necessary for good health as they infuse the skin directly with these building blocks, helping to support the skin’s entire cellular structure through the healing, growing and ageing process.

Why should you use it and when? Omega Oil has been lauded for its astonishing ability to heal a raft of skin concerns ranging from helping to rejuvenate the skin after a burn or surgery to minimise scarring; cradle cap on a baby; avoiding stretch marks during pregnancy; soothing eczema or intensively hydrating dry and irritated skin.

Who is it suitable for? Omega Oil and its companion, Omega Balm, are suitable for babies, children and grown-ups too. Safe to use on even the most delicate skin.

Every purchase of Omega Oil directly contributes to reforestation of the Amazon and improving the lives of those living in the Peruvian Amazonia.

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Why every purchase counts... All Botánico Vida products are ethically sourced and sustainable. The Bioactive Sacha Inchi oil in all of Botánico Vida’s products comes from Peru’s OMEGA Project – an initiative established in 2001 by the Peruvian government with the aim of respecting the environment and Amazonian farmers’ quality of life. The project aims to reforest 20,000 hectares of the Amazon with indigenous Sacha Inchi, native trees, indigenous food and medicinal plants. This project will create 8,000 new direct or indirect jobs in farming, industry and services. So far, fifty-five farmers’ associations, twenty-five collection centres and an oil production unit have been created. All Botánico Vida products are registered with Cruelty Free International and The Vegan Society and they source Fair Trade and Ecocertified ingredients. Botánico Vida believe there is no place for Mineral Oil (a cheap petrochemical) in family skincare and are working hard to campaign for brands to stop using petrochemicals in skincare. All Botánico Vida products are also 100% free of synthetic fragrance and colours, parabens, PEGs and sulphates. Everything Botánico Vida produce is a genuinely natural, therapeutic product with authentic and honest claims.

Botánico Vida is available nationwide in Sainsbury’s and Lloyds Pharmacies; online at www.botanicovida.com, Holland & Barrett.com and Next.com

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YOUR Healthcare

The Essentials of

Skin Care

Skin care is about developing a routine that’s right for you and your skin type – but where do you start, and what are the essentials?

Cleansing Removing dirt and pollutants is essential to avoid clogged pores, dullness and skin complaints such as acne. Wash twice a day, morning and night. The right facial cleanser formula will cleans your skin without removing essential, healthy oils. Use exfoliating scrubs sparingly, no more than once a week, and avoid those with abrasive ingredients such as crushed walnut shells. For oily or acne-prone skin, use a foaming liquid cleanser which removes excess sebum from pores. For dry or red skin, use a hydrating lotion with an emollient such as shea butter. For sensitive skin, use a gentle oil such as argan. For mature skin use a soothing, melting balm, and for any skin type, try micellar water, which removes debris without causing dryness. 102 | Live to 100 with Dr Hilary Jones

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What Does NonComedogenic Mean? This term frequently appears on product labels and is used by skin-care experts but is not always clearly explained. If a product claims to be noncomedogenic it means that it shouldn’t clog pores or trigger acne. Common ingredients like coconut oil and cocoa butter are known to be comedogenic.

Toning Toner has evolved a lot from the '80s when it was introduced as an alcohol-based product to dry up oily skin after cleansing. Modern toners often include skin health supplements and are an aid in balancing the complexion. Many modern toners contain hyaluronic acid, which is said to improve skin hydration, seal in moisture and plump skin to subtly treat fine lines. Toners can also contain antiinflammatory ingredients such as rosewater and green tea to calm irritation and reduce redness, and vitamins E and C to combat the effects of free radicals. Most toners can be used twice a day, but some

cosmeticians recommend using them only at night, or every other day.

Serums Serums are intended to combat specific conditions such as dark spots and wrinkles, and can have a range of ingredients depending on their function. Most have a general antioxidant to combat atmospheric debris, while many also feature hyaluronic acid to seal in hydration and strengthen the skin’s moistureretaining barrier function. Serums can also contain vitamins C and B3 to brighten dull skin, decrease dark spots, and stimulate the production of the proteins collagen and elastin to prevent wrinkles and skin sagging. Toners can also contain antiinflammatories and retinols, but this means you have to be aware of what time of day to apply them; antioxidants are best in the morning, while retinols will degrade if applied in daytime so are best used at night.

Moisturising Moisturisers hydrate and soften the skin, preventing water loss through the outer layers. As skin naturally loses the ability to retain moisture as we age, and daily activities will remove natural hydrators from the surface, moisturisers are the one skin care ingredient we should all use. There are different forms of moisturiser for day and night, for instance a morning cream may contain antioxidants an sunscreen, while a night cream will focus

Images: Dreamstime

f you’re lucky enough to have inherited great skin, and you have good personal habits (not drinking, smoking or getting too much sun), you may be able to establish a simple skincare routine. But for most of us – and this applies to men as well as women – working in the city and picking up bad habits means that we really have to work hard to keep our skin fresh and healthy. The ideal of model perfection may be beyond our reach, but we can all make the most of what we have, and treat any problem areas as they arise. So what are the basics of a skin care routine?

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YOUR Healthcare on skin repair and may include ingredients such as retinol. There are other cosmetics aimed at specific applications, such as eye care and sun protection. Eye creams will address problems such as dryness or puffiness, and are formulated to take into account the sensitive nature of the skin around the eyes. For undereye bags, ingredients such as caffeine, peptides and hyaluronic acid can be effective. But many experts agree that the most essential skin care cosmetic of all is sunscreen. You should use a daily moisturizer with

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a built-in broad spectrum Sun Protection Factor (SPF) of at least 30, to prevent the formation of certain skin cancers, reduce the development of fine lines and wrinkles, even out textural imperfections, and reduce changes in the appearance of pores over time.

SUNSCREEN There are two basic types of sunscreen, those containing chemicals such as oxybenzone and octinoxate which are absorbed into your skin to counteract the damage from ultraviolet light, and types with titanium dioxide and zinc oxide which form a layer on top of your skin to deflect

ultraviolet rays. In many cases itâ&#x20AC;&#x2122;s best to use a sunscreen which includes both types of ingredients, to maximise efficiency while reducing the appearance of a white tinge on the skin. â&#x20AC;˘

Cosmetic Tip With any skin-care product, you should apply in order of consistency, from thinnest to thickest; for example, cleanser, toner, serum, and then moisturizer.

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YOUR Healthcare

Prominent Peopleâ&#x20AC;&#x2122;s

Prostate Problems Prostate problems including cancer are among the most common male health issues. Now celebrities are lining up to aid awareness

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YOUR Healthcare

n the UK, there are more than 47,500 diagnoses of prostate cancer every year. One man dies of prostate cancer every 45 minutes in the UK, that’s more than 11,500 men per year, and it could affect up to one in every eight men. Age, ethnicity and family history are factors, but public awareness of the disease, its symptoms, consequences and treatment remain low. But what are the most common prostate problems? The prostate, a male gland the size and shape of a walnut, sits beneath the bladder and surrounds the urethra, the tube that carries urine out of the body. The principal function of the prostate is to create semen, the fluid that carries sperm. However, particularly with advancing age, the prostate is subject to enlargement, inflammation, and prostate cancer, when cells in the gland begin to grow uncontrollably.

Images: Shutterstock

Symptoms While prostatitis (inflammation of the prostate) can be painful, it often resolves itself without treatment (though acute prostatitis which comes on quickly can be serious and requires immediate medical attention). Unfortunately, a prostate cancer which is contained inside the gland (localised or early prostate cancer) is often not diagnosed until it’s detected as part of tests for other conditions. It can be benign and show no symptoms, though If symptoms do show, they tend to involve difficulty in urinating, and can come on very slowly, over several years. The effects are usually noted in men over 50 and are more common in black men and those with a family history of prostate cancer. While there has historically been a taboo about discussing prostate problems, with many men tending to dismiss them as an inevitable result of age, in the last few years awareness campaigns spearheaded by celebrities have been urging men to get checked (and the same applies to testicular cancer). The lack of symptoms in prostate celebrityangels.co.uk

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Did you know? One man dies every 45 minutes from prostate cancer. It kills more people than breast cancer. By 2030 it’s set to be the most common cancer in the UK.

cancer is because of the way the cancer grows. Early symptoms often only show if the cancer grows near the urethra and presses against it, which affects urination. However, as prostate cancer usually starts to grow in a different part (usually the outer part) of the prostate, early prostate

cancer often doesn’t press on the urethra and cause symptoms. Changes in the way you urinate are more likely to be a sign of a very common non-cancerous problem known as enlarged prostate, or other health problems. But these symptoms are a sign that you need to get checked by your GP. Symptoms can include: hh Difficulty starting to urinate or emptying your bladder hh A weak flow of urine hh A feeling that your bladder hasn’t emptied properly hh Urine dribbling after you finish hh Feeling the need to urinate more often than usual, particularly at night hh Sudden urges to urinate and leakage Live to 100 with Dr Hilary Jones | 105

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YOUR Healthcare If prostate cancer spreads from the prostate into other parts of the body, it can cause symptoms of advanced prostate cancer, including: hh Pain in the back, hips or pelvis hh Problems getting or keeping an erection hh Blood in the urine or semen hh Weight loss While all of these symptoms can also be caused by other health conditions, they should all be reported to your GP for investigation. There is no definitive way of diagnosing prostate cancer without a visit to the doctor. A GP or a specialist nurse can carry out a range of tests, including a urine test to rule out a urine infection, a prostate specific antigen (PSA) blood test, or a digital rectal examination (DRE). Depending on the results you may then need an appointment with a specialist at a local hospital. For reasons which are unclear, but which may be genetic in origin, black men are twice as likely to get prostate cancer – in fact in the UK, about 1 in 4 black men will get prostate cancer in their lifetime. If you are of mixed ethnicity, you are likely to be at higher risk of prostate cancer than a white male. Researchers haven’t yet established the exact risk, or whether there are different risk levels for people whose mother or father is black. The general advice is that if you're a black man and you're over 45, you should speak to your GP about your risk of prostate cancer, even if you don't have any symptoms. It’s important to discuss whether you have a family history of prostate cancer or breast cancer. If you are a man of African or Caribbean descent aged 40-69 and haven’t had prostate cancer, you may be suitable to take part in a study that can help Prostate Cancer UK understand more about the genetics of prostate cancer. The new study called PROFILE aims to understand if knowing more about 106 | Live to 100 with Dr Hilary Jones

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the genetic changes involved can help improve prostate cancer screening for men with a higher risk of the disease. By taking part in this study, you’ll help them understand why some men have a higher risk of prostate cancer, to help save and extend the lives of the next generation of black men. You’ll also receive regular tests for prostate cancer, which may benefit your long-term health if you are at higher risk for the disease. You can find out more about the PROFILE study at https:// prostatecanceruk.org/riskresearch.

Prevention As the causes of prostate cancer aren’t clear, it’s equally unclear how to prevent it, though it’s likely that a healthy lifestyle may be important. Being overweight seems to increase the risk of being diagnosed with prostate cancer. If your cancer is at an early stage and not causing symptoms, your doctor may suggest either "watchful waiting" or "active surveillance", rather than any immediate treatment. All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary symptoms, such as needing to use the toilet more urgently or more often. For this reason, some men choose to delay treatment until there's a risk the cancer might spread. Some prostate cancers can be cured if treated in the early stages. Treatments

Remember Chronic prostatitis, where the symptoms come and go over several months, is the most common type. Acute prostatitis, where the symptoms are severe and come on suddenly, is rare, but potentially lifethreatening and requires immediate treatment.

include surgically removing the prostate, or radiotherapy, either on its own or alongside hormone therapy. On the other hand, some cases are only diagnosed at a later stage, when the cancer has spread. If the cancer spreads to other parts of the body and cannot be cured, treatment is focused on prolonging life and relieving symptoms. Newer treatments, such as highintensity focused ultrasound (HIFU) and cryotherapy, aim to reduce these side effects. Some hospitals may offer these as an alternative to surgery, radiotherapy or hormone therapy, but the long-term effectiveness of these alternatives is not yet known.

Waterworks Urinary problems may be a symptom of a prostate condition, or a result of treatment. You might find that you suddenly have to rush to the toilet. This is called urinary urgency. There are products such as botox and anti-cholinergics which can help, and treatments such as Percutaneous Posterior Tibial Nerve Stimulation (PTNS) in which an electrical current is used to affect the nerves that control urination. celebrityangels.co.uk

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YOUR Healthcare

You can also learn to control your bladder by retraining the pelvic floor muscles. Several treatments for prostate cancer can cause you to leak urine. Again, anticholinergics, PTNS and muscle training can help with this condition, but if it is serious or long-term a small piece of material that presses gently on your urethra to keep it closed and stop urine leaking can be fitted. This is known as an internal male sling. Rarely recommended in the UK is the penile clamp, which is as uncomfortable as it sounds. If you have the opposite problem of urine retention, there are again medical treatments available including alpha blockers and prostate-shrinking 5-alphareductase inhibitors, or surgical options ranging from catheters to surgical widening of the urethra.

Images: Shutterstock, PCUK

Did you know? In the past 25 years, £50m has been invested in lifesaving research by the charity Prostate Cancer UK.

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Did you know? In the UK, about 1 in 4 black men will get prostate cancer in their lifetime.

Celebrity Factor In 2019, the charity Prostate Cancer UK launched a celebrity campaign aiming to educate everyone about prostate cancer and related prostate problems. The campaign, called Men, We Are With You included famous faces such as Stephen Fry, Bill Turnbull (above), Jim Broadbent, Nile Rogers, Jemma Redgrave and Ray Clemence, all of whom have some personal of family experience of the condition. TV personality Bill Turnbull took to Twitter to talk about his experience, legacy, and how Covid-19 has affected prostate research. Speaking on behalf of Prostate Cancer UK’s fundraising campaign, Bill Turnbull said: “It is really very humbling

to think that by sharing my prostate cancer experience, I may have helped more men come forward to have those important conversations with their GP and ultimately get diagnosed sooner. But with prostate cancer now the UK’s most commonly diagnosed cancer, what we urgently need now is the research to make sure that men get the best tests and treatments possible. “Sadly, Covid-19 has interrupted so much of this crucial research, which is why I’m supporting Prostate Cancer UK’s fundraising efforts. It’s a difficult time for many of us, but anything you can do will go a long way to making sure we don’t lose momentum in the fight against prostate cancer.” You can find out more about prostate conditions and Prostate Cancer UK’s research, support and fundraising efforts at https://prostatecanceruk.org. • Live to 100 with Dr Hilary Jones | 107

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YOUR Healthcare

Different Strokes While coronavirus dominated the news, other conditions such as stroke seem to have been neglected. We sum up the causes, symptoms, and risk groups for this dangerous condition

stroke is caused by in interruption to the blood supply to the brain, and can have devastating effects and can even be fatal. Itâ&#x20AC;&#x2122;s important that we all know about the symptoms and response to strokes, as swift treatment can make all the difference to the damage suffered and the chances of an effective rehabilitation. Stroke is the largest single cause of disability in adults. There are two main types of stroke: ischaemic and haemorrhagic. It is important to know the difference as they affect the brain in different ways and can have different causes.

Images: Shutterstock

Ischaemic strokes are the most common form of stroke, occurring when a blood clot blocks the flow of blood and oxygen to the brain. These typically form in areas where the arteries have been narrowed or blocked over time by fatty deposits known as plaques, a process known as atherosclerosis. Our arteries can naturally become narrower with age, but there are various factors that quickly and dangerously speed up this process, such as smoking, high blood pressure, obesity, high cholesterol, diabetes, and drinking alcohol to excess. Another cause of ischaemic stroke is atrial fibrillation, a type of irregular heartbeat. This is known to cause blood clots in the heart that break apart and form in the blood vessels that supply the brain. Haemorrhagic strokes, also called cerebral haemorrhages or intracranial 110 | Live to 100 with Dr Hilary Jones

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Did you know? There are more than 100,000 strokes patients in the UK each year, amounting to one every five minutes. Worldwide, someone will have a stroke every two seconds.

haemorrhages, are less common than ischaemic strokes. When a blood vessel inside the skull bursts and bleeds into and around the brain, a haemorrhagic stroke is caused. High blood pressure is their principal cause, which can weaken the arteries in the brain and make them more likely to split or rupture. There are many factors that increase the risk of high blood pressure, such as being overweight, smoking, not exercising enough, being stressed, or drinking over the recommended limit. These factors are similar to the causes of ischaemic strokes. Haemorrhagic strokes can also be caused by a brain aneurysm, where a balloon-like expansion of a blood vessel is ruptured, or a blood vessel has been abnormally formed in the brain. celebrityangels.co.uk

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Risk Factors It is difficult to predict and reduce the risk of a stroke because it is impossible to prevent some of the risks that lead to this condition. For example, you are more likely to have a stroke if you are aged over 55, though a quarter of strokes happen to younger people â&#x20AC;&#x201C; but you cannot control your age; similarly, you cannot change a close relative having a stroke, which makes it more likely that you could suffer from the condition. Similarly, if you are south Asian, African, or from the Caribbean, your risk is higher as the rate of diabetes and high blood pressure is higher amongst these groups. It is possible to significantly reduce your risk of having a stroke by making simple and highly effective lifestyle changes to avoid problems such as atherosclerosis and Live to 100 with Dr Hilary Jones | 111

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YOUR Healthcare high blood pressure. You should also seek medical advice if you think you may have an irregular heartbeat. This can be a sign of atrial fibrillation, which increases the risk of a stroke. If you have had an ischaemic stroke, a combination of medicines to treat the condition and prevent it happening again is usually recommended. These include statins, which reduce the level of cholesterol in your blood; blood pressure medicines; anticoagulants, which prevent blood clots from forming; thrombolysis, which dissolves blood clots and restores blood flow to the brain; as well as aspirin and other antiplatelets; which reduce the chances of blood clots from forming. Some of these medicines need to be taken immediately and only for a short time, while others may only be started once the stroke has been treated and may need to be taken long term. As with ischaemic strokes, some people who have had a haemorrhagic stroke will also be offered medicine to lower their blood pressure and prevent further strokes. If you were taking anticoagulants before you had your stroke, you may also need treatment to reverse the effects of the medicine and reduce your risk of further bleeding. There is also the occasional possibility that emergency surgery may be

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Remember Deaths related to stroke have declined by 49 percent in the past 15 years. This has been accredited to a combination of better prevention, earlier treatment and more advanced treatment. needed to remove any blood from the brain and repair any burst blood vessels

Rehabilitation There are a few paths to choose from when thinking about rehabilitation and therapy after your stroke. One way is through oxygen therapy. The process involves breathing pure oxygen through a mask under pressure in a specially constructed chamber. The benefits are that it is very safe with almost no side effects, unlike much medication. An oxygen chamber is like a room that is inside a large steel tube that can be sealed and pressurised, large enough for a small group. In these days of coronavirus social distancing, TeleRehab allows people to remotely access rehabilitation within their

home environment, under the supervision of a highly qualified Neurological Physiotherapist or Sports Therapist. It is a type of remote rehabilitation which uses a tablet, phone or webcam enabled computer with internet access. The process is a form of video conferencing, which allows your Physiotherapist to see you and communicate with you throughout your consultation. During this trying time, face-to-face or hands on treatment is either impossible or severely impeded. Thus, TeleRehab offers an effective alternative whereby physiotherapists can continue to deliver quality rehabilitation from your phone, tablet, lap-top or PC. A Physiotherapist will be able to see you throughout the consultation, which enables them to provide expert advice, guided exercise and feedback, to ensure you are continuing to meet your rehabilitation goals. Even through the coronavirus pandemic, this therapy makes sure that individuals maximise their independence following life changing events, such as a stroke. TeleRehab is highly beneficial for individuals who are currently unable to access Physiotherapy due to isolation requirements. Being in isolation has reduced the amount of activity most of us are doing each day, which can lead to a lack of motivation, reduced exercise tolerance and increased stiffness. It allows you to work closely with a Physiotherapist or Sports Therapist. They will provide one-to-one treatment specifically tailored to your individual needs. They will be able to ensure you are completing exercises correctly, provide progressions, advice and support you in working towards your identified goals. Keeping moving is essential to maintain health, and prevent joint stiffness and muscle tightness, and deconditioning. TeleRehab also provides access to social interaction, whether this is with your therapist in a 1:1 session, or as part a group. celebrityangels.co.uk

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YOUR Healthcare

Images: Shutterstock, Stroke Association

Aphasia One common condition resulting from a stroke is aphasia, is a complex language and communication disorder resulting from damage to the language centres of the brain. This damage may be caused by a stroke, a head injury, a brain tumour, or other neurological illnesses. While stroke isn't the only cause of aphasia, it's by far the biggest. Around a third of people who have a stroke will experience aphasia, and the Stroke Association estimates that there are more than 350,000 people with aphasia in the UK. Aphasia is sometimes referred to as dysphasia, but strictly speaking these are different conditions. Aphasia is the medical term for full loss of language, while dysphasia refers to partial loss of language. The word aphasia is now commonly used to describe both conditions. If you have aphasia you may have difficulty with: hh Speaking (expressive aphasia) hh Understanding speech (receptive aphasia) hh Reading and writing hh Using numbers and dealing with money hh Telling the time. Aphasia doesn't affect intelligence - people with aphasia still think in the same way, but are unable to communicate their thoughts celebrityangels.co.uk

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easily. But different people can be affected in different ways by aphasia. The Stroke Association cites as an example Ron Henshall, who lost his speech after his stroke. While in hospital he remembers hearing the doctor say he was not eating. He couldn't explain that he was asleep, so they were taking his food away. He also founds it challenging to resume his job of teaching the piano, because he knows how to play but can't always explain it. Ron said: "At the beginning, I had no words in my mind but I felt calm and peaceful when I was meditating. I got very frustrated when my words started to return but I could not express them. Now I do what I can, but people need to really listen."

critical research and campaigning to make sure people affected by stroke get the very best care and support to rebuild their lives. Fundraisers work nationally and with local communities to raise much-needed funds to support stroke survivors, and through initiatives such as the FAST campaign, developed with the Department of Health, the Association we have been hugely successful in making more people aware of the signs of a stroke and the importance of taking emergency action. Find out more at www.stroke.org.uk â&#x20AC;˘

Charity In 2015, the Stroke Association joined forces with national aphasia charity Speakability (Action for Dysphasic Adults) to ensure that more people across the UK living with aphasia receive vital support. The Stroke Association helps people rebuild their lives after stroke, providing specialist support, funding Live to 100 with Dr Hilary Jones | 113

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The Hard Facts

Atherosclerosis or hardening of the arteries is a major health risk, but there are lifestyle changes you can make that will hold it off Remember Over the age of 40, people in general good health have about a 50 per cent chance of developing serious atherosclerosis.

therosclerosis or hardening of the arteries is a worrying condition as it is symptomless, and has no definitive cure. You only know you are at risk of developing it when you have it. However, making lifestyle changes will drastically reduce your chances of developing this life-threatening condition. In atherosclerosis, the arteries become clogged with fatty substances called plaques or atheroma. When these plaques cause the arteries to harden and narrow, blood flow and oxygen supply to vital organs is restricted, which increases the risk of blood clots that could potentially block the flow of blood to the heart or brain.

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The condition does not tend to have any initial symptoms, and as a result many people may be unaware they have it, but it can eventually cause life-threatening problems, such as heart attacks and strokes if it worsens. Luckily, the condition is largely preventable, as a healthy lifestyle and treatment will help reduce the risk of serious problems occurring.

Health risks If left to get worse, atherosclerosis can potentially lead to a number of serious conditions known as cardiovascular diseases (CVDs). There will not usually be any symptoms until a CVD develops.

Types of cardiovascular disease include: hh Coronary heart disease (CHD) – When the main arteries that supply your heart (the coronary arteries) become clogged with plaques. hh Angina – Short periods of tight, dull or heavy chest pain caused by coronary heart disease, which may precede a heart attack. hh Heart attacks – Where the blood supply to your heart is blocked, causing sudden crushing or indigestion-like chest pain that can radiate to nearby areas, as well as shortness of breath and dizziness. hh Strokes – Where the blood supply to celebrityangels.co.uk

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YOUR Healthcare

Did you know? At least 2.6 million people in the UK have narrowing of the arteries around the heart, which can lead to a heart attack, angina, or both. (Source: British Heart Foundation)

Images: Shutterstock

your brain is interrupted, causing the face to droop to one side, weakness on one side of the body, and slurred speech. hh Transient ischaemic attacks (TIAs) – where there are temporary symptoms of a stroke hh Peripheral arterial disease – where the blood supply to the legs is blocked, causing leg pain when walking. Unfortunately, it is unclear why and how arteries become clogged. The scariest thing is that it can happen to anyone, although the following things can increase your risk; advancing age, smoking, eating an unhealthy, fatty diet, not exercising enough, being overweight, drinking to excess, having high blood pressure, high cholesterol, or diabetes, having a family history of the disease, and being a member of certain ethnic groups. Chest pain (angina) or shortness of breath on exertion are the most common symptoms. But sometimes the first sign of atherosclerosis is a heart attack or stroke, so it’s important to be aware of your risk factors so you can keep them under control and improve your chances of avoiding it. You cannot do anything about some of these factors, but by tackling things like an unhealthy diet and a lack of exercise you can help reduce your risk of atherosclerosis and CVD.

Testing If you are worried about atherosclerosis, the first thing to do is to speak to your GP. celebrityangels.co.uk

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If you're between the ages of 40 and 74, you should have an NHS Health Check every five years, which will include tests to find out if you're at risk of atherosclerosis and CVD. Your GP or practice nurse can work out your level of risk by taking into account factors such as your age, gender and ethnic group, your weight and height, if you smoke or have previously smoked, if you have a family history of CVD, your blood pressure and cholesterol levels, and if you have certain long-term conditions. Depending on your result, you may be advised to make lifestyle changes, consider taking medication or have further tests to check for atherosclerosis and CVD. Healthy lifestyle changes can reduce your risk of developing atherosclerosis and may help stop it getting worse, alongside reducing the chances of many diseases and health problems. As always, you should stop smoking – there is no greater preventable cause of death than smoking. You should eat a healthy diet, avoiding foods that are high in saturated fats, salt or sugar, and aim to eat five portions of fruit and vegetables a day. You should exercise regularly, doing at least 150 minutes of moderate aerobic activity every week, and strength exercises on at least two days a week.

Maintaining a healthy weight is difficult, but it is recommended to avoid developing atherosclerosis. Finally, you should moderate your alcohol consumption – do not drink over 14 alcohol units a week.

Treatment There are no treatments that can reverse atherosclerosis, but those healthy lifestyle changes suggested may help stop it getting worse. Sometimes, additional treatment to reduce the risk of problems like heart attacks and strokes may also be recommended, such as: hh Statins, for high cholesterol. hh Medicines that help high blood pressure. hh Medicines that reduce the risk of blood clots, such as aspirin (low dosage) or clopidogrel hh Dietary changes and medication for diabetes. hh A procedure to widen or bypass an affected artery – such as a coronary angioplasty, a coronary artery bypass graft or a carotid endarterectomy. Our advice? The best thing to do is to stop smoking, start exercising and eating well. You cannot control your age, but if you take charge of these three factors you are doing the best you can to beat artherosclerosis. • Live to 100 with Dr Hilary Jones | 115

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YOUR Healthcare

Attention on

Alzheimerâ&#x20AC;&#x2122;s Alzheimer's Disease is the most common form of dementia, and distressing for those affected and their loved ones.

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YOUR Healthcare

Images: Shutterstock

Causes The exact cause of Alzheimer’s Disease are not completely understood, however there are many factors believed to increase the risk of developing the condition, including age, untreated depression, lifestyle factors, and a history of Alzheimer’s in the family. Although Alzheimer’s is not an inevitable normal part of aging, the chances of developing the disease increase as we get older. People who get Alzheimer’s tend to be over the age of 65, with the likelihood of developing the disease doubling every five years after you reach 65. However, this does not mean it cannot affect young people. Around 43,000 people in the UK with dementia are under 65, around five percent of the total number. Cases like these are known as early-onset Alzheimer’s. celebrityangels.co.uk

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Did you know? 23 percent of people identify dementia as caused by brain disease or degeneration, 46 percent identified a major symptom as loss of memory. (Source: Alzheimer’s Research UK)

The genes you inherit from your parents can contribute to your risk of developing Alzheimer's disease, although the actual increase in risk is small. In a few families, Alzheimer's disease is caused by the inheritance of a single gene and the risks of the condition being passed on are much higher. If several of your family members have developed dementia over the generations, and particularly at a young age, you may want to seek genetic counselling for information and advice about your chances of developing Alzheimer's disease when you're older. Research indicates that several lifestyle conditions associated with cardiovascular disease may increase the risk of developing Alzheimer’s. You can help reduce your risk by stopping smoking, eating a healthy, balanced diet, leading an active life, both physically and mentally, losing weight if you need to, reducing your alcohol intake, and having regular health checks as you get older.

Treatments Unfortunately the treatments available for Alzheimer’s do not slow or stop the disease from getting worse, but they may help manage the symptoms for a time. It is important to discuss your treatment options with the people involved in your care. If you are prescribed a drug for Alzheimer’s disease, treatment is usually started by your own doctor following guidance from a specialist doctor. Specialist doctors who see people

with dementia include psychiatrists, geriatricians and neurologists. Alternatively, your own doctor may start your treatment and it may be continued and monitored either by a specialist or by your doctor. People with mild to moderate Alzheimer’s disease could benefit from taking a cholinesterase inhibitor. These drugs work by increasing the amount of a chemical called acetylcholine that helps messages to travel around the brain. Cholinesterase inhibitors do not prevent the disease from getting worse but may help people to function at a slightly higher level than they would do without the drug. There are three common types of this drug; Donepezil, Rivastigmine, and Galantamine. Memantine (Ebixa or Axura) is recommended for people with moderate or severe Alzheimer’s disease, and for people with moderate Alzheimer’s if cholinesterase inhibitors do not help or are not suitable. Memantine helps nerve cells in the brain communicate with each other. It does this by regulating a chemical called glutamate in the brain. In Alzheimer’s Disease this can allow brain cells to work more effectively for longer, and it can help to reduce the symptoms of Alzheimer’s Disease for a while. Ask your GP or pharmacist about side effects – which can include diarrhoea, tiredness, muscle cramps, headaches, dizziness, and constipation. Cognitive stimulation activities are designed to stimulate thinking skills and engage people who have Alzheimer’s. They are often group-based, with an

Remember Dementia is the leading cause of death in the UK and there are currently no treatments to stop or slow the brain diseases that cause it.

Images: Dreamstime

ur brains control almost everything we think, feel, say and do, controlling our memories, speech, emotions, and knowledge, so illnesses like Alzheimer’s Disease which affect the brain’s functioning have a devastating effect. The most common symptoms of Alzheimer’s Disease are problems remembering, thinking and speaking. The subject might say or do things that seem strange to others, and find it harder to do everyday things. They may not seem like the person they used to be. Alzheimer’s Disease is the most common form of dementia, impairment of mental function, affecting around six in every ten people with dementia in the UK. Some people can have more than one type of dementia, for example, they might have Alzheimer’s as well as vascular dementia or dementia with Lewy bodies. This is often called ‘mixed dementia’. Doctors use the word dementia to describe all these different problems, though here we will be focusing on Alzheimer’s, the most common type of dementia in the United Kingdom.

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YOUR Healthcare emphasis on enjoyment. The activities might include games, group discussions or practical tasks such as baking. The benefits of cognitive stimulation for people with Alzheimer’s may include improvement in memory, thinking skills and quality of life.

RESEARCH

wearable technologies like smart watches would provide a low-cost approach to identifying those most at risk of disease "Identifying the very earliest changes in these diseases would transform research efforts today, giving us the best chance of stopping these diseases before the symptoms of dementia start to get in the way of life.” The future looks optimistic for our relationship with dementia and Alzheimer’s. However, there is still a long way to go, and understanding the risks, causes, and treatments of Alzheimer’s is crucial for making the future less intimidating and more knowable. •

Did you know? One in five UK adults incorrectly agree that dementia is an inevitable part of getting older. (Source: Alzheimer’s Research UK)

Images: Shutterstock

Excitingly, there have recently been some major developments in research and potential treatment for Alzheimer’s. One planned trial with a million UK participants uses a ‘smartwatch’-style device to attempt to detect early signs of dementia using artificial intelligence to monitor more than 30 indicators, such as speech, fine motor skills and sleep. A three-year trial by the government’s Accelerating Detection of Disease programme, focused on a million adults over 40 could drastically enhance the chance of detecting dementia at an earlier stage, allowing earlier intervention. Alzheimer’s and other forms of dementia can develop up to twenty years

before symptoms begin to show and is rarely diagnosed until significant damage has been done, so trials like this, part of a worldwide initiative launched by Alzheimer’s Research UK, and part-funded by Microsoft founder Bill Gates, will help scientists accumulate data to identify the ‘fingerprints’ which can be used to help diagnosis. This initiative is a collaboration between Alzheimer’s Research UK, the Alan Turing Institute, University College London, Newcastle, Exeter and Cambridge universities, among other institutions. The project hopes to secure at least £67 million in funding in the first six years and up to £100 million by 2030. The Director of Research at Alzheimer’s Research UK, Carol Routledge, said: “Our research shows that 85 percent of UK adults would be willing to take a test that could tell them if they were in the early stages of a disease like Alzheimer’s, even before symptoms show. "Developing digital fingerprints that can be detected using phone apps or

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MEDICAL Tourism

Centre of Health Turkey is thriving as a centre for medical tourism – what is it about this beautiful country that attracts more and more health visitors?

ravelling abroad for medical services is becoming more and more popular, and though the coronavirus pandemic has naturally limited the amount of travel possible, it’s likely that with the delay to many routine operations, medical tourism will once again come into focus when restrictions are eased. Indeed, the main reason for wanting to get medical treatment abroad is that it often offers faster service, as well as financial savings. In some cases, of course, it’s also a case of patients travelling to

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access advanced modern treatment that are not available in their home countries. It’s estimated that the value of the global medical tourism market will reach $179.6 billion by 2026, so there’s every incentive for countries to offer more affordable treatment, reduced waiting times, modern facilities and technologies, and discreet services which can often be combined with a relaxing holiday.

Preferred Turkey is rising in the ranks of popular destinations for medical treatment,

is already in the top 20, and in 2018, 700,000 foreigners visited Turkey to use the modern medical treatment and care services. Turkey’s Health Tourism Ministry says that it aims to increase the number of the health tourists to 1.5 million by 2023 with a revenue of $10 billion, noting: “Our works have been continuing with regard to making Turkey one of the most preferred countries in terms of health tourism.” There are several reasons why Turkey’s medical services are increasingly attractive to visitors from far afield. celebrityangels.co.uk

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MEDICAL Tourism

As a central transport hub for Europe, the country is easily accessible and is well established as a centre of East-West commerce, culture and politics. Istanbul airport is one of the world’s largest, and has recently been expanded to handle 200 million passengers a year, with over 300 direct flight daily. Turkish travel organisations will often offer discounts to medial tourists, making flying abroad for treatment even more affordable. The country’s healthcare system is affordable, with surgery sometimes 90 percent cheaper than elsewhere in the West, and cosmetic routines often 70 percent cheaper than the rest of Europe.

Images: Dreamstime, Medical Park Turkey

Value Because the country’s health services understand the value of private treatment, it’s often possible to schedule a procedure in a couple of weeks which might take 18 months or more to obtain elsewhere. Turkey has a high number of hospitals accredited in the USA - in fact most Turkish doctors train in America or Europe before returning home to practice. The range of medical treatments celebrityangels.co.uk

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offered in Turkey is wide, from cosmetic procedures such as hair transplants and dental treatments, to affordable ‘fertility awareness’ checkups and in vitro fertilisation (IVF). In neurology, areas covered include stroke, epilepsy, sleep disorders, memory disorders, neuromuscular problems and Alzheimer's disease among others. Turkish oncology centres cover all sorts of cancer treatments, including radiotherapy, tomotherapy and the advanced Gamma Knife technology, while cardiology services include echocardiography, a non-invasive examination assessing the heart functionally and anatomically, as well as routines such as treadmill ‘effort tests’ and 24-hour EKG monitoring. The latest nuclear scanning technology is available for diagnosis and treatment of thyroid conditions, cardiac stress, bone scans for detection of cancer, infection or subtle bone injuries, lung scans for blood flow to the lungs and air exchange, and liver and gall bladder scans. Organ transplantation procedures

including kidney, liver and pancreas are well established, as are corneal transplants. Bone marrow transplantation for adults and children is available, and research is being conducted in high-dose chemotherapy and long-term outcomes for bone marrow transplantations. Also available are therapies such as addiction treatment and mental health care. Medical Park is the leading private hospital group in Turkey which has been serving international patients for decades. With 31 hospitals, it delivers high-quality medical service with world-renowned surgeons in JCI certified hospitals for a much desirable price. Services include transportation, hotel assistance, and translation services. Many of the hospital staff including surgeons speak English and they are experienced in taking care of foreign patients. Find out more at https://medicalparkinternational.com.

Support Because the Turkish government supports the private medical industry, development and upgrades to facilities are routine. This private-public partnership allows the country to develop both its public and private healthcare sectors. Of course the advantages of visiting Turkey as a tourist destination go without saying. A unique blend of Oriental, European, and Arab cultures, the country has attractions from the Byzantine and Ottoman glories of Istanbul such as the Aya Sofya Museum, to the marvellous Roman ruins of Ephesus, the surreal rock valleys of Cappadocia, and the hidden coves and marvellous beaches of the Mediterranean coastline. While you are in Turkey you must of course also sample the local cuisine, from the traditional small platters of meze to the delicious Turkish ravioli manti, the rich, sweet dessert pastry baklava, and of course the Turkish Delight. There’s something in Turkey to satisfy every taste and medical need. • Live to 100 with Dr Hilary Jones | 121

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OVER 60'S

OVER 60

Rest in peace When you have the stress of organising a funeral, the last thing you want is the added worry of how to pay for it. Could a pre-paid funeral plan be the answer?

n the last five years, it’s estimated that the average cost of a a funeral has risen a huge 25 percent. This figure is always rising, and together with the other stresses of organising a funeral it can add unwanted worries. But there are ways around this problem. By taking out a prepaid funeral plan, you will be locking in prices at today’s rates. This provides you with peace of mind during these difficult times and keeps loved ones from having to make stressful decisions. A pre-paid funeral plan will include the funeral director’s services, generally the most expensive part of the funeral, and often the cremation or burial fee and minister’s fees. If extras such as a wake or flowers are wanted, you can make a contribution towards this either when you take out the plan or afterward.

contributions for fulfilment of the plan are paid into an independent, secure trust fund, so you can rest easy knowing that your money is safe. You can take out a funeral plan for yourself or for a loved one, be they a parent, partner, or relative. Whatever your budget, wishes, or special requirements, taking out a prepaid funeral plan means that you and your loved ones can enjoy peace of mind, safe in the knowledge that this most stressful of times will go that little bit easier. •

Did you know? In 2020, the average cost of a funeral in the UK was £4,271. This varies depending on the type of service, with cremation costing £3,986 on average, and the average burial costing £5,000.

Perfect Service

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Images: Shutterstock

Another advantage of a pre-paid funeral plan, apart from securing you and your loved ones’ peace of mind that you are safeguarded against future price rises, is that it will ensure that all your requirements are fulfilled. With a prepaid funeral plan you can compare services from many funeral directors across the whole market, and their advisers can help you find the plan that fulfils your wishes. You can specify personal requests to make it the memorial that you would have wanted, and add optional extras like a church service and refreshments for an event afterwards. You can choose to pay in monthly instalments or a lump sum - either way celebrityangels.co.uk

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Funeral costs are rising above inflation. How will yours be covered?

The average UK funeral already costs £4,893, and prices are rising by up to 7% each year. Forward planning with a prepaid funeral plan could lift the burden of spiralling costs for the loved ones that you leave behind and ensure that you receive the send-off you wanted at the price you requested.

Why choose

Compare Your Funeral Plan? Tailored plans to suit every budget Lock costs in at today’s prices Friendly, empathetic advisors Free bereavement counselling

Compare Your Funeral Plan offers tailored, prepaid plans to suit every budget, from just a few pence a day. As the plans are locked in at today’s prices, and held in a secure trust, your loved ones are less likely to have to pay for your funeral before probate is settled. The Competition and Markets Authority recently found that customers are typically paying £400 more than they need to for funerals and £215 more than necessary for cremations. The regulator highlighted that consumers are suffering because of a lack of easily comparable information on price and the quality of service. With Compare Your Funeral Plan, you can compare over 800 different funeral directing firms across the whole of the market, and benefit from some of the lowest instalment fees available.

Planning your funeral means you leave a legacy of happy memories to your loved ones, rather than financial worries and stressful decisions at what is already a difficult time.

To start planning, and get the funeral you would like at today’s prices, call us on 0800 2545450 or visit www.compareyourfuneralplan.com Compare Your Funeral Plan.indd 1

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Insure Your Family’s Future The subject of life insurance may be a tricky one, but in the current situation it’s something every family ought to think about

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you have to think of life insurance as something you need to do for your dependents rather than for yourself. Worryingly, a 2019 study showed that more than 40% of mortgage holders, including many buy-to-let landlords, had no life insurance. Though 58% of mortgage holders had life insurance, just 28% had critical illness cover, while only 12% had income protection. The main questions surrounding life insurance for most people would be how much it costs, what the benefits are, and

how you can be sure that a policy will pay out and protect your dependents in the sad case of your death.

Paying In Life insurance, also known as life cover or life assurance, allows you to provide financial stability for your loved ones should you die while covered by the policy. You make monthly or annual payments into a policy, and should you die while covered, the policy pays out to your dependents. Of course, if you do

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he current pandemic has brought home to all of us just how precious life is and how easily our families can be hit by tragedy. Coronavirus can strike quickly and fatally, with even young and healthy people suddenly taken from us. All the more reason, then, to consider the importance of life insurance. Like a pension, it’s something the younger of us might reject as something we’ll think about when we’re older; but as soon as you have any family responsibilities,

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OVER 60 that going direct can be cheaper – brokers can often access better deals than you would find dealing direct with a life insurer.

Premiums Again, a broker will be able to explain the differences between varying types of life insurance. For instance, in a 'level term' policy, you pay in a fixed premium over a fixed term, and can claim a fixed amount. Other types include a ‘whole life’ policy which does not have a time limit, and a ‘decreasing term’ policy which can, for instance, reduce premiums once you have paid off your mortgage. Another form of insurance is a critical illness policy, which pay out not only your death, but also should you become too ill to work. Some of these policies will also include cover for children. There are also ‘over 50’ plans which do not involve a medical examination, but can still cover you for the remainder of your life and help your family to pay expenses such as funeral costs. If you have a partner and share a mortgage, you might also consider a joint cover life insurance policy with mortgage protection, which will pay out on the death of either partner.

Paying Out not have a partner or children you may not feel you need life insurance, but it can also be useful should you have a mortgage, which can be paid off in the case of your death. The amount you need to pay into a life insurance policy depends on how much you want it to pay out. Online calculators will help you to work this out. Your age, lifestyle, medical history (and your family’s) will also be taken into account in calculating your payments. Very roughly speaking, as a 30-year-old non-smoker paying £12 a month into a policy for 33 years, you may expect around £200,000 cover from the right policy, but it may be helpful to consult a celebrityangels.co.uk

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specialist life insurance broker for advice on which policy and provider to go for. One of the UK’s most popular free online brokers, ProtectLine.co.uk, says that life insurance is a bonafide bargain - you can protect your loved ones from as little as £4.99 a month, “less than the cost of Netflix or Amazon Prime”. In fact a broker can help with any aspect of life insurance, including shopping around for the best deals, explaining technical terms, and giving legal advice on how to protect your payouts by putting them into a trust. A broker shouldn’t charge you for these services, as they make their money from the insurance provider. It’s a myth

When a life insurance policy pays out, your dependents can use it to pay for initial expenses such as a funeral, or for regular household bills, costs of childcare, housing costs, or even costs of education or holidays. It’s up to them, whatever is needed to provide them with financial security. One odd statistic is that a 2018 survey showed that the public believed that only around 38% of life insurance claims were paid out. In fact the figure is more like 99%, with the few rejections likely to be if applications didn’t make full disclosure of facts such as whether the policyholder smoked. In insurance as in life, it always pays to play straight! • Live to 100 with Dr Hilary Jones | 129

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OVER 60

Hydration Contemplation Do you know the difference between skin moisturisation and hydration? Read on to learn the secrets of fresh and luminous skin

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Sometimes moisturizers can’t do their job well because aging and/or sun-damaged skin has too many layers of dead cells built up, so the moisturizers can’t penetrate. A little gentle exfoliation should do the trick, then you moisturize.

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to lacklustre skin.” This means that when you’re using a hydrator, you’re infusing your cells with water and improving your skin’s ability to absorb moisture and nutrients. To treat dehydrated skin you can try a hydrating serum. Look out for one containing hyaluronic acid, which retains an impressive 1000x its weight in water. Hydrating serums often also include moisturisers such aloe vera and honey.

The science Scientifically, ‘moisturizer’ is an umbrella term for several types of compounds: emollients (fats and oils), squalenes (oils), humectants, and occlusives. The difference between a hydrating and a moisturising product is slim. Perry Romanowski, co-founder of The Beauty Brains and cosmetic chemist, states that they “are marketing terms and can be

defined by the brands pretty much however they want.” The technical terms are occlusives, which you may see labelled as moisturizers; and humectants, or hydrators. Romanowski again: “Moisturizers are oil-based ingredients, including occlusive agents, such as petrolatum or mineral oil, and emollients like esters and plant oils. They work by creating a seal on the surface of skin which prevents water from escaping.” “Hydrators have ingredients called humectants, such as glycerine or hyaluronic acid, that absorb water from the atmosphere or your skin and hold it in place.” It’s important to recognize that they work very differently, because your choice can affect your skin health. The goal should be the same - better hydrated skin, but the path there depends on your skin type. •

Images: Shutterstock

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e all know the importance of moisturisation for keeping our skin healthy and looking fresh, yet what about skin hydration? Skin hydration is more than just washing your face with water. Skin that is not hydrated enough will become dry, tight and flaky. Dry skin is less resilient and small gaps can open up between the cells in the outer layers of the skin, making the barrier less robust at keeping harmful things out of the skin. This can lead to red, itchy, flaky skin, or sensitisation and reactions. According to dermatologist Anna Guanche, MD, FAAD, “Hydration [refers to] the water content within the cells that leads them to swell and be plump and bouncy, thus reflecting light well. If water flows out of the cells and the cells are dehydrated, they can become shrivelled, which leads

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