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Dr Chris Steele, MBE

Discuss the hottest health topics with ITV This Morning’s resident doc

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hen it comes to our health, we have made much progress in this country: we’re living longer than we ever have before and we have never been as comfortable and well educated as we are now. However, we are still facing a crisis. Today, around one in every four adults is obese—a shocking statistic that, if we don’t take action, will get worse. Obesity can come with an array of long-term, avoidable health problems— from high blood pressure and risk of heart attack and stroke to the (worryingly common) condition of diabetes. The solutions, however, are straightforward. Lowering sugar intake, quitting smoking, exercising frequently and overhauling our diets are all effective ways in which we can safeguard our health. Elsewhere we face other challenges. As our ageing population increases dementia will become

more widespread, but again there are simple lifestyle changes we can make to help reduce the risk: from maintaining a busy social life to keeping mentally active. Our increasing alcohol consumption is another cause for concern—even if you don’t consider yourself a binge drinker, the long-term negative health consequences of regularly exceeding 14 units every week are very real and we need to take them seriously. However, all is not doom and gloom and we should still be positive. Making easily achievable adjustments to your lifestyle and taking overall responsibility for your health will help avoid many of the conditions described above. If it feels daunting then start small—whether it’s walking to and from work everyday or cutting sugar from your tea and coffee, even the smallest of changes are worth it. Remember, we all have the tools for living long, healthy lives; we just need to use them.

Dr Chris Steele, MBE celebrityangels.co.uk

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01/02/2017 13:57



10 Health Matters

Resident doc on ITV’s This Morning, Dr Chris Steele has spent over 40 years working as a GP. Here he shares his concerns and insights into health today with Hannah Guinness

Today’s Common and Serious Conditions 16 The Dangers of High Blood Pressure

Left untreated, high blood pressure can have serious consequences for your health

18 Ovarian Cancer: How Early Detection Can Save Lives Dear Doctor emphasises the importance of early diagnosis in ovarian cancer

22 Halting Alzheimer’s

Dear Doctor investigates whether or not we can prevent this increasingly common condition


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25 Tackling Dupuytren’s Contracture

Dupuytren’s disease is a condition that affects around one in five men and one in 20 women over the age of 50 in the UK

29 Cannabidiol: Finding out the Facts

Certain compounds found within cannabis may have a wide range of health benefits

33 Varicose Veins

Varicose veins are a common condition that affects at least one out of three people today. Dear Doctor discusses treatment

35 Hip Replacement Surgery: the Facts

In 2016, over 64,000 people in the UK underwent hip replacement surgery on the NHS. Dear Doctor explores the facts

Your Health and Fitness 38 Your Essential Health Checklist From getting your five-a-day to meditating and sleeping through the night, there are many simple things we can do to stay in good shape

42 Top Risk Factors for Stroke

Anyone can suffer a stroke but certain factors may increase your risk, and only a few of these can be controlled

44 21st Century Fitness

Technology has redesigned the way we work out, how we measure progress, the way we plan fitness activities and how we look for health advice

47 Managing Your Weight

Maintaining a healthy weight is vital at every age, but warding off the extra pounds becomes increasingly important as we get older celebrityangels.co.uk

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68 51 Eye Health

It’s easy to neglect your eye health but regular optical check-ups are vital if we want to preserve good vision

56 Age-related Macular Degeneration

AMD is one of the leading causes of vision loss in older people. Dear Doctor explores how to treat this common condition

59 Protecting Your Hearing

Hearing loss can’t always be prevented, but a few simple actions may reduce your risk of damaging your ability to hear over time

62 Looking After Oral Health

Our teeth are a vital part of our overall wellbeing, so how can we best look after them as we age?

65 Smile Wide

Dentures can solve various issues with eating and speech. Dear Doctor provides information for those who are considering them, and advice for people who already wear them


Beating Diabetes

Recent research has shown that with lifestyle changes, Type 2 diabetes can be reversible with time


Feet First

People with diabetes have a much greater risk of developing foot and leg problems. Dear Doctor shares some top tips and prevention pointers for healthy legs and feet celebrityangels.co.uk

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81 Vitamins & Supplements for Later Life

We get vitamins and minerals from a balanced diet but when our bodies need extra help absorbing these nutrients, supplements can save the day

87 Safeguarding Gut Health

Dear Doctor explores the common complaints in digestive health and how to treat them

93 Men’s Most Important Health Checks

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Undergoing the right tests and check-ups at the right time is the most meaningful thing men can do to safeguard their health

Life Starts at 60+ 96 The Listening Hour

The Silver Line is a free, confidential helpline that offers advice and information for older people, 24 hours a day, every day of the year. Founder Esther Rantzen speaks to Hannah Guinness about the stigma of loneliness

101 Turning Back the Clock

As we get older, we tend to lose colour and radiance in our skin, but products and techniques tailored to our age and complexion can revolutionise our everyday beauty routine

105 Managing Menopause

Menopause marks the moment when a woman stops having periods and is no longer able to conceive naturally. Here’s what to expect and how to cope with it


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Health Matters with Dr Chris Steele MBE

What would you say is the single most important health concern today? Chris Steele: it has to be obesity. scientists labelled obesity as an epidemic some 30 years ago and it has got worse. obesity is causing a huge increase of diabetes—we’ve now got over three million people with diabetes in the UK and there’s an estimated one million with type 2 diabetes who don’t know they’ve got it, because you don’t get any obvious symptoms when diabetes starts. the consequences of diabetes include stroke, blindness, heart attack, kidney failure and circulation problems that can lead to gangrene—there are hospital wards where they do leg amputations because of gangrene, and seven out of 10 of those amputations are caused by diabetes. other problems occur in the pelvis with men getting erectile dysfunction, and you also get an effect upon the nerve fibres, where you lose sensation and you get pins and needles in the fingers and feet. it’s just a horrendous condition. that’s just one consequence of obesity. You’ve got others such as increase in risk of certain cancers and an increase in the risk of heart attack and stroke due to the fat around the waist—which is called central obesity. if you have a large waist size you’re at an increased risk of all those conditions: a man shouldn’t be over 38 inches and a woman shouldn’t be over 32 inches. of 10 dear doctor with dr chris steele

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Obesity is causing a huge increase of diabetes—we’ve now got over three million people with diabetes in the UK and there’s an estimated one million with Type 2 diabetes who don’t know they’ve got it course with obesity you’ve also got the strain on the joints, the wear and tear of arthritis and immobility. in any doctor’s mind, the most important health concern we have today is obesity—and it’s getting worse. Everyone once blamed fat for causing obesity, but now we see sugar as the new ‘villain’. What do you think of this? everyone has thought for a good few years that fat makes you fat but that is no longer the case. sugar is the number one culprit. People say ‘a calorie is a calorie is a calorie’, but a calorie of protein is not the same as a calorie of sugar. when sugars are absorbed the pancreas puts out insulin,

the hormone that brings your sugar levels down, to keep them normal. with a diet that’s high in sugar, which we have today, the body is getting so much sugar it cannot produce enough insulin or the insulin is not working properly— that’s called insulin resistance. i spent three hours walking around my local tesco recently looking purely at the sugar content of foods and it’s hidden away in all sorts of foods, especially in ‘low fat’ products. so you may think you’re eating a healthy low fat diet when in fact your sugar intake has increased. what people should be doing, if they’re looking at food labels, is to look at the carbohydrates content, because it lists total carbohydrate and then carbohydrate ‘as sugar’. You’d be surprised to see where sugar is hidden away. apparently 80 per cent of products in the supermarket contain sugar—80 per cent! it’s the sugar content that’s causing the problem, causing the obesity, causing the diabetes and all the other diseases i mentioned earlier. A study recently found that that people who live near busy roads have a higher chance of developing dementia. We get a lot of reports about the links to, or cures for, dementia. Is there really any proven way of avoiding the condition? these are reports that the population see in the national newspapers and in fact if you go and look behind the

IMAGES © Cour tesy of ITV’s This Morning; Shutterstock

Resident doc on ITV’s This Morning, Dr Chris Steele has spent over 40 years working as a GP. Here he shares his concerns and insights into health today with Hannah Guinness


01/02/2017 13:56


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t Just get ou y patients if m walk. With t, lose weigh they want to for a 10 t I say go ou rn around tu , lk minute wa at’s back—so th and come o s minute f actually 20 e ry day com walking eve . e rain or shin


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headlines as to where these reports come from and look at the science, you find that these are really not very good studies at all—but this is hard to get across to the public. And with dementia, because we are an increasingly elderly population, you will get an increase in the condition: as the brain ages, it deteriorates. Now, as to what might prevent this, no one knows, except for things like keeping physically active, keeping mentally active—doing things like quizzes and crosswords, keeping your mind working—and then a good social life with people around you. We know that binge drinkers and alcoholics are putting their health at risk but if you count yourself as merely a ‘social drinker’ are you still setting yourself up for health problems in later life?

can produce mini strokes that can lead to dementia. Because of our modern lifestyle of eating excess calories and not doing enough exercise, we’re going to see more and more vascular dementia.

Don’t forget that with every alcoholic drink you take, you are putting empty calories into your body

increase in the elderly population, which means an increase in the incidence of dementia. The other medical breakthrough would be the treatment of cancer. There are hundreds of different types of cancer, it’s not one disease, so we’re not going to get a cure for cancer across the board but cures are being developed in certain cancer areas—patients with leukaemia have a dramatically more positive outlook now and breast cancer survival rates are improving.

What do you think is likely to be the next medical breakthrough?

If you believe what’s reported in the newspapers it seems that the NHS is constantly in crisis. In your opinion as a GP is this an accurate representation?

Well, it would be nice if it was related to dementia. There’s a huge amount of research going on because of the

I would say definitely the NHS is in crisis, it’s a shambles it really is. The abuse of A&E by the public is

It’s fairly easy to go over the recommended 14 units a week, and we know a lot of people are way over that. You know you’re not an alcoholic per se but you are consuming too much alcohol and the consequences of that include cancer of the lips, cancer of the tongue, cancer of the throat, cancers all over your body, and there’s a second change and that is a fatty liver. Now, fatty liver is a healthy liver that has been infiltrated with fat, so it’s not working correctly. It’s usually thought of as a disease caused by just alcohol but it also can be caused by excess sugar in your diet. And of course don’t forget with every alcoholic drink you take, you are putting empty calories into your body. In your opinion what do you think will be the next serious health challenge that we’ll face? Obesity is the first one and the next I think is probably dementia. Remember dementia is not just Alzheimer’s. There are other common types of dementia and one in particular is called vascular dementia where the arteries—hence the word vascular—are narrowed and hardened due to high cholesterol and high blood sugar. Vascular dementia celebrityangels.co.uk

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Current guidelines recommend not drinking more than 14 units of alcohol per week. DEAR DOCTOR WITH DR CHRIS STEELE 13

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There are now three million people living with diabetes in the UK.

disgraceful. A&E is accident and emergency, so whether your case is an accident is fairly obvious, but is your case an emergency? People are turning up to A&E with minor complaints so they’re blocking the progress of patients who have got more serious complaints in the system. And of course we’ve got a shortage of doctors, a shortage of nurses, a shortage of funding for the members of staff and for technology and treatments available now. There’s a huge amount of wastage in the NHS, and that’s got to be addressed, we’ve got far too many managers managing the system. It really frustrates me, the state of the NHS. I have been an NHS GP all my life and I’m a firm believer of the health service but of course it’s very different to how it was when I started. It’s very sad to see the state of the NHS today. How has it changed since you first started as a doctor? Well from a GP’s point of view we would give our patients five minute appointments and people might think that’s terrible today but what we did is we gave them a time slot to come in—nine o’clock, five past


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Examining labels when food shopping can help you watch—and limit—your daily sugar intake.

nine, 10 past nine. I would see 50-60 patients a day and we didn’t take an afternoon off although we did close in the evening and during the night, we were on call over the weekend. General practice is now totally different, you’re ticking boxes to say they’ve done so many vaccinations etc, and patients now have a 10-minute appointment. And the latest recommendation is that a patient should only come in with one complaint per appointment so if you see your GP in a 10 minute appointment all you can do is tell them about one complaint, if you have other complaints you have to make another appointment. Well, the other appointment could be three weeks away and while you’ve been waiting you may have had some different symptoms! Although we were seeing patients officially on paper every five minutes (some patients would take 15 minutes of your time), you knew the patients very well, you knew the families you knew their parents even their grandparents—so you didn’t need a great amount of time. Now GPs are retiring earlier or going abroad to work with better health systems and there are less new GPs.

If you could pick some easy steps that everyone can take right now to improve their health what would they be? Number one, walk. Just get out there and walk. With my patients if they want to lose weight, I say go out for a 10-minute walk, turn around and come back—so that’s actually 20 minutes of walking every day come rain or shine. In other words, just be more active. The second one is try and eat a better diet. Less sugar, more fruit and more veg. Third, stop smoking. That’s not easy to do, I worked in nicotine addiction for 40 years and it’s very difficult to quit smoking but any attempt to quit is worth pursuing. Finally, reduce your alcohol intake to no more than 14 units per week. •

Everyone has thought for a good few years that fat makes you fat but that is no longer the case. Sugar is the number one culprit celebrityangels.co.uk

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The Dangers of High Blood Pressure Left untreated, high blood pressure can have serious consequences for your health


ccording to the 2006 Health Survey For England, around one in three people have hypertension—or high blood pressure as it’s more commonly known. As blood is pumped through a blood vessel it pushes against the sides, and when this pressure is too high it can put an extra strain on your arteries and heart which can lead to a host of serious health complications. High blood pressure has been described as a silent killer, because many people don’t experience noticeable symptoms until damage has already been done to the body. Two different numbers record your blood pressure. The higher number—systolic pressure—is the force at which your heart pumps blood around your body, while the lower number—diastolic pressure— measures the resistance to the blood flow in your arteries. Typically, a blood pressure of 140/90mmHg or more is considered high. Hypertension can result in a range of ailments that, if left untreated, can seriously affect your quality of life and even be fatal in some circumstances.


Hypertension can damage the inner lining of arteries, making it easier for fats to collect in them. Eventually they can become more narrow and less elastic, which limits blood flow throughout the


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body. The pressure of blood moving through a weakened artery can also cause it to form a bulge—or an aneurysm—that can rupture and lead to internal bleeding.


When arteries are narrowed by high blood pressure blood can’t flow freely to the heart— this can lead to chest pains, irregular heart rhythms or even a heart attack. Hypertension can also make the heart work harder, causing the left side to thicken and stiffen and increasing the chances of a heart attack or heart failure. The latter can also occur because the strain on the heart weakens the muscles and wears them out.

Did you know? Around 1/3 people who have high blood pressure do not know they have it Source: 2006 Health Survey For England


The narrowing or damage of the blood vessels in the brain may cause a temporary disruption of blood supply that can lead to a transient ischemic attack—or a ministroke, as it’s more commonly known. A full-blown stroke—where part of your brain is deprived


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Treatment Reducing your blood pressure by even small amounts can help lower your risk of developing health complications. Many causes of high blood pressure are related to your lifestyle—such as smoking, drinking a lot of alcohol and caffeine and a poor diet. Being overweight or obese can also increase your chances of developing this condition. Making changes to your lifestyle and diet can help bring down your blood pressure. These include losing weight, eating more fruits and vegetables, cutting down on salt and alcohol, exercising regularly and quitting smoking and trying to get at least six hours of sleep a night. Your doctor may also prescribe certain medicines to prevent your blood pressure from getting too high—whether or not you receive these depends on your age and how high your blood pressure is.

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of oxygen, causing damage to your brain cells—can occur when untreated hypertension weakens your brain’s blood vessels, leading them to narrow, rupture or leak. Poor blood flow to the brain can also lead to cognitive impairment of varying degrees of severity. Vascular dementia, which profoundly affects your ability to think as well as your speech, memory, vision and movement, can develop when the arteries that supply the brain are narrowed or blocked.


Kidney failure can occur when high blood pressure damages the arteries leading to your kidneys and the tiny vessels—called glomeruli— celebrityangels.co.uk

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found within them. The kidneys can’t filter waste from blood, meaning you may require dialysis or even a kidney transplant. Aneurysms can also happen in kidneys, leading to internal bleeding.


High blood pressure can damage the delicate blood vessels around your eyes, particularly the retina, causing retinopathy. This can lead to bleeding in the eye, blurred vision and even blindness. Hypertension can cause blood vessels to leak, letting fluid build up under the retina and impairing vision. Blocked blood flow can also damage the optic nerve and kill nerve cells, resulting in bleeding in your eye or loss of vision. •

REMEMBER All adults over the age of 40 should have their blood pressure checked every five years


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Ovarian Cancer:

How Early Detection Can Save Lives Did you know?

Around 1/3 people who have high blood pressure do not know they have it Source: 2006 Health Survey For England

Dear Doctor emphasises the importance of early diagnosis in ovarian cancer


ome 7,000 women are diagnosed with ovarian cancer every year, but the long-term survival outcomes have remained relatively static—and unpromising—for decades. today, just 35 out of every 100 women diagnosed with this disease survive for 10 years or more and almost 50 percent will survive their cancer for five years or more (source: cancer research UK). why has the fifth most common cancer in the UK for women become one of the deadliest? as with all cancers, early detection is absolutely crucial. around 90 percent of women who are diagnosed with stage one ovarian cancer will live for five years or more after diagnosis,

18 dear doctor with dr chris steele

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Did you know? Ovarian cancer is the fifth most common cancer in women, after breast, lung, bowel and womb cancer Source: Cancer Research UK

compared to just 20 percent and five percent for those diagnosed at stages three and four respectively. however, most ovarian cancers are only detected when they’re advanced, because the disease in its early stages presents with either no symptoms, or symptoms that are often vague and mistakenly attributed to other, less serious conditions. we urgently need women across the country to be more aware about the early warning signs of ovarian cancer—so what are they? the symptoms that occur frequently in women with ovarian cancer include feeling constantly bloated, pelvic and abdominal pain, a swollen abdomen, loss of appetite, feeling full quickly or feeling nauseous. other symptoms


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that may be present include irregular periods or vaginal bleeding after menopause, back pain, frequent urination, constipation and pain during sex. these are relatively common complaints that—more often than not—are indicative of non-cancerous illnesses. however if they are new, severe in nature and occur on most days for three weeks or more then you should visit your GP for a check-up. this is especially important if you’re over 50 or have a family history of breast or ovarian cancer.

IMAGES © Shutterstock

Diagnosis at your first visit to the GP your doctor will gently feel your abdomen and may also conduct an internal examination. if necessary you might also have a blood test to check for a protein called ca125 in your blood, which is produced by certain ovarian cancer cells. however, high levels of this protein are also present in other conditions such as pelvic inflammatory disease or endometriosis, so having raised ca125 levels doesn’t necessarily mean you have ovarian cancer. if you do have raised levels then your doctor will refer you for an ultrasound scan, where an internal or external probe is used to create an image of your ovaries to examine the shape, texture, presence of cysts and whether there is any swelling. if you are diagnosed with ovarian cancer then your doctor will want to find out how far the cancer has spread and how large it is, in order to best determine the right treatment for you. they do this by conducting a range of other tests that may include X-rays, a ct or Mri scan, abdominal fluid aspiration (where a fluid sample from your abdomen is taken to be tested for cancerous cells) and a laparoscopy, where a thin tube containing a camera is inserted through a small incision in your abdomen so that your ovaries may be examined and a biopsy collected. •


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RISK FACTORS Your chances of developing ovarian cancer may be increased if any of the following apply: INHERITED GENES Five to 15 percent of ovarian cancers are due to an inherited ‘faulty’ gene. These include BRCA1 and BRCA2, which also elevate the risk of breast cancer (because of this, women who have had breast cancer have up to double the risk of developing ovarian cancer). Speak to your GP if you are worried about your family history of ovarian cancer. BEING OVERWEIGHT Research has shown that premenopausal women with a BMI of 28 or higher have a greater risk of developing ovarian cancer. Research has also found that taller women have a higher risk of developing ovarian cancer.


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ENDOMETRIOSIS Sufferers of this condition, research has shown, have a higher ovarian cancer risk. AGEING Women who have gone through menopause are more likely to develop ovarian cancer, as the risk increases as you get older. HORMONE REPLACEMENT Less than one in 100 ovarian cancers in the UK are linked to hormone replacement therapy (HRT) use. SMOKING Smoking can increase the risk of developing certain cancers such as mucinous ovarian cancer. (Source: Cancer Research UK)

Here’s what you should do: Write down in a diary any symptoms that aren’t normal for you, noting how often they occur, their severity and whether they’re getting worse. If your symptoms are frequent (more than 12 times a month or occurring for three weeks or more), persistent and new to you then see your GP. Your diary will help you to present a detailed picture of what’s happening.


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Halting Alzheimer’s Dear Doctor investigates whether or not we can prevent this increasingly common condition


ementia is an umbrella term for a range of symptoms that include memory loss and difficulties with thinking, reasoning, problem-solving and language. These symptoms are caused by several conditions, of which Alzheimer’s disease is the most common—some 62 percent of dementia sufferers are diagnosed with it. Alzheimer’s occurs when certain proteins build up in the brain, creating structures that lead to connection


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Did you know? 850,000 people in the UK currently have dementia, but this number is set to increase—to over 1 million by 2025 and 2 million by 2051 Source: Alzheimer’s Society

problems between nerve cells. This leads eventually to cell death and a loss of brain tissue. Sufferers also have a shortage of certain chemicals that transmit signals around the brain. Alzheimer’s is a progressive disease that starts with relatively mild symptoms such as memory lapses (forgetting appointments or anniversaries, for example) and progresses as more and more of the brain is damaged. Eventually, sufferers will have severe problems with memory,


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communicating, orientation and reasoning, and will need help with every aspect of their daily lives. science has not yet discovered a proven means of preventing dementia, but research has shown that there may be ways you can delay the onset of symptoms.

Staying Sharp

remaining cognitively active into your old age could play a huge part in prevention, as there is some evidence to suggest that dementia rates are lower in those who remain mentally and socially active throughout their lives—it is thought that mental activity helps the brain to better cope with damage. activities such as playing musical instruments, reading, doing puzzles, playing sports, learning a foreign language and further education could all contribute towards reducing your risk.

heart happy

Maintaining your cardiovascular health by eating healthily and exercising for at least 150 minutes every week is essential, as an increased risk of alzheimer’s disease and vascular dementia has also been linked to cardiovascular disease. if you smoke you should quit—not only will this improve your heart health, but it will in itself lessen the chances of developing dementia as research has shown that smokers have a 50 percent greater chance of developing the disease (source: alzheimer’s society). You should also make sure your blood pressure is regularly checked as high blood pressure in middle age can increase the likelihood of developing dementia in later life.

IMAGES © Shutterstock

Cut down on your drinking

Binge drinking and excessive alcohol consumption damages the brain, as it can reduce the volume of the brain’s white matter, which helps to transmit signals between its many different areas. heavy, long term consumption can also lead to a vitamin thiamine B1 deficiency as well as Korsakoff’s syndrome, which affects short-term memory. at present there isn’t enough evidence to prove that celebrityangels.co.uk

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drinking in moderation also comes with an increased risk of dementia.

Let’S get phySiCaL

as well as improving cardiovascular health, being more physically active has been directly linked to improved cognitive performance in old age—the alzheimer’s society says it’s one of the best things you can do to reduce your risk of getting dementia. several studies have reported a link between aerobic exercise and improvements in thinking and memory among middle-aged and older adults— it also reduced the rates of dementia. in one instance, the combined results of 11 studies showed that regular exercise lowered the risk of developing dementia by about 30 percent (source: alzheimer’s society). You don’t necessarily need to play sport to engage in aerobic exercise—gardening, brisk walking and cleaning can also count as physical exercise. •

REMEMBER There are more than 40,000 people under 65 with dementia in the UK Source: Alzheimer’s Society

1 in 6 people over the age of 80 have dementia Source: Alzheimer’s Society

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LEARN THE STORY ABOUT THE ”VIKING DISEASE” AND HOW IT’S TREATED If one or more of your fingers bend towards the palm of your hand and you can’t straighten them, you may have Dupuytren’s contracture. To find out more about Dupuytren’s disease and all the available treatments, speak to your doctor or visit www.itisinyourhands.eu

NP-1838 Date of preparation: January 2017

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Dupuytren’s Contracture

Dupuytren’s disease is a condition that affects around one in five men and one in 20 women over the age of 50 in the UK


upuytren’s contracture is the thickening of the connecting tissue in the palm and fingers. It usually starts with nodules—tiny lumps—which are sometimes mistaken for calluses or blisters and cause the affected fingers to curl down into the palm of the hand. Even though the origin of this condition isn’t known, experts think it


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may possess an aspect of inheritance: it’s widespread in Scandinavia, and is often referred to as the ‘Viking disease’. It’s also common among people who have done hard manual labour throughout their lives.


The disease, which is named after the French surgeon—Baron Guillaume

Dupuytren—who first researched it in 1834, presents itself with symptoms that are usually mild and painless. Early symptoms include lumps under the skin in your palms: these nodules might be sore at first. According to NHS Choices, other symptoms can include the thickening of the skin on your palms and overall tenderness in the same area. As DEAR DOCTOR WITH DR CHRIS STEELE 25

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this is a progressive condition, with time the lumps may grow into a cord that permanently pulls fingers into the palm of the hand, causing discomfort, pain and—sometimes— even embarrassment. The ring finger is most commonly affected, followed by the little finger and the middle finger. In rare cases, the condition can also impact the toes and soles of your feet. Pay your GP a visit if you notice any of these symptoms.


For more information, visit the British Dupuytren’s Society website dupuytrens-society.org.uk/


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Common questions I have just been diagnosed with Dupuytren’s disease, what are the first steps I need to take? Dupuytren’s disease is not life-threatening, but it can be disabling. In the early stages the only thing to do is to keep a close eye on the lump in your palm. It may never get any worse, and if so, will not impact on your life at all. If a contracture starts, your GP will refer you to a specialist hand surgeon. Is Dupuytren’s disease a lifelong condition and what advice can you give for someone living with the disease? Yes it is a lifelong condition. Once it starts it does not usually disappear on its own. In about one third of cases Dupuytren’s disease will not cause any problems as far as we know. In those patients where the fingers start to contract into the palm, one of the several available treatments from a consultant hand surgeon would normally be offered and will often allow the patient to recover full use of their hand for some years. How will having Dupuytren’s disease affect me? This all depends on the degree of disability and which hands are affected. Unfortunately, because Dupuytren’s disease is highly visible, it can also affect your mental state and result in embarrassment or depression. It is important to remain optimistic about this: there are good treatments available and these will often restore hand function and appearance for several years.

IMAGES © Shutterstock

According to NHS Choices, treatment is only required if the condition affects the normal function of your hand. Effective treatment for severe Dupuytren’s disease mainly consists of surgery, some are minor procedures done in under a day. A surgeon can cut or remove the cords that cause the uncomfortable—and sometimes painful—contractures. If a non-surgical approach is preferable (and if the condition is milder), Dupuytren’s can also be treated with injections of collagenase, an enzyme that dissolves the cords themselves. However, this condition can only be treated and cannot be cured completely: it is likely that the cords will grow back and that further therapy might be needed. In any case, presence of the disease would need to be confirmed by a doctor, as there could be multiple reasons for the appearance of its trademark lumps. In 2010, the National Institute for Health and Care Excellence (NICE) issued guidance about the use of radiation therapy to treat Dupuytren’s disease. This other form of treatment involves aiming high-energy radiation at the cords to prevent or delay the need for surgery. As with all treatments, it is best to consider all the possible side effects—and consult with your doctor—before making any decision. •

Answers provided by Swedish Orphan Biovitrum, an organisation dedicated to improving the lives of people affected with rare diseases.


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Finding out the Facts Cer tain compounds found within cannabis may have a wide range of health benefits


annabis contains approximately 60 to 80 different compounds called cannabinoids, substances whose potential medical benefits— like reducing nausea and combatting tumours—are currently being explored by the scientific community. THC (tetrahydrocannabinol) is one of the most commonly occurring cannabinoids, a psychoactive substance that is responsible for why users feel ‘high’ when they ingest marijuana, experiencing pleasurable feelings of relaxation and euphoria. THC can also have a number of additional effects—such as decreasing pain and increasing appetite—that make it of medical interest for researchers, but it has also been linked to a growing incidence of psychotic symptoms and schizophrenia in users (particularly those with a genetic predisposition). Cannabinoids work by interacting with certain receptors on cells in the body: CB1 receptors, found on cells in the nervous system, and CB2 receptors, located within the immune system. THC’s intoxicating effects—and link to mental illness— are related to its activation of CB1 receptors. Cannabidiol, another common cannabinoid found within marijuana, interacts far less with these CB1 receptors, and when celebrityangels.co.uk

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it does it produces little to no psychoactive effects. This, combined with the fact that there is also increasing evidence that it may have an effect on other signalling systems in the brain, means that scientists are now investigating CBD’s possible therapeutic potential for treating a host of issues, from anxiety and psychosis to Alzheimer’s. In 2015, Nora D. Volkow, director of the National Institute on Drug

Abuse testified to the US Senate Drug Caucus on the research done so far on the possible medical uses of cannabidiol. Studies conducted in the last two decades have indicated that CBD may have antiseizure effects (when conducted with animal models), though only a small handful of randomised clinical trials have been run on the effectiveness of CBD as a treatment for epilepsy. CBD has also been DEAR DOCTOR WITH DR CHRIS STEELE 29

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shown to have neuroprotective and anti-inflammatory properties when tested on cell cultures and animal models, with positive outcomes on conditions such as Alzheimer’s, stroke, Parkinson’s diseases and multiple sclerosis (a medicine called Savitex, which contains both THC and CBD, is already being used in the NHS to treat the symptoms of MS). There have also been several pre-clinical reports indicating that CBD could have an anti-tumour effect in cell culture and animal models, though these results have not been confirmed in human subjects. There is evidence to suggest that CBD may alleviate the symptoms of certain mental illnesses. Marijuana has been linked in several studies to an increased risk of psychosis in some individuals, effects that, research suggests, CBD may limit. Thus far there have only been smallscale clinical trials on this. The anxiety and stress-lessening effects of CBD have also been documented in animal models and small human laboratory and clinical trials— particularly when it comes to social anxiety and post-traumatic stress. •

Cannabinoids and cancer


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IMAGES © Shutterstock

One of the areas that garners the most attention when it comes to the medical uses of cannabinoids is cancer treatment. However, it’s important to recognise that virtually all research on whether cannabinoids can treat cancer has been done on either animals or lab-grown cancer cells, not live patients. In addition, while there has been promising research on the beneficial effects that cannabinoids could have on fighting tumours, there isn’t enough reliable evidence to definitively prove that cannabinoids could effectively treat cancer. See Cancer Research UK’s science blog for more information on this subject.


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Varicose Veins Varicose veins are a common condition that affects at least one out of three people today ClariVein Treatment What is ClariVein®? The ClariVein® system uses a catheter with a unique rotating dispersion tip that offers a virtually pain-free treatment for varicose veins. What happens during the procedure? Once inside the vein through a pin-sized entry puncture, the tiny rotating tip of the catheter is set in motion inside of the vein, delivering medicine specified by your doctor. The procedure takes very little time and causes minimal discomfort.


n healthy veins, blood travels to the heart without interference; in varicose veins, it can collect and even flow backward—this tends to happen when blood vessel valves stop working properly. Even though any vein in the body can become varicose—swollen, enlarged and sometimes bulgy in appearance—this predominantly occurs in the legs and feet, mainly in the calves.

IMAGES © Shutterstock


Aching and uncomfortable legs are the main signs you should watch out for. Varicose veins can cause legs to become heavy and can lead to muscle cramping as well as dry skin and colour changes—especially in the lower part. Warm weather exacerbates these symptoms, as do long periods of physical inactivity. If


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Why choose it? Procedures which use ClariVein are often simpler, faster and less painful than other minimally invasive varicose vein treatment techniques, offering comparable results.

you are worried about the appearance of your veins, make sure you visit your GP. Pregnancy, being overweight and old age can all increase your chances of developing varicose veins. As for prevention, there is very little evidence to suggest you can stop the condition from getting worse or prevent it from manifesting altogether.


Although varicose veins might be unpleasant to the eye, they do not present a serious health problem and should not affect circulation for most people. There are three main types of treatment available: endothermal ablation, where heat is used to seal affected veins, sclerotherapy, where a special foam is used to close the veins, and ligation and stripping, where the vein is removed through surgery. •

What do patients say about the treatment? ‘When I took my stocking off to look at my leg I was amazed—it was just like a miracle,’ said Cathy Stamp, a ClariVein customer, ‘I’d had a great big knot of unsightly veins at the back of my knee and they had completely gone.’ What do clinicians say about the treatment? ‘ClariVein is a fast, safe, effective treatment for varicose veins that requires only one single needle injection for the patient,’ said Mr. Usman Jaffer, a consultant vascular surgeon working in the NHS and privately in London. Where can I get it done? ClariVein is performed nationally in the NHS and privately; visit clarivein.co.uk or call 01782 637009 for more information.


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Hip Replacement Surgery: the Facts In 2016, over 64,000 people in the UK underwent hip procedures on the NHS. Dear Doctor explores the facts WHAT IS IT?

The hip is a ball and socket joint at the juncture of the leg and pelvis and is one of the largest weight-bearing joints in the body, second to the knee. Hip replacement surgery—also known as total hip arthroplasty—may become necessary when the cartilage covering the hip joint becomes damaged. Although most common in elderly patients aged 60-80, hip replacement surgery is also recommended for problems with hip development in children or those with fractures in the hip bone. The surgery is generally recommended to patients who suffer from rheumatoid arthritis, osteoarthritis or the inflammatory condition ankylosing spondylitis. This major surgery replaces the damaged hip with a metal or hard plastic prosthesis that is designed to last 15 years. Alternatively, partial surgery, known as hip resurfacing, replaces damaged parts of the bone with metal alloy. Hip resurfacing is less popular, however, as the procedure has been known to damage the soft tissues surrounding the hip. Hip replacement tends to be offered as a last resort, with doctors implementing alternative measures to treat it first. These may include painkillers, physiotherapy or aids such as crutches and walking sticks.


As with all major surgeries, hip replacement can carry potential risks and complications. The most common


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Hip replacement surgery typically takes around 60-90 minutes to perform and you should be able to go home within three to five days. The procedure can be carried out under a local anaesthetic or with epidural anaesthesia (numbing the lower half of the body). While there will be initial pain from the operation, expect original pain felt before the surgery to be significantly reduced. If the surgery is minimally invasive, you may be encouraged to walk on the same day. A physiotherapist may be assigned to teach strengthening exercises for the hip, demonstrating 36 DEAR DOCTOR WITH DR CHRIS STEELE

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how best to sit and bend so as not to damage yourself or the prosthesis in the future.


It normally takes around three months to recover from a total hip arthroplasty. For the first six weeks you will be given a hip abduction wedge—a support mechanism placed between the legs designed to keep them straight during sleep. You will also need a walking stick or crutches to aid walking during this time. While healthcare professionals advise regular gentle exercise after the operation, like walking or swimming, it is important to avoid any extraneous activity. Continuing the exercises practiced with your physiotherapist is crucial to a happy recovery. It is critical to learn as much as possible about what is involved in the surgery before making a decision. Your hospital should provide literature and video information that covers all bases

when it comes to the surgery. If in doubt, arrange an appointment with a surgeon to discuss any questions you may have. •

Do I need hip replacement surgery? Look for: • Severe pain, swelling or stiffness in the hip that persists despite pain medication • Sleep interference • Difficulty in rising from a seated position • Reduced mobility • Feelings of depression due to pain and lack of mobility

IMAGES © Shutterstock

problem is loosening of the joint, which occurs in around 10 percent of patients. According to Arthritis Research UK, serious risks include blood clots, infection of the joint, nerve damage and wound haematoma (bleeding). Some patients also experience ongoing pain or a difference in leg length.


31/01/2017 16:36

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Your Essential

Health Checklist

IMAGES Š Shutterstock

From getting your five-a-day to meditating and sleeping through the night, there are many things we can do to stay in good shape

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t might not always be easy to find time to consciously work on our health, but a few simple actions can go a long way in safeguarding our wellbeing. Here, Dear Doctor outlines the top seven easy steps everyone can take to improve their quality of life at zero cost.

EAT RIGHT A healthy regime isn’t just about choosing to eat an apple over a generous serving of chips—it’s more about assessing when, how often, and how much you’re eating. Consider starting your day with a small breakfast to wake up your metabolism and fuel your body for the day. Eating healthily might not always be simple—sometimes it can prove to be expensive as well—but getting your five-a-day, eating whole grains and drinking plenty of water will do wonders to the body and also work towards building a more effective immune and illness response system.

been a lot of research done on the effects of alcohol on the body, and—just like smoking—it now appears there isn’t a safe amount of alcohol you can consume that would ultimately cut down the risk of harming your health. Managing your addictions should be at the top of your priority list; in addition to saving money, you would also be doing your body a lot of good.

Did you know? 150 minutes of exercise is enough to cut down your risk of an early death by at least 1/3 Source: JAMA Internal Medicine

VISIT YOUR DOCTOR Prevention is certainly much better— and simpler—than cure, therefore it’s vital to attend regular health checks and appropriate screening tests for your specific age. Most people don’t visit their GP until they are ill, so more often than not, diagnosis trumps early detection. The NHS Health Check (predominantly aimed at people aged 40-74) is a check-up designed to spot early signs of stroke, kidney disease, heart disease, diabetes and dementia.

REMEMBER The flu jab is free on the NHS for adults over 18 at risk of flu (including everyone over 65), pregnant women and children aged 6 months to 2 years at risk of flu Source: NHS Choices

A GOOD NIGHT’S SLEEP One in three people suffer from poor sleep, according to NHS Choices, and the price we pay for it might be more than just feeling grumpy and lacking in concentration—poor sleeping patterns can deteriorate physical health too. A solid night’s sleep (which can be anywhere between six and eight hours a night) is vital for a healthy life—without it, we are putting ourselves at higher risk of developing conditions such as obesity, heart disease and diabetes.

MANAGE YOUR ADDICTIONS Evidence of all the diseases and lifechanging conditions that smoking can exacerbate is too widespread to ignore. Quitting your tobacco addiction is always the best course of action, but cutting down can prove to be beneficial and a conscious step forward on the road to giving up for good. There has


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Adults in the specified age group can expect a letter from their GP inviting them for a free check every five years. Once the results are analysed, a doctor will discuss advice and relevant prevention strategies.

MEDITATION AND GOAL SETTING Working on physical health is vital, but it certainly cannot stop there—good mental health is also key—as humans have spiritual and emotional needs as well. Stress is harmful and can drain energy levels, so making the effort to relax and take a break to meditate regularly can only have positive effects on your health. If you have any goals or aspirations you want to achieve, note them down on paper and prioritise them. It’s important to always be realistic when setting targets: set yourself up for success rather than failure, as the latter increases stress and depletes productivity levels.


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NHS FLU JAB The flu shot is the best chance we have at protecting ourselves from the flu and its potentially serious complications—like pneumonia. Free on the NHS annually if you’re a child at risk (from six months to two years old), pregnant, over 65 or particularly likely to develop the flu, the jab is available in pharmacies, GP surgeries and local midwifery services. According to NHS Choices, even though the vaccine doesn’t guarantee complete protection against the flu, people who have it done tend to experience milder symptoms of the seasonal illness—if any at all.

EXERCISE A recent study of 64,000 people over 40 carried out in England and Scotland revealed that 150 minutes of exercise a week is enough to cut down the risk of an early death by at least one third (source: JAMA Internal Medicine). Taking a brisk ten-minute walk—or

choosing another type of exercise that boosts your heart rate—three times a day, five times a week can provide enough exercise for those who cannot commit to a gym membership. This can be done as an activity with your partner after work, during the morning commute and even on the way home. •


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Top Risk Factors For


Anyone can suffer a stroke but cer tain factors may increase your risk, and only a few of these can be controlled


troke is now considered the third biggest cause of death after heart disease and cancer—it is estimated that around 110,000 people in england suffer one every year. this life-threatening and life-altering condition occurs when blood supply to the brain is cut off. although older people—along with people who are asian, african or caribbean—are more at risk, strokes can happen at any age including in childhood and early adolescence. here, we discuss the greatest risk factors and the possible measures you can take to limit their impact.

Genetic conditions

conditions such as sickle cell disease—a disorder that affects the shape of red blood cells—can increase your risk of suffering a stroke as can other medical problems like vasculitis, inflammation of the blood vessels and a range of other bleeding disorders. similarly if a close relative has had a stroke, or you have suffered one yourself, your risk is likely to be higher.

AGe And Gender

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IMAGES © Shutterstock

our risk of suffering a stroke increases as we get older—though at a younger age, men are significantly more at risk than women. having said this, women are ultimately more likely to die as a result of a stroke—this is also exacerbated by birth control pills as high levels of oestrogen can lead to blood clots. celebrityangels.co.uk

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According to the Stroke Association, women who have certain types of migraines are also at a slightly higher risk of suffering a stroke.


Heart conditions such as coronary heart disease, heart failure, cardiomyopathy and atrial fibrillation are all major risk factors for stroke as they can cause blood clots. According to the Stroke Foundation, a heart attack is also a strong indication that you could have a stroke sometime in the future.


The way we choose to live our life has a huge impact on our health and wellbeing. Taking up smoking, drinking too regularly and illegal drug use are all linked to an increased risk of stroke—as is a sedentary lifestyle, lack of physical activity and an unhealthy diet. Working on your health and making these simple changes can significantly lower your risk while also improving quality of life.

Recognising the symptoms The ‘FAST’ test allows people to quickly identify the signs of stroke Facial weakness: Can the person smile? Has their face fallen to one side? Arm weakness: Can the person raise both arms and keep them in the air? Speech problems: Can the person speak clearly or is their speech slurred? Time: If you spot any of these signs, call 999 Source: Stroke Association

Did You Know? There is a stroke every 3 and ½ minutes in the UK Source: Stroke Association

REMEMBER After the age of 55 the chances of stroke double every 10 years, and 2/3 of strokes occur in patients over the age of 65 Source: NHS Choices


Plaque buildup and high cholesterol can cause abnormal blood flow, clogging arteries and blood vessels. In order to be considered within healthy parameters, you should have a cholesterol reading of less than 200, a high density lipoprotein (HDL, also known as ‘good cholesterol’) reading above 40 and a low density lipoprotein (LDL, also known as ‘bad cholesterol’) reading of less than 100. The easiest way to bring cholesterol down is a diet high in grains, fruit, vegetables and foods low in saturated fat.


As diabetes causes circulatory problems in the body, it is one of the most common risk factors for stroke. This chronic condition also gives rise to other health complications such as heart disease and high blood pressure—all of which can also increase an individual’s chances of suffering a stroke. • celebrityangels.co.uk

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21st Century Fitness


he fitness and technology industry is booming. everyone—from children and teens to elders—is jumping on the health bandwagon through their increased use of smart apps, wearables and gadgets. health consumers looking for personalised, smarter and responsive fitness experiences have turned to tech giants like GoPro, Microsoft, Garmin and Fitbit for the latest in fitness technology.

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the health industry has well and truly embraced tech—resulting in an easier, tailor-made, accessible and engaging fitness experience.

Fitness Fashion

today there are trackers and wearables on the market suited to everyone’s needs and tastes. while some will look for simple step counting and sleep tracking gadgets, others will want devices with built-in GPs, heart

Fitness app usage is growing 87% faster than the overall app market source: tech crunch

IMAGES © Shutterstock

Technology has redesigned the way we work out, how we measure progress, the way we plan fitness activities and how we look for health advice


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rate monitors and maximal oxygen consumption count—which is now considered the scientific gauge of fitness. Fitbit, probably the most well-known manufacturer of activity trackers of the same name, produces a range of wearables that measure and analyse fitness data. Their wristbands—which also tell time— can monitor activity, exercise, sleep, food intake and weight and can also store that data on a computer. Their newest generation bands now offer breathing training to combat stress. According to Forbes wearables don’t just improve health and wellbeing, they substantially increase job satisfaction and productivity as well—by 3.5 percent and 8.5 percent respectively. As far as revolutionary technologies go, Lumo’s smart capris—or shorts for men—seriously top the charts. Inspired by the desire to combine running with tech, Lumo Bodytech HQ have released Lumo Run, leggings with sensor technology embedded in the waistband that can track running and exercise. Just like most wearables, these leggings can also feed the data recorded during exercise to an app, which in turn gives users tips and tricks on how to improve and get the most out of their fitness sessions. Dubbed the world’s ‘smartest’ multi-sport headphones, KuaiWear’s coaching headphones track the user’s performance during exercise and provide live customised voice responses. Users will be given feedback on their fitness regime, breathing, heart rate, speed and distance with audio—all while listening to their choice of music. This highly responsive and tailored fitness regime gives users the chance to understand the relationship between effort and outcome—causing the workouts to become more meaningful and effective. Whether it’s through gadgets or clothing, it’s obvious that technology has revolutionised our journey to fitness and wellbeing.

of cyber training ideas, over 300 gym studios over Europe are now offering virtual classes. From developing course programmes and designing individual sessions, to selecting professional instructors and producing high-quality videos, companies like CyberConcept are at the cutting edge of fitness— gym goers can now attend classes completely taught and overseen by an on-screen coach. From workout videos on YouTube to easy step-by-step online fitness guides, social media continues to be at the forefront of innovative fitness— people wanting to get in better shape no longer have to leave their house and travel to a gym to do so. Certified online coaching websites can offer expert advice, tailored workouts, meal plans and exercise programmes created by professionals. Online personal training websites also provide easy step-by-step videos teaching consumers about the right postures to adopt while squatting, lifting weights and even running— sometimes at a very reasonable price.

Did You Know? Around 1/3 of smartphone users in the US—estimated to be around 46m people—used fitness and wellbeing apps in January 2014 Source: Nielsen

Sales of fitness bands and watches were up 118% in 2015 from the previous year Source: Mintel


According to CyberConcept, developer of CyberCycling and a leading provider celebrityangels.co.uk

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on the other hand, for people who do enjoy the social side of fitness—like attending group sessions—websites such as PayasUGym and GoMammoth let people find and book classes by creating a list of the closest gyms with the best deals on pay-as-you-go prices. this is the true epitome of flexible and convenient fitness—gone are the days of long and expensive memberships and having to call your gym to book your place on a class.

Virtual coaching

the internet has dramatically changed the way we look for health advice. according to a recent study by Mintel, around 61 percent of Brits place their trust in apps and websites to give health information and guidance as they are easy to use and can be personalised to fit the user’s needs. the widespread use of fitness apps can be attributed to the phenomenal popularity of smartphones—consumers can now monitor their exercise sessions and progress at the gym, at 46 dear doctor with dr chris steele

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work and even at home. apps such as 5k101 are encouraging people to take responsibility for their own health and exercise sessions. acting as a sort of ‘virtual personal trainer’, the app takes users through an eight-week running program and is aimed at anyone who is able to jog—no matter their age or physical condition. Under armour’s MyFitnessPal app, on the other hand, focuses on food. it tallies up the calories consumed in a day and allows consumers to keep a diet journal and monitor their health from virtually anywhere. the app is also compatible with a range of fitness trackers, which means users will be able to see just how many calories they burn, pushing them to be more aware of their diet and exercise habits. Focusing on fitness isn’t always as easy as it sounds, as many might find it difficult to set some time aside for daily workouts and activities. the Johnson & Johnson official 7 Minute workout app goes some way in solving this problem: it offers a range of short

Just under 50m wearable devices were shipped in 2015 and over 125m units are expected to ship in 2019 source: Forbes

exercises that can be done anywhere and anytime. Users will be able to personalise the app, choose the length and difficulty of their workout, opt for a simple warm-up session and monitor wellness levels. thanks to the rise in popularity of fitness apps there have been huge steps forward in the processing of fitness information—the ability to capture real-time data and feed it back to the consumer is creating an increasingly engaged fitness experience. • celebrityangels.co.uk

31/01/2017 16:46


Managing Your


Maintaining a healthy weight is vital at ever y age, but warding off the extra pounds becomes increasingly impor tant as we get older

IMAGES © Shutterstock


etting rid of excess weight gets harder as the years go on, but working to maintain a healthy body is perhaps the single best thing we can do to reduce our chances of developing serious long-term conditions—like diabetes, cancer and heart disease— and improve our quality of life. weight loss in later life can be difficult due to various reasons from ageing muscles and different hormones to physical strain and lifestyle changes—so


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how can we best tackle these issues and stay fit as we get older? attending annual health checks is important; during these sessions your doctor can monitor your weight, scan for any problems and conditions and make suggestions on your weight management—these will largely revolve around a healthy, balanced diet, regular trips to the gym, and suitable exercise programmes. the key is making small but concerted changes that you can commit to for life.

In order to maintain weight, on average men and women require 2,500 and 2,000 calories per day respectively source: Nhs choices

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So-called ‘quick fix’ diets can be harmful to our health and put our bodies through a great deal of stress. Losing weight the healthy way can only be done through swearing by a balanced regime and putting time aside for physical exercise. The journey to achieving a healthy weight can start by simply swapping out a high-calorie food with something healthier—like opting to eat fruit over pastry for breakfast. Getting your five-a-day is hugely recommended, as it is an integral part of every balanced and nutritious diet. On the whole, watching your calorie intake—and eating better nutritionally—while being more active will go a long way in losing excess weight and keeping it off for good.

Keeping it off Stick to eating a low-calorie diet: a low-fat and high-protein diet can help maintain weight loss as protein-rich meals tend to make you feel full—cancelling out the need to snack between meals. Habits: plan your meals ahead and stick to your healthier habits no matter if you go out to dinner or go on holiday. Goals: setting goals can motivate you to keep up the good work. Keep it interesting: if you feel like you may be about to spiral back into your old ways, make a change. Buy a new healthy cookbook, try a new activity or book a place on a cooking class. Watch the scales: keep track of your weight regularly and keep an eye on any sudden changes. Source: NHS Choices


According to NHS Choices, adults aged between 19 and 64 should get at least 150 minutes of physical exercise each week. This can include cycling, fast walking and any activity that increases your heart rate. If you’re just starting out, you should take it slow and gradually build up your level of exercise until you’re able to complete the recommended 150 minutes. Putting time aside for physical activity can significantly lower your risk of developing a series of conditions such as heart disease, diabetes, some types of cancer and stroke.


Although maintaining a healthy weight can do wonders for our long-term wellbeing, putting our bodies through the strain caused by extreme dieting and exercise will never pay off in the long run. According to NHS Choices, the safe rate of weight loss sits between one and two pounds—about half to one kilo—a week. Setting a realistic and achievable target will put you on the right track. If you’re unsure about what weight range is right for you, there are useful tools online such as the NHS weight calculator that can help you work it out. Similarly, you can download the 12-week weight loss guide from the NHS Choices website. •


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01/02/2017 08:53

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Everyone can now benefit from Specsavers’ value and choice, even if they are unable to visit a high street optician unaccompanied. With Specsavers Healthcall, eligible customers can have a full eye test at home, or in a care home, conducted by one of our homevisiting opticians. What’s more, should they need glasses, they’ll be able to choose from hundreds of styles and take advantage of the same offers that they’d find in our stores.

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30/01/2017 11:18


Essential Eye Health Checks


roblems with our eyes are easy to miss because we often don’t experience discomfort or pain when there’s a problem, making regular eye tests essential for spotting an issue that needs treating. it’s recommended that we get our eyes tested every two years, although individuals may have to be tested more frequently if they have diabetes, are a child wearing glasses, are over the


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age of 40 and have a family history of glaucoma or are aged 70 and over. a sight test will be able to tell you if you need glasses or whether you need to change your current prescription if you already wear glasses or contact lenses. Your eyes will be examined for signs of injury or abnormality and your optometrist or ophthalmic medical practitioner will be able to detect the early indicators of diseases such as age-related macular degeneration

Although it’s recommended that you have a checkup every 2 years, you should visit your GP if you’re concerned about your eyesight at any time

IMAGES © Shutterstock

It’s easy to neglect our eye health but regular optical check-ups are vital if we want to preser ve good vision

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and glaucoma—this is important as many of these conditions are treatable if caught early enough. They can also use eye tests to spot the signs of more general conditions such as diabetes and high blood pressure. After the test your practitioner will discuss the results with you and whether you need glasses or if you need more testing. You will also be given an optical statement or prescription stating what further action—if any—is needed, such as whether you need further treatment or glasses. Any NHS optical vouchers you are entitled to will also be given to you after your test. If you do need a new prescription, you can take the statement to a supplier to have new glasses created. •

REGULAR CHECKS It’s very important to have regular eye tests if any of the following apply: —You’re from ethnic groups that have a greater risk of certain conditions. Those from south Asian communities, for example, are more likely to develop diabetes and diabetic retinopathy. Those of AfricanCaribbean heritage have a greater risk of developing diabetes and glaucoma —You’re over 60 years old —You have a family history of eye disease

Shield your eyes from the sun Limited exposure to the sun is always important when it comes to your skin, but did you know that it’s just as crucial when it comes to your eyes? According to NHS Choices several studies have suggested that exposure to sunlight may increase your chances of developing cataracts, so make sure you wear wide-brimmed hats and dark sunglasses—look for the CE mark and the British Standard BS EN 1836:2005: this means that they offer the right level of ultraviolet protection. Whether you’re wearing sunglasses or not, you must never look directly at the sun as this can cause permanent damage and even blindness.


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01/02/2017 08:54


Cataract Surgery: What You Need To Know TAILORED TO YOUR NEEDS

One of the most common eye conditions is easily treatable Cataracts are one of the main causes of sight loss for older people, and cataract surgery is one of the most common procedures in the UK, with more than 300,000 operations carried out each year (source: NHS Choices). Cataracts are a painless condition where proteins gather in the lens—the clear part of your eye that helps focus light onto the retina. This makes the lens clouded and stops light passing through, causing your vision to become blurry. It’s a gradual condition, which means that your eyesight will progressively worsen over time, affecting everyday activities such as reading and driving. If left untreated it can result in blindness. There are a number of common symptoms associated with cataracts. These include cloudy or


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blurred vision, seeing double or multiple images from one eye and changing glasses or contact lenses often—as your prescription keeps changing. Colours may also appear faded and you may have poor night vision or problems with bright lights. Last year Dear Doctor editor Dr Chris Steele underwent cataract surgery on his left eye at the Optegra Eye Hospital in Manchester, which he filmed for viewers of ITV’s This Morning programme. The procedure was carried out under local anesthetic and took just 30 minutes. Recovery was straightforward: Chris had to wear a clear plastic eye guard for the first couple of days and use eye drops for three to four weeks. Just 24 hours after the operation Dr Chris felt no pain, and his vision had already improved. Speaking to thebestofhealth. co.uk, Dr Chris had this to say: ‘Do not worry, it’s a procedure that’s over very quickly. Within half an hour you’ll be out of there. You won’t feel anything, you won’t see anything and the results are dramatic.’

Optegra’s approach to cataract surgery is a personal one tailored to your needs and requirements. Your surgery will be performed by one of Optegra’s NHS-trained, world-class ophthalmic surgeons, who will first carry out a detailed, comprehensive consultation with you in order to determine what the best course of treatment is. They will also oversee the aftercare you receive after this surgery, thus ensuring the best standards of care. Optegra offer a range of cuttingedge cataract treatments that can be tailored to each patient’s individual needs. A typical cataract operation involves removing the lens and replacing it with a synthetic intraocular lens. Optegra also offers refractive cataract surgery, which replaces the natural lens with a sophisticated multi-focal lens that can correct sight problems such as short sightedness and long sightedness, improving your vision significantly. A consultant-led, personalised experience where you see the same surgeon throughout the entire process, state-of-the-art facilities, no waiting time, transparent pricing and flexible financing options make cataract treatment at Optegra an attractive option. Better yet, they offer numerous other procedures and treatments for a range of sight-related issues, from laser eye surgery to treating conditions such as glaucoma. If you think you may need cataract surgery or require advice about another eye health issue then visit optegra.com or call 0808 115 9730 to book a consultation or find out about Optegra’s open evenings.


01/02/2017 08:54

I no longer fear losing my eyesight, I have my life back Diabetic retinopathy is a serious complication of diabetes and one of the most common causes of blindness among people of working age in the UK. Read Sue’s story about how she’s managing this debilitating condition. retinal bleed. After 12 months, it was confirmed that for the first time in over two years, both her retinas were stable, showing no signs of small bleeds at all. “By using the Noctura 400 Sleep Mask every night for the past two years, it has helped me maintain my eyesight. I still have my driving licence, work full time and enjoy an active life, without the fear of my eyesight getting worse” explains Sue.

Sue enjoying a recent flying lesson

Sue Wales from Farnham, in Surrey, has lived with Type 1 diabetes for 32 years, and was diagnosed with diabetic retinopathy at a routine eye screening 4 years ago. Despite receiving over a dozen laser therapy sessions, as a keen gardener, she kept experiencing new bleeds whenever she did something strenuous like digging. Driving 100 miles a day to get to work and enjoying a happy independent life, Sue feared the very real prospect of losing her driving licence, job and home. Sue turned to the Noctura 400 Sleep Mask and found an improvement immediately. In the first 6 months of wearing the mask every night she did not have a single

Am I at risk? Within 20 years of diagnosis nearly all Type 1 and almost two thirds of Type 2 diabetes patients develop retinopathy. Early detection and treatment can reduce the risk of developing diabetic retinopathy by 90%. How does the Noctura 400 Sleep Mask work? When you have diabetes, high blood glucose levels and circulation problems can cause changes to the blood vessels in your eyes which may lead to diabetic retinopathy and diabetic macular oedema (DMO). The revolutionary treatment worn at night, Noctura 400 Sleep Mask provides a type of light therapy that has been shown to reduce the eye’s need for oxygen at night, breaking the cycle of retinopathy.

Break the cycle of retinopathy today, contact us: Call 01740 669 143 Visit www.noctura.com

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Macular Degeneration AMD is one of the leading causes of vision loss in older people. Dear Doctor explores how to treat this common condition


s we get older our sight often deteriorates, and the principal culprit for this is age-related macular degeneration, a painless condition that causes you to lose your central vision—what you see when you focus straight ahead. Although it can progress rapidly, AMD is typically a gradual condition where vision becomes increasingly blurred, making activities such as reading more difficult. People’s faces


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also become harder to recognise and colours appear less vivid. AMD occurs when the macula—the part of the eye responsible for central vision—stops working properly. There are two types of AMD: ‘wet’ and ‘dry’. The former occurs when abnormal blood vessels emerge underneath the macula and damage cells. This variant is more serious than dry AMD, which develops when macular cells are damaged by a buildup of deposits called drusen. This is by far the most

common type of AMD, occurring in nine out of 10 cases. If you notice that your eyesight is gradually worsening, visit your GP or optometrist. Make an emergency appointment if your vision deteriorates suddenly or you notice blind spots in your field of vision.

TREATMENT AND MANAGEMENT OF AMD There’s no cure for AMD—wet or dry—and treatments mostly focus on


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weight can also help. On sunny days, shield your eyes from the sun with wide-brimmed hats and sunglasses as the harmful UVB and UVA rays in sunlight could further damage your vision. You may also be referred to a low vision clinic, where a trained professional will give you an assessment that will help you get the most out of your sight. Depending on what challenges you are having with your AMD and what activities you would like help with, the clinic will prescribe you a varied array of low vision equipment and aids to help with maintaining your independence. The Royal National Institute of the Blind also sells a range of products to help with low vision, from speaking weighing scales to talking televisions. • rnib.org.uk

REMEMBER AMD doesn’t cause complete blindness as it only affects central vision—your peripheral (side) vision remains intact

Wet AMD Early detection is crucial for wet AMD, as without treatment your vision can worsen within days

IMAGES © Shutterstock

helping sufferers make the most of their remaining vision, such as using magnifying glasses to make reading easier. For dry AMD, NHS Choices states that a diet rich in leafy green vegetables may slow the condition while anti-vascular endothelial growth factor medication can be used to treat wet AMD. Laser surgery has even been suggested as a possible means of destroying the blood vessels that damage the macula. AMD is a long-term condition and sufferers will need to learn how to manage it and make the most of what sight they have left. Start off by making things easier to see around your house, such as using clocks and watches with large numbers, large print books and telephones with big buttons. Clever lighting will also help enormously—such as using a lamp that can be angled to shine directly on whatever you’re doing. It’s also important to make sure your lighting is controllable, consistent and even across the house. Using different, contrasting colours and tones in your home to make objects stand out is also useful—from using thick black pen on white paper to brightly coloured plates on dark tablecloths. It’s crucial that you look after your eyes by attending regular eye tests and checkups, and make sure you always take the medications and treatments you’ve been prescribed— whether AMD-related or not. As well as this, lifestyle changes such as eating more fruits and vegetables, quitting smoking and managing your


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01/02/2017 15:09

Ears. For life.

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Protecting Your Hearing Hearing loss can’t always be prevented, but a few simple measures may reduce your risk of damaging your ability to hear over time


ut simply, hearing loss is the result of sound signals not reaching the brain. according to action on hearing loss (ahl), a national charity, it affects around 11 million people— approximately one in six—in the UK, and is expected to impact as many as one in five by 2035. the condition can be neatly divided into two categories: sensorineural hearing loss, which is caused by damage to the auditory nerve and occurs as we age, and conductive hearing loss, which is caused by blockage such as earwax or glue ear. age-related hearing loss— also known as presbycusis—can be the result of both environmental and genetic factors. ageing is the single biggest cause of hearing loss; most people begin to lose their hearing in their 40s, and a significant proportion have serious problems by the time they’re 80 years old. other risk factors include continued exposure to loud noises, acoustic trauma, genetics, and illnesses such as cancer, meningitis, stroke and multiple sclerosis. hearing loss isn’t always preventable, but whatever its cause may be, there are some steps we can all take to protect our hearing for as long as possible. ears are very fragile structures. they can be damaged easily and often the harm done can prove to be irreversible. in order to limit your risk celebrityangels.co.uk

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of noise-induced hearing loss, Nhs choices recommends some simple lifestyle changes—it’s extremely important to evaluate how much noise you’re exposed to. if you’re worried about your hearing, avoiding recreational risks might be a good place to start: activities like riding a snowmobile, regularly attending live concerts and hunting can all damage your hearing. television, radio, and

Did you know? More than 900,000 people in the UK are severely or profoundly deaf Source: Action on Hearing Loss

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of common causes of hearing loss, which include ear infections—like otitis—mumps and measles. As with all health concerns, it’s always best to make an appointment with your GP (or a specialist) if you notice your hearing is deteriorating. It is a good idea to consider regular hearing tests and check-ups as early detection of any possible problems is key when it comes to treatment and further prevention. Most types of hearing loss can be helped by simple hearing aids—according to AHL around 80-90 percent of people benefit from using hearing aids and also experience a better quality of life—but they are most effective when fitted early as waiting might make adapting to the devices more difficult. Getting to the bottom of hearing problems is paramount as it has been shown that hearing loss can also be a gateway to other long-term health issues like cardiovascular disease, stroke and obesity. •

Out of the 11m people living with hearing loss in the UK, around 6.7m would benefit from using a hearing aid

IMAGES © Shutterstock

music should all be listened to on low volumes, especially if there are children around as their ears are more delicate than an adult’s. To safely listen to music through an iPod or MP3 player, the health service recommends abiding by the ’60:60’ rule—listen to your music at 60 percent of its full potential volume for no more than 60 minutes a day. Using noise-reducing earphones can block out considerable amounts of background noise, in turn cancelling the need for higher volume. For those who work in a particularly noisy environment—such as a nightclub, bar or building site—it’s advisable to use good earplugs and be aware of how to make use of them correctly. As ears are fragile and complex structures to begin with, NHS Choices also warns people against inserting any kind of object in their ears—whether that is cotton buds, tissues or fingers. It’s important to also be aware of the symptoms

Source: Action on Hearing Loss


01/02/2017 15:08

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Looking After Oral Health

Our teeth are a vital part of our overall wellbeing, so how can we best look after them as we age?


ccording to the oral health Foundation (ohF), only nine percent of men and 11 percent of women have oral health that can be classed as ‘excellent’. with similar reports from the British society of dental hygiene & therapy claiming that almost half of UK adults suffer from a mild fear of dentists—and over 12 percent have extreme dental anxiety—it’s safe to say that tackling oral health is not at the top of everyone’s list of medical priorities. however there are a few simple steps we can all take to protect and boost our oral health, but what exactly are they?

Protecting your Pearly whites Nhs choices recommends brushing your teeth at least twice a day for two minutes, using a good quality fluoride toothpaste containing at least 1,350 parts per million of the ingredient. this should be done first thing in the morning and last thing at night: it will limit the formation of plaque, the film of bacteria that covers your teeth and contributes to other—avoidable— conditions such as gum disease and tooth decay. whether you use an electric toothbrush or a conventional one is up to you, but both are good choices as long as you make sure to 62 dear doctor with dr chris steele

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clean all surfaces with care. after brushing, spit out excess toothpaste but don’t rinse your mouth with water as this will wash away the fluoride. a great fluoride mouthwash will help prevent tooth decay, but it’s important to never use the product straight after brushing your teeth and only eat and drink 30 minutes after use.

Did you know? Brushing your teeth only once a day means you’re 33% more likely to develop tooth decay at some point in your life Source: Oral Health Foundation


01/02/2017 08:56


TEETH WHITENING Professional teeth whitening is a great option for people who want their teeth to appear a bit lighter. If you choose to undergo the treatment, you’ll need to make a few visits to your dentist to prepare—they’ll make an impression of your teeth to create a mouth guard and will teach you how to use it in conjunction with a bleaching gel, which you can use from the comfort of your home. Another type of teeth whitening—laser whitening—consists of a bleaching product being painted on your teeth and later activated with a laser. This treatment lasts about an hour. The main culprits for stained and yellow tea are cigarettes, tea, alcohol and wine—keep the consumption of these to a minimum to keep your teeth from losing their white shine. •

THE TRUTH ABOUT FLOSSING A common misconception about flossing is that it should be done after brushing your teeth—you need to do it beforehand. Regular flossing can reduce your risk of developing gum disease or chronic bad breath by getting rid of food remnants and plaque between your teeth. NHS Choices recommends flossing with eight to 10 strokes between each tooth with a piece of dental tape about 12-18 inches long, slipping the floss between teeth and gums as far as it will go.

IMAGES © Shutterstock

ROUTINE CHECK-UPS The need for dental check-ups will largely differ from person to person— some may require a visit every six months, while others may need to visit their dentist more frequently (the average time between checkups varies from three months to two years). At each check-up you can expect your dentist to examine your teeth, gums and overall mouth health, give advice on teeth-cleaning celebrityangels.co.uk

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habits and discuss your diet, smoking and alcohol consumption. Leaving problems—like a sore tooth— untreated can make them more difficult to resolve.

TOP TIPS FOR TEETH Reducing sugar in your diet not only lowers your risk of tooth decay, it also lowers your risk of developing serious life-changing conditions like diabetes. It is therefore recommended to eat very small amounts of foods high in sugar and fat. It’s also advisable to limit intake of fizzy drinks, milky drinks with added sugar, fruit juice, pastries, ice cream and dried fruit. Simple lifestyle changes such as quitting smoking and cutting down on alcohol can also dramatically improve your oral health: smoking stains teeth yellow, causes bad breath and increases your risk of gum disease while alcohol erodes the enamel. According to NHS Choices, people who smoke and drink heavily have a 38 percent increased risk of developing mouth cancer.

REMEMBER Never use a toothpick to remove food trapped between your teeth as it may damage your gums and lead to an infection Source: NHS Choices

Facts and figures 31% of adults have tooth decay 74% of adults have had a tooth extracted 29% of adults suffer from regular dental pain 66% of adults have visible plaque Source: Oral Health Foundation


01/02/2017 08:56





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Smile Wide

Dentures can solve various issues with eating and speech. Dear Doctor provides information for those who are considering them, and advice for people who already wear them


itting neatly over gums—and correcting potential problems caused by gaps—dentures are mostly made from plastic, metal or nylon. whether you need a full set, replacing all your upper or lower teeth, or a partial one, replacing one or a few teeth, dentures can dramatically improve your quality of life: they can alleviate speech impediments, make it easier to eat, significantly improve the appearance of your smile and boost self-confidence.

GettinG your dentures fitted

Your dentist will start the process by taking measurements, producing several moulds of your mouth and then ordering full or partial dentures—depending on celebrityangels.co.uk

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your need—from a dental technician. the technician will provide you with trial dentures without the need for another visit to the dentist; the shape and colour of these can be adjusted before the final dentures are made. Full dentures will usually be fitted immediately after teeth are removed—the gums and bone might change in shape after this is done, meaning that the dentures may need altering after several months. in some occasions, your gums might need to be left to heal for a while before dentures can be fitted. Partial dentures usually clip securely into place on natural teeth with metal clasps; they can be removed—or unclipped—very easily. if your dentures fit correctly, you will find there’s no need to use adhesive.

however in some cases—when your jawbone or gums have shrunk—denture fixative might be the only way forward. if this is the case, your dentist will advise you on the best course of action. some people tend to feel more confident when they use adhesive; according to Nhs choices it’s best to use it sparingly and to always follow the manufacturer’s instructions. once applied, adhesive may be removed by brushing the dentures with soapy water—remnants in the mouth might need to be cleaned with a clean, damp flannel. having dentures might take some getting used to and the first few meals will seem a bit strange. at the very beginning, you should try to eat soft foods cut into small pieces, chew slowly dear doctor with dr chris steele 65

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and use both sides of your mouth. It’s important to avoid chewing gum and foods that have sharp edges, and are sticky or hard. As time goes on you’ll be able to revert back to your normal diet.


You should visit your dentist if… • Your dentures click when you’re talking • Your dentures slip or no longer fit properly • Your dentures feel uncomfortable or give you pain • Your dentures are visibly worn • You have signs of gum disease or tooth decay Source: NHS Choices

IMAGES © Shutterstock

Oral hygiene is just as important when you wear dentures—brush your remaining natural teeth, gums and tongue at least twice a day. NHS Choices recommends using fluoride toothpaste to fight tooth decay, gum disease and other conditions. Your dentist will advise you on whether it’s necessary to remove the dentures at night: this isn’t always mandatory, but it can help your gums rest as you sleep. If your dental technician recommends removing them, they should be kept moist in water, a polythene bag with dampened cotton wool in it, or in a

tailored cleaning solution. As with natural teeth, it’s vital to regularly clean plaque from dentures—failing to do so may result in bad breath, tooth decay and gum disease. Dentures should be cleaned at least twice a day by brushing them with toothpaste (or soapy water) and soaking them in a solution of denture-cleaning tablets to remove various stains and bacteria. Clean them over a bowl filled with water using a soft towel—dentures may break if dropped, so it is advisable to handle them with care. If you take good care of them, your dentures should last several years— though your gums and jawbone will eventually shrink over time, meaning you might need to get new dentures or start using adhesive. It is therefore vital that you continue to pay your dentist regular visits so they can check for problems. •


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01/02/2017 08:57

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Beating Diabetes

IMAGES Š Shutterstock

Being diagnosed with Type 2 diabetes can make you feel like you are stuck with a lifelong condition. However, recent research has shown that with lifestyle changes it can be reversible with time

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ut of 3.8 million people suffering from diabetes in the UK, 90 percent of these have type 2 diabetes. although there is currently no cure for any type of diabetes, a new wave of research has shown that type 2 diabetes may be reversible, meaning patients may be able to maintain a medication-free life by managing their condition with a good diet and exercise.

how does type 2 diabetes develop?

type 2 diabetes is usually associated with a high sugar consumption, however, it can also be caused by genetics and a sedentary lifestyle. as described by the Nhs, type 2 diabetes develops when the pancreas can’t produce enough insulin to maintain a normal blood glucose level, or when the body becomes insulin-resistant and is unable to use the insulin that is produced by the pancreas. in healthy people, the pancreas produces insulin—the hormone that moves glucose from your blood to your cells where it is then converted into energy. Because insulin is not used properly in diabetics, this does not allow the body to absorb the extra glucose, which is then dumped into the bloodstream, causing high blood sugar. according to diabetes UK, the most common cause of type 2 diabetes is obesity and a diet that is high in trans fats, refined carbs and low in essential nutrients, fibre and vitamins. this regime increases the chances of developing the condition as it can lead to a build up of fat around the abdomen which can release chemicals that interfere with the cardiovascular and metabolic systems. this can affect how well insulin works in the body. high blood sugar levels then put strain on the pancreas to produce more insulin, ultimately causing symptoms of hunger and lethargy that often lead to overeating. this

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combination of overeating, no physical activity and high insulin levels then starts to damage the pancreas’ insulinmaking beta cells. the damage makes it difficult for the body to produce insulin, increasing blood sugars and leading to the first signs of diabetes. there have been many studies on reversing diabetes and most have shown that through weight loss, the pancreas can begin to work again—in turn putting the disease into remission.

ReveRsing diabetes

reversing diabetes occurs when the hBac1 levels (the amount of glucose in the blood) are lowered to those of a non-diabetic person—which is below 42 mmol/mol according to diabetes UK—and maintained without the need for medication. there are many factors that can help with the reversal of diabetes, some of which are a lowcalorie diet, a low-carb diet, exercise and bariatric surgery.

dRop the caloRies

a 2011 study conducted by Newcastle University has found that type 2 diabetes could be ‘cured’ and put into

remission. the study followed 11 people who reduced their daily calorie intake to 600 calories a day for eight weeks. the low-calorie diet included meal replacement drinks and non-starchy vegetables enabling the type 2 sufferers to lose excess fat that clogged the pancreas—which then restarts their insulin-producing cells. three months after the study, seven out of the 11 people were no longer diabetic. From this study, leading academic Professor roy taylor put forward the hypothesis of the personal fat threshold theory (PFt). PFt suggests that everyone has their own personal level of fat storage that they can add on before the effects of obesity take place. when the fat around the liver and pancreas hits the PFt limit, this can lead to insulin resistance and— ultimately—type 2 diabetes. other diets have been developed from the idea of fat loss as a way to reverse diabetes—the 8-week Blood sugar diet is one of them. this diet aims to reverse diabetes with a limit of 800 calories a day, putting dieters into ketosis. Ketosis is a metabolic process where the body does not have


01/02/2017 14:56



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Almased can help people with Type 2 diabetes lose weight and furthermore, maintain weight after weight loss**. Our clinically tested 12-week plan is simple and easy to follow and can support your weight loss goals. Once this has been achieved, Almased can be used once a day for the purpose of weight maintenance. IT IS CLEAN WEIGHT LOSS IN EVERY SENSE - Almased contains NO artificial flavours, fillers, preservatives or stimulants.


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For many people with Type 2 Diabetes, Almased combined with a balanced diet and regular exercise, can help with any weight loss goal. You can replace any meal, by mixing 50g of Almased with 200-350ml of water or 200ml of low-fat milk and 2 tsps of oil rich in essential fatty acids (olive, rapeseed, walnut or flaxseed). To flavour your Almased shake, you can add cinnamon, unsweetened cocoa powder or extracts such as vanilla or almond.

*HELPFUL ADVICE Please consult your healthcare professional before starting any weight loss programme such as Almased. Almased is a meal replacement which can be used to replace up to two of your daily meals. Depending on how your diabetes is treated, you may require support to a) start checking your blood glucose levels/to check them more regularly, b) to make changes to your medications. ** In the first week an additional soup is required as Almased is not a total meal replacement. Replacing two daily meals of an energy restricted diet with Almased contributes to weight loss, while replacing one daily meal supports the maintenance of weight after weight loss.

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enough glucose to use for energy, so it burns excess fat instead. For people suffering with Type 2 diabetes, this diet will enable the body to kick-start the pancreas into using insulin correctly. When studying this diet, researchers found that in order to reverse Type 2 diabetes, people would need to lose 15 percent of their overall body weight—a sufficient fat loss for the liver and pancreas to function normally again.


Another diet that has been shown to reverse diabetes is the lowcarbohydrate diet. A 2014 study by the Second University of Naples, Italy, has shown that Type 2 diabetics who followed a low-carb Mediterranean diet were able to go into remission. The study showed that after one year of following the diet, 15 percent of participants were still in remission.


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In comparison, only four percent of participants in a low-fat diet had achieved remission after one year— suggesting that carb intake can also have an effect on insulin resistance. Although there have been studies that show the positive effects of following a low-carb diet for Type 2 diabetics, most medical guidelines promote dietary requirements full of high-carb and low-fat foods instead.


An increased level of exercise accompanied by a healthy diet is important when trying to reverse diabetes. Through exercise excess glucose is used as energy, in turn lowering blood sugar overall. It is recommended to go for a 10-20 minute walk after a meal to ensure that there are no spikes in blood sugar levels throughout the day.

REMEMBER If you plan on following any diet plan, make sure you consult with your doctor first to ensure the best steps for your particular condition


If sufficient weight loss has not helped with lowering blood sugar levels, bariatric surgery can cause large amounts of weight loss, as it takes the pressure off the pancreas—possibly helping to maintain lower blood sugar levels for an extended period of time. •


01/02/2017 12:42

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Available in a range of flavours and in 330ml, 500ml and 1 litre cartons. Buy Foco Coconut Water from selected Tesco, Sainsbury, Asda stores, leading Oriental Supermarkets and online at www.focococonutwater.co.uk

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Feet First

People with diabetes have a much greater risk of developing foot and leg problems. Dear Doctor shares top tips and prevention pointers for healthy feet

IMAGES © Shutterstock


aised blood glucose levels can greatly damage different areas of your body including your feet. Diabetes affects vessels and circulation, meaning that skin, muscles and tissues receive less blood. It can also cause nerve damage, which can lead to a loss of sensation and an inability to feel pain. Feet are typically the first part of the body to be affected by poor circulation and nerve damage, and it can mean that cuts, burns and sores heal slowly and may become seriously infected. Diabetes UK, a British-based charity, estimates


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that there are around 135 leg, toe or foot amputations taking place each week—of which four out of five are preventable. Therefore it’s crucial for anyone with diabetes, whether that is Type 1 or 2, to keep a close eye on their feet and regularly attend foot check ups with a trained expert. Keeping blood sugar levels in check can reduce the risk of complications from diabetes-related issues, but there are also other steps you can take to keep your feet in top shape.


Taking care of your feet when you have diabetes can be as easy as

Healing Wounds Wounds almost always hurt, but the degree of pain will vary according to the nature, location, and severity of the injury. Since 15 percent of all diabetic patients will develop a diabetic foot ulcer during their lifetime, efficient and effective wound care management is imperative. When acute, chronic, and/or complex wounds do not progress in a timely positive direction, new technologies such as DermaPure® may be used to stimulate healing.


01/02/2017 08:58

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avoiding certain types of socks and stockings, and knowing who to call when you spot the signs of an oncoming problem. it might be a good idea to visit a private clinic at least once a year, and make sure you develop an open and trusting relationship with your doctor—being engaged in your own care, up to date on your condition and aware of your risk of developing serious foot problems can go a long way in keeping your health under control. even though having constant contact with healthcare professionals is a must, a lot of the care can be done from the comfort of your own home. it is important that you check your feet every day, and look for signs of redness, infection, buildup of hard skin and changes in shape. do not use any corn-removing plasters or

78 dear doctor with dr chris steele

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REMEMBER Urgently seek treatment from your doctor if: -There is redness or swelling around an ulcer -You notice breaks in the skin of your foot -The skin over part or all of the foot becomes more red, blue, pale or dark -You notice extra swelling in your feet where there was a blister or injury -You spot discharge seeping from a wound Source: NHS Choices

sharp blades as they can damage healthy skin, and be wary of pointy object or stones when putting shoes on. looking after your toenails is key, as is moisturising every day and wearing well-fitting shoes that support and protect your feet. if you are at higher risk of developing foot problems, make sure you are referred to specialist care—this can be in the form of a podiatrist or a foot protection service.

Prevention is key

trying to prevent—rather than curing—wounds and foot ulcers can make the difference between an emergency trip to the hospital and a straightforward recovery. the easiest way to prevent diabetes-related foot problems is to simply eat a balanced diet. a healthy regime—that is low in


01/02/2017 08:58


Preventing Foot Problems Diabetes gives you a lot to manage—looking after your feet needs to be high on the list. Everyone with diabetes has a chance of developing a foot ulcer. 300 people every day get the news they have one. The facts are that half will not survive 5 years. Foot ulcers are wounds that won’t heal, so cuts, blisters and skin breakdown are things you really want to avoid. Here are some tips: • Never walk barefoot • Check your shoes before you put them on for any stones or sharp objects • Check your feet daily—tops and soles—looking for any changes in colour, blisters, sores or skin. Remember that if you suffer from neuropathy, you can have a wound but not even be aware, so check the soles of your feet using a mirror. If you see anything new, visit your doctor. The NHS promotes annual foot checks so make sure you get yours done. Your shoes should fit properly and if you have any of the ‘risk factors’—poor circulation, neuropathy (typically loss of sensation in the feet) or hard skin—you need to do everything to combat these factors. The most common cause of ulcers is excessive pressure on areas of the sole combined with poor circulation. Liqua Care Flowgel Insoles have been clinically trialed by the NHS, are available on NHS prescription and are proven to significantly reduce your chances of developing an ulcer. They fit in ordinary footwear and by reducing the peak pressures on the sole of the foot and increasing circulation the results were considered ‘remarkable’.


CS20.Diabetic Footcare.indd 79

IMPORTANT Be especially wary of loss of feeling in your feet—you may not immediately notice if you have a wound that needs attending to.

‘TOUCH THE TOES’ TEST saturated fat, sugar and salt, and is high in fruit and vegetables— will in turn also keep cholesterol, blood glucose levels and blood pressure in check. Attending all scheduled medical appointments is crucial, as is keeping on top of all the information you’re given about your condition, as that will stimulate a prompt reaction to unexpected wound exacerbations— make sure you develop a trusting relationship with your doctor. Whenever and wherever possible, trying to squeeze in any amount of physical activity is recommended; a simple, brisk walk can be a great start. Remember to contact your GP if you have any concerns—no matter how small—as waiting might result in irreversible damage to your feet, toes or legs. •

This quick and easy test involves briefly and lightly touching six toes— three on every foot—to find out how many toes are felt. The test, which was designed at Ipswich Hospital, can be done at home but it should by no means replace your annual foot review with a professional or specialist. If you feel the touch on all or five of the six toes, your sensation is normal and you are not at higher risk of developing a foot problem because of sensation. If you did not feel two or more of the toes touched, you are likely to have impaired or reduced sensation in your foot and may be at higher risk of a diabetic ulcer. In this case, visit your GP surgery or book an appointment with a specialist to have a full examination of your feet. According to Diabetes UK, in order to carry out this test correctly, each toe touch must be light and brief (one to two seconds long) and not be done more than once.


01/02/2017 09:18








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Vitamins & Supplements for Later Life We get vitamins and minerals from a balanced diet but when our bodies need extra help absorbing these nutrients, supplements can save the day

Getting Help From a Bottle You should always aim to get your vitamins and minerals from a full, balanced diet; however certain products on the market contain a surprisingly vast amount of nutrients that can help your body’s everyday functions and contribute to your overall wellbeing: Horlicks: One mug of Horlicks Traditional, Horlicks Light and Horlicks Light Chocolate contains 14 essential nutrients and is a rich source of vitamin D—an essential aid to calcium absorption. Horlicks is also a great source of vitamin B12 which is important for the normal functioning of the nervous system and red blood cell formation, vitamin C, an antioxidant which helps to protect the body’s cells and helps the body to absorb iron and vitamin B6 which contributes to the normal functioning of both the nervous and immune system and can reduce tiredness and fatigue. Marmite: This polarising savoury spread is rich in several B vitamins and is a great source of folic acid—historically it has also been used for remedial purposes.

Minvita Baobab Superfruit Powder:

This powder is 100% organic and a great supplement for topping up on vitamins, minerals and antioxidants. High in vitamin C, fibre, calcium and potassium, this superfruit product can be added to water, juices, yoghurts and bread and cake recipes.


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01/02/2017 10:39



t’s no secret that in order to get all the nutrients our body needs, a natural and balanced diet is key. However, there is evidence that we may need a bit of help retaining these vital minerals from time to time—especially as we age and our body loses the ability to absorb nutrients. It is important to follow advice from your GP when taking these supplements and to consume them in the recommended daily allowance as taking more than the suggested dose can be harmful to your health. In any case, it’s important to choose good-quality supplements with no additives—some tend to dissolve so quickly in the digestive system that they are excreted as waste instead of absorbed and utilised by the body. Here are the deficiencies most common in later life, and the appropriate supplements to take to counteract them.



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This essential mineral helps make the red blood cells that carry oxygen around the body. People will be able to get all the iron they need from their diet, as it is heavily present in foods such as red meat, green leafy vegetables, pulses, eggs, wholegrain products and fortified cereals. Older people should not routinely consume iron supplements unless they have a specific need or reason for their deficiency—like a recent operation or a restrictive diet like veganism. Iron deficiency in later life could signal an underlying health problem, so it is advisable to investigate it as soon as possible and take appropriate action.


There are various types of B vitamins, and they all serve different functions in the body from breaking down energy from food, helping to form red blood cells to keeping the skin, eyes and nervous system in top shape. As we age, our bodies can lose the ability to

REMEMBER Be very wary of antiageing claims and celebrity endorsements of vitamin products. So far there is no supplement, medication or other substance that will stop or slow the ageing process Source: Berkeley Wellness

Over 650m was spent on health supplements in the UK in 2013

IMAGES © Shutterstock

During the warmer months up until September, our bodies should be able to get enough vitamin D through sunlight on our skin—however, some may not get enough if their exposure to the sun is limited. This can be the case for people who are homebound or living in an institution. There are some foods that contain this vitamin— namely oily fish, liver, egg yolk and red meat—but these can be bound by dietary reasons and lifestyle choices. The Department of Health (DoH) recommends that people take a daily supplement containing 10 micrograms of vitamin D throughout the year if they are over 65, if they usually cover up when outdoors, if they are frail or if they live in a care home. These nutrients are vital for healthy bones, teeth and muscles, but as with everything, taking more than the recommended amount could be harmful to your health. NHS Choices recommends never taking more than 25 micrograms of the vitamin and always consulting with your GP—some people can have medical conditions that may mean they will not be able to safely take any added amount.

Source: Independent


01/02/2017 14:30


absorb vital nutrients—B12 vitamin deficiency is more common in older people, and it affects around one in 10 people aged 74 and older, and one in 20 people aged between 65 and 74. In some cases improving your diet can go a long way in counteracting deficiencies—green vegetables such as broccoli, brussel sprouts and peas are good sources of folate and vitamin B12 can be found in meat, fish and eggs—but in other instances, injections or tablet supplements may be advisable. A deficiency in any of these two vitamins can cause a wide range of problems such as extreme tiredness, low energy, muscle weakness and disturbed vision. It is important to visit your GP if you have any of these symptoms as it is vital that these deficiencies are compensated in the least amount of time possible. A daily supplement of 2 milligrams or less of vitamin B12 is unlikely to cause any harm, and the recommended intake of folate sits at 400 micrograms a day. As for vitamin B6—another important B vitamin—men over 50 tend to need 1.7 milligrams while women require 1.5. This vitamin is present in foods such as fortified cereals, whole grains and organ meats—like liver.

but are these pills worth the time and money? Even though there is some evidence that vitamin C helps the recovery process after a bout of flu or illness, research has established that in reality, the best way to get enough vitamin C is to simply eat a more balanced diet. Consuming the recommended amount of fruits and vegetables will give the body all that it needs. Citrus fruit, strawberries, mango, peppers and tomatoes are all excellent sources of vitamin C.


One of the most important functions of magnesium is to regulate blood pressure—this becomes a vital mineral for people over 40 who are already at a higher risk of high blood pressure because of the natural ageing process. Magnesium also helps our body absorb calcium better, playing an important role in heart, nerve and muscle function. You will be able to get tested for magnesium levels in your blood if you think you may be deficient.

Eating a balanced diet is still the best way to get all the nutrients you may need, but supplements can also be a good option—if your GP agrees. This mineral is mainly found in leafy greens, avocado, soy and beans. Taking too much of this supplement will not necessarily pose health risks, but it can cause side effects like nausea and cramping—it is therefore always preferable to take the recommended amount given by your doctor. •

The recommended daily allowance of vitamin C in the EU is 80mg and most people will achieve this figure by eating a sensible diet Source: NHS Choices


Coming up short on calcium can lead to brittle bones and has also been shown to increase the risk of fractures. The mineral is important for muscle contractions—including the heartbeat—and helps the blood to clot normally. Dairy is an excellent source of calcium, as are leafy greens and nuts. Before deciding to take any calcium supplement, it is always preferable to speak with your GP, as taking high doses can have negative side effects such as stomach pain and diarrhoea. These supplements are usually given to people who are at the highest risk of bone fractures.


Some people may choose to take vitamin C tablets to ward off colds,


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01/02/2017 14:30

Minerals are the key to our health issues When you’re suffering with health issues, looking at whether you’re getting the right balance of minerals could help your body get the nutrients it needs. Have you noticed that your everyday

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New Alflorex® - controlling gut health

A recent survey* shows what it’s like to live with chronic digestive problems and their limiting symptoms. 3 out of 4 women say that digestive problems affect their self-confidence. Over half reported problems such as bloating, abdominal pain and gas and one in three suffered with diarrhoea and constipation. To find a solution our scientists have worked with leading gastroenterologists and research institutions to develop a new food supplement, Alflorex®.

Only Alflorex® contains the unique PrecisionBiotic® strain 35624® and has been clinically proven to reduce: • Bloating • Abdominal discomfort • Urgent need to use the toilet and to normalise bowel movements. It’s the number 1 recommended bacterial culture by gastroenterologists in the United States.

Alflorex® is now available in Boots and other pharmacies. www.alflorex.com * The Alflorex “She’s Got Guts” was a national survey carried out by iReach on behalf of Alflorex®.

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Gut Health Dear Doctor explores the common complaints in digestive health and how to treat them


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igestive problems can be debilitating and chronic lifechanging conditions; they’re also far more common than many might think—around 40 percent of people in the UK suffer from at least one digestive symptom at any given time. Most are related to lifestyle choices, the amount of stress we put our body through, and the foods we consume. Taking simple steps to change our everyday habits may help—and even prevent—many of these problems.


A fairly common condition, IBS can cause stomach cramps, bloating, diarrhoea and constipation. The frequency and severity of these symptoms varies from person to person, but they can last for months at a time, causing sufferers stress, pain and discomfort. The condition—which is often lifelong—affects twice as many women as men, and usually manifests itself between the ages of 20 and 30. The cause for IBS is still relatively unknown, although it’s now widely accepted that it is related to sensitivity of the gut and issues with digestion. Medication is sometimes prescribed to alleviate symptoms, but these can also be managed by making concerted lifestyle changes such as reducing stress levels, altering the amount of fibre in your diet, avoiding foods that trigger symptoms and exercising regularly.


People with gastritis will exhibit a host of symptoms like indigestion, gnawing stomach pain, nausea and vomiting due to the stomach’s lining becoming inflamed. These may present themselves severely and last a long time. Some causes for the condition include a bacterial infection, excessive consumption of alcohol, stress, regular use of aspirin and—less commonly—an autoimmune reaction. Treatment mainly revolves around reducing the amount of acid in the stomach, and this can be achieved by taking antacids and histamine 2 blockers. The breakdown of the layer that protects the stomach lining from acid can also lead to stomach ulcers—open sores that cause pain in the centre of the stomach.


Occasionally the muscle at the bottom of the oesophagus can weaken, leading to acid in the stomach leaking up and causing gastro-oesophageal reflux disease (GORD). This condition can be an occasional nuisance for some, but for others it is a lifelong problem—and a chronic battle with heartburn, bad breath, bloating and difficulty with

swallowing. GORD can be treated through self-help efforts and various medicine but, in some cases, surgery may be needed. Eating smaller and more frequent meals, avoiding foods that exacerbate your condition and taking OTC or stronger prescription medicine may help alleviate symptoms and improve your quality of life. •

When should I see a doctor? If you have the following five symptoms—difficulty swallowing, unexpected weight loss, worsening heartburn, bleeding from the bottom or a sudden change in bowel habits— visit your doctor straight away as they might signal deeper and more serious digestive illnesses. NHS Choices also advises visiting your GP if you’ve taken medicines to treat digestive problems for two weeks without noticing any improvements. Source: NHS Choices



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IMAGES © Shutterstock

Trying to identify the cause of constipation is difficult—it may be due to a variety of factors such as not eating enough fibre, a change in routine, not drinking enough fluids, anxiety or depression, side effects of medication and ignoring the urge to pass stools. This condition can affect anyone, no matter the age, and can be treated through lifestyle changes or prescribed medication (such as laxatives). In most occasions, this condition will not lead to any complications, but those who suffer from long-term constipation may also find themselves battling with piles, faecal impaction and bowel incontinence.


01/02/2017 14:11


Zoe’s IBS Story oe’s experience with iBs began when she was just 16 and working in a dress shop while studying for her a levels. ‘i suddenly collapsed with the most awful abdominal pains,’ she said. ‘i didn’t know what was happening to me.’ her GP thought that the episode was a bad reaction to some food that she’d eaten but just one month later, Zoe had another flare up—this time straight after a meal. this marked the beginning of years of living with the condition which, through a process of trial and error, she identified as iBs. ‘when you have iBs you can get the most excruciating pain,’ Zoe explains. ‘You get terrible cramps which are caused by a complete blockage; this means you can also get bloating, diarrhoea and constipation.’ the unpredictability of the attacks meant that day-to-day life for Zoe was frequently disrupted. Zoe battled with the stress of iBs all through her university exams while she was studying law. as she began her career at the BBc and working with charities, managing her iBs was a constant challenge. ‘i think for me having attacks during work or when travelling was very challenging,’ she adds. ‘i constantly had to watch what i was eating and my stress levels to ensure an attack wouldn’t happen at a bad time.’ her worst episode occurred when she was at amsterdam airport, on her way back from filming the tV programme celebrity island with Bear Grylls. ‘i was the only one going on to Belfast,’ she explains, ‘when i got an attack that lasted 10 hours. there was absolutely no way i could get on that flight. if you’d paid me £1 million, i 90 dear doctor with dr chris steele

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couldn’t have crawled on to that plane, even though it’s such a short journey. People just don’t seem to understand what it’s like for people with iBs.’ after years of trying numerous remedies—from supplements to diets— Zoe started taking an over-the-counter probiotic supplements called alflorex, just before her wedding. ‘i’ve now been on alflorex for nine months. on my wedding day i ate whatever i wanted without nasty consequences,’ she says. ‘i can basically eat what i want now! i do choose to eat healthily the majority of the time but

on my honeymoon last year i ate pizza, bread and drank champagne and didn’t have an attack thanks to alflorex.’ alflorex has been clinically proven to relieve the symptoms of iBs, including bloating, abdominal pain and urgency to use the toilet. ‘there have been several occasions recently, such as a visit to France, when i thought i was sure to get an attack, but i haven’t had one while i’ve been on alflorex. i feel so much more relaxed and confident being iBs free,’ Zoe said. • alflorexbiotics.com

IMAGES © Hazel Coonagh


Former Blue Peter presenter Zoe Salmon-Corrie’s life was blighted by irritable bowel syndrome—until she found a solution


01/02/2017 14:16

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A disease awareness campaign supported by Besins Healthcare (UK) Ltd

16/01/2017 12:41


Men’s Most Important

Health Checks Undergoing the right tests and check-ups at the right time is the most meaningful thing men can do to safeguard their health


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revention and early diagnosis are a vital part of the fight against disease and the road to a longer and healthier life—screening can detect illness at the earliest of stages, when it is easiest and most straightforward to treat. The type of tests men need can largely depend on their age, smoking status, hereditary conditions and risk factors, however it is always important to keep health and wellbeing in check.

DIABETES According to Diabetes UK, it is estimated that over four million people in the UK have diabetes— whether they’re diagnosed or not. When detected early diabetes can be kept under control, and many of its complications can be avoided through changing simple things like dietary habits, weight, and exercise routine. A simple fasting blood sugar test can be used to screen for the condition. Adults should consider having the test done every three years once they turn 45—unless they have conditions such as high cholesterol or blood pressure, in which case it is advisable to start much earlier.

CANCER Prostate cancer is one of the most common types of cancer found in men—according to Cancer Research UK; one in eight men will be diagnosed with this type of cancer during their lifetime. Even though it can be a slow-growing illness, it may also manifest itself aggressively in some cases. Regular screening should begin at 50 for average-risk men, at 45 for men at high risk and at 40 for men with a strong family history of the disease. Tests can include a digital rectal exam, or a prostate specific antigen blood test.


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Testicular cancer, on the other hand, is less common and occurs mostly between the ages of 20 and 54. Men are strongly advised to perform regular self-exams by feeling for lumps, bumps or changes in size and shape of the testes. Because the effects of the sun accumulate over time, over-65s are more at risk of developing skin cancer—it is essential to check your skin for changes in colour, size or shape of any mole, and to visit your GP if you notice something amiss. Early detection can lead to prompt treatment and better outcomes.

TESTOSTERONE DEFICIENCY As men age, their testosterone level decreases, leading to symptoms such as lack of sexual desire, problems with erections, depression, weight gain and tiredness. The


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hormone is vital for maintaining sexual and general wellbeing in men. A simple blood test is an easy way to measure your testosterone levels. According to Dr Janine David, a GP with a special interest in men’s health, there are a few treatments available: ‘Initially patients are advised to improve lifestyle and diet in an attempt to increase testosterone levels, however this intervention alone is often not enough—the use of replacement therapy is recommended. It has been used effectively for over half a century. It comes in the form of a gel or an injection, requires monitoring and—in those that respond positively—is considered a lifelong treatment.’ Some benefits include a restored sense of wellbeing and sex drive, improved muscle mass and less fat around the abdomen. According to the British Society for Sexual Medicine , over eight percent of men between the ages of 50 to 79 years old are hypogonadal—showing a reduced functional activity of the testes. This section on Testoserone Deficiency was written with help from Besins Healthcare (UK), the company was consulted on the scientific accuracy of the article and conducted a review for compliance purposes.


IMAGES © Shutterstock

The risk of hypertension increases as we age and can lead to a host of other health compli cations and risks. High blood pressure can be treated and monitored, dramatically reducing the risk of heart disease, stroke and kidney failure. It’s vital to check your blood pressure regularly, and to speak to your doctor about ways to lower it and keep it within the right parameters. It’s important to remember that normal blood pressure measures less than 120/80 mmHg—typically, a reading of 140/90 mmHg is considered high.

DEPRESSION Changes in your emotional state are just as important as visible and celebrityangels.co.uk

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tangible changes in your body. It is strongly recommended to visit your GP if you find you are not enjoying life as much as you used to—you could be screened for depression. In 2013, out of over 6,000 suicides recorded in the UK, 78 percent were male—according to the Mental Health Foundation. It is therefore vital to keep mental health under control; your doctor can also refer you to specialist services if needed.

GLAUCOMA This condition, characterised by increased pressure in the eye, is substantially more common in men than women; if left untreated, it can result in blindness. It is important to have regular eye tests—especially if the condition is present in other members of your family—as glaucoma progresses very slowly, resulting in gradual sight loss. According to the Glaucoma Research Foundation, medication and surgery can halt further loss of vision, but once the condition has affected the eye it is impossible to reverse the damage. In addition to glaucoma, simple eye tests can also alert you to other possible conditions such as cataracts, diabetic retinopathy and age-related macular degeneration.

CHOLESTEROL Heart UK advises men to check their cholesterol every five years or so if they are between the ages of 40 and 75. High cholesterol is the biggest risk factor attributed to heart disease, as it toughens and narrows the arteries—reducing the risk of developing it is possible through switching to a Mediterranean diet, and consuming more fruit, vegetables, fish and nuts. Your GP can check your cholesterol levels by ordering a blood test and determining the ratio of good cholesterol to bad cholesterol and other types of harmful fats in your blood. • DEAR DOCTOR WITH DR CHRIS STEELE 95

01/02/2017 10:45


The Listening Hour The Silver Line is a free, confidential helpline that offers advice and information for older people, 24 hours a day, every day of the year. Founder Esther Rantzen speaks to Hannah Guinness about winter at The Silver Line, how we as a society can help vulnerable older people and the stigma of loneliness

Esther, what was Christmas like at The Silver Line? What did callers want to speak about? Esther Rantzen: Loneliness, above all. Over Christmas we also make outbound calls to people that we know have told us will be alone at Christmas. And speaking to some myself, I was appalled by the fact that even over Christmas so many of them go for days on end without talking to anyone. One lady, I’ll call her Evelyn, she is divorced, she has a no family, and I was talking to her the day after Boxing Day—so it was the Tuesday after Christmas—and she hadn’t spoken to anyone at all since the previous Thursday. I asked her how she felt about the New 96 dear doctor with dr chris steele

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I think we need to recognise that physical care and social care are not two separate worlds but are part of the same spectrum of care. We know that loneliness has a disastrous effect on people’s health

Year and she said she didn’t think she could bear another year like the last one; she’s reached the stage when she doesn’t actually get dressed, she stays in her pyjamas and dressing gown all day. She does go out on Thursday to a local group but she feels that they wouldn’t notice if she didn’t turn up. Aside from the services that doctors can recommend, are there any practical measures that everyone can take to ensure that vulnerable older people in the community aren’t forgotten? ER: Well I know of a fantastic project in Merseyside where the local fire service goes door to door to check people’s celebrityangels.co.uk

01/02/2017 12:42

IMAGES © Shutterstock



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smoke alarms. this is inspired by the fact that many older people are real fire risks and it’s also based on the knowledge that a fire officer in uniform with a fire engine on the corner is someone who isolated and vulnerable older people feel they can trust; they don’t tidy up the place for them, they let them in and they can get a really clear realistic idea of how people are living. if one were to call on evelyn, they would notice that she was still in her pyjamas and dressing gown, they would ask if she’s able to get out and about or whether she’s able to get visitors. I imagine a lot of people treasure their independence and don’t want to be seen as not being able to cope? ER: there is a stigma attached to loneliness. another person i spoke to said quite frankly—this is one of the men who had called the silver line—that he finds that because he can talk to someone who can’t see him, who can’t identify him, he can be far more honest. this was somebody who is physically very disabled, suffers from cerebral palsy, who requires the kind of support that he can only get from a nursing home but all the other residents are suffering from dementia so it’s quite inappropriate for him. he’s desperately lonely and he says the silver line literally saves his life.

community—evelyn had moved from a place where her friends used to live because her work took her there. it can be loss of mobility, loss of a driving licence, but the greatest loss of all is self-confidence. i was also talking to one of our volunteers who’s in her 90s, Bea she’s called, and she is so popular in her community and is a volunteer silver line friend so she reaches out to a lot of isolated older people who are younger than her. what she has is tremendous self-confidence, and the most disastrous effect of loneliness and isolation is low self-esteem. You don’t go out because you think nobody wants to know you. in effect you’re in solitary confinement, which is usually a punishment for a serious crime. Do you think the current government is allocating enough resources or concentrating on this issue? ER: i think it’s difficult to delegate to government. i think all of us in our communities, in voluntary organisations, in local authorities, as

neighbours in the street, need to take this on as part of our responsibility as human beings. the old lady pushing the walker with their head down, not meeting your eyes, could be suffering from desperate loneliness and depression. You know old age can be a wonderful time. i met a lady of 92 over christmas who told me it was the happiest time of her life. she felt that she was in charge of her own destiny, she had her health and strength, she can make decisions, she can decide to go on holiday, even though she’s on her own. so i think we need to be aware that if we can tackle this problem of loneliness we may be saving the health service an awful lot of money and may be adding a huge resource to our own community because they have so much to offer—like Bea. •  The Silver Line helpline is free, confidential and open 24/7: 0800 4 70 80 90, thesilverline.org.uk

In other cultures older people are looked after by their family members but this doesn’t seem to be the case in this country. In addition to this, the facilities we do offer to care for older people aren’t always suitable. Do we need to find a system of support and care that is more holistic? ER: i think we need to recognise that physical care and social care are not two separate worlds but are part of the same spectrum of care. we know that loneliness has a disastrous effect on people’s health. Why do people become so isolated? Is it loss of mobility, loss of a partner? ER: well it can be all kinds of loss. it can be loss of a partner, it can be loss of sight or hearing, it can be loss of a

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Turning Back the Clock

IMAGES Š Shutterstock

As we get older we tend to lose colour and radiance in our skin, but products and techniques tailored to our age and complexion can revolutionise our everyday beauty routine


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omen over 50 are now spending more money than ever on cosmetics. According to beauty website Escentual.com, on average, consumers aged 45-50 currently spend £2,238 a year on products—up four percent from previous years. Similarly, the 55-64 age group spend £2,190 a year, a rise of almost five percent and the biggest growth area in the UK. This rise in popularity and interest towards the cosmetics industry from 50+ consumers can be largely attributed to big-name brands using older women as their ambassadors, but also to women’s increasing desire to see and be able to buy products that are suited to their skin type and complexion. With a few simple tweaks to our beauty routine, we can bring out our best

What are the essentials for 50+ beauty? 1. A great moisturiser to protect and renew the skin 2. A nourishing serum that doubles up as a primer to create a smooth surface for makeup to stick to 3. A good glitter-free blush to replace lost natural colour 4. A lip liner in a nude colour to help lipstick stay on longer and make lips look fuller and more defined 5. A colour-correcting palette containing a green corrector for redness and spider veins and an apricot corrector for age spots and undereye decoration Grace Fodor, beauty expert and creator of Studio 10


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features and reverse the effects of the ageing clock through the use of makeup products targeted to our age and skin type. Anti-ageing creams have seen a dramatic rise in popularity over the last few years, but this begs the question, are they worth the money? According to Grace Fodor—industry insider and creator of Studio 10, a makeup brand for women as they age—anti-ageing creams are a sound investment, but only if sufficient research is carried out prior to their purchase: ‘Look for evidence of clinical trials that demonstrate the effectiveness of claims made by brands’, she advises. According to Grace, it’s always advisable to ‘invest in the best’ you can afford for your skin. ‘As we age, the skin loses elasticity due to decreasing levels of collagen. Skincare that helps the skin produce

this is extremely beneficial. We also lose plumpness in our face, which can increase the look of wrinkles and fine lines, so ingredients like hyaluronic acid help by encouraging the skin to hold extra moisture’. It’s always best to change your beauty regime to cater to your skin type—this will inevitably mean switching certain products for others, and getting rid of some altogether. Whatever makeup style you choose, it’s vital to start with a great base: an anti-ageing serum and moisturiser are both a great choice. For flawless beauty over 50, make an effort to ditch the black eyeliner, use makeup with a light shimmer (applied down the centre of the face), and invest in a great orange-free bronzer with no glitter to replace lost colour in the face and achieve a naturally ‘sun kissed glow’. •

TOP 5 MAKEUP & BEAUTY TIPS FOR 50+ WOMEN 1. Switch to crème formulation for base. Powder can sit in fine lines and be very heavy 2. Use peach—not pink—blusher. It’s more natural, suits all and adds a healthy flush of colour 3. Avoid heavy black liner and try rich brown instead. Use on the outer third of the top lid, close to the lashes for an instant lift 4. Brows are the fastest way to add structure to the face, but they can often become finer as we age. Fill in the sparse ones with light strokes in the direction the hair grows 5. We lose definition in the face as we age. Contouring in the natural hollows of the cheeks, along the jaw and around the forehead can mimic the bone structure, looking youthfully defined Grace Fodor, beauty expert and creator of Studio 10


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regelle.co.uk Regelle is a class llb Medical Device, CE Mark 0120. References: 1. Sturdee, D.W. and Panay, N. (2010) ‘Recommendations for the management of postmenopausal vaginal atrophy’, Climacteric, (13), 509-522. 2. Nachtigall LE. (1994) Comparative study: Replens versus local oestrogen in menopausal women. Fertil Steril.;61, (1): 178 – 80. 3. Loprinzi CL., Abu-Ghazaleh S., Sloan J., van Haelst-Pisani C., Hammer A., Rowland K., Law M., Windschitl H., Kaur J. and Ellison N. (1997) Phase III randomized double blind study to evaluate the efficacy of a polycarbophilbased vaginal moisturizer in women with breast cancer. J Clin Oncol., 15, (3): 969 - 73. Artwork Code: REGUK_011605 Date of Preparation: January 2017

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Managing Menopause Menopause marks the moment when a woman stops having periods and is no longer able to conceive naturally. Here’s what to expect and how to cope with it


enopause occurs between the ages of 45 and 55: it’s a natural part of ageing that takes place when oestrogen levels start to decline. Symptoms can vary in nature, severity and longevity from woman to woman, but the first sign is a change in your periods: they may be unusually light or heavy and will be irregular—some women have them every two to three months while others may not


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Did you know? Around 1 in 100 women experience menopause before the age of 40

have periods for months at a time. Eventually, they will cease altogether. Aside from this, most women will experience other symptoms before and after their periods stop. These include hot flushes, night sweats, insomnia, diminished libido, headaches, vaginal dryness, pain or discomfort during sex, heart palpitations and frequent urinary tract infections. You could also experience aches and stiffness in your joints, reduced muscle mass and you


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may have a greater risk of developing conditions such as osteoporosis (or weak bones, as it’s more commonly known). Typically these symptoms can start months or years before your periods stop and last for around four years from your last period—although a small minority have experienced them for much longer. These symptoms can impact negatively on daily life—many women, for example, struggle with hot flushes: brief but intense feelings of heat in the face, neck and chest that make your skin red and sweaty. Some women do not need to seek remedies for the symptoms of menopause, but if you are struggling then there are treatments available that may alleviate your discomfort.



It’s common to experience sudden changes in mood and anxiety during menopause, and remedies for this could 106 DEAR DOCTOR WITH DR CHRIS STEELE

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include doing plenty of exercise, and taking part in relaxing activities such as yoga. If your mood swings or anxiety are seriously affecting you, then HRT and cognitive behavioural therapy could also work—or anti-depressants if you are diagnosed with depression.


Women can experience a loss of sexual desire during menopause. HRT may help with this or your doctor might offer you testosterone, the male sex hormone—it can help restore your sex drive if you’re menopausal. Vaginal discomfort such as dryness, itching and pain can be treated with oestrogen, usually in the form of a pessary, cream or ring inside your vagina. Over-the-counter vaginal lubricants may also help.


Hot flushes and night sweats can make everyday life very uncomfortable for women. If you suffer from them make sure your bedroom is cool at night,

Osteoporosis You’re at a greater risk of weak bones if you’ve experienced menopause because you have lower levels of oestrogen in your body. Measures such as taking HRT, eating healthily, exercising, quitting smoking and drinking, getting more sunlight and taking calcium and vitamin D supplements could all reduce your chances of getting osteoporosis

and wear light clothing at all times. Cold showers and iced drinks may help, as will fans. Be aware of triggers such as stress, caffeine and alcohol. If your symptoms are severe then talk to your GP—they may recommend HRT. If that’s not suitable for you, other medications such as certain antidepressants or clonidine, a high blood pressure medicine, may help. •

IMAGES © Shutterstock

One of the main—and most controversial—treatments for the symptoms associated with menopause is HRT, where you take oestrogen to replace what your body is no longer able to produce. There are two types: combined (oestrogen and progestogen) for women who still have their womb, and oestrogen-only, for women who have had their womb removed. HRT became less popular as a treatment when it came under scrutiny in the early 2000s because of a link with breast cancer. However, new guidelines from NICE recommend that HRT should still be offered to women, providing that they’ve been informed about the risks and benefits it comes with. You can receive HRT in the form of skin patches, tablets, gel or implants, and the benefits include relief from menopausal symptoms such as hot flushes. However, the drawbacks can be significant. You may have breast tenderness, vaginal bleeding and headaches. It also comes with a higher risk of blood clots or breast cancer for certain women.


01/02/2017 10:40


Did you know? Normal hair loss is around 100 hairs per day based on a typical scalp containing 100,000 hairs on average Source: Belgravia Centre

Living With

Hair Loss

Common and often distressing, hair loss can come in various types and with different causes and symptoms

IMAGES © Shutterstock


attern baldness affects almost 50 percent of men by the time they reach 50, but it can also be present in women. The causes of female-pattern baldness are still unknown, though the condition tends to be more noticeable in women who have gone through menopause—this might be attributed to the lower hormone count common in menopausal women. Apart from pattern baldness, some of the most common types of hair loss include: Alopecia areata: this causes patches of baldness the size of a coin. Scarring alopecia: more often than not this is the result of complications brought on by other conditions. Hair is


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unable to grow as the hair follicles are destroyed. This condition can manifest itself through dry skin, an itchy rash and a mild form of lupus. Anagen Effluvium: this type of hair loss can affect the scalp, face and body and is mostly caused by treatments like chemotherapy and radiotherapy. Telogen Effluvium: this common type of hair loss can be caused by a variety of factors—hormonal changes, emotional stress, physical strain, long-term illness, changes in your diet and some kinds of medication— but it is characterised by widespread thinning rather than specific bald patches. This condition isn’t

irreversible: in most cases, your hair will stop thinning and start to grow again in a few months. These different types of hair loss will dictate which course of treatment is most suitable.

TREATMENT While some common types of hair loss—like male and female-pattern baldness—don’t need treatment as they don’t pose health risks and are a normal part of ageing, people might choose to consult with their doctor for cosmetic reasons. A medication called minoxidil can be used to treat femalepattern baldness, though responses to the drug vary widely among patients. This treatment is currently not available on the health service and may be expensive. Other possible treatments for hair loss—specifically alopecia areata—are steroid injections and ointments, immunotherapy, hair transplant surgery and hair implants.

EMOTIONAL STRAIN Hair loss can deeply affect selfconfidence—it can be a difficult reality to accept. However, support is available: speak to your GP if you feel your condition is affecting your mental health—they may refer you to a specialist and suggest counseling— or turn to charities like Alopecia UK for social support groups and online forums. •


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Life Style Art


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life starts at 60+

Intimate Health Women might choose to undergo vaginal rejuvenation procedures—both surgical and non-invasive—for a host of different reasons

IMAGES © Shutterstock


hether it’s because of childbirth, excessive weight loss, injury, menopause or simply the natural ageing process, women’s bodies change a great deal over time. tackling intimate health can be a taboo, but some treatments may increase comfort as well as selfconfidence. Vaginal rejuvenation, a procedure that is gaining popularity, usually combines vaginoplasty— tightening of the vagina—and vulvaplasty or labiaplasty—reshaping of the outer or inner lips. although some women may choose to celebrityangels.co.uk

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undergo this procedure for purely cosmetic reasons, it can dramatically improve intimate health and relieve uncomfortable issues such as muscle laxity, incontinence, loss of sensitivity and decreased sexual satisfaction (although visiting your GP may determine whether there is another underlying health reason for these discomforts). as for all procedures— both surgical and non—there are pros and cons to consider before making a decision; it’s important to consult with a trusted surgeon that possesses significant experience, training and appropriate certification.

as there are various types of rejuvenation procedures available, the decision will largely depend on what areas need correction or enhancement. according to Nhs choices, a labiaplasty can cost anywhere between £1,000-3,000 plus consultations and any followup care needed after the procedure. the surgery can be carried out with either local or general anaesthetic (the latter option may result in an overnight stay at the clinic) and it involves cutting away excess skin with a scalpel or a laser—the edges are then stitched up with dissolvable dear doctor with dr chris steele 109

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thread, limiting the amount of outer visible scarring. This type of procedure can take up to two hours, with some patients opting to go home the same day. Healing may take a few months, and patients are advised to keep the area clean, wear loose clothing, avoid sexual intercourse for a few weeks and to use sanitary towels instead of tampons. All surgeries can give rise to side effects, and women should look out for excessive bleeding, infection, scarring of tissue and reduced sensitivity—soreness, bruising and swelling are normal in the first weeks post surgery. Women are also recommended to take a few days off work and to avoid physical exercise for the first week or so. Non-surgical procedures, on the other hand, are simpler and may not require any anaesthetic or numbing creams.

WHAT ARE THE DIFFERENCES BETWEEN SURGICAL AND NON-SURGICAL PROCEDURES? According to Emma Soos, registered nurse and clinical director at Genesis Clinics Worldwide, surgical procedures are relatively permanent— with scar tissue and possible nerve damage—and more radical than non-surgical options but may be the only way to resolve severe issues with intimate health: ‘We often see patients who have had surgical procedures that still have laxity and sensitivity issues around the scar or operation site due to the ageing process of the unoperated tissue.’ The laser (non-surgical) treatment offered at Genesis Clinics can last around 15-20 minutes with little or no sensation. A protective receptacle is inserted into the vagina and a rotating laser is then inserted into the receptacle. Short bursts of energy are fired into the tissue to promote shrinkage—as the laser retracts, the whole canal is treated. Patients will experience immediate shrinkage and will be able to go back to work immediately and resume sexual 110 DEAR DOCTOR WITH DR CHRIS STEELE

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activity in approximately three to five days. The entrance and labia are also treated with a laser promoting external shrinkage. Emma explained: ‘The laser treatment is aimed at stimulating tissue to respond to what it perceives to be an injury. It then uses its own resources to heal this, triggering neo collagenesis—new collagen growth. The generated heat causes local contraction of the collagen fibres, thereby immediately tightening the skin to remodel and rejuvenate the previous effects of ageing. New collagen formation by local fibroblasts is stimulated by heating the dermis, acting as a new deep foundation for the skin. This produces further delayed tightening which only becomes evident over the next few months.’ ‘The treatment also improves blood flow and lymphatic drainage, thereby providing a better oxygen supply, greater toxin clearance and improved sensation to reduce the further effects of ageing,’ she added. •

Why do women seek these procedures? • Reduced sensation • Unsatisfactory climax • Dryness • Dyspareunia/pain • Fear of leakage • Partner feedback • Dysmorphia • Appearance • Regain confidence for new relationship • Seeking an alternative to surgery • Failed surgical options Source: Genesis Clinics


01/02/2017 09:58

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need it. It can be used when you are menstruating too.   Contiform combines the well known effectiveness of a pessary   with the familiarity of using a tampon like product.   Contiform, if used regularly can work in harmony with pelvic   floor exercises to bring about long-term improvement in muscle tone.   Contiform comes in 3 sizes. The starter pack contains all 3   sizes so you can choose which size is right for you.   Contiform is recommended by many healthcare professionals.     Contiform is available on prescription from your GP or you   can purchase it via our website www.contiform.eu.

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In recognition of Dr Rakus’ outstanding work in the field of cosmetic medicine


The award-winning clinic for body contouring, facial rejuvenation & lip enhancement


f you want to get your body in better shape, improve your looks or take years off your appearance, book a consultation with Dr Rita Rakus, the world renowned ‘Cosmetic Doctor to the Stars’. With over 25 years of aesthetic medical experience and winner of numerous awards there is no one better to help you look and feel at your best. At her elegant clinic in Knightsbridge, London she and her team of expert clinicians offer a comprehensive selection of non-surgical treatments from lip enhancement to facial rejuvenation and body contouring. The new you is just a phone call away. Book a complimentary consultation with Dr Rakus:

+44 (0)20 7460 7324 www.drritarakus.com

Lip Treatments



Dr Rita Rakus, dubbed “The London Lip Queen” by the press, is world-renowned for her subtle and beautiful lip treatments.

Younger Looking Skin



We offer a range of treatments to tighten and rejuvenate your skin on your face and body.

Facial Treatments



The widest selection of the best non-surgical facial treatments to tighten, tone, lift and rejuvenate aging skin.

Body Contouring



Get rid of stubborn fat and banish cellulite without the need for invasive surgery.


Dr Rita Rakus Dr Ri t a Rak us C l in ic , 3 4 Ha n s R o a d, K n igh tsbridge, Lon don S W 3 1R W – Opposite Harrods

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Nips & Tucks

Non-surgical cosmetic treatments—Hollywood’s biggest names swear by them. Now, more people are turning to these procedures to keep their appearance looking young for as long as possible


ew and revolutionary beauty treatments mean that it’s no longer necessary to plan big—and sometimes life-threatening—operations just for the sake of getting rid of some extra fat around our abdomen or those dreaded crow’s feet near our eyes. The cosmetic industry has ballooned over recent times, with over 11 million non-invasive procedures performed worldwide in 2014.

Did You Know? Men account for around 8% of all surgical and non-surgical procedures. This figure is up 1% from 2014 Source: Cosmetic Digital

IMAGES © Shutterstock


This type of treatment is certainly the most popular—according to Cosmedics UK it accounted for almost half of cosmetic treatments in 2014 (five million to be exact). It consists of injections of the botulinum toxin into the skin that temporarily relaxes facial muscles, smoothening frown and laughter lines, wrinkles, and creases between the eyebrows, achieving an instantly younger look. The cost for this procedure starts at £240 per sitting. This treatment is also FDA-approved to help with excessive sweating and migraines.


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It’s no secret that we all spend large amounts of time getting rid of unwanted hair—whether it’s on our face or body. Although somewhat pricey (full leg and bikini laser hair removal is currently priced at an average of £280 and £150 per sitting accordingly), this treatment promises smooth skin and permanent reduction of hair growth. It is suitable for both men and women, and results can be expected even after the first treatment—although a cycle of

six sittings is strongly advised in order to sufficiently damage the unwanted hair follicles.


Perhaps the most in-demand treatment to fall under this category— not least thanks to popular TV figures—is the lip enhancement procedure. Injections of hyaluronic acid, a gel-like substance that also occurs naturally in the skin and produces a natural plumpness, can be used for a variety of things from nose reshaping and chin enhancement to evening out frown lines and wrinkles. On average, the price for dermal fillers sits at £300, but this largely depends on the kind of treatment desired by the patient. Results tend to last between eight and 12 months.


Perfect for removing dead dermal cells and softening and improving the skin’s appearance, chemical peels are the right treatment to achieve brighter looking skin that has a soft glow. It consists of a chemical solution applied DEAR DOCTOR WITH DR CHRIS STEELE 115

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to the skin, which causes the topmost layer to exfoliate and peel off—making way for healthier skin. this procedure, which can also help with sun damage and acne, can cost anywhere between £75 and £100 per sitting.

RadiofRequency tReatment

this non-surgical procedure is especially useful for halting the early signs of aged and sagging skin. rF waves are used to heat up the skin and stimulate the underlying tissue to tighten and produce larger amounts of collagen. it is mainly used to treat areas such as the forehead, under the eyes, jaw line and neck. as with all procedures, it might have side effects such as swelling, redness and bumps—all of which should disappear after a few days. the price for this 116 dear doctor with dr chris steele

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treatment is steep: it can range from £1,500 to £2,000 for the forehead and eye areas to £3,000 for the whole face.

non-invasive liposuction

Non-invasive liposuction reduces fat by either melting it, liquefying it or freezing and destroying its cells. laser liposuction uses heat energy from various fibre-optic lasers to damage a fat cell’s cell wall. the fatty oils contained in the cell leak out and are then re-absorbed by the body—or removed by more invasive procedures. as for cryolipolisis, fat cells are frozen and sucked up into a cold-plated cup using a vacuum. a single treatment can cost around £150, but a full course of eight treatments—which is recommended—can set you back as much as £960 on average. •

REMEMBER Much like invasive treatments, these non-surgical beauty procedures can all come with risks and individual side effects. It’s therefore important to get advice from several specialists and to carefully evaluate all the pros and cons before committing to a decision


01/02/2017 09:43

Move Naturally


The Original Green Lipped Mussel Extract Gel. The natural choice for joint massage.

More and more people prefer to use PERNATON® Green Lipped Mussel Gel, the purest natural alternative from the sea. PERNATON® Gel is formulated to help relieve the aches and pains of everyday life. Just massage the Gel into the skin around the affected area and enjoy the cooling sensation. • Paraben Free • non-greasy • absorbed immediately • pleasant aroma • Available in 40ml,125ml, 250ml

PERNATON® products are available in leading pharmacies and chemists in the UK.


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16/01/2017 16:18

Award-winning Spa, Hotel & Wellness Retreats

Quieten the mind, rejuvenate the body and lift the spirit.

www.lifehouse.co.uk 01255 860050

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Restoring Health

Spas allow guests to de-stress, unwind and indulge in luxury, but they can also do wonders for our health and wellbeing


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Banishing stress

the British international spa association states that relaxation is the number one reason why people visit a spa (around 91 percent), followed by the desire to get rid of toxins (56 percent). even though we might not be able to control it at times, stress itself can be a hazard 120 dear doctor with dr chris steele

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to our health as it raises your blood pressure and has been shown to change the way blood clots— increasing an individual’s chances of suffering a heart attack. stress can also exacerbate muscle stiffness and tension, which can result in symptoms that range from headaches to abdominal cramps. Massages can alleviate that pressure and stiffness while also delivering oxygen and nutrients to cells, eliminating toxins, stimulating the lymphatic system and helping the body to release the ‘feel good’ hormone serotonin. spending some time in a sauna, booking a massage and soaking in a thermal pool can all lower stress levels, boost wellbeing and temporarily relieve a wide array of aches and pains.

recovery treatments

there are only a handful of spas in the UK that offer recovery treatments specifically designed for people who are living with cancer or are being treated for the disease. Visitors to these spas will be able to choose from a variety of treatments—from shoulder and neck massages to pressure point therapy and facials—based on their preferences with the help of an expertly trained therapist. look for establishments such as lifehouse spa & hotel which are recognised by wellness for cancer—and sport the ‘cancer aware’ badge—for meeting standards required for offering safe and nurturing treatments tailored to visitors with the disease and those who seek post-cancer recovery.

IMAGES © Shutterstock


ooking a luxury spa retreat can come with a variety of health benefits—from sleep therapy and detox programmes to holistic treatments and clean eating regimes. Frequent use of spas often translates to better physical and mental health and higher quality sleep, proving that there is much more to be gained from a spa retreat than just simple relaxation.


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Hot tubs aren’t just for relaxing anymore—they can significantly relieve the symptoms (and discomfort) associated with rheumatoid arthritis. Hydrotherapy, the use of hot water to treat certain health conditions and ailments, uses heat to stimulate blood flow to stiff joints and muscles— reducing pain and inflammation. According to the Arthritis Foundation, hot water can go a long way in alleviating all kinds of symptoms characteristic of musculoskeletal complaints like fibromyalgia and back pain. A hydromassage using three main elements—buoyancy, heat and massage—will go some way in relaxing joints, ultimately making movements easier. The relaxing hydrotherapy jets in most hot tubs and thermal pools can also greatly


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benefit muscles as they simulate light exercise, breaking down lactic acid and reducing stiffness. This is especially useful for visitors who are very physically active, but find little time to take care of and relax their muscles post-workout.


Relaxing in a sauna or soaking in a hot tub will also do wonders for your skin. When exposed to a temperature of around 38 degrees celsius, the body perspires and expels toxins such as bacteria and excess minerals from the epidermal layer. The hot water will also open pores, help remove dead skin cells and make way for healthier, softer and smoother skin. Taking a cold shower after a trip to the sauna will close the pores and remove any chemical residue. •

World travellers made 691m wellness trips in 2015—104.4m more than 2013 Source: Global Wellness Institute

Did You Know? Spa locations rose from 105,591 in 2013 to 121,595 in 2015 Source: Global Wellness Institute


01/02/2017 09:40

Fulfil your travel dreams in 2017 Request your copies of Titan’s brand new Ocean Cruise and River Cruise brochures today, featuring our full programme of award-winning worldwide cruise holidays for 2017 and even into early 2018.

• Many exciting new destinations for 2017

Enjoy included transfers , an experienced tour manager and a number of included excursions and meals on the majority of Titan cruise holidays.

• Superb cruise offers including premium drinks packages

To request your free brochures 0800 or visit titantravel.co.uk

• Travel adventures starting from just £189pp • A unique programme of small-ship cruises • Save up to £2,000pp on selected cruises • Exclusive Titan charters • Low and no single supplements on selected itineraries

988 5800 quoting DD0 1HC

Opening times: Mon - Fri 9am – 6pm, Sat 9am – 5pm, Sun 10am – 4pm Excludes Scottish islands and Sark, where vehicle access is restricted. Home transfers are not included on Titan’s ‘Essential Collection’ holidays. Terms and conditions apply on some offers. Calls free from BT landlines, mobiles may vary.

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Cruise Control Cruises offer the possibility of exploring the world in lavish comfort, and they can also come with a wide range of health benefits


ruises offer luxury, pampering, around-theclock entertainment, superb food, the chance to see the world and—surprisingly—plenty of opportunities to boost your health.

IMAGES © Shutterstock


chronic stress can seriously harm your health—both mentally and physically—and it’s crucial that holidays offer a break from the many demands of everyday life. the ease and convenience of cruises: a


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pre-planned itinerary, inclusive meals and every kind of entertainment— from spa treatments to cinemas—on hand, can significantly reduce the organisational hassle of trying to ‘cram’ everything in, making for a stress-free holiday experience.

eat well

it’s a well-worn cliché of cruises that the luxurious, indulgent food served on ships can make weight gain a distinct possibility. however, for those looking to keep healthy, it’s easy

to find lighter dining options. Most cruise chefs will be happy to cater for your dietary preferences, and if this isn’t possible make sure you eschew fattening foods such as burgers and rich desserts and raid the platters of fresh fruits and vegetables you’ll find in every buffet to ensure your meals are healthy and balanced. alternatively, opt for cruises with facilities that cater specifically for healthy eaters. Famed health resort canyon ranch, for example, runs spas on cruise lines such as oceania cruises and regent

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Seven Seas that offer menus full of highly health conscious dishes.


Although cruises offer numerous opportunities for relaxation, most ships are also well-equipped for the health conscious—whether you’re aiming to drop a few pounds or you’re a dedicated gym junkie. Many ships provide sophisticated fitness facilities such as state-of-the-art gyms, swimming pools, running tracks and more—cruise line Royal Caribbean, for example, offer everything from surfing to ice skating on their Quantum Class ships.


We’re constantly bombarded with edicts that we should protect 124 DEAR DOCTOR WITH DR CHRIS STEELE

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ourselves against the sun, but exposing yourself to limited amounts of natural sunlight is essential for helping your body to produce vitamin D. This helps to regulate calcium and phospate in the body, nutrients that keep bones, muscles and teeth healthy. Make sure you head to the ship deck to enjoy a short bout of gentle morning sunshine every day, or go out and explore on the many excursions available.


Deep relaxation can have many benefits for your body, from lowering your heart rate to raising your immunity. Whether you want to enjoy a massage in the spa or experience the simple pleasure of immersing yourself in a good book by the pool,

cruises offer numerous opportunities to take time out for yourself and relax.


Cruises offer the chance to disconnect from daily life (and your digital devices) and socialise with new people around the ship, whether it’s at a black tie dinner, in the spa or during a dance class. As well as this, let’s not forget the quality bonding time you’ll get to spend with your nearest and dearest.


Going on a cruise ensures you’ll always be close to the sea, whether you’re taking an ocean dip or frolicking on the beach once you get into port. Salt water can help with everything from healing cuts and treating bad skin to clearing sinuses. • celebrityangels.co.uk

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Trending in Travel: The Rise of the Solo Traveller

Recently there has been a huge increase in the number of Brits taking part in activities such as Tough Mudders or ParkRuns, as well as joining cycling clubs across the country. People are looking for new experiences, and ways to broaden their worlds. Exodus Travels see the increase in their solo traveller bookings, from 40%-66% in recent months, as a continuation of this trend: people doing something that makes them happy – whether they have a partner or friend who fancies doing it with them or not. destination. Occasionally people just can’t get the dates to line up and don’t want to delay. So they go ahead and do it anyway. Nobody wants to feel like they’re being held back from doing what they want.

So, why do people choose to travel solo? What makes this such an appealing way to go about things? Usually it’s because one person wants to do something none of their nearest and dearest are interested in. Our good friends in real life often want other things from their precious time off. When you want such disparate things from your holidays, it makes sense to travel separately. It happens all the time – somebody’s wife hates cycling, somebody else’s friends are put off by an overly exotic

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And the beauty of an Exodus group holiday is that although you can travel solo, you’ll never actually be alone. Whilst meeting like-minded travellers along the way and even making lifelong friends to share the memories with later. So whether you love walking along azure coastlines, enjoy the thrill of seeing wild animals up close or perhaps prefer the adrenalin rush of a cycling descent – there’s always an adventure waiting to be had – and no need to wait for someone else to join you.

travelling with fellow club members. That’s the beauty of an Exodus adventure, flexibility in who and how you travel – just as long as you love to travel. That’s the only real requirement of an Exodus holiday! To find out more about Exodus Travels and to request a brochure, visit www.exodus.co.uk/brochures

Alternatively, you can even put your own group together if you fancy

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The Health Benefits of

Owning a Pet

Our furry companions can impact and better our wellbeing more than we know


e’ve all heard of seeingeye dogs, animals that can detect seizures, and four-legged friends trained to spot the presence of cancer in the body—but pets can also significantly improve our health in a number of other ways. apart from being able to help with speech therapy, physical rehabilitation and occupational therapy, pets are excellent companions as well—so how does their presence affect our overall health?


according to the royal society for the Prevention of cruelty to animals (rsPca), pet owners report less depression and are better at coping with grief and anxiety. animals, especially dogs, can help their owners manage stress levels—they are especially helpful to vulnerable groups of people like individuals with Ptsd and anxious children. this is supported by a study in the 2011 Journal of Personality and social Psychology, which found that pet owners have higher self-esteem, are more extroverted, and less preoccupied and fearful of everyday life challenges.

IMAGES © Shutterstock


several studies have shown that simply having pets in the room can lower blood pressure better than popular medication, and that petting them can help take down cholesterol. engaging in activities such as jogging, walking, doga (dog yoga) and cycling with your celebrityangels.co.uk

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pet can be a true workout—even this simple form of physical activity can go a long way in improving heart rate and stamina. this combination of nature and exercise is also proven to improve mental health and raise vitamin d levels—which is vital for a healthy immune system.

HeArt HeAltH

a study performed by the University of california, los angeles focused on the effect of therapy dogs on patients hospitalised with heart failure. the research demonstrated that even after a short visit—12 minutes to be exact—patients showed improved cardiopulmonary pressure, healthier neurohormone levels and decreased levels of anxiety. another study, carried

out by the National institute of health, also shows that heart attack recovery rates for pet owners are much faster.


in addition to being a perfect icebreaker, pets—and dogs especially— have been shown to improve socialisation skills as they strengthen a person’s ability to meet and interact with others. training classes, animalfriendly parks, online pet-focused social networking sites and outdoor cafes can all provide comfortable social situations, even for people who don’t seem to have much in common. social support from a pet has also been shown to lower stress and make a person feel more relaxed, easing social isolation and shyness. • dear doctor with dr chris steele 127

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Our weekly newsletters contain details of our great free to enter competitions & prize draws, deals & offers, news & option on a range of health, and property related issues, exclusive celebrity interviews and digital editions of our great magazines.

Don’t miss out! Sign up at celebrityangels.co.uk/join-our-mailing-list

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01/02/2017 08:44


Health Checklist Prioritise your health with our top picks—from staying hydrated with coconut water to looking after your ears and managing your pet’s diet



Earwax is completely normal, but one in 15 of us produce too much. Its build up is often mistaken for hearing loss and its removal via microsuction is a lot more gentle and effective than oil, syringing or hopi candles. hearology.uk

Pevonia’s New Collagen Boost Face Balm is formulated especially for male skin—with anti-ageing ingredients to regenerate and repair vital skin components whilst also firming the skin. Contains plumping and toning marine collagen and elastin for extended age-defying benefits whilst protecting and preserving the skin’s youthfulness. pevonia.co.uk


BMI Healthcare is the UK’s largest private hospital group, comprising of 59 private hospitals and clinics across England, Scotland and Wales as well as 8,000 consultant specialists. Over 99 percent of patients agree they would recommend BMI Healthcare hospitals to friends and family. bmihealthcare.co.uk


Love Hemp’s range of natural extracts offer the true CBD entourage effect. Produced in Europe, this CBD oil meets the very highest standards in production and quality control. Ideal as a dietary supplement to be taken two to three times per day. cbdoilsuk.com


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Vivomixx is the world’s most concentrated probiotic containing around 450 billion bacteria and eight carefully selected strains. Vivomixx works by re-populating your gut with healthy bacteria which may have been affected by a medical condition or environmental factors. It is a safe, gluten-free food supplement that can be taken daily to help achieve a balanced digestive system. It contains no preservatives, colouring agents or synthetic sweeteners, and is both Halal and Kosher compliant. vivomixx.co.uk


01/02/2017 10:42



If you or your loved one snore—and don’t know what to do about it—try custom-fit sleep plugs (for the afflicted ears!). A 3D ear scan and 3D printing ensure a perfect fit, for a perfect night’s sleep, every night. hearology.uk


Make sure your pet’s food stays their own with the SureFeed Microchip Pet Feeder. It locks in 99.8 percent of moisture, reduces bad food smells and prevents flies. It’s purrfect for managing your pet’s diet or prescription medication. Find out more and check whether your pets microchip is compatible at sureflap.com


Sussex Healthcare is an award-winning group of care homes providing specialist care as well as care for older people. With over 30 years of providing healthcare in Sussex, they offer a range of quality person-centred services for people with complex health needs. sussexhealthcare.co.uk


Loaded with vitamins and minerals, FOCO 100% Pure Coconut Water is an all-natural, refreshing energy drink that helps you and your family live life to the fullest. Superior in taste, low in calories, nutrient rich with five essential electrolytes and awesome hydration, FOCO is available from selected Tesco and Sainsbury’s stores, leading Oriental supermarkets and online at focococonutwater.co.uk


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01/02/2017 12:50

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If things go wrong we understand that making a claim can be distressing so we support our clients and make sure the process is as straight forward as possible.

Strength in our people, trust in our approach

The medical negligence team at Hugh James is one of the largest in the UK and is recognised as a market leader in Wales and England. We represent individuals and their families who have suffered injury, illness or death as a result of negligent medical treatment.

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23/01/2017 12:13

Profile for Magazine

Dear Doctor with Dr Chris Steele: Issue 1/17  

Celebrity Angels: Dear Doctor with Dr Chris Steele. Issue 1/17. Highlights in this issue include: - Reversing Diabetes: How is it done? -...

Dear Doctor with Dr Chris Steele: Issue 1/17  

Celebrity Angels: Dear Doctor with Dr Chris Steele. Issue 1/17. Highlights in this issue include: - Reversing Diabetes: How is it done? -...