Durham research: How to keep your bones strong

Durham University | April 2019 | How to keep your bones strong

Durham University’s Department of Sport and Exercise Sciences hast studied more the physical activity and sedentary behaviour of more than 200 men and women aged 62 from the Newcastle Thousand Families Study. As part of this research each participant wore a monitor for seven days which measured their levels of activity. The participants also received a bone density scan of the spine and hip. 

The researchers found simply achieving your 10,000 steps a day can be important for keeping your bones strong. Another finding indicates that the more time people in their sixties spent sitting down, the lower their bone strength was.


The study is the first to show that a sedentary lifestyle in males is associated with a greater risk for osteoporosis.

In addition the study shows that men spent more time sitting still than women and those who were the most sedentary, had the lowest bone strength, particularly in their lower back. (Source: Durham University)



The influence of sedentary time and habitual physical activity on the bone health of middle aged adults is not well known.


Bone mineral density (BMD) and hip bone geometry were evaluated in 214 men (n = 92) and women (n = 112) aged 62.1 ± 0.5 years from the Newcastle Thousand Families Study birth cohort. Accelerometry was used to measure physical activity (PA) and sedentary time over 4 days. Regression models were adjusted for clinical risk factor covariates.


Men were more sedentary than women (P less than 0.05), and sedentary time was negatively associated with spine BMD in men, with 84 minutes more sedentary time corresponding to 0.268 g.cm−2 lower BMD. In men, light PA and steps/day were positively associated with bone geometry and BMD. Steps/day was positively associated with bone geometry and femur BMD in women, with a positive difference of 1415 steps/day corresponding to 0.232 g.cm−2 greater BMD.


Sedentary time was unfavourably associated with bone strength in men born in North East England at age 62 years. Higher volumes of light PA, and meeting the public health daily step recommendations (10 000 steps/day) was positively associated with bone health in both sexes.

Full reference: Hind, K., Hayes, L., Basterfield, L., Pearce, M. S., & Birrell, F. |2019| Objectively-measured sedentary time, habitual physical activity and bone strength in adults aged 62 years: the Newcastle Thousand Families Study| Journal of Public Health| https://doi.org/10.1093/pubmed/fdz029

Rotherham NHS staff can request a copy of this article from the Library 

Eating blueberries every day improves heart health

Eating 150g of blueberries daily reduces the risk of cardiovascular disease by up to 15% according to new research led by the University of East Anglia | The American Journal of Clinical Nutrition | story via ScienceDaily


New findings published in the American Journal of Clinical Nutrition show that eating 150g of blueberries daily reduces the risk of cardiovascular disease by up to 15 per cent.

Researchers looked at the benefits of eating 150 gram portions (one cup) compared to 75 gram portions. The participants consumed the blueberries in freeze-dried form and a placebo group was given a purple-coloured alternative made of artificial colours and flavourings. They found that eating one cup of blueberries per day resulted in sustained improvements in vascular function and arterial stiffness – making enough of a difference to reduce the risk of cardiovascular disease by between 12 and 15 per cent.

The research team from the University of East Anglia’s Department of Nutrition and Preventive Medicine say that blueberries and other berries should be included in dietary strategies to reduce the risk of cardiovascular disease – particularly among at risk groups.

Full story at ScienceDaily

Full research article: Curtis, P. J. et al. |Blueberries improve biomarkers of cardiometabolic function in participants with metabolic syndrome—results from a 6-month, double-blind, randomized controlled trial | The American Journal of Clinical Nutrition, Volume 109, Issue 6, June 2019, Pages 1535–1545



Achieving a digital NHS

Creating a digital NHS is a national policy priority. The NHS Long Term Plan emphasised  commitment to the digital agenda and promised fully digitised secondary care services by 2024. This report looks at digitisation from the perspective of acute trusts, and examines what lessons can be learnt for national policy | Nuffield Trust


As a new body, NHSX, has been established to lead national policy for technology, digital and data, and with the Secretary of State firmly behind plans to create a fully digital NHS, this report seeks to understand how national policy for digitisation is working from the perspective of acute trusts.

The authors spoke to 72 senior digital leaders in national organisations and NHS trusts as well as frontline health care professionals in an attempt to understand how national policy for digitisation is working from the perspective of acute trusts. The researchers wanted to know:

  • How national policy impacted on a trust’s approach to digitisation
  • How national policy was helping and hindering digital progress
  • What national policy could do differently to better support digitisation on the ground

This report sets out a number of areas that would benefit from national attention. A clear theme across all of the areas is the need for better communication and engagement between national policy makers and NHS providers.

Full report: Castle-Clarke S and Hutchings R  (2019) | Achieving a digital NHS: Lessons for national policy from the acute sector | Nuffield Trust

BMJ research: Children from disadvantaged backgrounds and certain ethnic minorities do less vigorous physical activity

University of Cambridge | May 2019 |Children from disadvantaged backgrounds and certain ethnic minorities do less vigorous physical activity 

Researchers from the University of Cambridge are the first to investigate socio-economic and ethnicity-related differences in children’s vigorous intensity physical activity behaviour.  The team studied the health of more than 5000 children using data from the Millennium Cohort Study -a longitudinal study that followed children born between September 2000 and January 2002-child participants were given accelerometers as their levels of physical activity were monitored for three days.


One of the study’s findings is that children whose mothers are highly educated are more likely to participate in the more physical activity  her child was likely to have, equally the experts also observed that children spent more time in vigorous intensity activity incrementally with increasing household income.

Other findings suggest White British children perform on average more than three minutes more daily vigorous physical activity in comparison to children from Pakistani and Bangladeshi backgrounds. Children from ‘other ethnic groups’ also accumulated 2.2 minutes fewer daily vigorous intensity activity overall.

The researchers emphasise there could be a number of reasons that might explain the differences, including access to or the cost of participating in sports activities, and a parent working longer, inconsistent work hours within a low-income job. There may also be differences in home and family support for physical activity between ethnic groups.

“Children from different backgrounds can face a number of barriers preventing them from participating in sports or other types of vigorous physical activity,” adds Dr Jean Adams, one of the study’s authors: “We need to find more ways to provide opportunities for all children to get involved in vigorous activity.” (Source: University of Cambridge)

Full press release from the University of Cambridge


 Objective: To investigate if daily vigorous physical activity, adjusted for minutes of moderate physical activity performed, differs by socio-economic position or ethnicity in a large sample of UK children with objectively measured physical activity.

Design: Nationally representative prospective cohort study.

Setting: UK children born between 2000 and 2002.

Participants: 5172 7-8-year-old children with valid accelerometer data for more than or equal to 10 h on more than or equal to 3 days, including one weekend day.

Main outcome measures: Time spent in vigorous physical activity (VPA) (more than 3841 counts per minute).

Explanatory measures: Maternal education, annual household OECD equivalised income, ethnicity.

Results: Multivariable linear regression models fitted to explore differences in average daily minutes of VPA (adjusted for moderate physical activity (MPA), mean accelerometer wear time, season of measurement, age and sex), revealed significantly higher amounts of VPA accumulated as a child’s socioeconomic position increased. Additionally, children from certain minority ethnicities  accrued less daily VPA compared with their white British counterparts.

Conclusions: The socioeconomic and ethnic patterning of vigorous activity observed in this study mirrors parallel inequalities in rates of childhood obesity. Given the stronger association of vigorous activity (VPA) with adiposity than of moderate activity (MPA), intensity specific differences may be contributing to widening inequalities in obesity. Accordingly, these findings suggest that the current global focus on overall MVPA may mask important behavioural inequalities.

Read the full article in The BMJ 

Speaking plainly about about what makes us healthy

This article from the Health Foundation discusses how changing the conversation will help to build public understanding of how social determinants affect health.

The Health Foundation is currently working with the FrameWorks Institute to develop a deeper appreciation of the ways in which people understand and think about health, to develop more effective approaches to communicating evidence.

A recent Health Foundation briefing explored how people think about what makes them healthy. It identifies four main communication challenges that can act as barriers to wider public acceptance of the evidence on the social determinants of health, including:

  • broadening what is understood by the term health
  • increasing understanding of the role of the social determinants of health
  • increasing understanding of how social and economic inequalities drive health inequalities
  • generating an understanding of the policy action needed to keep people healthy.

The next stage of their work with the FrameWorks Institute will be to develop and test strategies to address these challenges.

In the meantime, the Health Foundation offers some general guidance to bear in mind when communicating to the public around prevention and health issues including:

  • Beware of gesturing towards the importance of individual choice or responsibility.
  • Avoid ‘crisis messaging’ as this can backfire by reinforcing people’s sense of fatalism and encouraging disengagement.
  • Use step-by-step, causal explanations of how social determinants affect health, and provide concrete examples to help deepen the public’s understanding.

Full article at the Health Foundation

Female patients more likely to survive but experience worse side effects from cancer treatment

OnMedica  | May 2019 |Female patients more likely to survive but experience worse side effects from cancer treatment

Oncologists from The Royal Marsden NHS Foundation Trust have led analysis into patient data for more than 3000 people with cancer of the oesophagus and stomach; their findings indicate that female patients being treated with chemotherapy prior to having surgery were significantly more likely to experience side effects such as nausea (10% compared to 5%), vomiting (10% versus 4%) and diarrhoea (9% versus 4%), than male patients. 


The analysis of four large randomised controlled trials, in collaboration with the UK Medical Research Council Clinical Trials Unit at University College London, will be presented in a poster session at this weekend’s American Society of Clinical Oncology Annual Meeting in Chicago, could potentially help to tailor the management of patients and also highlight those more at risk from specific side effects (Source: OnMedica).

Full story from OnMedica 

The role of volunteers in ambulance services

This report explores the role and value of volunteering within ambulance services in England and identifies examples of different ways in which volunteering opportunities are being developed | Kings Fund


The role of volunteers within ambulance trusts is well-established, largely focusing on two key areas of provision – community first responder schemes and non-emergency patient transport services.

However, ambulance trusts are now taking steps to develop and diversify volunteering within their services, from improving recruitment and management, to developing new activities and roles to meet changes in demand and building relationships with communities.

The report concludes by highlighting some key lessons for future development of the role of volunteering in ambulance services and identifies some important next steps to ensure a more strategic approach that realises the potential of volunteers.

Full report: Volunteering in ambulance services: developing and diversifying opportunities

See also: Saving lives, supporting communities: The role of volunteers in ambulance services

The health consequences of eating ultra-processed food

Two studies which looked at the impact of consuming ultra- processed foods on health, report that higher consumption of ultra-processed foods ( more than 4 servings daily) was independently associated with a 62% relatively increased hazard for all cause mortality in the first study; and in the second study an association was identified between higher consumption of ultra-processed foods with higher risks of cardiovascular, coronary heart, and cerebrovascular disease.



The first study from the Seguimiento Universidad de Navarra followed almost 20000 graduates of the university every two years to assess their diet through a questionnaire.

The second study- a population-based cohort study- led by the University of Paris recruited over 100000 participants: dietary intakes were collected using repeated 24 hour dietary records (5.7 for each participant on average),  to record participants’ usual consumption of 3300 food items. These foods were categorised using the NOVA classification according to degree of processing.

Both studies are available in the BMJ

NICEimpact Stroke

NICE |  May 2019 | NICEimpact Stroke

NICEimpact Stroke is a report from NICE that focuses on how NICE’s evidence-based
guidance contributes to improvements in care for people who are at risk of or who have had a stroke.

Image source: nice.org.uk

Topics covered include:

  • Stroke prevention in atrial fibrillation
  • Acute care
  • Rehabilitation
  • Spotlight on thrombectomy

NICEimpact Stroke


The Homelessness Monitor: England 2019

Crisis &  Joseph Rowntree Foundation | May 2019| The Homelessness Monitor: England 2019

The Homelessness Monitor is the eighth annual report commissioned and funded by Crisis and the Joseph Rowntree Foundation (JRF) as well as the People’s Postcode Lottery, the report analyses the impact of economic and policy developments on homelessness, drawing on a survey of councils, statistical analysis and in-depth interviews. It also highlights
emerging trends and forecasts some of the likely future changes, identifying the
developments likely to have the most significant impacts on homelessness. 

Image source: crisis.org.uk

Among the key findings:

  • 71 per cent of local authorities participating in this year’s LA survey reported that homelessness had been recently increasing – in a quarter of cases to a “significant” extent. Nationally, 2017/18 saw a small drop in the recorded statutory homelessness caseload, although it still remains 42 per cent above their 2009 low point

Very few local authority respondents believed that existing social housing provision in their area is commensurate with homelessness needs, but many were at least equally concerned about the problematic profile of the local social housing stock portfolio, mismatched to need. There were also widespread anxieties about ongoing changes to housing association tenancy allocation policies impeding local authorities’ ability to resolve homelessness (Source: Crisis)