Category Archives: Heartburn

How unexpected chats spark ideas to transform healthcare | Anna Howells

How often does the chat you didn’t expect to have end up being the best conversation of your day?

It might be with a colleague you don’t often get a chance to talk to, the person from another team you never have quite enough time to sit down with, or someone you happen to bump into. Such unexpected conversations can spark ideas, open up new ways of thinking and help solve problems.

To encourage these conversations, Kaleidoscope Health and Care partnered with the Guardian Healthcare Professionals Network to send brown paper envelopes with £100 to five lucky recipients to spend on whatever they liked – as long as it was in the cause of having an unexpected conversation on the theme of health and care.

We startled a few finance departments, which sent incredulous emails enquiring what the envelope full of money was for. Coffees, lunches and train tickets were all options; we didn’t mind. All we asked was that winners spent the money within a month, had fun doing so and wrote us two 750-word blogs about the conversations.

To be in with a chance of receiving an envelope, we asked applicants to blog about their best unexpected conversation to date. We were blown away by the response. Entries came from as far away as Pakistan. Applicants from a variety of professions entered, including occupational therapists, policymakers, GPs and charity chief executives. The resulting blogs covered a host of topics, ranging from elderly care to US politics.

Did these conversations fulfil our aim? We think they did – or at least laid the foundations. Our project revealed that unexpected conversations can take place wherever you are, between people of all ages.

Becks Fisher’s unexpected conversation with a US pharmacist while on the campaign trail for Hillary Clinton led her to think differently about our healthcare system – both how lucky we are to have it but also how fragile it is.

Rhiannon is a pharmacist unlike any I have encountered in the UK. She does dispense medications, and she can help people with weight management, self-limiting illness and flu shots, but that’s not what she spends most of her time doing … For her patients, a prescription isn’t the drugs they will take, it is a wish list of those they might take if they have means to do so.

More than one applicant chose to blog about care for older people. Charlotte Williams, chief of staff for UCLPartners Academic Health Science Partnership, described a conversation focused on thinking differently about how we consider elderly patients.

The best unexpected conversation I had was with a geriatrician I was working with a few years ago. She had the view that no older person she looked after was a single unit. She felt that the best physicians – or any member of the clinical team – knew to treat the unit, to ask as much about the accompanying support as the person … in the chair or on the trolley.

For occupational therapist Melissa Purkis and a nurse, the conversation considered innovative solutions to care.

We talked about the initiative in the Netherlands where residential and nursing homes are pairing up with colleges and universities to provide affordable living spaces for students, in return for the students interacting with the older people. In an age where the disparity between young and old is developing like a gaping chasm, and there are numerous reports about loneliness in both younger and older people, it surely makes sense to counter this.

We learned that an unexpected conversation between Kath Parsons and a Macmillan Cancer Support officer led to the establishment of the Older Peoples Advocacy Alliance, the only national organisation supporting independent advocacy for older people.

When the pair discussed a Macmillan report which found older people are often at a disadvantage when it comes to receiving cancer care, their conversation sparked an idea to recruit older people who have been affected by cancer to support their peers.

Peer advocates walk side by side with older people, providing whatever support is needed, from emotional support to housing, benefits or social care advice, treatment needs, and planning for end of life.

Prof Mah Muneer Khan learned that children can be unexpectedly knowledgeable about hand hygiene, which is promising in a world where there are more than 1.4m cases of healthcare-associated infections at any given time.

Our “Unexpected Fellows” have since had more conversations and blogged the results. We hope they inspire you to think about how you can get more of the unexpected into your everyday.

Anna Howells is a partner at Kaleidoscope Health & Care

Join the Healthcare Professionals Network to read more pieces like this. And follow us on Twitter (@GdnHealthcare) to keep up with the latest healthcare news and views.

If you’re looking for a healthcare job or need to recruit staff, visit Guardian Jobs.

Channel 4 adverts to show viewers different sight loss conditions

TV viewers will have the opportunity to experience what their sight would be like with various eye conditions on Monday night when Channel 4 airs a unique advert break.

The broadcaster will show five commercials that will have different visual filters applied to them so the viewer can understand how their eyes would be affected by the most common eye conditions in the UK.

The conditions that will be demonstrated are macular degeneration, which affects the central part of a person’s vision; cataracts, which causes cloudy or misty sight; diabetes, which can damage blood vessels at the back of the eyes; hemianopia, where a person loses half of their vision, and glaucoma, which damages the optic nerve.

The adverts will be shown at 9.15pm during a break in The Undateables and will be replayed at 9.30pm with audio description for viewers with a visual impairment.

Channel 4 has put together the unprecedented advert break with the Royal National Institute of Blind People (RNIB) and Eye Health UK. The brands that will feature in the campaign are O2, Paco Rabanne, Amazon Echo, Freeview and Specsavers.

More than two million people in the UK – about one in 33 – are living with conditions that have caused sight loss. The Channel 4 campaign coincides with National Eye Health Week, which starts on Monday.

Sophie Castell, a director at RNIB, said: “This unique opportunity to work with Channel 4 and some really great advertisers will help show viewers different sight loss conditions and what living with sight loss can be like.

“The use of audio description across an entire ad break marks a cultural shift in advertising. We are really proud to be part of this exciting and rewarding initiative with Channel 4 and the advertisers.”

The campaign comes after Channel 4 aired a commercial break during the Paralympics in Rio de Janeiro last year that was fully signed by deaf artist and actor David Ellington.

Jonathan Allan, sales director at Channel 4 said: “Working with RNIB, we aim to illustrate the various perspectives of millions of people in the UK living with sight loss and provide full audio description to all our viewers.

“We hope this latest idea continues Channel 4’s legacy of delivering original, creative campaigns that focus on accessibility. From Superhumans Wanted and Maltesers to last year’s fully signed ad break and the launch of our diversity in advertising award we want to inspire advertisers to develop creative campaigns with their entire audience in mind.”

Poor diet is a factor in one in five deaths, global disease study reveals

Poor diet is a factor in one in five deaths around the world, according to the most comprehensive study ever carried out on the subject.

Millions of people are eating the wrong sorts of food for good health. Eating a diet that is low in whole grains, fruit, nuts and seeds and fish oils and high in salt raises the risk of an early death, according to the huge and ongoing study Global Burden of Disease.

The study, based at the Institute of Health Metrics and Evaluation at the University of Washington, compiles data from every country in the world and makes informed estimates where there are gaps. Five papers on life expectancy and the causes and risk factors of death and ill health have been published by the Lancet medical journal.

It finds that people are living longer. Life expectancy in 2016 worldwide was 75.3 years for women and 69.8 for men. Japan has the highest life expectancy at 84 years and the Central African Republic has the lowest at just over 50. In the UK, life expectancy for a man born in 2016 is 79, and for a woman 82.9.

Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.

causes of death graphic

“This is really large,” Dr Christopher Murray, IHME’s director, told the Guardian. “It is amongst the really big problems in the world. It is a cluster that is getting worse.” While obesity gets attention, he was not sure policymakers were as focused on the area of diet and health as they needed to be. “That constellation is a really, really big challenge for health and health systems,” he said.

The problem is often seen as the spread of western diets, taking over from traditional foods in the developing world. But it is not that simple, says Murray. “Take fruit. It has lots of health benefits but only very wealthy people eat a lot of fruit, with some exceptions.”

Sugary drinks are harmful to health but eating a lot of red meat, the study finds, is not as big a risk to health as failing to eat whole grains. “We need to look really carefully at what are the healthy compounds in diets that provide protection,” he said.

undernourishment graphic

Prof John Newton, director of health improvement at Public Health England, said the studies show how quickly diet and obesity-related disease is spreading around the world. “I don’t think people realise how quickly the focus is shifting towards non-communicable disease [such as cancer, heart disease and stroke] and diseases that come with development, in particular related to poor diet. The numbers are quite shocking in my view,” he said.

The UK tracks childhood obesity through the school measurement programme and has brought in measures to try to tackle it. “But no country in the world has been able to solve the problem and it is a concern that we really need to think about tackling globally,” he said.

Today, 72% of deaths are from non-communicable diseases for which obesity and diet are among the risk factors, with ischaemic heart disease as the leading cause worldwide of early deaths, including in the UK. Lung cancer, stroke, lung disease (chronic obstructive pulmonary disorder) and Alzheimer’s are the other main causes in the UK.

The success story is children under five. In 2016, for the first time in modern history, fewer than 5 million children under five died in one year – a significant fall compared with 1990, when 11 million died. Increased education for women, less poverty, having fewer children, vaccinations, anti-malaria bed-nets, improved water and sanitation are among the changes in low-income countries that have brought the death rate down, thanks to development aid.

People are living longer but spending more years in ill health. Obesity is one of the major reasons. More than a billion people worldwide are living with mental health and substance misuse disorders. Depression features in the top 10 causes of ill health in all but four countries.

“Our findings indicate people are living longer and, over the past decade, we identified substantial progress in driving down death rates from some of the world’s most pernicious diseases and conditions, such as under age-five mortality and malaria,” said Murray “Yet, despite this progress, we are facing a triad of trouble holding back many nations and communities – obesity, conflict, and mental illness, including substance use disorders.”

In the UK, the concern is particularly about the increase in ill-health that prevents people from working or having a fulfilling life, said Newton. A man in the UK born in 2016 can expect only 69 years in good health and a woman 71 years.

“This is yet another reminder that while we’re living longer, much of that extra time is spent in ill-health. It underlines the importance of preventing the conditions that keep people out of work and put their long term health in jeopardy, like musculoskeletal problems, poor hearing and mental ill health. Our priority is to help people, including during the crucial early years of life and in middle age, to give them the best chance of a long and healthy later life,” he said.

Artificial sweeteners raise risk of type 2 diabetes, study suggests

Artificial sweeteners, which many people with weight issues use as a substitute for sugar, may increase the risk of developing type 2 diabetes, according to research.

The study was small and the detailed results have not yet been published, but experts said its findings fitted with previous research showing an association between artificial sweeteners and weight gain.

Type 2 diabetes is linked to obesity and rates of the disease are soaring around the world. Its complications, if it is not controlled, can include blindness, heart attacks and strokes.

The study was carried out by researchers at the University of Adelaide, in Australia, who wanted to investigate whether large amounts of no-calorie artificial sweeteners altered the ability of the body to control the levels of glucose in the blood.

Some of the 27 healthy volunteers who were recruited for the study were given the equivalent of 1.5 litres of diet drink a day, in the form of capsules of two different sweeteners, sucralose and acesulfame K. They took the capsules three times a day for two weeks, before meals. The others in the study were given a placebo.

Tests at the end of the two weeks showed that the body’s response to glucose was impaired. “This study supports the concept that artificial sweeteners could reduce the body’s control of blood sugar levels and highlights the potential for exaggerated post-meal glucose levels in high habitual NAS [non-caloric artificial sweeteners] users, which could predispose them to develop type 2 diabetes,” said the authors.

They presented their findings at the European Association for the Study of Diabetes in Lisbon, Portugal.

Some experts said the findings were in line with previous research, while others said they did not support the conclusion that sweeteners could increase the risk of type 2 diabetes.

“This study addresses a very important global human health issue, as artificial sweeteners are food additives commonly used not only by patients with diabetes but also by healthy individuals aiming to manage their sugar intake,” said Dr Inês Cebola, from Imperial College London, who is a member of the Society for Endocrinology.

“Although generally thought as safe and even beneficial, artificial sweetener consumption has actually been previously associated with weight gain and development of glucose intolerance, which can lead to development of type 2 diabetes.”

She said studies had previously only been done on mice. “Even if it is proven in the future that artificial sweeteners are detrimental for the general population, this might not be true in all cases. Type 2 diabetes arises from an interaction between environmental and genetic factors, many of which we do not fully understand yet. It is thus premature to point the finger at artificial sweeteners as isolated elements of risk. The full story will probably prove itself a lot more complex.

“At the moment, I would not advise against artificial sweeteners per se, but instead I would stress the importance of a balanced diet and regular exercise.”

Victor Zammit, professor of metabolic biochemistry at the University of Warwick, said it was not possible from the data available to conclude that the body’s changed response to glucose would necessarily result in diabetes. Proper clinical trials were needed. “Increased sweetener intake may be associated with other lifestyle elements that may be more direct causes of type 2 diabetes,” he said.

Diabetes UK was sceptical. “This is a small study with interesting results, but it doesn’t provide strong evidence that artificial sweeteners increase the risk of type 2 diabetes,” said Emma Elvin, a clinical adviser. “We need to see the results of larger trials testing in settings more true to real life before we’ll know more.

“Consuming lots of sugary foods and drinks is very damaging to overall health and can increase risk of type 2 diabetes. We would advise people to reduce their intakes of sugar, and artificial sweeteners could be an option to help some people achieve this.”

Artificial sweeteners raise risk of type 2 diabetes, study suggests

Artificial sweeteners, which many people with weight issues use as a substitute for sugar, may increase the risk of developing type 2 diabetes, according to research.

The study was small and the detailed results have not yet been published, but experts said its findings fitted with previous research showing an association between artificial sweeteners and weight gain.

Type 2 diabetes is linked to obesity and rates of the disease are soaring around the world. Its complications, if it is not controlled, can include blindness, heart attacks and strokes.

The study was carried out by researchers at the University of Adelaide, in Australia, who wanted to investigate whether large amounts of no-calorie artificial sweeteners altered the ability of the body to control the levels of glucose in the blood.

Some of the 27 healthy volunteers who were recruited for the study were given the equivalent of 1.5 litres of diet drink a day, in the form of capsules of two different sweeteners, sucralose and acesulfame K. They took the capsules three times a day for two weeks, before meals. The others in the study were given a placebo.

Tests at the end of the two weeks showed that the body’s response to glucose was impaired. “This study supports the concept that artificial sweeteners could reduce the body’s control of blood sugar levels and highlights the potential for exaggerated post-meal glucose levels in high habitual NAS [non-caloric artificial sweeteners] users, which could predispose them to develop type 2 diabetes,” said the authors.

They presented their findings at the European Association for the Study of Diabetes in Lisbon, Portugal.

Some experts said the findings were in line with previous research, while others said they did not support the conclusion that sweeteners could increase the risk of type 2 diabetes.

“This study addresses a very important global human health issue, as artificial sweeteners are food additives commonly used not only by patients with diabetes but also by healthy individuals aiming to manage their sugar intake,” said Dr Inês Cebola, from Imperial College London, who is a member of the Society for Endocrinology.

“Although generally thought as safe and even beneficial, artificial sweetener consumption has actually been previously associated with weight gain and development of glucose intolerance, which can lead to development of type 2 diabetes.”

She said studies had previously only been done on mice. “Even if it is proven in the future that artificial sweeteners are detrimental for the general population, this might not be true in all cases. Type 2 diabetes arises from an interaction between environmental and genetic factors, many of which we do not fully understand yet. It is thus premature to point the finger at artificial sweeteners as isolated elements of risk. The full story will probably prove itself a lot more complex.

“At the moment, I would not advise against artificial sweeteners per se, but instead I would stress the importance of a balanced diet and regular exercise.”

Victor Zammit, professor of metabolic biochemistry at the University of Warwick, said it was not possible from the data available to conclude that the body’s changed response to glucose would necessarily result in diabetes. Proper clinical trials were needed. “Increased sweetener intake may be associated with other lifestyle elements that may be more direct causes of type 2 diabetes,” he said.

Diabetes UK was sceptical. “This is a small study with interesting results, but it doesn’t provide strong evidence that artificial sweeteners increase the risk of type 2 diabetes,” said Emma Elvin, a clinical adviser. “We need to see the results of larger trials testing in settings more true to real life before we’ll know more.

“Consuming lots of sugary foods and drinks is very damaging to overall health and can increase risk of type 2 diabetes. We would advise people to reduce their intakes of sugar, and artificial sweeteners could be an option to help some people achieve this.”

Artificial sweeteners raise risk of type 2 diabetes, study suggests

Artificial sweeteners, which many people with weight issues use as a substitute for sugar, may increase the risk of developing type 2 diabetes, according to research.

The study was small and the detailed results have not yet been published, but experts said its findings fitted with previous research showing an association between artificial sweeteners and weight gain.

Type 2 diabetes is linked to obesity and rates of the disease are soaring around the world. Its complications, if it is not controlled, can include blindness, heart attacks and strokes.

The study was carried out by researchers at the University of Adelaide, in Australia, who wanted to investigate whether large amounts of no-calorie artificial sweeteners altered the ability of the body to control the levels of glucose in the blood.

Some of the 27 healthy volunteers who were recruited for the study were given the equivalent of 1.5 litres of diet drink a day, in the form of capsules of two different sweeteners, sucralose and acesulfame K. They took the capsules three times a day for two weeks, before meals. The others in the study were given a placebo.

Tests at the end of the two weeks showed that the body’s response to glucose was impaired. “This study supports the concept that artificial sweeteners could reduce the body’s control of blood sugar levels and highlights the potential for exaggerated post-meal glucose levels in high habitual NAS [non-caloric artificial sweeteners] users, which could predispose them to develop type 2 diabetes,” said the authors.

They presented their findings at the European Association for the Study of Diabetes in Lisbon, Portugal.

Some experts said the findings were in line with previous research, while others said they did not support the conclusion that sweeteners could increase the risk of type 2 diabetes.

“This study addresses a very important global human health issue, as artificial sweeteners are food additives commonly used not only by patients with diabetes but also by healthy individuals aiming to manage their sugar intake,” said Dr Inês Cebola, from Imperial College London, who is a member of the Society for Endocrinology.

“Although generally thought as safe and even beneficial, artificial sweetener consumption has actually been previously associated with weight gain and development of glucose intolerance, which can lead to development of type 2 diabetes.”

She said studies had previously only been done on mice. “Even if it is proven in the future that artificial sweeteners are detrimental for the general population, this might not be true in all cases. Type 2 diabetes arises from an interaction between environmental and genetic factors, many of which we do not fully understand yet. It is thus premature to point the finger at artificial sweeteners as isolated elements of risk. The full story will probably prove itself a lot more complex.

“At the moment, I would not advise against artificial sweeteners per se, but instead I would stress the importance of a balanced diet and regular exercise.”

Victor Zammit, professor of metabolic biochemistry at the University of Warwick, said it was not possible from the data available to conclude that the body’s changed response to glucose would necessarily result in diabetes. Proper clinical trials were needed. “Increased sweetener intake may be associated with other lifestyle elements that may be more direct causes of type 2 diabetes,” he said.

Diabetes UK was sceptical. “This is a small study with interesting results, but it doesn’t provide strong evidence that artificial sweeteners increase the risk of type 2 diabetes,” said Emma Elvin, a clinical adviser. “We need to see the results of larger trials testing in settings more true to real life before we’ll know more.

“Consuming lots of sugary foods and drinks is very damaging to overall health and can increase risk of type 2 diabetes. We would advise people to reduce their intakes of sugar, and artificial sweeteners could be an option to help some people achieve this.”

May suffers humiliation as DUP backs Labour on NHS pay and tuition fees

Theresa May has suffered a major embarrassment in the House of Commons after the Democratic Unionist party backed Labour motions in favour of increasing NHS pay and against a rise in tuition fees.

Labour’s motions passed on Wednesday without being pushed to a vote after it became clear the government had no majority to oppose the call for an end to the public sector pay cap for NHS workers nor the £250 a year increase in student fees.

It is the first example of the DUP breaking with May since they struck a confidence and supply agreement to vote together on crucial legislation after the general election.

The motions fell outside the Tory-DUP deal as they were not binding, but their passage was nevertheless a symbolic victory for Labour and a sign that there is no longer a majority in the House of Commons for many of the austerity policies introduced by the Conservatives.

The DUP spoke out in favour of the pay motion and MPs also indicated the party backed a second motion tabled by Labour opposing a £250 a year rise in the cap on tuition fees to £9,250, which the Conservatives have passed by statutory instrument without a Commons debate despite protests from the opposition.

The DUP’s decision to side with Labour forced the Conservatives to abstain in an attempt to take the sting from the situation.

It will have no direct effect on policy, but is a sign that Labour may be able to exploit differences between the Conservatives and the DUP in the future in order to inflict more meaningful defeats on May.

Angela Rayner, the shadow education secretary, said the refusal to allow a binding vote on tuition fees had created a constitutional crisis. She said: “The government had no mandate to increase fees to begin with and if they do not now reverse the fee hike they will be defying the will of parliament in blatant disregard for our democracy”.

The DUP’s move is in line with its longstanding approach to wanting to lift the pay cap; it backed a similar early day motion earlier this year.

The party is also opposed to higher student fees, having voted against lifting the cap to £9,000 under the coalition.

Jeffrey Donaldson, the DUP MP for Lagan Valley MP, denied that supporting Labour on NHS wages and opposing tuition fees put the party’s deal that props up May’s government at peril.

“No, not at all,” Donaldson told the Guardian. “We made clear to her majesty’s government on issues like this we reserve the right to vote on the basis of our own manifesto. This doesn’t threaten the deal at all.”

Ian Paisley, the DUP MP for North Antrim, said he hoped the vote would be a “clarion call” from the Commons for fairer pay for NHS workers.

Downing Street has already signalled it will be “flexible” over the public sector pay cap in future, after coming under huge pressure over the issue since the election, when May lost her majority.

The prime minister initially held out against changing the policy but some Conservatives MPs in marginal seats lobbied for an end to seven years of austerity. May will need DUP votes in order for the budget to get the approval of parliament this autumn, so ending the cap may have been a political necessity.

Earlier this week, No 10 said the pay cap would end for prison officers, who will get a 1.7% pay rise, and police, who get a 2% pay increase next year, while signalling that the overall cap of 1% is likely to be eased at the next budget.

However, Labour and the unions have criticised the promised end to the pay cap as insufficient. In the Commons, Jonathan Ashworth, the shadow health secretary, said the rise amounted and amount to a pay cut with inflation is running at 2.9%.

“If the government are indeed abandoning this cap, let us put them on notice,” he said. “It must apply to the whole of the public sector, including the 55% of workers who are not covered by the pay review bodies.

“And we also put them on warning: we will not accept a divide-and-rule approach. We will not accept playing one set of public sector workers off against another.”

Ashworth said it “wasn’t good enough” for ministers to grant more flexibility over pay and expect hospitals to fund a wage increase for staff from existing budgets.

MPs told the House of Commons about examples of public sector workers, including ambulance technicians and nurses who are struggling to get by, being forced into debt or to take second jobs.

Following the debate, Ashworth called on May to abide by the wishes of the House of Commons and deliver higher pay for NHS workers. “The real question is, will the government now ignore the clear will of the house or will it take action to end the pay cap in the NHS?” he said.

Unison, the trade union for public sector workers, said the passage of the motion showed the Conservatives had lost the argument on public sector pay.

“Ministers must know they’re in the wrong when even their quasi-coalition partners in the DUP have turned against them, and backed pay rises for NHS workers,” said Dave Prentis, the general secretary of Unison.

“Theresa May is losing her majority on public sector pay, and we know there are Conservative MPs sympathetic to our calls for real pay rises for all public service workers.

“It’s now time for the prime minister and the chancellor to deliver those proper pay rises, and not drag this out a day longer. We’ll be keeping up the pressure on all MPs until the vote, and until all public servants get the pay rises they deserve.”

Resolve health initiative aims to save 100m lives worldwide

A new initiative to save 100 million lives globally through simple interventions such as cutting down on salt and banning trans fats, as well as getting countries prepared for epidemics like Ebola, is being launched with $ 225m of philanthropic funding.

At the helm is Dr Tom Frieden, former director of the Centers for Disease Control (CDC) in the United States and in charge of health in New York City before that. Frieden, with then-mayor Mike Bloomberg, pushed through a public smoking ban and other tobacco control measures which slashed smoking rates in the city and increased life spans. At CDC, he tackled tuberculosis, swine flu and Ebola.

The latest initiative has two distinct aims. One is to cut deaths from heart disease and stroke through three simple measures: reducing sodium intake worldwide, banning trans fats from foods in all countries and getting people with high blood pressure on treatment. The other is to help low and middle income countries prepare to deal better with the inevitable epidemics he says will come along, from flu to Sars.

He left CDC asking himself what he could do that would save most lives. “With a kind of unique privileged perspective of having been CDC director for eight years and working in global health for more than 20 years, I was able to identify a couple of areas which I believe are really at a tipping point, where there’s been a lot of good groundwork, there’s a very strong set of policies and tools available but they are somewhere between stalled and moving very slowly right now,” he told the Guardian.

Frieden is not aiming to bypass the World Health Organisation (WHO), which was heavily criticised over its handling of Ebola. He says he is a supporter of the WHO, which he worked for in India on secondment for some years. The work will support what the WHO – and the World Bank and the CDC and national governments – are doing, he says.

There were calls for the WHO to be scrapped, and although Frieden does not agree, he believes it does need help. “I think it is crucially important that we support the WHO, but I also think if the WHO is not able to deliver we can’t fail the people who need the service,” he said.

“We do see the WHO as a crucial part of the solution here, and we’d like to see them become more effective than they are now, but by doing this from a non-governmental sector, we’re able to move very quickly and very flexibly. For example, we don’t need 200 countries to agree,” he said.

“We’re not going to be reinventing the wheel. We’re going to be getting the car moving.”

Frieden will run the initiative with staff from Vital Strategies, a New York-based non-profit global health organisation, funded by Bloomberg and others, that works in 60 countries. “After more than 25 years in government it’s great to be in an organisation that can work at that pace,” he says.

The initiative, called Resolve, is being funded by Bloomberg Philanthropies, the Chan Zuckerberg Initiative and the Bill and Melinda Gates Foundation.

Cardiovascular disease causes 18 million deaths a year from heart attacks and stroke – a third of all deaths worldwide. But Frieden believes there are basic things governments can do to protect their people, such as helping to lower high blood pressure.

“Here we are really in a shameful situation,” said Frieden. “There are 1.4 billion people around the world with high blood pressure of whom 1.1 billion don’t have it under control. That’s despite the fact that the medicines are cheap, effective, safe and have been used in the west for more than 50 years. So it’s kind of ironic that we have scaled up treatment for HIV and TB and other things but not for high blood pressure, which kills more people than all infectious diseases combined and is much simpler to treat and much simpler to monitor the treatment of.”

Another easy win, he believes, is a ban on trans fats. “Why should we have a toxin in our food that isn’t necessary?” Resolve will support governments to monitor trans fats in food and get rid of them. Sodium is more tricky. “We are talking about steady gradual reduction,” he says. Some societies add a lot of salt to their food during cooking and others at the table; people like the taste. But he points out that the UK has shown that they don’t notice if salt content comes down slowly.

WHO has done some great work on epidemic preparedness, he says, but countries need help to put in place the four core elements: surveillance systems, laboratory networks, trained public health staff and rapid response.

Frieden certainly has experience of getting systems working. Nigeria stamped out the Ebola outbreak that flared dangerously in Lagos and spread to Port Harcourt. Frieden, then director of the CDC in the USA, had a hand in that.

“The first person put in charge of the outbreak was incompetent and spent more than four hours debating what to do with a corpse that had been embalmed and passed through Liberia,” said Frieden. “While he was having that four-hour debate with the entire team, a doctor and a nurse were dying in the back of an ambulance, no contacts were being traced, no facility was being found for treating Ebola patients and nothing was being done about screening at entry or exit.”

Frieden picked up the phone to the governor of Lagos state, Babatunde Fashola, for whom he has high praise. I said, “Governor – if you don’t control Ebola the only thing you will ever be remembered for is not controlling Ebola.” Fashola put the polio team in charge, who had been trained by the CDC and knew all about contact tracing and controlling outbreaks.

“They were able to build an Ebola treatment unit in 14 days, identify 893 contacts, do 17,000 home visits to measure temperatures, identify 43 people with suspected Ebola, diagnose 19 patients and stop the outbreak in two generations,” he said, reeling off the numbers from memory. “And replicate that in Port Harcourt when people went there from Lagos. If that hadn’t happened, Ebola could have swept all over Nigeria and Africa for months or years.”

The WHO and the World Bank and others are helping countries fight cardiovascular disease and prepare for the inevitable next epidemic. “We’re here to basically catalyse progress by being strategic about where rapid progress can be made. I’m just delighted at what we’re able to do,” he says.

Resolve health initiative aims to save 100m lives worldwide

A new initiative to save 100 million lives globally through simple interventions such as cutting down on salt and banning trans fats, as well as getting countries prepared for epidemics like Ebola, is being launched with $ 225m of philanthropic funding.

At the helm is Dr Tom Frieden, former director of the Centers for Disease Control (CDC) in the United States and in charge of health in New York City before that. Frieden, with then-mayor Mike Bloomberg, pushed through a public smoking ban and other tobacco control measures which slashed smoking rates in the city and increased life spans. At CDC, he tackled tuberculosis, swine flu and Ebola.

The latest initiative has two distinct aims. One is to cut deaths from heart disease and stroke through three simple measures: reducing sodium intake worldwide, banning trans fats from foods in all countries and getting people with high blood pressure on treatment. The other is to help low and middle income countries prepare to deal better with the inevitable epidemics he says will come along, from flu to Sars.

He left CDC asking himself what he could do that would save most lives. “With a kind of unique privileged perspective of having been CDC director for eight years and working in global health for more than 20 years, I was able to identify a couple of areas which I believe are really at a tipping point, where there’s been a lot of good groundwork, there’s a very strong set of policies and tools available but they are somewhere between stalled and moving very slowly right now,” he told the Guardian.

Frieden is not aiming to bypass the World Health Organisation (WHO), which was heavily criticised over its handling of Ebola. He says he is a supporter of the WHO, which he worked for in India on secondment for some years. The work will support what the WHO – and the World Bank and the CDC and national governments – are doing, he says.

There were calls for the WHO to be scrapped, and although Frieden does not agree, he believes it does need help. “I think it is crucially important that we support the WHO, but I also think if the WHO is not able to deliver we can’t fail the people who need the service,” he said.

“We do see the WHO as a crucial part of the solution here, and we’d like to see them become more effective than they are now, but by doing this from a non-governmental sector, we’re able to move very quickly and very flexibly. For example, we don’t need 200 countries to agree,” he said.

“We’re not going to be reinventing the wheel. We’re going to be getting the car moving.”

Frieden will run the initiative with staff from Vital Strategies, a New York-based non-profit global health organisation, funded by Bloomberg and others, that works in 60 countries. “After more than 25 years in government it’s great to be in an organisation that can work at that pace,” he says.

The initiative, called Resolve, is being funded by Bloomberg Philanthropies, the Chan Zuckerberg Initiative and the Bill and Melinda Gates Foundation.

Cardiovascular disease causes 18 million deaths a year from heart attacks and stroke – a third of all deaths worldwide. But Frieden believes there are basic things governments can do to protect their people, such as helping to lower high blood pressure.

“Here we are really in a shameful situation,” said Frieden. “There are 1.4 billion people around the world with high blood pressure of whom 1.1 billion don’t have it under control. That’s despite the fact that the medicines are cheap, effective, safe and have been used in the west for more than 50 years. So it’s kind of ironic that we have scaled up treatment for HIV and TB and other things but not for high blood pressure, which kills more people than all infectious diseases combined and is much simpler to treat and much simpler to monitor the treatment of.”

Another easy win, he believes, is a ban on trans fats. “Why should we have a toxin in our food that isn’t necessary?” Resolve will support governments to monitor trans fats in food and get rid of them. Sodium is more tricky. “We are talking about steady gradual reduction,” he says. Some societies add a lot of salt to their food during cooking and others at the table; people like the taste. But he points out that the UK has shown that they don’t notice if salt content comes down slowly.

WHO has done some great work on epidemic preparedness, he says, but countries need help to put in place the four core elements: surveillance systems, laboratory networks, trained public health staff and rapid response.

Frieden certainly has experience of getting systems working. Nigeria stamped out the Ebola outbreak that flared dangerously in Lagos and spread to Port Harcourt. Frieden, then director of the CDC in the USA, had a hand in that.

“The first person put in charge of the outbreak was incompetent and spent more than four hours debating what to do with a corpse that had been embalmed and passed through Liberia,” said Frieden. “While he was having that four-hour debate with the entire team, a doctor and a nurse were dying in the back of an ambulance, no contacts were being traced, no facility was being found for treating Ebola patients and nothing was being done about screening at entry or exit.”

Frieden picked up the phone to the governor of Lagos state, Babatunde Fashola, for whom he has high praise. I said, “Governor – if you don’t control Ebola the only thing you will ever be remembered for is not controlling Ebola.” Fashola put the polio team in charge, who had been trained by the CDC and knew all about contact tracing and controlling outbreaks.

“They were able to build an Ebola treatment unit in 14 days, identify 893 contacts, do 17,000 home visits to measure temperatures, identify 43 people with suspected Ebola, diagnose 19 patients and stop the outbreak in two generations,” he said, reeling off the numbers from memory. “And replicate that in Port Harcourt when people went there from Lagos. If that hadn’t happened, Ebola could have swept all over Nigeria and Africa for months or years.”

The WHO and the World Bank and others are helping countries fight cardiovascular disease and prepare for the inevitable next epidemic. “We’re here to basically catalyse progress by being strategic about where rapid progress can be made. I’m just delighted at what we’re able to do,” he says.

Moving every half hour could help limit effects of sedentary lifestyle, says study

Moving your body at least every half an hour could help to limit the harmful effects of desk jobs and other sedentary lifestyles, research has revealed.

The study found that both greater overall time spent inactive in a day, and longer periods of inactivity were linked to an increased risk of death.

“If you sit at work all day, if you sit at home a lot, then you should be really mindful of trying to take a break from your sitting habits as often as possible – at least every 30 minutes,” said Keith Diaz, co-author of the study from Columbia University Medical Center. “Even if you exercise, you still should be mindful of taking breaks and be moving throughout the day, because exercise is not enough to overcome the risks of sitting, and sitting in long bouts.”

Writing in the journal the Annals of Internal Medicine, Diaz and colleagues from seven US institutions describe how they kitted out nearly 8,000 individuals aged 45 or over from across the US with activity trackers between 2009 and 2013.

Each participant wore the fitness tracker for at least four days during a period of one week, with deaths of participants tracked until September 2015.

The results reveal that, on average, participants were inactive for 12.3 hours of a 16 hour waking day, with each period of inactivity lasting an average of 11.4 minutes.

After taking into account a host of factors including age, sex, education, smoking and high blood pressure, the team found that both the overall length of daily inactivity and the length of each bout of sedentary behaviour were linked to changes in the risk of death from any cause. The associations held even among participants undertaking moderate to vigorous physical activity.

Those who were inactive for 13.2 hours a day had a risk of death 2.6 times that of those spending less than 11.5 hours a day inactive, while those whose bouts of inactivity lasted on average 12.4 minutes or more had a risk of death almost twice that of those who were inactive for an average of less than 7.7 minutes at a time.

The team then looked at the interaction between the two measures of inactivity, finding the risk of death was greater for those who had both high overall levels of inactivity (12.5 hours a day or more) and long average bouts of sedentary behaviour (10 minutes or more), than for those who had high levels of just one of the measures.

“We were trying to understand what is the worst feature of a person’s sitting habits – is it how many hours a day you sit, or is it sitting in these long bouts,” said Diaz. “Unfortunately the message is more mixed … it looks like both are bad for you.”

Further analysis looking at how participants split up their stints of inactivity found that those who kept most of their bouts to under 30 minutes at a time had the lowest risk of death while the team also discovered that the longer, more frequent and more intense the breaks from inactivity the better.

While the study was funded by the US National Institutes of Health and Coca-Cola, neither were involved in the research.

The latest study is not the first to probe the health impacts of prolonged periods of inactivity, but the team say their use of activity trackers is a step up as it does not rely on self-reporting, which is less accurate.

But, they note, the study does not show that inactivity causes death, and the tracker could not tell whether individuals were sitting or just standing still.

What’s more, factors such as smoking status and blood pressure were only captured once, and the activity trackers were only worn over one week, meaning that changes in the health or behaviour of participants over time was not taken into account.

Nevertheless, the team say the study underscores the need for individuals to take breaks from inactivity. “The longer the better, the more intense the better,” said Diaz.

Dr Mike Loosemore from the Institute of Sport, Exercise and Health, who was not involved in the research, said sedentary behaviour was contributing to increasing levels of obesity, adding that being more active did not require huge efforts.

“You can do simple things like stand up to answer the phone, maybe instead of getting a full glass of water from the kitchen get half a glass and then go twice as often,” he said. “Just simple things that every half hour give you an excuse to stand up and move around a bit.”