Tag Archives: because

As a GP I’m not holding out on antibiotics because I’m a sadist | Elizabeth Oliver

I have two shortcuts in my medical software for this time of year.

Flu 1

“Has had joint aches, fever, vomiting, sore eyes and throat for three days. Now dry cough, severe fatigue. Feels like hit by bus. Usually fit and well. Looks terrible.”

I enter the specific features of their misery. Then comes my other shortcut.

Flu 2

“Advised regular paracetamol, ibuprofen. Rest, Netflix. Return in 72 hours if ongoing fever, develops chest pain, shortness of breath or heavily productive cough. Frequent hand washing. Avoid small babies, elderly and public transport. Advised recovery can take a month. Advised consider vaccination next year.”

Friends, the time is upon us. GPs are lining up the stethoscope, thermometer and tongue depressor on their desks. There will be at least eight people a day for the next four months who will roll in and say they have the flu, and they need something to “get it gone” by tomorrow, because they have canteen duty, or three kids, or they’re flying to Madrid. In the interest of my vocal cords, let’s clear up a few things.

  1. People will say that because they feel so awful, they must need antibacterials. But a virus and a bacteria are not opposite ends of the same spectrum of illness. They are totally different organisms. Antibiotics target the cell membrane of bacteria. Viruses do not have a cell membrane. They are not a cell. They are a piece of genetic code with some protein. I feel bad for you, son, but doctors aren’t holding out on you because they’re sadists. When you take antibiotics for influenza, the virus skips around between your dying hoards of healthy gut bacteria, laughing maniacally and breaking everything, like a toddler loose in a supermarket.
  2. Among the influenza, there will be at least five times as many people who get the “common cold.” A snotty nose and feeling a bit fuzzy is not “the flu.” Influenza (flu) is that thing you had that time – if you could have made your brain work, you would have worried you were dying. Some of you cried. Some of you called an ambulance. You remember it forever and recount the tale at family get-togethers. The common cold viruses cause some of the same symptoms as influenza, but are nowhere near as deadly, or unpleasant.
  3. Nothing will “get it gone.” If you see a doctor within the first few days of an influenza-like illness, you can invest in antiviral treatment (around $ 50), which may slightly lessen the severity. But to be honest, waiting out influenza is like dealing with the ATO, or being stuck in an elevator. Patient, calm, vigilant suffering is the order of the day.
  4. The vaccine is a gamble. It’s redeveloped seasonally, and last year the virus pulled a Jason Bourne and mutated after vaccine production had started. The vaccine was therefore misdirected, and we had twice the average number of cases. But for me, the odds are a no-brainer especially with everyone coughing in my face. Last year at least 3,000 Australians died of influenza, including healthy young adults and children. None died of the vaccine. I like it so much I have two – one in May and one in August, for the late comers.

If you’re sick and worried, see a doctor. “Just a virus” is about the stupidest phrase ever. (HIV is just a virus. Other strong performers include polio, Ebola, rabies, smallpox and herpes.) Influenza can be incredibly dangerous, as evidenced by the tragic deaths last season. Your doctor’s job is to assess how your body is handling the virus and whether you’re heading off road and need extra help in hospital. Other sneaky infections hide in the wave of influenza, and while they examine you, your GP is thinking about meningitis, measles, true bacterial lung infections and similar bad-ass rarities.

So if you’re sick, come on in. Just put on a mask in the waiting room. And understand that the doctor who writes you a script for antibiotics after 30 seconds is giving you what you think you need (as well as thrush and irritable bowel), therefore ensuring future business and saving themselves time. The doctor who elicits your particular cluster of symptoms, considers your medical history, examines you for signs of impending doom and writes you a medical certificate is doing the right thing by you and the people around you.

Elizabeth Oliver is a practicing GP and RACGP fellow. She blogs at That Lady Doctor

As a GP I’m not holding out on antibiotics because I’m a sadist | Elizabeth Oliver

I have two shortcuts in my medical software for this time of year.

Flu 1

“Has had joint aches, fever, vomiting, sore eyes and throat for three days. Now dry cough, severe fatigue. Feels like hit by bus. Usually fit and well. Looks terrible.”

I enter the specific features of their misery. Then comes my other shortcut.

Flu 2

“Advised regular paracetamol, ibuprofen. Rest, Netflix. Return in 72 hours if ongoing fever, develops chest pain, shortness of breath or heavily productive cough. Frequent hand washing. Avoid small babies, elderly and public transport. Advised recovery can take a month. Advised consider vaccination next year.”

Friends, the time is upon us. GPs are lining up the stethoscope, thermometer and tongue depressor on their desks. There will be at least eight people a day for the next four months who will roll in and say they have the flu, and they need something to “get it gone” by tomorrow, because they have canteen duty, or three kids, or they’re flying to Madrid. In the interest of my vocal cords, let’s clear up a few things.

  1. People will say that because they feel so awful, they must need antibacterials. But a virus and a bacteria are not opposite ends of the same spectrum of illness. They are totally different organisms. Antibiotics target the cell membrane of bacteria. Viruses do not have a cell membrane. They are not a cell. They are a piece of genetic code with some protein. I feel bad for you, son, but doctors aren’t holding out on you because they’re sadists. When you take antibiotics for influenza, the virus skips around between your dying hoards of healthy gut bacteria, laughing maniacally and breaking everything, like a toddler loose in a supermarket.
  2. Among the influenza, there will be at least five times as many people who get the “common cold.” A snotty nose and feeling a bit fuzzy is not “the flu.” Influenza (flu) is that thing you had that time – if you could have made your brain work, you would have worried you were dying. Some of you cried. Some of you called an ambulance. You remember it forever and recount the tale at family get-togethers. The common cold viruses cause some of the same symptoms as influenza, but are nowhere near as deadly, or unpleasant.
  3. Nothing will “get it gone.” If you see a doctor within the first few days of an influenza-like illness, you can invest in antiviral treatment (around $ 50), which may slightly lessen the severity. But to be honest, waiting out influenza is like dealing with the ATO, or being stuck in an elevator. Patient, calm, vigilant suffering is the order of the day.
  4. The vaccine is a gamble. It’s redeveloped seasonally, and last year the virus pulled a Jason Bourne and mutated after vaccine production had started. The vaccine was therefore misdirected, and we had twice the average number of cases. But for me, the odds are a no-brainer especially with everyone coughing in my face. Last year at least 3,000 Australians died of influenza, including healthy young adults and children. None died of the vaccine. I like it so much I have two – one in May and one in August, for the late comers.

If you’re sick and worried, see a doctor. “Just a virus” is about the stupidest phrase ever. (HIV is just a virus. Other strong performers include polio, Ebola, rabies, smallpox and herpes.) Influenza can be incredibly dangerous, as evidenced by the tragic deaths last season. Your doctor’s job is to assess how your body is handling the virus and whether you’re heading off road and need extra help in hospital. Other sneaky infections hide in the wave of influenza, and while they examine you, your GP is thinking about meningitis, measles, true bacterial lung infections and similar bad-ass rarities.

So if you’re sick, come on in. Just put on a mask in the waiting room. And understand that the doctor who writes you a script for antibiotics after 30 seconds is giving you what you think you need (as well as thrush and irritable bowel), therefore ensuring future business and saving themselves time. The doctor who elicits your particular cluster of symptoms, considers your medical history, examines you for signs of impending doom and writes you a medical certificate is doing the right thing by you and the people around you.

Elizabeth Oliver is a practicing GP and RACGP fellow. She blogs at That Lady Doctor

As a GP I’m not holding out on antibiotics because I’m a sadist | Elizabeth Oliver

I have two shortcuts in my medical software for this time of year.

Flu 1

“Has had joint aches, fever, vomiting, sore eyes and throat for three days. Now dry cough, severe fatigue. Feels like hit by bus. Usually fit and well. Looks terrible.”

I enter the specific features of their misery. Then comes my other shortcut.

Flu 2

“Advised regular paracetamol, ibuprofen. Rest, Netflix. Return in 72 hours if ongoing fever, develops chest pain, shortness of breath or heavily productive cough. Frequent hand washing. Avoid small babies, elderly and public transport. Advised recovery can take a month. Advised consider vaccination next year.”

Friends, the time is upon us. GPs are lining up the stethoscope, thermometer and tongue depressor on their desks. There will be at least eight people a day for the next four months who will roll in and say they have the flu, and they need something to “get it gone” by tomorrow, because they have canteen duty, or three kids, or they’re flying to Madrid. In the interest of my vocal cords, let’s clear up a few things.

  1. People will say that because they feel so awful, they must need antibacterials. But a virus and a bacteria are not opposite ends of the same spectrum of illness. They are totally different organisms. Antibiotics target the cell membrane of bacteria. Viruses do not have a cell membrane. They are not a cell. They are a piece of genetic code with some protein. I feel bad for you, son, but doctors aren’t holding out on you because they’re sadists. When you take antibiotics for influenza, the virus skips around between your dying hoards of healthy gut bacteria, laughing maniacally and breaking everything, like a toddler loose in a supermarket.
  2. Among the influenza, there will be at least five times as many people who get the “common cold.” A snotty nose and feeling a bit fuzzy is not “the flu.” Influenza (flu) is that thing you had that time – if you could have made your brain work, you would have worried you were dying. Some of you cried. Some of you called an ambulance. You remember it forever and recount the tale at family get-togethers. The common cold viruses cause some of the same symptoms as influenza, but are nowhere near as deadly, or unpleasant.
  3. Nothing will “get it gone.” If you see a doctor within the first few days of an influenza-like illness, you can invest in antiviral treatment (around $ 50), which may slightly lessen the severity. But to be honest, waiting out influenza is like dealing with the ATO, or being stuck in an elevator. Patient, calm, vigilant suffering is the order of the day.
  4. The vaccine is a gamble. It’s redeveloped seasonally, and last year the virus pulled a Jason Bourne and mutated after vaccine production had started. The vaccine was therefore misdirected, and we had twice the average number of cases. But for me, the odds are a no-brainer especially with everyone coughing in my face. Last year at least 3,000 Australians died of influenza, including healthy young adults and children. None died of the vaccine. I like it so much I have two – one in May and one in August, for the late comers.

If you’re sick and worried, see a doctor. “Just a virus” is about the stupidest phrase ever. (HIV is just a virus. Other strong performers include polio, Ebola, rabies, smallpox and herpes.) Influenza can be incredibly dangerous, as evidenced by the tragic deaths last season. Your doctor’s job is to assess how your body is handling the virus and whether you’re heading off road and need extra help in hospital. Other sneaky infections hide in the wave of influenza, and while they examine you, your GP is thinking about meningitis, measles, true bacterial lung infections and similar bad-ass rarities.

So if you’re sick, come on in. Just put on a mask in the waiting room. And understand that the doctor who writes you a script for antibiotics after 30 seconds is giving you what you think you need (as well as thrush and irritable bowel), therefore ensuring future business and saving themselves time. The doctor who elicits your particular cluster of symptoms, considers your medical history, examines you for signs of impending doom and writes you a medical certificate is doing the right thing by you and the people around you.

Elizabeth Oliver is a practicing GP and RACGP fellow. She blogs at That Lady Doctor

As a GP I’m not holding out on antibiotics because I’m a sadist | Elizabeth Oliver

I have two shortcuts in my medical software for this time of year.

Flu 1

“Has had joint aches, fever, vomiting, sore eyes and throat for three days. Now dry cough, severe fatigue. Feels like hit by bus. Usually fit and well. Looks terrible.”

I enter the specific features of their misery. Then comes my other shortcut.

Flu 2

“Advised regular paracetamol, ibuprofen. Rest, Netflix. Return in 72 hours if ongoing fever, develops chest pain, shortness of breath or heavily productive cough. Frequent hand washing. Avoid small babies, elderly and public transport. Advised recovery can take a month. Advised consider vaccination next year.”

Friends, the time is upon us. GPs are lining up the stethoscope, thermometer and tongue depressor on their desks. There will be at least eight people a day for the next four months who will roll in and say they have the flu, and they need something to “get it gone” by tomorrow, because they have canteen duty, or three kids, or they’re flying to Madrid. In the interest of my vocal cords, let’s clear up a few things.

  1. People will say that because they feel so awful, they must need antibacterials. But a virus and a bacteria are not opposite ends of the same spectrum of illness. They are totally different organisms. Antibiotics target the cell membrane of bacteria. Viruses do not have a cell membrane. They are not a cell. They are a piece of genetic code with some protein. I feel bad for you, son, but doctors aren’t holding out on you because they’re sadists. When you take antibiotics for influenza, the virus skips around between your dying hoards of healthy gut bacteria, laughing maniacally and breaking everything, like a toddler loose in a supermarket.
  2. Among the influenza, there will be at least five times as many people who get the “common cold.” A snotty nose and feeling a bit fuzzy is not “the flu.” Influenza (flu) is that thing you had that time – if you could have made your brain work, you would have worried you were dying. Some of you cried. Some of you called an ambulance. You remember it forever and recount the tale at family get-togethers. The common cold viruses cause some of the same symptoms as influenza, but are nowhere near as deadly, or unpleasant.
  3. Nothing will “get it gone.” If you see a doctor within the first few days of an influenza-like illness, you can invest in antiviral treatment (around $ 50), which may slightly lessen the severity. But to be honest, waiting out influenza is like dealing with the ATO, or being stuck in an elevator. Patient, calm, vigilant suffering is the order of the day.
  4. The vaccine is a gamble. It’s redeveloped seasonally, and last year the virus pulled a Jason Bourne and mutated after vaccine production had started. The vaccine was therefore misdirected, and we had twice the average number of cases. But for me, the odds are a no-brainer especially with everyone coughing in my face. Last year at least 3,000 Australians died of influenza, including healthy young adults and children. None died of the vaccine. I like it so much I have two – one in May and one in August, for the late comers.

If you’re sick and worried, see a doctor. “Just a virus” is about the stupidest phrase ever. (HIV is just a virus. Other strong performers include polio, Ebola, rabies, smallpox and herpes.) Influenza can be incredibly dangerous, as evidenced by the tragic deaths last season. Your doctor’s job is to assess how your body is handling the virus and whether you’re heading off road and need extra help in hospital. Other sneaky infections hide in the wave of influenza, and while they examine you, your GP is thinking about meningitis, measles, true bacterial lung infections and similar bad-ass rarities.

So if you’re sick, come on in. Just put on a mask in the waiting room. And understand that the doctor who writes you a script for antibiotics after 30 seconds is giving you what you think you need (as well as thrush and irritable bowel), therefore ensuring future business and saving themselves time. The doctor who elicits your particular cluster of symptoms, considers your medical history, examines you for signs of impending doom and writes you a medical certificate is doing the right thing by you and the people around you.

Elizabeth Oliver is a practicing GP and RACGP fellow. She blogs at That Lady Doctor

Pumarosa’s Isabel Munoz-Newsome: ‘I didn’t get a smear test because I was embarrassed. Stupid’

Almost exactly a year ago, I watched Pumarosa flood the cavernous Oval Space in east London with a swell of moody psych rock, heady and hypnotic on the eve of releasing their debut album, The Witch. The rest of the European tour, followed by festivals and a worldwide slot supporting Depeche Mode, was on the horizon. The band were giddy and, after the gig, their friends celebrated by putting on a warehouse party.

“It was great, everyone was going totally wild,” says frontwoman Isabel Munoz-Newsome, picking at poached eggs in a Brighton cafe. But she had been for some tests at the doctor’s a few days before and, at the back of her mind, a tiny voice nagged. Two weeks later, as the album picked up a string of stunning reviews, Munoz-Newsome was diagnosed with cervical cancer.

“I want to talk about it because I’d never had a smear test until then and that’s the only reason I found out,” she says, with quiet urgency. We have spent half an hour chatting about rave culture, small towns, sisters and Patti Smith before she admits awkwardly that the last year of Pumarosa’s success has been the weirdest of her life. “At a time when everything should have been pure magic and everyone was happy and congratulating us, I was so angry. It was surreal. Doing the Jools Holland show and all that stuff, I just thought: ‘What the fuck am I doing here?’”

She had not felt unwell beforehand, but within a month of the diagnosis Munoz-Newsome was operated on and her cervix was removed. “It was pretty gruesome, but [my] womb and everything is still intact, so I’m still getting periods and that’s still functioning, but …” She laughs bleakly. “But getting a smear test every three years is so important.” She can’t emphasise this enough, she says, because she knows so many women make excuses or miss appointments or believe a lack of symptoms means they don’t have to bother; attendance for cervical screenings in the UK was reported in January to be at a 20-year low. “I was so angry at myself that I just hadn’t gone because I was embarrassed. Isn’t that ridiculous? I was embarrassed by my own body. Stupid.”

[embedded content]

‘Doing the Jools Holland show and all that stuff, I just thought: “What the fuck am I doing here?”’

Munoz-Newsome founded Pumarosa three years ago with her boyfriend Nick Owen, the band’s drummer. The couple left behind the inner-city squat and DIY scene to move to the quieter, outer edges of London last year. She has more space to paint there (the band’s artwork is all hers) and write their songs in a less claustrophobic setting. While the cancer has now gone and she is OK, it has forced her to think about new things and to ask new questions.

“It’s harder to get pregnant,” she says, by way of example. “And once you are pregnant it’s just harder for it to not have complications because you don’t have a cervix. The other thing that was quite weird, which I’d never thought about is: if I do get pregnant, I won’t be able to give birth – it would have to be a caesarean, because [my uterus] is stitched up.” Her hands swoop for emphasis and her chest rises with her voice.

“I’d never considered that I’d never do that thing that’s so primal, and part of me really wanted to; I was super sad about it. When I read that, going through all the implications of the operation, I just broke down. And I was so shocked, because it’s not something I would’ve thought of, and they don’t tell you that stuff at the hospital – I was reading it on the internet, finding out for myself.” She didn’t know beforehand? “They don’t tell you,” she shrugs.

Munoz-Newsome’s mother is an artist who marked the birth of her elder daughter with an extensive photography project. “The whole of my birth is documented in photos. And when I was little we weren’t allowed to watch scary movies, so we’d look at that album. It’s really progressive and really radical and they’re beautiful photos, but we just thought: ‘Blood! Eurgh!’” She laughs, softening the stiff irony hanging in the air.

Munoz-Newsome grew up in Bath with her sister, Fernanda, in a spirited, creative household; their Chilean father is an illustrator and their mother now lectures part-time in fine art. Both daughters moved to London for art school: Fernanda has become a dance artist and something of a muse to her sister; Isabel studied theatre design and helped create sets for plays in pub theatres and the National before music became full-time.

Isabel Munoz-Newsome on stage with Pumarosa in 2016


Munoz-Newsome on stage with Pumarosa in 2016. Photograph: Graeme Robertson for the Guardian

“Fernanda is a big point of gravity in my life, I suppose – loads of stuff revolves around her. Even without realising it.” The two share circles of friends and explored London’s hedonistic elements together in their 20s.

Priestess, the seductive lead single from The Witch, was inspired by her sister’s performances, with a nod to Victorian occultism and pagan folklore. The concept of the album itself came via a copy of Silvia Federici’s cult Marxist-feminist text, Caliban and the Witch, which Isabel had borrowed from Fernanda.

“It’s an incredible piece of work about the transition from feudalism to capitalism from the female perspective,” she says. Federici centres on the dark saga of the 15th-century witch hunts that consumed Europe with terror for more than 200 years; the book challenges the idea that capitalism was a progressive or necessary development by revealing its reliance on spectacular violence against women.


I used to be obsessive with certain things to do with the band – but I can’t worry about it any more

“It was just completely eye-opening to read that, prior to that, women had actually occupied quite a different place in society in England, France, Italy. They were metalworkers, they worked in fields and were strong – we are strong – and men did lots of things that have now come to be traditionally seen as women’s work. The idea that the church was at one point setting up more and more brothels to push the idea of the woman as a whore is mindblowing, but learning it as a woman is so powerful – it’s freedom.”

The book became a source of energy for her, she explains; it also inspired the band’s current single, Lions’ Den. “It’s empowering to realise that this isn’t just the natural order of things, it didn’t naturally occur – it was horrifically pinned on us. Men, too.”

Federici writes about the multiple ways women have been vilified in history, “accused of being unreasonable, vain, wild, wasteful”. “Especially blamed was the female tongue, seen as an instrument of insubordination,” Federici argues. The tropes of the disobedient wife, the witch, the shrew, pervaded popular culture of the period; Shakespeare’s works could be read as a manifesto of the age.

Munoz-Newsome is beguiling on stage – all limbs and joyful abandonment – but enthusiastic, unpretentious company. She talks about growing up in love with “tacky dance music like Baby D, N-Trance, fairground music”, grateful that Somerset felt a less self-conscious place to be a teenager, compared with the capital. The night before we meet, the band play a sellout show in Brighton to a largely male audience. Today, they have been announced on the bill for Robert Smith’s pleasingly doomy but inescapably blokey Meltdown. How does she feel about the way she is inevitably objectified as ‘the sexy frontwoman’?

[embedded content]

Listen to Priestess by Pumarosa.

“It’s strange,” she admits. “When you’re a teenager, that’s all you want, so you kind of have to try and enjoy it. Last night felt fine, the energy was nice, but occasionally it’s gross and there are certain gigs where I feel I’m responding to it on stage but don’t feel so good afterwards.” Munoz-Newsome catches herself sometimes, uncomfortable at the pressure to look the part of the enigmatic, beautiful, blond waif. “It would be so much cooler just to be, like: ‘Fuck this.’ But I’ve always loved dressing up and playing with costumes; I don’t want to limit that for myself. Earlier on, I was more conventional in what I was trying to do and it was boring.”

Ultimately, women are conditioned to worry about the way they look. “Yes. It’s like having a radio on in the back of your head all the time saying something that’s completely unintellectual and not very interesting, but you can’t help listening to it.” We come back to Federici: “It’s just a symptom of capitalism; apparently, women spend something mad like up to 30% of their income on their appearance. There’s a huge industry playing on our insecurities. It’s disgusting.”

Outside, a jagged wind and rain whip against the cafe windows. It is resolutely gloomy, but Munoz-Newsome is sanguine. “I used to be quite obsessive with certain things to do with the band and so anxious about not being exploited as a woman and as artists – that’s just the way the industry has been set up – but I can’t worry about it any more,” she says. The shock of cancer hasn’t changed her outlook, but it has offered perspective. “Now I find a way to constructively get over [anxiety] – when I feel it creeping up, I just think: ‘Breathe! And do something else.”

Pumarosa play Meltdown festival at the Queen Elizabeth Hall on 23 June. Their new single, Lions’ Den, taken from the album The Witch, is out now

Children’s teeth rotting in their mouths because of sugary foods, say experts

A child has a rotten tooth pulled out in hospital every 10 minutes, Public Health England (PHE) has said, appealing to parents at the launch of the government’s sugar tax to switch their children’s drinks to mostly milk and water.

Sugar-sweetened soft drinks are the main source of the sugar that children consume. While the levy on high-sugar drinks is a response to the obesity crisis – 20% of children in the last year of primary school in England are now obese – there is huge concern about children’s teeth as well.

Every day, 141 children have teeth extracted in hospital and some are as young as one year old. It is the most common reason for children aged 5 to 9 to be admitted to hospital, causing 60,000 missed days of school each year. Children with decayed teeth suffer pain and problems with eating and sleeping, says PHE. The cost to the NHS is £3.4bn a year.

The sugar levy on the manufacturers of soft drinks will hike the price of a litre of high sugar drink (8g of sugar per 100ml) by 24p. Drinks with 5g per 100ml will go up by 18p a litre – if the manufacturers pass the tax to shoppers. Some companies have replaced sugar with artificial sweeteners and have avoided the tax. Others, like Coca-Cola, have chosen to stick with the recipe for their original brand which will rise in price, while pointing out they offer a zero-sugar version too.

But the tax will solve neither obesity nor tooth decay and PHE is urging parents to change their children’s eating and drinking habits.

“It’s upsetting to see so many children admitted to hospital with tooth decay, but swapping out sugary drinks could be an easy win for busy families,” said Dr Sandra White, dental lead for Public Health England.

“Parents can also help prevent decay by making sure their children’s teeth are brushed twice a day with fluoride toothpaste and reducing the amount of sugar they’re eating and drinking.”

The budget for public health sits with the local authorities. “These shocking figures strengthen the need for urgent investment in oral health education so that parents and children understand the impact of sugar on teeth and the importance of good oral hygiene,” said Izzi Seccombe, chairman of the Local Government Association’s Community Wellbeing Board.

“Untreated dental care remains one of the most prevalent and preventable diseases affecting children and young people’s ability to speak, eat, play and socialise.”

PHE suggests families should look at the advice on the Change4Life website on swapping to low fat milky drinks, water and low sugar drinks. Fruit juice and smoothies should be limited to 150ml a day. They may appear healthy but contain large amounts of natural sugars. Children should brush their teeth twice a day, including before bedtime, using fluoride toothpaste, says PHE.

The introduction of the sugar tax has been applauded by health campaigners. Caroline Cerny, Obesity Health Alliance lead, said it was great news that the levy was in force and that many manufacturers had reduced the sugar levels in their drinks. “We’re all eating more sugar than is recommended and sugary soft drinks contribute to this – particularly in teens where sugary drinks are their top source of sugar. They provide empty calories and contribute not only to rising levels of obesity but also to poor dental health,” she said.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs said: “Obesity can have a devastating impact on our patients’ long-term health and wellbeing, but we are particularly concerned about the increasing rates of obesity in children and young people – this is setting them up for a life plagued with serious health conditions, including increased risks of a range of cancers as well as diabetes and heart disease.” She added that they were working to help GPs have the “incredibly sensitive conversations” with parents about tackling their children’s weight.

Children’s teeth rotting in their mouths because of sugary foods, say experts

A child has a rotten tooth pulled out in hospital every 10 minutes, Public Health England (PHE) has said, appealing to parents at the launch of the government’s sugar tax to switch their children’s drinks to mostly milk and water.

Sugar-sweetened soft drinks are the main source of the sugar that children consume. While the levy on high-sugar drinks is a response to the obesity crisis – 20% of children in the last year of primary school in England are now obese – there is huge concern about children’s teeth as well.

Every day, 141 children have teeth extracted in hospital and some are as young as one year old. It is the most common reason for children aged 5 to 9 to be admitted to hospital, causing 60,000 missed days of school each year. Children with decayed teeth suffer pain and problems with eating and sleeping, says PHE. The cost to the NHS is £3.4bn a year.

The sugar levy on the manufacturers of soft drinks will hike the price of a litre of high sugar drink (8g of sugar per 100ml) by 24p. Drinks with 5g per 100ml will go up by 18p a litre – if the manufacturers pass the tax to shoppers. Some companies have replaced sugar with artificial sweeteners and have avoided the tax. Others, like Coca-Cola, have chosen to stick with the recipe for their original brand which will rise in price, while pointing out they offer a zero-sugar version too.

But the tax will solve neither obesity nor tooth decay and PHE is urging parents to change their children’s eating and drinking habits.

“It’s upsetting to see so many children admitted to hospital with tooth decay, but swapping out sugary drinks could be an easy win for busy families,” said Dr Sandra White, dental lead for Public Health England.

“Parents can also help prevent decay by making sure their children’s teeth are brushed twice a day with fluoride toothpaste and reducing the amount of sugar they’re eating and drinking.”

The budget for public health sits with the local authorities. “These shocking figures strengthen the need for urgent investment in oral health education so that parents and children understand the impact of sugar on teeth and the importance of good oral hygiene,” said Izzi Seccombe, chairman of the Local Government Association’s Community Wellbeing Board.

“Untreated dental care remains one of the most prevalent and preventable diseases affecting children and young people’s ability to speak, eat, play and socialise.”

PHE suggests families should look at the advice on the Change4Life website on swapping to low fat milky drinks, water and low sugar drinks. Fruit juice and smoothies should be limited to 150ml a day. They may appear healthy but contain large amounts of natural sugars. Children should brush their teeth twice a day, including before bedtime, using fluoride toothpaste, says PHE.

The introduction of the sugar tax has been applauded by health campaigners. Caroline Cerny, Obesity Health Alliance lead, said it was great news that the levy was in force and that many manufacturers had reduced the sugar levels in their drinks. “We’re all eating more sugar than is recommended and sugary soft drinks contribute to this – particularly in teens where sugary drinks are their top source of sugar. They provide empty calories and contribute not only to rising levels of obesity but also to poor dental health,” she said.

Professor Helen Stokes-Lampard, chair of the Royal College of GPs said: “Obesity can have a devastating impact on our patients’ long-term health and wellbeing, but we are particularly concerned about the increasing rates of obesity in children and young people – this is setting them up for a life plagued with serious health conditions, including increased risks of a range of cancers as well as diabetes and heart disease.” She added that they were working to help GPs have the “incredibly sensitive conversations” with parents about tackling their children’s weight.

The UK’s getting fatter – because we’re eating much more than we realise | Michael Hallsworth

We’re hugely under-estimating our daily calories – so the way we consume food needs to be overhauled

Pepperoni pizza in a takeaway box.


‘Men are consuming 1,000 more calories a day than previous figures suggested. This is the equivalent of not reporting that you ate a whole pepperoni pizza.’ Photograph: MBI/Alamy

Can you remember what you ate yesterday? If asked, most people will be able to dredge up a vague description of their main meals: breakfast, lunch, dinner. But can you be sure you’ve noted every snack bar en route to the car, or every handful of nuts at your desk? Most people will have the lingering feeling that they’ve missed something out.

We originally had this suspicion back in 2016, puzzled by the fact that national statistics showed calorie consumption falling dramatically over past decades. We found ​reliable evidence that people were drastically under-reporting what they ate – and the problem was getting worse over time.

Now the Office for National Statistics has responded tto our report by confirming its findings: we are consuming 50% more calories than our national statistics claim.


If people do not know how much they are eating, it can be really hard for people to stick to a diet

Why is this happening? We can point to at least three potential causes. One is the rise in obesity levels itself. There is good evidence ​that under-reporting rates are much higher for obese people. The main reason for this seems to be that obese people simply consume more food, and thus have more to remember.

Another cause is that the proportion of people who are trying to lose weight has been increasing over time (from 40% in 1997 to 50% in 2013, for example). People who want to lose weight are around 10 percentage points more likely ​to under-report their eating – regardless of whether they are overweight or not. This may be driven partly by self-deception or “wishful thinking”.

The final potential cause is an increase in snacking and eating out over recent decades – both in terms of how often they happen and how much they contribute to our overall energy intake. The amount of time spent eating out doubled ​between 1975 and 2000, for example. By 2015, one in five meals was eaten outside the home. This trend means it is more difficult for us to keep track of what we eat, not least because we have to remember more eating events. Again, there is evidence for this – food consumed out of the home is one of the most poorly recorded categories in surveys.

We will be presenting these findings in a BBC documentary called The Truth About Obesity. However, we want to stress that they are not just interesting statistical nuggets. First, the differences we are talking about are huge – men are consuming 1,000 more calories a day than previous figures suggested. This is the equivalent of not reporting that you ate a whole pepperoni pizza.

Second, these statistics guide and underpin policy. There is much concern about the health effects of obesity, but what do we do to reduce it? Based on the old numbers, our food consumption would not be seen as the problem: it seems to be below recommended intakes, and falling. So policymakers may be tempted to look elsewhere – perhaps to increasing physical activity instead. We showed that this is not the most effective way of preventing obesity, given that it takes much more effort to burn calories than consume them.

So, what’s the takeaway? For statistics, we should invest in more accurate measurement options – these do exist, but they can be expensive. For policy, we need to focus on options that make it easy for people to eat fewer calories. If people do not know how much they are eating, it can be really hard for people to stick to a diet. Instead, we should be looking for new ways to incentivise and achieve food reformulation. If this works, then people would not need to try to eat less – it’s just that what they eat won’t have the same impact on their waistlines. And it won’t matter so much if they can’t remember whether it was a muffin or a croissant yesterday morning.

Michael Hallsworth is director of health and tax at the social purpose company, Behavioural Insights Team

Lena Dunham has total hysterectomy because of endometriosis

Actor tells of radical surgery in attempt to end years of chronic pain from debilitating disease

Lena Dunham


Lena Dunham said the decision to have surgery was a tough one but that she felt more positive about the future. Photograph: Richard Shotwell/Invision/AP

Lena Dunham, the star and creator of the HBO comedy series Girls, has undergone radical surgery to remove her uterus and cervix in an attempt to rid herself of the debilitating disease endometriosis.

The actor, 31, announced her total hysterectomy in an essay in Vogue. She hopes to end the chronic pain she has suffered as well as the “years of complex surgeries measuring in the double digits”.

The decision was a tough one, she said, because she would like children, but she said she felt more positive about the future, hopefully free of a neglected disease that affects an estimated 176 million women worldwide.

“I may have felt choiceless before, but I know I have choices now,” she wrote. “Soon I’ll start exploring whether my ovaries, which remain someplace inside me in that vast cavern of organs and scar tissue, have eggs. Adoption is a thrilling truth I’ll pursue with all my might.”

Endometriosis was for decades a taboo subject – a disease caused by tissue similar to the lining of the womb growing elsewhere, most commonly in the abdomen, ovaries, in the rectovaginal septum, bladder and bowel. The tissue behaves like the lining of the womb, bleeding every month. It can cause such severe and chronic pain that women pass out or are admitted to hospital. Surgery is complex because the tissue grows around organs and fuses them together.

Many women suffer every month for years, unable to attend school, college or their job because of the crippling pain they suffer. Doctors do not always recognise it, assuming it is period pain. If women are referred to a gynaecologist and diagnosed, they may still not get specialist treatment for a condition which is still not well understood.

Dunham has been vocal about her suffering. She has tried every sort of alternative treatment, and lists “pelvic floor therapy, massage therapy, pain therapy, color therapy, acupuncture” and yoga. Neither those nor conventional medical interventions worked long term.

She has been admitted to hospital three times in less than a year. She thought it was all over last April, when she announced she was free of endometriosis after surgery to separate her ovaries from her rectal wall. During her appearance at the Met Gala in New York a few weeks later, however, she was rushed to hospital with complications.

Dunham promptly cancelled her nationwide Lenny IRL tour of six cities. She told fans she was “in the greatest amount of physical pain that I have ever experienced” after doctors discovered more endometriosis.

Experts say the lack of research and funding for a disease that affects one in 10 women of reproductive age is a scandal. “Endometriosis affects women in the prime of their life. It is not a lifestyle disease. It is not a disease you get later in life. It attacks teens, young women when they should be out being active, working, having children, having sex – 50% of them are struggling with sex because it is too painful,” Lone Hummelshoj, who heads the World Endometriosis Research Foundation and the World Endometriosis Society, told a Guardian investigation.

Surgery can end a woman’s suffering if all the rogue tissue is removed. Dunham’s total hysterectomy will only be a cure if none is found elsewhere in her abdomen or bowel.

When she awoke after surgery, Dunham was told her reproductive organs were in a worse state than had been thought. “In addition to endometrial disease, an odd hump-like protrusion and a septum running down the middle, I have retrograde bleeding, aka my period running in reverse so that my stomach is full of blood,” she said. “My ovary has settled in on the muscles around the sacral nerves in my back that allow us to walk. Let’s please not even talk about my uterine lining. The only beautiful detail is that the organ – which is meant to be shaped like a light bulb – was shaped like a heart.”

Endometriosis is always a feature in relationships – EndoActive interviewed 15 women about their experiences of sex, intimacy and living with endometriosis

Dunham is not the only celebrity to have tried to break the silence around endometriosis. Others affected include Emma Bunton, Dolly Parton, Anna Friel, Hilary Mantel, Susan Sarandon and Whoopi Goldberg. After the Guardian’s investigation, the former MP Oona King spoke out about her experiences in the House of Commons.

“When I was stretchered out of the House of Commons in an ambulance, after collapsing on the floor after six hours of earth-shattering pain, one of the attendants whispered, ‘MPs aren’t allowed to die in the palace’. I remember thinking, although I was a supposedly healthy 32-year-old, ‘maybe I am actually dying’,” she wrote. Five days of every month she was incapacitated and unable to give speeches, she said, and the disease made her infertile.

The NHS is suffering because it has become a political football | Letters

Everything in Britain is seen through the prism of tribal ideology

Health secretary Jeremy Hunt is questioned by MPs about the winter crisis in the NHS.


Health secretary Jeremy Hunt is questioned by MPs about the winter crisis in the NHS. Photograph: HO/AFP/Getty Images

While I would not wish to disagree with the thrust of your major article on the National Health Service (“Voices from the frontline”, Review), we are not going to make serious inroads if we don’t ask the right questions. I would suggest the question is not: “How do we better manage health?”, but :“How do we better manage Britain?”

We all know that our society needs more doctors, hospital beds and money. We know that the tremendous input from science and technology is a huge expense. Yet we don’t have sufficient doctors, beds or money. The spending on health in Britain is lower than other comparable countries. We have said this for years, but the answer has always been – as to Boxer in Animal Farm – “work harder”.

Everything in Britain is seen through the prism of tribal ideology, which leads only to adversarial politics. The left fights for its cause for a few years and then the right takes over, but the problem is never satisfactorily addressed because all the effort and much of the resources are governed by the ideological standpoint of those in power. We need to move from the competitive model of politics to a more collaborative, negotiating style.
Andrew Lacey
Mold
Flintshire

Dr Richard Banks takes you to task for repeating “the misleading statement that the NHS was ranked top in the Commonwealth survey of 11 healthcare systems” (The big issue). I assume that he refers to a report by the Commonwealth Fund, a private US foundation, and nothing to do with the British Commonwealth.

Dr Banks fails to mention that the report covers five measures of the efficacy of the 11 healthcare systems. The NHS came top in two, third in another two and next to last (as Dr Banks observes) in one. Oh, and the UK came top overall. The measure in which the UK came next to last was healthcare outcomes. The US came last. One might argue that the systems are at the opposite ends of some spectrum, with the UK’s a modestly funded monolithic state organised system and the US’s a privately delivered system costing, as a percentage of per capita GDP, about twice as much. It is hard to see what causes them to perform so badly on this measure. But it seems unlikely to be how they are organised, given their disparate natures.

I have no brief to defend Mrs May. I note that this is the second time since the last war that the NHS has been in such a poor state and on both occasions the Conservatives were in government. But self-serving and misleading arguments about the NHS will not help us get to a better place.
Dr Roger Oliver
Eastbourne

It is still vital to learn about what lies beneath the soil

It is simply impossible to appreciate the British landscape without understanding its underlying soils (“If we want to shape a landscape that’s fit for all, we must stop romanticising it”, Comment).

Ever since hominids first arrived here, they have had an impact, even with simple flint tools. The agricultural improvers of the early 19th century readily tapped the knowledge obtained after William Smith published his 1815 geological map, complete with a concise memoir full of detailed insights about our landscape. Often, when I have been mapping, it is tiny changes in vegetation that have provided me with clues as to the location of geological boundaries.

Instead of continuing this long tradition, the British Geological Survey ended the routine production of a highly impressive series of 1:50,000 geological maps and brief explanations for the general public and academics alike.

This is one of the worst false economies of modern times. During the 2001 foot and mouth crisis, such staff provided their field knowledge, on a 24-hour rota, to help find safe locations for burial pits and pyres, and essential university student field trips had to be held abroad.
David Nowell
New Barnet, Hertfordshire

Addressing loneliness

I was extremely delighted to come across the news regarding the appointment of a minister for loneliness by Theresa May’s government, as it is the first time such a portfolio has been created. Although loneliness is not an ailment, per se, it could lead to one.

Loneliness causes “feelings” to get accumulated and if one does not give vent to such pent-up feelings through interaction with others, it will lead to dangerous situations. Diversion of the mind is needed and this can be achieved only through mingling with others. Loneliness haunts not only the elders, but the younger ones, too.

As this is the first of its kind, the world will be watching with eagerness how the minister discharges her responsibility. One cannot but commend the government for preparing the ground to tackle loneliness.
VS Jayaraman
Chennai, India

Vive la différence? Non

“One should always listen to the French difference.” Really? Agnès Poirier (“ ‘Triumphant and free women’ who started a debate we needed to have? Or hostages to a culture of misogyny? An insider’s guide to French feminism”, In Focus) tries her best to defuse the international row over what has come to be known for short as the Deneuve letter, but lines such as: “The letter’s authors did not do themselves any favours by writing of men’s ‘right to pester’ women” are not a good look if you want to persuade people to your point of view.

The Deneuve school of French feminism, with its emphasis on the liberation of women’s sexuality, is a cry for women to have the same right to sexual pleasure as men. Nothing wrong with that, you might think. And there are plenty of clubs and other venues to accommodate any and every taste, if that is the sort of thing you like.

However, do not forget that the philosophical justification of libertinism is also a French invention and that for the last two centuries it has been used to justify forms of sexual behaviour, nearly always by powerful men, which many, if not most, people find abhorrent. The opposite of libertinism is not puritanism. It is a culture that encourages kind, loving, joyous and, above all, consensual sexual relationships. Perhaps we could call it consensualism? I don’t hear too much about this coming out of the French feminist movement.
Janet Stevens
Lézardrieux
France

Let’s vote again about Brexit

Thank you, Andrew Rawnsley (“How and why Britain might be asked to vote again on Brexit”, Comment).

Surely the rational argument for a second referendum lies within Westminster. Is there a single politician who would disagree with the statement: “I am in politics to do the best for the country and to improve the lot of the British people”? Yet when it came to the referendum, MPs of all parties were divided.

None of us, public and politicians alike, had any idea what the deal would be until it had been agreed with the EU. It is therefore perfectly rational that once we all know what the deal is and whether, overall, it will to be to our advantage, it should be put to the country. As a taxpayer, I would be happy for the government to spend the money required for a second referendum.
Dr Nick Maurice
Marlborough