What the papers say – weekly digest (26/04/24)

Your weekly digest of the top healthcare stories, covering news published from 22/04/2024 – 26/04/2024.

Daily Telegraph

Pensioners believe old age now starts at nearly 75 – almost four years later than they thought in the 1970s, research has shown. The findings suggest that people perceive middle age as lasting well into the 70s, which probably reflects increases in lifespan and health over the past 50 years. Since the 1970s, lifespan in Britain has increased from an average of 72 years to about 82. To find out if the change had also had an effect on the perception of old age, European and US researchers looked at data from more than 14,000 people enrolled in the German Ageing Survey, including people born as early as 1911. The researchers found that compared with the earliest born participants, younger people in the group reported a later perceived onset of old age. In the 1970s, participants who were 65 years old set the beginning of old age at 71. But those aged 65 in 2022 believe it started just before 75 on average. The team also found that the perception of when old age starts got higher the older people became. At age 74, the average person considered old age to start at nearly 77. Dr Markus Wettstein, the study author, of Humboldt University, said: ‘’Some aspects of health have improved over time, so that people of a certain age who were regarded as old in the past may no longer be considered old nowadays.’’ Most people have an idea in their minds of when old age begins, or from which age they consider a person old. Scientists refer to the concept as ‘’the perceived onset of old age’’ and it can vary widely between individuals. This study is the first one to look at how the general consensus changes over time. The researchers also examined how individual characteristics, such as gender and health status, contributed to differences in the perceived onset of old age. They found that women, on average, said that old age started two years later than for men – and that the difference between men and women had increased over time. At 65, modern females believe old age kicks in at about 76 compared to 74 for men. ‘’It is unclear to what extent the trend towards postponing old age reflects a trend towards more positive views on older people and ageing, or rather the opposite – perhaps the onset of old age is postponed because people consider being old to be an undesirable state,’’ Dr Wettstein added. ‘’The trend toward postponing old age is not linear and might not necessarily continue in the future.’’ The study, which was in collaboration with Stanford University and the University of Luxembourg, was published in the journal Psychology and Ageing.

Climate change is driving a crisis in workers’ mental health, a global report has claimed. Extreme weather, climate change-induced disasters and exposure to excessive heat are all contributing to anxiety, depression and post-traumatic stress disorder, according to the International Labour Organisation (ILO), a United Nations agency. ‘’Workers may feel distress related to financial and workload problems and from loss of hope for the future of their community,’’ the ILO said in its latest report into threats facing workers. ‘’Numerous health conditions in workers have been linked to climate change – including cancer, cardiovascular disease, respiratory illnesses and mental health conditions, among many others.’’ The report argued that climate change risks were hurting the mental health of some workers by worsening their financial situations. Farmers and fishermen, for example, are more likely to suffer lower crop yields and reduced catches in some waters because of rising temperatures, putting their livelihoods under strain and causing anxiety and depression. ‘’Climate change will also affect seasonal and transient farm workers such as fruit pickers and sheep shearers, as increasingly stressful environmental conditions and unpredictable crop yields have major impacts on livelihoods,’’ the ILO said, noting that farmers already have far higher suicide rate than those in many other industries. Water shortages are a key threat, the report said, while the increased use of pesticides also threatens farm workers’ physical health. Others will suffer trauma as they are involved in natural disasters, the ILO said.

Patients are more likely to survive if they are treated by a female doctor, a study suggests. US researchers examined more than 775,000 medical insurance claims between 2016 and 2019, noting how many people had died within 30 days of being seen by a doctor. The death rate for female patients was 8.15% when treated by female physicians compared to 8.38 per cent when the medic was male. It means that in every 1,000 patients treated, an extra two would be expected to survive if they were seen by a woman. While the difference for male patients was smaller, female physicians still had the edge with a 10.15 per cent mortality rate compared with male doctors’ 10.23 per cent, a difference of about one death in 1,000. The researchers found the same pattern for hospital readmission rates. Dr Yusuke Tsugawa, associate professor-in-residence of medicine at the David Geffen School of Medicine, at the University of California, said: ‘’What our findings indicate is that female and male physicians practise medicine differently, and these differences have a meaningful impact on patients’ health outcomes. ‘’It is important to note that female physicians provide high-quality care… having more female physicians benefits patients from a societal point of view.’’ The researchers are unsure what is driving the effect, but say the male doctors may underestimate the severity of their female patients’ illness. Earlier research has shown that male doctors underestimate their female patients’ pain levels, gastrointestinal and cardiovascular symptoms, and stroke risk, which could lead to delayed or incomplete care. The team suggested that female doctors may communicate with their female patients, making it likelier that these patients provide important information leading to better diagnoses and treatment. Finally, female patients may be more comfortable with receiving sensitive examinations and engaging in detailed conversations with family physicians. The study is published in the Annals of Internal Medicine.

The number of deaths specifically caused by alcohol across the UK has reached a record high, according to official figures. There were 10,048 deaths from alcohol-specific causes in the UK in 2022, the highest number on record, the Office for National Statistics (ONS) said. This is 32.8 per cent higher than in 2019 when there were 7,565 deaths and 4.2 per cent higher than in 2021. Between 2012 and 2019, deaths specifically attributed to alcohol were ‘’stable’’, the ONS said. David Mais, an ONS health statistician, said: ‘’Research has suggested that people who were already drinking at high levels before the pandemic were the most likely to have increased their drinking during this period.’’ The figures do not include all deaths that can be attributed to alcohol, such as heart disease or various types of cancer. The new figures also show that the rate of alcohol-specific deaths for men in 2022 remained about double that of women. Scotland and Northern Ireland had the highest rates of alcohol-specific deaths in 2022 and the North East had the highest rate of any English region in 2022. The East of England, meanwhile, had the lowest rate.

Since scientists began measuring brain function, young people have scored higher than older people as the ravages of time and generational increases in IQ combined to give youth the edge. Now that is changing. A study by Nottingham Trent University (NTU) has found that for the first time, the mental ability of older generations is catching up with the young. It is happening, scientists believe, because gains in intelligence of younger generations stalled around 2000, yet are still climbing for older people, meaning the mental gap between the young and old is closing. Dr Stephen Badham, an associate professor in psychology at NTU’s School of Social Sciences, said: ‘’Much existing research shows IQ has been improving globally throughout the 20th century. This means later-born generations are more cognitively able than those born earlier. However, there is growing evidence that time-based increases in IQ are levelling off. In the most recent decades, young adults are no more cognitively able than those born shortly before. As a result, the current data shows young adult advantages in cognition relative to older adults, such as memory ability and speed of processing, are now getting smaller over time. When we compare young and older adults today, the gap is smaller than in the past. Therefore, the decline an individual might expect as they become older is smaller than originally thought. In other words, we can expect to be more cognitively able than our grandparents were when we reach their age.’’ Dr Badham carried out a meta-analysis of 60 studies that have recorded mental ability of different generations. In 83 of the tests used, older adults showed better performance than earlier cohorts. However young adults’ cognition remained relatively flat across time. Scientists believe the phenomenon is being caused because the Flynn Effect has plateaued. The Flynn Effect states global IQ will rise steadily over time, mostly fuelled by improvements in education, diet and health. But it now appears to have stalled for people born at the turn of the millennium. In contrast, those born earlier are still recording improvements compared to older people of previous generations. The research was published in the journal Developmental Review.

Late-stage stomach cancer patients are being kept alive for three years with a new technique that bathes the abdomen in warm chemotherapy drugs. Gastric cancer is one of the deadliest diseases, with the average stage-four patient usually dying within 13 months. But trials by the Mayo Clinic show that patients can be kept alive far longer by removing internal tumours then swishing the stomach and abdominal cavity with chemotherapy drugs heated to 113.0 (45.5C) to kill any microscopic cancer cells. Researchers found that 96 per cent of patients survived for a year, while 78 per cent were still alive after two years. Some 55 per cent of trial participants were still alive at three years. Dr Travis Grotz, an oncologist at the Mayo Clinic, said: ‘’People with gastric cancer are usually told they have no hope and no options. Our research team was determined to improve outcomes for these patients so they can have more time with their family and friends. The median survival for most stage-four gastric cancer patients is around 13 months. By using this new combination of chemotherapy drugs during hyperthermic intraperitoneal chemotherapy, more than half of our patients are still alive three years after surgery.’’ The team is looking to perform similar procedures robotically in the future. The research was published in the Annals of Surgical Oncology.

Vegan alternative foods should be labelled more clearly because the public do not realise they are ultra-processed, according to a new study. While switching to plant-based alternatives for meat, eggs, cheese and yoghurt appears to be better for the environment, it is not necessarily healthier, experts have said. Researchers have called for vegan alternatives and meat substitutes to be labelled and categorised because they can often contain more sugar and salt than the product they are replacing. Ultra-processed foods are usually higher in fat, sugar and salt, and contain chemicals, colourings, sweeteners and preservatives that extend shelf life. The team analysed about 90 studies into vegan alternative foods to get one of the biggest sample sizes to date. They found plant-based substitutes could be healthy options because they were often higher in fibre and lower in fat, but this was not always the case and the nutritional values drastically varied from product to product. Vegan alternatives are better for the environment because they produce less greenhouse gases and do not use as much land. The research, published in the journal Nutrition Reviews, found that some plant-based cheeses had twice the saturated fat of normal cheese, while meat replacements usually had more sugar. The main primary ingredient, as well as processing techniques and brand, were all vital to determining a product’s nutritional value and environmental impact. While researchers said all plant-based alternatives are ‘’technically’’ ultra-processed, they found the nutritional value of some products align with healthy dietary recommendations. They suggested establishing a ‘’clear division’’ between products that are less processed and ultra-processed, and conducting further studies. Sarah Najera Espinosa, study author at the London School of Hygiene and Tropical Medicine, said: ‘’Some products, such as legume and vegetable-based drinks and legume-and mycoprotein-based meats, have the potential to be a useful stepping stone in the process of food system and dietary transformation.’’ The research – which excluded tofu, tempeh and seitan, foods that have been part of traditional Asian diets for centuries – analysed more than 90 studies and reports from 2016 and 2022. Academics said the ‘’limited evidence’’ on swapping meat for plant-based alternatives suggest the shift could be good for health, but the results for plant-based drinks were mixed, with links to micronutrient deficiencies. Meat and drink alternatives had, on average, the same salt levels as animal products, although meat alternatives had more sugar. The team suggested labelling plant-based alternatives – along with studies to evaluate how dietary changes affect the environment – should be a priority for policymakers,

The Guardian

NHS England is to offer children with brain tumours a groundbreaking targeted drug therapy, a development cancer charities are hailing as the biggest breakthrough in decades. Gliomas are the most common type of brain cancer in children, but experts say the standard of treatment of chemotherapy can be brutal and gruelling, and carries the risk of side-effects such as weight loss, seizures and headaches. Now a kinder drug therapy has been given the green light by the National Institute for Health and Care Excellence (Nice). Studies showed it produced fewer side-effects, improved children’s response rate to treatment and their survival time without the disease getting worse. Dabrafenib with trametinib was found to halt the growth of tumours for more than three times as long as standard chemotherapy for children with low-grade gliomas that have a specific genetic mutation, while helping spare them the many of the harsh side-effects of chemotherapy. The treatment will initially be available on the NHS in England for children aged one to 17 with low- or high-grade gliomas that have a BRAF V600E mutilation. The combination treatment, which can be received at home, targets the proteins made by the altered BRAF gene that are responsible for uncontrollable tumour growth. Gliomas grow in the brain or spinal cord and can be low grade, where they grow slowly, or high grade, where they grow more rapidly and may be fatal. About 150 children are diagnosed with low-grade gliomas every year in the UK and about 30 are diagnosed with high-grade gliomas. Clinical trials have shown that as well as having fewer side-effects than chemotherapy, the treatment stalled growth of low-grade gliomas for about two years (24.9 months) on average – more than three times as long as standard chemotherapy (7.2 months), NHS England said. In some cases, tumours disappeared, though longer-term follow-up of patients was needed. Dabrafenib is given as dissolvable tablets taken twice a day, and trametinib is an oral solution taken once a day. The two drugs work together by blocking the growth signal from the mutant BRAF protein and can slow or even stop the tumour from growing.

Ethnic minorities and young people require more visits than other people to the GP before being diagnosed with cancer, according to new analysis. On average, one in five people in England require three or more GP interactions before being diagnosed with cancer. But for people from ethnic minority backgrounds, the figure was one in three, according to analysis of the NHS cancer patient experience 2022 survey by QualityWatch, a joint programme from the Nuffield Trust and the Health Foundation. Of people aged 16-24, about half needed at least three GP visits before diagnosis, with 20% needing at least five visits. The analysis also found that people from the most deprived areas in England were 21% less likely to be referred for urgent suspected cancer than those from more affluent areas. The NHS’s own target is to have three-quarters of cancers diagnosed at an early stage by 2028. The research further reveals the disparities in cancer care between demographics across England. Deprivation already causes an extra 33,000 cancer deaths across the UK, while black and Asian people on average wait longer for a cancer diagnosis than their white counterparts. Prof Kamila Hawthorne, chair of the Royal College of GPs, said identifying cancer symptoms in young people could be challenging as the risk for the group was much smaller. Dr Liz Fisher, senior fellow at the Nuffield Trust, said: ‘’Delays to a cancer diagnosis pose real risks for people and an early diagnosis plays a pivotal role in determining the treatments available to people and determining outcomes. ‘’The NHS has set an ambitious goal to dramatically increase early detection of cancer, but performance in this area has stubbornly stalled in recent years.’’ Tim Gardner, the assistant director of policy for the Health Foundation, said: ‘’This analysis highlights the need to improve people’s access to primary care, especially in more deprived areas, so that more people can be diagnosed earlier. This ultimately depends on boosting primary care capacity through sustainable, long-term investment and growing and supporting the workforce.’’ An NHS spokesperson said: ‘’NHS staff are working hard to ensure that everyone affected by cancer receives a prompt diagnosis, regardless of their age, ethnicity or socioeconomic status. The NHS is diagnosing more people than ever for cancers at an early stage and, for the first time, over 3 million people were referred by GPs for potentially lifesaving cancer checks last year.’’

Female survivors of breast cancer living in the most deprived areas have a 35% higher risk of developing second, unrelated cancers, compared with those from the most affluent areas, research shows. Breast cancer is the most commonly diagnosed cancer in the UK, with about 56,000 people being told they have it each year. Improved diagnosis and treatments mean that five-year survival rates are now 86% in England. People who survive breast cancer have a greater likelihood of second primary (unrelated) cancer, but until now the exact risk has not been clear. Researchers led by the University of Cambridge analysed NHS data from almost 600,000 patients in England and found, compared with the general female population, women who had survived breast cancer had an increased risk of developing 12 other primary cancers. They had double the risk of cancer in the unaffected (contralateral) breast, an 87% higher risk of endometrial cancer, a 58% increased likelihood of myeloid leukaemia and a 25% higher risk of ovarian cancer. The study, published in Lancet Regional Health – Europe, found that the risk of second primary cancers was higher in people living in areas of greater socioeconomic deprivation. Compared with the most affluent, the least well-off female survivors of breast cancer had a 166% greater chance of lung cancer, a 78% higher risk of stomach cancer, more than 50% increased risk of bladder and oesophagus cancers, 48% higher risk of head and neck cancer and 43% increased risk of kidney cancer. Overall, those from the most deprived areas had a 35% higher risk of a second non-breast cancer. This may be because risk factors such as smoking, obesity and alcohol consumption are more common among more deprived groups. A 2023 study found that deprivation caused 33,000 extra cancer cases in the UK each year.

The UK has the worst rate of child alcohol abuse worldwide, according to a major report that found more than half of children had drunk alcohol by age 13. The study, one of the largest of its kind by the World Health Organization, looked at 2021/22 data from 280,000 children aged 11, 13 and 15 from 44 countries who were asked about their use of alcohol, cigarettes and vapes. The analysis found the UK had a significant issue with underage alcohol abuse. More than a third of boys (35%) and girls (33%) had drunk alcohol by the age of 11. By 13, 57% of girls and 50% of boys in England had had alcohol, the highest rate in the analysis. More than half of girls (55%) and boys (56%) in England from higher-income families said they had drunk alcohol in their lifetime, compared with 50% of girls and 39% of boys from lower-income backgrounds. The analysis found that girls aged 13 and 15 in the UK were drinking, smoking and vaping more than boys the same age:40% of girls in England and Scotland had vaped before 15, at a higher rate than in countries such as France and Germany. About 30% of girls aged 15, and 17% of boys the same age had vaped in the past 30 days in England, according to the research, at a higher rate than other countries including Ireland, Canada, Denmark, Norway and Portugal. Girls in the UK were more likely to have vaped by the age of 15 than the average for all 44 countries in the study. It included data from more than 4,000 children in England and about 4,000 in Scotland and Wales.

A sweetener used in cakes, soft drinks and chewing gum can seriously damage people’s health by weakening the gut, a study has found. Consumption of even a small amount of the sweetener neotame can lead to someone starting to suffer irritable bowel syndrome, insulin resistance and even sepsis, a condition that kills about 40,000 people in Britain a year. The findings underline that some of a new generation of sweeteners that give food products a super-sweet taste can have a ‘’toxic effect’’ on health, the researchers say. Dr Havovi Chichger, the senior author of the study, said that while sweeteners could be a healthier alternative to sugar, some could harm consumers. Neotame was developed in 2002 as a substitute for aspartame, a sweetener that has aroused concerns, and has become widely used in recent years in drinks and foodstuffs sold in the UK. It is often referred to as E961 on the list of ingredients found on labels of products. Chichger, an associate professor at Anglia Ruskin University, and co-author Dr Aparna Shil, of Jahangirnagar University in Bangladesh, said neotame carried a threat to health because it could damage the intestine by causing ‘’good bacteria’’ to become diseased and invade the gut wall. In the process that might lead to illness because the epithelial barrier, part of the gut wall, could break down. They published their findings, which they say are the first to show that neotame can have that damaging impact on healthy gut bacteria, in the medical journal Frontiers in Nutrition. Previous research has found that other common sweeteners – such as saccharin, sucralose and aspartame – can also have that harmful effect.

The Times

When patients are admitted to hospital in Australia, there is a high chance they will be treated by a British doctor. The number of doctors from the UK working at a group of hospitals in Adelaide has doubled from 17 in 2022 to 35 last year as a bitter pay dispute drives thousands away from the NHS. The trend of doctors moving abroad is set to intensify, the British Medical Association is warning today (Tuesday). Between 15,000 and 23,000 doctors left the NHS in the 12 months to September, analysis of official NHS England figures show. Dr Phil Colwell, who moved to Adelaide in 2017 after working in the NHS for three years, said: ‘’It’s become a bit of a cliche that if you go to emergency departments in Australia, you’re very likely to meet a doctor from the UK.’’ The report said the ‘’high attrition rate’’ costs more than £1.6 billion a year and each time a doctor leaves, it can cost up to £365,000 to replace them. It is partly why hospitals rely on locum doctors, who can charge £700 a day. Training new GPs and consultants costs £260,000, an investment that is lost if they move abroad. Colwell, 36, earns A$500,000 a year (£260,000), three times what he would in Britain. He said doctors were ‘’flogged’’ in the NHS, while in Australia they get ‘’space and time to learn’’. He added: ‘’The only thing that is difficult is being a 30-hour flight away from family. Despite that, people still find their life is better here.’’ The BMA said the high number of doctors leaving the NHS is jeopardising a workforce plan announced by Rishi Sunak, the prime minister, last year, which aims to solve shortages by doubling medical school places. It has called for a greater focus on retaining doctors. Presently, for every two doctors that join the UK medical register, one leaves. Doctors’ leaders say the government’s handling of the recent wave of strikes has been a catalyst for doctors to leave because they feel ‘’undervalued and underpaid’’. Two thirds who move abroad cite pay as a reason. Dr Latifa Patel, of the BMA, said: ‘’In a year where strikes have already estimated to have cost £1.2 billion, when you add the cost of losing more doctors, the government’s argument that it is unaffordable to properly value and support doctors falls completely flat.’’ The spokesman for the health department said: ‘’We don’t recognise these figures. There are a record number of doctors working in the NHS – 5 per cent more than a year ago. The rate at which doctors are leaving is decreasing and the NHS Long Term Workforce Plan, backed by £2.4 billion, will put staffing on a sustainable footing by helping retain more individuals.’’

A bestselling author whose book claims smartphones have rewired children’s brains is facing a backlash from experts. Jonathan Haidt’s The Anxious Generation is also being read in Whitehall before a government consultation that will propose a social media ban for children. However, other social psychologists have accused the author of misrepresenting evidence to fit his thesis. Haidt, of New York University’s Stern School of Business, claims there has been a dramatic decline in the mental health of teenagers because of the increase in smartphone use. He said a ‘’great rewiring of childhood’ from the early 2010s replaced physical play with the virtual world and ‘’is making young people sick and blocking their progress to flourishing in adulthood’’. Haidt’s book has led academics to air their concerns about his methodology and conclusions. Candice Odgers, of University of California, Irvine wrote in the journal Nature that Haidt was telling a ‘’scary story’’ that many parents are primed to believe. She said: ‘’The repeated suggestion that digital technologies are rewiring our children’s brains and causing an epidemic of mental illness is not supported by science. ‘’Linking social media use to causing depression, anxiety and suicide: that’s a huge claim. If you dig into (the research), it doesn’t say anything close to that. There’s a small correlation between social media and depression but… misrepresentation of data is a real issue.’’ The National Academies of Sciences, an advisory body in the United states, said in December: ‘’Research that links social media to health shows small effects and weak associations….Contrary to the current narrative that social media is universally harmful to adolescents, the reality is more complicated.’’ Haidt posted a response to Odgers citing various studies that he believes support his findings. However, Chris Ferguson, of Stetson University in Florida, who carried out a meta-analysis, concluded the studies were flawed and ‘’should not be used to support the conclusion that social media use is associated with mental health’’. Haidt uses data about the hospitalisation of teenagers as evidence for the mental health crisis, but Ferguson and others says suicide is a better metric. While suicide rates have gone up across all ages in the US, data in the EU and the UK does not suggest a noted increase in suicides, Ferguson said. Haidt stands by his use of hospitalisations as a metric. ‘’Across many measures, mental health among UK teens is in decline. Even when you look at suicide rates among 15 to 19 year-olds, the idea that there is nothing going on is challenged,’’ he said. Sonia Livingstone, of LSE, said it was ‘’a good thing’’ that Haidt was shedding light on the subject. However, Andrew Przybylski, of Oxford University, said: ‘’I don’t think we would allow Substack and business professors from the US to tell us how to handle maternal health or diabetes management. I have no idea why we’re letting this happen with adolescent mental health and suicide.’’

The apple may fall further from the tree than proverbial wisdom would have it. A study suggests that people inherit surprisingly little of their personality and that parents and children are only slightly more likely to have similar temperaments than pairs of strangers. Researchers compared the character traits of parents and their adult children, including how neurotic, extrovert , open, agreeable and conscientious they were. They also looked at pairs of siblings and other relatives. Previous studies have explored how closely matched family members tend to be by asking people to rate their own personalities. However, such self-assessments are seen as unreliable. To build a more accurate picture, those behind the new study, which used data from the Estonian Biobank, recruited more than a thousand pairs of relatives. Each person was asked to rate their own personality and to find a partner or friend to give a second opinion. The self-ratings and the second opinions were combined to give a more accurate assessment. The results suggested that about 42 per cent of the difference between the participants’ personality traits was explained by the kind of genetic factors that cause parents and offspring to be alike, said Rene Mottus, of Edinburgh University, who led the study. Previous studies had put it at about 25 per cent on average. The results suggested it was impossible to predict a child’s traits accurately by knowing those of their mother or father. If a group of parents and children were told that for a particular trait they were in the bottom, middle or top third of the population, the study suggests that only 39 per cent of the offspring would be in the same third as their parents, compared with about 33 per cent for unrelated pairs. ‘’People assume that upbringing shapes personality but there’s really no evidence for this,’’ Mottus said. The study has been released on the PsyArXiv website and submitted to a journal but has yet to be peer-reviewed.

Women have been told to avoid using weight-loss drugs to help them to get pregnant as doctors report a rise in surprise ‘’Ozempic babies’’. Some women struggling with infertility have become pregnant unexpectedly after being prescribed semaglutide, which is used to treat obesity and type 2 diabetes under the brand names Wegovy and Ozempic. Doctors in the United States also have begun using it ‘’off-label’’ to treat polycystic ovary syndrome (PCOS), a condition that is a common cause of infertility and is linked to obesity. However, scientists have warned that the injections may cause birth defects and should not be used by anyone hoping to become pregnant. Weight loss can improve fertility because obesity interferes with hormone levels, but semaglutide has not been tested on pregnant women. Research on animals including rats and monkeys suggests it can be toxic and can lead to miscarriage and abnormalities. The weight-loss drugs mimic a hormone called GLP-1, which suppresses appetite. They were first used to treat type 2 diabetes, under the brand name Ozempic. The same active ingredient – semaglutide – is being used to treat obesity as Wegovy. Novo Nordisk, Wegovy’s manufacturer, does not recommend it for women who are pregnant or breastfeeding and says that they should stop taking it two months before trying to conceive. Obesity can make it harder to conceive. Research shows that losing 5 per cent to 10 per cent of body weight can regulate menstruation and the release of eggs from the ovaries. Experts said women trying to get pregnant should not turn to weight-loss injections.

Food additives used in thousands of ultra-processed food products have been linked to an increased risk of type 2 diabetes. A study published in the Lancet looked at the impact of emulsifiers, a group of ‘’E number’’ additives added to mass-produced items such as biscuits, ice cream and processed meat. Emulsifiers are used to mix together foods that do not combine naturally, such as oil and water, to prolong shelf life and ensure an even texture. The study looked at 104,000 French adults, examining their average daily intake of different emulsifiers. They were followed for an average of seven years. Those who consumed lots of emulsifiers were significantly more likely to be diagnosed with type 2 diabetes, even after taking into account other risk factors, including obesity and smoking. In total, seven groups of emulsifiers were linked to type 2 diabetes. For example, every daily serving of foods with the emulsifier xanthan gum was found to increase the risk of type 2 diabetes by 8 per cent. The study, led by the University of Paris, was observational and therefore cannot prove cause and effect. It contributes to evidence on the health impact of ultra-processed foods, which make up more than half of the typical British daily diet and have been blamed for driving a wave of poor health.