Featuring in Dr Mosley’s podcast Just One Thing, Professor Dawn Skelton pointed out that “people who have poorer balance don’t live as long” as those who do. The Professor in ageing and health – from Glasgow Caledonian University – explained that the brain plays a vital part in balance. “To have good balance, our brains have to be able to integrate lots of information from across the body,” Professor Skelton said.
The brain – the most complex organ in the human body – pays attention to what we see, what we feel, and our inner ear balance.
If there’s a problem with any of our senses, it’ll show up in bad balance.
Professor Skelton added that if our brain isn’t working well to have good balance, then it’s not going to do well with hormones or the cardiovascular system.
Bad balance is a “marker of decline for other things”, said Professor Skelton.
Dr Mosley then queried if improving your balance could lead to better health.
“We certainly know that if you can improve your balance, so that you stop falling as much, that can make a big difference in terms of hip fractures and the poorer outcomes that results because of that,” replied Professor Skelton.
“We also know that lots of activities that improve balance involve dual tasking, so [they] make the brain work a bit harder.”
The professor said that there’s “some suggestion” that improving your balance can help with cognition and “potentially prevent” dementia.
Professor Skelton also said that there is “evidence that balancing exercises are better than standing up and walking around”.
Advising against prolonged sitting – an example of sedentary behaviour – Professor Skelton suggests balancing exercises every hour of sitting down.
“Perhaps do a 30-second stand on one leg,” she said, or to do a “tandem stand”.
A tandem stand is when you place the tip of the heel against the toe of another foot, as if you’re “walking along a tightrope”.
“That’s really challenging your balance, because it’s really reducing your base of support,” she noted.
“Walking backwards is also a really good balance challenge, [but] do be careful,” Professor Skelton added.
To help extend longevity, she recommends incorporating balance exercises into your daily life.
“So while you’re waiting for the kettle [to boil], stand on one leg,” said Professor Skelton.
Eventually, with practise, Professor Skelton says you can improve your balance.
“Your brain will integrate that information better,” she explained, but she advised people to practise near a “fixed support”.
What’s a fixed support?
“Ideally a good solid sink, a solid kitchen surface [not a chair], those sorts of things,” she explained.
“Those things that aren’t going to move,” she clarified, encouraging anybody of any age to start improving their balance today.
A leaked presentation showed plans to extend the school week by an extra two-and-a-half hours in a bid to help students catch up with their studies. The proposal was put together by education czar Sir Kevan Collins, who will be leading the education recovery efforts.
The presentation, seen by the Times, estimates that each pupil will need to spend an extra 100 hours in the classroom a year from 2022 to make up for the time lost to the pandemic.
It also showed that five million of the most affected pupils in England will receive additional tutoring.
Some 500,000 teachers will receive more training in order to deliver the expected results.
It follows warnings from leading health expert suggesting the UK is in the early stages of a third Covid wave.
Professor Ravi Gupta from Cambridge University called on the Government to delay ending Covid restrictions in England on June 21.
He told BBC Radio 4’s Today programme: “Of course the numbers of cases are relatively low at the moment – all waves start with low numbers of cases that grumble in the background and then become explosive.
“So the key here is that what we are seeing here is the signs of an early wave.”
Christina Pagel, a professor at University College London, made similar remarks and warned the UK should extend the lockdown measures for a further two months instead of reopening on June 21.
She said the UK “should wait a few more months to unlock fully” to ensure enough people have been fully vaccinated.
Dr Federica Amati gained her PhD in clinical medicine research from Imperial College London and is a registered nutritionist with the Association for Nutrition. Now she has partnered with Indi as their Chief Nutrition Scientist. “Fibre is a key component to our diet, but the more research is conducted, the more important this message becomes,” Dr Amati said. “It is crucial for our gut health and getting enough of it during our lifetime is linked to lowering the risk of premature death, cancer, type 2 diabetes and anxiety disorders to name but a few.”
“Make sure it’s the extra virgin kind and not the blended ‘olive oils’ that don’t retain any of the nutritional benefits,” said Dr Amati.
As for “whole plants”, the polyphenols they contain “counteract oxidative stress”.
An example of a whole plant is “cavolo nero” – a loose-leafed cabbage from Italy.
In fact, Dr Amati said that any dark greens or fruits, such as haskap berries, “support lipid metabolism and a healthy microbiome profile”.
“Eating a combination of these foods every day helps support our body’s immune and anti-inflammatory functions for a long and healthy life,” she said.
Three “key” ingredients to help boost longevity:
Extra virgin olive oil
Dr Amati also advises to eat a healthy, varied diet, consisting of:
“The key to variety is meals that offer different combinations of nutrients, minerals and flavours every time,” Dr Amati made clear.
Dr Amati also mentioned that the “occasional, high-quality animal product” can also be included in a healthy diet.
As well as eating well, the NHS recommend other lifestyle tips to extend your longevity.
This includes exercising for at least 150 minutes each week, which can be achieved if you create time for 30 minutes of daily activity.
Other noteworthy life-boosting guidelines include drinking alcohol in moderation (if any at all) and not smoking.
More than 24 million adults have rolled up their sleeves and received their two doses of the vaccine, including the dangerously overweight who were among those prioritised. The Joint Committee on Vaccination and Immunisation identified morbid obesity as an underlying health condition which puts individuals at a higher risk of serious disease and death. But longer needles are needed in morbidly obese patients so the layer of fat under the skin is penetrated to reach the muscle tissue containing immune cells.
If vaccines are injected in fat tissue they can fail because the fat does not contain any of the immune cells and there is less blood flow.
Now the NHS supply chain has put out a tender for a one-year contract starting in August to supply combined safety syringes and needles for “future vaccine candidates that are not yet available but form part of the UK’s overall vaccine programme”.
Around 28 percent of adults in England are classified as obese, and 3.3 percent are classed as morbidly obese, having a BMI of 40 or over.
Standard needles issued as part of the rollout are an inch (25mm) long but Public Health England advises needles of 1.5ins (38mm) are used for morbidly obese individuals to ensure the vaccine is injected into muscle. It said vaccine centres should request the longer needles when ordering the vaccine if required.
An informative infographic presented by Harvard University displays how much of each food category needs to be on your plate come meal time. Which foods does it include? One half of a dinner plate should be filled with vegetables or fruits – “aim for variety and colour”, the university said. There is a caveat to this though, potatoes don’t count as vegetables – so chips, mash, and roast potatoes are off the menu.
Harvard University offered other helpful advice on what to avoid, such as sugary drinks.
Red and processed meat, such as bacon and sausage, should be limited, as should dairy products.
One of the best ways to make sure you live a long and healthy life is to eat plenty of fruit and vegetables – but you’ve also got to make sure you keep active. Scientists have now revealed how many steps you should take each day to make sure you stay healthier for longer.
Maintaining a healthy lifestyle is essential for living a long life.
But you could also increase your life expectancy by doing regular exercise.
In fact, the NHS describes exercise as “the miracle cure we’ve all been waiting for”.
You don’t need to run a marathon every day to benefit, either. A simple daily walk could add years to your life.
“Older adults face many barriers to participating in structured exercise programs,” said lead author of the study, Christopher C. Moore.
“So, some may find it more convenient and enjoyable to increase everyday walking behaviours, like parking slightly further from their destination or doing some extra housework or yardwork.”
“Technological advances made in recent decades have allowed researchers to measure short spurts of activity. Whereas, in the past we were limited to only measuring activities people could recall on a questionnaire.
“With the help of wearable devices, more research is indicating that any type of movement is better than remaining sedentary.”
For most people, the easiest way to add more activity to your daily routine is to put the car keys down, and get out a bicycle or your walking shoes.
The more exercise you do, the greater the reward.
Regularly taking part in sport or exercise class you help you to be even healthier.
In particular, any exercise that raises your heart rate and makes you feel warmer will be beneficial.
Would the ISCHEMIA trial be quite the compass for conservative care it now is in stable coronary artery disease (CAD) if follow-up for the primary outcome had been a few years longer? That question may have helped inspire a new meta-analysis of 25 trials, with almost 20,000 patients, that pitted coronary revascularization plus medical therapy against meds alone in stable CAD populations.
ISCHEMIA showed no significant difference between the two strategies for its clinical primary endpoint after a median follow-up of about 3 years. The trial and these provocative findings have been influential and widely debated since their unveiling in 2019.
Conversely, in the new meta-analysis — with almost half the trials following patients for 5 to 15 years, and one much longer — the risk for cardiac death with invasive management fell 21% overall and was seen to decline 19% for every 4 years of follow-up vs a conservative strategy.
Benefits from invasive management were dependent on optimization of medical therapy as well as follow-up duration, and were partly driven by a 26% reduction in risk for spontaneous myocardial infarction (MI), reported Eliano P. Navarese, MD, PhD, Nicolaus Copernicus University, Bydgoszcz, Poland, this week during the virtual 2021 Congress of the European Association of Percutaneous Cardiovascular Interventions (EuroPCR).
The analysis suggests that, in patients with stable CAD and myocardial ischemia, “the benefits of revascularization and optimizing medical therapy are additive, and the combination of them can reduce cardiac mortality and spontaneous MI,” he said.
“Based on these findings, which are solid and consistent, I think it should be considered strongly, and it will be probably almost unethical not to offer revascularization to stable patients with coronary artery disease,” Navarese, who is also lead author on the study’s May 18 publication in the European Heart Journal, said in a panel discussion following his presentation.
ISCHEMIA had assigned 5179 stable patients with moderate-to-severe ischemia at stress testing to the invasive strategy or conservative care, that is, to optimal medical therapy with vs without cardiac catheterization and possible coronary revascularization. Investigators found no significant difference between the strategies for the primary endpoint, a composite of cardiovascular (CV) death, MI, hospitalization for heart failure or unstable angina, or resuscitated cardiac arrest.
As often noted, ISCHEMIA’s primary endpoint curves showing no significant difference between management strategies at a median of 3.2 years crossed after about 2 years on an apparent trajectory to show later superiority for the invasive strategy.
Although the trial was underpowered for conclusions about any individual clinical endpoints, Navarese observed, it produced a signal of benefit for the outcome of CV death at 5 years in patients assigned to the invasive strategy.
“Recommendations for medical therapy alone based on trials with limited follow-up have likely underestimated the benefits of revascularization plus medical therapy,” the meta-analysis publication states about managing patients with stable CAD, likely pointing a finger at ISCHEMIA.
“The weight of evidence suggests that revascularization in CCS [chronic coronary syndromes] should be considered a nonprognostic procedure,” except in patients with left-main coronary disease or severely impaired ventricular function, Christopher Cook, MD, National Heart and Lung Institute, Imperial College London, United Kingdom, said as an invited discussant after the Navarese presentation.
“But do the results of the current meta-analysis warrant a change?” The new analysis, he said, “is clearly methodologically robust. Secondly, the findings identify longer time horizons as being a potential reason for the lack of effect in the original study.” Finally, “its findings of reduced cardiac mortality and spontaneous MI are consistent with other datasets.”
Four Decades of Trials
Questioning the relevance of a meta-analysis of mostly older trials to current practice, Cook wondered about the role of “contemporary optimal medical therapy, particularly the impact of important drugs such as SGLT-2 inhibitors, which are underrepresented in the current trial data.”
Another discussant, Davide Capodanno, MD, PhD, University of Catania, Italy, pointed out that the trials contributing to the meta-analysis date from as early as 1979, with half conducted more than a decade ago. Also, the widely ranging studies all contributed to the meta-analysis to different degrees.
“Five studies carried the heavy weight as drivers of the full result” for the endpoint of cardiac mortality, making the data overall less broadly representative. The reduction in spontaneous MI was driven primarily by three studies, he said.
Navarese said such weighting didn’t seem to matter in successive analyses that each omitted the contribution of one trial, in succession. “No matter the weight of the study, the results were always the same, always strongly consistent.”
Also, he said, the chronological order of the trials, and therefore their variation in the CV therapy state of the art each represented, had no significant effect on the meta-analysis findings.
“Moreover, it has been argued that by current standards, older trials had a lower percentage of medication use — that the medical therapies were suboptimal in those trials,” Navarese said. But within each trial, the state of medical therapy was always the same in both treatment arms, “and the percent on medical therapy was generally comparable,” making it possible to assess the difference made by revascularization.
But the vintage of many trials in the meta-analysis is one of its major faults, William E. Boden, MD, Boston University School of Medicine and VA New England Healthcare System, told theheart.org | Medscape Cardiology.
“Frankly, it’s what I’d call a garbage meta-analysis,” he said. “They mix apples, oranges and pears” by including some “old and outmoded” studies from as early as the 1980s that were followed by seismic changes in the landscape of medical therapy for patients with CAD.
“I would submit that pooling data prior to 2000 is worthless, because you’re going to be pooling old data of inferior medical therapy,” said Boden, who chaired the COURAGE trial and was coprincipal investigator for ISCHEMIA.
“That’s the big criticism, the high degree of selection that was undertaken, sort of an indiscriminate pooling of very heterogeneous, disparate studies over a 30- to 40-year time horizon.”
Selection of Endpoints
The 25 trials in the meta-analysis encompassed 10,023 patients with stable CAD who had been randomly assigned to invasive intervention on top of medical therapy and 9783 who were managed with meds alone; their average follow-up was 5.7 years.
The relative risk (RR) for cardiac death in the invasive cohort compared with those managed conservatively was 0.79 (95% confidence interval [CI], 0.67 – 0.93; P < .01) and for spontaneous MI was 0.74 (95% CI, 0.64 – 0.86; P < .01). The study showed no significant differences in all-cause mortality risk or risk for stroke.
The reduction in risk for cardiac death for patients in the revascularization cohort was linearly associated with length of follow-up, Navarese reported, for an RR of 0.81 (95% CI, 0.69 – 0.96; P = .008) for every 4 additional follow-up years.
The selection of outcomes in the meta-analysis is another of its weaknesses, Boden said. “The entire analysis hinges on endpoints that were never primary endpoints in the trial to begin with.” Cardiac mortality is an example. In ISCHEMIA, “the reason we used all-cause mortality is because there’s no quibbling about it. Cardiac mortality, on the other hand, is very tricky because it usually has to be adjudicated.”
It’s unclear, he said, “how cardiac mortality was either defined in those studies, how it was measured, or whether or not it was adjudicated.”
In another example, the MI outcome in the meta-analysis is limited to only spontaneous MI. “In ISCHEMIA we had an overall MI endpoint with six subtypes,” Boden said, referring to the MI typing system in latest iterations of the Universal Definition of Myocardial Infarction. Limiting the analysis to spontaneous MI would, for example, exclude periprocedural MIs.
They “cherry picked” their endpoints, he said. “It’s manipulating the data to make the outcome that you want to achieve, achievable.”
2021 Congress of the European Association of Percutaneous Cardiovascular Interventions, Presented May 18.
Eur Heart J. Published online May 18, 2021. Full Text.
Navarese disclosed receiving research grants from Abbott and Amgen, and lecture fees or honoraria from AstraZeneca, Bayer, Pfizer, and Sanofi-Regeneron. Boden disclosed receiving consultant fees or honoraria fromAbbVie, Amgen, AstraZeneca, and Janssen, and research grants from Amarin.
He says: “The results of this year will be felt for decades. The kids, families, husbands, wives, everybody.”
Harry positions himself as an expert in the new clip and comes across as more authoritative than in previous cameo appearances with his wife Meghan Markle, Judi claimed.
The expert and author told Express.co.uk: “There is a line in this trailer about people ‘hurting together’ and it’s clear that Harry, like all the other A-listers shown weeping in clips, is going to be sharing his pain here.
“But there are also strong hints from his words and the tone and pace he uses to deliver those words that he will be speaking as a wisdom-spouting expert reflecting on his past to help people with their future.”
If you’ve been enjoying Harvest Moon: One World on Nintendo Switch, you’ll be pleased to know that Natsume has dropped a new update addressing a couple of quality of life issues raised by player feedback.
The patch, available to download as we speak, focuses on the length of your in-game days and the lifespan of your animal buddies. Essentially, in-game time now passes more slowly, giving you more time to farm, mine, and adventure before having to pack up for the day, while your animals and pets have been upgraded to enjoy longer lifespans, meaning you can enjoy their company for longer than ever before.
If you haven’t checked the game out yet, make sure to read our full review to learn all about it and see whether or not it might be for you. We’ll also leave you with this handy feature list:
– Explore 5 unique and colorful areas: the sprawling grasslands of Calisson, the gorgeous beaches of Halo Halo, the searing desert heat of Pastilla, the cozy hills of Lebkuchen, and the snowy mountains of Salmiakki! – Play as a boy or a girl and woo one of 5 handsome bachelors and 5 beautiful bachelorettes, each with their own unique personality and backstory! – Raise and keep animals such as cows, sheep, goats, and even reindeer! – Use your Expando-Farm to easily travel from one area to another!
Are you liking the sound of these new changes? Let us know in the comments.