A recent article has stated that British children are among the unhappiest in the world – and negative perception of body image is largely at fault. The article claims that children in England are less satisfied than their counterparts in developing countries, according to a global wellbeing chart published by the Children’s Society.Despite the fact that we have some of the highest living standards in the world, English children are less satisfied with their life compared to children in developing countries such as Brazil and South America. England ranks 9th out of 11 countries based on this study in terms of happiness and sources of stress, with only South Korea and Uganda scoring lower.  Matthew Reed, Chief Executive of the Children’s Society rightly states that we cannot shut our eyes and ears to half a million children who say they are unhappy and dissatisfied with their lives.The study showed that 1 in 5 pre-teen girls were plagued with anxieties about their bodies. We’re all well aware of the body pressures that teen girls and young women put themselves under – but it’s troubling to see this issue affecting much younger children. Children have the right to be carefree and enjoy their lack of responsibility; it’s awful to think that their happiness is being depleted by something as petty as appearance.Although these findings are very sad indeed, they are not exactly surprising. I have often commented on the unrealistic expectations of our ‘size zero’ culture, idolisation of ‘skinny’ and the unhealthy obsession with body image in our society. Don’t get me wrong, I feel it is very important to look after yourself and keep your body in the best health, especially in this age of rising childhood obesity, but the levels of obsession are now bordering extreme and are causing a great deal of heartache and even mental illness. I believe that this change in attitude is, at least in part, down to the media. The perpetuation of unrealistic body images and unattainable ideals in every form of media will surely be feeding the insecurities of these young girls and boys, especially as children are exposed to technology, celebrity culture and social media at younger and younger ages.A positive element that we can take from this study is that it was found that children who play sports and active games were more likely to score highly for happiness. Surely the answer is a simple one. Tear your children away from iPads/televisions/Twitter and get them into sport.My own opinion is that, in general, children are given too much too quickly. Instead of watching the Kardashians and posting selfies on Facebook, encourage your kids to get outside, join a sports team or just play tag. Allow them to be kids for as long as possible and I believe their happiness will see a vast improvement. Every once in a while you read a great article that stirs you to your core. I would like to praise Angela Epstein who interviewed Professor Roger Kirby, Director of The Prostate Centre in London, for her fantastic interview with Professor Kirby in the Good Health section of the Daily Mail on Tuesday 26 August. Professor Kirby was very candid in his interview entitled, “Why all men over 50 must demand a prostate test – it helped save my life”. He describes his diagnosis with cancer about a year ago. Because of his specialist knowledge he was able to act quickly when he suspected the disease and because he had the best tools at his disposal he was able to give himself the best chance at beating it.But most men aren’t so lucky. Epstein states that unfortunately most of the 40,000 men diagnosed with prostate cancer in Britain each year cannot bank on such in-depth expertise. There is more of an arbitrary approach to the diagnosis, which is usually driven by symptoms such as rushing to the bathroom or a conscientious GP who does a check-up of the prostate and provides PSA (prostate specific antigen) test.It always puzzled me that there is no National screening programme for prostate cancer; with my public health hat on I feel there should be, many other doctors would believe that as well. But a European randomised study of screening for prostate cancer involving 162,000 men aged between 50 and 74 concluded that, whilst screening could save around 2,300 lives in Britain annually, 2 out of 5 men who were told they had cancer would be over-diagnosed (i.e. they will be diagnosed even thought the disease would never cause symptoms or death in the patient). Epstein suggests that this could lead to unnecessary investigations such as biopsies, radiotherapy or even surgery. However, the article then states that over-diagnosis could be ruled out if every man over 50 were to ask for an annual PSA test. Anyone with the raised level could then have an MRI scan performed to identify the presence or extent of cancer. Epstein correctly deduces that that doing this could eradicate the scattergun approach with biopsies that could cause side effects and intense anguish.I was very happy to hear of Professor Kirby’s own personal experience, but as is stated at the very beginning; knowledge is power. Finally, the article goes on to state that since 10,000 men are dying of prostate cancer every year, his advice would be that men over 50, especially those with a risk factor such as family history, should have a PSA test. And don’t be distracted by a GP who says results are unreliable.I would like to congratulate Professor Kirby as this prompted me also to rethink my ideas and made me also aware of the necessity and the value of having this test performed. The latest craze to take the internet by storm – our Twitter, Facebook and Instagram feeds have been inundated with sodden, screaming people soaking themselves with icy water – what a way to fundraise! The amount of people (including some high-profile celebrities; David Beckham, Eminem, Jennifer Anniston, to name but a few) who have got involved and donated has been truly astonishing. This really highlights how social media can be used in a fantastic way to fundraise and raise awareness about crucial issues. The Ice Bucket Challenge has been around since 2013, the origins are actually unclear but it can be traced back to Northern United States. The task usually involves the option of either donating money to a cancer research charity or having to jump into cold water. But it seems that ALS fundraisers have adopted the craze, and the money raised so far has been incredible. But with so many people getting involved, how many really know what ALS is and what they are really donating for?ALS (amyotrophic lateral sclerosis), or Lou Gehrig’s disease, is a rare neurological disease with various causes. ALS is characterised by muscle spasticity and rapid progressive weakness due to muscle atrophy resulting then in difficulty speaking and swallowing and breathing. In fact ALS is the most common form of motor neurone disease. I find it truly amazing how this internet craze has raised he profile of this disease to another level, skyrocketing their donations to a level researchers could never have dreamed of. But is the ice bucket challenge really the best way to go about this?I was recently shown a YouTube video of a very young child doing the Ice Bucket Challenge (what were the parents thinking?) and then the child swearing. I didn’t find this funny. It just sends out the wrong message. Seeing the vulgarity of this toddler’s language and the unconcerned response from the parents filming it just caused me concern over this child’s welfare. Normally I would include the video clip in the blog, but I don’t want to give this clip any unwarranted exposure. If you have seen it then I’m sure you will understand my complete disgust.The Independent has also recently found that over half of Brits polled didn’t actually donate to ALS after posting their Ice Bucket Challenge online. This just suggests that the challenge itself is losing it’s way and is becoming just another way for people to gain attention online and boost their popularity and ‘cool’ factor – that’s not what this challenge was meant to be about.I’m sure many of you will have also seen posts online voicing concerns about how the donated money is actually being used and whether or not the ‘text-in’ system is actually causing the charity to lose out. This suggests more research needs to be done into the realities of this charity venture, and I would advice people to really consider all the facts before jumping on the latest Internet bandwagon.But the facts can’t be denied. The Ice Bucket Challenge has created a tidal wave of donations for a fantastic cause and regardless of the shadier aspects of this particular challenge, more money and awareness is a fantastic thing! The craze shows how we can come together as a society to do something brilliant and I would love to see more of this in the future for a wide range of under-publicised diseases.If you would like to donate to ALS but don’t fancy the Ice Bucket Challenge, then you can donate directly to the US ALS Association: https://secure2.convio.net/alsa/site/Donation2?df_id=27420&27420.donation=form1 In a recent report it has been stated that sugar is as dangerous as alcohol and tobacco and it goes on to state that Britain’s obesity crisis could be reversed within five years if food companies reduce sugar in products by 30%.  Wow! This is an incredibly surprising statement.For me, the obesity crisis has a great deal more to do with the lack of physical activity and regular exercise, not purely sugar intake. And I can’t help but recall the days when the first cotton candy machine came to my street. I grew up in a neighbourhood of about 15 kids and when this cotton candy machine came we used tons of sugar and obviously loved it. But when I was growing up I don’t remember seeing many obese children. It’s only now, over the last 25 years, that we have seen such dramatic increase in obesity. Why is that? We were eating our fair share of sugar when I was growing up – so sugar can’t be held completely accountable.I go back to my point that it is not only our diets but again the lack of physical activity that is perpetuating the obesity crisis – children being driven to school and not walking or riding their bikes, after-school physical activity programmes dwindling, kids becoming addicted to their iPads and Playstations. But I have to concede that it would be a good idea to cut at least 100 calories from each person’s daily diet – and with the high content of sugar in many of today’s processed foods I have to agree that these levels must be lowered if we’re to see improvement.Simon Capewell, a Professor of Clinical Epidemiology, states that sugar is the new tobacco and I agree with his sentiments: ‘Everywhere, sugary drinks and junk foods are now pressed on unsuspecting parents and children by a cynical industry focused on profit not health. The obesity epidemic is generating a huge burden of disease and death.’It is also stated that 1 in 4 adults in England is obese and these figures are set to go up to 60% of men, 50% of women and 25% of children by 2050. The incidence of type 2 diabetes leading to cardiovascular disease and morbidity is going to be unmanageable unless this stops. Currently, obesity and diabetes already cost the UK £5 billion every year and experts state that it could reach £50 billion in the next 36 years. This is an astronomical rise, and should have us all very worried.So, is taxing the food industry the right way to go or should we be focusing on education?  There is a general consensus that children are the primary targets of food marketing and as a very vulnerable group, heavy marketing of sweets and sugary drinks contributes to skyrocketing childhood obesity. I am of two minds here. I am a huge advocate of public health and believe that it’s vital for public health officials to educate us in the right choices.  But, I think somewhere along the line we must take responsibility for ourselves as individuals; we can’t always blame everyone else for our problems. I do feel deep down that the government has a role to play with healthy messages to deal with the ill effects of high calorie intake, but it must be a structured push from the government and ultimately the onus lies with us to take action.I am still very happy that this report didn’t come out when I was a kid, as I’ll never forget those fantastic days when we had our own cotton candy machine. I am always up for a good party, as many of you who grew up with me can remember the three-day parties at 104 High Street. But since those days things have changed and it’s more important than ever to be aware of your personal safety. Notting Hill Carnival is one of the oldest carnivals held in Europe and has been the pinnacle of fun at the end of summer for as long as I can remember. I can’t wait. But to make the most out of your weekend make sure you take the following precautions and keep yourself, your friends and your family safe.
  1. Do not over-indulge in alcohol and make sure that you are well hydrated with other sources of non-alcoholic beverages.
  2. Be very careful what you eat and where you eat from – make sure that foods have been handled well by the vendors you go to and that the meats are thoroughly cooked. We love jerk chicken, but food poisoning can be very dangerous.
  3. You should wear sensible footwear. With stray glass and debris on the ground cuts can easily get infected.
  4. If you sense trouble/danger, do not go towards it – move away from it quickly and calmly.
  5. Be very careful of your valuables. We want to look our best at carnival, and show off our bling – but it’s a great opportunity for pickpockets.
  6. Always have an exit strategy and be very aware of your surroundings. Arrange a meeting point for if you become separated from your friends – phone signal can be unreliable in big crowds.
If you follow these guidelines you’re going to have a fantastic time soaking up the Caribbean atmosphere and catching the last of the summer rays. Have a fantastic weekend! This is a tricky one. This blog has no intention of causing offence to any of my colleagues, but simply to give my opinion. I have written extensively on the subject of athletes as role models, and I don’t believe that we should hold them on a pedestal or put sport stars in that elevated position. However, doctors should be role models and, in my opinion, they need to look ‘healthy.’ Doctors have a responsibility to their patients to exude an aspirational image of health.A close friend of mine was very disturbed about the amount of obese and overweight doctors and the amount of doctors who smoke. The first thing that comes to mind is ‘practice what you preach.’ Would you go to a financial advisor who was bankrupt, or to a plumber who’s sink was leaking? How are patients supposed to take advice from a doctor who doesn’t project the image of a healthy lifestyle?But then again appearances can be deceptive. People come in all shapes and sizes and we know we can’t make snap judgments about overweight physicians; they may practice good habits while many seemingly fit physicians may have very bad habits. So, do we rush to judgement? Dr Regina Benjamin, former US Surgeon General, once said that, ‘what makes a physician credible is whether they practice what they preach and the lifestyle recommendations they propose.’ I can’t help but agree with this sentiment – but judging physicians solely on their outward appearance could be detrimental.Now the NHS has spoken up on this issue. A recent article in the Telegraph states that overweight doctors and nurses have been told to slim down by the NHS Chief. There are 700,000 NHS staff classed as overweight or obese and they must shed these excessive pounds in order to set a good example to patients according to Simon Stevens, NHS England Chief Executive. My question is: how are they going to implement this? I can understand the NHS’ urgency to address this issue as it emerged recently that obesity and its related health problems, may now account for a third of the 110 billion NHS budget. But is it a feasible task?Finally, there is another side to the argument. Physicians are still people, and they can be just as imperfect as their patients. Expecting a doctor to always follow recommendations that he or she gives their patients, whilst intuitively logical to expect, is probably not realistic in real-life situations. This is a very interesting debate. I look forward to see whether Stevens’ order will actually change the aesthetics of the NHS. ‘So long as the memory of certain beloved friends lives in my heart I shall say that life is good’ – what a fantastic quote by Helen Keller.Where does that leave many Londoners? A recent study shows that 1 in 20 Londoners have no close friends. This would surely leave many without vital support. Ruth Sunderland, the Chief Executive of RELATE, said that this survey reveals a divided nation with many people left without support, friends or partners. She goes on to say that it appears a significant number of people have no close friends or rarely feel loved. WOW!This sense of isolation would have a devastating effect on someone’s self-esteem. Who would you turn to during life’s challenges? London throws a whole array of challenges in your face on a daily basis, your career, romantic relationships, finances, injury, illness – without a close friend, dealing with these problems can become overwhelming.Could this be a result of modern technology? Twitter, Facebook and LinkedIn have all but eliminated the need to talk to people face-to-face. Is this technological distancing killing our ability to maintain meaningful relationships? With divorce rates constantly on the rise it’s clear that as a nation our ability to preserve long-term bonds is slipping. But why is the incidence of loneliness so high in London? Does the fast-pace of this vibrant city overwhelm us and sweep us along in an autonomous current? The evidence suggests so.Maybe there are some people who actually prefer to be alone. Maybe we have become such an untrusting society that people don’t want to venture out for the risk of being hurt.  These are all questions that need to be investigated. But regardless of preferences, humanity need friendships and relationships in order to survive, and this study highlights a worrying shift in our culturePersonally I can assure you that our approach to friendships now feels much different than 30 or 40 years ago when values, trust, politeness and behaviour was much different. Maybe generational factors have a part to play in this whole issue. I am sure that there will be more academic work to determine why we seem to be a society with less and less close friends.

‘The best time to make friends is before you actually need them.’

The emergence of obesity represents one of the most widespread threats to public health and wellbeing in the UK, with 67% of men and 57% of women either overweight or obese.The NHS is estimated to spend over £5bn a year on diseases linked to obesity such as strokes and diabetes. Within a few decades, that is predicted to climb to £15bn. Ok, so where do we go from here? Surgical solutions? This is an extremely contentious issue, and one that I feel very strongly about. The issue of diet in this country needs addressing – now!The intrinsic problem with diets is one of sustainability. Most diets demonstrate some short-term weight loss, but these loses don’t seem to be maintained over a long period of time. Therein lies the problem – overweight people turn to diets to lose weight, they achieve short-term weight loss, but then gain the weight back, if not gaining even more than they started with.Diets work because they are highly restrictive eating programs. Trust me… most diets I have seen (and I have seen a lot) are not a lot of fun. Food is to be enjoyed and is a very important part of our culture and how we interact with each other. That’s why it’s more important to teach people how to eat rather than resorting to just limiting your food. EDUCATION, EDUCATION, EDUCATION.With such a widespread obesity problem it is surely wise to investigate why people overeat. The underlying, psychological factors are a crucial factor. I truly believe that being over weight has a great deal to do with behavioural issues and as health professionals we should be providing behavioural support and psychological counselling as part of the weight control programs.These restrictive diets just can’t work as a long-term solution – they restrict you from eating foods that you actually enjoy and this may even lead to a diet-bingeing cycle. In addition, when you restrict food, your body has a mechanism where it doesn’t want to be starved; in response the body actually slows its metabolism, which of course makes it more difficult to lose weight. Diets can also be very harmful as they may lack essential nutrients and force you into bad eating behaviours leading to yo-yo dieting. And I haven’t even touched on the potential psychological problems and eating disorders that can be a by-product of intense dieting. Let’s face it, as I said earlier there’s no pleasure in a restrictive diet.Finally people should be wary of the diet industry that peddles magic weight loss potions; THEY DON’T WORK…. Remember, these products, pills and potions are marketed for one purpose – money. Do you think these companies are primarily concerned with the state of the nations health? I don’t.The bottom line is, fad diets just don’t work. The most important thing is to develop proper eating habits with a healthy variety of different foods and regular physical activity – that is the key for a healthier lifestyle and weight management. I started this blog with the idea of looking at sports and medicine and life and the intrinsic relationship that links these three elements. In other words, I wanted to discuss other relevant medical topics. With this in mind, it’s absolutely imperative that I address the latest medical crisis, the Ebola outbreak.It’s vital to understand that this is not just an African problem. I say that because I can remember as a medical student, when HIV first came to prominence, many people thought it was a problem limited to the Gay community and most heterosexuals felt safe and that it was not their problem. As we all know now, this was not the case. The same is true of the Ebola virus. This is not a problem that we can sweep under the rug or confine to certain part of the world – this is a global crisis and the sooner we recognise that the better.The Ebola viral disease is severe and is reported to be 90% fatal in humans. It first appeared in the mid-1970s in a village situated near the Ebola River from which the disease takes its name. The virus is transmitted through close contact of bodily fluids such a sweat and blood. The symptoms include fever, muscle pain and sore throat which rapidly escalate to diarrhoea, vomiting and external and internal bleeding. When you think how this virus is transmitted, you have to consider whether could it affect sporting competition, especially in contact sports such as football.The World Health Organisation (WHO) and the US Center for Disease Control (CDC) have both said that the risk of Ebola spreading beyond Western Africa is extremely low. In fact, Gregory Hartl, a spokesman for the World Health Organisation, stated that the virus is actually difficult to transmit. But just imagine what would happen if Ebola came to the UK?  Despite what the WHO and CDC state, I don’t think this scenario is as far-fetched as it might sound – especially with air travel as common as it is. Borders don’t mean as much as they did in the past.Remember, this is not just an African problem… this is a World problem. I am a real fan of the NHS. It does the best it can with the available resources, but there’s a demand for more funding and significant restructuring. It seems quite obvious that we need a change in the way the NHS is funded. When the NHS began there were no MRI scans, people didn’t live as long as they do now; drugs and procedures were not expensive as expensive as they are now. Our knowledge of medicine has evolved, now NHS must evolve as well.An article in the May BMJ highlighted that GPs had voted against charging patients for their services. I fully appreciate that the NHS was built as a free service, but you can’t have it both ways. If you want improvements, you have to pay the price – there’s no way around that. The NHS cannot continue in the way that it’s going, but Governments are scared of change. Any suggestions of part payment for the NHS could lead to a catastrophic result in the polls. In many ways the NHS is like Social Security in the United States… no Government has the courage to try to change it.What I would suggest is a graduated co-payment system. Why should a billionaire have free health care? Why can’t that billionaire contribute a little bit towards the NHS? We should provide free health care for those who can’t afford it and have a graduated co-pay system for people who can afford to contribute more. Surely this would be a sensible solution.I believe that General Practice is unsustainable in its current format and has suffered years of under-funding causing immense and irrevocable damage. There is a recruiting and retention problem of GPs; especially with the increasing workloads, it is becoming unmanageable and unsustainable. These sentiments were presented in a motion by Helen McKeown from Wiltshire Local Medical Committee, she goes on to say that the time has come to lead a profession that puts a true price on the value of General Practice. She further says that if the cornerstone of the NHS is to remain firm then it’s vital that money is put in to General Practice. A fee for some services for wealthier individuals would sustain the NHS while they build up a reliable workforce and make General Practice more attractive than retirement and General Practice abroad. Finally, she goes on to say that we need an honest Government who is willing to say who and what will be completely covered by GPs as an NHS service.I agree with McKeown when she emphasised that a system of charging patients should not profit the private sector but would directly support General Practice. However, there are GPs, for example Laurence Buckman, a member of the BMAs General Practice Committee, who disagree and states: “You then get survival of the richest and not treatment for the sickest”.  Personally I am not sure about that.It’s clear that this debate will continue and the current way that the NHS, especially General Practice, is funded has to be reformed. The NHS is a great concept, a great idea, but unsustainable in its current format. We need our leaders to step up and make the necessary changes.