Alzheimer's Link to Vitamin D Deficiency

A study from the University of California (on 382 men and women aged from 60 to 90) has shown that those with a vitamin D deficiency were more prone to dementia than those with a substantial vitamin D intake.

Those with a low vitamin D intake declined mentally three times faster than those with adequate levels.

Experts extimate that one in five adults and one in five children in England have low vitamin levels.

Vitamin D is formed by the action of sunlight on the skin, so during winter your levels can drop; walking outside as much as possible can help. Foods that contain vitamin D include oily fish, eggs and fortified foods. Aletrnatively you can take a supplement.

Lifespan Breaking News, issued Nov. 2015, from the Healthspan company.

Death and Social Media

Increasing numbers of people now use social media and may have multiple accounts on different services - Facebook, Twitter, LinkedIn, Instagram, Snapchat ... and more. So what happens when someone dies and their online accounts are still sitting there, visible to the world?

Here are a few facts on the situation in October 2015.

DeadSocial is a service that provides tools and advice for people wanting to manage their digital legacies and has a very informative website.

Facebook encountered pressure from users experiencing the additional loss of the deletion of their loved ones profiles, including irretrievable photos and memories. To avoid this, you can now nominate a Legacy Contact - someone you trust to look after your profile once it has been 'memorialised' by adding pre-arranged messages, accepting friend requests and other maintainance. The Legacy Contact cannot change any previous posts, read private messages or log in to the actual profile. With a memorialised account 'Remembering' is added as a prefix to their profile name; it won't show up in public searches but friends and family can still post and share photos. Facebook pages can also be closed down.

Google offers a similar service, where you can nominate a specific person to act as your 'inactive account manager' after your death.

Twitter will remove a person's account after proof of death has been received (a death certificateand proof that the person making the request is either immediate family or authorised to act) but do not allow (as of Oct. 2015) any form of access or memorialisation of an account. [This practice is common for most other online providers.]

A digital deactivation document from Saga Legal Services gives a list of the most popular websites and how to access and close accounts on behalf of a deceased relative. Co-op Funeral Care also have a useful online guide.

While not currently a legally recognised concept in UK law, you can nominate a digital executor in your will. This should ensure that a trusted person will be able to access to your accounts and deactivate them if you wish. You'll need to ensure that a list of your accounts and password details are in a safe place that your executor can access, especially as this information cannot be given to your solicitor (due to complications with the Computer Misuse Act). And never include online usernames and passwords in your will, as it could become a public document after your death.

Not comfortable with handing over your passwords? Make an effort to back up your online content as often as possible onto an external hard drive. Document what you want to happen to your accounts - you may wish your blog to stay online.

To preserve digital photos stored on cameras, laptops and photosharing sites, get physical copies of favourites printed and copy originals onto a hard drive.

Back up any music or film-based material - it is impossible to bequest your online library to anyone else as you only purchase a licence to access the resource (which terminates on your death), and not perpetual access.

Some social media users are leaving a final Tweet or facebook status in their last wishes, to be uploaded on their death.

Sources
Georgina Cronin: Living and Dying on Social Media in CILIP Update October 2015

Feature in Good Housekeeping, October 2015

Lowering Cholesterol

60% of people in Britain have cholesterol levels that are too high and increasingly are recommended to go on statins, but these have side effects and many are reluctant to go on a lifetime of pills. A small study conducted by Kings College, London, for the Trust Me, I'm a Doctor TV series, looked at whether cholesterol levels could be effectively lowered by changing your diet.

Most cholesterol is made in the liver and then sent to the cells that need it, bound to a lipoprotein called LDL (low density lipoprotein). LDL is often called "bad cholesterol" because high levels are associated with an increased risk of heart disease. HDL (high density lipoprotein) is known as "good cholesterol" because it carries cholesterol away from the arteries to the liver. Current recommendations are that levels of "bad" LDL-cholesterol should be less than 3mmol/l (millimoles per litre) and "good" HDL-cholesterol more than 1mmol/l.

Before the study, volunteers had their blood cholesterol levels sampled. They were then randomly allocated into three groups and followed one of three diets for four weeks.

• The first group was asked to switch from animal fats (full fat milk, full fat cheese, butter) to vegetable-based or low fat options. They were asked to cut out eggs, bacon and sausages, and stick to skinless chicken.
• The second group wasn't asked to give up any of the foods but were asked to eat 75g of oats a day, equivalent to three servings. Oats are full of fibre and any form of fibre - whether it is from grains, legumes (beans and lentils) or vegetables is likely to lower cholesterol by binding with fat and cholesterol in the gut and stopping it being absorbed.
• The third group was asked to eat normally but to add into their diet 60g of almonds a day (two handfuls). In recent years tree nuts such as almonds, walnuts and hazelnuts have become hugely popular thanks to studies which suggest they can lower cholesterol. Tree nuts are rich in fibre and plant sterols which may delay fat and cholesterol absorption.

Presenter Michael Mosley has a personal interest as his family tree is riddled with heart disease and, if unchecked, his cholesterol scores tend to soar. Rather than doing any one diet he tried combining elements of all three, cutting back a bit on bacon and sausages and adding the almonds and the oats. This approach is based on the Portfolio diet, developed by David AJ Jenkins in Toronto. The idea is to try lots of different cholesterol-lowering approaches at once.

The full Portfolio diet includes not only nuts and oats but plant sterols and soya. Plant sterols are found in fruit, vegetables and nuts, but in low amounts and they are in fortified margarines and yoghurts. Soya products have a reputation as a healthy alternative to dairy, but most randomised controlled studies don't show an effect. Soy seems to work by inhibiting cholesterol synthesis in the liver. Amounts of 15-25g have been recommended in order to get the maximum effect. A study published in 2011 found that people who tried the diet for six months saw an average reduction of about 13% in LDL-cholesterol. The best results were obtained by those who stuck closest to it.

So how did the programme volunteers get on? The results were not quite as expected.

•  Almonds: Half the group had a positive response and one person had an 18% reduction in their total cholesterol. However, some people had an adverse response. Their cholesterol actually went up, in some cases significantly. The raised levels of cholesterol in some almond eaters balanced the falls in others. On average there was no change.

• The porridge eaters and the low-animal-fat group did rather better, with an average fall in LDL-cholesterol of 10% and 13% respectively.

• Michael Mosley on the combination approach: His LDL cholesterol fell by 42%. This is in line with what most people experience who go on statins. Why did he do so well? Either the combination approach works better than isolated approaches, or his body responds more dramatically to the combination than most people.

Conclusion: Yes, you can drop your cholesterol significantly through modest changes to diet, but to get as big an effect as you would through taking statins you would probably need to combine a number of different approaches.

The 'Portfolio' Diet feature on Trust Me, I'm a Doctor, BBC2, July 22 2015

Care of Intimate Areas

Some useful facts about your 'lady bits'.

• The bits you can see are the vulva which consists of the labial lips, the clitoris and the urethra. The vagina is the tube that runs from the opening in this area up to the cervix (entrance to the womb).
• The bacteria that populate your vagina (vaginal flora) are mostly lactobacillus species and their role is to keep the vagina healthy by producing acids that inhibit the growth of yeasts and other harmful bugs. If this balance is disrupted, you become prone to infections.
• The inner lips of the vagina are the sweatiest part of your genitalia and very sensitive to emotional stress. The sweat glands prevent these super-sensitive areas from friction and over-heating.
• Do check with your GP any lumps or bumps (rarely a cause for worry), blisters or ulcers (may be caused by herpes infection) or warts (tend to have a cauliflower appearance, are contagious and can grow large).
• Some vaginal discharge is normal and is the vagina's own cleaning system. But check with your GP if it smells unpleasant, becomes blood-stained or very different from normal, or the area feels itchy or burning, as you may have an infection.
• Perfumed soap and feminine hygiene products and douching can upset the delicate pH balance of the vagina and leave you more prone to infection, and you may also have an allergic reaction to soap or shower gel in this area.
• Vaginal skin gets thinner and more fragile after the menopause. Your GP may prescribe topical oestrogen cream (not if you have oestrogen-dependent cancer). Non-oestrogen vaginal moisturisers are also available from your pharmacist.
• Cotton is best for underwear. Tight jeans and leggings and synthetic fibres raise temperature at the vaginal opening, leaving you vulnerable to yeast infections.
• Don't get a Brazilian wax. Your pubic hair provides protection for the vulva against friction, and helps prevent bacteria and other bugs entering your vagina.
• Use the loo after sex; urinating helps protect against urinary tract infections by washing away potentially harmful bacteria.

Feature in Good Housekeeping, April 2015

Living Longer

Some myths about ageing.

• It's inevitable our brains will decline. No. While we may get slower at problem solving or decision making, other skills (vocabulary, knowledge, number skills,etc.) peak in middle age and then remain fairly constant.
• We will all get dementia. No. The latest research shows that overall prevalence in the population has gone down by 1.8% to an estimated 6.5% of the population. Other high income countries show the same trend. This seems to be the result of better education, more stimulating environments and reductions in cardiovascular risk.
• Our best and most creative years are behind us. No. Highly creative people often live fast and die young which skews the data.
• Your work life is virtually over at 60. No. There is no evidece that older workers perform less well, have lower levels of motivation or are less productive. Highly personalised work arrangements may be available.
• You'll end up a grumpy old witch. No. A wide range of studies indicate we are increasingly happy until the age of 30; then there is a low point around 40; then people get happier again. This happens regardless of money, employment status or children. (And its the same for chimps and ornagutans.)
• You will wind down with age. No. Inactivity is what ages us. There is an age-related decline in aerobic capacity and muscle mass but bodies expect to be exercised. With age, muscles become deaf to the body's calls to take up amino acids to stay strong, but if you combine exercise with a small amount of protein around the time of exercise your muscles get the trigger they need to do this.
• Sex will peter out. No. People who have never liked it much give it up, while those who did like it continue to enjoy it.
• We will be miserable and dependent on others. No. The Newcastle 85+ study found that 84% had complete or a reasonable degree of independence, while only 8% needed intensive levels of care.
• There is nothing you can do about old age. No. Longevity has long been associated with restricitng calories. It seems we are designed to function at our optimum when hungry and active.

Feature in Good Housekeeping May 2015