26 October 2023
Over half of Brits may have high cholesterol. Will ending ‘bad’ cholesterol testing add to the problem?
The most comprehensive research into cholesterol ever conducted in the UK has found 54% of Brits could have high total cholesterol levels. Now a medical expert says the recent switch from measuring LDL ‘bad’ cholesterol levels to a new ‘non-HDL’ test could be causing many Brits confusion.
October is Cholesterol Awareness Month, and a leading medical expert says increased awareness of this condition can’t come too soon. A quarter of a million volunteers have taken part in a huge testing programme for blood pressure and cholesterol levels, and the results are very concerning.
Dr Avinash Hari Narayanan (MBChB), Clinical Lead at London Medical Laboratory, says: ‘27% of people taking part in Our Future Health’s new research programme were found to have high blood pressure and a huge 54% were found to have high total cholesterol levels.
‘High cholesterol is a major underlying risk factor for cardiovascular disease (CVD), which is the leading cause of death worldwide, often leading to heart attacks and strokes. In England, high cholesterol leads to over 7% of all deaths and affects up to 60% of adults, according to NHS figures. Further research has revealed that, if 90% of people with CVD were identified and treated, almost 14,000 heart attacks, strokes and deaths would be prevented in three years.
‘With cholesterol levels having such a critical long-term impact on our overall health and 54% of us likely to have the condition, absolute clarity is needed in test results and interpretation. However, the UK has recently switched from the well-known and understood measurement of LDL (low-density lipoprotein), traditionally known as “bad” cholesterol, to a new measure. It’s vital that this change doesn’t confuse anyone receiving a test.
‘Previously, the focus of a cholesterol test was on our LDL (“bad”) cholesterol levels. That’s because not all cholesterol is a problem. It’s a natural fatty substance in our blood, produced in the liver and in some of the foods we eat, which helps to keep the cells in our bodies healthy. However, high LDL levels, uncontrolled, can increase our risk of heart attack and stroke.
‘Our LDL “bad” cholesterol levels used to be compared alongside our HDL (high-density lipoprotein) “good” cholesterol levels, as well as the total cholesterol level. Many people who are carefully watching their diet have become used to measuring their LDL levels over time as a key indicator of their potential health risks.
‘However, some researchers believe that measuring your “non-HDL” cholesterol levels gives a better assessment of the risk for heart disease than measuring only “bad” LDL levels. Because of this change, your “non-HDL” level is the measurement patients will probably be given now by their GPs.
‘Many people with high blood pressure will have become knowledgeable about LDL cholesterol, which makes up most of the body’s cholesterol. LDL carries cholesterol to the cells that need it. If there’s too much cholesterol for the cells to use it can build up in the artery walls, leading to disease of the arteries. In general, the higher your total and LDL cholesterol levels, the higher your risk for coronary heart disease. The former NHS guidance (still given by NHS Scotland) said LDL levels should be 3mmol/L or less.
‘However, the new non-HDL measure is very different. England’s NHS says, as a guide, your non-HDL cholesterol should be lower than 4mmol/L. That is potentially confusing, as a 4mmol/L reading of LDL would put you at a notably higher risk of cardiovascular disease.
‘So why has this change been made and are patients always clear about what their new measurements should be?
‘There are some good reasons for the change. Some heart attacks happen to people who don’t have a high LDL level. Researchers found we also need to consider other parts of “bad” cholesterol, known as VLDL (Very low-density lipoproteins), IDL (Intermediate-density lipoproteins) and lipoprotein(a), a type of LDL with an added protein. Previous testing also ignored triglyceride, another type of blood fat.
‘What do these new measurements tell us? VLDLs carry triglycerides and, to a lesser degree, cholesterol to our tissues. IDLs are created when VLDLs give up their fatty acids. They’re then either removed by our liver or converted into LDL. The added protein in lipoprotein(a) makes it stickier, narrowing arteries. It is thought to be largely caused by our genes rather than diet. Finally, triglycerides are another type of blood fat. If your triglycerides are high, it can mean you’re at risk of heart disease, liver disease and diabetes.
‘When you take the new test, as well as your new non-HDL reading, you will also be given an HDL (good cholesterol) and total cholesterol reading, which should be 5mmol/L or less. With cholesterol becoming something of a “silent epidemic”, impacting 1-in-2 people, the new, more accurate testing should be welcome. However, those used to checking their LDL “bad” cholesterols may feel confused or still wish to monitor this reading separately. Many people have monitored their LDL cholesterol levels for years, to see how diet and lifestyle are impacting their readings. Losing this continuity could potentially lead to complications.
‘Fortunately, there are some up-to-date tests that, while offering the new non-HDL measure, also continue to identify LDL “bad” cholesterol levels. For example, London Medical Laboratory’s Cholesterol Profile testis a revolutionary and convenient home-fingerprick test. It measures total cholesterol, LDL, HDL, non-HDL, triglycerides and two other key markers.
‘London Medical Laboratory’s fingerprick Cholesterol Profile test is considered the gold standard in regular testing. It is used to measure seven key biomarkers enabling people to make the positive lifestyle and dietary changes needed to improve their chances of a long and healthy life. It can be taken at home through the post, or at one of the many drop-in clinics that offer these tests across London and nationwide in over 95 selected pharmacies and health stores. For full details, see: https://www.londonmedicallaboratory.com/product/cholesterol-profile
ENDS
London Medical Laboratory’s Clinical Lead, Dr Avinash Hari Narayanan, is available to supply exclusive written comment or for interview.
Australian Mental Health News
MPs have called for an urgent parliamentary inquiry into the impact of advertising on children and young people by harmful industries
A new study reveals that one in three (30%) parents are always worrying about their finances.
The report, created by Lowell, reveals how parents are impacted on a financial, personal and social level when having children, as well as how children are affected by debt in the family and the general financial implications for parents in debt from having children.
Key Stats include:
- 39% of parents say their debt has socially isolated them from friends and family
- 43% of new parents say their mental well-being has deteriorated as a result of the debt
- 32% are struggling to find money for food, bills and essentials after having children
- 36% even say they can’t spend enough time with their child as they have to work more
Please see the full press release below, as well as further information via the blog here: https://www.lowell.co.uk/about-us/lowells-blog/lifestyle/dealing-with-debt-after-having-a-child/
2023 Suicide Prevention Awareness Day
“Creating Hope Through Action”
Suicide is a major public health problem with far-reaching social, emotional and economic consequences. It is estimated that there are currently more than 700 000 suicides per year worldwide, and we know that each suicide profoundly affects many more people.
“Creating Hope Through Action” is the triennial theme for the World Suicide Prevention Day from 2021-2023. This theme serves as a powerful call to action and reminder that there is an alternative to suicide and that through our actions we can encourage hope and strengthen prevention.
Brazil’s NHS equivalent, the SUS, is the largest Government-run public healthcare system in the world. It’s free at the point of access but faces strong demand and increasing wait times. London Medical Laboratory is now in talks about sharing some of the knowledge behind its revolutionary blood testing technology, to help the SUS identify health issues early and dramatically reduce future demand.
London Medical Laboratory, the UK’s first omni-channel blood testing, diagnostic and health check business, is in talks with the world’s largest Government-run public healthcare system, to help slash Brazil’s patient waiting lists.
Brazil’s NHS equivalent, the Unified Health System (in Portuguese the Sistema Único de Saúde or SUS) offers free care at the point of delivery. The SUS offers generally high-quality services but has growing concerns around patient access due to high demand and long wait times.
London Medical Laboratory(LML) is now discussing sharing some of the knowledge behind its revolutionary blood testing technology, to help the SUS transform into a preventative healthcare system. Using methods originally developed by LML and its partners, the SUS would be able to identify problems before patients even show symptoms. This could dramatically reduce future demand by diagnosing early some of Brazil’s most common health issues.
The founder and Co‑CEO of London Medical Laboratory, Flavia Araujo‑Rankin, was born in Brazil and is very familiar with the country’s healthcare system. She met with two representatives from Brazil’s Institute for Applied Economic Research (IPEA): Pedro Miranda, IPEA’s Deputy Director of Sectoral Policies and Studies, Innovation and Infrastructure and Priscila Koeller, who is a researcher at IPEA´s Centre for Research on Science, Technology and Society. The IPEA is responsible for investigating public policies and one of its projects is now focused on technological development and technology transfer in the health sector and for Brazil’s health care system.
Says Flavia: ‘This is a wonderful opportunity for LML to share its knowledge to help reduce the burdens on Brazil’s amazing but incredibly hard-pressed health service. There are currently around 618,593 doctors registered in Brazil; that’s an increase of around 70% over 2010. However, the total population is around 217 million and everyone is entitled to use SUS services (although 23% of Brazilians have private healthcare plans). That show the scale of the potential demand on Brazil’s public healthcare.
‘Another challenge is that Brazil has some 50,000 clinics but, largely, these cover more urban areas, whereas its landmass is some 3.3 million square miles.
‘With that in mind, LML’s blood testing technology could transform Brazil’s health care by preventing many cases of the most common conditions before they ever develop. For example, we were able to introduce LML’s tests for diabetes and high cholesterol to IPEA representatives. It’s thought at least 8 million Brazilians are suffering from undiagnosed diabetes. The disease leads to almost 55,000 leg or foot amputations every year. By identifying it at an early stage, through simple, finger-prick blood tests, the SUS could save both lives and money.
‘Similarly, more than 4 in 10 Brazilians are likely to have high cholesterol, which puts them at significant health risk. It can lead to heart attacks, strokes, dementia and other cardiovascular problems. Early diagnosis will dramatically impact outcomes and help decrease the strain on local services.
‘Here is how the blood testing system could work, helping to transform local healthcare:
- A patient attends their local health centre, such as a UPA (Unidade de Pronto Atendimento) clinic, to pick up a finger-prick blood testing kit.
- They take the test at home and drop the sample back at the clinic.
- The sample is delivered to a local SUS public laboratory, where it is processed.
- Using integrated technology, the results are assessed by healthcare professionals, with the potential assistance of AI.
- The results are sent to the patient and they and their clinic will be alerted if a health problem is identified.
- The patient can then be reviewed at their local clinic if needed, the diagnosis confirmed and any necessary treatment started.
‘In Britain, LML’s blood testing services are only directly accessible privately. Brazil could point the way forward, by being the first country to embrace a national policy of blood testing to pre-empt many conditions before they ever develop.
‘Prevention is always better than cure, no matter where in the world you are. We are very excited to see how LML’s knowledge and experience can be shared with Brazil’s IPEA representatives and its wider healthcare system to help further improve the success of its ambitious public healthcare services.
Mental health teams in schools are improving access to support
Mental health teams in schools are improving access to support, but not all children and young people are benefiting.
University of Birmingham News
Mental health teams in schools are improving access to support, but not all children and young people are benefiting
An NHS-funded programme delivering mental health services in schools and further education colleges has made significant early progress in its first three years, a study shows.
According to new analysis, there have also been considerable challenges, including supporting children with more specialist needs and staff retention within the service.
The study was funded by the National Institute for Health and Care Research (NIHR) and was undertaken jointly by the Birmingham, RAND and Cambridge Evaluation (BRACE) Centre and the Policy Innovation Research Unit (PIRU). The study also involved the London School of Hygiene & Tropical Medicine, RAND Europe and the Primary Care Unit, University of Cambridge.
In January 2020, the first mental health support teams (MHSTs) in England started delivering services. The teams work directly in schools and colleges, helping staff to promote emotional well-being for all pupils, and supporting children and young people with mild to moderate mental health problems. The programme is jointly led by the Department of Health and Social Care, the Department for Education and NHS England. By April 2023, an estimated 400 teams will have been created, supporting around three million 5 to 18 year olds.
Researchers explored the experiences of setting up and delivering MHSTs in the first 25 ‘Trailblazer’ areas, and their analysis is published today in the NIHR Journals Library. It includes survey data from nearly 300 schools and colleges; interviews with 132 people involved in implementing MHSTs; and focus groups with children and young people.
Positive feedback from schools and colleges showed staff felt more confident talking to children and young people about mental health issues, and were able to access advice and support more easily. Strengthened relationships between different agencies, such as education providers and mental health services, were also reported.
However, concerns were raised about the poor suitability of the cognitive behaviour therapy (CBT) approaches that teams had been trained in for some young people and some mental health conditions. While schools and colleges universally welcomed investment in ‘in-house’ mental health support, some were frustrated that MHSTs were focused just on ‘mild to moderate’ mental health issues, and concerned about the difficulties and long waiting times that children with more severe problems faced when trying to access help.
An additional challenge was achieving a balance in the different types of service offered. The researchers found that practitioners often spent the majority of their time supporting children with mental health problems, rather than working with teaching and other staff to promote good emotional health across settings.
Lead researcher Dr Jo Ellins, from the University of Birmingham, said: “Overall, children and young people who had contact with an MHST reported an overwhelmingly positive experience. Mental health services in schools and colleges are facing increased pressure, particularly following the pandemic, and the programme has significant potential. But teams may find it difficult to sustain activities focusing on promoting well-being, given the increasing demand for mental health support.”
Professor Nicholas Mays from the London School of Hygiene & Tropical Medicine, a co-author of the report, added that: “Our findings suggest that the gap between the support that MHSTs are providing and the criteria for accessing specialist help may be widening as a result of the Covid-19 pandemic. Schools and colleges in particular were concerned about the lack of available support for children and young people whose mental health needs fell between these services.”
Mental Health Minister Maria Caulfield said: “It’s excellent to see that Mental Health Support Teams are having a positive impact in schools, giving staff more confidence, improving access to advice and support, and strengthening relationships between schools and mental health services.
“This research shows there is room for improvement which I hope will be taken onboard as the number of Mental Health Support Teams will increase to almost 400 by April 2023. These will cover three million children and young people – part of an extra £2.3 billion a year investment into mental health services.”
Ellins et al (2023). ‘Early evaluation of the Children and Young People’s Mental Health Trailblazer programme’.
The study was carried out by two units funded by the National Institute for Health and Care Research (NIHR): the BRACE Rapid Evaluation Centre, and the Policy Innovation and Evaluation Research Unit.
The Birmingham, RAND and Cambridge Evaluation (BRACE) Centre is funded by NIHR’s Health and Social Care Delivery Research Programme to conduct rapid evaluations of promising new services and innovations in health and social care. It is a collaboration between the University of Birmingham, RAND Europe, the University of Cambridge and National Voices.
The Policy Evaluation and Innovation Research Unit (PIRU) is a collaboration between the London School of Hygiene & Tropical Medicine, the Care Policy and Evaluation Centre (formerly PSSRU) at the London School of Economics and Political Science, and Imperial College London Business School. It is funded by the NIHR’s Policy Research Programme principally to evaluate innovative policies and programmes across health services, social care and public health in England.
The University of Birmingham is ranked amongst the world’s top 100 institutions. Its work brings people from across the world to Birmingham, including researchers, teachers and more than 6,500 international students from over 150 countries.
The London School of Hygiene & Tropical Medicine (LSHTM) is a world-leading centre for research, postgraduate studies and continuing education in public and global health. LSHTM has a strong international presence with over 3,500 staff and 4,000 students working in the UK and around the world, and an annual research income of £180 million.
RAND Europe is a not-for-profit research organisation whose mission is to help improve policy and decision making through research and analysis. RAND Europe’s work lies on the spectrum between that of universities and consultancies, combining academic rigour with a professional, impact-oriented approach.
The mission of the National Institute for Health and Care Research (NIHR) is to improve the health and wealth of the nation through research. We do this by:
Funding high quality, timely research that benefits the NHS, public health and social care;
Investing in world-class expertise, facilities and a skilled delivery workforce to translate discoveries into improved treatments and services;
Partnering with patients, service users, carers and communities, improving the relevance, quality and impact of our research;
Attracting, training and supporting the best researchers to tackle complex health and social care challenges;
Collaborating with other public funders, charities and industry to help shape a cohesive and globally competitive research system;
Funding applied global health research and training to meet the needs of the poorest people in low and middle income countries.
NIHR is funded by the Department of Health and Social Care. Its work in low and middle income countries is principally funded through UK Aid from the UK government.
It is now widely acknowledged that mental health and well-being are as essential as physical health to the positive life chances of children and young people and the wider population. Protecting mental health at an early age is vitally important to ensure future mental well-being and resilience. This has become even more important as the country responds to the ongoing pandemic. We recognise the very important role that schools are currently playing, and the hard work which all school staff have done, in supporting children and young people’s mental health at this time. As we move forward through the phases of this pandemic, there will be a continued focus on good mental well-being, and on ensuring that the right help and support is available whenever it is needed. Recognising that teachers and school staff are not mental health professionals, this framework is intended to provide schools with guidance to assist in the continued support of children and young people’s mental health and well-being. The mental health and well-being of all staff, as well as children and young people, is key to the whole school approach…..More