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** 21 August 2023
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** UK
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** Wales: (#2) Food and drink culture compared with smoking in 1960s (#2)
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** Scientists hope weight-loss drugs could treat addiction and dementia (#1)

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** International
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** US: E-cigarette usage nudges people toward quitting smoking, study shows (#3)
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** UK
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** Food and drink culture compared with smoking in 1960s
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**
Does Wales have a problem with unhealthy lifestyles?
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This summer, two leading politicians have suggested people need to manage their personal behaviour around eating and drinking in order to help the Welsh NHS function.

TV's Dr Chris van Tulleken, who is well-known to a generation of children as one half of the CBBC programme Operation Ouch, likened today's obesity and excess drinking to that of smoking culture in previous decades.

But for Dr Chris, an infectious diseases specialist at University College London, the problem is not the people but the social and commercial environment they are surrounded by.

His new book, Ultra Processed People, looks at the forces promoting the ultra-processed food. This is food which is very altered from its original state, with additives and ingredients not found in a typical kitchen.

Chris said the regulation of alcohol, ultra-processed and gambling apps "that we know function as addictive products" was "so light touch so as to be almost non-existent".

He compared this with the attitude taken towards tobacco 40 or 50 years ago when it was "an addictive product aggressively marketed 24/7. Saying that people should drink less and eat healthier is a bit like saying to people in the 1960s that they should smoke less," he explained.

"It was available everywhere; it was as cheap as dirt and so everyone smoked. No-one looks back at the '60s and wonders 'why didn't everyone just gird their loins and stop smoking?' That would be absurd.’’

That is now the case with food and alcohol, he argues, and takes a sideways look at drink packaging to prove his point. "We have on all our [alcoholic] drinks the instruction to drink. It says 'drink aware'. Imagine if on your pack of cigarettes it said 'smoke aware', or 'smoke responsibly'. What does that mean?

When it comes to food, he said people did not suddenly "collectively lose willpower" over how much they were eating, but the type of food available - processed, calorie dense, low in fibre and addictive in a way wholefoods are not.

Chris also lays much of the blame for this squarely at the door of social inequality and poverty. Obesity among the most deprived social groups is 32% compared with 20% in the least deprived.

People need short-term solutions to the discomfort of their lives. Ultra-processed food is another way of the harms of poverty being manifest," he said.

Source: BBC News, 20 August 2023
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** Scientists hope weight-loss drugs could treat addiction and dementia

They have taken the celebrity world by storm as a slimming jab and become a vital tool for managing type 2 diabetes. Now drugs such as Ozempic are being researched to look at whether they could help conditions ranging from alcohol misuse to dementia.

These medications have become hugely popular, not least because they can help people lose more than 10% of their body weight. Researchers who hope the drugs could bring further benefits are setting up clinical trials.

Dr Christian Hendershot, director of the clinical and translational addiction research programme at the University of North Carolina at Chapel Hill, said: “We know that drugs in this class are remarkably effective for several important health outcomes – many of which can influence longevity and quality of life’’.
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Dr Harshal Deshmukh, a consultant endocrinologist and senior clinical lecturer at the University of Hull, said: “Excessive weight has been identified as a significant risk factor for a range of comorbidities, including fatty liver, various cancers, dementia, and cardiovascular diseases.
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After people given these drugs reported a reduction is their alcohol consumption, the idea came about that the drugs found in Ozempic could be used in drug addiction. Hendershot has said that animal models suggest that the medication could affect drug-seeking and consumption, with the finding being consistent, especially for alcohol.

The use of weight-loss drugs for other conditions, including PCOS, addiction and dementia are not yet certain with many clinical trials being in their early stages, there is still a chance that some applications will turn out to be unfeasible.

Yet despite a dose of caution, researchers such as Simmons seem upbeat, excited even.
“These drugs are already changing the world, we just don’t know whether they will change how we treat addiction,” he said.

Source: The Guardian, 21 August 2023
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** International
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** US: E-cigarette usage nudges people toward quitting smoking, study shows

E-cigarettes do have value as a smoking cessation aid, according to a new study just released by a team of MUSC Hollings Cancer Center researchers.
This new study, the largest trial of e-cigarettes in the U.S., showed that e-cigarette usage nudged people toward quitting smoking – even people who had entered the trial saying they had no intention of quitting. The results were published in eClinical Medicine this month.

"This is not a panacea for smoking cessation," cautioned Matthew Carpenter, Ph.D., first author on the paper and co-leader of the Cancer Control Research Program at Hollings.
Nonetheless, he was surprised to find that all of the hypotheses tested in the study were confirmed.

Carpenter and his colleagues, including Hollings members Tracy Smith, Ph.D., Jennifer Dahne, Ph.D., Michael Cummings, Ph.D., and Graham Warren, Ph.D., designed the study in a naturalistic way to mimic real-world conditions as much as possible – also a first for e-cigarette studies.

"First off, we took smokers who did and did not want to quit. So right off the bat, not everybody wanted to quit. Secondly, we gave them very little instruction on how to use it," he continued.

Instead, people were given e-cigarettes and told they could use them or not, as much or as little as they wanted. A control group didn't receive anything.

The study showed that people in the e-cigarette group were more likely to report complete abstinence from combustible cigarettes. They were also more likely to report that they'd reduced the number of cigarettes per day that they smoked and their number of "quit attempts." Quit attempts are an important metric because people usually need multiple tries before they can successfully stop smoking.

Source: News Medical, 18 August 2023
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** See also: Carpenter MJ et al. Effect of unguided e-cigarette provision on uptake, use, and smoking cessation among adults who smoke in the USA: a naturalistic, randomised, controlled clinical trial ([link removed]) . eClinicalMedicine. 2023 Aug 15.
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