EU to review some drugs containing sodium oxybate
June 20 (Reuters) - The European Union's medicine regulator said on Friday it has begun a review of some medicines that contain sodium oxybate and are used to treat alcohol withdrawal syndrome.
Sodium oxybate is an active ingredient that works by calming the activity of certain cells in the central nervous system and is also used to treat narcolepsy.
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Telegraph
44 minutes ago
- Telegraph
Bernie Ecclestone fired everyone in the team apart from me
As a man who came up with some of Formula One's greatest innovations, it is not a surprise that Gordon Murray marvels with fascination about the futuristic robots that operated on him last year. For decades, Murray – who spent two successful decades in F1 with Brabham and McLaren – has suffered from acid reflux, which increases the risk of oesophageal cancer. At the start of 2024 he was diagnosed with adenocarcinoma [cancer that starts in the glands]. 'For 15 years I've been going for an endoscopy every year and a biopsy. We caught it with one of those. The problem with oesophageal cancer is that it doesn't have many symptoms until it's too late, which is why the survival rate is very low,' Murray tells Telegraph Sport. Murray's brother Terry died of the disease 11 years ago. From there it was a choice of having surgery straight away or chemotherapy first and then robotic-assisted surgery. Murray chose the latter. 'The oncologist spent the best part of an hour going through the possible side-effects with me and my wife before I started the chemo and boy I got everything,' he says. The most extreme of the side-effects was atrial fibrillation, where Murray's heart rate soared to 180bpm. To remedy this, his heart was stopped and restarted. This delayed his procedure but he eventually had the operation to remove the cancer in July last year. The Da Vinci XI surgical robot used in Murray's procedure is controlled by a doctor. In Murray's case this was Professor Shaun Preston, based at Private Care at Guy's Hospital. Preston and his team have now performed more than 250 robotic-assisted cancer operations. 'The Da Vinci robots allow keyhole surgery to be performed with a magnified, immersive, 3D image that is better than the naked eye,' Professor Preston explains. 'It is like operating from within the abdomen and/or chest.' This groundbreaking technology, which allows surgeons to operate with greater precision, was a natural point of fascination for Murray the engineer. 'The surgeon sits on the other side of the room with a PlayStation, basically, and you are lying there and everything is done with robots,' he says. The surgery was a success and Murray was out of intensive care within six days. He claims to be back to working 11-hour days – although he has been getting used to being fed by tube. Murray, as enthusiastic as ever at 78, sees the similarities in the medical technology used in his operation and his own career. 'It's a bit like us prototyping a racing car. That's the fun bit for me: when you think of an idea and then you have to develop it before you actually go racing,' he says. 'Racing' is still what Murray is best known for, 35 years after he left F1. His years helping to revive Brabham, working with then owner Bernie Ecclestone, were undoubtedly the peak of his (and arguably anybody's) innovation in motorsport. Murray moved to the UK from his native South Africa in 1969 as a 23-year-old. Not too long after, he secured a job on Brabham's design team after meeting with then-designer and co-founder Ron Tauranac. In 1972 the struggling outfit was bought by Bernie Ecclestone, who sacked everyone in the technical team apart from Murray. He became chief designer at just 26, starting a period of revival that would result in 22 grand prix wins and two world championships. 'I should have gone home and had many sleepless nights thinking about it. But I didn't. I just came in in the morning and got stuck in and designed a car I thought would win,' Murray says. 'Bernie Ecclestone was my business partner for 14 years at Brabham. He fired the other four guys and just kept me in and said right, you're it, you're the chief designer – I want a brand new Formula One car.' To this day, Murray is still not totally sure why Ecclestone decided to keep only him on board. 'Nobody has ever got the real answer. One time he said 'I found him under a dust sheet in the corner of the design office'. Another time it was everybody – I don't know who 'everybody' was – told me to fire Gordon so I decided to keep him. Bernie loves coming up with these fun answers.' Murray has a suspicion that interest from other teams – he designed Alain de Cadenet's Duckhams LM for the 1972 edition of Le Mans and was approached by Italian team Tecno to design their F1 car – made Ecclestone think he was worth retaining. Murray says he would 'hate' to design F1 cars today because of the lack of freedom for designers. Back then the latitude in the regulations allowed him space to come up with some of motorsport's most enduring innovations and designs, including structural carbon fibre and pull-rod suspension. There was also the introduction of strategic pit-stops and refuelling in F1 towards the end of the 1982 season with the BT50. 'I did some calculations on the lap-time differential between half tanks and full tanks and that was very easy to calculate. We knew that going from empty tanks to full tanks was about 2.5sec a lap. So, if you could start on half tanks you would have a second-a-lap advantage, every lap,' Murray explains. 'Because there were no rules about refuelling I used pressure – we had a couple of old beer barrels and we pressurised one, I think 2.5bar or something and we could get 30 gallons of fuel in in three seconds. It was highly dangerous!' The problem was that turbo-charger issues were so persistent that they only got to the pit stop once in that period. The chance of a real and lasting advantage, Murray believed, had disappeared. 'Because we never finished a race, I said to Bernie 'we've completely blown it'. We've shown them now for about four or five races what we're going to do and when we arrive at the first race in Brazil [next season], everybody will have a half-tank car, a pit-stop car and they didn't. I couldn't believe our luck!' When you think of innovation and Gordon Murray and embody it within a single Formula One car, though, the machine that will pop into most people's heads is 1978's Brabham BT46B, or the 'fan car'. The design came about almost by accident. Brabham's flat-12 Alfa Romeo engine was too large to go down the ground-effect route of the Lotus 78, so Murray had to come up with another solution. He did so by studying the regulations and finding a loophole. The idea with the fan was to use it to create downforce – which it did, enormously – but because its 'primary purpose' was cooling it was not classified as a moveable aerodynamic device and was permitted within regulations. Getting it to last was problematic, though. 'We did some private testing at Donington and then Brands Hatch and the fans, which were composite plastic, all exploded,' Murray says. 'With only one week before the Swedish Grand Prix I had to recast all the blades in magnesium and machine the plastic hub for the fan in aluminium. When we got to Sweden I had no idea if it would work.' Although Niki Lauda and John Watson had to adapt their driving styles to get the best from the new car ('I had to explain to them that their approach to a corner – forget everything they knew') the Austrian won the race at Anderstorp by 34 seconds. However, after protests and wrangling between the teams and the sport's governing body, the fan concept was banned. Murray's time at Brabham ended in 1986 after two drivers' titles. By that point he decided he wanted out of F1. 'We lost Nelson Piquet, we lost the tyre contract, we lost the BMW engine contract. I thought I've just won two world championships… I should go and do something different. Bernie by then had definitely got his mind set on running Formula One,' Murray says. Ron Dennis at McLaren had eyed Murray to replace Ferrari-bound John Barnard. After some persuading, Murray took up the offer to become the team's technical director for 1987. At the time, McLaren had a reputation for stuffiness and rigid formality. Woking was a stark contrast to Brabham, partly down to the enormous difference in resources. Murray says he was still given latitude to operate, technically and personally. 'My contract said I had a completely free hand, even the way I dressed – so it didn't change much there. Likewise, just like Bernie, Ron Dennis gave me a completely free hand with the technical side of the business.' The result was a perfect end to a storied F1 career and 'a nice way to bow out': three double world championships, with Ayrton Senna taking two drivers' titles and Alain Prost the other. Of all the drivers Murray worked with, it is no shock that he rates Senna as fastest. But he has a lot of affection for another Brazilian – Nelson Piquet, who won two drivers' championships in 1981 and 1983 in Murray's cars. 'He had a bicycle and a flat nearby and he came in every day and sat at my drawing board and asked questions all day. The interaction I had with Nelson in those seven years was very, very special.' After leaving F1, Murray designed the McLaren F1, the company's first sportscar. Its revolutionary design, fittingly, utilised a carbon fibre monocoque. 30 years ago last weekend, a modified F1 GTR won the 24 Hours of Le Mans, the last road car to do so. Of all Murray's achievements, he calls this 'top trumps'. 'Forget the fact that it was a GT car, not a prototype – it wasn't supposed to win. I think that is a much harder thing to do than winning a world championship in Formula One because you only get one shot at it. 'When I first thought about doing Le Mans in '72, I was terrified because I knew what went wrong in a grand prix car in two hours. That is like doing a whole season without stopping.'
Telegraph
2 hours ago
- Telegraph
The healthiest cornflakes (and the ones to avoid)
Back in 1969, Neil Armstrong's one small step for man was fuelled by one big bowl of cornflakes, according to Kellogg's, who sent cubes of their cereal into orbit for his Apollo 11 trip to the moon. The cereal was already a favourite back on firmer ground in Britain, having been a staple on supermarket shelves since 1922 – and it's still going strong today. Around 60 million boxes are produced in the UK every year – and that's for Kellogg's alone. Despite the rise of smashed avocado on toast and fancy Greek yogurt and berries, a bowl of simple cereal remains the go-to breakfast for around a quarter of the population, providing around half of fibre intake for the average adult, according to the latest National Diet and Nutrition Survey. But how healthy is the perennially popular breakfast? 'Cornflakes are generally low in fat and calories and often fortified with vitamins and minerals, such as iron and B vitamins, which is a positive,' says Nichola Ludlam-Raine, a nutritionist and author of How Not to Eat Ultra-Processed (£16.99, Telegraph Books). 'However, they are also fairly low in fibre and protein, and some versions contain added sugars.' Plus not all cornflakes are equal, so it's important to choose your box wisely. It's for this reason that we gathered the nutritional information and ingredients for 10 different types of cornflakes – from the classic Kellogg's to an 88p box from Aldi – and asked our nutritionist to rate them based on their nutritional values. Although each box has near identical calorie counts (from 111 to 118 per 30g portion), as well as fat and protein levels, Ludlam-Raine sifted through the sugar, fibre and salt content to unpick the best from the worst. Skip to: Nestlé Sainsbury's M&S Kellogg's Tesco (Free From) Waitrose Aldi Asda Tesco Lidl 10) Nestlé GoFree Cornflakes The main ingredient in cornflakes is, unsurprisingly, corn, but they also contain barley, which is a source of gluten. This gluten-free option, made without barley, is high in sugar, with 2.6g per 30g portion, making them more sugary than Kellogg's. 'These have the highest sugar content on the list, still fortified and gluten-free, but worth noting if keeping sugar intake low is a priority,' Ludlam-Raine says. 9) Kellogg's The original Kellogg's cornflakes is not the healthiest as it contains 2.4g of sugar per 30g portion (0.7g more than the top-ranked cornflakes). 'It's higher in sugar than supermarket own brands, though well fortified,' Ludlam-Raine notes. It is also one of the highest in salt, with 0.34g per 30g portion. This organic cereal from Sainsbury's contains 0.6g of sugar per 30g portion, around a third of the sugar found in most other own-brand cornflakes. However, as it is organic, it is not fortified, Ludlam-Raine notes. It's a good option if you're trying to reduce your sugar intake but it won't offer the vitamins and minerals that many people are lacking in, such as vitamin D, adds Alison Clark, a registered dietitian and spokesperson for the British Dietetic Association. 7) M&S Only 1 Ingredient Corn Flakes Part of the M&S range made with few ingredients, the one-ingredient cornflakes contain only corn and naturally-occurring sugars. As a result, they are the lowest sugar cornflakes from major supermarkets, with 0.2g per 30g portion. However, their ranking has been nudged down because they are not fortified. 'This option is good if you're specifically looking to avoid sugar, but lacks the micronutrient benefits of fortified options,' Ludlam-Raine says. 6) Tesco Free From Cornflakes This gluten-free option from Tesco has a similar calorie and fat level to standard cornflakes but is higher in sugar (2g per 30g) than most other options. However, it is also higher in fibre (1.2g) and lower in salt (0.08g) than other cornflakes. 'This is a good gluten-free option with moderate sugar content and full fortification – a strong choice for those with dietary needs,' Ludlam-Raine says. 5) Waitrose Waitrose Essential cornflakes contain slightly higher sugar than the option from Aldi (2g per 30g) but have a bit more fibre (0.8g per 30g). 'It is still a reasonable choice with fortification,' she says. 4) Aldi The cornflakes from Aldi contain a slightly higher amount of sugar (1.9g per 30g) and they're also lower in fibre, with 0.5g compared to the 0.8g found in most of the other supermarket own brand versions. 'But the sugar level is still low overall and the cereal is fully fortified,' Ludlame-Raine notes. 3) Asda ' This option from Asda is comparable to other supermarket own-brand offerings, low in sugar (1.8g per 30g) and fully fortified – a good choice,' Ludlam-Raine says. 2) Tesco The cornflakes from Tesco contain slightly more sugar (1.8g per 30g) than the top-ranked cornflakes, but less than most options on this list, with 1.8g per 30g serving. 'This is a good low-sugar option from Tesco, with full fortification,' Ludlam-Raine says. Best overall for health: 1. Lidl It's the Crownfield Corn Flakes from Lidl that come out on top, according to Ludlam-Raine. They are low in sugar, containing 1.7g per 30g portion, she notes. This is the lowest out of all other options, apart from M&S Only 1 Ingredient cornflakes, which are not fortified. As these are fortified with vitamins, they are the best choice. How much should you eat? The portion size listed on the box of cornflakes, and other cereals, is 30g. But pour out your usual bowl and weigh it for a shock about how little 30g is. 'In reality, many adults naturally pour a larger portion (closer to 40–50g),' Ludlam-Raine confirms. In fact, most adults will need more than a 30g portion to not only keep them full but provide enough nutrients, as cornflakes are low in fibre and protein, she explains. 'If you want a larger portion, that's OK, especially if you're quite active – but be mindful of balancing it by adding protein fibre, and healthy fats.' How to boost the healthiness of your cornflakes Obviously, milk is the first addition to start with. Around 150ml to 250ml is a good guide, as it's enough to moisten and cover the flakes, but the exact amount you choose to add depends on preference and if you are drinking more milk later in the day, she notes. Choosing semi-skimmed or whole milk will provide protein and fat to support fullness, or you could try combining your flakes with Greek yoghurt or kefir (a fermented milk drink) for extra protein and gut-friendly probiotics, Ludlam-Raine says. 'Unsweetened fortified plant-based milks (such as soya or pea milk) can also be good options, as they provide protein and contain added calcium and vitamin D (note that organic versions do not have nutrients added),' she says. 'We use fortified oat milk at home.' For toppings, she recommends fresh fruit such as berries, sliced banana or grated apple and pear for extra minerals, fibre and natural sweetness. A small handful of nuts or seeds, for example chia seeds, flaxseeds or almonds, will add even more healthy fat, protein and fibre. It will benefit your health to add these top-up ingredients if you're regularly having cornflakes for breakfast, as, on its own, cornflakes are too low in protein and fibre to keep us sufficiently fuelled for the morning. 'It can be fine as part of a more complete breakfast if you add other foods for example fruit, nuts and kefir,' Ludlam-Raine adds. How do cornflakes compare to other breakfasts? Cornflakes are low in calories and fat, making them healthier than many other types of cereal, like sugar-coated Frosties (which are one-third sugar, containing 11g per serving, compared to the 0.2g to 2.6g in cornflakes) or granola, which despite appearing healthy, are often very high in calories, fat and sugar, Ludlam-Raine says. Saying that, there are healthier cereals. Shredded wheat, for example, has no added sugar and is high in fibre, Ludlam-Raine notes. 'Weetabix too is good as it's high in fibre and fortified with nutrients,' she says. 'These are cereals which can be added to easily too – from different milks to fruits and nuts too.' For a healthier everyday breakfast that isn't cereal, she recommends porridge oats with milk, fruit and seeds; wholegrain toast with nut butter and fruit; Greek yoghurt with fruit, seeds and muesli; and wholegrain cereals with a good fibre content, mixed with fruit and seeds. 'These options provide more lasting energy, better support blood sugar control and help meet your fibre needs, which many people (over 90 per cent) in the UK fall short on,' Ludlam-Raine says. Verdict: Are cornflakes healthy? 'Cornflakes can form part of a healthy breakfast, but on their own they aren't the most balanced choice,' Ludlam-Raine says. 'They are low in fibre and protein, meaning they may not keep you full for very long, which can lead to impulse or excessive snacking later in the morning.' Clark agrees. 'I wouldn't recommend cornflakes as a healthy cereal due to the low fibre content,' she says. While most options are fortified with vitamins, this is the case for most cereals so it doesn't make cornflakes especially healthy, she adds. 'If you enjoy cornflakes, choose those that are fortified with added nutrients,' Ludlam-Raine adds. 'Pair them with a protein source (such as milk or kefir, yoghurt and nuts) and fibre (fruit and seeds),' for an extra health boost.
The Guardian
2 hours ago
- The Guardian
Alcohol should have labels warning drinkers of cancer risks, charities say
Cans and bottles of beer, wine and spirits should explicitly warn drinkers that alcohol causes cancer, an unprecedented alliance of doctors, charities and public experts have said. Warning labels would tackle 'shockingly low' public awareness in the UK that alcohol is proven to cause seven forms of cancer and 17,000 cases a year of the disease, they claim. Dozens of medical and health organisations have written to Keir Starmer urging him to take the radical step of compelling alcohol producers to include such warnings in order to improve public health. The labels must be 'bold and unambiguous', said the World Cancer Research Fund (WCRF), which coordinated the letter. 'The evidence is clear: health labelling on alcoholic drinks is urgently needed in the UK to help save lives,' it said. 'They should carry strong, clear messages about the health risks, which include the risk of cancer, far beyond vague advice like 'consume in moderation'.' Kate Oldridge-Turner, the WCRF's head of policy and public affairs, said: 'Providing alcohol warning labels would empower millions to make informed choices by clearly understanding the risks.' Evidence cited by charities such as the WCRF and Cancer Research UK shows that alcohol increases the risk of breast, bowel, stomach, head, neck, liver and mouth cancer. Ireland is to become the first country in the world to include cancer warning labels on alcoholic products. From next May, alcohol sold in the republic will have to carry a warning that 'there is a direct link between alcohol and fatal cancers'. The labels will also warn that drinking can cause liver disease and affect foetuses. Prof Sir Ian Gilmore, the chair of the Alcohol Health Alliance, urged the UK to follow suit. He said: 'We must look to the fearless work of our neighbours in Ireland whose new labelling policy provides a level playing field for all producers, leaving no room for loopholes or hiding information behind QR codes or tiny print. 'Improved alcohol labelling, including clear health warnings about the link to cancer, is not just a public health measure, it's a fundamental consumer right. People deserve to know the risks so they can make informed choices about their health. But current labels and weak regulations are keeping drinkers in the dark.' The drinks industry dismissed the call and said warnings would make drinkers anxious. A spokesperson for the Portman Group, a drinks industry-funded body that oversees alcohol labelling in the UK, said: 'Whilst we do not dispute the link between alcohol and certain cancers, and that drinking at harmful levels is dangerous and increases risks, blanket cancer warning labels are not a proportionate policy measure and do not put the risks into an appropriate context. 'This can create unnecessary anxiety, eroding trust in health advice and alienating the very people who require support.' The spokesperson said most alcohol products already included advice from the chief medical officers of the UK's four home nations to drink no more than 14 units of alcohol a week. 'Most people already drink within this guidance, which means their risks for associated diseases are low', they said. In February, the World Health Organization's European office declared: 'Clear and prominent health warning labels on alcohol, which include a specific cancer warning, are a cornerstone of the right to health.' In a report, it urged governments to introduce them to help reduce alcohol-related harm and raise awareness of the link between drinking and cancer. Dr Gauden Galea, a WHO adviser, said in the report that policymakers should 'resist all the pressure that will inevitably come from commercial actors' who claim such warnings do not work. In January, Vivek Murthy, the US surgeon general under the then president, Joe Biden, said cancer warning labels were needed because drinking led to about 100,000 cancer diagnoses a year in the US. It was the third most common preventable cause of cancer after tobacco and obesity, he added. A Department of Health and Social Care spokesperson said: 'Drinking alcohol increases the risk of a range of health issues, including several cancers. That is why we recommend people drink within the UK chief medical officer's alcohol guidelines of fewer than 14 units a week, and strongly recommend these are displayed clearly on all alcohol products. 'We recognise the need for more action on the impact of alcohol on health; for too long there has been an unwillingness to lead on this issue. Our plan for change will shift healthcare towards prevention, including through early intervention, to support people to live longer, healthier lives across the UK.'
