New study reveals which diets will help avoid illness in later life
Research has revealed that a healthy diet - such as the Mediterranean diet which is high in plants, fish and unsaturated fats - could slow down the accumulation of chronic diseases including dementia in older adults. Inflammatory diets full of processed meat and sugar may accelerate it.
Researchers from Karolinska Institutet in Sweden studied four diets to investigate their impact on chronic diseases in older adults.
Three of the diets studied were healthy and focused on the intake of vegetables, fruit, whole grains, nuts, legumes, unsaturated fats and reduced intake of sweets, red meat, processed meat and butter/margarine.
The fourth diet, however, was pro-inflammatory and focused on red and processed meat, refined grains and sweetened beverages, with lower intake of vegetables, tea and coffee.
Researchers followed the diets of 2,400 adults aged 60 and older in Sweden for 15 years and tracked their chronic conditions.
Dietary intake was measured using food frequency questionnaires, and adherence to four dietary patterns: the Empirical Dietary Inflammatory Index (EDII), AHEI, the Alternate Mediterranean Diet (AMED), and the MIND (Mediterranean–DASH Intervention for Neurodegenerative Delay).
Multimorbidity was defined as the number of chronic diseases and grouped by organ system - musculoskeletal, cardiovascular, and neuropsychiatric.
The results published in the journal Nature Aging revealed those who followed the healthy diets had a slower development of chronic diseases.
For example, long-term adherence to healthy dietary patterns, particularly the AMED, AHEI, and MIND, was linked to a slower accumulation of chronic diseases in older adults.
This applied to cardiovascular disease and dementia, but not to diseases related to muscles and bones.
But those who followed the pro-inflammatory diet, on the other hand, increased their risk of chronic diseases.
'Our results show how important diet is in influencing the development of multimorbidity in ageing populations,' said co-first author Adrián Carballo-Casla, postdoctoral researcher at the Aging Research Centre, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet.
The protective effects of diet may be explained by reduced inflammation, a key factor in aging-related diseases.
Study authors want to further their research by identify the dietary recommendations that may have the greatest impact on longevity and the groups of older adults who may benefit most from them, based on their age, gender, psychosocial background and chronic diseases.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Telegraph
27 minutes ago
- Telegraph
Enough doom-mongering about climate change
As a student, Johannes Ackva wore a hair shirt so itchy and uncomfortable that even Greta Thunberg might have approved. The young, idealistic German limited his use of water, stuck to a strict vegetarian diet, refused to drive and flew as little as possible. But, two decades on, Ackva, who works as a climate researcher, has changed his views considerably. He remains concerned about the environment and he still doesn't drive or eat meat. But there is cause, he believes, for optimism. Two things have changed since his hair-shirt days, he says. One is that the data looks a little less bleak than it used to. Instead of predicting that global temperatures are likely to increase by between 1.5°C (the best case) and 4.5°C (the worst), as it did for many years, the Intergovernmental Panel on Climate Change (IPCC) now says the increase will be between 2.5°C and 4°C. That 0.5°C reduction in the worst-case scenario makes a substantial difference – and itself represents a significant reduction from the 8°C rise that had, in the Noughties, been predicted by scientists such as James Lovelock for the world's temperate region. 'You have to be more optimistic than you would have been 10 years ago,' Ackva says, 'and even five years ago.' And the second thing that has changed, according to Ackva, is the rate of technological progress: 'We can see from what we've been doing with solar, or with electric cars, that we know how to fundamentally solve this problem.' The most rapid energy transition in history The price of solar energy has fallen almost at the speed of light; solar panel costs have fallen 90 per cent in the past decade alone. Renewables are helping to push coal and natural gas out of power grids. In 2009, 74 per cent of British electricity came from fossil fuels; in 2023, it was only a third. Over the same period, the share of British electricity coming from renewable sources (solar, wind etc.) has gone from two per cent to 40 per cent. In short, we are living through the most rapid energy transition in history. It is incomplete because renewables are dependent on the sun shining and the wind blowing, and because we do not have adequate battery technology to store vast amounts of electrical energy for months at a time. And, of course, it is expensive because of all the infrastructure that needs building, be it car-charging facilities, wind farms, or the apparatus that connects both of these things and more to our power grids. However, the recent progress in the energy transition is demonstrative of a truth that many environmental activists – groups like Just Stop Oil, Extinction Rebellion and the new Youth Demand – would prefer to ignore. Because, while they advocate for 'degrowth', whereby we shrink our economy and consume less in order to constrain our emissions, the innovation of recent years suggests the opposite is true: that it is investment and economic growth that will improve lives worldwide and solve the crisis. I spoke to Ackva during my research for a book about people who have dedicated their careers to saving the world from catastrophe, The Anti-Catastrophe League. He works at a non-profit organisation called Founders Pledge, where his research guides the philanthropy of entrepreneurs who want to use their wealth to address the climate crisis. And degrowth organisations are not the kind that he recommends his philanthropists support. Instead, he recommends that they fund innovation: inventions, and government action, that take the battle beyond wind farms and electric cars. 'We need to make sure that we also do it for cement, that we do it for [the manufacture of] steel, that we do it for long-range transport,' he says. 'But this is not rocket science. This is, in principle, doable.' It has been doable for longer than we might care to admit. After the Second World War, governments on either side of the Iron Curtain built nuclear power stations by the dozen. But nuclear power stations are gargantuan structures, complete with puffing chimneys atop blue-glowing reactors, and they are expensive to build. They also produce radioactive waste. This effluent is relatively unproblematic in itself, but conceptually unattractive to the public. Even more unattractive is the concept of nuclear meltdown. Chernobyl's death toll, including deaths from the explosion and acute radiation sickness within the first few months, is estimated to have been 30 to 60 people. These figures are lower than one might imagine but the victims of the Chernobyl disaster stick much more indelibly in the mind than do the abstract millions who die of fossil fuel-related air pollution each year. Despite the Chernobyl disaster, and despite smaller events at Fukushima and Three Mile Island, nuclear power is much safer than fossil fuels. The use of nuclear energy results in 99.8 per cent fewer deaths than does the use of coal; 99.7 per cent fewer than oil and 97.6 per cent fewer than gas. We can predict with some confidence that fossil fuels will be thoroughly outmoded over the course of the 21st century. It is important that governments continue to underwrite what Ackva calls 'big bets'. Fusion technology, for instance, stands a much better chance of working if, through being given public funding, it is given the gift of time. Once a technology outperforms fossil fuels, though, it will need no subsidy. We will need no carbon taxes, nor carbon credits. Thanks to far-sighted government support, the market has greedily adopted solar power and electric vehicles. Further greedy adoptions are inevitable. Bettering the miracle of fossil fuels is a lofty goal, but one that humanity is likely to meet. That still leaves a serious problem unsolved. That problem is the warming (1.17°C / 2.11°F) that has already occurred – and the warming that we are due from the greenhouse gases already in the atmosphere. Many people are trying to prevent the temperature from rising in the future; very few are trying to reverse the heating that has already occurred. But a small minority is attempting to do just that: the environmental dark wizards. Speaking with Andrew Song, he rejects the pieties of climate change. 'A lot of people were indoctrinated,' he tells me, 'including myself. I was an American boy scout, thinking: 'I just need to recycle and recycle and plant some trees, and I'm good.'' But these soothing instructions, Song came to realise, were 'all a f—ing lie!'. Telling me the story, he bursts into laughter. And he is right: recycling, in some respects, is overrated. It will not solve the climate crisis. Song has helped start several businesses in San Francisco. While enrolled in Y-Combinator, the prestigious accelerator for start-ups, Song met Luke Iseman. This was in 2016; after some false starts, Iseman said: 'Andrew, I've just learnt about stratospheric aerosol injection.' Stratospheric aerosol injection is the method by which we might be able to reduce the heat of the planet. It is achieved by launching sulphur dioxide into the stratosphere. Here sulphur dioxide reacts with other gases to form sulphate aerosols, which are fine particles. These fine particles reflect the Sun's light back into space. And the more light is reflected back into space, the less it warms the Earth. But there are downsides. The term 'uncontrolled termination' describes the scenario in which humanity starts a massive project of stratospheric aerosol injection, then abruptly stops. It is thought that this would result in ' termination shock ', whereby the temperature would swiftly rebound. Such a rebound would result in much more disruption of weather and ecology than would a more gradual rise in temperatures. And termination shock is far from the only reason to be wary of stratospheric aerosol injection. It could deplete the ozone layer. It could cause acid rain. It could have various other unintended effects. And it would not address air pollution, acidification of the oceans, and other nasty effects of the burning of fossil fuels. Instead, stratospheric aerosol injection might encourage us to stick with our bad habits. In April 2022, Iseman launched his first balloons, releasing them from his home in Baja California, Mexico. By the following February, Time magazine was calling him 'an innovator, renegade, or charlatan, depending on who you ask, but certainly the biggest climate tech trouble-maker in recent memory.' He and Song incorporated Make Sunsets, their new company, that October. Having been ticked off by the government of Mexico, they currently operate a patch of hilly Californian scrubland owned by Iseman. Journalists tagging along with Iseman and Song have witnessed a homebrew operation that resembles some of the more chaotic scenes from the TV series Breaking Bad: two rascals taking an RV to the wilderness in order to cook up something that most observers would probably call deeply irresponsible. Song, a talented marketer, tends to liken stratospheric aerosol injection to sunscreen. As he pointed out to me, humanity already puts 60 million tonnes of sulphur dioxide into the troposphere each year. Song and Iseman propose simply to put a much smaller amount of the chemical compound a little higher up. In Song's view, we have been misapplying our sunscreen. We have been 'just spraying the sunscreen lotion on our face, but with our mouths open. And since some of that is being swallowed, we're getting sick off it.' As for the ozone layer, Iseman and Song refer to evidence that its depletion will be comparatively small. Song does accept there is a risk of acid rain, but he argues that the risks of inaction are even greater. His view is that we should be less precious about geoengineering. 'We've injected two trillion tons of greenhouse gases into our atmosphere since the 1870s,' he says. 'So are we suddenly drawing a line of where we can deploy these aerosols? Literally, as we speak, we're emitting CO2, geoengineering the Earth, even just by breathing.' Global buy-in required Another difficulty, though, is that stratospheric geoengineering will require global buy-in. Or will it? Perhaps it is naive to imagine that solar geoengineering will occur after diplomatic efforts rather than before. As the climate expert Ben James writes: 'I find it impossible to imagine a UN mechanism approving something so universally contentious. Rather, someone will probably just do it.' Stratospheric aerosol injection, like nuclear fission, is a technology to which we already have access. And there are several more under development and notable for their promise. An American startup, Terraform Industries, demonstrated last year that it could produce synthetic natural gas from sunlight, water, and airborne carbon dioxide. In other words, the prototype can conjure some of the world's best-performing fuel from almost nothing. It is also possible that we will be able to take not only energy from the air, but pollution. Via carbon capture, we can remove fossil fuel-generated pollutants from the atmosphere, though we have not yet worked out how to do this in an energy-efficient manner. However, the technology I consider the most underrated involves not the air above us, but the ground below us. Today, geothermal power, which harnesses the heat of the Earth's core, constitutes a sliver of global energy production: an estimated 0.35 per cent. The figure seems even more meagre when one considers that an infinitesimal fraction of the Earth's geothermal heat, a tenth of one percent of that heat, goes the calculation, would power humanity's current outgoings for 20 million years. As it stands, we use geothermal power only where that heat happens to be closer to the surface than usual. Volcanic areas are useful in this regard. The hot springs of Bath are a less dramatic example. Elsewhere, geothermal power is harder to exploit. The idea is that you pump water down one well, bring it up via an adjacent well, and use that hot water to power turbines or heat buildings. We can drill deep enough, several kilometres down, to reach rock the temperature of a boiling kettle, or even a heated oven, but it's expensive, and can cause mild tremors. Moreover, to pay back that up-front cost, geothermal systems need to produce heat for years – which, given how hard it is to know what's going on several kilometres down, presents yet further difficulty. For that reason, this promising technology has been far less attractive an investment than drilling for fossil fuels, and has therefore remained underdeveloped. Necessity is forcing us into action. So is new technology. Commissioned by a think tank, I spent much of last year examining the performance of FORGE, the US government's geothermal field laboratory, in Utah. The lab shares its results and allows companies to visit and test their gear. Its drilling speed had increased fivefold between 2017 and 2022 and costs had fallen by as much as 50 per cent from 2022 onward. As all of FORGE's research was public, the entire geothermal industry could benefit from it. FORGE is working on 'enhanced geothermal', which employs techniques imported from the fracking industry. Likewise, the oil and gas industry has pioneered 'directional drilling', which is now allowing geothermal projects to drill not just vertically, but laterally, thus making it possible to create underground structures resembling radiators. Even more thrillingly for fanboys of geothermal power, Quaise, another company, is trying to go even deeper, which would enable it to access heat that can give water the energy density of natural gas. Quaise's method is to vapourise rock using a millimetre wave, which is something akin to a transparent laser. The company was founded by Carlos Araque, a disenchanted oil and gas engineer, advised by Paul Woskov, a fusion scientist. They must solve a litany of technical problems. But if they are successful, they could unlock a power source that would leave fossil fuels outmoded and make fusion an irrelevance. Due to advanced geothermal being in the category of those 'big bets', that would be a vindication of Ackva's approach. We failed to make the most of nuclear power; we might shy away from stratospheric aerosol injections; but to start to turn the situation around, we might need only one of those big bets to pay off.
The Guardian
38 minutes ago
- The Guardian
He worked with artificial limbs for decades. Then a lorry ripped off his right arm. What happened when the expert became the patient?
When the air ambulance brought Jim Ashworth-Beaumont to King's College hospital in south-east London, nobody thought he had a hope. He had been cycling home when a lorry driver failed to spot him alongside his trailer while turning left after a set of traffic lights. The vehicle's wheels opened his torso like a sardine tin, puncturing his lungs and splitting his liver in two. They also tore off his right arm. Weeks after the accident, in July 2020, Ashworth-Beaumont would see a photo of the severed limb taken by a doctor while it lay beside him in hospital. He had asked to see the picture and says it helped him come to terms with his loss. 'My hand didn't look too bad,' he says. 'It was as if it was waving goodbye to me.' Ashworth-Beaumont, a super-fit and sunny former Royal Marine from Edinburgh, would go on to spend six weeks in an induced coma as surgeons raced to repair his crushed body. But as he lay on the road, waiting for the paramedics, his only thoughts were that he was dying. He did not have the wherewithal to consider the irony of his predicament. In the late 1990s, after he had left the marines, Ashworth-Beaumont, now 59, studied for a degree in prosthetics and orthotics at the University of Strathclyde in Glasgow. Clinicians in these disciplines help patients with pain, function and mobility by making and fitting devices such as prosthetic limbs and orthotic braces. He had written research papers and trained prosthetists while specialising as an orthotist at the Royal National Orthopaedic hospital (RNOH) in north-west London. 'Now I was the patient,' he says. I meet Ashworth-Beaumont for the first time in Greenwich Park, near the south London home he shares with his wife, Keri, a solicitor he met on a night out in 2002. It's early summer 2024, almost four years after the accident in nearby Catford. He speaks softly through a smile that cracks only when he considers how far he has come and the support he has had: 'Without Keri, I think I would have sat in a corner and wasted away.' At first, his missing arm was a low priority for Edmund Fitzgerald O'Connor, the plastic surgeon who attended to his horrific abdominal injuries. But, by another twist of fate, the ambitious surgeon, who is 47, had a particular interest in limb loss. For years, he had been searching for the perfect candidate for a radical procedure he wanted to begin offering to amputees. Osseointegration (OI), or direct skeletal fixation, is a relatively new way to attach prosthetic limbs. Rather than rely on a socket moulded to fit over a residual limb or stump – a method that dates back centuries – arms or legs are attached to a titanium implant inserted into the surviving bone ('osseo' means bone). Fixing a prosthesis to the implant, which emerges from the stump like a little tusk, is as easy as changing a camera lens. OI patients need no longer tolerate irritation or infection where the socket rubs against skin and flesh. They gain a fuller range of motion and improved control and proprioception – the innate sense of where we and our extremities are in space. A prosthesis becomes part of the body rather than an awkward appendage. 'It feels like I've got my own leg back,' Hanneke Mooij, a Dutch secretary, tells me three years after receiving an implant following decades of torment from ill-fitting sockets. At the same time, rapid advances in electronic limbs mean surgeons can now effectively wire them into the brain. Taken together, OI and the latest prosthetics appear to bring a bionic future within reach. But the technique's evolution has also been fraught, limiting its adoption. In a small number of cases, implants or bones have cracked. Painful infections have taken hold in the fleshy hole that surgeons must create around the implant. OI is also very expensive at a time when amputees struggle to access basic prosthetics care. Fitzgerald O'Connor is convinced more of the 25,000 patients seen by the NHS prosthetics service each year could benefit from OI. When we first meet, the National Institute for Health and Care Excellence (Nice), the body that issues guidance on NHS treatment and funding, is reviewing OI. 'When you're doing 15 to 20 amputations a year and you have patients coming back with recurrent problems with their stump, it's saddening to know there's a viable alternative they can't access,' he says. The surgeon had been building a team to start offering OI, in the private sector at first, when he got the call from King's. He had been searching for a patient who was resilient and in good health, who could help drive wider acceptance of the technique. If Ashworth-Beaumont could fund his treatment, his professional knowledge of what it takes to come back from a traumatic amputation would be a bonus. 'You couldn't have made up a better candidate,' Fitzgerald O'Connor says. 'The conversation started in my mind the day he came in, but I wasn't going to bring it to him until I knew he would survive.' Osseointegration relies on a process that was discovered by accident. In the 1950s, Per-Ingvar Brånemark, a Swedish scientist based in Gothenburg, put optical devices housed in titanium into the legs of rabbits to observe the way bones heal. Once the study was over, the metal had fused to the bone and couldn't be removed, defying conventional wisdom about the body's tendency to reject foreign objects. The discovery inspired Brånemark, who died in 2014, to invent dental implants, first used in the 1980s, that fuse to the jaw with titanium screws, removing the need for dentures. Wondering if the bond could hold larger devices, Brånemark and his son, Rickard, an engineer training as an orthopaedic surgeon, designed a larger implant. In 1990, they screwed two into the above-knee stumps of a woman who had been run over by a tram. The procedure was eye-catching, evoking scenes from science fiction – Star Wars or The Six Million Dollar Man. It was also divisive. 'I remember lecturing in the US in the late 90s when this senior professor stood up and said, 'Only an idiot can believe this will ever work,'' says Rickard Brånemark, 65, who founded Integrum, the first OI company, in 1998. But a handful of enterprising surgeons saw an irresistible logic in bone-anchored prosthetics. Integrum soon had competition. In Sydney, Australia, Munjed Al Muderis, an Iraqi-born orthopaedic surgeon who had fled Saddam Hussein's regime after refusing to cut off the ears of draft dodgers, developed his own device, which he first implanted in 2008. He says patients have received more than 2,000 of his implants, which are hammered rather than screwed into bone. (Brånemark says surgeons have installed more than 700 Integrum devices.) Al Muderis, 52, is the technique's most bullish advocate. He is now offering it to victims of vascular conditions including diabetes, the biggest cause of leg amputations. (Other surgeons typically turn down such candidates, fearing their rehabilitation could be hampered by lifestyle factors.) 'There is a big opportunity for this technology to take over from the traditional socket-mounted prosthesis,' Al Muderis insists via Zoom as he changes out of his scrubs. The surgeon tells me about a current case he says demonstrates OI's potential – a seven-year-old Iraqi orphan who lost an arm in a roadside dog attack while he slept. He was later adopted by a wealthy Chinese family. In the coming months, Al Muderis plans to fit the boy with an implant, which will need to be replaced as he grows. Unlike other OI surgeons, he argues that children can be suitable candidates despite the need for further operations. In the case of leg amputees, he says, OI gets children walking again sooner. 'It's all a balance,' he adds, pointing out that sockets in children need changing a lot more often than OI implants. The boy will also undergo a procedure called targeted muscle reinnervation (TMR), which involves rerouting amputated nerves. This can help relieve pain in the stump, where the severed nerves can thicken into tumour-like neuromas. Remarkably, it can also help amputees control prosthetic limbs with their minds. To achieve this, Al Muderis will surgically attach the severed nerves, which had travelled to muscles in the boy's arm and hand, to small, inessential sections of muscle in his chest instead. Tiny electrodes implanted under the skin will connect these muscle sites to the prosthetic arm via eight cables wired through the body and the titanium implant. When the boy moves to grab a water bottle, his brain will activate the chest muscles, which will forward the signal to the corresponding motors in his arm and hand. 'It's amazing because the transmission is instant,' Al Muderis says of TMR, which he adds is not yet widely available. Integrum has also adapted its implants to allow amputees to upgrade to TMR and other advanced control systems in the future. Yet Al Muderis – who, like Brånemark, has been to Ukraine to offer OI to injured soldiers – says scepticism holds back the technique, including in the UK. He partly blames regulations and resistance to the idea of an implant that perforates the skin: 'This is a completely revolutionary technology which violates many of the principles of orthopaedics.' Brånemark is more conservative but also thinks far more amputees could benefit than the few thousand globally who have implants. When Fitzgerald O'Connor told him about his plans and the unlikely case of the one-armed prosthetist, the Swedish surgeon agreed to back his British OI team and oversee its first operation. 'A lot of people still don't know about OI, even in Sweden,' Brånemark says. 'As someone who also works in the field, Ashworth-Beaumont can be a really good advocate.' For weeks, HIs life hung in the balance. He had lost almost all liver and kidney function. Sepsis set in as he lay in a coma. His first wife and their two grown-up children came down from Scotland to say goodbye. 'The first thing I remember, coming out of the coma, was my daughter's face; it's still a really strong image in my mind,' Ashworth-Beaumont says. He thinks he inherited his fighting spirit from his father, a docker's son from Liverpool, who worked as a bellboy before becoming a successful restaurateur. His mother still runs a gift shop in her 80s. He also has childhood memories of a cousin who lost his legs in a car crash. 'I guess amputation was always on my radar,' he says. After struggling to focus at school, at 16 he joined the marines, where he excelled. Fitness was a passion, and he became skilled in mechanical and electronic engineering, which led to his prosthetics career. In the final year of his degree, begun in 1996, he worked at Steeper, a British prosthetics firm that would one day supply his motorised elbow. He joined the RNOH in 2005 while racing in triathlons and moonlighting as a personal trainer. He was at peak fitness when the lorry hit him. Sign up to Inside Saturday The only way to get a look behind the scenes of the Saturday magazine. Sign up to get the inside story from our top writers as well as all the must-read articles and columns, delivered to your inbox every weekend. after newsletter promotion While amazed to be alive, Ashworth-Beaumont realised his limitations as soon as he tried to shift his weight around in his hospital bed. 'I knew these things professionally, but it really brings it home when you first try to move your shoulder and nothing happens.' As his vital organs rallied, he became determined to return to work. He would need a highly functional prosthesis; his job is physical, requiring the manipulation of limbs, as well as the making and fitting of devices. He was all ears when Fitzgerald O'Connor shared his plans. He also knew it would take time, and that the advice in prosthetics care is to try standard devices first. It was almost a year after his accident, when he was about to return to work, that Ashworth-Beaumont received a body-powered arm on the NHS. These mechanical devices are a step up from static prostheses, which can incorporate hooks or skin-coloured hands. By rounding his shoulders, he could open a metal claw attached by a cable to a back harness: 'It works, but the technology has been around for hundreds of years.' Socket attachments date back to the 16th century or earlier. Designs and materials have changed, but the principle is the same: a socket must grip the stump for good function but not so tightly as to cause discomfort. Suction helps keep a socket on, but Ashworth-Beaumont needed strapping to pull his against his short stump, which further limited comfort and mobility. He ended up wearing the arm for just a few hours a day at work, and describes a circular problem for arm amputees. The motivation to use a prosthetic leg is high, to avoid relying on crutches or a wheelchair: 'But there's so much we can still do with one arm.' Patients tend to get frustrated with prosthetic arms, often stashing them away and making do. Ashworth-Beaumont says this partly explains a reluctance in the NHS to offer advanced devices, particularly early on. 'But the problem is they're also not giving people the opportunity to try these components when so many of us would benefit.' He went private to get a better arm sooner, using money raised from a legal settlement with the lorry company and a family crowdfunder. Working with Alan McDougall, a prosthetist at Proactive, a private clinic in Surrey, he upgraded to a stealthy black electric device with motors in the elbow, wrist and hand. He learned to flex his residual biceps and triceps independently to activate the motors, via sensors built into the socket. Subtle hand movements allowed him to adopt different grips. It's a step below TMR, but it works: I see it in action when we next meet and Ashworth-Beaumont gives me one of the firmest handshakes I've had. The electric arm, which is worth more than £100,000, meant he could do more, but it further exposed his socket's shortcomings. It was heavier than the NHS device, requiring a tighter, less comfortable fit. He could pick up a mug, say, but the flesh interface also made it hard to position the hand precisely, creating a lag between brain and hand. OI increasingly felt like the solution. Ashworth-Beaumont considered himself an overqualified guinea pig with an opportunity to highlight his profession and widen access to the latest tech. 'I see it almost as a duty to explore the possibilities,' he told me in 2021, when I first got in touch. Ashworth-Beaumont would not be the first British amputee to receive an Integrum implant. Starting in the late 90s, Brånemark's new devices were used in a trial involving 18 patients at Queen Mary's hospital in Roehampton, south-west London, where the modern British prosthetics industry emerged after the first world war. While the trial had some success and provided valuable data, the experience of its least fortunate participants still reverberates around the field and the debate about NHS provision. Gemma Trotter, a fitness instructor from south London, was 16 when she had a leg amputated above the knee after a car crash. Held back for years by uncomfortable sockets, she set aside her reservations about OI, which she had viewed as 'crackers', and joined the trial in 2003, aged 21. It was transformative. 'Suddenly I could feel the floor through my leg again. If I wore jeans, a lot of people didn't even know I was an amputee,' she says. 'I got married, had a baby … they were the best nine years of my life.' Then the implant broke and became infected. By then the trial team had disbanded, limiting follow-up care. Trotter, now 42, has endured more than a decade of pain and attempted fixes by surgeons including Brånemark. She is waiting to have her third implant removed after more problems, and won't risk having another. (Brånemark tells me that, while there is a risk of failure with any implant, Integrum's success rate has significantly improved since the Roehampton trial.) Trotter remains one of only a few dozen patients in the UK who have had OI, which is more widely available in countries with insurance-based health systems. Hanneke Mooij, the Dutch patient, is surprised to hear OI is hard to access in the UK. She received an Integrum device in 2022, 36 years after losing her leg in a motorbike crash. She is part of a Dutch group of 20 one-legged female friends who call themselves 'the flamingos', half of whom have had OI surgery in the past few years. 'I'm convinced this is the future,' she says. Most British OI recipients are patients at Relimb, a private clinic founded at the Royal Free hospital in north-west London in 2018. Its directors, Norbert Kang and Alex Woollard, use Al Muderis's implants and have about 60 patients on their books, almost all funded by legal settlements after traumatic accidents. Partly with the Roehampton trial in mind, they do not think the NHS has the resources to offer the skilled and long-term care required to make OI successful. 'No matter how beneficial it is and how well we can do it now, we're not going to change health economics,' Woollard says. He and Kang are not alone in having doubts. Nicky Eddison, chair of the British Association of Prosthetists and Orthotists, says the professions are already facing a staffing and recruitment crisis, and some NHS trusts are making do with just two specialists. 'Whatever technical advances you make, we can't deliver them without skilled clinicians,' she says. Yet proponents of OI make a case for long-term cost savings. Stephen Cruse, founder of the Amputation Foundation, a charity in Merseyside, had OI surgery with Al Muderis in 2016, eight years after losing his legs in a car crash while in Australia. After returning to the UK, he convinced an Australian government compensation scheme to fund his surgery after calculating it would save money in five years. 'They were paying about £30,000 a year on sockets, liners and maintenance,' says Cruse, who had a 'nightmare' with sockets but now rarely needs to see his prosthetist. Last December, Nice published new guidelines. It now recommends that OI can be used in the NHS but only by multidisciplinary teams with specific training, and the NHS tells me its policy – not to offer it widely – isn't changing, based on the risks and its funding priorities. Fitzgerald O'Connor says there may be ways to secure funds in exceptional cases, and he will continue to push for wider access as evidence of OI's efficacy grows. 'To leave it in a silo, where it's only accessible with vast amounts of money, does a disservice to patients who are suffering,' he says. After long delays caused by Covid and post-Brexit paperwork, Ashworth-Beaumont finally gets a date for his private surgery: a Saturday in October 2024. 'I tend to take things in my stride, but it feels like jumping out of a plane,' he tells me a few weeks before the operation. 'You know the systems are there to protect you, but there's always that 1% chance things could go awry.' The day before the surgery, which will take place at St Thomas's hospital in central London, I join Ashworth-Beaumont at a private clinic farther up the Thames at Battersea power station. Fitzgerald O'Connor and Aaron Saini, an orthopaedic surgeon who is also part of the new OI team, have gathered amputees and professionals to discuss this case and prosthetics technology more widely. The subject of NHS care keeps cropping up. Craig Mackinlay, a former Conservative MP from Kent, lost all four limbs to sepsis in 2023. Five months later, he received a standing ovation when he strode into the House of Commons wearing prostheses. Fitzgerald O'Connor, who performed the amputations, looked on from the public gallery. It was a triumphant comeback, but Mackinlay has since highlighted NHS shortcomings, including long waits and early black rubber prostheses that resembled 'clubs … I couldn't see what they'd be good for apart from breaking windows or pub fights.' Mackinlay, now a life peer, has since gone private, with support from device firms and his own money. In a debate in the Lords this May, he said he would still be in a wheelchair had he not accessed better legs sooner. 'The technology is out there and the NHS will give some of it to you, but it takes years,' he says. 'Why are we holding people back?' In response, Baroness Merron, a health minister, announced a review of the provision of advanced prostheses. In a statement, an NHS spokesperson insists that it 'provides a comprehensive package of care and support for people who have lost limbs, including a range of prosthetics'. When I ask Ashworth-Beaumont if everything is starting to feel a bit real, he takes a deep breath. 'This is all positive,' he says, his voice cracking. 'Sorry, I'm just thinking about the last four years.' Fitzgerald O'Connor places a hand on his shoulder. 'It was tough, but you made it,' he says. The next morning, Brånemark, Fitzgerald O'Connor and Saini screw the Integrum implant into Ashworth-Beaumont's humerus, carefully rebuilding his soft tissue around it. 'I've been walking around like I'm made of crystal,' he tells me two days later via Zoom as he waits for bone and metal to bond. Not long after Christmas, he is ready for an arm. McDougall has adapted Ashworth-Beaumont's body-powered device so he can attach it to his implant. Even with the encumbrance of the cable and harness needed to move the hand, he is struck by the enhanced control of a firmly anchored limb. 'I went out for dinner with Keri for my birthday and used a knife and fork properly,' he says. 'I feel more competent as an individual.' By early March he is ready to go full bionic, connecting his heavier electric arm. At Proactive, plaster casts of stumps stand like sculptures in the workshop. As well as adapting the more advanced arm, McDougall has added a small cuff to house the muscle sensors that used to sit inside Ashworth-Beaumont's socket. The arm would look at home in a sci-fi props department, with its carbon fibre-effect shell and translucent glove, which reveals some of the hand's moving parts. Then there's the gap in the upper arm, where only the titanium implant links flesh to hardware. Yet when the prosthesis hangs from Ashworth-Beaumont's shoulder, it somehow looks like part of him. Without the socket and straps, his silhouette is symmetrical: he is whole again. Soon motors whirr as he tests his bionic joints, raising his arm above his head in a way he hasn't been able to do since the accident. McDougall adjusts it using a Bluetooth-connected iPad app. 'This is really good,' Ashworth-Beaumont says as he picks up a stray screw from a workbench. Within days, he's performing tasks previously beyond him. Hoovering feels like a privilege. Five years after his old arm appeared to wave goodbye, Ashworth-Beaumont is as aware as anyone of the limitations of the health service. 'I've spent, what, five hours with Alan today, there's no way you'd get that time in the NHS,' he says. While he watches the OI debate continue, returning to his own NHS job has felt like his biggest achievement. As well as being able to meet the physical demands of his work, his ordeal has changed his relationship with patients. 'I was quite emotional about it after my first few appointments,' he says. 'I really did know how they felt.'
Medical News Today
an hour ago
- Medical News Today
3 diet types may help reduce chronic disease risk in older adults
Researchers from Karolinska Institutet studied how dietary patterns influence the development of chronic diseases such as heart disease, dementia, and diabetes in older adults who regularly ate healthier diets that included vegetables, whole grains, nuts, and healthy fats experienced a slower buildup of chronic who consumed more red meat, processed foods, and sugary beverages were more likely to develop multiple chronic conditions over often brings new health challenges, including an increased risk of chronic diseases like heart disease, arthritis, COPD, and dementia.A new study from researchers in Sweden offers hope for older adults concerned about their studying what effect diet has on chronic disease, the researchers found that people who consumed healthier diets tended to see a slower progression of chronic health issues and fewer chronic diseases overall. In contrast, participants who consumed a pro-inflammatory diet were more likely to develop multiple chronic study appears in Nature the link between food choices and agingAging may bring about new health problems such as hearing loss, mobility issues, and a weakened immune system. While some decline is expected, being proactive about one's health, including dietary choices, can help reduce the risk associated with chronic authors of the current study focused on chronic disease in older adults. Some of the health problems they considered included cardiovascular disease, neuropsychiatric diseases, and musculoskeletal diseases. To do this, they analyzed data from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), a long-term registry that tracks health metrics, medical histories, and cognitive testing among aging researchers included a group of more than 2,400 older adults from SNAC-K who were an average age of 71.5 years at the baseline. The researchers divided the participants into four groups based on the answers they provided on food questionnaires: MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), which focuses on consuming fruits, vegetables, whole grains, and healthy (Alternative Healthy Eating Index), which evaluates diet quality based on foods linked to a lower risk of chronic diseases like heart disease and diabetes, such as fish, whole grains, fruits, and vegetables. AMED (Alternative Mediterranean diet), which focuses on plant-based foods and healthy fats, but adjusts recommendations for some food items such as red (Empirical Dietary Inflammatory Index), which is a pro-inflammatory diet pattern high in red meat, processed foods, and sugary researchers considered the first three diets healthy, while the EDII represented an unhealthy, inflammation-promoting diet. The scientists used 15 years of data to examine how the diets impacted the accumulation of chronic adults who ate well developed fewer chronic illnesses The results of this study demonstrated yet another way maintaining a healthy diet is important to health. Over a 15-year period, participants who followed one of the healthy diets experienced a slower progression of chronic diseases. Additionally, these participants had up to two fewer diseases compared to people with the least adherence to healthy eating. Healthy eaters also experienced a slower rate of heart disease and neuropsychiatric diseases such as dementia. The only area where researchers did not find a negative association between a pro-inflammatory diet and health outcome was regarding musculoskeletal disease. The protective effects of the MIND and AHEI diets on neuropsychiatric health were strongest among the oldest participants. This suggests that even later in life, adopting a healthy diet can make a warn that shifting eating patterns may pose challengesDavid Cutler, MD, board certified family medicine physician at Providence Saint John's Health Center, shared his thoughts about the study with Medical News Today. 'These results suggest that diet quality is a modifiable risk factor in slowing the rate of chronic disease accumulation among older adults,' said emphasized that the study made it clear that a pro-inflammatory diet can be harmful to one's the study demonstrated the importance of healthy eating habits, Cutler noted that 'changing eating behaviors is challenging.''This is especially true of [older adults] whose patterns have been ingrained longer, and they may see a shorter period of time to appreciate the benefits of a healthier diet,' Cutler continued. Mir Ali, MD, board certified general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center, also spoke with MNT.'I thought this was a good study linking a healthier diet to slower disease progression,' said Ali. 'Though it is difficult to separate all factors, I think it is reasonable to conclude that diet plays a major role in chronic inflammation and disease.'Ali also shared concerns about the difficulty in changing eating patterns for older adults.'The older someone is, the harder it is to make long-term changes; furthermore, disease and inflammation can progress more as we age, so it becomes more difficult to reverse these changes,' explained Ali. 'In general, we recommend to all our patients, including older adults, to reduce carbohydrate and sugar intake and emphasize protein and vegetables. This helps direct the body towards breaking down fats, reducing diabetes and inflammation overall.'— Mir Ali, MD
