Monthly Archives: September 2015

Sustainable Development Goals

On 25 September 2015, these 17 goals were created at the United Nations Summit. These follow on from the 8 Millennium Development Goals that were created in 2000.

First some good news…

Before moving on to the next set of goals, it is important to reflect on some of the huge achievements that have already been made:
– Since 1990, extreme poverty has been halved
– In developing countries, 90% of children now receive primary education, compared to 83% in 2000
– There is now gender equality in primary education
– 17,000 fewer children die each day than in 1990
– Maternal mortality has been reduced by 45% since 1990
– In 2012, 9.7 million people received HIV medication
– Since 1990, 2.3 billion people have gained clean water access
– The MDRI and HIPC initiatives have cancelled $97 billion worth of debt, since 1996, mostly in sub-Saharan African countries.

What next?

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These new goals have been set as targets for 2030. Many of these goals build upon the MDGs, however there are several new issues included. For example, the need to increase environmental sustainability is reflected in many of these goals. This means that developed countries have targets to work towards at home, as well as overseas, such as altering national policies and improving education to tackle climate change. The Pope is in support of this, saying this week, on the topic of climate change, that “that we have a sacred obligation to protect our planet”.
Barack Obama has also given a powerful defence of this new agenda, making the statement that this new agenda is ‘not charity but instead is one of the smartest investments we can make in our own future’.

Meat eaters

Is there a link between meat and cancer? It’s been hotly debated for years, and the findings of different studies is often contradictory. However, several large scale studies have been carried out and much of the evidence has been found repeatedly. The World Health Organisation have found that 30% of cancers in Western countries can be attributed to dietary factors. With more than one quarter of deaths in the UK being due to cancer, this is clearly a crucial area of research.

Which meats to blame?
A 2007 Plosmed study of 500,000 people aged 50-71 found a significant association between red meat consumption and increased risk of esophageal, colorectal, liver and lung cancer risk. The difference in risk for each cancer type, varied between 20% and 60%, between the lowest and highest consuming groups.
The European Prospective Investigation into Cancer and Nutrition (EPIC) followed over 500,000 people in 10 European countries, and was published in 2013. This, however, found no association between fresh meat consumption and cancer risk, but suggests that an increase of 50g per day of processed meat increases a person’s risk of death from all causes by 18%, partly due to cancer.
It has been repeatedly been found that there is no correlation between the consumption of white meats and cancer. For example, a 2002 Pubmed Meta-analysis found no significant association between total meat consumption and colorectal cancer risk. The EPIC study mentioned above, also found that people eating no meat at all were at a higher risk of early death from any cause than those eating a small amount of red meat.
These mixed reviews of meat can be confusing, however, small amounts of fresh meat can be an important source of essential amino acids, iron and vitamins B6 and B12, in a healthy diet. Processed meats, on the other hand, generally get a poor right up, and have been blamed for causing heart disease and cancer. The Department of Health recommends that you eat less than 70g of red or processed meat per day. It is widely accepted that there is no risk of cancer associated with white meat, so the following information only refers to red and processed meats.

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Causal Relationship
There are several suggested mechanisms that have been put forward to possibly explain the relationship between meat and cancer risk. These processes are ways in which meat could actually cause cancer, and a thorough understanding of these could become proof of the relationship.

– A 2014 study in the journal ‘Proceedings of the National Academy of sciences’ suggested that the link between red meat and cancer may be due to Neu5Gc (N-glycolylneuraminic acid). Red meat contains high concentrations of bioavailable Neu5Gc. This molecule can act as a foreign antigen, and cause systematic inflammation when in contact with antibodies, therefore increasing cancer risk. The findings were that exactly this did happen in mice, and the risk of cancer was increased 5 times by long exposure.

– A 2012 study published in ScienceDirect, drew attention to the heterocyclic amines (HCAs) that are present in red meat that has been heated to high temperatures. These are formed when molecules in the meat, such as amino acids and sugars, react at high temperatures. These compounds are carcinogenic, and the study did find associations between the intake of specific HCAs and risk of breast and lung cancer.

– Polycyclic aromatic hydrocarbons are also formed in flames, and attach to the surface of the meat when it is cooked over an open fire or smoked. These compounds are also known to be carcinogens.

– Red and processed meat also contains haem, which could damage cells of the bowel, causing them to divide at a greater rate, and therefore increasing the potential for cancer to occur. Alternatively the haem may stimulate the production of N-nitroso compounds in the gut. A 2003 Pubmed study supports this hypothesis, as it found that haem supplements increased the concentration of the carcinogenic N-nitroso compounds in human faeces.

The Role of Equality in Health and Happiness

It is an interesting observation that there is almost no correlation between GNP per capita and life expectancy, amongst developed countries. Within a society, however, we know that personal wealth does play a large role in determining life expectancy. The difference between these two measures is that within a society, GNP per capita is a measure of relative wealth, and is therefore a comparison with others. By using the difference in wealth of the top 20% and bottom 20%, Richard Wilkinson has drawn attention to the strong positive correlation between income inequality and health and social problems. This is shown on the graph below.

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This does not simply point out that poverty causes poor health and unhappiness. The evidence actually goes beyond the evidence and suggests that inequality actually leads to worse health outcomes and happiness for the most affluent in society as well as those in relative poverty.

It is thought that higher income inequality causes greater feelings of status insecurity due to comparisons against others in society. The fear of this judgement and a lack of social cohesion increases stress and therefore cortisol levels. This results in increased health and social problems.

Evidence from several studies supports this link between inequality and poor health. For example in the USA in 2001, Lochner et. al found that individuals living in states with greater inequality were at a 12% higher risk of death. In 2009 a study published in the British Medical Journal produced some shocking statistics about the impact that inequality is having on people’s lives in the USA. This study concluded that almost 884,000 deaths per year could be attributed to high inequality, and that this number would be prevented if the Gini coefficient value could be reduced to 0.3 (the average for OECD countries), from its value of 0.357. This is one third of deaths in the USA!

Supporting this, a 2009 BMJ meta-analysis by Kondo et al, found an 8% higher mortality risk per 0.05 increase in the Gini coefficient value.

There is also evidence to suggest that income inequality correlates with lower happiness in societies. For example, a 2011 study carried out in the university of Virginia found that from 1972 to 2008, people in America were happiest in years when income inequality was lower.

The 2015 World Happiness Report found that three quarters of differences in happiness between all countries is due to 6 factors: GDP per capita, healthy years of life expectancy, social support, trust, freedom and generosity (measured in donations comparative to income). Although this does not specifically highlight income inequality as a factor in happiness, it has been found to be linked to several of these 6 factors. For example, Richard Wilkinson’s research has also found a strong negative correlation between levels of trust in society and income inequality. There is also a strong correlation between income inequality and social immobility which would therefore mean that there was less freedom in more unequal societies. It is also likely that social support may be reduced by inequality as isolation tends to be higher.

The following maps show happiness rankings, and the Gini Coefficient (a measure of income inequality). It can be seen that there is some correlation, especially when considering the worlds happiest countries: Switzerland, Iceland, Denmark, Norway, Canada, Finland, Netherlands, Sweden, which all have fairly low Gini Coefficient values.

Happiness:

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-from the Washington Post

Gini Coefficient: (higher being less equal)

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-from the Business Insider using World Bank Data

The 2015 World Happiness Report states that ‘happiness is increasingly considered a proper measure of social progress and a goal of public policy’, and there are several organisations, such as Action for Happiness, who encourage people to see the importance of happiness, rather than focusing on financial and status goals.

There is also a large amount of research to suggest that happiness results in a healthier life. For example, Kubzansky’s 2007 paper found that enthusiasm, hopefulness, engagement in life, and emotional balance correlated to a lower risk of coronary heart disease. This is only the tip of the ice burg when it comes to how happiness can be beneficial to your health. It has been suggested that being happy can also reduce the risk of type 2 diabetes, high blood pressure and infection.

Despite happiness having recently gathered interest and making several headlines, there is still a lack of research. An Online Library search reveals around 400,000 results for the word ‘depression’, compared with only 50,000 for ‘happiness’. Now that’s depressing!

Sources used:
inequality.org
TED
PubMed
WHO – obesity and inequalities
BMJ – income inequality, mortality and self rated health
Psychology today
Harvard School of Public Health