HEALTH BULLETIN .CO: January 2015

Wednesday, January 28, 2015

Girls as young as TEN are being given the contraceptive implant - sparking fears it puts them at risk of 'horrendous abuse'

Primary school age children among thousands of minors given implant

The implants, never tested on under-18s, were given to 10 and 11-year-olds

More than 50 12-year-olds and nearly 300 13-year-olds also given implant

Almost 10,000 given the contraceptive before they reached age of consent

'Relaxed attitude' puts children at risk of 'horrendous abuse', says expert

Girls as young as 10 have been given the contraceptive implant, potentially exposing them to ‘horrendous abuse’.

The primary school age children are among thousands of minors given the slow-release contraceptive device since 2010 despite being far under the age of consent.

The implants, which have never been tested on under-18s, were given to at least three 10-year-olds in the last five years, according to figures obtained by MailOnline.

Girls as young as 10 have been given the contraceptive implant, potentially exposing them to ‘horrendous abuse’, an expert has warned (file picture)

East Lancashire NHS Trust, University Hospitals of Leicester NHS Trust and Alder Hey Children’s Hospital, in Liverpool, each gave the implant to a 10-year-old during the last five years.

Meanwhile South Devon Healthcare NHS Foundation Trust, based in Torbay, gave the contraceptive device to a 10 or 11-year-old, but would not specify which.

During the last five years, at least 53 12-year-olds were given the implant, as well as a minimum of 281 13-year-olds.

More than 3,000 14-year-olds and at least 6,300 girls aged 15 were also given the device, which releases the hormone progesterone to prevent pregnancy, inserted under the skin in their arms.

A total of 61 NHS Trusts across England admitted they had fitted the implants in minors after a series of Freedom of Information Act requests by MailOnline.

The numbers are likely to be even higher, as dozens of Trusts did not or were unable to provide full figures.

BREAKDOWN OF THE AGES OF GIRLS GIVEN THE IMPLANT

Age of girls given the implant

Total

10 years old:

11 years old:

12 years old:

13 years old:

14 years old:

15 years old:

Three girls

One girl

53 girls

281 girls

3,032 girls

6,208 girls

Despite the Nexplanon implants never being tested on children, there is a strong possibility that hundreds of minors given the contraceptives had them fitted without the knowledge of their parents.

Norman Wells, from the Family Education Trust, said: ‘Fitting young girls with contraceptive implants is quite simply indefensible. It is giving them the green light to engage in illegal sexual activity and robbing them of the protection that the age of consent law is intended to give.

‘This casual and relaxed attitude towards underage sex is exposing young people to the most horrendous abuse.

‘The fact that the safety of these implants has not been established for girls under the age of 18 in itself means that health professionals are taking a massive risk with the immediate and long-term health of these girls.

‘It is deeply disturbing that parents are frequently left completely in the dark and know nothing about the high-stakes gamble that is being taken on the physical and emotional well-being of their daughters.

‘There needs to be an urgent review of the policies of NHS Trusts in relation to underage sex and the provision of contraception to children.’

The primary school age children are among thousands of minors given the slow-release contraceptive device since 2010 despite being far under the age of consent

According to the NHS website, the implants can cause headaches, acne, nausea and mood swings in adults using them.

Nexplanon manufacturers MSD said the contraceptive’s ‘efficacy’ had only been established in women aged between 18 and 40.

A Department of Health spokesman said: ‘It is extremely rare that doctors prescribe contraceptives to under-13s, and while we would not comment on individual cases, the doctor is likely to be acting on serious concerns about exploitation or abuse.

‘Guidance from the GMC states that doctors must as a matter of routine share information about sexual activity involving children under 13 with police or social services.’

HOW DOES THE IMPLANT WORK?

The contraceptive implant is a small flexible tube about 1.5 inches long that is inserted under the skin of women's upper arm by a doctor or nurse.

The implant stops the release of an egg from the ovary by slowly releasing progestogen into your body.

Progestogen thickens the cervical mucus and thins the womb lining, making it harder for sperm to move through the cervix.

The Nexplanon implant, which is 99 per cent effective, lasts for three years before it must be taken out or replaced.

It is offered at most GP surgeries.

Source: NHS Choices

A spokesperson for University Hospitals of Leicester NHS Trust said: ‘Only under extremely rare circumstances would a patient under the age of 13 ever receive a contraceptive implant.

‘This is never taken lightly and would be a decision made between a healthcare professional and the parent or guardian as a result of health problems or in order to safeguard the child.’

Vanessa Hollings, from the family care division at East Lancashire Hospitals NHS Trust, said: ‘We cannot comment on specific cases due to patient confidentiality but any contraceptive implants are fitted in compliance with national guidance on consent, competence and safeguarding.’

A spokesman for South Devon Healthcare NHS Foundation Trust said: 'Contraceptive implants for girls under the age of consent are not issued lightly. Serious consideration is given to each individual situation including liaising with the patient themselves, the Safeguarding Team and with the patient’s parents or guardians.

'Implants would only be used where it is in the girl’s best interests and where consent is given by the parents or guardians.'

“Contraceptive implants for girls under the age of consent are not issued lightly. Serious consideration is given to each individual situation including liaising with the patient themselves, the Safeguarding Team and with the patient’s parents or guardians. Implants would only be used where it is in the girl’s best interests and where consent is given by the parents or guardians.”

Alder Hey Children’s NHS Trust said the implant may have been used for medical reasons, such as when a child was suffering from heavy periods, but otherwise they do not offer Nexplanon.

Sugary drinks 'can bring on a girl's periods earlier': Youngsters who drink more than one a day begin puberty at younger age

Those drinking 1.5 sugary drinks a day had first period 2.7 months earlier

Breast cancer risk increase when periods start early in adolescent girls

Almost 6,000 girls took part in the five year study in the USA

Experts described the findings as 'significant'

Girls who drink more than one sugary drink a day are likely to start having periods sooner, say scientists.

A new study of almost 6,000 adolescent girls links the consumption of sugary drinks to earlier menstruation.

The research found those drinking more than 1.5 sugar-sweetened beverages a day had their first period 2.7 months earlier than those consuming two a week or fewer.

The discovery is important as the risk of getting breast cancer later in life increases when periods start early.

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The research found those drinking more than 1.5 sugar-sweetened beverages a day had their first period 2.7 months earlier than those consuming two a week or fewer

Sugary drinks are also said to be contributing to the obesity epidemic in children.

US lead researcher Dr Karin Michels, from Harvard Medical School, said ‘Our study adds to increasing concern about the widespread consumption of sugar-sweetened drinks among children and adolescents in the USA and elsewhere.

‘The main concern is about childhood obesity, but our study suggests that age of first menstruation (menarche) occurred earlier, independently of body mass index, among girls with the highest consumption of drinks sweetened with added sugar.

‘These findings are important in the context of earlier puberty onset among girls, which has been observed in developed countries and for which the reason is largely unknown.’

A one year reduction in age at first period is estimated to raise breast cancer risk by five per cent.

The impact of bringing forward menarche by 2.7 months was likely to be ‘modest’ said the scientists.

But they expected some girls to be consuming more sugary drinks than reported which would lead to an ‘even more dramatic’ drop in the age of menstruation.

The researchers said there could be significant public health implications and, importantly, it was possible to encourage less sugary drink consumption.

Altogether 5,583 girls were included in the research, drawn from a US-wide Growing Up Today study, says a report published in the journal Human Reproduction (must credit).

Questionnaires were used to ask the girls about their diets at several points between 1996 and 2001, and collect information about what they drank.

A drink serving was defined as either a can or a glass. Sugary drinks included drinks such as Coca Cola and Pepsi, sodas, fruit drinks, lemonade, iced tea and the powder mix Koolaid.

The study found no link with fruit juices or diet colas with added sweeteners.

By the end of the five year period, all but three per cent of the girls had started menstruating.

The average first period age for girls consuming the most sugary drinks was 12.8 years compared with 13 years for those drinking the least.

After taking account of Body Mass Index (BMI), girls drinking the most were 22 per cent more likely to start their period in the month after being questioned about their diet than the lowest consumers.

The researchers found artificially added sugar was chiefly responsible for their findings rather than natural sugars In fruit juices.

Drinks with added sugar can lead to rapid ‘spikes’ of the hormone insulin.

Boosted insulin can result in higher concentrations of sex hormones, and large changes in the levels of these have been linked to periods starting earlier, said the scientists.

Dr Ken Ong, from the Medical Research Council Epidemiology Unit at Cambridge University, said ‘This is a very large study, which was representative across the USA, and the findings are strongly statistically significant.

‘From previous research we know that sugar-sweetened beverages (SSB) intake promotes weight gain, and that weight gain promotes early puberty in girls.

‘The surprise here is the claim that the association is independent of childhood size - there is a more direct effect of SSB on puberty. This is unexpected.’

Prof Ieuan Hughes, Head of Paediatrics, University of Cambridge, questioned whether a difference of 2.7 months was ‘biologically relevant’.

He said ‘The authors admit that future studies should examine the impact of early childhood nutrition on menarche.

‘It seems to me that the observation in this study suggests that it is weight related so that the message is clear about the dangers of such sugary drinks.’

A spokeswoman for the British Soft Drinks Association (BSDA), said: 'Neither this study nor the body of science shows that sugar-sweetened beverage consumption causes early onset of menstruation.

'What the body of science supports is that adolescent girls are reaching puberty earlier than prior generations; however, there is no scientific consensus concerning the cause of this trend.'

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Tuesday, January 27, 2015

Even slightly raised cholesterol levels in middle age 'increase the risk of heart disease by up to 40%'

Even mildly raised cholesterol levels increase risk of heart disease

Every ten years of raised cholesterol between 35 and 55 raises risk by 40%

Statins - anti-cholesterol drugs - 'should be prescribed to younger people'

Having even mildly raised cholesterol levels can significantly increase the risk of heart disease in later life, scientists today warned.

Long-term damage to the arteries starts in your 30s and 40s, they claim.

And for every ten years of increased cholesterol between the ages of 35 and 55, the heart disease risk goes up by up to 40 per cent, according to a new US study.

Scientists looked at data from the Framingham Heart Study, which began in 1948 and is one of the largest ongoing research projects focused on heart health.

For every ten years of increased cholesterol between the ages of 35 and 55, the risk of heart disease increases by 39 per cent, suggesting the cumulative effects of even mildly raised levels can pose a significant risk to heart health

They examined 1,478 55-year-olds who were free of cardiovascular disease, and calculated the length of time each participant had experienced high cholesterol by that age.

The volunteers were then followed for up to 20 years to see how having high cholesterol for long periods of time affected their risk of heart disease.

In the study, overall cholesterol levels of 160mg/dL – 4 millimoles per litre using UK measurements – or higher were considered raised.

For LDL, or ‘bad’ cholesterol, 130mg/dL – or 3.3mmol/L – or higher was the cut off point.

At age 55, 389 people had experienced one to 10 years of elevated cholesterol, 577 had 11 to 20 years and 512 did not have high cholesterol.

They found that those with 11 to 20 years of high cholesterol had a 16.5 per cent overall risk of heart disease, while those with one to 10 years of cholesterol exposure had 8.1 per cent risk.

TEN YEARS OF INCREASED CHOLESTEROL INCREASES RISK OF HEART DISEASE BY 40%

The study found that those with 11 to 20 years of high cholesterol had a 16.5 per cent overall risk of heart disease.

Those with one to 10 years of cholesterol exposure had 8.1 per cent risk.

Those without high cholesterol had only a 4.4 per cent risk.

This means that each decade of high cholesterol raised the risk of heart disease by 39 per cent, suggesting the cumulative effects of even mildly raised levels can pose a significant risk to heart health.

In the study, overall cholesterol levels of 160mg/dL – 4 millimoles per litre using UK measurements – or higher were considered raised.

For LDL, or ‘bad’ cholesterol, 130mg/dL – or 3.3mmol/L – or higher was the cut off point.

Those without high cholesterol had only a 4.4 per cent risk.

The study, published in American Heart Association journal Circulation, also suggested that anti-cholesterol drugs such as statins should be used at younger ages for those most at risk.

Under current guidelines, only one in six of the adults in the study with prolonged high cholesterol would have been recommended for statin therapy at age 40, and one in three at age 50.

Around half of UK adults have a cholesterol score above 5mmol/L, according to NHS Choices.

Lead author Dr Ann Marie Navar-Boggan, of the Duke Clinical Research Institute, said: ‘Our findings suggest that adults with longstanding mild to moderately elevated cholesterol levels may benefit from more aggressive prevention strategies earlier.

‘What is happening in your blood vessels, in particular your cholesterol levels, during your 30s and 40s affects your heart health in your 50s, 60s and 70s.’

She added that it was surprising that the effect was more pronounced among adults who are otherwise healthy.

She said: ‘Even if you control everything else – you don’t smoke, your blood pressure and weight are normal, and you don’t have diabetes – having elevated cholesterol over many years can still cause problems in the long run.’

The researchers suggested that statins - anti-cholesterol drugs - should be taken by younger people most at risk of high cholesterol

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