Obesity is a big problem. It is the second biggest cause of cancer. People who are overweight are more likely to suffer from coronary heart disease, type 2 diabetes, and some types of cancer. Furthermore, women are more likely to have complications during and after pregnancy. A recent report estimated that in England 30,000 deaths per year are obesity-related. Not surprisingly, the healthcare cost implications are very significant. Society, be that government or individuals, have a responsibility to address this problem.

Juxtaposed the issue of obesity is the growing problem with eating disorders in the young. A report released today suggests that young people are increasingly concerned about their bodies. More than half of girls aged 12 to 16 years felt that their body image adversely affected their relationships with boys. It is this negative view of body image that leads to the onset of an eating disorder. Research indicates that the typical age of onset for an eating disorder is between 14 and 25 years. We know that the present younger generation are bombarded by images of thin women; the ‘body beautiful’ sells clothes, music and films. The recent furore over ‘size zero’ fashion models highlighted the public’s growing concern about the adverse impact of such images. With these reminders of supposedly ‘ideal’ bodies, in combination with the well-documented teenage stresses of exams, peer pressure and family conflict, is it any wonder that eating disorders in the young are on the increase? Indeed, what about the increasing incidence of depressive illness in puberty?

So, in the light of the growing incidence of anorexia and bulimia, addressing the issue of obesity in children becomes more difficult. One clearly must avoid sending the wrong message about ideal body form to young people. As a GP, I have unfortunately encountered the ramifications of eating disorders and depression. The frequency of these problems are sadly on the increase. Of particular concern to me, however, is that over 20% of boys and almost 30% of girls are either overweight or obese. Those statistics contribute significantly to the fact that Type 2 diabetes is projected to increase over the coming decades. So much so, that it is thought that 25% of the entire NHS budget will be taken up treating diabetes alone by 2025. Hence, this childhood obesity phenomenon needs addressing now.

Some research has indicated that an increased awareness of body image can be of benefit when addressing childhood obesity. A study by a team from Bath University divided children into two groups – only one of the groups was asked to draw pictures of themselves (an apparently subtle approach to eliciting ideas about self-image). Both groups were then shown two adverts about healthy breakfasts – one urging children to slim down, the other providing educational information about the benefits of eating well. The study found that 75% of those who had been asked to draw pictures of themselves before viewing the adverts had felt encouraged to eat more healthily and do more exercise. Interestingly, only 58% of the other group responded in the same way, the conclusion being that getting young people to think about themselves made them much more receptive to healthy eating campaigns. More food for thought I believe (pun not intended).

I am a firm believer in choice in life. However, that freedom of choice applies to adults not children, since they are not fully informed, competent individuals. For that reason, society does have a responsibility to look after its young. Government is a part of society and hence as an important role in legislating to protect children. Part of that involves responsibility for getting tough on childhood obesity. Not by being ‘fattist’, but by promoting healthier lifestyles in our children. For example, we need to encourage competitive sport in school, not sell off playing fields to local developers. School catering standards must be improved and maintained to guarantee a decent diet for our children. Not only that, we should also be drawing parents’ attention to the food they are buying for their children, and not be shy to indicate where mistakes are being made. I believe public information films have a role here.

Obesity shortens life and it can kill. Eating disorders can also ruin lives and kill. Getting the balance right on body imagery for young people is difficult, however, to do nothing would be wrong. Not only do doctors and parents have roles to play, the media, and in particular, advertisers, need to recognise their own responsibilities to the society in which they operate. If you think sending out the wrong message about body image cannot harm, have a look at this (Hat Tip: MT).

I’m in. And I’m in to win. – Hillary Clinton

We have just entered the Chinese Year of the Pig. To be specific, it is the Year of the Golden Pig, an occurrence, I am told, that comes around only every 60 years. To bear children in the year of the pig is considered very fortunate, for they will be happy and honest. One such child born in 1947 was Hillary Rodham Clinton, US Senator for New York.

On January 20th 2007, Hillary Clinton announced her candidacy to run for the US Presidency. Her aim is to be first woman to be elected to that position. Not only was she born in a ‘Pig Year’, she also has the elemental sign of fire. According to Wikipedia, it is associated with “the planet Mars, summer and the south, and the colour red. It is believed to govern the heart”. Furthermore, fire is linked with “dynamism, strength and persistence, and with restlessness and a sense of adventure”.

What does this all say about Mrs Clinton’s chance of success in 2008? I am not superstitious and do not read astrological predictions. Allow me, however, to indulge in some weekend dalliance with this pseudoscience.

Her happiness over recent years appears genuine, her honesty I am sure we will find about over the next twelve months. She is undeniably dynamic and has never sought to hide her desire to succeed, so strength and persistence are clearly in abundance. The mention of adventure and Mars makes me hope that a decision to put a man on that planet will take place during her Presidency. The South and the colour of red could feasibly be a reference to the Republican South she needs to court and win over. Any mention of the heart I would suggest is related to the presence and influence of Bill. Clearly, I am no Jonathan Cainer. It was, however, a pretty fair attempt (I think).

Seriously though, I do not see Hillary Clinton as the next US President. Her position on social issues and the presence of Bill at her side, will not help her in the States where she needs to win. More likely, a Centrist Republican will get to the White House, a candidate not dissimilar to Alan Alda’s character in The West Wing. One Democrat who might upset that prediction is the outsider Barack Obama. He needs, though, to have a good year, and it will be very tough. Fortunately for him, his birth sign is the metal Ox.

MALLORY And we went to the moon. Do we really have to go to Mars? SAM Yes. MALLORY Why? SAM ‘Cause it’s next. For we came out of the cave, and we looked over the hill, and we saw fire. And we crossed the ocean, and we pioneered the West, and we took to the sky. The history of man is hung on the timeline of exploration, and this is what’s next. (West Wing II, Ep. 9)

The release yesterday of more stunning photographs of the surface of Mars reminds us once more of the relative insignificance of Earth. On a day when concerts to highlight the realities of climate change are announced, we must remember that Man has yet to set foot on another planet. Furthermore, the scientific endeavour and bravery of those previous generations who dared to contemplate space travel now allows us to look at our Earth from afar, to fully realise the damage we humans are doing to the global environment.

Man is nothing without endeavour. I have written previously on the importance of science. The desire to travel and discover contributes greatly to what makes us all human. For me space travel is truly inspirational. I firmly disagree with those people who think space exploration is too higher a cost to pay. For example, there are undeniably many hungry people in the world. However, I do not believe their plight has been exacerbated by Man going into space. Indeed, if we take the example of Bangladesh, one can see that Man’s ability to see the coastal erosion has vividly illustrated the urgent need to address climate change. The exploration of Space has benefitted the human race.

Man should be about pushing back frontiers. We should be about seeking new knowledge. It is for that reason that the absence of Britain at the forefront of Space exploration has always puzzled me. The ‘Great’ of Great Britain was established on the back of exploration and technological advance. It was because we went to new places first that we established an Empire. It was because we had the first industrial revolution known to Man that we became so powerful. That revolution was firmly based upon inventions such as the combustion engine, and our confidence to take on the next challenge. When did we lose the desire to be first?

Britain should make a firm commitment to explore Space. Public and private funds should be made available to put Britain back at the front of human exploration. Obviously, I recognise that we are no longer a superpower, however, that is no excuse. We should be joining with our international friends in the pursuit of putting man further into Space. So where should we go now? It has to be a planet, so therefore, it has to be Mars. Why Mars? Well, as Sam Seaborn said in my favourite political TV drama, “‘Cause it’s next”.

Applications to universities have risen according to UCAS. Are we to be happy about this? The Labour government has long had the ambition of 50% of school leavers securing a ‘university’ education. Evidence to suggest this policy benefits all is to my mind pretty scanty.

Last year, a report suggested that some students had regretted taking their degrees. One third of graduates when asked by the Chartered Institute of Personnel and Development (CIPD) thought they had done the wrong degree. Furthermore, the increase in average starting salaries between those who graduated in 2000 and 2005 was found to be just 8%. Worryingly, one-third of those who graduated in 2005 were failing to contribute to a pensions saving scheme. Despite these woeful statistics, three-quarters of graduates indicated that their degree had allowed them to develop better communication and presentation skills, and generally built their self-confidence. So, not all bad then! I am not convinced that one needs to undertake an expensive three year ‘degree’ course to achieve personal development. Apprenticeships could serve the same purpose, and in view of graduate employment prospects, provide a more likely route into work.

Where and when was it written that half of the population would benefit from a university education? Once upon a time, university was a place for the academically gifted. Degrees were conferred that had value and were recognised by industry as evidence of intellectual achievement. Are we sure that this remains the case? Baroness Deech has reported today that degree courses can encourage cheating. She said that the structure of a typical degree course was far from ideal: “Everything is processed. Instead of students sitting and reading and listening and writing their own material, everything is presented visually.” Not particularly encouraging is it?

Labour’s problem is that it is not elitist. Indeed, elitism is a dirty word for most Socialists, e.g. note their strong objections to grammar schools. Universities, however, exist to find the elite, support them and educate them. Indeed, they are sustained by the very same elite, as it is they who either stay to educate the next generation or go into industry and generate wealth. It is that wealth generation which Britain needs if it is to have the hospitals, schools, universities, police and armed forces that most Britons desire. The importance of a successful and well-funded tertiary education sector cannot be over stated.

I am in favour of every individual in this country fulfillling his or her potential. Our country cannot afford to squander talent of any form. I am not convinced, however, that the fulfilment of that potential necessarily involves undertaking a degree course. What about apprenticeships? What about just going to work after school? Tony Blair may be quite rightly highlighting the university funding problem today. He would do better, however, to get the quality of the product right first. What is it about this government? Why do they insist upon spending our money before the necessary reforms are in place?

Today’s Guardian includes a piece on the supposed benefits of breast-feeding made for interesting reading. Apparently, breast-feeding has been shown to aid social mobility. The article is based on research to be published in the Archives of Diseases of Childhood.

For some time now, midwives have actively (indeed, sometimes aggressively) advocated that breast-feeding babies is better than bottle-feeding. This has been because evidence has suggested that breastfeeding aids bonding between mother and child, as well as neurocognitive development in later life, i.e. children will be brighter. Because of these claims, I have witnessed on a number of occasions new mothers being reduced to tears on post-natal wards by midwives insisting that bottlefeeding is ‘short-changing’ the new born. Unfortunately, I fear today’s ‘findings’ will encourage more such behaviour.

Closer inspection of the report reveals that the difference between the bottle-fed and breast-fed groups in terms of moving up a social class was pretty small – 58% as compared to 50%. The data, extracted from the Boyd Orr study of diet and health in pre-war Britain, has been assessed by Richard Martin, Reader in clinical epidemiology at the University of Bristol. Interestingly, he has admitted that the findings should be treated with caution.

Claims about the relative benfits of breastfeeding are widely reported. There has been, however, some dispute over their validity. An article published in the British Medical Journal last year indicated that a child’s living environment was more important in influencing social mobility than breastfeeding. It concluded that intelligence was determined by many factors other than breast-feeding. Although, it still advocated that breastfeeding was “the smart thing to do.”

Despite a concerted government-funded campaign over the last few years, only 76% of British women breast-feed. Even though mothers are encouraged to breast feed for the first six months, less than 30% actually do so. And this is also despite the active campaigning of midwives. Most doctors known that midwives are notorious for being ‘pro-active’ about the benefits of breast-feeding. Undeniably, the ‘immunity’ conferred from mother to child in the first few days cannot be achieved by bottle-feeding, however, after that it remains far from confirmed that breast-feeding is so particularly advantageous to the baby. The advantages certainly do not warrant upsetting mothers by making them feel inadequate. Hopefully, this research will not be used in the same way. Social mobility has gone down under this government. A more likely conclusion is that, that has more to do with the performance of the education sector than with the popularity of breast-feeding. My mother tells me I did just fine on Carnation milk. It is for others to determine whether I have been socially mobile.