Daily Archives: 13 August, 2012

Chronic fatigue syndrome treatments

Long-term psychiatric and exercise treatments for chronic fatigue syndrome are good value for money, a study has found.

Cognitive behaviour therapy (CBT) and graded exercise therapy (GET) are both known to help patients with CFS, also known as myalgic encephalomyelitis (ME).

The new findings show that, given in addition to medical care, they are also cost effective.

Another treatment option, adaptive pacing therapy (APT), was not judged to be good value.

Researchers based their conclusions on the same criteria used by the NHS efficiency watchdog, the National Institute for health and Clinical Excellence (Nice).

Nice makes a calculation based on years lived in good health, known as quality-adjusted life years or Qalys. A treatment costing less than £20,000 to £30,000 per Qaly is believed to represent value for money.

In the study, CBT given in addition to specialist medical care was found to cost £18,374 per Qaly, GET £23,615 and APT £55,235.

Professor Paul McCrone, a health economist from King’s College London, who led the new study, said: “It’s very encouraging that two treatments found to help a significant number of CFS/ME patients are also cost-effective based on existing Nice criteria.

“There is now a strong case for the NHS to invest in these therapies. Our research suggests this investment would be justified in terms of improving quality of life for patients and could actually save costs to society if the impact on family members is taken into account.”

chronic fatigue syndrome

chronic fatigue syndrome

CFS/ME is a complex and debilitating condition that affects around 250,000 adults and children in the UK.

Symptoms include extreme physical and mental fatigue, muscle and joint pain, disturbed sleep, and concentration and memory problems.

The new results, published in the online journal Public Library of Science ONE, are the latest from the Pace trial, funded by the Medical Research Council.


The trial began in 2005 and recruited 640 patients. It compared four of the main treatments available for people with CFS/ME, specialist medical care, CBT, GET and APT.

CBT helps patients understand how to affect their symptoms by thinking about them differently. GET involves a tailored exercise programme taking into account a patient’s fitness and symptoms.

APT is an occupational therapy approach that matches a patients’ activity level to the amount of energy they have.

Early findings from the trial reported last year showed that CBT and GET could benefit 60% of patients for whom fatigue was the main symptom.

The latest study looked at cost effectiveness over a period of one year.

Specialist medical care was the cheapest single option. But when benefit to quality of life was taken into account, medical care plus CBT became the most cost-effective treatment followed by GET.

Eggs – Good or bad?

Once demonised as bad for the heart, eggs have been repositioned as a health food in recent years as researchers have found that not only are they good for hearts, but can even help you to lose weight.

But last week Canadian researchers published findings that could crack eggs’ nutritious reputation.

In the study of 1,200 subjects with an average age of 61, it was suggested that build-up of carotid plaque, a waxy substance that clogs blood vessels and is linked to cardiovascular disease, was greater in people who ate at least two eggs per week.

The researchers specifically blamed egg yolks for this effect.

Britons eat nearly 30 million eggs a day. Should we curtail our egg habit to protect our hearts?

Are eggs bad for your cholesterol levels?

The latest Canadian research ‘goes against the grain of current scientific thinking’, says Helen Bond, of the British Dietetic Association.

A few years ago, Bruce Griffin, professor of nutritional metabolism at the University of Surrey, analysed 30 egg studies carried out over 30 years and found eggs ‘have no clinically significant impact’ on cholesterol levels.

Can eggs protect your heart?

In fact, a study in the American Journal of Clinical Nutrition found eggs helped to maintain healthy blood pressure levels, says Helen Bond.

Eggs

Eggs

And last year, scientists at the University of Alberta discovered egg yolks contain two important amino acids, tryptophan and tyrosine, and that two raw egg yolks have almost twice as many antioxidants as an apple.

Frying or boiling reduced antioxidant levels by about half.

Eggs are packed with nutrition:

Thanks to changes in chicken feed, eggs today are healthier than those produced 30 years ago.

Modern eggs contain 70 per cent more vitamin D and double the amount of selenium.

Levels of these are low in the UK diet, and linked to an increased risk of cancer, cardiovascular disease and infertility. Each egg yolk also provides 13 essential nutrients.


How many eggs can I eat?

The Department of Health now says we can eat as many eggs as we like, as long as they form part of a healthy, balanced diet. There is no upper limit, says Bond, unless you have inherited high cholesterol.

Of the Canadian study, she says that carotid plaque rises anyway with age after 40.

And the researchers didn’t take into account lifestyle factors such as exercise and diet.

Are eggs fattening?

In the Department of Health analysis it was found that eggs contain around 20 per cent less fat, 13 per cent fewer calories and 10 per cent less cholesterol than 30 years ago.

In one study, overweight women had eggs or a bagel for breakfast. The egg eaters consumed fewer calories in the following 24 hours.

‘Scientists put the positive effects down to the satiating effects of egg protein,’ says Bond.