Poor diet is a factor in one in five deaths, global disease study reveals

Study compiling data from every country finds people are living longer but millions are eating wrong foods for their health

Poor diet is a factor in one in five deaths around the world, according to the most comprehensive study ever carried out on the subject.

Millions of people are eating the wrong sorts of food for good health. Eating a diet that is low in whole grains, fruit, nuts and seeds and fish oils and high in salt raises the risk of an early death, according to the huge and ongoing study Global Burden of Disease.

The study, based at the Institute of Health Metrics and Evaluation at the University of Washington, compiles data from every country in the world and makes informed estimates where there are gaps. Five papers on life expectancy and the causes and risk factors of death and ill health have been published by the Lancet medical journal.

It finds that people are living longer. Life expectancy in 2016 worldwide was 75.3 years for women and 69.8 for men. Japan has the highest life expectancy at 84 years and the Central African Republic has the lowest at just over 50. In the UK, life expectancy for a man born in 2016 is 79, and for a woman 82.9.

Diet is the second highest risk factor for early death after smoking. Other high risks are high blood glucose which can lead to diabetes, high blood pressure, high body mass index (BMI) which is a measure of obesity, and high total cholesterol. All of these can be related to eating the wrong foods, although there are also other causes.

causes of death graphic

This is really large, Dr Christopher Murray, IHMEs director, told the Guardian. It is amongst the really big problems in the world. It is a cluster that is getting worse. While obesity gets attention, he was not sure policymakers were as focused on the area of diet and health as they needed to be. That constellation is a really, really big challenge for health and health systems, he said.

The problem is often seen as the spread of western diets, taking over from traditional foods in the developing world. But it is not that simple, says Murray. Take fruit. It has lots of health benefits but only very wealthy people eat a lot of fruit, with some exceptions.

Sugary drinks are harmful to health but eating a lot of red meat, the study finds, is not as big a risk to health as failing to eat whole grains. We need to look really carefully at what are the healthy compounds in diets that provide protection, he said.

undernourishment graphic

Prof John Newton, director of health improvement at Public Health England, said the studies show how quickly diet and obesity-related disease is spreading around the world. I dont think people realise how quickly the focus is shifting towards non-communicable disease [such as cancer, heart disease and stroke] and diseases that come with development, in particular related to poor diet. The numbers are quite shocking in my view, he said.

The UK tracks childhood obesity through the school measurement programme and has brought in measures to try to tackle it. But no country in the world has been able to solve the problem and it is a concern that we really need to think about tackling globally, he said.

Today, 72% of deaths are from non-communicable diseases for which obesity and diet are among the risk factors, with ischaemic heart disease as the leading cause worldwide of early deaths, including in the UK. Lung cancer, stroke, lung disease (chronic obstructive pulmonary disorder) and Alzheimers are the other main causes in the UK.

The success story is children under five. In 2016, for the first time in modern history, fewer than 5 million children under five died in one year a significant fall compared with 1990, when 11 million died. Increased education for women, less poverty, having fewer children, vaccinations, anti-malaria bed-nets, improved water and sanitation are among the changes in low-income countries that have brought the death rate down, thanks to development aid.

People are living longer but spending more years in ill health. Obesity is one of the major reasons. More than a billion people worldwide are living with mental health and substance misuse disorders. Depression features in the top 10 causes of ill health in all but four countries.

Our findings indicate people are living longer and, over the past decade, we identified substantial progress in driving down death rates from some of the worlds most pernicious diseases and conditions, such as under age-five mortality and malaria, said Murray Yet, despite this progress, we are facing a triad of trouble holding back many nations and communities obesity, conflict, and mental illness, including substance use disorders.

In the UK, the concern is particularly about the increase in ill-health that prevents people from working or having a fulfilling life, said Newton. A man in the UK born in 2016 can expect only 69 years in good health and a woman 71 years.

This is yet another reminder that while were living longer, much of that extra time is spent in ill-health. It underlines the importance of preventing the conditions that keep people out of work and put their long term health in jeopardy, like musculoskeletal problems, poor hearing and mental ill health. Our priority is to help people, including during the crucial early years of life and in middle age, to give them the best chance of a long and healthy later life, he said.

Read more: https://www.theguardian.com/society/2017/sep/14/poor-diet-is-a-factor-in-one-in-five-deaths-global-disease-study-reveals

Plastic fibres found in tap water around the world, study reveals

Exclusive: Tests show billions of people globally are drinking water contaminated by plastic particles, with 83% of samples found to be polluted

Microplastic contamination has been found in tap water in countries around the world, leading to calls from scientists for urgent research on the implications for health.

Scores of tap water samples from more than a dozen nations were analysed by scientists for an investigation by Orb Media, who shared the findings with the Guardian. Overall, 83% of the samples were contaminated with plastic fibres.

The US had the highest contamination rate, at 94%, with plastic fibres found in tap water sampled at sites including Congress buildings, the US Environmental Protection Agencys headquarters, and Trump Tower in New York. Lebanon and India had the next highest rates.

European nations including the UK, Germany and France had the lowest contamination rate, but this was still 72%. The average number of fibres found in each 500ml sample ranged from 4.8 in the US to 1.9 in Europe.

The new analyses indicate the ubiquitous extent of microplastic contamination in the global environment. Previous work has been largely focused on plastic pollution in the oceans, which suggests people are eating microplastics via contaminated seafood.

We have enough data from looking at wildlife, and the impacts that its having on wildlife, to be concerned, said Dr Sherri Mason, a microplastic expert at the State University of New York in Fredonia, who supervised the analyses for Orb. If its impacting [wildlife], then how do we think that its not going to somehow impact us?

A
A magnified image of clothing microfibres from washing machine effluent. One study found that a fleece jacket can shed as many as 250,000 fibres per wash. Photograph: Courtesy of Rozalia Project

A separate small study in the Republic of Ireland released in June also found microplastic contamination in a handful of tap water and well samples. We dont know what the [health] impact is and for that reason we should follow the precautionary principle and put enough effort into it now, immediately, so we can find out what the real risks are, said Dr Anne Marie Mahon at the Galway-Mayo Institute of Technology, who conducted the research.

Mahon said there were two principal concerns: very small plastic particles and the chemicals or pathogens that microplastics can harbour. If the fibres are there, it is possible that the nanoparticles are there too that we cant measure, she said. Once they are in the nanometre range they can really penetrate a cell and that means they can penetrate organs, and that would be worrying. The Orb analyses caught particles of more than 2.5 microns in size, 2,500 times bigger than a nanometre.

Microplastics can attract bacteria found in sewage, Mahon said: Some studies have shown there are more harmful pathogens on microplastics downstream of wastewater treatment plants.

Plastic fibres found in tap water across the world

Microplastics are also known to contain and absorb toxic chemicals and research on wild animals shows they are released in the body. Prof Richard Thompson, at Plymouth University, UK, told Orb: It became clear very early on that the plastic would release those chemicals and that actually, the conditions in the gut would facilitate really quite rapid release. His research has shown microplastics are found in a third of fish caught in the UK.

The scale of global microplastic contamination is only starting to become clear, with studies in Germany finding fibres and fragments in all of the 24 beer brands they tested, as well as in honey and sugar. In Paris in 2015, researchers discovered microplastic falling from the air, which they estimated deposits three to 10 tonnes of fibres on the city each year, and that it was also present in the air in peoples homes.

This research led Frank Kelly, professor of environmental health at Kings College London, to tell a UK parliamentary inquiry in 2016: If we breathe them in they could potentially deliver chemicals to the lower parts of our lungs and maybe even across into our circulation. Having seen the Orb data, Kelly told the Guardian that research is urgently needed to determine whether ingesting plastic particles is a health risk.

The new research tested 159 samples using a standard technique to eliminate contamination from other sources and was performed at the University of Minnesota School of Public Health. The samples came from across the world, including from Uganda, Ecuador and Indonesia.

How microplastics end up in drinking water is for now a mystery, but the atmosphere is one obvious source, with fibres shed by the everyday wear and tear of clothes and carpets. Tumble dryers are another potential source, with almost 80% of US households having dryers that usually vent to the open air.

We really think that the lakes [and other water bodies] can be contaminated by cumulative atmospheric inputs, said Johnny Gasperi, at the University Paris-Est Creteil, who did the Paris studies. What we observed in Paris tends to demonstrate that a huge amount of fibres are present in atmospheric fallout.

Plastic fibres may also be flushed into water systems, with a recent study finding that each cycle of a washing machine could release 700,000 fibres into the environment. Rains could also sweep up microplastic pollution, which could explain why the household wells used in Indonesia were found to be contaminated.

In Beirut, Lebanon, the water supply comes from natural springs but 94% of the samples were contaminated. This research only scratches the surface, but it seems to be a very itchy one, said Hussam Hawwa, at the environmental consultancy Difaf, which collected samples for Orb.

This
This planktonic arrow worm, Sagitta setosa, has eaten a blue plastic fibre about 3mm long. Plankton support the entire marine food chain. Photograph: Richard Kirby/Courtesy of Orb Media

Current standard water treatment systems do not filter out all of the microplastics, Mahon said: There is nowhere really where you can say these are being trapped 100%. In terms of fibres, the diameter is 10 microns across and it would be very unusual to find that level of filtration in our drinking water systems.

Bottled water may not provide a microplastic-free alternative to tapwater, as the they were also found in a few samples of commercial bottled water tested in the US for Orb.

Almost 300m tonnes of plastic is produced each year and, with just 20% recycled or incinerated, much of it ends up littering the air, land and sea. A report in July found 8.3bn tonnes of plastic has been produced since the 1950s, with the researchers warning that plastic waste has become ubiquitous in the environment.

We are increasingly smothering ecosystems in plastic and I am very worried that there may be all kinds of unintended, adverse consequences that we will only find out about once it is too late, said Prof Roland Geyer, from the University of California and Santa Barbara, who led the study.

Mahon said the new tap water analyses raise a red flag, but that more work is needed to replicate the results, find the sources of contamination and evaluate the possible health impacts.

She said plastics are very useful, but that management of the waste must be drastically improved: We need plastics in our lives, but it is us that is doing the damage by discarding them in very careless ways.

Read more: https://www.theguardian.com/environment/2017/sep/06/plastic-fibres-found-tap-water-around-world-study-reveals

Hunger eats away at Venezuelas soul as its people struggle to survive

The Maduro regime denies its once oil-rich country is in crisis. But on the streets the desperation cannot be hidden

Hunger is gnawing at Venezuela, where a government that claims to rule for the poorest has left most of its 31million people short of food, many desperately so. As night falls over Caracas, and most of the citys residents lock their doors against its ever more violent streets, Adriana Velsquez gets ready for work, heading out into an uncertain darkness as she has done since hunger forced her into the only job she could find at 14.

She was introduced to her brothel madam by a friend more than two years ago after her mother, a single parent, was fired and the two ran out of food. It was really hard, but we were going to bed without eating, said the teenager, whose name has been changed to protect her.

Since then Venezuelas crisis has deepened, the number of women working at the brothel has doubled, and their ages have dropped. I was the youngest when I started. Now there are girls who are 12 or 13. Almost all of us are there because of the crisis, because of hunger.

She earns 400,000 bolivares a month, around four times the minimum wage, but at a time of hyperinflation that is now worth about $30, barely enough to feed herself, her mother and a new baby brother. She has signed up to evening classes that run before her nightly shift, and hopes to one day escape from a job where everything is ugly.

Velsquez grew up in one of Caracass poorest and most violent districts, but Venezuelas food crisis respects neither class nor geography. The pangs of hunger are felt through the corridors of its major businesses, behind the microphone on radio shows, in hospitals where malnutrition is climbing sharply and already claiming lives, and at schools where children faint and teachers skip classes to queue for food.

Nearly three-quarters of Venezuelans have lost weight over the past year, and the average loss was a huge 9kg, or nearly a stone and a half, according to a survey by the countrys top universities. For many that is simply because food is too expensive. Nine out of 10 homes cant cover the cost of what they should eat.

And 10million people skip at least one meal a day, often to help feed their children.

David Gonzlez, not his real name, had a college degree, a career and modest middle-class dreams of owning a car and a house before Venezuela slipped towards its current crisis, and spiralling inflation made the food he needed to stay alive unaffordable. In a cafe in downtown Caracas, he explains how his dreams shrank with his wasting body, now so emaciated that ribs and collarbones poke through a once-chubby chest.

Play Video
0:44

Venezuelan group declare rebellion against President Nicols Maduro video

Its sad because you stop thinking of what your professional goals and challenges are and instead just focus on what you can eat, said the 29-year-old activist and journalist. Like many of Venezuelas hungry middle classes he was ashamed of his situation.

I had seen people suffering, I saw people queueing for bread, but it had not reached me, I didnt expect it would, he said. Never in my life had I spent a night worrying about what I would eat tomorrow.

This year he has done little else. He stands 5ft 7in tall, and has lost more than a quarter of his body mass, shrinking to little over 50kg (7st 12lb) since the start of the year. During a checkup for a new job, doctors diagnosed a heart murmur caused by stress and hunger. He gets up at 5am to queue for food, but sometimes it isnt there.

Its like an obstacle course. You have to find money to buy food, a place to buy it and then get there in time, he said, with a wry grin that has survived better than his health, before adding: One of the good things about Venezuelans is they laugh about it all food, and security and health.

This summer he swallowed his pride and signed up for a monthly box of subsidised food sold by the government for about $1. I didnt want to be part of that scheme. But I had to change my decision, to literally not die of hunger.

President Nicols Maduro says Venezuelas problems are the result of economic warfare waged by the US. He points to Donald Trumps public mulling of a military option earlier this month as evidence Washington is pushing for regime change, and on Friday slammed ramped-up US sanctions against the government and the state-owned oil corporation as an overt bid to undermine the government by forcing it to default on debt.

Former foreign minister and top aide Delcy Rodrguez has denied the country has a food crisis, denouncing the blackmail of hunger. She told the new legislative super-body she heads: In Venezuela there is no hunger, there is willpower. There is indignation and courage to defend Venezuela.

But critics and economists say the crisis is both real and self-inflicted, the result of a government using a raft of imports as a shortcut to meet promises of development and food security during the heady years of an oil price boom. Venezuela used to produce more than two-thirds of its food, and import the rest, but those proportions are now reversed, with imports making up around 70% of what the country eats.

When crude prices began sliding in 2014, bringing down oil earnings, it left the country short of dollars, and the government decided to focus its income on servicing the national debt rather than importing food.

Katiuska
The Katiuska family face a daily struggle. Photograph: Emma Graham-Harrison for the Observer

This administration decided people have to eat less for them to balance their accounts, said Efran Velsquez, president of the semi-official National Economic Council. That implies poverty, social deterioration, that people are worse off.

Supplies dried up and inflation sliced through savings and earnings, slashing the value of the currency by more than 99% since Maduros 2013 election. Bolivares bought with $1,000 then would be worth little over a dollar at todays black market rate.

There has been no official inflation data from the government since 2015, but the opposition puts the figure at 250% in the first seven months of the year. In a tacit recognition of the scale of the problem, the president himself boosted the minimum wage nearly 500% last year, to offset inflation.

We are the only country in the world where people dread a wage hike, because they know the price of food will follow [up], said Ingrid Soto de Sanabria, head of nutrition at Venezuelas top childrens hospital, who has been raising the alarm about the steep rise in cases of malnutrition.

The number of children with severe malnutrition who were admitted to the hospital rose from 30 in 2015 to 110 last year, and looks set to climb further this year based on figures from the first half of the year, she said. There has been a subtle shifting in the nature of the problems parents face. Formula for babies who cant be breastfed was hard to track down anywhere last year, with shortages so severe they claimed the lives of newborns.

Since the government unofficially relaxed price controls there are more supplies, but parents struggle to pay for what they need, she said. Last year there were terrible shortages, this year there are less shortages, but the prices are through the roof.

We dont have formula, and what little we do is thanks to donations, she said. Mothers who are malnourished can struggle to breastfeed, exacerbating the problem.

Catholic charity Caritas has been among those raising the alarm, after launching a project to monitor and tackle child nutrition across four Venzeulan states. Humanitarian help is needed to save lives. I wouldnt have said that a year ago, because people werent dying, said Susana Raffalli, who led the project. After decades tackling food crises around the world, from Pakistan to Algeria, she was horrified to find herself doing the same in her native Venezuela.

People
People check bags of foodstuff inside one of the food distribution centres, which have been set up by local committees for supply and production in Caracas. Photograph: Ronaldo Schemidt/AFP/Getty Images

Its not a country with a tradition of humanitarian crises like others in the region, she said. But malnutrition has been rising sharply, with more than half of all children affected in some way. The percentage of children showing signs of acute malnourishment climbed from 8% last October to 12% in July. That is well over the 10% threshold for a severe food crisis, and she fears it is still rising. If acute malnourishment reaches 15%, international agencies consider a country or area to be in a state of food emergency.

They are getting younger, and the cases more serious, said Raffalli, who is particularly disturbed about the long-term implications, for individuals and for the country. Malnutrition in the youngest children can stunt development for life.

If children are severely malnourished under two years old, it has an irreversible effect. The first 1,000 days are the most important in the life of a baby, and sets up the cognitive situation that will affect them for their whole life.

She is waiting for funding to take the survey, and food support, to a wider range of provinces. It fills a gap in data left by a government that has not published statistics on nutrition for several years, and a gap in support left by failed public support programmes.

But she warns that no feeding programme can do anything more than protect individual children. We need this help because people are being harmed, they are dying. But its a temporary solution, it wont resolve the problem of supply and access to food.

Many mothers are already fearful. Luisa Garca, not her real name, wept when she heard her malnourished son had been nursed back to health by the Caritas feeding project, but not tears of joy. She was still unemployed, with empty cupboards and a bare fridge, and yet the food handouts he had been living on would end.

On the day they said he was up to weight, I went away crying, because I had nothing to give him to eat. I counted on that food, the 38-year-old recalled as she waited in line at a church soup kitchen, also organised by Caritas. We eat like crabs, picking a little where we can. Often only once a day, at best twice.

The volunteers who make and serve the soup understand the desperation; they too have become familiar with the gnawing pain of an empty stomach. We are all professionals and we spend almost everything we earn on food and basic needs, said Rosalinda Rodrguez, a retired teacher who hasnt bought new clothes since 2014, and has lost 12kg over the past year.

Although she is still in her own words stout, she was recently diagnosed with anaemia because she is eating such poor quality food. Another volunteer has shrunk even more. Life has been totally derailed, said Ricardo Lpez, a lawyer whose son went to an international school until the crises shrank his salary paid in bolivares to far below the foreign currency tuition fees.

Empty
Empty shelves in Caracas. Photograph: Ueslei Marcelino/Reuters

I try to leave lunch as late as possible myself, so you can just have a snack in the evening. My colleagues sometimes faint from hunger, or dont have lunch.

As with other former members of the middle class, the crisis has brought not just hunger but a hollowing out of his life. Cinemas, meals out, gym membership, even hiking in hills around the city have been cut out by the need to stave off hunger. Lpez, who asked for his real name to be withheld, has so little money left these days after paying for food and other essentials that he could only budget 15,000 bolivares, or a single US dollar, to enjoy the summer holiday with his son.

Instead of beach trips, he spent August weekends feeding those who are even worse off. We thought no one would come but then we were full. Hunger doesnt take holidays.

The crisis has left the promises, and legacy, of former president Hugo Chvez, in tatters. He rose to power and stayed there until his death from cancer in 2013, in large part promising a more equitable distribution of the countrys oil wealth and food security for all. The benefits were real for many Venezuelans, and even if they have not proved sustainable they nurtured a fierce loyalty that carried Maduro to power and a base that is sticking with him through hardship.

Even today his supporters include those who have lost serious amounts of weight, pine for their favourite food, and have been separated from beloved relatives by the vast exodus of Venezuelans seeking a better chance of going to bed on a full stomach.

If we supported Chvez with oil at $100 a barrel, we have to support him now with it down at $40 a barrel, said Henny Liendo, a cocoa cooperative member in the village of Chuao. Diets have shifted back to patterns more familiar to parents and grandparents, to fish, root vegetables and bananas, with less sugar, flour and meat.

He sees his curtailed diet and occasional hunger as sacrifices in a bigger war, but mourns for the past. We were happy and we didnt know it, Venezuelans say in towns and villages, looking back over recent turbulent decades. The governments most recent effort to hang on to Chvezs legacies has been the boxes of subsidised food, known colloquially by their Spanish initials CLAP, that were launched last year. They bundle imported food together for a low price. They never last a whole month, often little more than a week for large families, but they bring cheap food and much needed variety, staples-turned-luxuries like mayonnaise, butter and milk powder into homes.

When Gonzlez, the activist, got his first government box after months of waiting, he sat down to a dinner of arepas, the national corn-flour patties, with butter and cheese and a cup of milky coffee. Once an everyday meal, it felt, he said, like a luxurious indulgence.

For the very poorest in this crumbling economy, though, even a dollar to pay for them can be out of reach. We eat yuca, bananas, green papaya, said Katiuska Prez, not her real name, a 28-year-old mother of six, who lives in the village of Tocoron. When the boxes come Im allowed two, but sometimes I can only afford one, or none at all.

Her five daughters all registered as severely malnourished when Caritas did checks, even though like many parents she had been cutting back her own meals to boost their portions.

I feed them first, so they have enough to eat, and we go without, she said. Most recovered with feeding support, but on the latest visit her one-year-old had slipped back to six kilograms, a weight more appropriate for a baby half her age. Prez said she feels hopeless. We have been screwed for several years now. Everything that Chvez built with his hands has been kicked down.

Read more: https://www.theguardian.com/world/2017/aug/26/nicolas-maduro-donald-trump-venezuela-hunger

Teenage boys wear skirts to school to protest against ‘no shorts’ policy

Dozens of pupils at Isca academy in Exeter stage uniform protest after school insists they wear trousers despite heatwave

Some had borrowed from girlfriends, others from sisters. A few had gone the extra mile and shaved their legs. When the Isca academy in Devon opened on Thursday morning, an estimated 30 boys arrived for lessons, heads held high, in fetching tartan-patterned skirts. The hottest June days since 1976 had led to a bare-legged revolution at the secondary school in Exeter.

As the temperature soared past 30C earlier this week, the teenage boys had asked their teachers if they could swap their long trousers for shorts. They were told no shorts werent permitted under the schools uniform policy.

When they protested that the girls were allowed bare legs, the school no doubt joking said the boys were free to wear skirts too if they chose. So on Wednesday, a handful braved the giggles and did so. The scale of the rebellion increased on Thurday, when at least 30 boys opted for the attire.

Quite refreshing was how one of the boys described the experience, pointing out that if even Royal Ascot had allowed racegoers in the royal enclosure to remove their jackets, then the school ought to relax its dress code. Another said he rather enjoyed the nice breeze his skirt had afforded him.

A third, tall boy said he was told his short skirt exposed too much hairy leg. Some of the boys visited a shop on their way to Isca the name the Romans gave to Exeter to pick up razors to make sure they did not fall foul of any beauty police.

Ironically, the temperature had dropped in Exeter to a more manageable 20C, but some boys said they had enjoyed the freedom afforded by the skirts and that they might continue.

The school said it was prepared to think again in the long term. The headteacher, Aimee Mitchell, said: We recognise that the last few days have been exceptionally hot and we are doing our utmost to enable both students and staff to remain as comfortable as possible.

Shorts are not currently part of our uniform for boys, and I would not want to make any changes without consulting both students and their families. However, with hotter weather becoming more normal, I would be happy to consider a change for the future.

It was too late. The revolution was picked up by media organisations across the globe, and Devon county council was forced to help the school out with inquiries. A spokesperson said: About 30 boys arrived at school this morning wearing school skirts. None of the boys have been penalised no one was put in isolation or detention for wearing a skirt.

The mother of one of the boys who began the protest said she was proud of him. Claire Lambeth, 43, said her son Ryan, 15, had come home earlier in the week complaining about the heat. He said it was unbearable. I spoke to a teacher to ask about shorts and she said it was school policy [that they could not be worn]. I did say this was exceptional weather, but they were having none of it. If girls can wear skirts, why cant boys wear shorts?

Ryan came up with the idea of wearing a skirt, so that evening we borrowed one. He wore it the next day as did five other boys. Then this morning I didnt expect it to take off like that. The school is being silly really this is exceptional weather. I was very proud of Ryan. I think it was a great idea.

Another mother said: My 14-year-old son wanted to wear shorts. The headteacher told them: Well, you can wear a skirt if you like but I think she was being sarcastic. However, children tend to take you literally, and because she told them it was OK, there was nothing she could do as long as they were school skirts.

A third mother said: Children also dont like injustice. The boys see the female teachers in sandals and nice cool skirts and tops while they are wearing long trousers and shoes and the older boys have to wear blazers. They just think its unfair that they cant wear shorts in this heat.

There were signs that the revolution might be spreading. The Guardian has heard of at least one more school in Wiltshire where one boy turned up in a skirt, although it did not go down quite so well with his friends.

And schoolboys were not the only ones making controversial dress choices because of the heat. Michael Wood, who works as a porter at Watford general hospital, claimed he was facing disciplinary action from his employers Medirest for rolling his trousers up to try to cool down. A spokesperson for the company declined to comment on the case, but said: The health and safety of our colleagues is always our number one priority.

What happened to summer school uniforms? Matthew Easter, managing director of the schoolwear supplier Trutex, said they had become less popular for reasons of economy. Its really up to the individual school to decide, but the headteacher is in a difficult position. A decade or so ago, summer wear was more popular, but theres been a change recently to try to make uniforms as economical as possible. Summer uniforms are only worn for a matter of weeks.

If parents havent bought uniform shorts, then some children may feel disadvantaged, so perhaps the decision in this case is simply down to fairness.

It may be that the weather will solve the problem for the school. The Exeter-based Met Office situated up the road from the school predicts pleasant, but not searing, temperatures over the coming week.

Read more: https://www.theguardian.com/education/2017/jun/22/teenage-boys-wear-skirts-to-school-protest-no-shorts-uniform-policy

The Gambia bans female genital mutilation

President Yahya Jammeh outlaws practice that affects three-quarters of women in west African country

The Gambia has announced it will ban female genital mutilation (FGM) after the Guardian launched a global campaign to end the practice.

The president, Yahya Jammeh, said last night that the controversial surgical intervention would be outlawed. He said the ban would come into effect immediately, though it was not clear when the government would draft legislation to enforce it.

FGM involves cutting female genitalia often when girls are young to remove their labia and clitoris, which often leads to lifelong health complications, including bleeding, infections, vaginal pain and infertility. More than 130 million women worldwide are subjected to the procedure in Africa and the Middle East.

The practice is widespread in many African countries, including the Gambia, where 76% of females have been subjected to it. The age at which FGM takes place in the Gambia is not recorded, but it is reported that the trend of practicing FGM on infant girls is increasing. By the age of 14, 56% of female children in the country have had the procedure.

Highlights of the Guardians global media campaign to help end FGM

Jaha Dukureh, an anti-FGM activist whose campaign to end the practice in the country has been supported by the Guardian, spent the past week meeting cabinet ministers in the Gambia and sent them articles from the newspaper to inform them about the issue.

Im really amazed that the president did this. I didnt expect this in a million years. Im just really proud of my country and Im really, really happy, she told the Guardian. I think the president cared about the issue, it was just something that was never brought to his attention.

Jammehs announcement came late last night, as the president was visiting his home village on Kanilai as part of a nationwide tour. The announcement was unexpected for both campaigners and public.

The amazing thing is its election season. This could cost the president the election. He put women and girls first, this could negatively affect him, but this shows he cares more about women than losing peoples votes, said Dukureh.

Dukureh will return to the Gambia on Tuesday to thank Jammeh for the ban and to help with drafting the legislation that will enforce it.

A ban on FGM would be a significant development on an issue that has proved controversial and divisive in the Gambia, with some arguing that FGM is permitted in Islam, the major religion in the country.

Senior Muslim clerics in the Gambia have previously denied the existence of FGM in the Gambia saying instead that was is practiced is female circumcision. In 2014, state house imam, Alhaji Abdoulie Fatty told Kibaaro News, I have never heard of anyone who died as a result of female genital mutilation (FGM)… If you know what FGM means, you know that we do not practice that here. We do not mutilate our children.

Jaha Dukureh: Im really amazed that the president did this. I didnt expect this in a million years. Photograph: Mae Ryan for the Guardian

Mary Wandia, the FGM programme manager at womens rights campaign group Equality Now said: The ban is an essential first step towards ending FGM and we commend President Jammeh on finally announcing it.

A law must now be enacted and properly implemented to ensure that every girl at risk is properly protected. The government needs to show strong commitment and prioritise this issue in a country where three quarters of women have been affected and reductions in prevalence have been slow to materialise.

Though support for FGM is widespread in the Gambia, reports have shown that public support for the practice has dropped in recent decades among women across all age groups.

Support for the continuation of the practice is strongest among the countrys richest women and varies dramatically in different ethnic communities, with 84% of Mandinka women supporting the continuation of FGM compared with 12% of Wolof women.

This year FGM was banned in Nigeria, which joined 18 other African countries that have outlawed the practice, including Central African Republic, Egypt and South Africa.

Somalia, which has the highest prevalence of FGM in the world, has indicated it would like to end the practice, with a spokeswoman for the ministry for womens affairs saying it was committed to make this happen despite significant resistance in the country. Currently, 98% of girls aged between four and 11 are subjected to FGM in Somalia.

The Guardian launched a major campaign to end FGM around the world in 2014, with the support of the campaign petition website, Change.org.

The Guardian Global Media campaign works closely with local activists in the Gambia, Kenya and Nigeria to help them provide education and awareness on the issue and hope to expand the campaign to Sierra Leone, Senegal and Uganda next year.

Read more: http://www.theguardian.com/society/2015/nov/24/the-gambia-bans-female-genital-mutilation

Canary Island tourists warned to avoid toxic ‘sea sawdust’ algae

Global warming helping spread of micro-algae, forcing the closure of several beaches including popular Teresitas at Santa Cruz de Tenerife.

Tourists have been warned to avoid blooms of toxic micro-algae that have been proliferating in hot weather in the sea off Spains Canary Islands.

Tenerife in particular is awash with visitors at this time of year but some of those having a dip in the Atlantic ocean have come out scratching themselves after brushing up against the tiny algae.

The spreading algae have produced a greenish-brown hue in the waters off some beaches in the tourist haven.

Since the end of June we have seen episodes of massive efflorescence, or bloom, of microalgae, sometimes reaching as far as bathing beaches, said Jose Juan Aleman, director of public health for the Canaries.

The algae are a type of bacteria, trichodesmium erythraeum, also known as sea sawdust, said Aleman.

Its proliferation is a natural, temporary phenomenon which is going to disappear in due course, he added, suggesting global warming was helping the algae spread.

The bacterium contains a toxin which can lead to skin irritation, dermatitis, hence one must avoid coming into contact with it in the water and on the sand.

With the islands last year welcoming more than 13 million foreign tourists, local authorities were keen to reassure sun-seekers.

Generally it has not been necessary to close the beaches, said Aleman.

Bill Entwistle (@bemahague)

No swimming, algae alert @playasanjuan @tenerife pic.twitter.com/0sqIeAblqu

July 22, 2017

However, AFP found that several have been closed to swimmers over recent weeks, including the popular Teresitas beach at Santa Cruz de Tenerife.

Marta Sanson, professor of plant biology at Tenerifes La Laguna university, said that ideal conditions are allowing proliferation of these micro-algae.

Those include an increase in water temperature as well as a dust cloud sweeping in off the Sahara which is rich in iron, a nutrient which micro-organisms like.

Read more: https://www.theguardian.com/world/2017/aug/08/canary-island-tourists-warned-to-avoid-toxic-sea-sawdust-algae

Trump to rally: GOP senators who oppose health bill ‘will have a lot of problems’

Trump speaks for an hour at campaign-style rally in Youngstown, Ohio, and boasts of accomplishments while pledging once again to build that wall

Donald Trump warned that Republican senators who dont support legislation repealing and replacing Obamacare will have a lot of problems.

Speaking for an hour at a campaign-style rally in Youngstown, Ohio, Trump took a victory lap after the Senate voted to begin debate on legislation to repeal the Affordable Care Act. We are now one step closer to liberating our citizens from this Obamacare nightmare, he said.

Before a raucous crowd in the blue-collar city, Trump went on to warn that any senator who votes against repeal and replace tells America that they are fine with the Obamacare nightmare, and I predict theyll have a lot of problems.

However, Trump spent comparatively little time discussing healthcare. Instead, he returned to familiar themes from his freewheeling presidential campaign, deriding fake news and pledging once again to build that wall on the border between the United States and Mexico. He also returned to familiar boasts about how, with the exception of Abraham Lincoln, he can be more presidential than any president thats ever held this office and taunted protesters, saying about one: Hes going back home to mommy.

He spent much of the rally boasting about his accomplishments since taking office: I think, with few exceptions, no president has done anywhere near what we have done in his first six months.

In particular, Trump dwelled on his efforts to curb illegal immigration and deport undocumented migrants from the United States. Trump claimed that in doing so we are liberating our towns and cities and warned darkly of immigrants in gangs committing crimes.

They dont want to use guns because its too fast and its not painful enough, claimed Trump. So theyll take a young, beautiful girl, 16, 15 and others, and they slice them and dice them with a knife because they want them to go through excruciating pain before they die, and these are the animals that weve been protecting for so long.

Trump though did not address the investigations into Russian interference in the 2016 election or his growing displeasure with Jeff Sessions, the attorney general, for recusing himself from the justice departments investigation into the 2016 campaign.

Read more: https://www.theguardian.com/us-news/2017/jul/25/trump-republicans-healthcare-bill-rally-ohio

John McCain had the chance to do the right thing on healthcare. He failed | Lucia Graves

There are many reasons to respect the Arizona senator, but his remarkable stoicism and service cant excuse his yes vote in the Senate

John McCain often gets cast as a truth-teller to Donald Trump, but his voting record says otherwise. And nowhere was that more clear than on Tuesday when, despite his own ill health, when it came to the decision of whether to take other peoples healthcare away, he cast a decisive vote in the wrong direction.

Addressing his fellow lawmakers, McCain called passionately for a return to regular order, and for senators to work constructively across the aisle. Why dont we try the old way of legislating in the Senate, the way our rules and customs encourage us to act, he said in his Tuesday speech. If this process ends in failure, which seems likely, then lets return to regular order!

Though he has often railed against Trump as if he cant actually affect what he is complaining about, McCain isnt a helpless observer hes an influential senator. And on Tuesday, as the country draws closer than ever before to the death of the Affordable Care Act, he was a pivotal one.

Had McCain simply voted no to the question of whether the Senate should begin debate on a repeal or replacement of Obamacare, which squeaked by in the Senate with a vote of 51-50, the chambers leader Mitch McConnell might well have been forced to do the very thing McCain claimed to want: restore the chamber to order.

Instead, McCain, who was recently and tragically diagnosed with an aggressive form of brain cancer, and who returned to DC explicitly to help save the GOP healthcare bill, voted yes.

To put it another way, faced with a rare opportunity to make a real tangible difference, he risked traveling amid failing health to make possible the very thing he decried.

More damningly, he voted yes to take away healthcare from millions of Americans including an untold number of other cancer patients even as he continues to access benefits of the quality care afforded him as a senator, care subsidized by American taxpayers.

Never mind that at this point in time Republicans have little idea what the bill they would replace Obamacare with will contain. Never mind that we have arrived at this point through a secretive process devoid of public hearings, or even that Republicans would have the healthcare of millions of American women dreamed up entirely by men.

Politics appears to have triumphed over logic. Sadly, the politics that won out today are is not even a sort personally dear to John McCain that much was made clear in his floor speech. Its not even his own electoral politics that won out, either; after a tough re-election battle, he wont be up again until 2022, freeing him up as much as electorally possible to act solely with his moral compass as the guide.

Instead, McCain did the very thing he had just railed against, acting out of partisan loyalty.

There are many reasons to respect McCain, a former prisoner of war who endured torture in the five and a half years he spent captive in North Vietnam, and has campaigned against torture by the US. His 2008 campaign against Barack Obama now looks like the very model of civility in the wake of Trump.

But even his remarkable stoicism and service cant excuse what he just did.

The grim reality is that health insurance is of the utmost importance when it comes to surviving cancer, the second leading killer in America after heart disease. Put simply, the uninsured are much more likely to die than those with insurance and sooner.

A recent study in the journal Cancer found the uninsured were 88% more likely to die of testicular cancer than those with insurance. For patients with Medicaid, the number dropped to a 58% greater chance of dying than privately insured patients like McCain.

The study found the same trend held true for patients with glioblastoma, the malignant brain cancer McCain was recently diagnosed with. Its a terribly disease with a median life expectancy with his type of just 15 months, and thats as true for McCain as anyone, but the uninsured still die faster than anyone.

Voting to subject any one of millions of Americans to go to meet such a fate without even the benefit of the best tools medicine has to fight it is cruel, given McCains new-found appreciation of the benefit.

The estimated cost of McCains recent surgery to remove the cancer above his eye is a sum that would bankrupt many Americans, using the Medicare rates for which McCain qualifies.

Theres a way to fix the fact that many Americans under the age of 65 dont have access to any such care: let everyone under it buy in, a scheme for which many on the left have argued. But on Tuesday, McCain helped move the country in precisely the opposite direction.

We still dont know which of several bills Republicans will bring up for a vote, but all of them involve millions of Americans losing the very sort of health insurance upon which McCain depends.

The only question is whether its a matter of 22, 32, or just 15 million people who will lose access. What we can say with confidence is whatever version moves forward, McCains lost more than his good health hes lost his decency.

Read more: https://www.theguardian.com/commentisfree/2017/jul/25/john-mccain-healthcare-senate-vote-republicans

Turkish activists decry attack on press freedom as journalists stand trial

Charges include claims that Cumhuriyet journalists helped the separatist Kurdistan Workers party and Glen movement

The trial of 17 reporters and executives from Cumhuriyet, one of Turkeys last standing opposition newspapers, is set to begin on Monday with rights activists decrying the continuing muzzling of free speech in one of the worlds largest jailers of journalists.

The charges include accusations that the newspapers journalists aided the separatist Kurdistan Workers party (PKK) and the Fethullah Glen movement, which is widely believed in Turkey to have orchestrated last years coup attempt, and complaints of irregularities in the elections of the organisations board of executives.

Rights activists say the trial is an assault on freedom of expression and the accusations are absurd, because Cumhuriyet, the countrys newspaper of record that is committed to secularism, has long warned of the dangers of the Glen movement, which itself has long been at odds with the PKK.

They argue that the other charges are an attempt at replacing the newspapers board of directors with government appointees more pliable to the ruling partys influence.

I have been a journalist for a long time and have dealt with this for a long time, said Aydn Engin, a veteran journalist with Cumhuriyet who is also standing trial on Monday, but had been released for health reasons. I will say that I am ashamed and in agony for my country because of these irrational accusations, he said.

President Recep Tayyip Erdoan and his ruling Justice and Development (AK) party have, for years worked to dismantle or co-opt Turkeys free press. That crackdown has accelerated in the year since last Julys coup, with more than 150 journalists believed to be behind bars in Turkey, the highest in the world ahead of China and Egypt.

As of March this year, 173 media outlets had been shut down, including newspapers, magazines, radio stations, websites and news agencies. More than 2,500 journalists have been laid off as part of the closures and 800 have had their press cards revoked, according to the Republican Peoples party (CHP), the main opposition bloc.

The government has also exerted pressure on media outlets that do not toe the official line by pressuring advertisers not to do business with them and pursuing cases of defamation, or by slapping them with large, unpayable fines. After media outlets that once belonged to the Glen movement were seized, the government-appointed trustee boards that have transformed those newspapers and TV stations into a loyalist press.

These loyalist media outlets are often referred to as penguin media because a TV station that was fearful of antagonising the government during the Gezi protests of 2013 aired a documentary about penguins instead of broadcasting the protests.

That threat of a trustee board hangs over Cumhuriyet, a newspaper that was founded in 1924 and is the only serious newspaper in circulation that is vehemently opposed to government policies. It has described the crackdown after the coup in which the government dismissed or detained tens of thousands of civil servants, police and military officers, academics, judges and journalists as a witch-hunt, and has repeatedly criticised Erdoan as an authoritarian attempting to destroy democracy.

Erdoan has described democracy as a train before, said Engin, referring to a quote by the president that described democracy as a train that one can get off from once you reach you destination. Its going to be worse for Cumhuriyet. Maybe it will be a shut down, a quick and painless death, or we will suffocate slowly.

The newspaper has also joined calls for a ceasefire and peaceful resolution to the conflict with the PKK at a time when the government had opted for a security-focused response amid heightened tensions. The former editor-in-chief, Can Dundar, is in exile after being prosecuted for a 2014 article that revealed the National Intelligence Organisation (MIT) was sending weapons across the border into Syria under the guise of humanitarian aid, a story that the authorities say was leaked by Glenist conspirators.

On Monday, a week of hearings is expected to begin in the Cumhuriyet case against 17 of the newspapers journalists and executives. The case will commence with a reading out of the indictment and opening defense statements, and they expect for the presiding judge to decide whether to release the defendants on bail by Friday.

This trial offers the government another opportunity to change course in its campaign against Turkeys independent media, said Tobias Garnett, a human rights lawyer with P24, an organisation that advocates for press freedom and supports Turkish journalists on trial. Journalism is not a crime. Prosecutors should stop dressing up legitimate criticism as terrorism and harassing journalists through the courts.

Blent zdoan, the managing editor of Cumhuriyet, said in an interview with the Guardian that the trial was not just about press freedom, but about the governments campaign in the aftermath of the coup more broadly.

Its not just a struggle for free press, he said. Our arrested colleagues are people of a high moral and intellectual calibre. Its for everyone who lost their jobs, those who have been on hunger strike. Theyre struggling for both of us. Thats why I believe its a new start.

The arrest of journalists has earned Ankara criticism from abroad. Late last month, the UN human rights councils working group on arbitrary detentions issued a legal opinion arguing that the arrest of the Cumhuriyet staff contravened the universal declaration of human rights and was arbitrary. The panel of experts called on the Turkish government to release the journalists.

Read more: https://www.theguardian.com/world/2017/jul/24/turkish-activists-decry-attack-press-freedom-journalists-stand-trial

Philip Morris cigarettes charged millions after losing plain packaging case against Australia

Court of arbitration finds Philip Morris Asia case to be an abuse of rights and says it must pay Australias multi-million dollar legal costs

The tobacco manufacturer Philip Morris will be forced to pay millions of dollars in legal fees to Australia after its failed case against plain packaging laws.

Big tobacco companies have fought vigorously against the Gillard governments plain packaging laws since they were introduced in 2011.

By banning logos and distinctive-coloured cigarette packaging, Australias laws went further than the advertising bans and graphic health warnings introduced in many other countries.

Philip Morris, Imperial Tobacco and Japan Tobacco quickly attempted to have the laws overturned through a constitutional challenge in the high court, which they lost in 2012.

Philip Morris Asia then took a case to the permanent court of arbitration in 2012. It tried to use the conditions of a 1993 trade agreement between Australia and Hong Kong to argue a ban on trademarks breached foreign investment provisions.

The corporate giant not only lost but was criticised by the court, which found the case to be an abuse of rights.

The court published a decision on the payment of costs at the weekend, which it made in March. The decision, which brought five years of proceedings to a close, found Philip Morris Asia liable to pay Australias multimillion-dollar claim for legal costs.

The final costs figure was kept secret but Fairfax Media reported it as being up to $50m.

Australia successfully argued Philip Morris must pay its court fees and expenses, the cost of expert witnesses, travel, and solicitors and counsel. It also claimed interest. Australia had told the court its claim was modest and was a small proportion of what the tobacco giant had sought in damages.

It said Philip Morris had sought to challenge a public health measure of critical importance to Australia, making it important to mount a robust and comprehensive response to all aspects of the claim.

Philip Morris had tried to argue the governments costs were unreasonable for a legal team that consisted primarily of public servants.

The company argued that two similar countries, Canada and the US, had never claimed more than US$4.5m and US$3m respectively in costs and fees.

Australias claim was much more than that.

The claimant emphasizes that, even excluding the fees of four outside counsel, the respondents government lawyers claim over [redacted] in fees, even though Australia itself pays them very modest government salaries, the courts decision read.

But the court found Australias claim was reasonable, rejecting Philip Morriss arguments.

Taking into account the complexity of issues of domestic and international law relevant in this procedure, particularly for a government team usually not engaged in such disputes, the Tribunal does not consider that any of these costs claimed by the Respondent were unreasonable and should not have been incurred, it found.

In making this assessment, the Tribunal also takes into consideration the significant stakes involved in this dispute in respect of Australias economic, legal and political framework, and in particular the relevance of the outcome in respect of Australias policies in matters of public health.

Earlier this year big tobacco failed in a separate bid to have the laws overturned by the World Trade Organisation. The decision was widely seen as a green light for more countries to follow Australias lead.

Read more: https://www.theguardian.com/business/2017/jul/10/philip-morris-cigarettes-charged-millions-after-losing-plain-packaging-case-against-australia