A major new study led by the University of Sydney suggests that walking 7000 steps a day offers similar health benefits across several outcomes as walking 10,000.il 7000 steps, at which point the benefits began to taper offA major new study led by the University of Sydney suggests that walking 7000 steps a day offers similar health benefits across several outcomes as walking 10,000.
Led by Professor Melody Ding from the School of Public Health, the study was published in The Lancet Public Healthand analysed data from 57 studies from 2014 to 2025 that were conducted in more than ten countries including Australia, USA, UK and Japan.
The largest and most comprehensive review to date, the researchers examined the impact that different daily step counts have on the chance of dying from cardiovascular disease and cancer, and developing diseases such as cancer, type 2 diabetes, dementia and depression. Professor Melody Ding says the findings offer a more achievable benchmark for people who struggle to meet traditional exercise guidelines.
“Aiming for 7000 steps is a realistic goal based on our findings, which assessed health outcomes in a range of areas that hadn’t been looked at before,” said Professor Ding.
“However, for those who cannot yet achieve 7000 steps a day, even small increases in step counts, such as increasing from 2000 to 4000 steps a day, are associated with significant health gain.
“We know daily step count is linked to living longer, but we now also have evidence that walking at least 7000 steps a day can significantly improve eight major health outcomes — including reducing risk of cardiovascular disease, dementia and depressive symptoms.”
Health benefits at different step counts

The researchers looked at studies in which participants wore step counting devices, such as pedometers, accelerometers and fitness trackers, to track their daily step counts. Starting at 2000 steps, experts compared the health outcomes of people walking more steps a day at 1000 step increments to see whether there was any difference in the risk of early death or other major diseases.
When compared with 2000 steps a day, researchers found that: Walking 7000 steps a day reduced the risk of death by 47 percent, which was almost identical to the benefit seen at walking 10,000 steps per day. Dementia risk dropped by 38 percent from walking 7000 steps a day, with only a 7 percent extra reduction at 10,000 steps. Risk of type 2 diabetes fell by 22 percent from walking 10,000 steps a day and reduced to 27 percent at 12,000 steps. Significant health improvements were seen when people increased their average daily steps from 2000 to between 5000 and 7000 steps.”For people who are already active, 10,000 steps a day is great,” said Dr Katherine Owen, co-author and chief analyst of the study from the School of Public Health. “But beyond 7000 steps, the extra benefits for most of the health outcomes we looked at were modest.”
The researchers are working with the Australian government to use the evidence from this study to inform future updates to physical activity guidelines.
“Our research helps to shift the focus from perfection to progress. Even small increases in daily movement can lead to meaningful health improvements,” said Professor Ding.
Experts are calling for future studies to explore how step goals should vary based on age, health status and region, and to include diverse populations and longer-term data to strengthen the evidence. Professor Ding says this kind of detail is rare and will be useful for health practitioners when tailoring advice for patients.

Ivermectin administered to the whole population significantly reduces malaria transmission, offering new hope in the fight against the disease. The BOHEMIA trial, the largest study on ivermectin for malaria to date, showed a 26% reduction in new malaria infection on top of existing bed nets, providing strong evidence of ivermectin’s potential as a complementary tool in malaria control. The results of this project, coordinated by the Barcelona Institute for Global Health (ISGlobal) -an institution supported by the “la Caixa” Foundation- in collaboration with the Manhiça Health Research Centre (CISM) and the KEMRI-Wellcome Trust Research Programme, have been published in The New England Journal of Medicine.
Malaria remains a global health challenge, with 263 million cases and 597,000 deaths reported in 2023. Current vector control methods, such as long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), have become less effective due to insecticide resistance and behavioral adaptations in mosquitoes to bite outdoors and during dusk or dawn, when people are not protected by these measures. This underscores the urgent need for innovative solutions to combat malaria.
Ivermectin for malaria: A novel strategy
Ivermectin, a drug traditionally used to treat neglected tropical diseases like onchocerciasis, which causes river blindness, and lymphatic filariasis, which causes elephantiasis, has been shown to reduce malaria transmission by killing the mosquitoes that feed on treated individuals. Given the rising resistance to conventional insecticides, ivermectin could offer an effective new approach totackle malaria transmission, especially in regions where traditional methods have become less effective.
The Unitaid-funded BOHEMIA project(Broad One Health Endectocide-based Malaria Intervention in Africa) conducted two Mass Drug Administration (MDA) trials in the high-burden malaria regions: Kwale County (Kenya) and Mopeia district (Mozambique). The trials assessed the safety and efficacy of a single monthly dose of ivermectin (400 mcg/kg) given for three consecutive months at the start of the rainy season in reducing malaria transmission. In Kenya, the intervention targeted children aged 5-15, while in Mozambique it focused on children under five.
Malaria reduction in Kenya
In Kwale County, Kenya, children who received ivermectin experienced a 26% reduction in malaria infection incidence compared to those who received albendazole, the control drug used in the study. The trial involved over 20,000 participants and more than 56,000 treatments, demonstrating that ivermectin significantly reduced malaria infection rates — particularly among children living further from cluster borders or in areas where drug distribution was more efficient. Moreover, the safety profile of ivermectin was favorable, with no severe drug-related adverse events and only mild, transient side effects already seen with ivermectin in campaigns against neglected tropical diseases.

“We are thrilled with these results,” says Carlos Chaccour, co-principal investigator of the BOHEMIA project and ISGlobal researcher at the time of the study. “Ivermectin has shown great promise in reducing malaria transmission and could complement existing control measures. With continued research, ivermectin MDA could become an effective tool for malaria control and even contribute to elimination efforts,” Chaccour, who is now a researcher at the Navarra Centre for International Development at the University of Navarra, adds.
“These results align with the World Health Organization’s (WHO) criteria for new vector control tools,” states Joseph Mwangangi, from the KEMRI-Wellcome Trust Research Programme. “The findings suggest that ivermectin MDA could be a valuable complementary strategy for malaria control, particularly in areas where mosquito resistance to insecticides is a growing concern,” adds Marta Maia, BOHEMIA’s lead entomologist from the University of Oxford.
Lessons from the Mozambique trial
In contrast, the implementation of the Mozambique trial in the rural district of Mopeia faced severe disruptions due to Cyclone Gombe (2022) and a subsequent cholera outbreak, which significantly disrupted operations. “One of the most important lessons we learned from the trial in Mopeia is that strong community engagement is essential,” states Francisco Saúte, director of the Manhiça Health Research Centre (CISM). “Building trust with local communities and fostering close collaboration with the Health Ministry, National Malaria Control Program, and local authorities was key to ensuring acceptance of the ivermectin MDA.”
Expanding the Impact Beyond Malaria
In addition to reducing malaria transmission, ivermectin MDA offers significant collateral benefits. The BOHEMIA team found an important reduction in the prevalence of skin infestations such as scabies and head lice in the ivermectin group in Mozambique, and the community reported a major reduction in bed bugs in Kenya. These effects are particularly valuable when ivermectin is integrated into existing delivery systems, maximizing its impact on public health.
Shaping the future of malaria prevention
The study is part of a larger global effort to assess ivermectin’s potential in malaria control. The findings have been reviewed by the WHO vector control advisory group, which concluded that the study had demonstrated impact and recommended further studies. Findings were also shared with national health authorities as they evaluate the potential inclusion of ivermectin in malaria control programs.
“This research has the potential to shape the future of malaria prevention, particularly in endemic areas where existing tools are failing,” concludes Regina Rabinovich, BOHEMIA PI and Director of ISGlobal’s Malaria Elimination Initiative. “With its novel mechanism of action and proven safety profile, ivermectin could offer a new approach using a well-known, safe drug that can add to the effect of other mosquito control tools available today.”

2 days agoShareSaveLucy Clarke-BillingsBBC NewsEmily AtkinsonBBC NewsShareSavePAThe resident doctors strike in England has begun after a dispute over pay between the government and the British Medical Association (BMA). Thousands of doctors are walking out over five days, with Health Secretary Wes Streeting insisting that disruption will be kept to a minimum. But several NHS patients have told the BBC they fear their conditions could become worse after delays to scheduled procedures, while some have also expressed sympathy over the concerns the doctors are raising.Peter Plant, 58, of Tamworth, who has kidney cancer, said his surgery to remove the organ on Friday was cancelled on Thursday morning. The operation has been rescheduled for 20 August, but he fears the delay could be a “death sentence”.”Resident doctors do not care that delaying operations like mine are very likely a death sentence,” he said.”I’m absolutely angry and frustrated. It is not just about me, it’s about our whole family.”You try and gear yourself up for it and then it’s utter deflation.”Mr Plant said he and his family had been living in “limbo” and that he felt “utterly lost”. “Wes Streeting says he has told hospitals to carry on as normal and they’re clearly not,” he added.Official figures have not yet been released on the impact of the strike. Some hospitals are reporting more than 80% of their non-urgent work is still being carried out.Previous walkouts have led to mass cancellations of operations, appointments and treatments: more than one million were cancelled during resident doctor strikes in March 2023 and routine care was cut by half at some hospitals.EPA’My three-year-old needs surgery now’Hassnain Shahid, from Bradford, said his three-year-old daughter urgently needed lung surgery but it had been indefinitely postponed – despite medical warnings about the risks of delay.”It’s been an emotional rollercoaster and it’s very frustrating for us,” Mr Shahid said.Mr Shahid’s daughter has Congenital Pulmonary Airway Malformation (CPAM), a rare lung condition.He said consultants told him surgery was urgent and that it was important it took place in the summer when there was less chance his daughter could catch a cold.”Now we’ve been told the surgery has been cancelled and they have no availability – not even in September,” he said.”They were the ones that said she needed to have it done.”I understand why the doctors are striking, but when you take this path and you go to university you know how much you’re going to earn – if you’re not happy with the pay, look at an alternative career.”Repeated delays to surgerySarah, a patient from the north-west of England, said she was due to have a hysterectomy – an operation to remove her uterus – on Monday but it had been cancelled for a second time. “They don’t have a rescheduled date for me at this time,” she said. “It’s very hard when you have been mentally preparing yourself for major surgery, especially as I was first told that I needed one in November 2024.”Andrew Mundy, 58, from Lincoln, expressed fears that repeated delays to his tendon surgery could leave him permanently injured.He injured his knee in early February and was given an initial date for surgery at the end of May, which he said was cancelled because the consultant was on holiday.The surgery was rearranged for Friday but was cancelled because of the strike, he said.”I am furious and aware that every delay in surgery will make the chances of a successful repair even less likely,” he said.”It is not fair that I may never recover from this injury due to delays in treatment.”It’s frustrating because [the NHS] say that they are not cancelling stuff and things are running as normal, but they are cancelling stuff.”Michele, from Somerset, has been waiting three years for spinal surgery. She has been told her appointment, which had been scheduled for Thursday, has been cancelled, which she believes is down to the strikes.Michele said she suffers “constant” and “relentless” nerve pain down the left side of her body.”I feel I’ve been let down, I feel like I’m not worth it. It’s knocked me,” she said.Michele said she had taken sick leave from work for more than a fortnight, having already taken a step back from her leadership role to work part-time from home due to the pain.”It’s got to the point so I can’t even do that now. It’s really affecting my life,” she added.Lorien OversonJohn Dixon, 81, from the Isle of Wight, said he found out that his knee operation scheduled for Friday at Southampton General Hospital was cancelled with just three hours’ notice.Mr Dixon said he was already on the ferry to Southampton when he received a call from the hospital informing him of the cancellation.”How can the NHS treat patients like this?” he said. “They must have [had] a good idea [on Thursday] without letting people go on long journeys just to return home.”Michael Overson, from Gainsborough, Lincolnshire, has been waiting three years for a knee operation and found out on Friday his surgery, which had been scheduled for Tuesday, had been cancelled.Mr Overson is a delivery driver for a national supermarket chain and says the delay means he will have to “continue living and working in pain”. “This places me in limbo as I have no idea when it’ll be rearranged. I can’t plan anything,” he said.”The increased costs the strikes cause only causes greater harm to the NHS.”Dr Tom Dolphin, the chairman of the BMA, said before the action began that “we are very sorry that strikes have become necessary”.”Of course if people have emergencies or need urgent care they should still present to the hospital or their GP as usual, as they always would,” he said.”Striking is something that doctors don’t want to have to do.”Additional reporting by Bernadette McCague, Mary Litchfield, Rozina Sini and Kris Bramwell

22 minutes agoShareSaveNoel TitheradgeShareSaveBBCWhen “Sarah” climbed up into the attic of her father’s house – she was completely unprepared for what she would find.Her father, “James”, was a modest man who worked most of his life for the same company. He retired about 20 years ago when he was diagnosed with Parkinson’s.He had managed the tremors and balance difficulties caused by the disorder by taking a prescription drug called Ropinirole.But during the Covid-19 pandemic, Sarah had grown increasingly alarmed about her father’s secrecy and wanted to see what he had been spending his time doing.In the loft, she discovered reams of handwritten notes and a dozen recording devices he had been using to bug his own home.In writing and on tape he had documented innocent sounds his wife had made as she moved around the house, and while she slept, to try to prove she was having an affair. He had also catalogued details of numerous chat lines and porn websites he had been obsessively using.When Sarah told her elderly mother about what she had found, she was horrified to hear that James had also been sexually coercive towards her.It was only when Sarah took him to see his specialist nurse five years ago that she learned the medication her father was on could have such extreme side effects.”Oh, he’s gone down the randy route, has he?” the nurse said.The couple are now living separately in their old age, because James poses too much of a risk to his wife, says Sarah. James lives in a specialist care home and Sarah says she has been told that he has sexually assaulted staff there.”This medication has torn my family apart,” says Sarah – whose name we have changed along with her father’s.Sarah has power of attorney for both her parents, including for their medical treatment.She has carefully weighed their interests in deciding to tell her family’s story, she says, but wants people to know about the impact the drugs can have.James’s case is one of 50 the BBC has now been contacted about, the majority concerning men being treated for movement disorders whose behaviour changed dramatically after being prescribed medication from a specific family of drugs. Often, behaviour changed after many years of taking the medicines at increasing doses, the men told us.In March, we revealed how women had not been warned by doctors that taking the same type of medication for restless leg syndrome (RLS) could cause them to cruise for sex and gamble compulsively – placing them at personal risk and ruining their finances, careers and relationships.Many of the cases we have now learned of involve the exploitation of women and children. These include:A man who was convicted of child sexual offences after abusing a childAn octogenarian who says he has become addicted to pornography including bestiality and child abuse imagesA father of three children who said the drugs left him needing to have sex up to seven times a day – and caused him to walk out on two marriages when partners could not satisfy himAll three men said they had had no previous history of such sexual behaviour before taking the drugs. They also said they felt profound shame about their behaviour but believed the medication helped their conditions.Other men the BBC spoke to said they did not want to take themselves off the drugs because the medication had led them to discover new sexual interests – which are legal and consensual – and because they enjoyed their increased libido.One married grandfather in his 60s has begun crossdressing and has entered into online relationships with men. Another man says the drugs disinhibited homosexual feelings he had not previously explored.Prescription records show that some of the men we spoke to tried reducing their dosage but all felt it had negatively impacted their health.The Ropinirole that James takes belongs to a family of drugs known as dopamine agonists, which are prescribed for Parkinson’s, RLS, pituitary tumours and other conditions.The risk of impulsive behaviour side effects of dopamine agonist medication have long been known – but the BBC has discovered that doctors are still not warning all patients who have been prescribed the drugs for a variety of conditions.In March we revealed how British drug company GSK had found a link between Ropinirole and what it called “deviant” sexual behaviour – including paedophilia – in 2003.GSK told the BBC it had shared these findings with health authorities, included this safety advice in medication leaflets, and conducted extensive trials for the drug which has been prescribed for 17 million treatments.But warnings about such behaviour were not included in leaflets until 2007 – and, even now, only specify “altered” sexual interest and “excessive” or “increased” libido as risks.Safety advice about the medication’s “toxic” side-effects needs to be strengthened immediately because their impact can be “devastating”, according to the acting chair of the Health Select Committee, Labour MP Paulette Hamilton.”Nine out of 10 people do not read what is on those leaflets,” she says.”And if you do read it, what does it mean by altered sexual interest? I haven’t got a clue.”The drugs work by mimicking the effects of dopamine, a natural chemical that helps transmit messages in the brain, such as those governing movement. Dopamine is also known as the “happy hormone” because it is activated when something is pleasurable or we feel rewarded.Dopamine agonists can over-stimulate such feelings – helping sufferers of some movement disorders which may be caused by low levels of dopamine. But they can also diminish the appreciation of consequences, leading to impulsive behaviour – according to academics.The medication can also actually worsen existing symptoms of restless legs – according to dozens of the people who spoke to the BBC – sometimes causing an uncontrollable urge to move in other parts of the body. This is a well-documented risk for those who take the medication over a prolonged period, and is known as augmentation.If you have more information about this story, you can reach Noel directly and securely through encrypted messaging app Signal on: +44 7809 334720, by email at noel.titheradge@bbc.co.uk, external or on SecureDropThe BBC has also learned of concerns about two studies that looked at the ability of another dopamine agonist drug – Rotigotine – to tackle such exacerbation of health conditions. Both were sponsored by the drug’s manufacturer, Belgian firm UCB.We have been told that senior officials at the company repeatedly dismissed evidence of augmentation caused by Rotigotine, during the first study in 2012.One of its authors, Dr Diego Garcia-Borreguero, says UCB staff sat-in on and discussed findings with academics. He says the interference was “subtle”, but that the published results were not impartial.The BBC has also discovered that eight out of nine authors of a second Rotigotine study in 2017 had been paid at some point by UCB – and that five of them were direct company employees.The paper’s conclusions – that Rotigotine was effective in treating augmentation – are “ridiculous”, according to Dr Andy Berkowski, a neurologist who has co-authored clinical practice guidelines for the treatment of RLS in the US.He says data shows that more than 50% of the patients stopped taking the drug during the study largely because of adverse events or a lack of effectiveness – and more than half of those who completed it required an increase in dosage, potentially because of the worsening of their RLS symptoms.UCB says its studies were unbiased, underwent independent peer review, and that authors who were its employees, or who it had prior affiliations with, fully complied with guidelines on disclosing conflicts of interest.It said that Rotigotine’s effectiveness was proven in multiple trials and most patients who completed its 2017 study experienced a significant clinical improvement. This corresponds to 37 of the 99 patients who began the study.A list of organisations in the UK offering support and information with some of the issues in this story is available at BBC Action Line.Dopamine agonist drugs were prescribed nearly 1.5 million times by GPs alone in England last year, according to published data seen by the BBC.Another drug, Aripiprazole – a partial dopamine agonist used to treat mental health problems – is also known to cause impulsive behaviours. It was prescribed for more than 1.7 million treatments in England alone last year, often to younger patients.One patient taking the drug told us his compulsive gambling had become so bad that he was stealing to fund his habit. The mother of another believes the medication caused her son to expose himself in public.The UK’s drug safety regulator, the MHRA, says it has no plans to change its warnings about dopamine agonist drugs.It previously told the BBC that sexual impulses vary and a general warning about activities which may be harmful is included.The Royal College of GPs said its updated curriculum – which is used to train doctors and will be published next month – will now include the monitoring of impulsive behaviour side effects for RLS, thought to affect between 6% to 17% of patients.A side effect can be considered to be “common” when it affects just 1% of the people who take the medicine, according to health guidance body NICE.The Department for Health and Social Care did not comment.

Stevia may provide more benefits than as a zero-calorie sugar substitute. When fermented with bacteria isolated from banana leaves, stevia extract kills off pancreatic cancer cells but doesn’t harm healthy kidney cells, according to a research team at Hiroshima University.
The researchers published their findings in the International Journal of Molecular Sciences.
“Globally, the incidence and mortality rates of pancreatic cancer continue to rise, with a five-year survival rate of less than 10%,” said co-author Narandalai Danshiitsoodol, associate professor in Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences. “Pancreatic cancer is highly invasive and prone to metastasis, showing significant resistance to existing treatments, such as surgery, radiotherapy and chemotherapy. As such, there is an urgent need to identify new and effective anticancer compounds, particularly those derived from medicinal plants.”
Prior studies by other researchers indicated that stevia leaf extract demonstrated potential as an anticancer drug, but isolating and applying the specific bioactive components that protect against cancer cells has remained challenging, Danshiitsoodol said. However, fermenting with bacteria can structurally change the extract and produce bioactive metabolites, which are compounds that can impact living organisms.
“To enhance the pharmacological efficacy of natural plant extracts, microbial biotransformation has emerged as an effective strategy,” said corresponding author Masanori Sugiyama, professor in the Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences. Sugiyama’s lab has isolated and evaluated the health benefits of more than 1,300 lactic acid bacteria (LAB) strains from fruits, vegetables, flowers and medicinal plants. “In this study, we aimed to compare LAB-fermented and non-fermented extracts to identify key compounds that enhance bioactivity, ultimately contributing to the efficacy of herbal medicine in cancer prevention and therapy.”
Specifically, the team fermented stevia leaf extract with plant-derived Lactobacillus plantarum SN13T strain (FSLE) and compared its effects on pancreatic cancer (PANC-1) cells in the lab, alongside non-cancerous human embryonic kidney cells HEK-293, to the effects of non-fermented stevia extract. The cells utilized in these experiments were acquired from established commercial cell lines.
“Our findings indicate that FSLE demonstrates significantly greater cytotoxicity than the non-fermented extract at equivalent concentrations, suggesting that the fermentation process enhances the bioactivity of the extract,” Sugiyama said. “Notably, FSLE exhibited lower toxicity toward the HEK-293 cells, with minimal inhibition observed even at the highest concentration tested.”
Additional analyses identified chlorogenic acid methyl ester (CAME) as the active anti-cancer compound. When fermented, the concentration of chlorogenic acid in the extract dropped six-fold, indicating a microbial transformation, according to Danshiitsoodol.

“This microbial transformation was likely due to specific enzymes in the bacteria strain used,” Danshiitsoodol said. “Our data demonstrate that CAME exhibits stronger toxicity to cells and pro-apoptotic effects — which encourage cell death — on PANC-1 cells compared to chlorogenic acid alone.”
Next, the researchers said they plan to study the effects in a mouse model to better understand the effectiveness of various dosages across a whole-body system.
“The present study has substantially enhanced our understanding of the mechanism of action of the Lactobacillus plantarum SN13T strain in the fermentation of herbal extracts, while also offering a valuable research perspective on the potential application of probiotics as natural anti-tumor agents,” Danshiitsoodol said.
Other contributors include Rentao Zhang and Masafumi Noda, Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University; and Sayaka Yonezawa and Keishi Kanno, Department of General Internal Medicine, Hiroshima University Hospital.

What if we could prevent people from developing obesity? The World Obesity Federation expects more than half the global population to develop overweight or obesity by 2035. However, treatment strategies such as lifestyle change, surgery and medications are not universally available or effective.
By drawing on genetic data from over five million people, an international team of researchers has created a genetic test called a polygenic risk score (PGS) that predicts adulthood obesity already in early childhood. This finding could help to identify children and adolescents at higher genetic risk of developing obesity, who could benefit from targeted preventative strategies, such as lifestyle interventions, at a younger age.
“What makes the score so powerful is its ability to predict, before the age of five, whether a child is likely to develop obesity in adulthood, well before other risk factors start to shape their weight later in childhood. Intervening at this point can have a huge impact,” says Assistant Professor Roelof Smit from the NNF Center for Basic Metabolic Research (CBMR) at the University of Copenhagen and lead author of the research published in Nature Medicine.
The study arises from the Genetic Investigation of Anthropometric Traits (GIANT) Consortium, an international collaboration of human genetics researchers dedicated to studying the genetic architecture of anthropometric traits such as human height and body mass index. The research involved a collaboration with the consumer genetics and research company 23andMe, inc., and the contributions of more than 600 scientists from 500 institutions, globally.
Twice as effective at predicting obesity as the next best test
The subtle variations in our genomes can greatly impact our health. Thousands of genetic variants have been identified that increase our risk of obesity, for example, variants that act in the brain and influence our appetite. A PGS is like a calculator that combines the effects of the different risk variants that a person carries and provides an overall score.
To create their PGS, the scientists drew on the genetic data of more than five million people – the largest and most diverse genetic dataset ever. They then tested their new PGS for obesity on datasets of the physical and genetic characteristics of more than 500,000 people. They found that their new PGS was twice as effective as the previous best test at predicting a person’s risk of developing obesity.

“This new polygenic score is a dramatic improvement in predictive power and a leap forward in the genetic prediction of obesity risk, which brings us much closer to clinically useful genetic testing,” says Professor Ruth Loos from CBMR at the University of Copenhagen.
Genetics is not destiny
The scientists also investigated the relationship between a person’s genetic risk of obesity and the impact of lifestyle weight loss interventions, such as diet and exercise. They discovered that people with a higher genetic risk of obesity were more responsive to interventions but also regained weight more quickly when the interventions ended.
However, the new PGS has its limitations. Despite drawing on the genomes of a broader, more globally representative population, it was far better at predicting obesity in people with European-like ancestry than in people with African ancestry.

3 days agoShareSaveRuth CleggHealth and wellbeing reporterShareSaveGetty ImagesIt felt like there was a collective sigh of relief when a study, published this week, suggested 10,000 steps a day isn’t the health utopia we had all been led to believe.The news that we only had to reach 7,000 steps was enough to quite literally stop us in our fervent step-counting stride.So what about some of the other health targets that many of us swear by? Can we fall short of the mark but still live long, healthy and happy lives?We’ve taken a handful of commonly cited healthy lifestyle benchmarks, examined them with various experts to get an idea of why they exist, explored the health claims, and, most importantly asked if there is any wriggle room.Is sleep so important that we have to spend so much of our lives doing it? How much exercise is enough? What about drinking water? How much do we really need?Disclosure – the below is not medical advice, it’s more of an inspection of many of the health ideals we have on our radar.Water (6-8 glasses a day)Getty ImagesAccording to the NHS, the average grown-up should be drinking between six and eight glasses (1.5-2 litres) of water a day. However, maybe we don’t need to cart our fancy flagons around with us as much as we thought. Prof Neil Turner, kidney specialist at the University of Edinburgh, says as humans we existed for thousands of years without knowing what a pint or a litre was.”I mean, mice don’t need flashing water bottles telling them how much to drink – why do we?” he says.”Our bodies are set up to do things just right – we eat when we are hungry, we breathe when we need to breathe, and we drink when we are thirsty.”Oh.Is it really that simple? According to Prof Turner, who has seen a lot of kidneys in his time, that rule applies to the vast majority of us. Those with specific conditions, like a kidney disorder, may have to drink more.He says if our urine is dark, in the general healthy population, we shouldn’t panic that we haven’t drunk enough – that is the kidney doing its job. It is reserving water in our body, he explains, and our body should tell us that we feel thirsty and then we will get a drink.Dr Linia Patel, a performance nutritionist, disagrees. We might drink different amounts, she says, due to factors like our size, how warm we are, whether we’ve been drinking alcohol, but she feels having a target of 1.5 to 2 litres is a good thing – especially for women.”I would definitely say from a women’s health point of view, where I work, what I see is a lot of the symptoms [associated] with being dehydrated. It might be fatigue, constipation, brain fog, feeling hungry [or] cravings.”She says that if the problem is related to hydration then it’s “an easy one to get right, if you’re consistent with it”.Sleep (7-9 hours a night)Getty ImagesMoving on to sleep – the NHS recommends seven to nine hours a night for the average adult, and there’s not much wriggle room to be had there. Prof Ama Johal, a specialist in sleep disorders, says sleep is vital; without it we are beginning to shave years off our lives.”The evidence is there, there are huge bodies of research which show that the health benefits are multiple.”A good night’s sleep – that’s at least seven hours of quality sleep – reduces the risk of obesity, diabetes, depression and finally, it lowers mortality rates.”He points to a study which used 10,000 British civil servants – those that slept for fewer than five hours a night had an increased risk of early death.But could we shave an hour off the minimum recommended – and settle for six hours a night?”No,” Prof Johal says. “As soon as we lower the limit then there’s a risk people will think it’s ok to sleep for less time.”Cat napping?”Unfortunately not,” he says, “Our bodies have very different reactions to naps through the day, and eventually if we tried to make up the hours we were missing overnight by sleeping through the day, we would struggle to fall asleep at night.”But all is not lost, nappers among us – there are studies that suggest a short snooze in the day can keep the brain youthful, and even compensate for poor or broken sleep the night before.Prof Johal suggests that for those who struggle to get the recommended amount, try to target a few nights of good sleep a week, and just being “more aware that sleep is so important”.Emily & LucyEmily and Lucy are two avid walkers from Manchester. But alongside their love of walking, the two women share a less healthy trait: they struggle to nod off because of their anxiety.But they say the target of seven hours sleep a night is something they “are working towards”.Exercise (150 mins a week)Emily and Lucy are, however, “definitely nailing it” when it comes to exercise. Through their group, Soft Girls who Hike, they have found a love of walking which has not only improved their mental health, they say, but connected them with many other women.They don’t try to meet all the healthy benchmarks on their radar, they explain, because “life just gets in the way”. But they are doing 7,000 steps a day and taking long, low impact walks at the weekend.The Chief Medical Officer recommends doing 150 minutes of exercise a week and two strength training sessions. Is that achievable for most?Dr Sinead Roberts, a sports nutritionist who trains elite athletes, is pragmatic in her approach. While moderate strength training and physical activity are vital for maintaining muscle mass, she says, as well as resistance to injuries and supporting our immune systems, you have to adapt the recommendations to fit with your life.”Rules are for the obedience of fools and the guidance of wise people,” she says. “This phrase really does apply here.”I have friends who do nothing – and that really does show, I say, ‘You’re walking like an 80-year-old!'”But if you are doing one strength session a week and some moderate exercise then that is definitely a good thing, just try and do more if you can.”She uses an analogy of a highway – the more things we can do to stay healthy the wider the road, which, in turn means we can go off course sometimes without careering up a grassy verge.”All those benchmarks are interlinked – you can’t just do one healthy thing and ignore the rest. Equally you don’t need to put so much pressure on yourself to achieve them all.”This attitude chimes with Emily and Lucy, who say they happily “chip away” at some of the health benchmarks.”For example, we might do five minutes of meditation [which is] better than nothing, but we wouldn’t stress about not hitting the recommended goal.”Mindfulness (10 mins a day)Getty ImagesThrough its Every Mind Matters campaign, the NHS recommends 10 minutes of mindfulness a day. Basically, instead of pondering the future or thinking about the past, you pay attention to the moment, noticing what is going on inside and outside ourselves, letting our thoughts pass by without judgement.Some studies suggest activities like mindfulness can have a positive effect and also help change the structure of the brain.Psychologist Natasha Tiwari, founder of The Veda Group, says 10 minutes is a good start to “give the mind time to settle, and the brain enough time to truly benefit” from the process of mindfulness.But many of us lead busy lives, and to carve out 10 minutes in the day can be a luxury. In some respects, could having these targets make life more stressful?Ms Tiwari disagrees – it’s less about the time spent and more about the awareness of mindfulness and bringing it to our everyday lives.”Even brief pauses,” she explains, “can still have a positive impact”.Most experts I’ve spoken to agree that while benchmarks are useful, and simplicity is key, it’s better not to fixate on a number. Rather, find a way to incorporate a healthy outlook to diet, exercise and mental health into everyday life.After sitting for some time writing this, I am going to sign off – there is another health benchmark I’ve just come across: limiting sitting down to less than eight hours a day. So, I had better get moving.Additional reporting by George SandemanMore Weekend Picks

12 minutes agoShareSaveRuth CleggHealth and wellbeing reporterShareSaveGetty ImagesIt felt like there was a collective sigh of relief when a study, published this week, suggested 10,000 steps a day isn’t the health utopia we had all been led to believe.The news that we only had to reach 7,000 steps was enough to quite literally stop us in our fervent step-counting stride.So what about some of the other health targets that many of us swear by? Can we fall short of the mark but still live long, healthy and happy lives?We’ve taken a handful of commonly cited healthy lifestyle benchmarks, examined them with various experts to get an idea of why they exist, explored the health claims, and, most importantly asked if there is any wriggle room.Is sleep so important that we have to spend so much of our lives doing it? How much exercise is enough? What about drinking water? How much do we really need?Disclosure – the below is not medical advice, it’s more of an inspection of many of the health ideals we have on our radar.Water (6-8 glasses a day)Getty ImagesAccording to the NHS, the average grown-up should be drinking between six and eight glasses (1.5-2 litres) of water a day. However, maybe we don’t need to cart our fancy flagons around with us as much as we thought. Prof Neil Turner, kidney specialist at the University of Edinburgh, says as humans we existed for thousands of years without knowing what a pint or a litre was.”I mean, mice don’t need flashing water bottles telling them how much to drink – why do we?” he says.”Our bodies are set up to do things just right – we eat when we are hungry, we breathe when we need to breathe, and we drink when we are thirsty.”Oh.Is it really that simple? According to Prof Turner, who has seen a lot of kidneys in his time, that rule applies to the vast majority of us. Those with specific conditions, like a kidney disorder, may have to drink more.He says if our urine is dark, in the general healthy population, we shouldn’t panic that we haven’t drank enough – that is the kidney doing its job. It is reserving water in our body, he explains, and our body should tell us that we feel thirsty and then we will get a drink.Dr Linia Patel, a performance nutritionist, disagrees. We might drink different amounts, she says, due to factors like our size, how warm we are, whether we’ve been drinking alcohol, but she feels having a target of 1.5 to 2 litres is a good thing – especially for women.”I would definitely say from a women’s health point of view, where I work, what I see is a lot of the symptoms [associated] with being dehydrated. It might be fatigue, constipation, brain fog, feeling hungry [or] cravings.”She says that if the problem is related to hydration then it’s “an easy one to get right, if you’re consistent with it”.Sleep (7-9 hours a night)Getty ImagesMoving on to sleep – the NHS recommends seven to nine hours a night for the average adult, and there’s not much wriggle room to be had there. Prof Ama Johal, a specialist in sleep disorders, says sleep is vital; without it we are beginning to shave years off our lives.”The evidence is there, there are huge bodies of research which show that the health benefits are multiple.”A good night’s sleep – that’s at least seven hours of quality sleep – reduces the risk of obesity, diabetes, depression and finally, it lowers mortality rates.”He points to a study which used 10,000 British civil servants – those that slept for fewer than five hours a night had an increased risk of early death.But could we shave an hour off the minimum recommended – and settle for six hours a night?”No,” Prof Johal says. “As soon as we lower the limit then there’s a risk people will think it’s ok to sleep for less time.”Cat napping?”Unfortunately not,” he says, “Our bodies have very different reactions to naps through the day, and eventually if we tried to make up the hours we were missing overnight by sleeping through the day, we would struggle to fall asleep at night.”But all is not lost, nappers among us – there are studies that suggest a short snooze in the day can keep the brain youthful, and even compensate for poor or broken sleep the night before.Prof Johal suggests that for those who struggle to get the recommended amount, try to target a few nights of good sleep a week, and just being “more aware that sleep is so important”.Emily & LucyEmily and Lucy are two avid walkers from Manchester. But alongside their love of walking, the two women share a less healthy trait: they struggle to nod off because of their anxiety.But they say the target of seven hours sleep a night is something they “are working towards”.Exercise (150 mins a week)Emily and Lucy are, however, “definitely nailing it” when it comes to exercise. Through their group, Soft Girls who Hike, they have found a love of walking which has not only improved their mental health, they say, but connected them with many other women.They don’t try to meet all the healthy benchmarks on their radar, they explain, because “life just gets in the way”. But they are doing 7,000 steps a day and taking long, low impact walks at the weekend.The Chief Medical Officer recommends doing 150 minutes of exercise a week and two strength training sessions. Is that achievable for most?Dr Sinead Roberts, a sports nutritionist who trains elite athletes, is pragmatic in her approach. While moderate strength training and physical activity is vital for maintaining muscle mass, she says, as well as resistance to injuries and supporting our immune systems, you have to adapt the recommendations to fit with your life.”Rules are for the obedience of fools and the guidance of wise people,” she says. “This phrase really does apply here.”I have friends who do nothing – and that really does show, I say, ‘You’re walking like an 80-year-old!'”But if you are doing one strength session a week and some moderate exercise then that is definitely a good thing, just try and do more if you can.”She uses an analogy of a highway – the more things we can do to stay healthy the wider the road, which, in turn means we can go off course sometimes without careering up a grassy verge.”All those benchmarks are interlinked – you can’t just do one healthy thing and ignore the rest. Equally you don’t need to put so much pressure on yourself to achieve them all.”This attitude chimes with Emily and Lucy, who say they happily “chip away” at some of the health benchmarks.”For example, we might do five minutes of meditation [which is] better than nothing, but we wouldn’t stress about not hitting the recommended goal.”Mindfulness (10 mins a day)Getty ImagesThrough its Every Mind Matters campaign, the NHS recommends 10 minutes of mindfulness a day. Basically, instead of pondering the future or thinking about the past, you pay attention to the moment, noticing what is going on inside and outside of ourselves, letting our thoughts pass by without judgement.Some studies suggest activities like mindfulness can have a positive effect and also help change the structure of the brain.Psychologist Natasha Tiwari, founder of The Veda Group, says 10 minutes is a good start to “give the mind time to settle, and the brain enough time to truly benefit” from the process of mindfulness.But many of us lead busy lives, and to carve out 10 minutes in the day can be a luxury. In some respects, could having these targets make life more stressful?Ms Tiwari disagrees – it’s less about the time spent and more about the awareness of mindfulness and bringing it to our everyday lives.”Even brief pauses,” she explains, “can still have a positive impact”.Most experts I’ve spoken to agree that while benchmarks are useful, and simplicity is key, it’s better not to fixate on a number. Rather, find a way to incorporate a healthy outlook to diet, exercise and mental health into everyday life.After sitting for some time writing this, I am going to sign off – there is another health benchmark I’ve just come across: limiting sitting down to less than eight hours a day. So, I had better get moving.More Weekend Picks

25 minutes agoShareSaveJames GallagherShareSaveGetty ImagesThe Euros are reaching their conclusion in a massive summer across women’s sport.But away from the drama and excitement on the pitch, there is also a scientific revolution taking place. Teams of scientists are researching the unique ways that elite sport affects the female body – how breasts alter the way you run, but the right sports bra could give you the edge; how the menstrual cycle could impact performance and what role period trackers could play; and why is there a higher risk of some injuries, and what can be done to avoid them?It’s a far cry from the era when professional female athletes told me they were thought of simply as “mini-men”.Breast biomechanicsCast your mind back to the iconic scene from the final of the last European Championships in 2022.It was extra time at Wembley and Lioness Chloe Kelly scored the winning goal against Germany. In the ensuing euphoria, she whipped off her England shirt showing the world her sports bra.It was fitted by Prof Joanna Wakefield-Scurr, from the University of Portsmouth, who proudly goes by the nickname the Bra Professor.Getty ImagesHere are her breast facts:Breasts can bounce an average of 11,000 times in a football matchAn average bounce is 8cm (3in) without appropriate supportThey move with up to 5G of force (five times the force of gravity), comparable to the experience of a Formula 1 driverLaboratory experiments – using motion sensors on the chest – have revealed how a shifting mass of breast tissue alters the movement of the rest of the body, and in turn, sporting performance.”For some women, their breasts can be really quite heavy and if that weight moves, it can change the movement of your torso, it can even change the amount of force that you exert on the ground,” Prof Wakefield-Scurr tells me.University of PortsmouthCompensating for bouncing breasts by restricting the movement of your upper body alters the positioning of the pelvis and shortens the length of each stride. That’s why sports bras are not just for comfort or fashion, but a piece of performance gear.”We actually saw that low breast support meant a reduction in stride length of four centimetres,” Prof Wakefield-Scurr explains.”If you lost four centimetres every step in a marathon, it adds up to a mile.”Sports bras also protect the delicate structures inside the breast, “if we stretch them, that’s permanent,” the professor says, so “it’s about prevention rather than cure”.The menstrual cycle and its effect on performanceCalli Hauger-ThackeryThe menstrual cycle has a clear impact on the body – it can affect emotions, mood and sleep as well as cause fatigue, headache and cramps.But Calli Hauger-Thackery, a distance runner who has represented Team GB at the Olympics, says talking about its sporting impact is “still so taboo and it shouldn’t be, because we’re struggling with it”.Calli says she always notices the difference in her body in the lead up to her period.”I’m feeling really fatigued, heavy legs, I [feel like I’m] almost running through mud sometimes, everything’s more strained than it should be,” she says.Calli finds she “lives” by her menstruation tracker, as being on her period is a source of anxiety “especially when I’ve got big races coming up”.One of those big races was in April – the Boston Marathon – and Calli’s period was due. She finished in sixth place, and recalls that she “luckily got through” – but says she can’t help wondering if she could have done even better.The menstrual cycle is orchestrated by the rhythmic fluctuations of two hormones – oestrogen and progesterone. But how big an impact can that have on athletic performance?”It’s very individual and there’s a lot of nuance here, it’s not quite as simple as saying the menstrual cycle affects performance,” says Prof Kirsty Elliott-Sale, who specialises in female endocrinology and exercise physiology at Manchester Metropolitan University.”Competitions, personal bests, world records, everything has been set, won and lost on every day of the menstrual cycle,” she says.This famously includes Paula Radcliffe, who broke the marathon world record while running through period cramps in Chicago in 2002. Working out whether the menstrual cycle affects sporting ability requires an understanding of the physiological changes that hormones have throughout the body, the challenge of performing while experiencing symptoms, the psychological impact of the anxiety of competing during your period and perceptions about all of the above.Prof Elliott-Sale says there “isn’t a phase where you’re stronger or weaker”, or where “you’re going to win or you’re going to lose”, but in theory the hormones oestrogen and progesterone could alter parts of the body such as bone, muscle or heart.”What we don’t yet understand is: Does that have a big enough effect to really impact performance?” she says.The professor adds that it is “a very sensible conclusion” that poor sleep, fatigue and cramping would have a knock-on effect on performance, and that dread and anxiety were an “absolutely tangible thing” for athletes on their period who are performing in front of large crowds.She has spoken to athletes who “sometimes even triple up with period pants” to avoid the risk of leaking and embarrassment, and “that’s a heavy mental burden”.Rugby union team, Sale Sharks Women have been working with Manchester Metropolitan University.I met Katy Daley-McLean, former England rugby captain and England all-time leading point scorer.The team are having open discussions around periods to help them understand the impact that menstruation can have, and how to plan for it. This includes taking ibuprofen three days before, rather than thinking: “I can’t do anything about it,” Daley-McLean says.”It’s through that knowledge and that information that we can talk about this, we can put plans in place, and we can change our behaviour to make you a better rugby player,” she says.How to avoid injuriesOne issue that has emerged as women’s sport has been given more attention is a difference in the susceptibility to some injuries.Most of the attention has been around the anterior cruciate ligament (ACL) – a part of the knee that attaches the upper and lower parts of the leg together. Injuries can be brutal and take a year to recover from.Not only is the risk three to eight times greater in women than men, depending on the sport, but they are becoming more common, says Dr Thomas Dos’Santos, a sports biomechanics researcher at Manchester Metropolitan University. However, there is “no simple answer” to explain the greater risk in women, he says.Partly it could be down to differences in anatomy. Bigger hips in women mean the top of the thigh bone starts from a wider position and this changes the angle it connects to the lower leg at the knee, potentially increasing risk. The ACL is also slightly smaller in women “so it’s a little bit weaker, potentially”, Dr Dos’Santos explains.ACL injuries can happen at all stages of the menstrual cycle, but hormonal changes are also being investigated, including a study sponsored by Fifa, the governing body for world football. High levels of oestrogen prior to ovulation could alter the properties of ligaments, making them a bit more stretchy so “there could be an increased risk of injury, theoretically,” he says.But Dr Dos’Santos argues it’s important to think beyond pure anatomy as women still do not get the same quality of support and strength training as men.He compares it to ballet, where dancers do receive good quality training. “The [difference in] incidence rates is basically trivial between men and women,” Dr Dos’Santos says.There is research into whether it is possible to minimise the risk of ACL injuries, by training female athletes to move in subtly different ways.But there is a risk of lessening performance, and some techniques that put strain on the ACL – like dropping the shoulder to deceive a defender before bursting off in another direction – are the necessary moves in sports like football.”We can’t wrap them up in cotton wool and say you should avoid playing sport,” Dr Dos’Santos says. “What we need to do is make sure that they’re strong enough to tolerate those loads, but it isn’t just as simple as some people saying we can 100% eradicate ACL injuries, we can’t.”No longer ‘mini-men’Even though there are still many unanswered question, it is still a world of difference for Katy Daley-McLean at Sale Sharks Women.When she got her first cap in 2007, she remembers that all the assumptions around how her body would perform were based on the data from male rugby players.”We were literally treated as mini-men,” Daley-McLean recalls.And now, she says, girls and women don’t feel like the outsiders in sport, which is not only improving performance at the elite level but helping to keep more women in sport.”It’s awesome, it’s something to be celebrated because if you look at the stats, one of the biggest reasons young girls drop out of sport is body image, it’s around periods and not having a correct sports bra, which is so easily sorted.”Inside Health was produced by Gerry HoltMore Weekend Picks by James Gallagher

3 days agoShareSaveNick TriggleHealth correspondentShareSaveGetty ImagesThe NHS is facing a challenging few days during the doctors’ strike in England as it attempts to keep as many services as possible running, said the health secretary. Wes Streeting said while it was not possible to eliminate disruption from the five-day strike by resident doctors, it was being kept to a minimum.The strike by thousands of resident doctors, previously known as junior doctors, began on Friday after the government and British Medical Association (BMA) failed to reach an agreement over pay.The NHS wants to keep non-urgent services running, with patients urged to attend appointments unless told they are cancelled. The BMA has warned staff are being stretched too thinly.The union has started to agree to some requests for doctors to come off picket lines and work in hospitals experiencing the most pressure.A doctor has been told to return to work at Nottingham City Hospital’s neonatal intensive care unit over the weekend.And the BMA has granted a request from Lewisham Hospital in south London for two anaesthetists to work on Saturday.Before this strike, the 12th since March 2023, the union had only granted five requests for doctors to return to work, known as a derogations.No official figures have been released yet on the impact of the latest strike, but some hospitals are reporting more than 80% of their non-urgent work is still being done. Senior doctors are covering for resident doctors.Members of the public have been urged to still come forward for NHS care in England during the walkout.GP surgeries will open as usual, and urgent care and A&E will continue to be available, alongside NHS 111, NHS England said.Streeting said the government would “not let the BMA hold the country to ransom” and it was doing “everything we can to minimise the risk to patients”.Writing in the Times on Friday morning Prime Minister Sir Keir Starmer urged resident doctors not to follow their union down the “damaging road” of strike action.He said the walkout would cause a “huge loss for the NHS and the country”, as he criticised the BMA for “rushing” into strikes.Resident doctors took to picket lines at hospitals in England on Friday, holding placards calling for pay restoration.At St Thomas’ Hospital in London, resident doctor Kelly Johnson said suggestions the strike was unjust felt like a “slap in the face”.”When doctors decide to take strike action it’s always portrayed as though we’re being selfish, but we’re here as a body to help the public day in, day out,” she said.At Leeds General Infirmary, Cristina Costache, a paediatrics registrar, said it was a “difficult decision” to go on strike.”I get depressed if I’m not in work,” she said. “My heart is always at work. But I also care about my colleagues and my profession.”Previous walkouts have led to mass cancellations of operations, appointments and treatments.More than one million were cancelled during resident doctor strikes in March 2023 and routine care was cut by half at some hospitals.But this time NHS England ordered hospitals to only cancel non-urgent work in exceptional circumstances.Doctors in Wales, Scotland and Northern Ireland are not part of the pay dispute. Talks between the government and the union have been focused on non-pay issues, such as exam fees, working conditions and career progression, after Streeting had said pay was not open to negotiation.There are currently no plans for more talks but this could change once the current strike action is over. Government sources say the ball is in the BMA’s court and they still will not negotiate on pay. The BMA says, despite a 5.4% average pay rise this year following a 22% increase over the previous two years, pay is still down by a fifth since 2008 once inflation is taken into account.During their first foundation year after finishing a medical degree, resident doctors in England now earn a basic salary of £38,831. In the second year, this rises to £44,439. Salaries exceed £73,000 by the end of training.Medics are often expected to work night shifts, weekends and longer hours for extra pay. These top up their earnings by more than a quarter on average.BMA resident doctor co-leaders Dr Melissa Ryan and Dr Ross Nieuwoudt said: “Resident doctors are not worth less than they were 17 years ago. “Restoring pay remains the simplest and most effective route toward improving our working lives.”Mr Streeting had every opportunity to prevent this strike, but he chose not to take it.”EPA/ShutterstockWhile the majority of resident doctors work in hospitals, some GP practices and community services could also be affected. Resident doctors represent nearly half the medical workforce.Some patients have been affected. Hassnain Shahid, 32, from Bradford, said his three-year-old daughter had her lung surgery on Monday cancelled.She has a rare lung condition which means a cold is a serious risk to her health.”It’s been an emotional rollercoaster. It’s very frustrating,” said Hassnain. The BMA said that it had written to NHS England to say that staff who work through the strike could be stretched too thinly. The union said it would be better to significantly reduce non-urgent care, as has happened previously.But Saffron Cordery, deputy chief executive of NHS Providers, which represents hospitals, said hospitals trying to keep services running would do so within “rigorous safety guidelines”.She said the situation was complicated by the fact that doctors were not obliged to say whether they would turn up.”Nobody will know until they actually turn up for their shifts or not.”Around two thirds of resident doctors are BMA members.The Liberal Democrats have called for an NHS strike resilience plan, using private hospitals for some elective treatments.The Conservative shadow health secretary Stuart Andrew said the strikes threatened to drag hospitals into chaos and leave patients “dangerously exposed”.He criticised what he called Labour’s “spineless surrender to union demands” last year, which he said allowed the BMA to come “back for more”.Rory Deighton, of the NHS Confederation, which represents frontline health managers, said: “The impact of these strikes and the distress they will cause patients rests with the BMA.”