News briefs

Young people less satisfied with their GP experience

Findings from the Australian Bureau of Statistics (ABS) Patient Experience Survey indicate that young people are less satisfied with their GP experiences than older patients. About 5.2 million people aged 15–34 years saw a GP in 2017–18, but only 67% felt that the GP always listened carefully to them, compared with 83% of those aged 65 years or more. Young people also less likely than older people to feel that the GP always showed them respect (75% v 87%) and less likely to feel that the GP always spent enough time with them (70% v 84%). Director of Health Statistics at the ABS, Louise Gates, said: “Further results from the survey show that as expected, young people aged 15–34 years generally used health services less often than older people, with 77% seeing a GP, 26% seeing a medical specialist, and 10% being admitted to hospital. This compared with 96%, 57% cent and 20% of people aged 65 years and over. However, those aged 15–34 years were twice as likely to have seen an after hours GP (10%) as those aged 65 years and over (5%). At the same time, people aged 15 to 34 years were three times more likely to delay seeing a medical specialist (27% compared with 9%) and nearly twice as likely to delay seeing a dental professional (35% compared with 20%) than those aged 65 years and over. In particular, younger people were more likely to delay or not use health services due to cost (13% v 2% of people aged 65 years or more). Similarly, 21% delayed or did not see a dental professional due to cost compared with 9% of people aged 65 years and over,” Ms Gates said.

http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4839.0Main+Features12016-17?OpenDocument

Evidence for value of low carbohydrate diet in maintaining weight loss

A low carbohydrate diet could help people maintain weight loss by increasing the number of calories burned, according to US research published in The BMJ. The researchers say this effect may improve the success of obesity treatment, especially for people with high insulin secretion. Energy expenditure declines with weight loss as the body adapts by slowing metabolism and burning fewer calories, often leading to lost weight being regained. But little is known about how dietary composition influences this adaptive response in the long term. One hypothesis, the carbohydrate–insulin model, proposes that recent increases in the consumption of processed, high glycaemic load foods trigger hormonal changes that increase hunger, leading to weight gain. Researchers at the Boston Children’s Hospital compared the effects of diets with different carbohydrate-to-fat ratios on energy expenditure. The trial involved 234 overweight adults aged 18–65 years with a body mass index of 25 or higher who initially took part in a weight loss diet for about 10 weeks. After shedding 12% on the run-in diet, participants were randomly assigned to one of three test diets for 20 weeks: high (60%), moderate (40%) or low (20%) carbohydrate diets. Each participant was provided with fully prepared meals of similar protein and fat content. After adjusting for potentially influential factors, they found that total energy expenditure over the 20 weeks was significantly greater for participants on the low carbohydrate diet than for those on the high carbohydrate diet: 209–278 kilocalories more per day, or an increase of 50–70 kilocalories a day for each 10% reduction in the contribution of carbohydrates to total energy intake. For people with the highest insulin secretion at the start of the study, the difference in total energy expenditure between low and high carbohydrate diets was even greater: up to 478 kilocalories a day, consistent with the carbohydrate–insulin model. If this effect persisted, “it would translate into an estimated 10 kg weight loss after 3 years, assuming no change in calorie intake,” the authors noted.

https://www.bmj.com/content/363/bmj.k4583