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By Dr. Chinta Sidharthan Apr 28 2023 Reviewed by Lily Ramsey, LLM

In a recent study published in the PLOS ONE Journal, researchers reviewed existing studies on physical activity interventions for treating substance use disorders excluding studies that focused solely on tobacco use.

Study:  Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review. Image Credit: agny_illustration/Shutterstock.com Background

Substance use disorder is the problematic use of substances such as cannabis, alcohol, phencyclidine, hallucinogens, hypnotics, sedatives, inhalants, stimulants, opioids, anxiolytics, and other similar substances despite experiencing serious physical, behavioral, and cognitive symptoms.

The misuse of substances causing overdose or intoxication has short and long-term impacts on mental and physical health, including anxiety disorder, depression, asthma, heart disease, and cancer.

The treatment options for substance use disorders generally include residential and outpatient facilities that offer detoxification, but these have a significant relapse rate and low adherence.

Physical activity involving movement requiring energy expenditure has recently gained interest as a therapeutic tool in treating mental illnesses such as bipolar disorder, major depressive disorder, and schizophrenia.

Besides improving cardiovascular health and reducing depressive symptoms, physical activity has also decreased craving symptoms in tobacco users.

However, a shortage of reviews have focused on substance use disorders other than tobacco use, and many of the reviews have focused on a single substance. A large number of individuals with substance use disorders often misuse multiple substances.

Therefore, it is important to examine studies that include poly users of substances other than tobacco to understand the impact of physical activity in treating substance use disorder. About the study

In the present review, the researchers included studies involving adults above the age of 18 who were treated for substance use disorders related to various psychoactive substances such as cannabis, alcohol, phencyclidine, hallucinogens, opioids, inhalants, sedatives, stimulants, hypnotics, and anxiolytics, while excluding studies that focused on tobacco alone. Related StoriesResearchers examine impact of gamification on the effectiveness of digital health interventionsMore daily walking and moderate-to-vigorous physical activity reduced dementia, cognitive impairment riskBeing physically active at any time in adulthood linked to later life cognitive performance

The studies also involved chronic physical activity interventions offered during residential or detoxification treatments, including group or individual exercises and sports.

The examined outcomes included flexibility, aerobic capacity, other body composition and physical fitness outcomes, psychological outcomes such as changes in depressive symptoms, and life outcomes related to the social environment and behavior. The review only considered observational and experimental studies. Results

The results reported that 43 studies fit the eligibility criteria for the review and covered 3,135 participants. A large number (81%) of the studies were randomized controlled trials, followed by pre-post design and cohort studies (14% and 5%, respectively).

Physical activity of moderate intensity, spanning approximately 13 weeks with three sessions a week of about an hour each, was the most common intervention found in most studies.

The most examined outcome was the reduction or cessation of substance use, with 49% of the studies reporting a 75% reduction in substance use after the physical activity intervention.

The second most examined outcome was aerobic capacity, reported by 14 out of the 43 studies (33%), and 71% of these studies reported improvement in aerobic capacity after the intervention. Furthermore, 28% (12) of the studies also reported improvements in depressive symptoms.

The life outcomes examined by most studies covered quality of sleep and overall quality of life, and most studies reported improvements in both parameters after the initiation of physical activity interventions.

Cycling, walking, resistance exercises, and jogging were the most commonly preferred activities. Some studies also reported the use of tai chi and yoga.

The review discussed the mechanisms through which physical activity interventions could benefit substance use disorder patients. The increased physical awareness of the body, fitness, and health is thought to reduce dependence on drugs or alcohol.

Furthermore, changes in depressive symptoms were also associated with changes in anxiety disorder symptoms, indicating a concomitance between the two symptoms. Conclusions

To summarize, the review examined studies that investigated the application of physical activity interventions in treating substance use disorders, not including tobacco use alone.

Overall, the findings reported that physical activity interventions were associated with improvements in physical, psychological, and life outcomes.

Moderate levels of physical activity involving cycling, jogging, resistance exercises, walking, yoga, and tai chi were the preferred activities for most patients, and improvements were observed in aerobic capacity, depressive and anxiety disorder symptoms, and overall quality of life.

However, the authors believe that while physical activity interventions seem promising in treating substance abuse disorders, more rigorous and extensive research is required in the field. Journal reference:

Piché, F. et al. (2023) "Characteristics and impact of physical activity interventions during substance use disorder treatment excluding tobacco: A systematic review", PLOS ONE, 18(4), p. e0283861. doi: 10.1371/journal.pone.0283861. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0283861

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Bread producers Hovis and Kingsmill close in on historic merger

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Bread producers Hovis and Kingsmill close in on historic merger

The owners of Hovis and Kingsmill are closing in on a definitive agreement to merge two of Britain’s most famous grocery brands following months of talks.

Sky News has learnt Associated British Foods (ABF), the London-listed company which owns Kingsmill’s immediate parent, Allied Bakeries, has proposed paying roughly £75m to acquire Hovis from its long-term private equity backers.

Banking sources said a deal could be formally agreed to combine the businesses as early as the end of next week, although they cautioned the complexity of the transaction meant the timing could yet slip.

Confirmation of a tie-up would come nearly three months after Sky News revealed ABF and Endless – Hovis’s owner since 2020 – were in discussions.

Industry sources have estimated that a combined group could benefit from up to £50m of annual cost savings from a merger.

ABF has also been exploring options for the future of Allied Bakeries separate from its talks with Hovis in the event a deal could not be agreed or is prevented from completing by competition regulators.

If it does go ahead, the merger will unite two historic bread producers under common ownership, with Allied Bakeries having been founded in 1935 by Willard Garfield Weston, part of the family which continues to control ABF.

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Hovis traces its history back even further, having been created in 1890 when Herbert Grime scooped a £25 prize for coming up with the name Hovis, which was derived from the Latin ‘Hominis Vis’ – meaning “strength of man”.

Persistent inflation, competition from speciality bread producers and shifting consumer habits towards lower-carb diets have combined to impair breadmakers’ financial health in recent decades, however.

In accounts filed at Companies House earlier this month, Hovis said it had “achieved positive financial progress despite continued tough trading conditions”.

The company reported sales of £439.6m in the 52 weeks to 28 September last year, down from £477.6m in the 53 weeks to 30 September 2023.

Earnings before interest, tax, depreciation and amortisation fell from £20.9m to £18.7m, which Hovis said was the result of the revenue decline and higher distribution costs.

“Overall bread share remained stable, despite significant price inflation and the ongoing cost-of-living crisis, demonstrating the resilience of the Hovis brand and its iconic status as one of Britain’s most loved food brands,” the accounts said.

This week, the trade publication The Grocer reported that Britain’s big four supermarkets, including Asda and Sainsbury’s, had delisted a number of Hovis-branded products.

The publication quoted a Hovis spokeswoman as saying the company was “aware of some adjustments to Hovis product lines in certain stores”.

“We remain fully committed to working collaboratively with our retail partners to grow our mutual businesses.”

The overall UK bakery market is estimated to be worth about £5bn in annual sales, with the equivalent of 11m loaves being sold each day.

Critical to the prospects of a merger of Allied Bakeries, which also owns the Sunblest and Allinson’s bread brands, and Hovis taking place will be the view of the Competition and Markets Authority (CMA) at a time when economic regulators are under intense pressure from the government to support growth.

Warburtons, the family-owned business which is the largest bakery group in Britain, is estimated to have a 34% share of the branded wrapped sliced bread sector, with Hovis on 24% and Allied on 17%, according to industry insiders.

A merger of Hovis and Kingsmill would give the combined group the largest share of that segment of the market, although one source said Warburtons’ overall turnover would remain higher because of the breadth of its product range.

Responding to Sky News’ report in May of the talks, ABF said: “Allied Bakeries continues to face a very challenging market.

“We are evaluating strategic options for Allied Bakeries against this backdrop and we remain committed to increasing long-term shareholder value.”

In a separate presentation to analysts, ABF – which is also in the process of closing its Vivergo bioethanol plant in Hull after pleading for government support – described the losses at Allied, which also owns own-label bread manufacturer Speedibake, as unsustainable.

The company does not disclose details of Allied Bakeries’ financial performance.

Prior to its ownership by Endless, Hovis was owned by Mr Kipling-maker Premier Foods and the Gores family.

At the time of the most recent takeover, High Wycombe-based Hovis employed about 2,700 people and operated eight bakery sites, as well as its own flour mill.

Hovis’s current chief executive, Jon Jenkins, is a former boss of Allied Milling and Baking.

This weekend, ABF declined to comment, while Endless could not be reached for comment.

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UK

Unlicensed Botox-like injections spark outbreak of disease many doctors have never treated

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Unlicensed Botox-like injections spark outbreak of disease many doctors have never treated

A woman who thought she was being injected with Botox was left unable to swallow and doctors thought she had suffered a stroke – after she contracted a life-threatening illness from a potentially illegal product.

Nicola Fairley is one of dozens of people who have developed botulism linked to unlicensed anti-wrinkle injections.

She had the procedure done with her regular beautician after winning a Facebook competition for three areas of “Botox”.

Nicola Fairley
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Nicola Fairley

“Within two or three hours my forehead and the sides of my eyes had started to freeze,” Nicola says.

“At first I thought ‘amazing’, that’s what I wanted – then it just carried on.”

Nicola was eventually sent to A&E in Durham, where she met several other patients who all had similar symptoms.

Doctors were stumped. “They thought I’d had a stroke,” she says.

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“We all had problems with our eyes, some of us with our breathing. I couldn’t swallow – they put me on nil by mouth because they were worried I would choke in the waiting room.”

Nicola Fairley
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Doctors were worried Nicola could choke after she was injected with a suspected illegal product

It turns out all of the patients had recently had anti-wrinkle injections containing botulinum toxin.

Health officials believe they were imported, illegal products.

Botulism – the disease they caused – is so rare many doctors never see it in their entire careers.

It can cause symptoms including slurred speech and breathing problems, and can be deadly.

The disease is so unusual, and so many cases were coming in, that doctors exhausted their stocks of anti-toxin and had to ask hospitals as far away as London to get more.

Botulism

The UK Health Security Agency has so far confirmed 38 cases of botulism linked to cosmetic toxin injections, but Sky News has been told of several more.

The outbreak began in the North East but cases have now been seen in the East of England and East Midlands as well.

There are only a handful of legal botulinum toxin products in the UK – of which Botox is one.

But cosmetic treatments are largely unregulated, with anyone allowed to inject products like fillers and toxins without any medical training.

Cheap, illegal products imported from overseas are easily available.

Steven Land
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Dr Steven Land

‘It’s the Wild West’

Dr Steven Land runs Novellus Aesthetics clinic in Newcastle upon Tyne. He worked for decades as an emergency medicine doctor before moving into aesthetics.

He says he has been warning health officials of an outbreak for years.

“It’s the Wild West,” Dr Land told Sky News.

“Because anyone can do this, there is a lack of knowledge around what is legal, what’s not legal, what is okay to be injected.

“These illegal toxins could have 50 units, 5,000 units or rat poison – there could be anything in there.”

Read more from Sky News:
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Scots divided as Trump flies in for visit

Botulism

Dr Land showed us messages that he says he gets on a weekly basis, from sellers trying to push him cheap, unlicensed products.

They advertise “limited time offers” and cheap bundles on toxins imported from overseas. He calls them “drug dealers”.

“They are preying on the lack of knowledge among non-medical practitioners,” he says.

Consultations on how to regulate the aesthetics industry have been ongoing for years – but so far, no changes have been introduced.

The UK government now says it does plan to regulate certain procedures, but it’s not said how it will do this, or when.

“What will it take?” Nicola says. “One of the women we were with did almost die – she had to be resuscitated.”

Nicola’s beautician has stopped responding to her messages, so she says she still has no idea what the product was “or how much of it is in me”.

She doesn’t know how long her symptoms will last, but just hopes she will eventually recover.

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Entertainment

Gregg Wallace speaks out after MasterChef sacking

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Gregg Wallace speaks out after MasterChef sacking

Gregg Wallace has spoken about his sacking from MasterChef after inappropriate behaviour while working for the BBC – but insisted he is “not a groper, a sex pest or a flasher”.

Wallace, 60, has apologised after a report, commissioned by the cooking show’s production company Banijay UK, found 45 out of 83 allegations were substantiated.

In an interview with The Sun, he said: “I know I have said things that offended people… I understand that now – and to anyone I have hurt, I am so sorry.

“I don’t expect anyone to have any sympathy with me but I don’t think I am a wrong ‘un.”

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BBC reputation damaged by ‘serious errors’

MasterChef co-host John Torode also had an allegation that he used an “extremely offensive racist term” upheld, as part of the same investigation.

Torode, who insisted he had “absolutely no recollection” of the alleged incident, has not had his contract for the show renewed.

Wallace has now defended Torode, saying: “I’ve known John for 30 years and he is not a racist.

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“There is no way that man is a ­racist. No way. And my sympathies go out to John because I don’t want anybody to go through what I’ve been through.”

Former MasterChef presenters John Torode and Gregg Wallace. File pic: PA
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Gregg Wallace has defended his former MasterChef co-host John Torode (left). File pic: PA

At one point, Wallace became tearful during the interview when describing the impact of the investigation on his family.

“I have seen myself written about in the same sentence as Jimmy Savile and Huw Edwards, paedophiles and sex offenders. That is just so, so horrific.”

In respect to the specific allegation of unwanted touching, Wallace denied groping a woman and said that, while he was attempting to flirt with her, he did believe the contact it was consensual.

“She gave me her phone number. I considered that to be intimacy. It was 15 years ago. Me, drunk, at a party, with my hand on a girl’s bum,” he said.

He also accepted he had briefly appeared with a sock on his private parts in front of four colleagues in MasterChef studio. But he said his is not a flasher, and people were either “amused or bemused” but not distressed.

Read more from Sky News:
Actor Micheal Ward charged with rape
Jazz singer Dame Cleo Laine dies
BBC reveals highest-earning stars

On the broader allegations about using inappropriate language, Wallace accepted the criticism and suggested that some of his conduct could be explained by his autism and his background.

“I know I am odd. I know I struggle to read people. I know people find me weird. Autism is a… registered disability. Just because you can’t see it doesn’t mean it’s not real.”

He also blamed his former career: “I’m a greengrocer from Peckham. I thrived in Covent Garden’s fruit and veg market. In that environment that is jovial and crude. It is learned behaviour.”

Wallace told the newspaper he is now scared to appear in public: “I go out now in a disguise – a baseball cap and sunglasses, I don’t want people to see me. I’m scared.”

On Wednesday, the BBC confirmed a series of MasterChef filmed last year, before allegations against presenters Gregg Wallace and John Torode were upheld, will still be broadcast.

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