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On cake

There are times when the only thing that keeps us going is the thought of cake with coffee. It is something to look forward to, a soupçon of joy linking us to lunch, which can often seem a long time away when you are sitting in front of a blank computer screen with a blanker brain.

Cake, however, is often not available. The reasons are many and varied, but cake is not part of anybodies healthy living checklist. The things that are really matter, like exercise, sensible diets and drinking, and so on. Bandolier has commented before that keeping healthy makes a huge difference, and a new report of an ongoing observational study from Hawaii emphasises the point. Nor is it too late! Avoiding risk factors for a man of 55 has major impact on being alive, and especially being alive and healthy, at 80 or 85. That's lots more time for cake.

Controversy is a useful substitute when cake is not available. A bit of controversy can make the blood flow a bit faster. So a few controversies - all of which come down to the nature of the evidence that people have chosen to use or ignore. In asthma, several meta-analyses come to different conclusions over long-acting beta-agonists added to inhaled corticosteroids. Trouble is, included studies in some meta-analyses didn't have the inhaled corticosteroids in the first place, which makes interpretation a tad difficult, and perhaps an interpretation too far.

Guidelines never get tested. They may give us a nice fluffy feeling inside, but a guideline that isn't tested is a waste of time and space. Too often when they are looked at, either the evidence is poor, or people just don't follow them. Either way, it isn't good management.

Next month Bandolier has another birthday. Birthdays are Nature's way of telling us to eat more cake. And birthdays are good for us, because people with the most live the longest.

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