'Radical rethink needed to tackle hunger, obesity'

Agencies
January 29, 2019

Paris, Jan 29: To defeat the intertwined pandemics of obesity, hunger and climate change, governments must curb the political influence of major corporations, said a major report Monday calling for a 'global treaty' similar to one for tobacco control.

But this will not happen unless ordinary citizens demand a "radical rethink" of the relationship between policymakers and business, nearly four dozen experts from The Lancet Commission on Obesity concluded.

"Powerful opposition from vested interests, lack of political leadership, and insufficient societal demand for change are preventing action," they said in a statement.

Nearly a billion people are hungry and another two billion are eating too much of the wrong foods, causing epidemics of obesity, heart disease and diabetes.

Unhealthy diets account for up to 11 million premature deaths every year, according to the most recent Global Disease Burden report.

"Malnutrition in all its forms -- including undernutrition and obesity -- is by far the biggest cause of ill-health and premature death globally," said Commission co-chair Boyd Swinburn, a professor at the University of Aukland.

"Both undernutrition and obesity are expected to be made significantly worse by climate change."

The way in which food is currently produced, distributed and consumed not only fuels the hunger and obesity pandemics, it also generates 25 to 30 percent of planet-warming greenhouse gas emissions.

Cattle production alone accounts for more than half of those gases, in the form of methane-laden flatulence and CO2 when forests -- especially in Brazil -- are cleared to make room for livestock.

A transport system dominated by cars contributes another 15 to 25 percent of emissions, and supports a sedentary lifestyle.

 "Underpinning all of these are weak political governance, the unchallenging economic pursuit of GPD growth, and the powerful commercial engineering of overconsumption," the report said.

"Undernutrition is declining too slowly to meet global targets, no country has reversed its obesity epidemic, and comprehensive policy responses to the threat of climate change have barely begun."

Despite 30 years of warnings from science about the dire impacts of global warming, CO2 emissions hit record levels in 2017 and again last year.

Because all these problems are interwoven, the answers must be too, the researchers emphasised.

"Joining three pandemics" -- hunger, obesity, climate -- "together as 'The Global Syndemic' allows us to consider common drivers and shared solutions."

Another Lancet Commission report published last week calling for a dramatic shift in global diet to improve health and avoid "catastrophic" damage to the planet.

"Until now, undernutrition and obesity have been seen as polar opposites of either too few or too many calories," said Swinburn.

"In reality, they are both driven by the same unhealthy, inequitable food systems, underpinned by the same political economy."

The report calls for a Framework Convention on Food Systems -- similar to global conventions for tobacco control and climate change -- to restrict the influence of the food industry.

The experts argue that economic incentives must be overhauled.

Some five trillion dollars (4.4 trillion euros) in government subsidies for fossil fuels and large-scale agribusiness should be rechanneled toward "sustainable, healthy and environmentally friendly activities," they said.

To sharply reduce red meat consumption, for example, the report favours high taxes, abolishing subsidies, along with transparent health and environment labelling.

In addition, they favour the creation of a one billion dollar philanthropic fund to support grassroots action.

"Support from civil society is crucial to break the policy deadlock," said co-author William Dietz, a professor at George Washington University.

"As with other social movements -- such as campaigns to introduce sugary drink taxes -- efforts ... are more likely to begin at the community, city or state level."

Nearly all facets of daily life are at play.

"Tackling 'The Global Syndemic' requires an urgent rethink of how we eat, live, consume and move," said Richard Horton, editor-in-chief of The Lancet.

The two Lancet reports are not the only urgent appeal from science in recent months. In October, the UN's Intergovernmental Panel on Climate Change likewise called for an economic and social "paradigm shift" to avoid global chaos.

Health advocates and climate experts hailed The Lancet commission's sweeping call for deep change.

"For too long we have been day-dreaming our way to a diseased future," said Katie Dain, CEO of the Noncommunicable Disease Alliance.

"A food system that secures a better diet for this and the immediate next generations will save millions of lives and, at the same time, help save the planet."

Industry representatives and libertarians slammed the findings as overwrought and an assault on free choice.

"Nanny-state zealots are no longer hiding their intention to use the anti-tobacco blueprint to control other areas of our lives," said Christopher Snowdon, head of lifestyle economics at the London-based Institute of Economic Affairs.

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Agencies
June 17,2020

Leading physicians are celebrating a small dose of good news that arrived Tuesday about dexamethasone, a cheap and widely used steroid shown to be able to save lives among COVID-19 patients, but also cautioning against releasing study results by press release during a global health emergency, like in the case of the latest dexamethasone study by University of Oxford.

"It will be great news if dexamethasone, a cheap steroid, really does cut deaths by one-third in ventilated patients with COVID19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper", Atul Gawande, surgeon and CEO of Haven Healthcare, tweeted.

"Bottom line is, good news," Dr. Fauci, America's foremost infectious diseases expert told a US newswire on Tuesday, soon after the dexamethasone results were announced in the UK.

Fauci, who has long championed the therapeutics-first view said that dexamethasone is a "significant improvement" in the available therapeutic options currently available.

On Medical Twitter and Facebook, doctors broadly agree that dexamethasone use aligns well with the way COVID19 attacks the body's immune system. Fauci said the results in the Oxford study make "perfect sense" in that context.

"We should see the number of people who actually survive go up, if the study holds up," virologist and epidemiologist Dr. Joseph Fair told a television network.

Global coronavirus cases crossed 8 million on Tuesday. In the US, Texas and Florida are facing a new wave of cases after lifting lockdown orders earlier than medical experts recommended. Amidst the relentless graph upwards, the dexamethasone study results injected hope for better survival rates among those most seriously ill.

World Health Organization chief scientist Soumya Swaminathan welcomed the results from the randomised control trial.

Dr Eugene Gu, Founder and CEO of CoolQuit tweeted that he is "genuinely impressed" with the UK dexamethasone trial. This may be a "game changer", he wrote.

"There's no conflict of interest as dexamethasone is a generic steroid. The mechanism of action makes sense because steroids can reduce cytokine storms and overactive immune systems that makes COVID-19 so deadly. The number needed to treat is 8 ventilated patients which is great."

The Oxford study found that dexamethasone reduced deaths by 35 percent in patients who needed treatment with breathing machines and by 20 percent in those only needing supplemental oxygen. Dexamethasone was one of 5 drugs studied in a large clinical trial in the United Kingdom named RECOVERY, short for Randomised Evaluation of COVID-19 Therapy.

Peter Horby, chief investigator of the University of Oxford clinical trial, said dexamethasone is the first drug to be shown to improve survival in COVID-19. Details of the study have not been released. The trial organisers said they made their announcement via a news release because of "the public health importance of these results." According to Horby's public comments, there was a lot of initial resistance to studying steroids.

During the study, 2,104 patients were randomly selected to be given 6 milligrams of dexamethasone once a day (either by mouth or by intravenous injection) for 10 days. That group was compared with 4,321 patients who received the usual care alone.

Researchers estimated that dexamethasone would prevent one death for every eight patients treated while on ventilators and one for every 25 patients on extra oxygen alone.

UK experts have called the study results a breakthrough in the fight against the virus. The researchers have promised they would publish the results soon.

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Agencies
February 27,2020

Washington D.C, Feb 27: New research shows that adults who have low fruit and vegetable intake are more likely to be diagnosed with an anxiety disorder.

"For those who consumed less than 3 sources of fruits and vegetables daily, there was at least at 24% higher odds of anxiety disorder diagnosis," says the lead author of the Canadian Longitudinal Study, Karen Davison, who is a health science faculty member, nutrition informatics lab director at Kwantlen Polytechnic University, (KPU) and North American Primary Care Research Group Fellow.

"This may also partly explain the findings associated with body composition measures. As levels of total body fat increased beyond 36%, the likelihood of anxiety disorder was increased by more than 70%," states co-author Jose Mora-Almanza, a Mitacs Globalink intern who worked with the study at KPU.

"Increased body fat may be linked to greater inflammation. Emerging research suggests that some anxiety disorders can be linked to inflammation," says Davison.

In addition to diet and body composition measures, the prevalence of anxiety disorders also differed by gender, marital status, income, immigrant status and several health issues.

An important limitation of the study was that the assessment of anxiety disorders was mostly based upon self-reporting of a medical diagnosis.

"It is estimated that 10% of the global population will suffer from anxiety disorders which are a leading cause of disability," says Karen Davison

"Our findings suggest that comprehensive approaches that target health behaviours, including diet, as well as social factors, such as economic status, may help to minimize the burden of anxiety disorders among middle-aged and older adults, including immigrants," she concluded.

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Agencies
March 3,2020

Taking multiple courses of antibiotics within a short span of time may do people more harm than good, suggests new research which discovered an association between the number of prescriptions for antibiotics and a higher risk of hospital admissions.

Patients who have had 9 or more antibiotic prescriptions for common infections in the previous three years are 2.26 times more likely to go to hospital with another infection in three or more months, said the researchers.

Patients who had two antibiotic prescriptions were 1.23 times more likely, patients who had three to four prescriptions 1.33 times more likely and patients who had five to eight 1.77 times more likely to go to hospital with another infection.

"We don't know why this is, but overuse of antibiotics might kill the good bacteria in the gut (microbiota) and make us more susceptible to infections, for example," said Professor Tjeerd van Staa from the University of Manchester in Britain.

The study, published in the journal BMC Medicine, is based on the data of two million patients in England and Wales.

The patient records, from 2000 to 2016, covered common infections such as upper respiratory tract, urinary tract, ear and chest infections and excluded long term conditions such as cystic fibrosis and chronic lung disease.

The risks of going to hospital with another infection were related to the number of the antibiotic prescriptions in the previous three years.

A course is defined by the team as being given over a period of one or two weeks.

"GPs (general physicians) care about their patients, and over recent years have worked hard to reduce the prescribing of antibiotics,""Staa said.

"But it is clear GPs do not have the tools to prescribe antibiotics effectively for common infections, especially when patients already have previously used antibiotics.

"They may prescribe numerous courses of antibiotics over several years, which according to our study increases the risk of a more serious infection. That in turn, we show, is linked to hospital admissions," Staa added.

It not clear why hospital admissions are linked to higher prescriptions and research is needed to show what or if any biological factors exist, said the research team.

"Our hope is that, however, a tool we are working for GPs, based on patient history, will be able to calculate the risks associated with taking multiple courses of antibiotics," said Francine Jury from the University of Manchester.

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