Workout before breakfast to get better results, says study

Agencies
October 20, 2019

Washington D.C., Oct 20: Your blood sugar levels can easily be controlled by changing a few eating and exercising schedules, suggest researchers.

The six-week study involved thirty men classified as obese or overweight and compared results from two intervention groups (who ate breakfast before/after exercise) and a control group (who made no lifestyle changes), found that people who performed exercise before breakfast burned double the amount of fat than the group who exercised after breakfast.

They found that increased fat use is mainly due to lower insulin levels during exercise when people have fasted overnight, which means that they can use more of the fat from their fat tissue and the fat within their muscles as a fuel.

To test proof-of-principle the initial study involved only men, but future studies will look to translate these findings for different groups including women.

Whilst this did not lead to any differences for weight loss over six weeks, it did have 'profound and positive' effects on their health because their bodies were better able to respond to insulin, keeping blood sugar levels under control and potentially lowering the risk of diabetes and heart disease.

Building on emerging evidence that the timing of meals in relation to exercise can shift how effective exercise is, the team behind this study wanted to focus on the impact on the fat stores in muscles for individuals who either worked out before or after eating and the effect this had on insulin response to feeding.

"Our results suggest that changing the timing of when you eat in relation to when you exercise can bring about profound and positive changes to your overall health," explained Dr Javier Gonzalez of the Department for Health at the University of Bath.

"We found that the men in the study who exercised before breakfast burned double the amount of fat than the group who exercised after. Importantly, whilst this didn't have any effect on weight loss, it did dramatically improve their overall health," added Dr Javier Gonzalez.

The study was published in the 'Journal of Clinical Endocrinology & Metabolism'.

"The group who exercised before breakfast increased their ability to respond to insulin, which is all the more remarkable given that both exercise groups lost a similar amount of weight and both gained a similar amount of fitness. The only difference was the timing of the food intake," said Dr Javier Gonzalez.

Over the six-week trial, the scientists found that the muscles from the group who exercised before breakfast were more responsive to insulin compared to the group who exercised after breakfast, in spite of identical training sessions and matched food intake.

The muscles from those who exercised before breakfast also showed greater increases in key proteins, specifically those involved in transporting glucose from the bloodstream to the muscles.

For the insulin response to feeding after the 6-week study, remarkably, the group who exercised after breakfast were in fact no better than the control group. 

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Agencies
February 24,2020

Singapore, Feb 24: Last week Singapore's Ministry of Trade and Industry revised their 2020 GDP growth projections downwards to -0.5 to 1.5 per cent, confirming fears of economic fallout from the coronavirus COVID-19. Just three days earlier, while visiting Changi Airport, the Prime Minister told the media that the country is bracing for a significant hit on the economy and the possibility of a recession.

In the budget announcement on February 18, various measures to help affected companies were announced.

This included a jobs support scheme to help companies retain workers that will see the government offset 8 per cent of wages up to SGD3,600(USD2,600) per worker, per month, for a three-month period. Companies will also get a 25 per cent rebate on their taxes for the year capped at SGD15,000 (USD10,800) per company.

There will be additional support for sectors directly affected by the virus outbreak such as tourism, aviation and retail. Qualifying companies will be given property tax rebates and can apply for temporary bridging loans to ease cash flow. Rebates will be offered on aircraft landing and parking charges as well as rental rebates for shops and cargo agents at Changi Airport.

Overall, the economic package will cost Singapore some USD 4.6 billion, well in excess of the USD 500 million some analysts had predicted. The resulting spending plan including the virus economic package will see a budget deficit of SGD 10.9 billion or 2.1 per cent of GDP, the highest since the Asian financial crisis of 1997.

It is hoped that with financial support, companies in Singapore will not only be able to ride through the current rough patch but be able to position themselves better to take off once the economic crisis brought upon by the contagion is over.

Which then are the Singapore companies that can potentially ride out the current storm and emerge stronger?

Aviation and hospitality firms are among those most impacted by the virus outbreak and Singapore Airlines (SIA) comes to mind. SIA is a well-run company but has seen its share price fall about 5.2 percent since the beginning of the year. In the short term, revenue and profits will no doubt be affected but it will recover in the long run.

Hospitality sector companies like Ascott Residence whose main sponsor is Capitaland, Southeast Asia's largest landlord, and CDL Hospitality, have seen 1.5 and 5.5 percent (respectively) shaved off their share prices since the start of the year.

In reporting financial results for the quarter which ended in December on February 14, Alibaba CEO Daniel Zhang said that due to the virus, they are seeing large changes in buying patterns. With widespread home confinement, there is a growing demand for delivery services including online food and grocery delivery, as well as office apps and streaming entertainment.

Similarly, in Singapore, with more people staying and working from home, the three main food delivery services, Grab Food, Foodpanda and Deliveroo, are doing roaring business. All three are privately held.

In late January, as the scale of the outbreak became more apparent, investors began pouring money into health-product firms in Asia that they think will benefit from the virus outbreak.

Bloomberg reported that when Chinese pharmaceutical companies like Da An Gene Co, Xilong Scientific and Shanghai Kehua Bio-Engineering said they have developed kits for detecting the virus, their stocks soared to hit the 10 per cent daily limit. Firms manufacturing protection gear and air-cleaning equipment climbed more than 10 per cent in Japan, while Malaysian rubber gloves producers climbed at least 5 per cent.

Naturally, many would view that pharmaceutical companies that have the technology and expertise to develop drugs to treat patients with the virus or are able to develop a vaccine, would stand to benefit from the coronavirus outbreak.

Firms like and Johnson & Johnson, Pfizer, MSD, GlaxoSmithKline (GSK) and Sanofi are the pharmaceutical behemoths that dominate the global vaccine market.

However, industry experts speaking to the BBC warned that a pot of gold is not necessarily waiting for any company that successfully develops a vaccine. Although the global vaccine market is expected to grow to USD60 billion this year, it is costly and time-consuming to develop and pass it through for use by the general public.

It is also unclear if Indian pharmaceutical firms will be able to benefit from the demand for medicines that can treat or prevent the virus.

India is the world's largest manufacturer of generic drugs and it supplies 20 percent of the world's drugs by volume. However, it sources 70 percent of its raw material from China. If supplies are disrupted beyond a month to a month and a half, they may see a slow-down in production. According to a CNN report, the companies that are most impacted by material shortages are GSK India, Pfizer (PFE) and Cipla. Other companies like Aurobindo Pharma, Cadila Healthcare and Sun Pharma are said to be carefully monitoring the situation.

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Dr G K Sudhakar Reddy
August 4,2020

Being overweight or obese is now recognised as a serious cause of ill health and disability. There is a significant positive association between orthopaedic disorders and the level of obesity causing pain, deformity and difficulty in walking.

Excess body weight accumulation increases pressure on joints, particularly the hips, knees and ankles.

Here are a few type of  arthritis:

Osteoarthritis

It is a condition of damage/ wear and tear of the joint lining or cartilage. Obesity triggers this by loading excessive weight on the weight bearing joints like the knee and the hip. 

Knee Osteoarthritis

This is the most common arthritis especially in the Indian subcontinent.

While walking, an individual exerts 3 to 6 times pressure that of the body weight on the weight-bearing knee joint, which means in an obese with excess body weight, larger forces are exerted, which lead to higher risk of deterioration of cartilage.

In addition, there are excessive fat tissues that produce hormones and other factors that affect the joint cartilage metabolism and cause inflammation of the joints giving rise to joint pathology.  Leptin is one of the hormones causing knee osteoarthritis. 

Hip osteoarthritis

The force exerted across the hip is 3 times that of body weight. Hip osteoarthritis is caused by factors such as joint injury, increasing age and being overweight.    

Hand osteoarthritis

The observation that obese individual has a higher risk in having hand osteoarthritis has led to a hypothesis that the metabolic effect produced by fat tissue is the underlying factor. 

Osteoporosis

It is a progressive bone condition of decrease in bone mass and density (Bone Mineral Density or BMD) which can lead to an increased risk of fracture. Recent research suggests that obesity may accelerate bone loss. It is the amount of muscle mass which is seen in an active person, which accounts for bone strengthening effects and not due to the fat seen in a heavy person.

Low back pain

Low back pain from degenerative disc disease of the lumbar spine is one of the most disabling conditions in the community and overweight and obesity have the strongest association with seeking care for low back pain.

Managing Hip and Knee Osteoarthritis

Life style changes

If one is overweight, try to lose weight by doing more physical activity and eating a healthier diet. Regular exercise keeps you active and mobile and builds up muscle, thereby strengthening the joints and can improve symptoms. 

Pain Killers

Painkillers help with pain and stiffness for short term. They don’t affect the arthritis itself and won’t repair the damage to your joint. Creams and gels can be applied directly onto painful joints.

Nutritional Supplements

Glucosamine and chondroitin are nutritional supplements. Animal studies have found that glucosamine can both delay the breakdown of and repair damaged cartilage. However, there is insufficient evidence to support the use of glucosamine in humans and one can expect only a mild-to-moderate reduction in pain

Joint injections

If pain from osteoarthritis is severe joint steroid injections are injected into the joints that can reduces swelling and pain. The injections can start working within a day or so and may improve pain for several weeks or months. 

Hyaluronic acid injections, which help to lubricate your knee joint also give short term relief. In early stages. Stem cell treatment or cartilage regeneration procedures are being tried in young people with small defects, however it is still experimental and lacks long term evidence.

Surgery

May be recommended if you have severe pain or mobility problems.

Arthroscopy

If one has frequent painful locking/stiffening episodes especially in the knee joint, an operation to wash out loose fragments of bone and other tissue as joint can be performed by a minimally invasive key hole procedure called Arthroscopy.

Arthrodesis

If hip or knee replacement is not suitable, especially in young people who do heavy manual work, one can consider an operation known as an arthrodesis, which fuses your joint in a permanent position. This means that your joint will be stronger and much less painful, although you will no longer be able to move it.

Osteotomy

In young, active people in whom a knee joint replacement would fail due to excessive use one can consider an operation called an osteotomy. This involves adding or removing a small section of bone either above or below your knee joint.  This helps realign your knee so your weight is no longer focused on the damaged part of your knee. An osteotomy can relieve your symptoms of osteoarthritis, although you may still need knee replacement surgery eventually as you grow old

Joint replacement surgery

Joint replacement therapy is most commonly carried out to replace hip and knee joints. It involves replacing a damaged, worn or diseased joint with an artificial joint made of special plastics and metal.

For most people, a replacement hip or knee will last for at least 20 years, especially if it is cared for properly and not put under too much strain.

Dr G K Sudhakar Reddy is a Sr Consultant Orthopaedic Surgeon at Citizens Speciality Hospitals, Hyderabad

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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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