'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 21,2020

Lower neighbourhood socioeconomic status and greater household crowding increase the risk of becoming infected with SARS-CoV-2, the virus that causes COVID-19, warn researchers.

"Our study shows that neighbourhood socioeconomic status and household crowding are strongly associated with risk of infection," said study lead author Alexander Melamed from Columbia University in the US.

"This may explain why Black and Hispanic people living in these neighbourhoods are disproportionately at risk for contracting the virus," Melamed added.

For the findings, published in the journal JAMA, the researchers examined the relationships between COVID-19 infection and neighbourhood characteristics in 396 women who gave birth during the peak of the Covid-19 outbreak in New York City. Since March 22, all women admitted to the hospitals for delivery have been tested for the virus, which gave the researchers the opportunity to detect all infections -- including infections with no symptoms -- in a defined population

The strongest predictor of COVID-19 infection among these women was residence in a neighbourhood where households with many people are common.The findings showed that women who lived in a neighbourhood with high household membership were three times more likely to be infected with the virus. Neighbourhood poverty also appeared to be a factor, the researchers said.Women were twice as likely to get COVID-19 if they lived in neighbourhoods with a high poverty rate, although that relationship was not statistically significant due to the small sample size.

The study revealed that there was no association between infection and population density.

"New York City has the highest population density of any city in the US, but our study found that the risks are related more to density in people's domestic environments rather than density in the city or within neighbourhoods," says co-author Cynthia Gyamfi-Bannerman."

The knowledge that SARS-CoV-2 infection rates are higher in disadvantaged neighbourhoods and among people who live in crowded households could help public health officials target preventive measures," the authors wrote.

Recently, another study published in the Journal of the American Planning Association, showed that dense areas were associated with lower COVID-19 death rates.

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Agencies
June 29,2020

Washington DC, Jun 29: Young children with narrow retinal artery diameters were more likely to develop higher blood pressure, and children with higher blood pressure levels were more likely to develop retinal microvascular impairment during early childhood, according to a new study.

The first study to show this connection in children was published today in Hypertension, an American Heart Association journal.

High blood pressure, the main risk factor for the development of cardiovascular disease (CVD), can manifest as early as childhood, and the prevalence of high blood pressure among children continues to rise. In previous studies, analysis of blood vessels in the retina has shown promise as a predictor of CVD risk among adults. In the study titled, "Retinal Vessel Diameters and Blood Pressure Progression in Children," researchers sought to predict the development of high blood pressure in children over four years based on retinal blood vessel measurements.

"Hypertension continues as the main risk factor for the development of cardiovascular diseases and mortality," says Henner Hanssen, M.D., the study's lead author and a professor in the department of sport, exercise and health at the University of Basel in Switzerland. 

"Primary prevention strategies are needed to focus on screening retinal microvascular health and blood pressure in young children in order to identify those at increased risk of developing hypertension. The earlier we can provide treatment and implement lifestyle changes to reduce hypertension, the greater the benefit for these children."

Researchers screened 262 children ages six to eight from 26 schools in Basel, Switzerland, in 2014, for baseline blood pressure and retinal arterial measurements. Both measures were taken again in 2018. Blood pressure measurements at both baseline and follow-up were performed in a sitting position after a minimum of five minutes of rest and were categorized based on the American Academy of Pediatrics' blood pressure guidelines. These guidelines utilize the same measurements as the American Heart Association/American College of Cardiology 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults.

Results from the analysis indicate: children with narrower retinal vessel diameters at baseline developed higher systolic blood pressure at follow-up; retinal vessel diameters could explain 29 -31 per cent of the changes in systolic blood pressure progression between 2014 and 2018; children with higher blood pressure levels at baseline developed significantly narrower arteriolar diameters at follow-up, depending on weight and cardiorespiratory fitness; and initial blood pressure measures explained 66-69 per cent of the change in retinal arteriolar diameter from baseline to follow-up.

"Early childhood assessments of retinal microvascular health and blood pressure monitoring can improve cardiovascular risk classification. Timely primary prevention strategies for children at risk of developing hypertension could potentially counteract its growing burden among both children and adults," said Hanssen.

Researchers noted limitations of their study include that they could not confirm blood pressure measurements over a single 24-hour period, so they would not account for "white coat" hypertension, a condition where patients have high blood pressure readings when measured in a medical setting.

Developmental stage including puberty status of each child was not accounted for in the study, as well as genetic factors or birth weight - variables that could impact blood pressure development and microvascular health.

In addition, reference values for appropriate retinal vessel diameters in children do not currently exist, so future studies are needed to determine age-related normal values during childhood.

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Agencies
July 2,2020

The American pharmaceutical giant Pfizer Inc. and the European biotechnology company BioNTech SE have conducted an experimental trial of a COVID-19 vaccine candidate and found it to be safe, well-tolerated, and capable of generating antibodies in the patients.

The study, which is yet to be peer-reviewed, describes the preliminary clinical data for the candidate vaccine -- nucleoside-modified messenger RNA (modRNA), BNT162b1.

It said the amount of antibodies produced in participants after they received two shots of the vaccine candidate was greater than that reported in patients receiving convalescent plasma from recovered COVID-19 patients.

"I was glad to see Pfizer put up their phase 1 trial data today. Virus neutralizing antibody titers achieved after two doses are greater than convalescent antibody titers," tweeted Peter Hotez, a vaccine scientist from Baylor College of Medicine in the US, who was unrelated to the study.

Researchers, including those from New York University in the US, who were involved in the study, said the candidate vaccine enables human cells to produce an optimised version of the receptor binding domain (RBD) antigen -- a part of the spike (S) protein of SARS-CoV-2 which it uses to gain entry into human cells.

"Robust immunogenicity was observed after vaccination with BNT162b1," the scientists noted in the study.

They said the program is evaluating at least four experimental vaccines, each of which represents a unique combination of mRNA format and target component of the novel coronavirus, SARS-CoV-2.

Based on the study's findings, they said BNT162b1 could be administered in a quantity that was well tolerated, potentially generating a dose dependent production of immune system molecules in the patients.

The research noted that patients treated with the vaccine candidate produced nearly 1.8 to 2.8 fold greater levels of RBD-binding antibodies that could neutralise SARS-CoV-2.

"We are encouraged by the clinical data of BNT162b1, one of four mRNA constructs we are evaluating clinically, and for which we have positive, preliminary, topline findings," said Kathrin U. Jansen, study co-author and Senior Vice President and Head of Vaccine Research & Development, Pfizer.

"We look forward to publishing our clinical data in a peer-reviewed journal as quickly as possible," Jansen said.

According to Ugur Sahin, CEO and Co-founder of BioNTech, and another co-author of the study, the preliminary data are encouraging as they provide an initial signal that BNT162b1 is able to produce neutralising antibody responses in humans.

He said the immune response observed in the patients treated with the experimental vaccine are at, or above, the levels observed from convalescent sera, adding that it does so at "relatively low dose levels."

"We look forward to providing further data updates on BNT162b1," Sahin said.

According to a statement from Pfizer, the initial part of the study included 45 healthy adults 18 to 55 years of age.

It said the priliminary data for BNT162b1 was evaluated in 24 subjects who received two injections of 10 microgrammes ( g) and 30 g -- 12 subjects who received a single injection of 100 g, and 9 subjects who received two doses of a dummy vaccine.

The study noted that participants received two doses, 21 days apart, of placebo, 10 g or 30 g of BNT162b1, or received a single dose of 100 g of the vaccine candidate.

According to the scientists, the highest neutralising concentrations of antibodies were observed seven days after the second dose of 10 g, or 30 g on day 28 after vaccination.

They said the neutralising concentrations were 1.8- and 2.8-times that observed in a panel of 38 blood samples from people who had contracted the virus.

In all 24 subjects who received two vaccinations at 10 g and 30 g dose levels, elevation of RBD-binding antibody concentrations was observed after the second injection, the study noted.

It said these concentrations are 8- and 46.3-times the concentration seen in a panel of 38 blood samples from those infected with the novel coronavirus.

At the 10 g or 30 g dose levels, the scientists said adverse reactions, including low grade fever, were more common after the second dose than the first dose.

According to Pfizer, local reactions and systemic events after injection with 10 g and 30 g of BNT162b1 were "dose-dependent, generally mild to moderate, and transient."

It said the most commonly reported local reaction was injection site pain, which was mild to moderate, except in one of 12 subjects who received a 100 g dose, which was severe.

The study noted that there was no serious adverse events reported by the patients.

Citing the limitations of the research, the scientists said the immunity generated in the participants in the form of the T cells and B cells of their immune system, and the level of immunity needed to protect one from COVID-19 are unknown.

With these preliminary data, along with additional data being generated, Pfizer noted in the statement that the two companies will determine a dose level, and select among multiple vaccine candidates to seek to progress to a large, global safety and efficacy trial, which may involve up to 30,000 healthy participants if regulatory approval to proceed is received.

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