Regular exercise can keep lifestyle diseases away

April 5, 2015

Apr 5: Cardiovascular disease, diabetes, and osteoporosis - Indians are facing an unhealthy future burdened with a slew of lifestyle diseases. But instead of expensive medication and therapy, the cure lies in making exercise a compulsory part of everyday life, health experts say.

"Indians are increasingly leading a sedentary and machine-dependent life, which may seem comfortable but has extremely adverse effects on health," T.S. Kler, Head of the Department Cardiology, Fortis Escorts Heart Institute and Research Centre said.

Regular exerciseKler said with increasingly hectic lifestyles, most Indians in urban areas nowadays do not walk to the neighbourhood store but rather order groceries on phone for home delivery or drive down.

"We do not climb stairs any more, with lifts being omnipresent. Riding bicycles to work or to school is not cool in urban areas any more. Forget adults, this conditioning begins with children who prefer to stay indoors watching television or playing video games rather than spending time in the playground," he added.

"We all know that cardiovascular diseases are today a major health concern in India. They are the single largest leading cause of deaths in the country, and relatively younger people are today afflicted by coronary artery disease," the noted cardiologist said.

Various surveys done in India have shown that the incidence of coronary heart disease is 8-10 percent in urban areas and 5-6 percent in rural areas.

Kler said regular exercise can help prevent risk factors for cardiovascular diseases such as hypertension and type II diabetes. It also keeps the weight in check.

"Incidences of coronary artery disease can be reduced substantially if the entire Indian population religiously takes to physical exercise. Even 30 minutes of moderate exercise daily can be immensely beneficial. We need a national focus on this less-talked about subject," Kler said.

According to Rajeev K. Sharma, senior consultant orthopedics and joint replacement surgery, Indraprastha Apollo Hospital: "Adequate levels of physical activity decreases the risk of a hip or vertebral fracture and helps control weight. In fact, exercise is very crucial for maintaining good bone health, besides adequate intake of calcium."

"WHO estimates that globally, one in four adults is not active enough while more than 80 percent of the world's adolescent population is insufficiently physically active. This is a dreadful scenario as all these inactive people are making themselves vulnerable to several health issues," he said.

Osteoporosis-related injuries such as vertebrae fractures not only cause pain but also degrade the quality of life, curtail movement and increase dependence. Since the bone is a living tissue, it becomes stronger when subjected to exercise, Sharma said, adding that loss of bone mineral density that begins during the 30s can be curtailed by exercising regularly.

"People who exercise are found to have greater peak bone mass as compared to people who do not exercise."

According to the International Osteoporosis Foundation, the malaise annually causes more than 8.9 million fractures around the globe.

"Though exercising can, to a large extent, help in building strong bones, there is a general lack of an exercise culture in India. This needs to change. Schools, colleges and other institutions should take the lead in nurturing an exercising culture."

Harvinder Singh Chhabra, medical director and chief of spine services at Indian Spinal Injuries Centre, Vasant Kunj, said Indians generally do not realize the importance of exercising unless hit by an ailment.

"Many patients start walking regularly after back pain or osteoarthritis has already set in their bodies. We tell them they could have delayed it by being active all their lives," he added.

According to Chhabra, in the West, there is a lot of focus on physical activity and people are moving away from sedentary ways of life. "They are junking television and going for cycling, running, or adventure sports such as rock climbing. This shift is yet to take place in India."

To make exercise a national culture, apart from awareness, many enabling policy measures are also needed.

"In urban areas, several environmental factors discourage people from leading more active lives even if they want to. Lack of public spaces such as parks and grounds, safety issues on the roads, pollution and irksome traffic do not allow many people to step out of homes to run or walk. This needs to change," he said.

The latter half of the 20th century has brought substantial progress in disease control due to expansion of health infrastructure. With food and nutritional consumption also improving for a vast majority of population, life expectancy in India has gone up over the years. Experts say that deaths due to communicable diseases have decreased while those from non-communicable diseases (NCDs) have risen.

NCDs at present account for 53 percent of all deaths and 44 percent of disability adjusted life-years lost. Projections indicate a further increase to 67 percent of all deaths by 2030. Cardiovascular disease is the major contributor to this burden, attributable to 52 percent of NCD-associated deaths and 29 percent of total deaths.

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Agencies
June 10,2020

Early treatment with the antiviral drug remdesivir has been found to reduce viral load and prevent lung disease in macaques infected with SARS-CoV-2 that causes COVID-19, according to a study.

The findings, published in the journal Nature on Tuesday, support the early use of remdesivir treatment in patients with COVID-19 to prevent progression to pneumonia.

Researchers from the National Institutes of Health in the US noted that remdesivir has broad antiviral activity and has been shown to be effective against infections with SARS-CoV and MERS-CoV in animal models.

The drug is being tested in human clinical trials for the treatment of COVID-19, they said.

Researcher Emmie de Wit and colleagues investigated the effects of remdesivir treatment in rhesus macaques, a recently established model of SARS-CoV-2 infection.

Two sets of six macaques were inoculated with SARS-CoV-2.

One group was treated with remdesivir 12 hours later -- close to the peak of virus reproduction in the lungs -- and these macaques received treatment every 24 hours until six days after inoculation.

In contrast to the control group, the researchers found that macaques that received remdesivir did not show signs of respiratory disease, and had reduced damage to the lungs.

Viral loads in the lower respiratory tract were also reduced in the treated animals; viral levels were around 100 times lower in the lower-respiratory tract of remdesivir-treated macaques 12 hours after the first dose, they said.

The researchers said that infectious virus could no longer be detected in the treatment group three days after initial infection, but was still detectable in four out of six control animals.

Despite this virus reduction in the lower respiratory tract, no reduction in virus shedding was observed, which indicates that clinical improvement may not equate to a lack of infectiousness, they said.

Dosing of remdesivir in the rhesus macaques is equivalent to that used in humans, the researchers noted.

They cautioned that it is difficult to directly translate the timing of treatment used in corresponding disease stages in humans, because rhesus macaques normally develop only mild disease.

However, researchers said the results indicate that remdesivir treatment of COVID-19 should be initiated as early as possible to achieve the maximum treatment effect.

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Agencies
May 26,2020

Tedros Adhanom Ghebreyesus, the World Health Organisation's (WHO) Director-General, said that a clinical trial of hydroxychloroquine (HCQ) on COVID-19 patients has come to "a temporary pause", while the safety data of the the anti-malaria drug was being reviewed.

According to the WHO chief, The Lancet medical journal on May 22 had published an observational study on HCQ and chloroquine and its effects on COVID-19 patients that have been hospitalized, reports Xinhua news agency.

The authors of the study reported that among patients receiving the drug, when used alone or with a macrolide, they estimated a higher mortality rate.

"The Executive Group of the Solidarity Trial, representing 10 of the participating countries, met on Saturday (May 23) and has agreed to review a comprehensive analysis and critical appraisal of all evidence available globally," Tedros said in a virtual press conference on Monday.

The review will consider data collected so far in the Solidarity Trial and in particular robust randomized available data, to adequately evaluate the potential benefits and harms from this drug, he said.

"The Executive Group has implemented a temporary pause of the HCQ arm within the Solidarity Trial while the safety data is reviewed by the Data Safety Monitoring Board. The other arms of the trial are continuing," Tedros added.

WHO initiated the Solidarity Trial, a plan to evaluate the safety and efficacy of four drugs and drug combinations against COVID-19 more than two months ago, which include HCQ.

According to the WHO, over 400 hospitals in 35 countries are actively recruiting patients and nearly 3,500 patients have been enrolled from 17 countries under the Solidarity Trial.

Tedros added that the safety concern over the drug related only to the use of HCQ and chloroquine in COVID-19, and "these drugs are accepted as generally safe for use in patients with autoimmune diseases or malaria".

"WHO will provide further updates as we know more," he added.

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News Network
May 13,2020

California, May 13: A fasting-mimicking diet could be more effective at treating some types of cancer when combined with vitamin C, suggests a new study conducted by the scientists from USC and the IFOM Cancer Institute in Milan.

In studies on mice, researchers found that the combination delayed tumour progression in multiple mouse models of colorectal cancer; in some mice, it caused disease regression. The results were published in the journal Nature Communications.

"For the first time, we have demonstrated how a completely non-toxic intervention can effectively treat an aggressive cancer," said Valter Longo, the study senior author and the director of the USC Longevity Institute at the USC Leonard Davis School of Gerontology and professor of biological sciences at the USC Dornsife College of Letters, Arts and Sciences.

"We have taken two treatments that are studied extensively as interventions to delay ageing-- a fasting-mimicking diet and vitamin C -- and combined them as a powerful treatment for cancer," added Longo.

The researchers said that while fasting remains a challenging option for cancer patients, a safer, more feasible option is a low-calorie, plant-based diet that causes cells to respond as if the body were fasting.

Their findings suggest that a low-toxicity treatment of fasting-mimicking diet plus vitamin C has the potential to replace more toxic treatments.

Results of prior research on the cancer-fighting potential of vitamin C have been mixed. Recent studies, though, are beginning to show some efficacy, especially in combination with chemotherapy.

In this new study, the research team wanted to find out whether a fasting-mimicking diet could enhance the high-dose vitamin C tumour-fighting action by creating an environment that would be unsustainable for cancer cells but still safe for normal cells.

"Our first in vitro experiment showed remarkable effects. When used alone, fasting-mimicking diet or vitamin C alone reduced cancer cell growth and caused a minor increase in cancer cell death. But when used together, they had a dramatic effect, killing almost all cancerous cells," said Longo.

Longo and his colleagues detected this strong effect only in cancer cells that had a mutation that is regarded as one of the most challenging targets in cancer research.

These mutations in the KRAS gene signal the body is resisting most cancer-fighting treatments, and they reduce a patient's survival rate. KRAS mutations occur in approximately a quarter of all human cancers and are estimated to occur in up to half of all colorectal cancers.

The study also provided clues about why previous studies of vitamin C as a potential anticancer therapy showed limited efficacy. By itself, a vitamin C treatment appears to trigger the KRAS-mutated cells to protect cancer cells by increasing levels of ferritin, a protein that binds iron.

But by reducing levels of ferritin, the scientists managed to increase vitamin C's toxicity for the cancer cells. Amid this finding, the scientists also discovered that colorectal cancer patients with high levels of the iron-binding protein have a lower chance of survival.

"In this study, we observed how fasting-mimicking diet cycles are able to increase the effect of pharmacological doses of vitamin C against KRAS-mutated cancers," said Maira Di Tano, a study co-author at the IFOM, FIRC Institute of Molecular Oncology in Milan, Italy.

"This occurs through the regulation of the levels of iron and of the molecular mechanisms involved in oxidative stress. The results particularly pointed to a gene that regulates iron levels: heme-oxygenase-1," added Tano.

The research team's prior studies showed that fasting and a fasting-mimicking diet slow cancer's progression and make chemotherapy more effective in tumour cells while protecting normal cells from chemotherapy-associated side effects. The combination enhances the immune system's anti-tumour response in breast cancer and melanoma mouse models.

The scientists believe cancer will eventually be treated with low-toxicity drugs in a manner similar to how antibiotics are used to treat infections that kill particular bacteria, but which can be substituted by other drugs if the first is not effective.

To move toward that goal, they say they needed to first test two hypotheses: that their non-toxic combination interventions would work in mice, and that it would look promising for human clinical trials.

In this new study, they said that they've demonstrated both. At least five clinical trials, including one at USC on breast cancer and prostate cancer patients, are now investigating the effects of the fasting-mimicking diets in combination with different cancer-fighting drugs.

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