Let's link hands against diabetes

A 68-year old Mrs. S. developed high fever and had to be hospitalised since her blood sugars were very high. With no personal income or medical insurance, she had to depend on her son for paying hospital expenses for which he was not too willing.

Mr. S, 58, a watchman in a company, developed fever and infection in the foot. He had very high blood sugars and was hospitalised. Despite all efforts, his left leg had to be amputated and he had to use his entire savings which he had kept aside for his daughter’s wedding. This was a sad story of a man who lost his leg and his personal savings because he had diabetes, of which he was unaware. Innumerable are such pathetic cases.

Diabetes is one of the major health and development challenges of the 21st century. In India, it is estimated that around 62 million people have diabetes. One in two people with diabetes doesn’t know he/she has it. But diabetes and its complications are largely preventable, and proven, affordable interventions available. Everyone is concerned and everyone has a role to play in helping to turn the tide of diabetes to protect our future.

What can be done?

There are two major components of the burden of diabetes in India — genetic and environmental factors. Environmental factors such as physical inactivity and unhealthy diet pattern play an important role. There is an immediate need to seek the involvement of several stakeholders in prevention and control of diabetes.

To start with, the media plays a major role in not only creating awareness of the risk factors but also making policymakers and others focus on various avenues leading to a better living environment. The existing knowledge of prevention of diabetes can be disseminated to all with the help of the Ministry of Information and Broadcasting, NGOs and healthcare centres in both the private and public sectors.

Next, to put the knowledge into practice, it is necessary to create a conducive environment for the public to increase their physical activity. This needs earmarked funding for construction of parks, safe footpaths and cycle pathways.

In order to ensure healthy eating habits, retail shops, fast food outlets and chain restaurants should be encouraged to provide alternative healthy food choices. An additional tax could be levied on junk food. Regulation of pricing policy for fruits and vegetables is necessary.

The government should encourage small entrepreneurs to manufacture nutritious and palatable snacks for people belonging to different economic strata at an affordable cost. Agricultural research is also required for producing low glycemic cereals and grain. More operational research is necessary to develop strategies to reduce the burden of diabetes and its risk factors. Allocation of funds for such projects has to be given high priority by the funding agencies.

In order to help people with pre-existing diabetes, insurance companies should introduce policies which will cover both outpatient and hospitalisation costs.

This will help a large number of people in India with diabetes to have good control of their blood sugar levels and thus prevent dreadful complications.

Although various stakeholders are required to build the web of partnership for diabetes prevention, the most essential is individual commitment to a better living.

(The writer is Head and Chief Diabetologist, MV Hospital for Diabetes, and Prof. M Viswanathan Diabetes Research Centre, Chennai. Email: drvijay@mvdiabetes.com)

Whole Health Source: Sleep and Genetic Obesity Risk

Evidence is steadily accumulating that insufficient sleep increases the risk of obesity and undermines fat loss efforts.  Short sleep duration is one of the most significant risk factors for obesity (1), and several potential mechanisms have been identified, including increased hunger, increased interest in calorie-dense highly palatable food, reduced drive to exercise, and alterations in hormones that influence appetite and body fatness.  Dan Pardi presented his research at AHS13 showing that sleep restriction reduces willpower to make healthy choices about food.

We also know that genetics has an outsized influence on obesity risk, accounting for about 70 percent of the variability in body fatness between people in affluent nations (2).  I have argued that “fat genes” don’t directly lead to obesity, but they do determine who is susceptible to a fattening environment and who isn’t (3).  I recently revisited a 2010 paper published in the journal Sleep by University of Washington researchers that supports this idea (4).


Dr. Nathaniel Watson and colleagues used twins to tease apart what proportion of obesity risk is due to genes vs. environment, and if sleep duration influences that relationship.  Consistent with other studies, genetics explained 60 percent of the variability in body fatness between participants.  Also consistent with other studies, people who slept less tended to be fatter.  However, what sets this study apart is that they determined how sleep duration influences the relationship between genetics and body fatness.

What they found is nothing short of remarkable.  In people sleeping less than 7 hours per night, genetics determined 70 percent of body fatness, while the environment (lifestyle/diet and ‘random’ effects) explained only 30 percent.  In people sleeping more than 9 hours per night, genetics only explained 32 percent of body fatness, while environment explained 68 percent.  In other words, in people who sleep more than 9 hours, the environment and not genes was the primary determinant of body fatness.

The result was summarized in the following graph:



According to the authors, short sleep duration appears to favor the expression of genetic risk factors for obesity:

Our work suggests latent genetic variability in susceptibility to obesity requires activation by sleep curtailment.

In other words, in an obesity-promoting (low-sleep) environment, people who are genetically susceptible to obesity gain fat, while in a non-obesity-promoting (high-sleep) environment, genetic risk factors are less relevant and don’t influence body fatness as much.  “Obesity genes” act primarily in an obesity-promoting environment.

As a whole, I find the sleep-obesity research quite compelling.  This is one of the reasons why the Ideal Weight Program focuses on improving sleep quantity and quality, a strategy that sets it apart from nearly every other fat loss program.  We combine a tracking system that provides consistent objective feedback on sleep habits, with sleep guidance that helps overcome barriers to restorative sleep.

Five meals a day prevents youth obesity | Yle Uutiset | yle.fi


Mittanauha

A new 5-a-day rule seems to be in the offing.

Image: Arja Lento / Yle

Master of Health Sciences Anne Jääskeläinen’s doctoral research shows that a regular five meal rhythm on weekdays protects against overweight and obesity in young people – as well as in infants who might be prone to overly padded waistlines.

According to the study, even those who are genetically more susceptible to weight gain will not pack on more kilos than their more genetically fortunate peers if they stick to the five a day rule.

The results also show that if a father was overweight before the mother’s pregnancy, the risk factors are almost the same as if the mother was overweight before the pregnancy began – for both girls and boys. In addition, mothers who packed on the pounds at the start of their pregnancy increased the risk of continuing the trend in their offspring.

The study brings new information on early risk factors associated with young Finns at risk of overweight and obesity.

How to reduce the risk of diabetes


For those at risk of type 2 diabetes, a new study finds that cutting your sitting time every day by 90 minutes could change your health more than taking on a vigorous workout program.
Currently, patients at risk for type 2 diabetes are advised to engage in moderate-to-vigorous physical

activity for at least 150 minutes per week. But new research finds that the best advice may be to reduce sedentary time — time spent sitting at a desk, lying down, or watching television — by 90 minutes a day.

In the study from the University of Leicester, lead researcher Joseph Henson and colleagues analyzed patients from two studies: 153 from project STAND (Sedentary Time and Diabetes study), where subjects were an average age of 33, and the Walking Away from Diabetes study, where subjects were an average age of 64.

In each study, the team examined time spent sitting or sedentary, as well as time spent engaging in moderate-to-vigorous exercise, against risk factors for diabetes.

The researchers found that time spent sitting was significantly associated with higher blood sugar and cholesterol levels, reports HealthDay, as well as other heart and diabetes risk factors. This held true even after compensating for the amount of time spent exercising.

While the study doesn’t prove a cause-and-effect relationship between sitting and diabetes, Henson says it does raise questions about protocols for reversing risks.

Research appears in the journal Diabetologia.
http://www.diabetologia-journal.org

Sitting Less Reduces Risk Of Type 2 Diabetes

Editor’s Choice
Academic Journal
Main Category: Diabetes
Also Included In: Sports Medicine / Fitness;  Obesity / Weight Loss / Fitness
Article Date: 02 Mar 2013 – 0:00 PST

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Healthcare Prof:

People at high risk of developing type 2 diabetes can reduce the risk by sitting less and moving around more frequently, rather than exercising regularly.

The finding came from a study at the University of Leicester which indicates that decreasing sitting time by 90 minutes in total each day may result in critical health advantages.

Patients at risk for type 2 diabetes are currently told to do moderate-to-vigorous physical activity (MVPA) every week for at least 150 minutes.

However, the new research, published in Diabetologia demonstrates that individuals should actually be told to decrease their sedentary time. This means that they need to reduce the time they spend moving very little or not all, such as when they are lying down or sitting.

The investigation was led by Joseph Henson and a team from the Diabetes Research Unit, University of Leicester and National Institute for Health Research (NIHR) Leicester Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit (BRU), UK.

The researchers examined patients from 2 reports:

  • 153 from project STAND (Sedentary Time and Diabetes study, 29% men, 33 years old on average)
  • the Walking Away from Diabetes study (65% men, 64 years old on average)

The degree to which MVPA, total physical activity, sedentary time, and breaks in sedentary time were independently linked to cardiometabolic risk factors were observed in people with recognized risk factors for diabetes type 2.

In order to evaluate MVPA, total physical activity and sedentary time, the experts used accelerometers. Breaks in sedentary time were considered a change from a sedentary to an active state.

According to the results, patients with known risk factors for type 2 diabetes recruited from primary care, sedentary time was harmfully linked to 2 h glucose, HDL-cholesterol, and triacylglycerol, independent of confounders that were evaluated.

After controlling for MVPA and adiposity, the results were still significant.

The results were constant across different age groups, demonstrating that the adverse outcomes of surplus sedentary time prevail among young and old adults.

Henson explained:

“These studies provide preliminary evidence that sedentary behavior may be a more effective way to target the prevention of type 2 diabetes, rather than just solely focusing on MVPA. Moreover, sedentary time occupies large portions of the day, unlike MVPA.”

The authors added that sedentary time had a more powerful link to many critical cardiometabolic markers, such as HDL-cholesterol, triacylglycerol, and 2 h glucose, as opposed to total physical activity and MVPA, after controlling for each other and other crucial hidden variables.

The novel findings raise concerns about the potential prescription of optimal daily movement for well-being.

Henson concluded:

“Diabetes and cardiovascular prevention programs concentrating solely on MVPA may overlook an area that is of fundamental importance to cardiometabolic health. Along with messages related to accumulating at least 150 min/week of MVPA, which form the cornerstone of diabetes prevention programs, such interventions may be more effective still if individuals are further encouraged to simply sit less and move more, regardless of the intensity level.

This approach requires a paradigm shift, so that individuals at high risk of developing type 2 diabetes think about the balance of sedentary behavior and physical activity throughout the day.”

The results coincide with a different study also published this week which showed that sitting for long hours is linked to an elevated risk of developing chronic diseases, such as diabetes, cancer, and heart disease.

Written by Sarah Glynn

Copyright: Medical News Today

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What happens during a miscarriage?

A miscarriage is a pregnancy that ends before 24 weeks, which is before most developing babies can survive outside the womb.

The majority of miscarriages happen during the first 12 weeks of pregnancy, which is often referred to as the first trimester and are much more common that people realise. Many women who miscarry do not like talking about.

An estimated 20% of pregnancies end in miscarriage, according to the NHS, but many cases go unreported because a woman often loses the baby before she even realises she’s pregnant.

What causes a miscarriage?

About half of all early miscarriages happen when a problem in the way chromosomes from the egg and sperm combine during the fertilization process, according to Bupa, leading to problems with the foetus. Many couples never find out why this has happened, and it is often put down to chance rather than another underlying cause.

While these chromosome problems often happen by chance, there are some known risk factors, which increase the chances of these issues occurring in the first 3 months of pregnancy (first trimester):

  • Age – women under 25 are at lowest risk with 9%, whereas those over 45 have a 75% chance of miscarrying, the NHS states.
  • Obesity
  • Smoking
  • Drug use
  • Alcohol and caffeine consumption – drinking more than one cup of coffee a day and 2 small glasses of wine a week increases risk.

Second trimester miscarriages can often be caused by:

  • Underlying health conditions such as diabetes, lupus, kidney disease or thyroid problems
  • Infections such as rubella or bacterial vaginosis (BV)
  • A higher than usual level of the antibody called antiphospholipid (aPL) in the blood
  • A weakened cervix
  • Polycystic ovary syndrome

The NHS dispels myths by stating that miscarriage risks ARE NOT linked to:

  • The mother’s emotional state during pregnancy
  • Being shocked or having a fright
  • Exercising during pregnancy (the most appropriate type of exercise should be discussed with a doctor)
  • Lifting or straining
  • Working during pregnancy or having sex

What are the symptoms of miscarriage?

The most common symptom of a miscarriage is vaginal bleeding. This can vary from light to very heavy, including blood clots and brown discharge. There may also be:

  • Cramping and pain in the pelvis and back
  • Usual pregnancy symptoms such as sickness and breast tenderness suddenly stopping

[adsense]You should contact your doctor or midwife immediately if you start experiencing bleeding during your pregnancy. A gynaecologist can diagnose a miscarriage through an ultrasound scan and blood tests.

How is a miscarriage treated?

Treatment depends on whether or not the miscarriage is complete or incomplete. In cases of a complete miscarriage, no further medical treatment is needed. If the latter occurs, however, the foetal tissue needs to be removed otherwise it may become infective. This can be done in three ways:

  • Surgical treatment where minor surgery is used to remove the tissue,
  • Medical treatment – where medication is used to remove the tissue, or
  • Expectant treatment – where you wait for the tissue to pass naturally out of your womb.

If you are experiencing recurring miscarriages, it is important to talk to your doctor about what treatments are available to maximise the chance of having a successful pregnancy.

Celebrities who have previously had miscarriages include screen siren Sharon Stone and songstress Lily Allen. Also read about Kym Marsh’s agony over giving birth to a premature baby and how Chris Evans’ wife nearly died during an ectopic pregnancy.

Images: Wikimedia Commons

Colon cancer not exacerbated by coffee or soda

People who drink coffee and soda are not more at risk of developing colon cancer than those who do not, according to a recent study.

The research, conducted at the Harvard School of Public Health and published in the Journal of the National Cancer Institute, looked at 13 previous studies on the disease conducted in the US and Europe.

Some of these studies have previously suggested that coffee and tea could increase the risk, and some have claimed it could be lowered. Science Daily points out that tea contains anti-oxidants that could serve to prevent cancer but also has polyamines, which theoretically promote cancer.

Coffee drinkers are not more at risk of getting colon cancer

The new survey looked at 731,441, followed for up to 20 years, 5,604 of which developed colon cancer. Insight into their eating and drinking habits found that coffee lovers – even those who drank up to 6 cups a day – were not more likely to develop the illness. This also applied to those who drank large amounts of soda.

“Drinking coffee, even more than six cups a day, was not associated with risk of colon cancer,” confirmed researcher Dr. Xuehong Zhang of the Harvard School of Public Health.

“The relationship between tea and colon cancer is unclear for the time being,” Dr Zhang added, however.

Images: Jeff Kubina and Marcelo Alves