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Sunday, 23 October 2016

Prompt intervention can help lower blood sugar and bad cholesterol: medical experts

Doctors from all over India deliberated that changing lifestyle, coupled with genetic pre-disposition have adversely affected the young generation of India’s population. The doctors were speaking on the sidelines of Protect Young India Summit, hosted by the NCD PreDisease Forum in New Delhi.

Deliberations were based on the findings of the ESSENS study, conducted across India to evaluate the efficacy and safety of food-derived bio-actives in lowering the risk factors for heart disease and diabetes. 

ESSENS, a multicentre, randomized, double-blind study was a first of its kind study conducted at 16 centres across India under the guidance of Dr Naresh Trehan from Delhi, Dr. Ravi Kasliwal from Delhi, Dr. Hemant Thacker from Mumbai and Dr Sanjay Kalra from Karnal. 27 clinicians participated as investigators. The ESSENS study has been published in the North American Journal of Medical Sciences (NAJMS) and the international journal -NUTRITION.

This burden of premature cardio-metabolic diseases on the productive workforce aged 30–60 years is cause of larger social and economic concern, said experts. 

Diabetes and heart disease present serious health challenges for India. Guidelines governing treatment mandate that prescription drugs usually come into play only after the confirmed diagnosis of the condition (diabetes or high cholesterol).  

This also implies that for a large section of population that is on the cusp of these conditions, which is known as the pre-disease state, with higher than normal blood sugar and cholesterol levels, there is no pre-emptive intervention presently possible. Lifestyle modifications are one possible pre-emptive avenue but experience has shown that these often do not have desired impact due to low compliance.

“We need to focus on delaying the onset of disease in this at risk population using novel lifestyle interventions or interventions through food - derived bioactives in high risk population there by saving huge expenses and complications of disease”, said Prof. N K Ganguly, former director-general of Indian Council of Medical Research (ICMR) and director of the NCD Pre-Disease Forum, India, an affiliate of the Global Forum. 

“India has a high burden of non-communicable disease. We are facing a perfect storm of compounding factors which is unique in almost every aspect- epidemiology, genetics, patient beliefs, availability of resources, and finally, governmental will and efforts to fight them. But, policy interventions by government or awareness campaigns will be effective only when individuals take pro-active steps for their own health care”, he added.

According to Dr. Ravi Kasliwal, chairman – Preventive Cardiology, Medanta- The Medcity, “Every day at Medanta we see younger and younger adults coming in with heart attacks. This in not only a tragedy for the individual, but has consequences for the family and society as a whole. It is imperative we focus on solutions which young people can adapt easily and set achievable goals, for example, lowering the LDL-Cholesterol to 100 mg/dL”.

Dr. Abraham Oomman, a senior consultant cardiologist from Chennai, one of the investigators in the study, said “The ESSENS data showed that most subjects could achieve the goal of LDL-Cholesterol level of 100 mg/dL during the period of the study using the investigational bio-active”.  

He went on to add “Now, this bio-active is included in the 2016 clinical practice guidelines to lower cholesterol by the European Society of Cardiology.”

The meeting was focused on solutions particularly geared for the at risk population and the educated workforce, Dr. Sanjay Kalra, executive editor of the Indian Journal of Endocrinology and Metabolism said, “Instead of diabetes, we should focus on the pre-diabetes state, where we have the best opportunity to reverse the course of the young individual’s future health.”  

He further added, “In fact, the guidelines also clearly state that lifestyle modification and nutritional intervention should be tried before any medication for a newly diagnosed patient with increased blood sugar.” 

Dr. Banshi Saboo, secretary of the Diabetes-India, added “ESSENS studied the efficacy and safety of well-known ingredients in our food supply in lowering blood sugar levels in newly diagnosed subjects”.

“We must intervene earlier before our patients develop disease. But, in order to do that, the first step is to recognize the entity of pre-disease,” said Dr. Hemant Thacker, a leading doctor from Mumbai. “While there is no complete cure, we should, in the least, know when and with what to pre-emptively strike disease from progressing, in the pre-disease stage,” he added.

South Asians, including Indians, have a greater pre-disposition towards lifestyle diseases. Even in the US, the MASALA (The Mediators of Atherosclerosis in South Asians Living in America) study currently underway, aims to understand what factors lead to the magnitude of heart disease among South Asians.

The Pre-Disease Forum represents a cross-section of the public from physicians, patients, media, policy makers, celebrities, industry representatives, and other key healthcare stakeholders. The Forum’s goal is to bring the attention to earlier intervention in the pre-disease state of NCDs (Non Communicable Diseases). 

IPC's herbal monograph manual to spur exports of plant extracts, bioactive products

Indian Pharmacopoeia Commission issued a guidance manual on herbal monograph which is expected to spur exports of plant extracts and bioactive products among others, said Dr DBA Narayana, pharma consultant.

Marker compound isolation and supply after due characterization are indicating huge demand globally both for standardization and screening for biological activity. Researchers engaged in clinical research to assess the health benefits of herbs are already looking for  IP grade material so that their studies are done with quality materials. Therefore, herbal monographs will increase India’s chances of exports of Ayurveda drugs, Dr Narayana who is also the chairman, herbals committee, IPC, told Pharmabiz.

“Both ministry health and ministry of commerce are promoting exports of Indian herbal products. This guidance manual on herbal monograph will further propel the exports prospects,” he added.

The industry has already been using some of these monographs as part of their quality control practices. In fact, IPC Committee accepted inputs provided by the industry to improve these monographs. For many herbs/processed herbs/herbal products for which monographs do not exist in IP, this manual will help the industry to develop quality specifications in an objective way. Since these monographs have been appreciated and accepted globally, it would reduce rejections due to differences in specifications of testing methods, noted Dr Narayana.

The manual lays down the processes for development. Hence new teams replacing the existing committee members can continue to work as per processes for the manual. Researchers can get tremendous guidance from the manual. It is hoped that the departments of pharmacognosy and phyto-chemistry of pharmacy colleges in the country will adopt the manual for future research. The guidance of herbal monographs can also give a fillip to start-up research companies.

In the global arena, India has shown its capability and leadership in the area of quality monograph development. Perhaps India has shown leadership in publication of the processes involved in such a highly scientific and regulatory led work, which can help many developing nations to follow suit. The excellence in creation of the manual is now enabling the Indian Pharmacopoeia Commission to provide its inputs to draft the Chapter on Good Pharmacopoeial Practices (GPP) for herbals being prepared by WHO. 

This guidance expected to stimulate more scientists to contribute monographs and also hone their skills and competencies in this area.  The challenge was to develop objectively assessable, reproducible and globally acceptable monographs for herbs. It was critical to distinguish between routine research on herbs with regulatory enforceable quality specifications and methods. Difficult steps were adopted for the development of  specifications like mandatory TLC profile, DNA barcode test for botanical identity, reproducing photograph of the plant covered in the monograph, publishing TLC atlas/chromatograms of assay, said Dr Narayana. 

Understanding The Link Between Mouse Songs And Human Speech

There's a particular order to the sounds of the ultrasonic song that a male mouse performs to impress his potential partner.
But for male mice carrying a genetic mutation known to affect human speech, it is difficult to get this syntax of sounds right, according to a new study. Humans with the same mutation have problems with correctly sequencing phonemes into words. 
‘Super high-pitched mouse singing was identified decades ago, but only recently has it been possible to assign patterns to the chirping noises.’
"Mouse songs are not an exact parallel to human speech, but we found something very robust," said Erich Jarvis, a professor of neurobiology at Duke University and Howard Hughes Medical Institute investigator who co-led the study appearing online in Frontiers in Behavioral Neuroscience. 

Jarvis collaborated with Duke postdoctoral researcher Jonathan Chabout and Simon Fisher, director of the Max Planck Institute for Psycholinguistics in Nijmegen, the Netherlands. 

"This work provides an innovative way to study how genes affect sequencing of vocal sounds," said Fisher, who is also a professor of language and genetics at Nijmegen's Donders Institute. "It's important because quite a few children have mysterious problems with learning to produce proficient speech, and we have found that genetic factors play a big role. The big challenge, then, is to understand exactly why damage to a particular gene can lead to those kinds of difficulties, and that is hard to do if we can only investigate humans." 

The Duke researchers recorded ultrasonic sounds (above the range of human hearing) made by 50 adult male mice under a variety of conditions. They deciphered the structure of these mouse songs using new statistical tools to identify the ways four basic 'syllables' were strung together into more complicated sequences. They analyzed how these sequences (the syntax of the songs) changed in different social situations, such as when the male was in the presence of a female instead of another male. 

Their goal was to see whether mutation of the gene Foxp2 (forkhead-box P2) can affect the sequencing of the mouse songs, as it is known to do in human speech. 

Foxp2 has been the subject of intensive research in the 15 years since it was identified by Fisher and others as a key to mastering the rapid coordinated sequences of mouth, face and larynx (voice-box) movements that enable fluent human speech. 

"We first found a mutation in this gene causing speech deficits in many relatives of a large British family," Fisher said. "They made errors when speaking and these became worse as the things they were trying to say got longer and more complicated." 

Scientists using mice to understand how Foxp2 can affect vocal behaviors have mainly focused on the acoustic structure of individual syllables in juvenile mice, which have more basic vocalizations. The new study by Jarvis and his team instead looked carefully into the sequence of syllables in the songs of mature adults. 

Super high-pitched mouse singing was identified decades ago, but only recently has it been possible to assign patterns to the chirping noises. In a 2012 paper appearing in PLoS One, the Duke team first proposed that mice have a limited version of the vocal learning brain structures and some of the vocal adaptability found in song-learning birds and humans. 

Follow-up work appearing last year in Frontiers in Behavioral Neuroscience showed that male mice change their tune in response to different social situations -- especially the presence of active females. 

In this most recent study, the Duke team found that the songs of the mice become significantly more complicated in the presence of an active female than they do for a sleeping female, female urine or a sleeping male. 

"Social context matters," Jarvis said. "You have to be careful about the social context in which you record the mouse's behavior." 

Half of the male mice in the current study were genetically engineered to carry a mutation identical to the one that Fisher and colleagues had discovered causing speech problems in humans. Those mice did not switch to the more complex syntax in the presence of the live female, almost as if they were "tongue-tied," Jarvis said. These findings are consistent with other newly emerging studies of mice with different mutations of the gene. 

"So, while the mice aren't an exact model, and unlike humans they don't seem to learn their vocalizations, we did find that this mutation is having a similar impact on the sequence of ultrasonic songs," Jarvis said. 

But the researchers didn't have a way to statistically quantify changes in syntax, even for human speech. Jarvis and Chabout worked with Duke statisticians David Dunston and Abhra Sarkar to develop new tools to analyze the mouse syntax. 

"If we're looking for the effect of a gene, we need real statistical power," Jarvis said. "It's not enough to just eyeball it." The team also traced the location of neurons that connect the muscles of the voice box with the higher parts of the brain involved in controlling movements. In mice with the Foxp2 mutation, the neurons were spread out in a wider pattern in this part of the brain. 

Because Foxp2 is a transcription factor -- a gene that tells other genes what to do -- this altered pattern of neurons suggests it may play a role in how neurons are routed across the brain, Jarvis said. But he emphasized that more research is needed on that question. 

The finding expands the usefulness of mice for studying human speech and the brain, Jarvis said. Though he and others have made tremendous progress by studying the brains of songbirds that can learn songs the way we learn words, "having a mammalian model with even some rudimentary genetics and connectivity for vocal communication could still get you closer to the simpler aspects of speech," Jarvis said.
Source: Eurekalert 


When it comes to protein, there’s a common misconception about how much we actually need on a daily basis. And in the fitness world, many people swear by living a high-protein diet to build muscle and aid in weight loss by making you feel fuller. But how much is too much?The American Dietetic Association says that for the majority of active adults, they only need to consume 0.8 grams of protein per kilogram (1 kg = 2.2 pounds) of body weight per day. So for those that are consuming meat at every meal? They’re ingesting about five times too much of their recommended daily intake. On the other hand, too little protein is a bad thing as well. Proteinmalnutrition can lead to a condition called kwashiorkor, and can also cause growth failure, loss of muscle mass, decreased immunity, a weakening of the heart and respiratory system, and even death.
Meat is often looked at as being one of the top sources for protein, hence why so many scratch their heads in confusion as to how a vegetarian or vegan will go on without biting off a piece on a regular basis. But there are a lot of misconceptions regarding this ideology that ought to be cleared up. First off, we need to consume foods that provide us with the nine essential amino acids that our bodies are not capable of creating on their own.
While many have argued that meat is the go-to source because it provides the entire pack, there are some plant-based foods that also contain them.
While underconsumption of protein is harmful to the body, overconsumption comes with risks as well. In the United States, the average omnivore gets more than 1.5 times the optimal amount of protein, and most of that protein is from animal sources. This is bad news, because excess protein is turned into waste or turned into fat. This stored animal protein contributes to weight gain, heart disease, diabetes, inflammation and cancer.
On the other hand, the protein contained in whole plant foods is connected to disease prevention. According to Michelle McMacken, MD, a board-certified internal medicine physician and an assistant professor of medicine at NYU School of Medicine:
There is a lot to love about these powerful seeds. They have 4 grams of protein in every 2 tablespoons, they aid in digestion, and they help to keep you feeling fuller for longer. They also provide you with all of the essential amino acids your body needs. I like to sprinkle them on top of my yogurt for a little added crunch.


Speaking of yogurt, it is also a high-protein option. With twice the amount of protein as regular yogurt, a 6-ounce container packs a protein punch with 17 grams. It’s great for either a breakfast item or anytime snack.


This ancient grain is another complete protein that has been making waves in the health world recently as a trending superfood to fill up on. And with 8 grams of protein per cup, it’s no wonder why. It’s also a great alternative to rice with its impressive fiber and iron count.


The only vegetable that is a complete protein, edamame, or soybeans, are a great alternative to meat. A half-cup of soybeans has about a whopping 34 grams of protein, whereas a half-cup of chicken comes in at roughly 17 grams.


With 18 grams per boiled cup, lentils provide you with 37 percent of your daily recommended iron. If that’s not enough to spike your interest, they also contain more than half of your daily recommended fiber intake, AND they can aid in lowering cholesterol. Lentil soup anyone?


With 10 grams of protein per a 2 tablespoon serving, hempseed provides a generous helping of all nine essential amino acids. If you’re vegan, these should be on your list, as they contain essential fatty acids, like omega-3s. I sprinkle them on my salad for added texture.


For a great protein-filled snack, almonds are your go-to. They provide about 5-7 grams per ounce, are packed wth healthy monosaturated fat and fiber, and you’d be surprised at how much just a handful can curb your appetite.


avo toast
Avo toast, avocados sliced on a salad, in a sandwich, or eaten straight up with a spoon makes me swoon. This fruit is a melt-in-your-mouth healthy treat. It also has 2.9 grams of protein per one cup, sliced.

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