Health on Health issue

Ethics on health related advertising

PUBLIC AWARENESS: Doctors at the recently concluded annual scientific sessions of the Sri Lanka Medical Association SLMA, focused attention on the need for the advertising profession to adopt a code of ethics in relation to the medically and health related advertising they carry in the media.

In an oral presentation on medically and health related advertisement in the media study done by a six-member team of doctors from the Pharmacology Department of the Colombo Medical Faculty the doctors said.

"In our study done on medical and health related advertisements in the print media from November-December 2005, we found that 67 per cent of the advertisements conveyed wrong information on diseases and medicines to the public".

Further they alleged of the advertisements which had an influence on health promotion 48 per cent promoted alcohol and 41 per cent promoted other unhealthy behaviour (eg. unhealthy diet, sedentary lifestyle, wrong health messages) and only a small percentage 7 per cent promoted healthy behaviour and 71 per cent of the advertisements were targeted at children or youth.

They concluded "In our view these advertisements need to be regulated by legislation and codes of practice. Public awareness should be promoted to look at them critically".

The survey was done on health related advertisements carried in seven widely read national newspapers covering the period from November-December 2005.

The following comprised the study team Drs. A.A. Abdulla, N.M.R. Fernandopulle, P. Velummayilum, S.A. Abayaratna, Sri S. Ranganathan, B.M.R. Fernandopulle.

The following is the abstract of the study carried in the special issue of Ceylon Medical Journal Vol. 51, March 2006 supplement.

Objective: To analyse newspaper advertisements on health.

Method: Seven widely read national newspapers published over the period November-December 2005 in the three official languages were studied. Health related advertisements were selected and a content analysis was carried out using a structured pre tested checklist to describe their effects on health.

Results: A total of 188 health related advertisements were studied (Sinhala 56, Tamil 57, English 75); Sunday papers carried almost half (42.6%) of these. Three quarter (75%) of these were targeting at children or youth.

Over a half (53.2%) was observed to have an influence on overall health promotion, whereas 18% advertised alternative medicines and 7% allopathic products; 17% were nutritional supplements. 22% and 67% of these conveyed false information on diseases and medicines respectively.

Of the advertisements which had an influence on health promotion, 48% promoted alcohol and 41% promoted other unhealthy behaviour (eg. unhealthy diet, sedentary lifestyle, wrong health messages).

There were no tobacco advertisements. A small percentage (7%) promoted healthy behaviour, such as cautioning on handling fire crackers and advertisements on World AIDS day.

Detailed analysis showed that 71% had misleading captions and 79% inappropriately emphasised certain aspects. None of the advertisements for medicinal, food or alcohol products gave appropriate health warnings.

Legislature regulating advertisements were inadequate and there were no codes of practice for advertising in print media.

Conclusion: Advertisements need to be regulated by legislation and codes of practice. Public awareness should be promoted to look at these advertisements critically.

Wish to know about Ageing?

Each person ages in a different manner

ELDERS: In a manual for care of the elderly put out by the Health Education Bureau, doctors say that -

"Each person ages in a different manner. Some get old at a relatively young age, while others remain 'young' even at a more advanced age".

There are numerous theories put forward to explain this, but none of them explain all the facts as to why it happens.

Growth and development during intrauterine life, childhood and early adulthood may affect health in later life. Even later life interventions such as adherence to a proper diet, physical activity and avoidance of risk factors have been shown to help in preventing and minimising impairment and disability among older persons.

What happens in ageing?

We need to understand what happens in ageing to the human body. Ageing is a normal biological process common to all living organism.

We all start ageing from the day we are born. It is something that cannot be stopped or reversed.

Changes take place

In the human body changes take place continuously through which the structure and functions of the human body undergo gradual changes. These changes affect the functions and the appearance of the body. Many Psychological and emotional changes also take place with increasing age.

Older persons experience

Older persons experience decreased functional abilities such as those affecting mobility and dexterity, due to musculo - skeletal changes.

They find it more difficult to get around and do the things they used to do. As people grow older their immune systems functions lesser. Older person thus tend to have more Illnesses than younger persons do, and often these illnesses are multiple and chronic in nature.

Changes that take place in ageing

As age advances, several, biological changes gradually affect the individual in such a manner that the individual is not aware of these changes. These changes are not as a result of disease but are normal changes that occur with ageing.

Body changes

The human body has four major components - bone, body cell mass, body fat and body water, with ageing all four components are affected each in a different way.

Bones once formed, do not change in size or shape, except in serious bone disease.

With ageing the quality of the bone gradually deteriorates. The mineral calcium gives the rigidity and the desired shape to the bone with deposition of calcium beginning even before birth. By about 30 years of age, the bones of a healthy human reaches the maximum density, indicating that the maximum amount of calcium has been deposited to give the desired strength and the rigidity.

Calcium balance

In the human the calcium balance is maintained by calcium in the bones being excreted through the blood circulation and replaced by fresh calcium through dietary intake.

With advancing age

With advancing age, especially in persons who are not active and mobile and who have sluggish blood circulation and reduced dietary intake calcium loss from the bones is far more than the deposition of calcium. Due to this gradual reduction in calcium, the bones become less dense and brittle, a condition known as osteoporosis.

In such situations, even a minor fall can cause the bones to break, Hip fractures and fractures of the femur (thigh bones) are the common fractures in older persons. These are more common in older females.

Avoiding fractures

If older persons themselves and their carers are informed about this weakness of the bones, they could take precautions which will help in avoiding such fractures that could lead to permanent handicap.

'Is coconut oil better than the unsaturated oils in general?'

Dr. D. P. Atukorale's reply to Dr. T. Saravanapavanathan (Consultant anaesthetist) from Ragama

Yes, Dietary (unadulterated) coconut oil (CNO) is very much better than polyunsaturated vegetable oils such as corn oil, soya oil and sunflower oil because of the following reasons:

(a) For all practical purposes dietary coconut oil (CNO) does not contain trans-fatty acids unlike vegetable oils which have transfats that are produced (i) during the manufacturing process of the oil, (ii) during transport of the oil and (iii) during storage of the oil in the supermarkets and boutiques and grocery stores and during the period the oil is kept at home (unless these oils are kept in the refrigerator) Transfats are harmful to our health as these artificial chemicals (i) decrease level of our HDL (good) cholesterol (ii) Transfats have been proved to act as carcinogens in animal experiments (iii) Transfats cause elevation of our LDL (bad) cholesterol.

Coconut oil (CNO) can be used for deep (repeated) frying without production of poisonous chemicals such as ketones, aldehydes free radicals and transfats. When we use vegetable oil for frying above harmful chemicals are produced; therefore it is advisable for us to throw away the vegetable oil after using for frying once.

On the other hand CNO can be used for frying even hundred times without production of above harmful chemicals. Olive oil is an exception and when olive oil is used for cooking purposes, HDL (good) cholesterol level goes up.

Olive oil is the most expensive cooking oil available in our supermarkets and should be kept in the refrigerator to prevent formation of transfats.

(b) According to the most recent research, out of the two coronary risk factors namely (i) low HDL (ie HDL below 40 mg per dl in males and below 50mg/dl in females) and (ii) high LDL (bad) cholesterol; low HDL is more important than high LDL cholesterol.

It is common knowledge among physicians that a significant percentage of Sri Lankans (and other Asians) are prone to have low HDL. It is our experience that in some patients with coronary heart disease (CHD), low HDL is the only known risk factor.

When we use vegetable oil for cooking purposes, the LDL level goes down but at the same time HDL (good) cholesterol too goes down and the ratio of total cholesterol/HDL increases making the person prone to get CHD.

But when we use CNO, the total cholesterol and LDL levels don't decrease but the HDL level remains at the same level and the ratio of total cholesterol to HDL does not go up. So in patients who have low HDL, it is not advisable to use vegetable oil. Coconut oil is the best cooking oil for Sri Lankans.

Coconut oil has been used for cooking purposes by Sri Lankans for over 1000 years and by Indian for more than 5000 years without getting any side effects such as allergy, cancer etc.

Do free radicals form when coconut oil is heated?

As far as I am aware no free radicals are formed when coconut oil is heated. When vegetable oils are heated significant amounts of free radicals are formed. It is common knowledge that free radicals contribute to our ageing process, development of coronary heart disease and cancer and a large number of other degenerative diseases.

Is it good to use coconut oil or is it not harmful?

It is good to use coconut oil in moderation as all of us need certain amount of harmless fat in our diet. Coconut oil is a relatively inexpensive and stable oil and there are no harmful side effects unlike vegetable oils.

Coconut oil helps in the absorption of fat soluble vitamins such as vitamin A and E. As I have mentioned earlier, it is better to use coconut oil as compared to vegetable oil which have harmful side-effects such as reduction of HDL (good) cholesterol, production of free radicals harmful transfats, aldehydes and ketones during deep frying, increase in your weight (unlike CNO).

It is noteworthy that consumption of too much of any fat or oil is harmful. Consumption of two much of vegetable oil result in hypertriglyceridaemia (elevation of serum triglycerides) and lowering of HDL (good) cholesterol which are well known coronary risk factors.

Dr. Saravanapavananthan in her letter to Dr. Atukorala states:-

I am herewith sending a copy of the letters of correspondence I had with Dr. Lamas a Cardiologist conducting a clinical trial in USA as it will interest you.

I would like to clear some doubts which came to my mind recently.

1) Is coconut oil better than the unsaturated oils in general?

2) Do free radicals form when coconut oil is heated?

3) Is it good to use coconut oil or is it that it is not harmful?

Eating less may lead to longer life

A preliminary study in human suggests that reducing calories may well extend life, researchers report in this week's Journal of the American Medical Association.

"A lot of evidence already exists to suggest that calorie restriction increases maximum life span in several animal species.

However, there hasn't been any proof of it being the case in humans," co-author Dr. Eric Ravussin, from Louisiana State University in Baton Rouge, told Reuters Health. "This is the first step toward looking at the beneficial effects of calorie restriction in humans."

Ravussin and his team enrolled 48 healthy overweight (but not obese) men and women in a 6-month trial looking at the effects of calorie reduction. The researchers also observed lower blood levels of insulin after fasting and a lower body temperature in all participants who undertook a restricted calorie regimen.

"Body temperature and blood insulin levels are markers of longevity like gray hair or wrinkles can be," said Ravussin. "It has been shown both in animals and humans that those with lower body temperature tend to live longer, and so do those with lower fasting insulin levels."

"One of the many theories of aging is that there is more DNA damage happening, which is the destruction of genetic information - smokers for example have more DNA damage," said Ravussin. "So this is a very important information, totally novel in humans, that calorie restriction can reduce DNA damage."

NEW YORK (Reuters)

How to know you're having a stroke

The signs and symptoms of the stroke include a pale face, change in voice, absence of feeling or sensation in half of the body, loss of eyesight or double image and acute headache or unconsciousness should be immediately reported to the doctor.

According to Neurology Awareness & Research Trust (NART) President Dr Farrukh Shahb Khan, one person falls has a stroke every 20 minutes and one third of those affected did not survive for long. He stated this while speaking at the launch of the Falij Control Program (FCP) recently at the Karachi Press Club.

A stroke involves a loss of brain functions caused by a loss of blood circulation to areas of the brain. The blockage usually occurs when a clot or piece of atherosclerotic plaque breaks away from another area of the body and lodges within the vasculature of the brain.

He said that the major causes of stroke were smoking, high blood pressure, diabetes, obesity, sedentary lifestyle, diet/ hypercholesterolemia, cardiac disease, hypercoagulable state, alcohol intake and carotid artery stenosis.

About 90 per cent of cases stroke were due to genetic reasons. A stroke is the most common neurological disorder and main cause of death among senior citizens in the country. Every year, 300,000 people suffer from the disease and 45 to 50 per cent of the above-40 population suffer some degree of the disease in Pakistan.

Courtesy: Daily Times

Health Quest Talk No. 2 - Venue changed

Readers please note that we had to change the venue of the above talk from SLMA auditorium to the National Diabetic Centre auditorium.

The talk on coping with stress in married life by Dr. Jeyan Mendis President Sri Lanka College of Psychiatrists will now be held on Saturday May 27 at 10.50 a.m. at National Diabetic Centre Auditorium, No. 50, Sarana Mawatha, Rajagiriya (Opposite Elections office). All who sent in questions and others interested on the topic are welcome.

The talk is sponsored by PhiloBiotics who are giving prizes to the best three questions sent by readers on the topic.

Dr. Mahen Wijesuriya President Diabetic Association of Sri Lanka will chair the meeting, and will also give a short talk on stress on diabetes.