Health Watch

Preventing Non Communicable Diseases

Nipuni Wimalapala

Around the world, majority of deaths are due to Non Communicable Diseases (NCD). NCDs are non-infectious and non-transmissible. There are four main categories of NCDs namely, diabetics, cancers, heart diseases and chronic lung diseases, which are basically caused by alcohol consumption, tobacco consumption, physical inactivity and unhealthy diet patterns.

Considering the rapid increase of NCDs among youth and adults, a workshop on Mobilizing Youth for NCDs Prevention, organized by the Health Ministry, Youth Affairs and Skills Development Ministry in collaboration with World Health Organization was held recently at the Sri Lanka Foundation Institute. The objective of the project is to mobilize youth to prevent NCDs via awareness programmes at district level.

Mainly the project is designed to train the youth on the NCDs in order to promote healthy life styles among them and to empower the community. To carry on the project, a National level Steering Committee is formed in which multi stakeholders are included. The committee will be handling the national level work. To mobilize youth, a group of youth is assigned from different educational and working backgrounds. The group is consisted of 20 members who are active having strong capability to undertake the work. This group is the resource pool which will handle the awareness programmes to be conducted throughout the country.

Increasing NCDs among youth has become one of the serious health issues since people under 25 make up 43 percent of the world's population with 1.2 billion between the ages of 10 and 19. The present cohort of young people worldwide is the largest it has ever been. Their ability to enter the workforce as healthy, educated, productive workers will shape national and global economic prospects. Therefore youth's lack of attention towards their health helps increase the numbers of NCD which will automatically decrease the productivity and contribution of youth to the development.

Studies of 50 year morality trends in children and young people show that the child mortality rates have decreased while rates of mortality in adolescents have only marginally improved, with NCDs one of the leading causes of death. Through the existing data sources, it is indicated that risks for NCDs in later life are spreading rapidly in young people, with associated immediate as well as long-term consequences.

According to Dr. Palitha Mahipala, Additional Secretary of Health Ministry, there is a rapid increase of NCDs which are mainly caused by the modern life styles influenced by globalization and urbanization. People look for fast foods which are tasty and easy to prepare. But they do not think that these foods are junk and totally unsuitable for health. And also consumption of tobacco and alcohol increase this while physical inactivity makes the situation worse.

As he emphasized, in reality today people do not have time to do physical activities. But they can easily avoid fast food and find enough varieties of green vegetables and fruits. They should start consuming large amount of vegetables and fruits avoiding fatty foods and sugary foods. A balanced diet is a very important concept to promote among youth and adults. He specifically advised to avoid being seated the whole day and travel entirely in vehicles. Walking, doing sports, doing exercises and even doing house hold work or gardening would help avoid diseases. A person should do some kind of physical activity at least one hour per day.

The relevant authorities have to pay their maximum attention to turn down the promotions of tobacco and alcohol which are attracted by youth in many ways. Since adolescents are quite price sensitive, rising price would reduce consumption. Social attitudes towards alcohol and tobacco should be changed to make a difference in youths’ lives. And also the print and electronic media's advertising on fast foods increase the desire of youth to consume them.

NCDs among youth is not only a health issue but have a wide reaching social, economic, development and human rights implications.

Therefore this project would be a very productive one through which the whole society will be benefitted. The awareness will be given from grass root level to the top. Being a youth you could also contribute to this to make a healthy population.

Bad sleep may predict Alzheimer’s, says study

Problems sleeping may be an early sign of Alzheimer's if a study in mice also applies to people, say researchers. Clumps of protein, called plaques, in the brain are thought to be a key component of the illness.

A study, published in the journal Science Translational Medicine, showed that when plaques first developed, the mice started having disrupted sleep.

Alzheimer's Research UK argued that if the link was proven it could become a useful tool for doctors.The hunt for early hints that someone is developing Alzheimer's is thought to be crucial for treating the disease.

People do not show problems with their memory or clarity of thought until very late on in the disease. At this point, parts of the brain will have been destroyed, meaning treatment will be very difficult or maybe even impossible.

‘Detectable sign’

It is why researchers want to start early, years before the first symptoms.

If sleep abnormalities begin this early in the course of human Alzheimer's disease, those changes could provide us with an easily detectable sign of [the disease]”

One large area of research is in plaques of beta amyloid which form on the brain.

Levels of the beta amyloid protein naturally rise and fall over 24 hours in both mice and people. However, the protein forms permanent plaques in Alzheimer's disease.

Experiments at Washington University showed that nocturnal mice slept for 40 minutes during every hour of daylight. However, as soon brain plaques started to form the mice were sleeping for only 30 minutes.

One of the researchers, Prof David Holtzman, said: “If sleep abnormalities begin this early in the course of human Alzheimer's disease, those changes could provide us with an easily detectable sign of [the disease].”

“If these sleep problems exist, we don't yet know exactly what form they take, reduced sleep overall or trouble staying asleep or something else entirely.”

However, findings in mice do not always apply to people as there are many reasons for disrupted sleep.

Dr Marie Janson, from the charity Alzheimer's Research UK, called for more studies in people to see if there was a link between sleeping patterns and Alzheimer's.

She added: “There has already been research linking changes in sleep patterns to a decline in thinking skills, but these results suggest that disrupted sleep may also be a warning sign of Alzheimer's.

“If research confirms specific sleep changes as a possible early marker of Alzheimer's, it could prove a useful strategy for doctors to identify patients at risk of the disease.”

BBC

Fish oils ‘help slow age decline’

Jonathan Ball

Moderate exercise, and a regular intake of oily fish fatty acids, keeps elderly immobility at bay, a study suggests. Findings of a recent trial show that women aged over 65 who received omega-3 fatty acids gained almost twice as much muscle strength following exercise than those taking olive oil.

A larger trial is planned to confirm these findings and to determine why muscle condition improves.

The findings are being presented at the British Science Festival in Aberdeen.

Some studies have linked diets high in omega-3 - commonly found in oily fish such as mackerel and sardines - to potential health benefits, such as a lower risk of coronary heart disease. During healthy ageing, muscle size is reduced by 0.5-2% per year. This process - known as sarcopenia - can result in frailty and immobility in old people.

Little is known about the prevalence of sarcopenia in the UK, but data from the US shows that 25% of people aged 50-70 have sarcopenia and this increases to more than half of those aged over 80 years.

According to Dr Stuart Gray from the University of Aberdeen, the cost of sarcopenia is immense; either in direct nursing and care costs or in hospital admissions through falls.

“Around one-and-a-half percent of the total US healthcare budget is spent on sarcopenia-related issues”, he said.

The rate of muscle loss is dictated to some extent by lifestyle - consumption of a low protein diet and a sedentary lifestyle are known to exacerbate muscle loss.

Previous studies demonstrated that livestock fed on omega 3-rich diets had increased muscle bulk.

This prompted Dr Gray to investigate whether these fatty acids could help reverse sarcopenia in the elderly.

In his initial studies, he showed by MRI imaging that middle-aged rats taking fish oil supplement had a lower loss of lean mass than counterparts fed a normal diet.

“The fish oil seemed to be having anabolic [muscle-building] protective effects in the rats, but rats aren't humans, so the next step was to try it in humans,” he said.

So, Dr Gray recruited 14 women aged over 65 years and asked both groups to undergo a 12 week exercise programme consisting of two 30-minute sessions of standard leg muscle exercises.

Half the women were given the omega-3 fatty acids EPA and DHA, whist the other half received an olive oil placebo (negative control). At the start and end of the trial, the women's leg muscle strength was measured. The results were compelling. Women receiving olive oil increased their muscle mass by 11% whilst those receiving EPA and DHA showed a 20% increase - a statistically significant improvement.

But as Dr Gray was quick to point out, not all fish oil supplements contain beneficial amounts of these fatty acids. He told BBC News: “One of the problems with a lot of these supplements is that the amount of EPA varies.

“A capsule containing one gram of fish oil might only contain 100 milligrams (mg) of EPA and some might contain 400”.

His advice for anyone wanting to improve their intake of dietary EPA and DHA was to take a supplement that contained the highest levels of these two fatty acids.

Alternatively, half of the average portion of oily fish contains equivalent amounts of beneficial EPA and DHA as those used in the trial.

-BBC

Information helps men make prostate cancer decisions

When given additional information, prostate cancer patients are less likely to remain undecided about which treatment they want and are less likely to want their prostates removed, in a new study.

Perhaps not surprisingly, Dutch researchers found that just 2 percent of patients remained undecided after being educated about the two or three treatments available to them. That's compared to about 8 percent of patients who had normal doctor's visits.

Additionally, 65 percent of patients in the educated group preferred to have their prostates removed - a surgery known as a radical prostatectomy - compared to 73 percent of patients who were not given additional information.

“The contribution this study makes is that it fits with a number of other trials that have been done with surgery,” said Floyd J. Fowler, senior scientific advisor for the Informed Medical Decisions Foundation (IMDF) in Boston.

Fowler, who was not involved with the new work, said past research shows people usually pick more conservative treatments after they're exposed to more information.

For example, the new study found that the educated patients were more likely to prefer one of two radiation treatments that may allow them to keep their prostate instead of having the gland completely removed.

To see whether a “decision aid” - a structured meeting that provides patients with the pros and cons of various treatments - helped those with prostate cancer to decide on a treatment choice or changed their existing choice, the researchers monitored 240 patients at three Dutch hospitals between 2008 and 2011.

The researchers, led by Julia J. van Tol-Geerdink at Radboud University Medical Centre in Nijmegen, The Netherlands, randomly assigned 163 patients into a group that received the additional education, while 77 were assigned to a comparison group that had regular doctor's visits.

In each group, urologists met with prostate cancer patients and told them about the available treatment options, but did not decide on one during those first visits.

Those in the education group then had a second visit with a researcher who described each treatment through a standardized discussion, while those in the comparison group had a normal follow up visit with their specialists.

The patients’ treatment preferences - along with which side effects they were most concerned about - were then recorded.

Overall, 65 percent of those in the education group preferred to have their prostates removed, 33 percent preferred a form of radiation and 2 percent remained undecided.

In those who had normal doctor's visits, 73 percent preferred a radical prostatectomy, 20 percent preferred radiation and 8 percent were undecided.

As for what the patients were most concerned about, researchers found that - aside from survival - bowel and urinary problems were most important, while sexual problems and the procedure itself were less so. The study is part of a long body of research that says involving patients in decision making leads to making better decisions, Dr. Michael J. Barry, a primary care doctor at Massachusetts General Hospital in Boston and IMDF president, told Reuters Health.

“People should know what all of their options are, and with prostate cancer there are a lot of options,” Barry, who was also not involved with the new study, added.

But both Barry and Fowler said the study would have been better if the researchers also offered patients the option to just monitor the cancer's growth - an approach known as

“I think you might have seen more interesting results if they included that,” said Fowler.

Despite that limitation, researchers, writing in the British Journal of Urology International, recommend that hospitals and doctors use similar “decision aids” to help patients reach a decision. As for now, Fowler said patients should ask their doctors for information on all of their treatment options.

“I think if a patient goes in and says, ‘I want to understand the pros and cons of all my options - including doing nothing,’ most (doctors) would do it,” he said.

The American Cancer Society projects that 241,740 men will be diagnosed with prostate cancer in 2012, and 28,170 will die from it.

– Healthnews

Fear of the dark

Mariella Frostrup

A passing mention of an irrational fear of the dark brought Mariella Frostrup one of her biggest ever mailbags. Here, our agony aunt faces up to her demons, and looks for answers.

This may come as less of a surprise to readers than it does to me but I’m not nearly as functional as I imagined. Think of the classic fright-flick poster: blonde woman, eyes wide in terror, hands clasped to cheeks as she confronts some unimaginable (and to the viewer invisible) horror… that’s me most nights.

When I went public on my fear of the dark, writing “me too” in what may have been one of my least helpful responses to a troubled reader, a deluge of sufferers wrote to admit they were similarly afflicted. The letters weren’t just from those sensibly nervous when wandering an empty street after midnight, but full-on phobics like myself left paralysed with fear and virtually unable to sleep alone. Is it some form of mass hysteria or is the dark, as I’ve always believed, actually scary?

I can’t sleep in an isolated place without pills, earplugs and both my children in bed with me for fear of scary, feral characters with a hankering for the wilderness. In the city I wake bolt upright in the small hours convinced that intruders are marauding through our apartment despite Swiss bank-style security arrangements. Instead of delivering me into oblivion, too often exhaustion heralds hours of agitated wakefulness, initially kick-started by a creak in the floorboards or the rattle of a window pane.

A few months ago I vowed in this magazine to attempt hypnosis as a cure for these night fears and I return with the assurance that all my worst nightmares are in my head. Admittedly, that’s not much of a comfort.

To my relief, “fear of the dark” isn’t as irrational as it seems. According to the esteemed psychotherapist Phillip Hodson, to whom I turned for a more informed opinion, we needn’t feel foolish in our trepidation. “From tales of the Egyptian gods,” he says, “to all the most successful series on HBO, the shadows are employed to create an air of menace by relying on the vulnerability and lack of control we experience in darkness.”

He has a point when it comes to the way night-time is abused by film directors. A diet of movies where nothing good happens after the sun sets, from To Kill A Mockingbird to Batman to Friday the 13th, doesn’t help to nurture a healthy relationship with the small hours. Great terror maestros such as Hitchcock knew how to play on such fears and manipulate them into paroxysms of terror.

One of my few childhood memories is as an eight-year-old, refused permission to watch the Hitchcock season on Irish television, sneakily viewing The Birds though a crack in the living-room door. It transformed my hitherto perfectly enjoyable half-mile walk to school, down a country lane patrolled by watchful birds, into a terrifying ordeal.

The hypnotherapist I consulted, in my effort to understand what seems to me a shameful condition for a near-50-year-old, was more than a little curious about the “Grand Blanks”, as I’ve dubbed my early years. Mentally mislaying a vast chunk of your life doesn’t automatically qualify you for membership of the fear-of-the-dark brigade but it certainly seems to help.

I sat in a reclining leatherette armchair in Lulu Appleton’s Harley Street consulting room while she listened sympathetically to my symptoms. But instead of lulling me into a gentle hypnosis and convincing me that nightfall was as soft as it sounds, she wanted me to elaborate on my wiping-out of memories from eight to 16. Poking around in those dark recesses seemed to her, a firm believer in the curative powers of inner-child work, the obvious place to find more tangible demons.

- The Guardian