Vector-borne diseases

‘A single mosquito bite can make you sick’ (The Hindu:20180823)

https://www.thehindu.com/news/cities/Delhi/a-single-mosquito-bite-can-make-you-

sick/article24755764.ece

Given the burden of vector-borne diseases, WHO gives simple tips on how to stay safe

For Delhiites, the onset of monsoon brings with it an increase in cases of vector-borne

diseases like malaria, dengue and chikungunya. A single mosquito bite can give you any of

these vector-borne diseases, said the World Health Organization.

DAILY NEWS BULLETINLEADING HEALTH, POPULATION AND FAMILY WELFARE STORIES OF THE DayThursday 20180823

Of the 190 million cases of dengue reported worldwide, 96 million cases require treatment, it

said. India has seen 25% increase in cases of dengue reported each year, mainly attributed to

ineffective steps to prevent mosquito breeding.

Preventive measures

Understanding the burden of these diseases, the WHO’s South East Asia region office has

released simple tips on how to stay safe this season. These include installing window screens,

use insect repellents, getting rid of stagnant water, sleeping under an insecticide-treated bed

net and wearing light-coloured clothes that covers the limbs.

D. S. Chadha, director and head of department, Internal Medicine, Fortis, Vasant Kunj, said:

“Dengue results in high fever, rashes, severe headache, pain behind the eyes, muscle pain and

joint pain. Nausea, vomiting, and loss of appetite are also common.”

“A rash usually appears three to four days after the start of fever. Patient sometimes get

transient flushing on the face, with the glands in the neck and groin swelling up. Dengue

illness can last up to 10 days, but complete recovery can take as long as a month. There is no

specific treatment or vaccine for dengue. It is treated symptomatically. The principal aim is to

control temperature fluctuation, maintain hydration and provide relief from joint pain,” Dr.

Chadha said.

Speaking about people who are more susceptible to dengue Rajeev Gupta, senior consultant,

Fortis Hospital, Shalimar Bagh, explained that people who live in a high-risk zones — dingy,

unclean surroundings with stagnant water that encourages mosquito breeding — have an

increased incidence of vector-borne diseases.

“People with low immunity are also affected,” Dr. Gupta said.

Doctors added that people should seek medical help immediately if common symptoms

persist.

Pollution

PM2.5 is cutting life short by over a year, finds study (The Indian Express:20180823)

https://indianexpress.com/article/india/pm2-5-is-cutting-life-short-by-over-a-year-finds-

study/

In May, the WHO Global Ambient Air Quality Database for 2018, showed that India had 14

out of the 15 most polluted cities in the world in terms of PM2.5 concentrations.

In many countries in South Asia, especially India, the loss is more than 1.5-1.75 years

(Express Photo/File)

Average human life is about one year shorter because of PM2.5 ambient air pollution, with

lives shortened by 1.5-2 years in the most polluted Asian and African countries, a new study

that uses data from the Global Burden of Disease Project has found.

In many countries in South Asia, especially India, the loss is more than 1.5-1.75 years, with

the impact of air pollution on human lifespan in India being much larger than that of all

cancers combined, the study finds.

In May, the WHO Global Ambient Air Quality Database for 2018, showed that India had 14

out of the 15 most polluted cities in the world in terms of PM2.5 concentrations. Kanpur was

the worst at 173 micrograms per cubic metre (mg/m3), while Delhi was at 143 mg/m3.

Kanpur was followed by Faridabad (172), Varanasi (151), Gaya (149) and Patna (144). The

Central Pollution Control Board hasn’t released the annual average PM2.5 concentrations for

2017 so far.

The finding also notes the disproportionate effect air pollution has on the elderly. “Across

South Asia, the probability of surviving from age 60 to 85 would have been 20% higher if

PM2.5 exposure were removed as a mortality risk factor,” the study notes.

Titled ‘Ambient PM2.5 Reduces Global and Regional Life Expectancy’, the study published

in the Environmental Science and Technology Letters on Wednesday systematically

identifies how air pollution leads to shorter lives in each country.

It applies an actuarial standard life table method and combines it with data from the Global

Burden of Disease Project to estimate global and national reductions in life expectancy for

185 countries that can be attributed to ambient PM2.5.

“The life expectancy is based on a survival curve. We start by evaluating how a population

survives over time from birth onwards to estimate the baseline life expectancy. We then

consider a hypothetical scenario where air pollution is no longer a health risk. In that

scenario, the probability of surviving from each age to the next is incrementally higher than

in the baseline,” lead author Joshua S Apte from the University of Texas told The Indian

Express. “The difference between this hypothetical life expectancy and the baseline life

expectancy is what we interpret as the life expectancy impact of air pollution.”

Apte said this is more pronounced in “most polluted countries” like Bangladesh, Pakistan and

India, where people are losing more than 1.5 years from air pollution. “A year doesn’t sound

like a lot but considered across population, this is a truly immense loss of lives, which has

economic impacts as well,” he said.

“In addition to looking at outdoor PM2.5 air pollution, we looked at the combined effect of

all air pollution, including outdoor ozone pollution and indoor sources like cooking and

heating. Here, South Asia is in a particularly unfavourable position, since household air

pollution, and outdoor pollution are both major issues,” he said.

Apte said the results “clearly show how cleaner air can lead to longer lives. If India were to

meet the WHO air quality guidelines, the average Indian would live more than a year longer”.

“If there are more India-led studies of the health effects of air pollution, it will increase the

need for taking this problem seriously,” he said.

The study, however, is cautious while discussing improvements in life expectancy. “Mortality

for any risk factor will evolve over time as a result of demographic and epidemiological

transitions. Life expectancy is strongly dependent on age-specific death rates, which tend to

decrease over time in countries where general population health is improving,” it notes.

“Thus, the life expectancy benefit of PM2.5 reductions in many polluted lower-and middle-

income countries might be 20-40% lower than our core estimates if those countries also had

age-specific death rates that were typical of high-income economies,” it points out.

The study is co-authored by Apte along with Michael Brauer from the School of Population

and Public Health, University of British Columbia; Aaron J Cohen from the Health Effects

Institute in Boston; Majid Ezzati from the Centre for Environment and Health, Imperial

College London; and C Arden Pope from Brigham Young University in Utah.

Pollution (The Asian Age:20180823)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=11388508

Pollution (The Asian Age:20180823)

https://epaper.jagran.com/ePaperArticle/23-aug-2018-edition-Delhi-City-page_4-1398-9565-

4.html

Female hygiene

Health kits to check girls’ dropout (The Tribune:20180823)

https://www.tribuneindia.com/news/nation/health-kits-to-check-girls-dropout/641248.html

Rs 100 crore Sanctioned to provide kits

Rs 1,600Worth of each kit containing 13 items, besides menstrual pads

6 lakh Girls studying in govt-run institutions to get kits from Friday

Still in a nascent stage, Telangana has launched first of its kind initiative in the country in the

form of Balika Aarogya Raksha (Health and Hygiene) kits for school girls. Besides

promotion of hygiene, the scheme aims at curtailing the school dropout rate.

This is in sharp contrast to announcement of schemes to promote female hygiene by north

Indian states like Haryana and Punjab. To be kick-started on Friday, the project will be

completed by next weekend.

Nearly six lakh girl students studying in government-run educational institutions across the

state will get health kits, which will include, besides menstrual pads, 13 items for overall

grooming of the girls. Each kit worth Rs 1,600 will contain a bathing soap, toothpaste,

detergent, hair oil, shampoo, comb, etc. Chief Minister K Chandrashekhar Rao has

sanctioned Rs 100 crore for the purpose.

Deputy CM and Education Minister Kadiam Srihari said that the kits had already reached the

districts and the entire exercise would be completed within a week. He said the government

has set August 31 as the deadline.

The government has tied up with Baba Ramdev’s Patanjali, Dabur, Eyetex, etc., to supply

majority of the items. The kits will be given to all girls aged between 12 and 18 and studying

in government, general and residential schools (4,18,440 girls), Kasturba Gandhi Balika

Vidyalayas (80,999 girls), Model Schools (55,195 girls) and aided schools (26,695 girls). To

ensure hygiene among all, hand washing soaps will also be provided to boys. The entire cost

will be borne by the government.

In Haryana, the government has proposed to supply only sanitary napkins to girl students in

government schools at a cost of Re 1 till the age of 18. In Punjab too, the government has

allocated Rs 10 crore for providing free sanitary napkins to all girls from Class VI to XII in

government schools. In 2013, then Himachal Pradesh CM Virbhadra Singh had launched a

scheme called “Jagriti” with a budget of Rs 13 core. In contrast, Telangana has sanctioned Rs

100 crore for a more comprehensive scheme.

Dehydration (The Asian Age:20180823)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=11388801

Flu Vaccine (The Asian Age:20180823)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=11388813

Obesity (The Asian Age:20180823)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=11388809

Alcohol Consumption (The Asian Age:20180823)

http://onlineepaper.asianage.com/articledetailpage.aspx?id=11388808

Dementia

Better heart health may mean lower dementia risk in older people (Medical News

Today:20180823)

https://www.medicalnewstoday.com/articles/322842.php

Older adults with more ideal measures of cardiovascular health were less likely to develop

dementia and experience cognitive decline.

healthy greens and running shoes

Better measures of heart health protect older people from dementia.

This was the main finding of a recent study now published in JAMA that followed 6,626

people aged 65 and over in France for an average of 8.5 years.

It based the cardiovascular health measures on the American Heart Association (AHA)

"Simple 7" guide.

The guide recommends: giving up smoking; being physically active; having a diet rich in

vegetables, fruit, and fish; having a healthy weight; and managing blood pressure,

cholesterol, and blood sugar.

Lead study author Dr. Cecilia Samieri, from the Université de Bordeaux in France, and

colleagues explain in their study paper that few researchers have "investigated the combined

effect of these risk factors on the risk of dementia and cognitive aging."

Those that have, they observe, have tended to concentrate on the first four "lifestyle" factors

— namely, smoking status, physical activity, diet, and weight.

'Optimal levels' of cardiovascular health

The people examined in the research lived in Bordeaux, Dijon, and Montpellier, all in France.

None had dementia or a history of cardiovascular disease when they joined the study, which

began recruiting in 1999. Their average age was 73.7 years and 4,200 were women.

All of the participants took repeated tests of cognitive ability during the follow-up. In

addition, they underwent screening for dementia, and an independent panel of neurologists

confirmed any diagnoses.

How liver health impacts the risk of Alzheimer's

Scientists have linked Alzheimer's disease risk to low levels of substances produced in the

liver that help maintain brain cells.

At the start of the study, the scientists also assessed each individual according to how well

they matched the "optimal level" of each of the seven cardiovascular health measures.

They defined the optimal levels of these measures as:

never having smoked or having quit for at least 12 months

regular physical activity, such as walking at least 8 hours per week or 4 hours per week or

more of moderate-intensity sport or leisure activity

at least one daily portion of raw vegetables, fresh fruits, and cooked fruits or vegetables and

two or more servings per week of fish

a body mass index (BMI) under 25

total cholesterol under 200 milligrams per deciliter, untreated

blood pressure below 120/80 millimeters of mercury, untreated

fasting blood glucose under 100 milligrams per deciliter, untreated

At the start of the study, 36.5 percent of people were in the optimal level in 0–2 of the

measures, while 57.1 percent achieved optimal levels in 3–4 measures and 6.5 percent

achieved 5–7.

Over the follow-up, the panel diagnosed and confirmed 745 cases of dementia.

Brain and heart share risk factors

When they analyzed the results at the end of the study, the researchers revealed that having

more optimal levels of cardiovascular health measures was tied to a lower dementia risk and

cognitive decline rate.

They conclude that:

"These findings may support the promotion of cardiovascular health to prevent risk factors

associated with cognitive decline and dementia."

In discussing the study's limitations, the authors note that because it included mainly white

people living in urban settings, the results may not be typical of other groups.

Another limitation that they highlight is the fact that they did not consider changes to

individuals' cardiovascular measures over the period of the study.

In a linked editorial, Drs. Jeffrey L. Saver and Mary Cushman comment on these results and

those of another investigation, led by the University of Oxford in the United Kingdom,

published in the same issue of the journal.

The other study examined healthy young adults for any links between cardiovascular health

and measures of brain structure and function that were assessed using state-of-the-art imaging

technology.

Those results showed that good cardiovascular health — "already at this early age" — was

tied to signs of "more robust" blood circulation and less damage of white matter in the brain.

"Failure to attain optimal cardiovascular health," note Drs. Saver and Cushman, "appears to

subtly compromise the fundamental anatomic structure of the brain vascular system in

addition to its functional physiology and the integrity of the brain tissue it nourishes."

Breastfeeding

Foods to eat and avoid while breastfeeding (Medical News Today:20180823)

https://www.medicalnewstoday.com/articles/322844.php

What to eat while breastfeeding Foods to avoid Can some foods increase breast milk? Meal

strategies Summary

A healthful breastfeeding diet is essentially the same as a nutritious diet when not

breastfeeding. The main difference is that people who are breastfeeding need more calories.

When breastfeeding, a person requires around 450 to 500 extra calories per day. People who

wish to lose weight after pregnancy may not need to increase their calorie intake while

breastfeeding, but they should discuss this with their doctor.

Specific nutrients, such as iron, calcium, potassium, and vitamins A and D, are particularly

beneficial when breastfeeding. Eating a wide variety of foods is also essential, as this will

expose the baby to different tastes and may result in them being more receptive to solid foods

later on.

In this article, we look at the foods that experts advise people to eat or avoid while

breastfeeding. We also provide information on supplements and strategies for preparing

nutritious meals.

What to eat while breastfeeding

No single diet will be ideal for everyone who is breastfeeding. The goal should be to eat a

healthful, varied diet. When breastfeeding, aim to include the following foods in each day's

meals:

Fruits

Woman eating bowl of grapefruit in lap.

Grapefruits and oranges are good souces of essential nutrients.

Fruits are a rich source of many nutrients. They may also help relieve constipation, which

some people experience after giving birth. Aim for about 2 cups of fruit per day, which

should include a wide variety of different fruits.

The United States Department of Agriculture (USDA) recommend the following fruits as

these are all excellent sources of potassium, and some also contain vitamin A:

cantaloupe

honeydew melon

bananas

mangoes

apricots

prunes

oranges

red or pink grapefruit

Vegetables

People who are exclusively breastfeeding should aim to eat 3 cups of vegetables a day. Those

who are combining breastfeeding with formula-feeding should eat 2.5 cups of vegetables

each day.

Vegetables are rich in vitamins and antioxidants. Consuming a sufficient quantity will help

the body to replenish the nutrients it needs to make milk.

The USDA recommend the following vegetables due to their potassium and vitamin A

content:

spinach

cooked greens, such as kale and collards

carrots

sweet potatoes

pumpkin

tomatoes

red sweet peppers

Grains

Grains offer vital nutrients, especially whole grains, such as brown rice and whole-wheat

bread. People should aim to eat 8 ounces (oz) a day if they are exclusively breastfeeding, or 6

oz if they are also formula-feeding.

Some grains, such as quinoa, are also high in protein, which is an essential nutrient to eat

when breastfeeding.

Fortified cereals provide added nutrients and are also a good option. It is best to stick to

whole-grain cereals that do not contain added sugar.

Protein

When breastfeeding, the body requires an extra 25 grams (g) of protein per day and at least

65 g per day in total.

Experts recommend including some protein with every meal.

The USDA recommend the following sources of protein:

beans and peas

nuts and seeds

lean beef, pork, and lamb

oysters, crab, and mussels

salmon, herring, pollock, sardines, and trout

Seafood is rich in omega-3 fatty acids, which can support healthy brain development in the

baby. Salmon, sardines, and trout are excellent choices because they are high in omega-3s but

low in mercury.

People who are breastfeeding should avoid other fish, such as albacore tuna, swordfish,

shark, and king mackerel, which are high in mercury. Other forms of tuna are safe to eat.

Dairy

Both pregnancy and breastfeeding can leach calcium from the bones. This puts people at risk

of osteoporosis if they do not get enough calcium and vitamin D. Dairy products, such as

cheese and milk, are excellent sources of calcium, and many have added vitamin D.

People who are breastfeeding should aim for a minimum of 3 cups of dairy products each

day. The following are good sources of vitamin D and calcium:

milk

yogurt

natural cheese

People who do not eat dairy can also get calcium from dark leafy greens, beans, and fortified

orange juice. The National Academy of Sciences recommend that people who are

breastfeeding should consume 1,000 milligrams (mg) of calcium a day.

The sun is a primary source of vitamin D, but consuming mushrooms and oily fish can

increase intake. Supplements may also be beneficial.

Nutritional supplements

oil supplement capsules spilling from pot.

A doctor can offer advice about taking nutritional supplements while breastfeeding.

In most cases, a well-balanced diet should provide all the nutrients that a person who is

breastfeeding needs.

However, nutritional demands increase when breastfeeding, so some people may need

vitamin and mineral supplements.

It is important to note that supplements cannot replace a healthful diet. People who are

breastfeeding should speak with their doctor before taking any herbal or dietary supplements.

People who have dietary restrictions or follow a vegan or vegetarian lifestyle should also be

mindful of certain vitamins and minerals that may be missing from their diet. Anyone who is

concerned about meeting all of their nutritional needs should speak to a dietician.

Other diet tips

Many people worry that they have to measure food portions, or that missing a few nutrients

will affect their ability to make enough milk. However, people all around the world are able

to produce milk with a wide variety of diets. The goal should be a well-rounded diet, not a

perfect one.

It is crucial to drink plenty of water, especially in the first few weeks after the birth when

some people are so overwhelmed and distracted that they forget to drink. The need for fluid

also increases when breastfeeding.

Not drinking enough fluids can lead to dehydration and may even affect milk supply.

People who are breastfeeding can remind themselves to drink by keeping a bottle of water in

each room in the house. They should also have a water cup within easy reach of the place

they tend to breastfeed.

The USDA's "MyPlate Plan for Moms" provides information on the best types and amounts

of food for people who are breastfeeding. It is possible to personalize the plan according to

age, height, weight, activity levels, and breastfeeding status.

Foods to avoid

The list of foods that a person should avoid during pregnancy is long. This may be why some

people believe that they must also eat a restrictive diet when breastfeeding.

In fact, there is no list of foods that people who are breastfeeding should avoid altogether.

Instead, they should eat food that is healthful and pay attention to cues from their body.

Breast milk comes from nutrients that pass into the blood. Many of the potentially dangerous

ingredients that could cross the placenta during pregnancy do not get to the breastfeeding

baby.

Some tips that can support healthful eating include:

Limiting consumption of seafood that may contain mercury.

Paying attention to how caffeine affects the baby. When a person who is breastfeeding drinks

coffee, the baby will only get a very tiny dose of caffeine in the breast milk, but this could be

enough to affect their sleep.

Monitoring how the baby reacts to the diet, and making changes according to the needs of

both the baby and the person who is breastfeeding.

Some experts warn against so-called gassy foods, such as cruciferous vegetables, but most

babies are unaffected by these foods. Likewise, there is no reason to avoid spicy or strong-

flavored foods unless the baby reacts negatively to them.

Medical authorities and parenting guides often provide mixed or unclear advice regarding

alcohol consumption when breastfeeding.

Alcohol is dangerous during pregnancy because it crosses the placenta, but a breastfeeding

baby only gets the amount of alcohol that passes into the blood of the person breastfeeding.

In other words, the blood alcohol content of the person breastfeeding is the amount of alcohol

that reaches a breastfeeding baby.

With moderate consumption, this amount of alcohol is negligible and unlikely to cause harm.

The Centers for Disease Control and Prevention (CDC) recommend no more than one drink

per day. They also suggest reducing the risk further by waiting at least 2 hours to breastfeed

after drinking alcohol.

Nine tips for weaning an infant onto solids

Weaning a baby onto solids can be difficult. Learn nine tips for adjusting to a new feeding

routine.

Can some foods increase breast milk?

The body of research on foods that increase breast milk supply is scant and mixed. Some

anecdotal evidence suggests that, for some people, the following foods may support a higher

production of milk:

fenugreek seed

goat's rue

oatmeal

Trying these remedies is safe. However, people wanting to use proven milk production

strategies can try:

Breastfeeding on demand. If the baby is also getting solids or formula, pump when the baby

gets these foods. The production of breast milk occurs according to need, which means that

supply decreases when demand does.

Pumping after each breastfeeding session. This technique raises supply by increasing demand

and can provide additional milk.

Trying "hands-on pumping." Massage the breasts before pumping. After pumping, massage

the breasts and then pump again. People should aim to pump eight or more times over 24

hours.

Meal strategies

Banana smoothie

Smoothies are easy to prepare and nutritionally dense.

The first weeks of breastfeeding can be demanding. People have to contend with recovering

from birth, lack of sleep, and the emotional demands of caring for a newborn. For many, the

most challenging part of eating a healthful meal is finding the time and energy to prepare

food.

Enlisting the assistance of a partner is a great way to share the burden. One partner can pump

or breastfeed while the other prepares food.

If a supportive partner is not available, a few easy-to-prepare meals can ensure adequate

nutrition. The following meal strategies could help:

Consuming a morning smoothie to load up on fruits and vegetables. Try blending frozen

berries, a banana, and an avocado. Add more protein by adding a container of Greek yogurt.

Preparing instant oatmeal as a filling, fiber-rich snack that may support a healthy milk supply.

To add more calories and increase protein content, use milk or yogurt instead of water.

Snacking on nuts during the day. Try placing a can of nuts in a favorite breastfeeding spot.

Buying pre-cut cheeses. These snacks are high in protein and very filling.

Considering enrolling in a ready-meal service, or asking people to bring meals around a few

times a week. Freeze any leftovers to thaw for a quick snack.

Summary

Breastfeeding can be a challenge, especially during the first weeks. Many new parents and

caregivers feel so overwhelmed that they forget to eat. Others may worry that taking time for

themselves means taking time away from the baby.

The health of a baby often depends on the well-being of its caregivers. Self-care is a way for

caregivers to ensure that they have enough energy and emotional resources to care for the

baby.

Proper nutrition is crucial both for babies and for people who are breastfeeding. Listen to the

body, and eat what feels right.

Diabetes

What's the link between vitamin D, gum health, and diabetes? (Medical News

Today:20180823)

https://www.medicalnewstoday.com/articles/322830.php

A new paper draws interesting links between gum infections, a reduced level of vitamin D,

and diabetes. This marks the first time that the joint effects of periodontitis and vitamin D

deficiency on diabetes have been examined.

False teeth

Gum disease, diabetes, and vitamin D share deep links.

Diabetes, as many people realize, is a growing problem in the United States and globally.

In 2015, almost 1 in 10 adults were estimated to have diabetes. There are about 1.5 million

new diagnoses each year in the U.S.

While there are certain well-known risk factors for diabetes, such as obesity and high blood

pressure, there is still more to learn.

Diabetes is complex and involves multiple systems.

Uncovering the full range of potential risk factors could help prevent diabetes from occurring

in some individuals and help others manage symptoms more effectively.

Recently, a team at the University of Toronto in Canada investigated the potential influence

of vitamin D deficiency and periodontitis, a gum infection.

Diabetes and periodontitis

They chose to look at gum disease because earlier studies had shown that diabetes increases

the risk of periodontitis, which is a bacterially induced inflammatory disease that can damage

soft tissue and bone.

This relationship is bidirectional, meaning that periodontitis also makes management of type

2 diabetes more challenging.

Could vitamin D help to fight diabetes?

A recent study asks whether vitamin D might provide a new route to diabetes treatment.

Lead study author Aleksandra Zuk explains why vitamin D was also of interest to the

researchers.

"We know that vitamin D is not only helpful for bone health," she notes, "but is also shown

to have antimicrobial and anti-inflammatory effects. Sufficient vitamin D levels can

potentially decrease inflammation and affect oral microbes related to gum disease."

Aside from vitamin D's role in fighting infections and reducing inflammation, some research

has shown that vitamin D receptors are directly associated with periodontitis.

Analyzing the interaction

To delve into the web of connections, the scientists took information from the 2009–2010

National Health and Nutrition Examination Survey.

The sample included data from 1,631 people with type 2 diabetes and 1,369 without. All

participants were over 30 years old, and each individual underwent a dental exam and was

assessed for vitamin D levels and measures of fasting glucose and insulin.

The researchers' intriguing results have now been published in BMJ Open Diabetes Research

& Care. Following their analysis, the authors concluded:

"Consistently, the joint effects of vitamin D-3 insufficiency and total vitamin D insufficiency

with periodontitis were significantly associated with diabetes."

The data showed that, separately, periodontitis and vitamin D deficiency increased the risk of

type 2 diabetes. The authors also discovered that when the two factors were combined, the

risk was "greater than the sum of the individual effects."

Because around half of U.S. adults have gum disease and over 40 percent are vitamin D

deficient, the study's conclusions could be incredibly important.

More work is needed to confirm the results and dig a little deeper into the mechanisms

involved. This study is the first to examine the joint effects of periodontitis and vitamin D

insufficiency on diabetes.

If the findings are replicated, it could offer a new way to approach diabetes in some cases.

For instance, for adults with type 2 diabetes and periodontitis, increasing vitamin D levels to

the suggested levels could help them manage their condition.

As Zuk says, "Because it's the first study, we really need to look at these two exposures again

in other studies and populations. It might impact further diabetes research."

Cancer

How to create and destroy metastatic cancer cells (Medical News Today":20180823)

https://www.medicalnewstoday.com/articles/322823.php

A new study has identified a way to interfere with cancer cells and prevent them from

metastasizing. The key lies in shutting down the cell's ability to take out the trash.

Cancer cells metastasis

Cancer cells' ability to divide and move around the body makes them difficult to find and

destroy.

One of the most challenging aspects of cancer is its ability to metastasize.

Cancer cells can break away from their current position, travel through the body, and begin

multiplying in new, distant locations.

Metastasis makes tumors difficult to find and to treat. Since metastasis is such a pivotal area

of cancer research, scientists put a great deal of work into understanding how cancer does it.

A recent study, carried out by Michael J. Morgan, Ph.D., at the University of Colorado

Cancer Center in Aurora, adds new detail to an already complex picture. The findings are

published in the Proceedings of the National Academy of Sciences.

The scientists were particularly interested in cellular garbage disposal. Morgan explains why

this is, saying, "Highly metastatic cells leave their happy home and have all these stresses on

them. One way that the cell is able to deal with stresses is through disposing of cellular

wastes or damaged cell components and recycling them."

If one interferes with this recycling process, metastasis can be blocked.

"When we turn off the activity of cellular structures called lysosomes," says Morgan, "which

a cell uses to do this recycling, the metastatic cells become unable to survive these stresses."

Important in this recycling is autophagy, a natural process wherein the cell breaks down and

recycles faulty parts of the cell.

Morgan and Andrew Thorburn — who helped with the recent research — are both considered

experts on the topic of autophagy. Also involved was Dr. Dan Theodorescu, an expert in

metastasis.

The process of autophagy

Autophagy is essential for the survival of healthy cells and malignant cells alike. In basic

terms, autophagy begins when cellular "rubbish" is surrounded by a spherical structure called

an autophagosome.

This double-membraned structure carries the rubbish through the cytoplasm until it reaches a

package of destructive enzymes known as a lysosome. The autophagosome fuses with the

lysosome and the contents are destroyed.

Cell death: Is our health at risk?

Cell death is essential for normal function, but it can have side effects, and if it malfunctions,

our health is at stake.

By tinkering with this process, Morgan and team uncovered ways to interfere with a

cancerous cell's ability to metastasize.

"What was surprising," says Morgan, "was that it was not the process of autophagy itself that

was specifically important for the metastatic cell. If you inhibit autophagy at an early stage,

you can reduce the cell growth of both metastatic and non-metastatic cells."

"But if you block the lysosome function of late-stage autophagy, it hits these metastatic cells

a lot harder, and they actually die."

Michael J. Morgan, Ph.D.

In other words, when the team blocked autophagy by genetically switching it off, both

metastatic and non-metastatic cells suffered. However, when they inhibited autophagy and

lysosomes with the drug chloroquine, non-metastatic cells were slowed down a little, but

metastatic cells were completely destroyed.

"There was something about lysosomes that was specific to these metastatic cells," says

Thorburn.

Why are lysosomes so important?

Next, the scientists wanted to drill down and understand exactly why lysosomes are so

incredibly important to metastasizing cancer cells. To do this, they developed chloroquine-

resistant cells.

This involved growing metastatic cells alongside small quantities of chloroquine. Most of the

cells died, but those that survived were kept and grown again with chloroquine. As they

divided many times, each successive generation became increasingly resistant to chloroquine.

However, as the cells steadily became resistant, they lost their ability to metastasize.

As Morgan explains, "The door swings both directions: when we selected for cells that

resisted chloroquine, they became non-metastatic. And when we selected for cells that were

metastatic, they gained sensitivity to chloroquine. They stopped growing and they died

because, all of a sudden, they came to depend on the lysosomal action that chloroquine takes

away."

This finding may be useful in the treatment of cancer. Theodorescu gives an example, saying,

"With a patient, if they had a bladder cancer tumor and we gave chloroquine, let's suppose

that some cancer cells became resistant to chloroquine."

"We would predict, based on our study, even if the resistant cells start to grow again, they

wouldn't be metastatic anymore. This may have clinical benefit for the patient."

Lastly, the researchers found that a protein called ID4 seems important in this process. Cells

with lower levels of ID4 were sensitive to chloroquine and metastatic; those with higher

levels of ID4 were less metastatic and chloroquine-resistant.

It is possible that ID4 could be used as a marker to predict patient outcomes. In fact, higher

levels of ID4 are already known to predict better outcomes for bladder, breast, and prostate

cancer.

Currently, there is a great deal of interest in autophagy inhibitors for use in cancer treatment;

this study provides an interesting insight, and will no doubt inspire further investigation.

Testing of Antibiotics (Dainik Jagran:20180823)

https://epaper.jagran.com/ePaperArticle/23-aug-2018-edition-Delhi-City-page_13-1383-

7827-4.html

Healthcare (Dainik Jagran:20180823)

https://epaper.jagran.com/ePaperArticle/23-aug-2018-edition-Delhi-City-page_20-1293-

2790-4.html

Hereditary Disease (Hindustan:20180823)

http://epaper.livehindustan.com/imageview_167307_97273672_4_1_23-08-

2018_i_4.pagezoomsinwindows.php

Genetic Screening (Navbharat Times:20180823)

http://epaper.navbharattimes.com/details/786-65811-1.html

Stomach Pain (Hindustan:20180823)

http://epaper.livehindustan.com/imageview_167323_98207948_4_1_23-08-

2018_i_20.pagezoomsinwindows.php