Tuesday, January 27, 2015

Losing weight through daily injection! A new therapy being commercialized

Losing weight is a multibillion dollar business in western countries and there  are many specially designed foods and dietary regimes offered in the market place to help overweight and obese people to trim down. In-house treatment of obese people in specialty centers is also becoming popular though they are called by the romantic name "Wellness Centers". While those with BMI figures slightly higher than normal limits can manage with minor adjustments in the diet and better eating discipline, it is those who score BMI values beyond 30 who need special attention. Extreme measures like Bariatric surgery and other interventionist procedures are increasingly being resorted to by desperate patients to get relief from the dangerous outcome of uncontrolled weight gain. Recently even an implantation procedure to interfere with the hunger signals from the brain through the vagus nerves in the stomach has been cleared for application in highly obese people.  Against this backdrop comes the news that the EU has cleared a new therapy using daily injections that will help people to reduce their food consumption at least by 10% and shed excess weights with assured results. Here is a take on this new development.

"A treatment of injections that can help people lose a stone more than they normally would by dieting or exercising more has been approved by health watchdogs. Liraglutide, which has been described by doctors as life-changing, could be available on prescription in months. Slimmers typically lose almost a stone more than they would by simply watching how many calories they consume and doing more exercise. Trials showed that some severely obese patients lost so much weight they were able to abandon their wheelchairs and walk normally for the first time in years. Liraglutide also lowers blood pressure, raises good cholesterol and prevents diabetes. According to its makers, Novo Nordisk of Denmark, the drug even produces a 'feel-good factor', making dieting a pleasure. But some experts have already warned it does not provide a long-term solution to the growing problem of obesity in Britain. Novo Nordisk will apply for it to be prescribed on the NHS after Friday's ruling by the European drugs regulator that it is safe and effective. There are fears however that Nice – Britain's drugs rationing body – will judge it too expensive for routine use on the NHS. Liraglutide costs from £2.25 a day, which is roughly double the price of Orlistat, the only other prescription diet drug. Patients inject the drug into their stomach before breakfast every day. It works by suppressing appetite. Liraglutide, which will be given the brand name Saxenda, is already used at a lower dose to treat diabetes. It is based on a hormone found in the gut and sends signals to the brain that trick it into feeling full. As a result, people eat 10 per cent less food than normal. Trials of Liraglutide found that men and women who injected themselves daily lost an average of 19lb in 12 months. This is almost a stone more than they would lose by being on a diet and increasing the amount they exercise. Furthermore one third or those who took part in the trials shed 23lb – more than a stone and a half. For a 14 stone woman that kind of weight loss would usually mean dropping two dress sizes. The drug which, like insulin, comes in an injectable pen, also has such a significant effect on blood pressure that patients can dispense with the drugs they use to keep it under control. Like Orlistat, its prescription is likely to be limited to those who are obese or who are overweight and have another health problem such as high blood pressure."

The fact that this drug is already in use to treat diabetics is a plus factor as there may not be any serious side effects. Also encouraging is the fact that Novo Nordisk of Denmark, a reputed international firm has developed this therapy adds further confidence in the product. As a bonus it seems patients using this drug had also lower blood pressure and higher HDL values.besides preventing on-set of diabetes. Of course there is this uncomfortable feeling when patients have to administer this injection in the stomach before breakfast. The innovators have cautioned that the new drug is not for use by healthy individuals for indulging in gluttony but for obese patients who have difficulties in moving and doing their daily chores.


Monday, January 26, 2015

"Let thy food be thy medicine!---"- How true it is!

Though Socrates said 2000 years ago that "let thy food be thy medicine", the modern world does not want to have any thing to do with this famous "truth". How else we can explain the reckless living style people have adopted depending increasingly on a plethora of drugs churned out by the pharma industry for treating, ironically, the diseases caused by over eating, imbalanced eating and irregular eating? The recent report that the American population, about one third of them being obese, does not suffer from want of calories but is severely "malnourished" is indeed a shocking revelation. According to many health pundits if people are educated early enough the close linkage between food and health and if balanced foods are consumed regularly almost all diseases now raging in that country due to bad foods would not have been there! There is a strong view that it is time to think differently when it comes to dealing with the life style disorders which are eating into the vitals of American society and through better food and balanced diet only any future catastrophe can be avoided. Here is a commentary on this issue as put forward by one of the reputed surgeons who has a close ring side view about the health scenario unfolding in that country. 

"The number of people who are malnourished despite being obese is scandalous, a leading weight loss surgeon has said today. A recent study showed despite high levels of obesity in the U.S., many people are undernourished.  A diet of pizza, fries, crisps, pasta, rice, biscuits, cakes leaves many people consuming a lot of calories but few nutrients, says Dr Sally Norton, an NHS consultant specialising in weight loss and upper gastrointestinal surgery. The problem is exacerbated by coffee shops serving sugary and fatty drinks appearing in hospital foyers and junior doctors being given minimal training on nutrition. Drug companies push the sales of expensive drugs which treat the symptoms of the disease but not the cause, she says.Instead we should treat disease with nutrition, letting food be our medicine".

It is a tragedy of Himalayan proportion that the food environment in this so called "most powerful" country in the world is so vitiated that people are behaving like zombies rushing to wards food service joints serving most unhealthy foods offered by the latter rich in sugar, saturated fat, salt, carbohydrates and practically free from that vital food component, viz dietary fiber so necessary for maintaining good health. Modern generation has no clue regarding the advantages of whole cereals, unrefined flours, fruits, vegetables and other health protecting food materials. Blaming food industry.for churning out unhealthy foods will not take the country far, unless citizens assume more responsibility for their own health through scientific and rational food selection. The golden words of Socrates that "thy food is thy medicine" should be the "national icon" for the US for the next one decade if the current trend of over eating and wrong eating practices are to be reversed.


Saturday, January 24, 2015

Heritable microbiome? New findings with some hope for overcoming life style diseases

Can any one believe that microbes can be inherited by children from their parents and the vulnerability of the off springs to major diseases like CVD, Diabetes and obesity is determined by the bacterial species inherited? Such a hypothesis is being put forward by a group of scientists working together from the UK and the US. The study further claims that lean individuals with least susceptibility to put on weight have a family of bacteria that may hold key to solving the obesity epidemic confronting the world. They have been able to confirm their hypothesis through animal experiments using these specific bacterial cultures and would be looking for a pro-biotic therapy approach to treat obesity related diseases. Here is a take on this unbelievable claim which if proved correct may open up an entirely new therapy giving hope to millions of obesity affected people across the world.

A new study has determined that not only are bacteria naturally found in the gut involved in obesity, diabetes, and cardiovascular disease, but they are genetically inherited. Researchers at King's College London and Cornell University identified a highly-heritable bacterial family that is more common in individuals with low body weight and that could pave the way for genetics-based personalized probiotic therapies for obesity-related diseases. The study examined 1,081 fecal samples taken from 977 people – 171 pairs of identical twins and 245 pairs of non-identical twins, plus 145 other, individual twins. Microbes from a bacterial family called Christensenellaceae, and to a lesser extent other specific microbe populations, were significantly more similar in the identical twins than non-identical twins, suggesting a strong genetic (and thus hereditary) influence in gut microbe composition. The study suggests that altering the Christensenellaceae population may have a direct impact on susceptibility to obesity, as mice treated with the microbe gained less weight than untreated mice. The researchers believe that similar personalized microbe treatments in humans could be a promising new aid in the fight against obesity – both in terms of prevention and reduction.

Whether the word "inherited" can be used here is some what questionable because bacterial cells are not considered transferable to the child while in the womb. Usually the new born child develops its microbiome during the early days of breast feeding by the mother and during suckling only surface bacteria can be transferred through the oral route. The gut bacteria which is a part of the gastrointestinal system of the mother may have no easy route to the GI of the child though many organisms in the gut are also present in other parts of mother's body. Whether such passage of microbiome from mother to the off spring is determined by the genes of the mother inherited by the baby is not clear. Another confusing picture is that the gut microbiome is influenced very much by the diet and its profile rapidly changes depending on the food consumed. Probably further research may bring out how mother's gut bacteria is transmitted to the baby to develop the "weight" control faculty of the mother in the child.


Friday, January 23, 2015

Food safety infringement-Who will go to jail?

If a food sample is found to be below the standards prescribed or is not safe as per the laid down criteria, who is to be blamed? The retailer, wholesaler, distributor, the warehouse owner or the manufacturer. It is true that the onus of proof regarding food safety and quality squarely lies with the manufacturing company. Unfortunately if the company is in the public sector, cooperative sector, small scale sector or corporate sector how can the government prosecute a company? Of course government can cancel the license or impose heavy fines but if the crime is serious some one has to go to the jail after due judicial decision to that effect. Who will go to the jail? Each manufacturer is supposed to designate one person as the "fall guy" for going to jail if there is an indictment under the food safety law. Is this fair? Probably such issues are not peculiar to India as reflected by the recent debate in a country like the US regarding the rationale of sending one person to jail for the fault of the system. Read further below:

One high profile case was the prosecution of Eric and Ryan Jensen in Colorado. This case is particularly scary because federal prosecutors used the Park Doctrine to prosecute the Jensens. The Park Doctrine creates strict liability. It provides that a responsible corporate official can be held liable for a first time misdemeanor.  (and possible subsequent felony) without proof that the corporate official acted with intent or even negligence, and even if such corporate official did not have any actual knowledge of, or participation in, the specific offense. It means executives may be held criminally responsible for the short-cuts, negligence, wrong-doings of their employees, simply because they "should have" known or supervised or simply because they were in a position of authority over employees or organization that committed wrongdoing. Executives can no longer insulate themselves from prosecution simply because they aren't in the trenches. This can be a daunting proposition for executives of large corporations that are managing hundreds or thousands of employees and have the inability to monitor everyone and everything at all times.   The Jensens were the primary principals in a farming operation known as Jensen Farms in Granada, Colorado.  Jensen Farms supplied cantaloupe to the likes of Walmart and Kroger. The Jensens were tasked with, among other things, operating a conveyor system that cleaned and packaged cantaloupe from the farm.  In or around May 2011, the Jensens revamped the conveyor system that cleaned the cantaloupe. The new conveyor system was never outfitted with the chlorine spray function, which would have reduced the risk of microbial contamination of fruit.  Starting in or about July 2011, Jensen Farms sent out cantaloupe contaminated with listeria that the Government alleges and the Jensens conceded killed at least 33 individuals and caused illnesses in at least 147 people.  The Jensens pled guilty to misdemeanors and were sentenced to a five year probation terms with six months home detention. The prosecution of Eric and Ryan Jensen is significant because there was absolutely no evidence that the Jensens knew the cantaloupe was adulterated before it was sent out into commerce. Instead, all the Government could show is that the Jensens should have been aware that the cantaloupes could be contaminated because the chlorine spray was not used." 

In India a deputy manager of a large cooperative dairy was sentenced for imprisoned for 6 months in May 2014 after one of the samples supplied from his unit was not found to conform to mandatory specifications. One can only sympathize with this official because the punishment is for a lapse on the part of the production system staffed with many workers at different levels. In a manufacturing facility hundreds of workers might be working and the management system could be several tier deep and how can one particular individual be held responsible for the collective failure? After all the employees are paid to work under certain well laid down guidelines and disciplined way but does the pay include the risk involved in going to jail for faulty products from the production line? What is the responsibility of the top management or the owners of the factory when such incidences take place? As they are the beneficiary when it comes to profit taking, logically they should be the one who should go to jail. The government must separate organizations and individuals when it comes to food laws infringement. While individuals who are proved to be adulterating the food callously ignoring the health dangers of the consumer could be punished by imprisonment, organizations must be monetarily punished to the maximum extent possible which can hit them where it hurts. The impact of jailing can have long term implications as less and less persons will opt for training in food technology because of such a "Damocles sword" hanging over their career!


Thursday, January 22, 2015

Food subsidies in India-New suggestions to make them more rationale

The so called Food Security Act is an anachronism as it was based on a populist policy with the sole aim of collecting votes during election time from an electorate thought to be obliged to the political party that piloted the bill. The then government forgot that it was pledging future earnings of the country in perpetuating this dole out year after year working out to more than 1 lakh crore rupees an year! Revisiting this Act by the new government raised some hope that the senseless commitment of future generations to sustain the program might turn out to be a millstone around the neck of the nation. The Shantakumat committee set up to review the Act has submitted its recommendations recently wasting minimum time as is usually the case with government set up commissions. A perusal of the report gives hope that there would be drastic revision of the Act soon if government is serious about its intentions. A gist of the report is reproduced below which gives an insight into the thoughts of the experts who did a commendable job in record time. 

The government should reduce coverage under the National Food Security Act (NFSA) to 40% of the population from 67% and defer implementation of the scheme in states which have not complied with the rollout conditions, a panel appointed by Prime Minister Narendra Modi has recommended. The panel headed by former food minister Shanta Kumar submitted the report to the PM on Wednesday. Reforming the subsidy regime is a key plan of Modi's economic reforms. It has recommended far reaching changes in the functioning of the state-run Food Corporation of India (FCI) and the minimum support price (MSP) regime. It has suggested that the food grain under NFSA for those under the below poverty line should be raised to 7kg per person from the current norm of 5 kg. It has also called for moving to a direct cast transfer regime for food subsidy and estimates that the savings on food subsidy could be as much as Rs 30,000 crore per year. "Move to cash transfer and start with 53 million-plus cities. The states which are deficit in grains should be given the option of either grain or cash," said a source. The panel has also suggested that fertilizer subsidy should be paid to farmers directly on per hectare basis which comes to around Rs 7,000 per hectare. "This will result in saving nearly Rs 10,000 to Rs 15,000 crore annually in fertilizer subsidy," the source said. There should be a liquidation policy which will kick in immediately when the stocks go beyond the buffer stock limit. At present, FCI sells in open market or exports after approval cabinet which some experts say raises its carrying cost. "FCI should get a free hand," the source said. The panel has recommended that the name of FCI be changed. "The new of FCI will be akin to an Agency for Innovations in Food Management System with a primary focus to create competition in every segment of food grain supply chain, some procurement to stocking to movement and finally distribution in public distribution system so that the overall costs of the system are substantially reduced, leakages plugged and it serves large no of consumers and farmers," the source said. The panel has said that FCI should move its procurement move to eastern states. "If any state is giving bonus, the payment for the extra procurement should be borne by that state and not FCI," the source said. It has also suggested that there should be an upper limit on taxes imposed by states for procurement. For example, Punjab has 14.5% tax while Gujarat has less than 2%. "The upper limit should be 4%," the source said. The FCI should revamp its grain handling and stocking operations, the committee has recommended. It should move to bulk handling and mechanize the operations to reduce its dependence on so called "labour gangs." Temporary storage should be done away with gradually with no grain stock remaining for more than three months. The agency should run "grain trains" for moving food grains. The stocking operations should be handed over to the Central Warehousing Corporation, state warehousing corporations. The private sector should also be encouraged to build silos. All existing silos of FCI should be revamped, the panel has recommended. The country needs 10 million tones capacity of storage."Government needs to revisit its MSP policy. Currently, MSPs are announced for 23 commodities, but effectively price support operates primarily in what and rice and that too in selected states," the source said.

Suggestions like reducing the coverage to include only deserving population, reforming Food Corporation of India, reducing taxes on grains, moving to cash transfer mode for delivery, increasing the quantum receivable by a person by 40%, revising the norms for distribution of fertilizer subsidy to farmers, changing the minimum support price system etc will have far reaching benefits if implemented sincerely. There is one area where the Panel did not seem to have bestowed its attention and that pertains to integrating food security with nutrition security. Instead of a cereal only policy under NFSA, probably pulses at least could have been included in the benefit basket. The Andhra Pradesh model implemented recently under a new scheme provides 9 commodities including pulses, oil, salt etc though the coverage is comparatively small targeting certain poor segments of the population. Probably as a socially responsible country India must aim to improve the nutritional status of the poor people through supply of such a balanced food basket. 


Wednesday, January 21, 2015

Water needs-Food industry Vs Agriculture, opposing pressures!

Soda which is the international name given to sweetened fizz drinks like Coke and Pepsi is gain in troubled 'waters"; literally! These beverages are focus of attention from health critics as well as conservationists who blame the bottlers for over utilization of water and environmental pollution through the sludge they let out. Farmers are agitating wherever the soda plants are located because of their fear that such massive extraction of ground water causes water shortage affecting their livelihood. Interestingly the two soda giants are also courting controversy in their own country, USA because of the widely held perception that their products sweetened with sugar cause many health disorders including obesity. Because of their vice-like grip on the political class that rule the country, they are never restrained from hawking their "potion", especially to young kids. In India the Delhi Government has laid red carpet for foreign investors in the hope that their investments will generate significant employment in the country. Unfortunately the impact of this open arm policy on the common man is never kept in mind when such FDI proposals are cleared. The Coke bottling plant to be set up in Gujarat is in the news recently because of the reckless policy of the state government in allotting huge volume of water from Narmada river which is supposed to be meant for agriculture sector. Here are the details of the drama unfolding in that state and the common man is just a mute spectator on the sidelines unable to do any thing to stop this loot of public water resources.

"Soft drinks giant Coca-Cola is finding itself in troubled waters, again. After rows over water usage at its plants in Kerala and Uttar Pradesh, it is now the turn of its Gujarat factory.Congress leader Ahmed Patel has questioned the Gujarat government's decision to allot to a Coca-Cola plant over three million litres of water a day from the Sardar Sarovar Dam, even as many villages in Sanand go without water.In a letter to Chief Minister Anandiben Patel on October 10, Patel expressed concern over her government's September decision and noted that the dam had been built to provide water to drought-prone parts of North Gujarat, Saurashtra and Kutch. Patel highlighted concerns raised by non-government organisations and citizens' groups over the alleged daily effluent discharge of 450 kilolitres by the plant, which executives of the multinational beverage company said were baseless because the unit was located in a no-effluent industrial cluster. Coca-Cola India executives did not want to get drawn into the controversy. They said the company had taken all approvals for the plant and any response to Patel's letter should come from the Gujarat chief minister, to whom it was addressed. The plant, being set up by Hindustan Coca-Cola Beverages, the largest bottling partner of Coca-Cola India, will be the company's second unit in Gujarat. Coca-Cola has a plant in Goblej in Kheda district, its second-largest in the country after the Dasna unit in Uttar Pradesh. The Gujarat government has allotted 185,000 square metres to the company to make sweetened aerated drinks like Coke, Sprite, Fanta and Thums Up".

Governments never seem to learn any lesson from past experiences as evidenced by the attitude of the Gujarat Government in allocating precious natural resources especially after the humiliating retreat of this soft rink giant from Kerala a few years ago because of the same problem. Politician-industry nexus is not new in India and diversion of water from dams built for irrigation to sugar mills and breweries in Maharashtra is another example of this nebulous practice. A moot question that the country faces is whether a health debilitating beverage industry can be given priority over food production when half the population in the country does not have adequate food to satisfy their hunger? No body is denying the fact that food industry is invariably water guzzlers because huge quantity of water is absolutely necessary to maintain safety and quality of the end products. But locating them in proximity to irrigated agricultural lands cannot be condoned. It is not understandable why these synthetic beverage manufacturers are forced to make nutritionally better products rather than easily salable junk foods like potato chips and sugar sweetened drinks. If this trend continues India may be following the foot steps of America where one in three citizens are obese with bloated bodies spending billions of dollars for treating their diseases!


Tuesday, January 20, 2015

Paper from plastics! An environment friendly technology

A new technology called Cronology developed in Mexico seems to be headed for adoption by the paper industry which is being criticized by the environmentalist for massive deforestation in obtaining their input materials. An indirect beneficiary will be the plastic waste recycling industry which seeks to reduce the environment pollution through reprocessing the plastic waste into useful products. While recycling does help in getting a temporary reprieve in terms of pollution, ultimately plastics end up in landfills staying there for more than 800 years without getting degraded. The paper obtained by the new technology is claimed to be photodegradable decomposing within 6 months. Here is a take on this exciting technological development about which lot will be heard in the coming years.

"A group of young entrepreneurs from Mexico has developed a system that converts PET bottles into mineral paper and which they claim will save up to 20 trees and 56,000 liters of water per ton of paper produced. The photodegradable, waterproof paper can be used to print books, boxes and general stationery. "By not cutting trees, nor using water we reduce costs and help the planet," says Ever Adrian Nava, cofounder of the Cronology company, located in Ecatepec, a municipality in Mexico State, just north from Mexico City. The Cronology process is claimed to be 15 percent cheaper than traditional paper manufacture because it doesn't use chemicals, like chlorine, or water. Although countries like Spain and Taiwan already use similar processes to manufacture mineral paper (also known as peta paper or stone paper), its developers say the Cronology system is four times cheaper than conventional methods. The original idea for this type of paper is to reduce production costs and deforestation. Mexico currently produces 700,000 tons of paper each year, mostly for books and notebooks, but also for wrapping papers and toilet paper. Ever Nava says that producing one ton of traditional paper has an effect on the environment for 100 years, but that mineral paper eliminates that, with 235 kg (518 lb) of pellets, or PET beads, obtained using recycled plastic bottles, calcium carbonate and stone, capable of producing a ton of the mineral paper. "The mineral paper is stronger than the standard, you can not break it with your hands, it is waterproof, has the quality of being photodegradable and only absorbs the necessary amount of ink when printing," says Ever Nava. Recycled plastic bottles are first crushed with various pieces of calcium carbon to form pellets (plastic beads), which are then subjected to a casting process at over a 100° C (212° F), before being rolled to form large sheets of paper. The paper degrades in just six months, with the company saying the only downside is that ink gels can't be used on it because they contain alcohol, which the paper does not support."

What is more interesting is the water saved by this process in making high quality paper compared to traditional paper making from wood. Already forests are being denuded in South America massively for planting Palm plants for oil. Demand for palm oil, one of the cheapest oils in the world is literally exploding because of its dual utility as a food ingredient as well as a fossil fuel substitute. PET, also known as polyester, is chemically Polyethylene Terephthalate and world produces about 25 million tons annually out of which only 30% is used for bottle production remaining going into textile industry. Also known as Dacron or Terylene or Lavasa, fabrics made from PET are extraordinarily strong and crease resistant. The new technology to convert PET into paper can thus be a large industry capable of solving one of the most vexing issues facing mankind viz disposing of 25 million tons of PET into useful products with excellent environmental credentials. Another beauty is that the technology uses comparatively lower temperatures, about 100C while for recycling it has to be done at temperatures beyond 250C. Thus PET paper production technology can be a win-win situation for all the stake holders connected with PET industry.