Diet Diary: The ‘see’ food diet

By Ishi Khosla

Most of us would decline if offered food right after a meal, yet if something tempting is served to us, we would reach out for it. External cues are often hidden and are known to influence our appetite and have very little to do with hunger. These include family, friends, packages and plates, names and numbers, labels and lights, colours and candles, shapes and smell, distractions and distances, cupboards and containers. Visual cues are very powerful drivers to eating and determine how much we eat.

One of the strongest psychological motivators to eat more than what we should seems to be the need to empty our plates. The obligation to finish all that is on the plate from our childhood and the dislike of waste, drives us to eating regardless of our hunger. Don’t let anyone put you on a guilt trip about hunger in Somalia and poor children. Don’t worry about leaving a morsel on your plate when pleasantly full.

Also, the larger the portion, the more we eat; the bigger the container, the more we pour. It takes about 20 minutes before the brain gets the signal that the stomach is full, meaning that if you finish your meal in less than 20 minutes, then the sensation that the belly is full will arrive too late, likely to make you eat more than you need. So, eat slowly and pay attention to what you eat and stop when you are 80 per cent full. Put your spoon or fork down between each bite. Ask yourself whether you are hungry rather than wait to be full. The ‘not hungry’ situation happens early and that’s when you must stop.

When eating out, if portions are large, don’t hesitate to ask the waiter to pack some of it before it reaches the table. For the same reasons, don’t stock undesirable food around the house. Don’t store undesirable food in transparent containers.

In some cases, looking at food can make you eat less. If you are presented with an indication of how much you have already eaten, perhaps by wrappers, bottles and bones or by ‘pre-plating’ your food or even on your food diary, you may be surprised to find that you will end up eating less.

By understanding why we eat the way we do, we can eat a little less, eat healthier and enjoy it a lot more. Take control of subtle influences in our environment that can persuade us to eat or overeat. How small changes in our daily habits can contribute to reducing our expanding girth is amazing.

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Early detection, management, key to living with hemophilia

An injection given to Tarun Kumar’s son when he was three-months-old resulted in non-stop bleeding for a few hours. The infant was referred to the capital’s Sir Ganga Ram Hospital where the condition was identified as hemophilia, a blood clotting disorder.

Similar was the story of Karan, 21, who used to regularly bleed from his mouth as an infant and had blue patches on his body. The bleeding would recur every two hours. His father Chandan took him to PGI-Chandigarh and later to a hospital in Mumbai where he was declared to be haemophilic.

But, despite the extremely serious nature of the condition, Tarun Kumar’s son and Karan are leading near normal lives today.

Tarun Kumar’s son is now 21-years-old and is doing his graduation while Karan is studying in one of India’s best technical institutes. So how are they coping with haemophilia?

The key to leading a better life with hemophilia is early detection and condition management and the responsibility for that lies with the parents. There is no cure for haemophilia, only management, say doctors.

“Parents should immediately highlight trivial injuries leading to profuse bleeding, big blue patches on the body, small wounds taking a very long time to heal and swelling in joints. These are all symptoms of haemophilia,” V.P. Choudhry, haematologist at Gurggaon’s Paras Hospital, told IANS.

Unexplained nasal bleeding and blood in the urine or the stools are also indicators.

Hemophilia is acquired at birth by children with a family history of the condition. However it has also been observed that the disorder can be found in children without any family history as well.

The protein needed for normal blood clotting is absent in hemophilia, so even a small injury can develop into a life-threatening condition.

Choudhry said that the incidence of hemophilia in India is 1:10,000 and there are estimated to be 120,000 cases.

“Since hemophilia is discovered mostly in toddlers, parents should know about it and stay alert for any signs. Diagnosis and timely beginning of treatment with some caution can allow the child normal unhindered growth,” said Satish Koul, internal medicine specialist at Gurgaon’s Columbia Asia Hospital, told IANS.

Hemophilia is a genetic disorder. It is mostly found in boys and very rarely in girls, said Choudhry, who worked for 35 years in the haemotology department of AIIMS.

The disorder can be managed by infusion of clotting factor, using medicines to promote clots and healing, avoiding bleeding, exercising regularly, avoiding contact sports, maintaining good dental hygiene and following safe practices.

Medical management of the condition includes infusing blood clotting factor concentrates into the body to prevent bleeding. This is called prophylactic therapy and is administered on the basis of the patient’s weight. It also entails giving injections to the patient whenever they bleed, also called on demand prophylactic therapy. The efficacy of the medicine, contained in vials, is measured in units.

“A 20 kg baby requires 250 units of prophylactic therapy thrice a week and 3,000 …continued »

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Soon, an injection to reverse age-related vision loss

An injection of stem cells into the eye may soon slow or reverse the effects of early-stage age-related disorder that causes vision loss, shows a promising study.

Currently, there is no treatment that slows the progression of age related vision loss caused by macular degeneration, which is the leading cause of vision loss in people over 65.

“This is the first study to show preservation of vision after a single injection of adult-derived human cells into a rat model with age-related macular degeneration,” said lead author of the study Shaomei Wang, research scientist at the Cedars-Sinai Board of Governors Regenerative Medicine Institute in the US.

The stem cell injection resulted in 130 days of preserved vision in laboratory rats, which roughly equates to 16 years in humans.

For the study, the researchers first converted adult human skin cells into powerful induced pluripotent stem cells (iPSC), which can be expanded indefinitely and then made into any cell of the human body.

These induced pluripotent stem cells were then directed toward a neural progenitor cell fate, known as induced neural progenitor stem cells, or iNPCs.

“These induced neural progenitor stem cells are a novel source of adult-derived cells which should have powerful effects on slowing down vision loss associated with macular degeneration,” contributing author to the study Clive Svendsen, director, Board of Governors Regenerative Medicine Institute, pointed out.

“Though additional pre-clinical data is needed, our institute is close to a time when we can offer adult stem cells as a promising source for personalised therapies for this and other human diseases,” Svendsen noted.

The study was published in the journal Stem Cells.

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New method spots heart attack in one hour

A new method to spot heart attacks in suspected patients within an hour has been found effective in three out of four cases in a clinical trial involving over 1,000 participants, reports a study.

The new technique to measure cardiac troponin T levels in the blood, a preferred biomarker for the diagnosis of acute myocardial infarction (MI), commonly known as heart attack, was previously tested in a small pilot study.

A new strategy called high-sensitivity cardiac troponin T 1-hour algorithm could help physicians treat patients with suspected heart attack faster and help save many lives as early diagnosis is critical for treatment and survival of such patients.

“Introducing the high-sensitivity cardiac troponin T 1-hour algorithm into clinical practice would represent a profound change and it is therefore important to determine if it works in a large patient group,” said Tobias Reichlin from University Hospital Basel in Switzerland.

The team of researchers from Switzerland and Spain enrolled 1,320 patients who visited the emergency department with suspected acute MI and applied the high-sensitivity cardiac troponin T 1-hour algorithm to blood samples.

With the algorithm, the researchers were able to determine that 786 (60 percent) of patients did not have an acute MI (“rule-out”), 216 (16 percent) were “rule-in” and 318 (24 percent) were to be observed because results were not conclusive.

“This rapid strategy incorporating high-sensitivity cardiac troponin T baseline values and absolute changes after the first hour substantially accelerates the management of patients with suspected acute MI by allowing safe rule-out as well as accurate rule-in of acute MI in three out of four patients,” the authors said.

The findings were detailed in CMAJ – Canadian Medical Association Journal.

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Dogs trained to detect prostate cancer with 90% accuracy

Trained dogs can sniff out prostate cancer from urine samples with over 90% accuracy, scientists have found.

The findings from an Italy-based team of researchers raise the possibility of canines’ sense of smell helping doctors identify a number of human cancers and infectious diseases.

In the study published in the Journal of Urology, two female German shepherd dogs sniffed urine samples from 900 men, 360 with prostate cancer and 540 without.

Both animals were right in well over 90% of cases, ‘The Guardian’ reported.

The researchers, from the Humanitas Clinical and Research Centre in Milan and other institutes, admitted further work is needed to determine how valuable the dogs’ skill might be in identifying, in daily practice, the signs of prostate cancer.

Currently, prostate cancer is detected by a blood test known as the PSA test, by physical examination and by biopsy.

The PSA test is not routinely offered because it is not considered reliable enough for screening.

The study results were welcomed by the Buckinghamshire-based charity Medical Detection Dogs which has been training dogs to sniff out diseases. It has carried out similar research which showed dogs can achieve 93 per cent accuracy.

Co-founder Claire Guest of Medical Detection Dogs said the results offer further proof that dogs have the ability to detect human cancer.

“It is particularly exciting that we have such a high success rate in the detection of prostate cancer, for which the existing tests are woefully inadequate,” she said.

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Middle-age obesity could protect against dementia

In a surprising finding, a large study shows that middle-aged obese people have a significant — nearly 30 percent — lower risk of developing dementia than people of a healthy weight.

The findings based on medical records of nearly two million people contradicts results from some previous research, which suggested that obesity leads to an increased risk of getting diagnosed with the disorder.

“Our results also open up an intriguing new avenue in the search for protective factors for dementia,” said professor Stuart Pocock from the London School of Hygiene & Tropical Medicine.

“If we can understand why people with a high BMI(body mass index)have a reduced risk of dementia, it’s possible that further down the line, researchers might be able to use these insights to develop new treatments for dementia,” Pocock pointed out.

For the study, the researchers analysed the medical records of nearly two million (1,958,191) people with an average (median) age of 55 years at the start of the study period, and an average (median) BMI of 26.5 kg/m2 (kilograms/square metre) — just within the range usually classed as overweight.

During an average (median) of nine years follow-up, nearly fifty thousand (45,507) people were diagnosed with dementia.

People who were underweight in middle age were a third (34 percent) more likely to be diagnosed with dementia than those of a healthy weight, and this increased risk of dementia persisted even 15 years after the underweight was recorded.

As participants’ BMI at middle age increased, the risk of dementia reduced, with very obese people (BMI greater than 40 kg/m2) 29 percent less likely to get dementia than people in the normal weight range, the researchers noted.

“The reasons why a high BMI might be associated with a reduced risk of dementia are not clear, and further work is needed to understand why this might be the case,” the study’s lead author Nawab Qizilbash from OXON Epidemiology, a London/Madrid-based clinical research organisation, noted.

“If increased weight in mid-life is protective against dementia, the reasons for this inverse association are unclear at present. Many different issues related to diet, exercise, frailty, genetic factors, and weight change could play a part,” Qizilbash said.

The research was published in the journal The Lancet Diabetes and Endocrinology.

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Blame this gene loss for your obsession with size zero

While social factors, particularly the western ideal of thinness, is largely blamed for increasing rate of eating disorders over the past several decades, loss of a gene also contributes to your obsession with having a thin figure, suggests a study.

The researchers identified that lack of the estrogen-related receptor alpha (ESRRA) gene is linked to anorexia nervosa, an eating disorder characterised by food restriction and an irrational fear of gaining weight.

“This work identifies estrogen-related receptor alpha as one of the genes that is likely to contribute to the risk of getting anorexia nervosa or bulimia nervosa,” said lead researcher Michael Lutter, assistant professor of psychiatry at the University of Iowa.

“Decreased calorie intake usually motivates animals, including humans, to seek out high-calorie food. These findings suggest that loss of ESRRA activity may disrupt that response,” Lutter explained.

Loss of this gene in mice leads to several behavioural abnormalities that resemble behaviours seen in people with anorexia nervosa, the researchers noted.

For the study, the researchers manipulated ESRRA in mice to investigate the gene’s role in behaviour.

Through a series of experiments with genetically engineered mice, Lutter and his team showed that mice without the ESRRA gene have behavioural abnormalities related to eating and social behaviour.

In particular, mice without ESRRA showed reduced effort to work for high-fat food when they are hungry.

The mice also exhibited impaired social interaction and female mice without the gene showed increased compulsive grooming, which may mimic obsessive-compulsive-type behaviour in humans, the researchers noted.

However, according to Lutter, the increasing rate of eating disorders over the past several decades is likely due to social factors, not genetics.

“Clearly social factors, particularly the western ideal of thinness, contribute the remaining ‘non-genetic’ risk,” Lutter noted.

The study appeared in the journal Cell Reports.

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Single-dose vaccine to counter deadly Ebola virus developed

Researchers have developed a quick-acting Ebola vaccine that is both safe and effective with a single dose against the strain of the virus that killed thousands of people in West Africa last year.

“These findings may pave the way for the identification and manufacture of safer, single dose, high efficiency vaccines to combat current and future Ebola outbreaks,” said Thomas Geisbert, from the University of Texas Medical Branch at Galveston.

During 2014, the outbreak of the West African Makona strain of Ebola Zaire virus killed nearly 10,000 and caused worldwide concern, researchers said.

Many vaccine approaches have shown promise in being able to protect nonhuman primates against Ebola Zaire. In response to the Ebola Zaire outbreak, several of these vaccines have been fast tracked for human use.

“We are excited at the possibility of helping develop a way to stop this deadly disease. We have a lot of more work to accomplish but it’s important to note that this is a big step,” said Geisbert.

The research team developed a vaccine effective against Ebola Zaire with a single dose in a nonhuman primate model.

This new vaccine employs a virus not harmful to humans called vesicular stomatitis virus that had a part of the Ebola virus inserted into it.

This “Trojan horse” vaccine safely triggered an immune response against Ebola Zaire.

To address any possible safety concerns associated with this vaccine, the team developed two next generation candidate vaccines that contain further weakened forms of the vaccine.

Both of these vaccines produced an approximately ten-fold lower level of virus in the blood compared to the first generation vaccine.

“It was not known whether any of these vaccines could  provide protection against the new outbreak West African Makona strain of Ebola Zaire currently circulating in Guinea,” said John Eldridge, Chief Scientific Officer-Vaccines at  Profectus Biosciences, Inc, which developed the vaccine with UTMB researchers.

“Our findings show that our candidate vaccines provided complete, single dose protection from a lethal amount of the Makona strain of Ebola virus,” said Eldridge.

Both weakened vaccines have features of the Mayinga strain of Ebola virus, as do most other candidate Ebola Zaire vaccines currently under evaluation.

The findings are published in the journal Nature.

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Shorter people at higher risk of heart disease

A shorter height is directly associated with increased risk of coronary heart disease, a new large-scale study led by an Indian-origin scientist has found.

The study by the University of Leicester found that every 2.5 inches change in height affected the risk of coronary heart disease by 13.5 per cent.

For example, compared to a 5ft 6inch tall person, a 5 foot tall person on average has a 32 per cent higher risk of coronary heart disease because of their relatively shorter stature.

“For more than 60 years it has been known that there is an inverse relationship between height and risk of coronary heart disease,” said Professor Sir Nilesh Samani, British Heart Foundation Professor of Cardiology at the University of Leicester, who led the research.

“It is not clear whether this relationship is due to confounding factors such as poor socioeconomic environment, or nutrition, during childhood that on the one hand determine achieved height and on the other the risk of coronary heart disease, or whether it represents a primary relationship between shorter height and more coronary heart disease,” he said.

Using a genetic approach, researchers have shown that the association between shorter height and higher risk of coronary heart disease is a primary relationship and is not due to confounding factors.

“Height has a strong genetic determination and in the last few years a large number of genetic variants have been identified in our DNA that determines one’s height,” said Samani.

“The beauty about DNA is that it cannot be modified by one’s lifestyle or socio-economic conditions. Therefore if shorter height is directly connected with increased risk of coronary heart disease one would expect that these variants would also be associated with coronary heart disease and this is precisely what we found,” he said.

The researchers analysed genetic data on almost 200,000 persons with or without coronary heart disease. They examined whether 180 genetic variants that affect height are also associated with coronary heart disease.

They found that for every change in height of 6.5 cm (approx. 2.5 inches) caused by these variants the risk of coronary heart disease changed on average by 13.5 per cent.

“The more height increasing genetic variants that you carry the lower your risk of coronary heart disease and conversely if you were genetically shorter the higher your risk,” said Dr Christopher Nelson, British Heart Foundation-funded lecturer who undertook the analysis.

The study is published in the New England Journal of Medicine.

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Video games show how criminals ‘justify’ killing

An important brain area involved in making moral decisions lights up in scans when killing a person is not justified, a study where participants played violent video games has found.

The findings show that the neural mechanisms that are typically implicated with harming others become less active when the violence against a particular group is seen as justified.

Participants in the new study played video games in which they imagined themselves to be shooting innocent civilians (unjustified violence) or enemy soldiers (justified violence).

Their brain activity was recorded via functional magnetic resonance imaging (fMRI) while they played.

Dr Pascal Molenberghs from the Monash University said the results provided important insights into how people in certain situations, such as war, are able to commit extreme violence against others.

“When participants imagined themselves shooting civilians compared to soldiers, greater activation was found in the lateral orbitofrontal cortex (OFC), an important brain area involved in making moral decisions,” Molenberghs said.

“The more guilt participants felt about shooting civilians, the greater the response in the lateral OFC. When shooting enemy soldiers, no activation was seen in lateral OFC,” said Molenberghs.

“The findings show that when a person is responsible for what they see as justified or unjustified violence, they will have different feelings of guilt associated with that – for the first time we can see how this guilt relates to specific brain activation,” Molenberghs added.

The researchers hope to further investigate how people become desensitised to violence and how personality and group membership of both perpetrator and victim influence these processes.

The study is published in the journal Social Cognitive and Affective Neuroscience.

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