Find out what happens to a woman and her child’s body if sugar consumption is restricted in the first 1000 days after conception

The mother’s diet may influence a child’s lifelong health, according to a new study. Published in the journal Science, it was found that reducing sugar in the first 1,000 days after conception, throughout gestation, and up to the age of 2 of the child may help cut the risk of chronic illnesses, especially diabetes, in adulthood. The researchers indicated that the risk of type 2 diabetes was reduced by about 35 per cent while high blood pressure risk was cut by roughly 20 per cent. “They also found a delay in disease onset of four and two years, respectively,” it read.

The study authors looked at data from before and after the end of the United Kingdom’s World War II-era sugar rationing in September 1953 when the UK began rationing to allow “fair shares” of food for the country during the wartime shortage. According to the Imperial War Museums, access to foods like sugar, fats, bacon, meat, and cheese was limited. However, when the rationing of sugar and sweets ended in September 1953, sugar consumption doubled immediately.

Why is sugar a concern?

Dr Rajiv Kovil, head of diabetology at Zandra Healthcare and co-founder of Rang De Neela Initiative, said obesity drives the epidemic of diabetes, cancer, and heart disease. “Sugar cravings are often rooted in both biology and psychology. Biologically, sugar stimulates dopamine release, giving a “feel-good” sensation. Over time, this can become habit-forming, leading to cravings.

Here’s what happens when you forgo sugar (Source: Freepik)

“I strongly believe sugar is the biggest addiction in this world. During periods like World War II, many countries rationed sugar due to limited availability. People adapted by using substitutes or simply consuming less. These rationing periods highlighted how reducing sugar availability influenced dietary habits, and obesity rates were much lower. Post-rationing, however, sugar intake surged, correlating with an increase in obesity rates,” added Dr Kovil.

Our forefathers used to get food once in a while. “Hence, our genes store fat in the liver, muscles, etc, to make it available when food is unavailable. This is called the thrifty gene hypothesis,” said Dr Kovil.

This hypothesis suggests that humans evolved to efficiently store energy in the form of fat during food abundance. “In ancient times, people faced frequent food scarcity, so individuals with a ‘thrifty’ genotype who stored fat more effectively were more likely to survive during famines. This adaption in our genes becomes a liability and maladaption today when we have abundant food,” said Dr Kovil.

Today, however, this once-beneficial genetic trait can lead to an increased risk of obesity and metabolic disorders. “In a world where high-calorie, sugar-rich foods are easily accessible, the ‘thrifty’ genotype may contribute to weight gain and obesity, as these individuals are predisposed to store excess energy,” said Dr Kovil.

What are the effects of sugar on maternal and child health?

Dr Poonam Sidana, director of neonatology and paediatrics at CK Birla Hospital, Delhi, noted that the first 1000 days of life, which include the 40 weeks of pregnancy (approximately 280 days) and the first two years of life (about 730 days), are crucial for a child’s development. “This period is essential for optimal nutrition, and recent research has refocused attention on the impact of high sugar intake during pregnancy,” said Dr Sidana.

The findings reinforce the idea that excessive sugar intake during pregnancy, particularly among mothers who are overweight or consume more sugar than recommended, can have lasting effects on both maternal and child health. “Public health experts have long recognised the importance of improved nutrition in the first 1000 days of life, linking maternal health and nutrition with long-term cognitive development, risk of chronic diseases, and lifestyle issues in the child’s future. If a mother is overweight before or during pregnancy, there is a heightened risk of gestational diabetes, hypertension, and obesity in the newborn. Overweight infants are more likely to experience complications, such as the need for cesarean or instrumental deliveries,” said Dr Sidana.

Furthermore, if a mother consumes high-sugar, processed foods, she may be “depriving herself and her baby of other essential nutrients, impacting both their health.” “Studies indicate that babies exposed to high sugar content in utero are at increased risk of obesity, allergies, and chronic conditions like diabetes and hypertension later in life,” said Dr Sidana.

The importance of maternal health extends beyond pregnancy. A “life cycle approach” to women’s health is essential, which includes promoting a healthy diet, ensuring vaccination,

and conducting pre-pregnancy check-ups to identify and address any issues early. “During pregnancy, guidance on healthy eating, with a focus on fresh foods, whole grains, and regular exercise, can significantly improve outcomes,” said Dr Sidana.

Breastfeeding, particularly exclusive breastfeeding for the first six months, is also essential for a child’s immunity, neurodevelopment, and long-term health. “Research shows that mothers with healthier lifestyles during pregnancy are more likely to breastfeed. Once the child begins semi-solids, the focus should remain on fresh, home-cooked food, with natural sweeteners like fruits and nuts rather than processed sugars,” said Dr Sidana, emphasising that it helps support healthy habits in young women, mothers, and infants.

https://indianexpress.com/article/lifestyle/health/what-happens-woman-child-sugar-restricted-first-1000-days-after-conception-pregnancy-diabetes-risk-benefits-experts-9654242/

Can Ozempic and Wegovy help reduce knee osteoarthritis-related pain?

A new trial finds that GLP-1 agonists may help reduce knee osteoarthritis-related pain.

The use of GLP-1 medications such as semaglutide — more widely known under the brand names of Ozempic and Wegovy — have greatly increased over the last few years.

There has also been an increase in research examining other benefits these types of drugs might offer aside from type 2 diabetes management and weight loss.

Recent results from a phase 3 clinical trial show that semaglutide may help reduce knee osteoarthritis-related pain in people with obesity.

The use of glucagon-like peptide-1 (GLP-1) medications such as Wegovy and Ozempic has greatly increased over the last few years.

While these drugs are mainly used to help control type 2 diabetes and boost weight loss, over the last few years, there has been a lot of research surrounding GLP-1 medications, such as semaglutideTrusted Source, and how they provide additional benefits.

For example, recent studies report that GLP-1 drugs may have neuroprotective benefitsTrusted Source, lower Alzheimer’s diseaseTrusted Source risk, and offer protection against cardiovascular disease.

Now, new clinical trial results recently published in The New England Journal of Medicine show that semaglutide may also help reduce knee osteoarthritis-related pain in people with obesity.

Semaglutide reduces pain scores for knee osteoarthritis

This new study featured the results from the STEP 9 phase 3 clinical trial conducted by healthcare company Novo Nordisk aimed at evaluating the efficacy of semaglutide versus placebo as an additional to lifestyle modifications — such as eating a reduced-calorie diet

and exercising — in lowering weight and knee osteoarthritis-related pain in patients with obesity.

Researchers recruited 407 participants with an average age of 56 and body-mass index (BMI) of 40.3 for the study, who received either a 2.4 mg dose of semaglutide once a week or a placebo for 68 weeks.

At 68 weeks, researchers found that participants taking semaglutide experienced a mean decline in their body weight by 13.7%, compared to a 3.2% decrease in those taking the placebo.

Researchers also evaluated study participants’ Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores during this study. WOMAC is a patient-reported questionnaire that helps rank pain on a scale of zero to 100, with higher numbers indicating more pain.

Scientists discovered that those taking semaglutide experienced a mean decrease in their WOMAC pain score of 41.7 points from 70.9 at the start of the study, compared to those taking the placebo whose WOMAC scores only decreased by 27.5 points.

“Obesity-related knee osteoarthritis is a progressive condition that can lead to pain and stiffness of the knee and impair critical daily functions such as walking or moving around,” Henning Bliddal, MD, MSci, clinical professor in the Department of Clinical Medicine and director of the Parker Institute at Copenhagen University Hospital in Denmark and lead author of this study says in a press release.

“The risk of developing the condition is more than four times higher in people with obesity. Weight reduction along with physical activity is often a recommended approach to managing painful symptoms, but adherence can be challenging. There is a significant need for non-surgical and sustainable treatment options for those living with obesity-related osteoarthritis. The STEP 9 trial aimed to provide rigorous evidence as to how semaglutide may help these people,” Bliddal says.

Too early to prescribe Ozempic for osteoarthritis

After reviewing this study, Mir Ali, MD, a board certified general surgeon, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, told Medical News Today that its findings were in line with what doctors have seen with any kind of weight loss.

“As a patient loses weight, all of their medical conditions improve, including pain from osteoarthritis. They’re taking pressure off of those joints, so it improves their discomfort and we see that with our surgical weight loss patients as well.” — Mir Ali, MD

“That’s a big factor for a lot of people because the more discomfort they have in their joints, the less active they are. And the less active they are, the easier it is to gain weight. So if you can find ways to reduce pain and inflammation in the joints to allow them to be more active,

then they can be more proactive about exercise and other ways to improve their health and lose weight,” Ali explained.

Ali said he would be interested in seeing if researchers can eventually show that semaglutide improves inflammation independent of weight loss.

“That would be a tough study to design, but that would be helpful to show that there’s some additional effect, not just the weight loss,” he added.

Semaglutide may have anti-inflammatory effects

MNT also spoke with Bert Mandelbaum, MD, sports medicine specialist and orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute and Co-Director of the Regenerative Orthobiologic Center at Cedars-Sinai Medical Center in Los Angeles, about this study.

“Certainly we have always known that obesity is a risk factor for not only the onset of osteoarthritis, but the progression of it — there is no question about that. When you have a study like this that shows that there’s two things that are happening at one time. One is that obviously their patients are losing weight, so there’s a physical and mechanical aspect, but also there’s something about semaglutide that also has an anti-inflammatory (effect).” — Bert Mandelbaum, MD

“It’s not proven in this study, but there have been other studies that show that (semaglutide) reduces cardiovascular risks. And the mechanisms of that are that it is functionally an anti-inflammatory as well. It has another effect, creating a decreased inflammation that affects blood vessels in and of themselves, as well as other catabolic mediators such as the interleukinsTrusted Source and TNF (tumor necrosis factor), and other metalloproteases seem to be inhibited as part of its inhibitory inflammatory effect,” Mandelbaum said.

Mandelbaum said doctors are looking for help in reducing pain from osteoarthritis, whether it’s related to obesity or not.

“Obesity is just a negative factor that worsens the challenge for us. We’re trying to reduce the amount of what we call catabolism and create an anabolic environment for the joints,” he explained.

“I think if researchers have found that we could reduce cardiovascular disease with these medicines, we can reduce the pain from osteoarthritis,” Mandelbaum continued.

“At the end of the day, the orthobiologic family, we have to look at other things that can make a difference, along with taking Wegovy or any of the other GLP-1s. So I think it’s an interesting study, but (it) really portends us to really think about what our next steps are so we can get into more adjuvant approaches, in addition to this, at the same time,” he added.

https://www.medicalnewstoday.com/articles/ozempic-wegovy-obesity-help-reduce-knee-osteoarthritis-pain 

Blood-biomarker tests may aid in early diagnosis of Alzheimer's: Report

While early detection of Alzheimer’s disease is crucial for better outcomes, a report on Wednesday said that blood-based tests are emerging as valuable tools.

The report by GlobalData, a data and analytics company, offers accessible alternatives to PET scans and cerebrospinal fluid (CSF) analysis.

Currently, Alzheimer’s affects over 55 million people globally, and cases are projected to triple by 2050.

Advances in diagnostic methods that can make diagnosis faster, less invasive, and more affordable can help in the timely intervention of the neurodegenerative disease. However, the report said questions remain about their real-world impact on patient outcomes.

Ashley Clarke, Senior Medical Analyst at GlobalData said that blood-based biomarker tests that are cost-effective and efficient in early assessment, have taken a major leap forward in diagnostics with it being used for conditions like heart attacks.

“For Alzheimer’s disease, reliable and accessible testing could lead to earlier detection, giving patients more time to pursue interventions and lifestyle changes,” Clarke said.

According to GlobalData’s Pipeline Products Database, more than 150 in vitro diagnostic tests for Alzheimer’s disease are currently in development. However, the USFDA has yet to grant full approval to blood-based Alzheimer’s tests.

“With high negative predictive values, blood-based tests could serve as reliable screening tools, helping reserve hospital resources for procedures such as PET scans for patients most likely to need them,” Clarke said.

GlobalData reports that at least five pipeline devices are now in the regulatory approval process across the US and Europe, yet ethical and regulatory challenges persist.

These tests raise concerns about overdiagnosis, exposure of sensitive health data, and the potential for insurers to adjust premiums based on test outcomes.

Predictive testing also introduces ethical considerations around informed consent, and potential psychological impacts for patients learning their risks in a disease still lacking a cure, the report said.

https://www.newkerala.com/news/2024/69734.htm

Consuming high levels of omega-3, omega-6 may keep cancer at bay

Omega-3 and omega-6 fatty acids are "healthy fats" and essential for human health.

A higher consumption of omega-3 and omega-6 fatty acids may help ward off a variety of cancers, finds a study of more than 2,50,000 people on Tuesday.  Cancer has become a global health concern, especially with increasing early onset.

Omega-3 and omega-6 fatty acids are "healthy fats" and essential for human health. These are important to the cells and are known to reduce bad cholesterol levels, keep the brain healthy and boost mental health. Higher levels of omega-3s showed protection against colon, stomach and lung cancer, according to the study, published in the International Journal of Cancer.

On the other hand, high omega-6 levels protect against brain, malignant melanoma, bladder and 14 different cancers. "Higher omega-3 and omega-6 levels were associated with lower rates of cancer," said lead author Yuchen Zhang, a doctoral student at the University of Georgia's College of Public Health.

Zhang noted that with the significant rise in cancers worldwide, the study “suggests that the average person should focus on getting more of these fatty acids in their diets.”

The researchers analysed data from more than 2,50,000 people, of which about 30,000 developed some form of cancer in the 10 years of follow-up.

Omega-3 and omega-6 are present in fatty fish, nuts and even some plant oils. However, as diets may not provide the recommended amounts, people often turn to fish oil supplements — one of the most popular dietary pills on the market. However, it may not be suitable for all, said the researchers.

 The study showed that elevated omega-3 levels raised a slightly higher risk of prostate cancer in men. However, the study found no such associations in women. Instead, it found women and young people to have “stronger beneficial effects of omega-6”.

https://www.tribuneindia.com/news/health/consuming-high-levels-of-omega-3-omega-6-may-keep-cancer-at-bay/

Vitamin C deficiency in elderly can cause abnormal bleeding, fatigue: Study

Older adults suffering from abnormal bleeding, fatigue, and weakness, must be assessed for scurvy -- a disease caused by vitamin C deficiency, suggests a study on Monday. Detailing a case study of a 65-year-old woman with mobility issues and social.

Older adults suffering from abnormal bleeding, fatigue, and weakness, must be assessed for scurvy -- a disease caused by vitamin C deficiency, suggests a study on Monday.

Detailing a case study of a 65-year-old woman with mobility issues and social isolation, the study published in CMAJ (Canadian Medical Association Journal) showed that scurvy, or vitamin C deficiency, is not just an 18th-century seafarers' disease.

Researchers from the University of Toronto in Canada implored clinicians to consider scurvy in patients with abnormal bleeding and nonspecific symptoms.

The elderly patient visited the emergency department at a downtown Toronto hospital for leg pain and weakness, skin lesions, and discoloration. She also had several chronic health conditions.

Mobility issues restricted her ability to go grocery shopping, cook, and perform other daily activities. She lived largely on canned soup and fish, with no fresh produce.

“This case presents a complex example of food insecurity manifesting as an uncommon diagnosis,” said Dr. Sarah Engelhart, a general internist at Mount Sinai Hospital and the University of Toronto.

The researchers noted that vitamin C deficiency is more common than expected in the 21st century. However, its diagnosis is often challenging as symptoms are often nonspecific, such as fatigue, weakness, and shortness of breath.

The patient also smoked, which further contributes to vitamin C deficiency. Her symptoms improved once she started on vitamin C treatment, and a blood test for vitamin C deficiency eventually confirmed the diagnosis, said the doctors.

“Clinicians should be alert to vitamin C deficiency when assessing patients, including children and isolated older adults,” the doctors said.

The team noted that people who follow restrictive eating patterns (for example, those with autism spectrum disorder or those on a tea and toast diet), who smoke cigarettes, who have a substance use disorder, or who have malabsorption syndrome, can also be at risk of scurvy.

https://www.tribuneindia.com/news/health/vitamin-c-deficiency-in-elderly-can-cause-abnormal-bleeding-fatigue-study/

Cannabis pill may reduce agitation in people with Alzheimer's disease

Research has found that cannabis-derived drugs may help improve some Alzheimer’s symptoms.

Agitation is a common problem that people with Alzheimer’s disease experience.

Researchers are interested in finding the best ways to manage agitation, including determining which medications may be most helpful.

One new study suggests that the drug dronabinol derived from cannabis could help reduce agitation in people with Alzheimer’s disease without significantly increasing the risk for adverse events.

Alzheimer’s disease is a chronic and challenging condition to manage, from its diagnosis to the symptoms that individuals experience. For example, people with Alzheimer’s disease can experience agitation that makes care and daily life difficult.

Recent study results were shared at the International Psychogeriatric Association conference that indicate cannabis could help address agitation related to Alzheimer’s disease.

In research including 75 participants over a three-week intervention period, researchers found that the drug dronabinol — a synthetic version of the psychoactive delta-9-tetrahydrocannabinol (THC) compound in cannabis — helped reduce agitation better than the placebo.

The results demonstrate that it might be helpful to use dronabinol in clinical practice for this purpose in the future.

Challenges of diagnosing Alzheimer’s disease

Alzheimer’s disease is a common dementia type that can involve memory loss, changes in learning abilities, and behavioral changes. There is no one test that can diagnose Alzheimer’s disease, which can be challenging for doctors and people experiencing symptoms of Alzheimer’s disease.

DiagnosingTrusted Source Alzheimer’s disease can involve multiple tests, including ways to rule out other causes for the symptoms someone is experiencing.

There are blood tests available that can help with Alzheimer’s disease diagnosis. One recent studyTrusted Source found that biomarkers in blood that are related to Alzheimer’s disease may change based on the time of day. Experts may need to take this into account when it comes to diagnosing and treating Alzheimer’s disease. It also implies that there is even more data to consider when it comes to accurately diagnosing Alzheimer’s disease.

After receiving a diagnosis of Alzheimer’s disease, it’s important for everyone to work together to address Alzheimer’s disease symptoms to come up with the best management strategies.

How to reduce agitation in people with Alzheimer’s disease

AgitationTrusted Source is a symptom related to Alzheimer’s disease. Authors of the current research note that agitation can lead to some challenging behaviors, including resisting care, trouble sleeping, and combativeness. They note that while behavioral strategies are part of agitation management, medication can also play a role.

This current research explored using the drug dronabinolTrusted Source, which is a synthetic version of delta-9-tetrahydrocannabinol (THC). THCTrusted Source is a compound in cannabis that leads to cannabis’ psychoactive effects. Dronabinol can help with nausea and vomiting and help improve appetite.

Researchers compared the use of dronabinol with placebo to see if there would be a noted reduction in agitation symptoms in participants with Alzheimer’s disease.

Using dronabinol twice a day to reduce agitation

The placebo-controlled, double-blind trial had a three-week intervention period. All participants had dementia due to Alzheimer’s disease and were between 60 and 95 years old. Researchers excluded some individuals, such as those taking lithium and those who already had baseline delirium, which is the temporary cognitive and behavioral changes that can occur because someone is taking medication or has a certain illness.

Researchers used several assessment scales to look at participant behavior, including the Pittsburgh agitation scale (PAS) and Neuropsychiatric Inventory, Clinical Version (NPI-C). They utilized questionnaires to look at drug effects and side effects. They also monitored participants for adverse events.

Researchers recruited 75 participants from five different clinical research sites, and 63 participants completed the whole study. The research included inpatient and outpatient participants. Throughout the timeframe, there were no significant differences in adverse events between the control group and placebo group. Three severe adverse events occurred in the intervention group and none in the placebo group, so this was not enough for researchers to make a valid statistical comparison.

Over three weeks, participants received five mg of dronabinol twice a day or a placebo. Overall, researchers found that dronabinol was a safe intervention for participants and helped decrease agitation better than the placebo.

Study author Paul B. Rosenberg, M.D. Professor of Psychiatry and Behavioral Sciences with the Johns Hopkins School of Medicine, noted the following highlights of the study’s findings to Medical News Today:

“We found that dronabinol (a prescription form of THC) was safe and effective in treating agitation in Alzheimer’s disease over a 3-week period in 75 patients. This is particularly relevant because this was very much a ‘real-world’ population in that we did not exclude patients with advanced dementia or taking other medications, so it is all the more impressive that we saw the benefit.”

Study limitations

This study does have limitations. First, the full study has not currently been published and is not available to the general public. Second, it only involved a small number of participants, so larger studies can help confirm the findings. The time of the intervention was only three weeks, so it does not address the potential long-term effects.

Participants in both intervention and placebo groups were also receiving other antipsychotic and antidepressant treatments, which could have impacted the results.

Since the data came from multiple facilities, it’s possible there were inconsistencies in assessments and differences between inpatient and outpatient participants. The trial itself was also affected by the COVID-19 shutdown. One measurement of cognitive function was higher in participants who completed the study than those who did not. 65% of participants were female, so future studies could include more male participants.

Addressing symptoms, not curing Alzheimer’s

It is important to note that dronabinol specifically addressed a symptom related to Alzheimer’s disease, not Alzheimer’s disease itself.

David Merrill, MD, PhD, a board certified geriatric psychiatrist at Providence Saint John’s Health Center in Santa Monica, CA, who was not involved in the study, noted the following:

“While the treatment did show a statistically significant reduction in agitation symptoms, the patients remained with significant symptoms, and the underlying causes of the disease process are not addressed by the drug. The treatment is symptomatic. Similar symptomatic treatments also already exist, and though the authors cite potential side effects of these other drug options, dronabinol itself is not without risks.”

Overall, the study demonstrates that dronabinol may help manage agitation in people with Alzheimer’s disease. If future research confirms the findings, this could lead to dronabinol being used in clinical practice for agitation.

Rosenberg noted the following about continued research in this area:

“We need to determine whether response is long lasting, and we need to study cannabis products available at dispensaries. This latter is very challenging scientifically but very important since we know patients and families are using these products.”

https://www.medicalnewstoday.com/articles/cannabis-pill-may-reduce-agitation-people-alzheimers-disease

The impact of breast cancer on women’s fertility

Breast cancer treatments, such as chemotherapy, radiation, and hormone therapy, can significantly impact fertility in younger women. Fertility preservation options, including egg freezing and ovarian suppression, alongside proper counseling, are crucial for those wanting to conceive post-treatment.

The impact of breast cancer on women’s fertility

Breast cancer, one of the most common cancers affecting women worldwide, not only threatens life but also significantly impacts reproductive health and fertility. For women of reproductive age diagnosed with breast cancer, the concern of whether they will be able to conceive and carry a child becomes as critical as their overall survival. The treatments that are critical for combating cancer, such as chemotherapy, radiation therapy, and hormone therapy, can often affect a woman’s ability to conceive.

Understanding the implications of these treatments on fertility is crucial for women facing breast cancer, as is the importance of fertility preservation and counseling.

Breast Cancer Diagnosis in Younger Women

Although breast cancer is more prevalent in women over the age of 50, an increasing number of younger women are being diagnosed with the disease. Women in their twenties, thirties, and early forties—prime childbearing years—are being confronted with this life-altering diagnosis. The fact that breast cancer therapies can affect ovarian function and reduce fertility means that many of these young women must make difficult decisions about fertility preservation before beginning their cancer treatment.

How Breast Cancer Treatment Affects Fertility

1. Chemotherapy and Ovarian Function

Chemotherapy, a cornerstone of breast cancer treatment, can severely damage ovarian function. The drugs used in chemotherapy target rapidly dividing cells, which include not only cancer cells but also the cells within the ovaries responsible for producing eggs. This damage can lead to diminished ovarian reserve, premature ovarian insufficiency (POI), or early menopause, particularly for women who are closer to 40 years of age. This reduction in ovarian reserve means fewer eggs are available for fertilization, decreasing the chances of conception post-treatment.

The impact of chemotherapy on fertility largely depends on the type of chemotherapy used, the dosage, and the woman's age. Alkylating agents, for example, are particularly toxic to the ovaries. Younger women may be more likely to regain some ovarian function post-treatment, but the risk remains significant, and many may experience permanent infertility.

2. Hormonal Therapy

Hormonal therapies, such as tamoxifen or aromatase inhibitors, are often used in treating hormone receptor-positive breast cancer. These treatments are usually prescribed for several years and are known to affect fertility. While tamoxifen does not cause permanent ovarian damage, it is not recommended to conceive while on this medication due to the risk it poses to the fetus. Thus, women undergoing long-term hormonal therapy must often delay pregnancy for five to ten years, which can be challenging, especially as fertility declines with age.

3. Radiation Therapy

Radiation therapy, particularly when administered near the pelvic area, can also affect fertility. Although breast cancer patients typically undergo radiation to the chest, certain treatments may involve areas close to the reproductive organs, putting the ovaries at risk. The cumulative effect of radiation on ovarian function can result in infertility or increase the risk of miscarriage and pregnancy complications.

Fertility Preservation Options

Fertility preservation has become an essential component of breast cancer care for women who wish to conceive after treatment. Some options include:

1. Egg or Embryo Freezing (Cryopreservation)

Cryopreservation is the most commonly used method to preserve fertility. This process involves stimulating the ovaries to produce multiple eggs, retrieving those eggs, and freezing them for future use. Women may also choose to fertilize their eggs with sperm to create embryos, which can be frozen for later implantation. However, this process must be done before chemotherapy or other treatments that can harm ovarian function, and it requires a delay in treatment for about two weeks.

2. Ovarian Suppression

Some doctors recommend the use of gonadotropin-releasing hormone (GnRH) agonists during chemotherapy to temporarily suppress ovarian function. The theory is that by "putting the ovaries to sleep," they may be protected from the damaging effects of chemotherapy. While studies on the effectiveness of this approach are ongoing, it offers a potential option for women who cannot delay cancer treatment to undergo egg retrieval.

3. Ovarian Tissue Cryopreservation

This is a newer and experimental method where ovarian tissue is removed and frozen before treatment. After cancer therapy, the tissue can be re-implanted into the body, where it may restore hormonal function and fertility. This technique is particularly useful for young girls who have not yet reached puberty, as it does not require ovarian stimulation.

Counselling and Support for Women

A breast cancer diagnosis is emotionally challenging, and for young women who have not yet started or completed their families, fertility concerns add to the distress. Fertility counseling should be an integral part of cancer care for all reproductive-age women diagnosed with breast cancer. Oncologists and fertility specialists need to work collaboratively to provide women with information about their fertility risks and preservation options. Counseling should also address the emotional impact of potential infertility, offering support for coping with loss or changes in reproductive plans.

Conclusion

The impact of breast cancer on fertility is a significant concern for many young women facing this diagnosis. While treatments like chemotherapy, hormonal therapy, and radiation can jeopardize fertility, advances in fertility preservation provide hope for many. With early intervention and proper counseling, women diagnosed with breast cancer can make informed decisions about their fertility, preserving the option to conceive after their cancer treatment is complete. Nevertheless, the emotional toll of these decisions should not be underestimated, and ongoing support is critical for navigating this complex journey.

https://www.hindustantimes.com/lifestyle/health/infertility-alert-how-your-bmi-or-weight-could-be-blocking-your-path-to-parenthood-101728484194094.html

Infertility alert: How your BMI or weight could be blocking your path to parenthood

According to health and fertility experts, Body Mass Index (BMI) has a direct impact on reproductive health and the ability to conceive, making it a crucial factor in women's fertility. BMI is a straightforward formula that accounts for a person's height and weight.

In an interview with HT Lifestyle, Dr Rupali Tambe, Fertility Consultant at Nova IVF in Pune, shared, “Although a healthy reproductive system is frequently linked to a BMI within the normal range (18.5-24.9), women who are underweight or overweight might have difficulties becoming pregnant. For women who intend to become pregnant, knowing how BMI affects fertility is crucial since keeping a healthy BMI can improve the odds of conception.”

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Underweight Women and Fertility

Dr Rupali Tambe explained, “A BMI below 18.5 is regarded as underweight. Hormonal imbalances frequently cause difficulty conceiving for women in this category. The production of vital reproductive hormones like estrogen, which is necessary for controlling the menstrual cycle and ovulation, might be interfered with by low body fat. The likelihood of ovulation and pregnancy is decreased when body fat levels are very low because estrogen production decreases. This might result in irregular periods or even amenorrhea, the full cessation of menstruation.”

She elaborated, “In addition, women who are underweight may not be getting enough nutrients, which might lower the quality of their eggs and raise the chance of miscarriage. Low BMI can also have an impact on the lining of the uterus, which reduces the likelihood that a fertilized egg will implant well. Gaining weight to reach a normal BMI can assist enhance the chances of conception and restore regular ovulation in women who are attempting to get pregnant.”

Overweight and Obese Women

On the other hand, a BMI of more than 25 is regarded as overweight and a BMI of more than 30 is categorised as obese. Dr Rupali Tambe revealed, “The overproduction of estrogen brought on by excess body fat might disrupt ovulation and the menstrual cycle. One of the most frequent reasons of infertility in overweight and obese women is this disorder, called anovulation. Polycystic ovarian syndrome (PCOS), a hormonal condition that reduces egg quality and causes irregular or absent periods, is also more common in women with high BMIs. Additionally, obesity can impact insulin levels, resulting in insulin resistance, which further disrupts the balance of reproductive hormones and hinders ovulation.”

She added, “Furthermore, women who are overweight may experience pregnancy-related issues such as gestational diabetes, hypertension, a higher risk of miscarriage, and birth abnormalities. Because of these reasons, it's critical that women with high BMIs reduce their weight before attempting to conceive. Research indicates that even a little weight loss of 5–10% will boost general reproductive health and restore ovulation, which will increase fertility. Women with advanced maternal age that is more than 30 years and not able to conceive should not waste too much time in weight loss as it can further deteriorate the quantity and quality of oocytes, in such cases an expert opinion from a fertility consultant and a programmed approach towards weight loss plus fertility will help them to achieve desired results.”

The Importance of a Healthy BMI for Assisted Reproduction

The BMI of women using in vitro fertilization (IVF) or other reproductive procedures may potentially have an impact. Dr Rupali Tambe pointed out, “Due to poor egg quality, decreased ovarian response to stimulation, and problems with implantation, women who are underweight or overweight may experience lower success rates with in vitro fertilization.

Maintaining a healthy body mass index (BMI) enhances the chances of successful pregnancy by optimising egg quality, hormone equilibrium, and uterine receptivity.”

Asserting that a key component of women's fertility health is their BMI, Dr Rupali Tambe concluded, “Hormonal imbalances, irregular ovulation and other reproductive difficulties make conception difficult for both overweight and underweight women. Whether pregnancy occurs naturally or through fertility treatments, maintaining a healthy BMI through balanced diet, regular exercise, and lifestyle modifications can greatly enhance reproductive results and increase the odds of conception. In order to maintain their reproductive health and may ensure a more seamless transition to parenting, women who intend to become pregnant should aim for a BMI within the healthy range.”

https://www.hindustantimes.com/lifestyle/health/infertility-alert-how-your-bmi-or-weight-could-be-blocking-your-path-to-parenthood-101728484194094.html

Stressing out your pancreas can lead to diabetes. Study finds new ways to prevent, treat it

Pancreatic cells, like human cells, have a limit to how much stress they can handle before they start to break down. Through overstimulation of these cells, certain stresses like inflammation and hyperglycemia lead to the onset of type 2 diabetes.

As it turns out, pancreatic cell stress tolerance to two distinct types of molecular stress is correlated with DNA sequence variations that are known to raise an individual's risk for diabetes. These findings were made by researchers at The Jackson Laboratory (JAX). Stress and inflammation may increase the risk of failure or death of the insulin-producing cells in individuals with these genetic alterations in the pancreas.

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"Ultimately we want to develop new ways to prevent and treat type 2 diabetes by targeting the genes and pathways that are perturbed in people who are most susceptible to the disease," said Michael L. Stitzel, associate professor at JAX and co-senior author of the new study with JAX professor Dugyu Ucar, published in the Oct. 8 advanced online issue of Cell Metabolism. "These findings give us new insight into some of those genes and pathways."

The work points toward dozens of genes that connect cell stress and diabetes risk, including one that is already under investigation as a drug target for type 2 diabetes complications.

When living cells face challenges, including damage, inflammation, or nutrient changes, they activate protective responses to try to cope with and reverse the stress. But over time, sustained stress can overwhelm the cells, causing them to slow down or die.

"Researchers have completed multiple studies looking at what molecular pathways are important in regulating insulin production in happy, healthy islet cells," said Stitzel. "But we were working on this hypothesis that islet cells are not always happy. So what pathways are important when the cells are under stress, and how do diabetes-linked DNA sequence changes in each of us affect them?"

Stitzel's group exposed healthy human islet cells to chemical compounds known to induce either ER stress or cytokine stress. Then, they tracked changes to levels of RNA molecules in the cells as well as how tightly or loosely packed different stretches of DNA were inside the cells--a proxy for what genes and regulatory elements are being used by the cells at any given time.

To analyze the results, the team collaborated with Ucar, a professor and computational biologist at JAX. Together, the scientists found that more than 5,000 genes, or nearly a third of all the genes expressed by healthy islet cells, change their expression in response to ER stress or cytokine stress. Many were involved in the production of proteins, which is crucial for islet cells insulin-producing role. And most of the genes were only involved in one or the other stress response, raising the idea that two separate stress pathways play a role in diabetes.

In addition, around one in eight regulatory regions of DNA typically used in islet cells were altered by stress. Importantly, 86 of these regulatory regions had been previously found to contain genetic variants in people most at risk of type 2 diabetes.

"What this suggests is that people with these genetic variants may have islet cells that respond worse to stress than other people," said Stitzel. "Your environment - things like diabetes and obesity--pulls the trigger with type 2 diabetes, but your genetics loads the gun."

Stitzel hopes that the new list of regulatory regions and genes eventually lead to new drugs to prevent or treat diabetes by potentially making islet cells more resilient to stress.

The researchers homed in one gene that was altered by both ER stress. Called MAP3K5, the gene was shown to alter islet beta cell death in mice containing a diabetes-causing mutation in the insulin-encoding gene.

In the new paper, Stitzel and his colleagues showed that higher levels of MAP3K5 led to more islet beta cells dying in response to ER stress. Eliminating or blocking MAP3K5, on the other hand, made the islet cells more resilient to ER stress and less likely to die.

Early studies of Selonsertib, a drug targeting MAP3K5, have showed that it could reduce the risk of severe complications of diabetes. The new results point toward another possible role of the drug--in the prevention of diabetes in people most at risk of the disease, to help their islet cells remain functioning and alive in the face of cellular stress.

"It's really exciting that this therapeutic is already in clinical trials but much more work is needed to understand whether the drug might be able to be leveraged in primary prevention," said Stitzel. 

https://www.hindustantimes.com/lifestyle/health/stressing-out-your-pancreas-can-lead-to-diabetes-study-finds-new-ways-to-prevent-treat-it-101728481324242.html

More than 85pc of blindness cases in India preventable: Experts

While India has the maximum number of blind people in the world, most do not know that in more than 85 per cent of the cases, the condition is preventable, said experts on Thursday on World Sight Day.

India is home to an estimated 34 million people living with blindness or moderate or severe visual impairment (MSVI).

"Nearly 85 per cent of blindness in the world is avoidable which can either be preventable or treatable," Dr. Rajesh Sinha, Professor, Dept. of Ophthalmology, AIIMS New Delhi said.

The expert called the need for public awareness so that a majority of people in the society who may become blind due to ignorance maintain their sight for life.

"Ocular causes of preventable blindness can be infections, vitamin A deficiency while causes of treatable blindness can be cataract, uncorrected refractive error, diabetic retinopathy," Sinha said.

According to the National Blindness and Visual Impairment Survey, cataract is the leading cause of blindness, accounting for 66.2 per cent of all cases of blindness in India.

Uncorrected refractive errors account for 18.6 per cent, and glaucoma for 6.7 per cent. Other causes of blindness and vision impairment include corneal opacities (0.9 per cent), childhood blindness (1.7 per cent), and diabetic retinopathy (3.3 per cent).

"It is important to spread awareness around preventable blindness because more than 85 per cent of the blindness is preventable if only people know how to address them," said Dr. Ikeda Lal, Senior Cornea, Cataract and Refractory Surgery Specialist, at Sir Ganga Ram Hospital New Delhi.

The common reasons for blindness in India include cataract, glaucoma, macular degeneration, uncorrected refractive error, and corneal blindness.

Diabetic retinopathy is another very important reason for blindness in India, especially considering the high prevalence of diabetes in the country, Lal said.The experts advocated the need for early screenings to detect eye problems and prevent vision loss.

https://www.newkerala.com/news/2024/63766.htm

You’re due for a colonoscopy, but what if you don’t want it?

If more people knew about other kinds of colorectal cancer testing, some experts hope, perhaps some who put off colonoscopies would be screened and deaths from colon cancer could be avoided, colonoscopyIf more people knew about other kinds of colorectal cancer testing, some experts hope, perhaps some who put off colonoscopies would be screened and deaths from colon cancer could be avoided.

This year about 53,000 Americans are expected to die from colon or rectal cancer. Doctors say most people should start getting screened at age 45. Yet many who are eligible skip testing.

When most people in this country think of colon cancer screening, they think of colonoscopies, which let doctors examine the colon but can be inconvenient. Yet there are other equally acceptable options for screening.

If more people knew about other kinds of colorectal cancer testing, some experts hope, perhaps some who put off colonoscopies would be screened and deaths from colon cancer could be avoided.

Here’s what you need to know about colonoscopies and fecal tests, which to ask for, and why your doctor might be recommending one over the other.

How do colonoscopies and fecal tests work?

Colonoscopies are widely used, but there is another option available: fecal tests.

Both types of test attempt to find cancers and large polyps — growths on the wall of the colon — that occasionally turn into cancers. Cancers that are found early often can be cured when doctors simply cut them out. Finding and removing polyps can also prevent cancers.

Colonoscopies start with a patient’s taking strong laxatives to empty the colon. On the day of the test, the patient is sedated. Then, a doctor inserts a colonoscope — a flexible tube with a video camera at the end — into the rectum and colon and looks for polyps and cancers to remove. The doctor may also take samples for study in a lab.

If no polyps or cancers are found, the average patient can wait 10 years before having another colonoscopy.

Fecal tests can be done at home. Patients collect a stool sample and mail it to or drop it off at a testing lab.

One option is the fecal immunochemical test, or FIT, which should be repeated annually. A lab analyzes the sample for traces of blood, which can indicate a polyp or cancer. Large polyps and colon cancers sporadically ooze small amounts of blood. If blood is detected, the patient must have a colonoscopy.

Another more complex fecal test is Cologuard, repeated every three years. It looks for blood in stool and also for abnormal DNA from large polyps and colon cancers. Like the FIT test, Cologuard must be followed by a colonoscopy if blood or abnormal DNA are present.

If a person who has a large polyp has a colonoscopy, the test will detect it 95% of the time. If that person has a Cologuard test, there is a 42% chance that it will be positive because of the polyp. If the person has a FIT test, there is about a 22% chance it will be positive.

Colonoscopies find 95%. A one-time Cologuard test will be positive 94% of the time if a cancer is present, and a FIT test will be positive 74% of the time.

The ultimate goal, though, is preventing colon cancer deaths. For now, no one really knows which test performs better. One large clinical trial by the Department of Veterans Affairs is comparing the number of colon cancer deaths among 50,000 patients randomly assigned to have a colonoscopy or an annual FIT test and followed for 10 years.

Results are expected in 2027 or 2028.

While those studies are continuing, other studies have compared a screening test with no test.

One study found that after 30 years, people who had fecal tests had a 33% lower death rate from colon cancer than people who were not screened. The death rate fell to 2%, from 3%.

A 10-year European study of colonoscopy found a 30% reduction in the risk of getting colon cancer. It was 0.84% in a group that had colonoscopies and 1.22% in a group that was not screened. There was no difference in the risk of dying from colon cancer.

Whether the reduction in the risk of getting colon cancer is worth a potential risk of injury during the surgery is “in the eye of the beholder,” said Dr. Michael Bretthauer, a gastroenterologist at the University of Oslo who led the study.

The ultimate goal, though, is preventing colon cancer deaths. The ultimate goal, though, is preventing colon cancer deaths. (Source: Freepik)

Can I ask my doctor for a fecal test if I prefer it to a colonoscopy?

Of course — if you are of average risk, meaning no family history of colon cancer and no genetic condition that predisposes to colon cancer. If you are at a higher risk, your doctor is likely to advise a colonoscopy.

When patients of average risk ask Dr. David Lieberman, a gastroenterologist at Oregon Health and Science University, if they can skip the colonoscopy, he explains that a fecal test and a colonoscopy accomplish different things. Fecal tests are likely to find cancers when they are early enough to be cured. But he says those tests are not so good at finding precancerous polyps. While the hope is that, repeated over time, the fecal tests will find polyps, colonoscopies find both with a single test.

Hearing that, he said, most patients decide they want colonoscopies.

What do the tests cost?

Many patients pay little or nothing because insurance, including Medicare, covers the tests. But testing does cost the health care system.

Prices for the testing vary, but one estimate says a colonoscopy for people with private insurance costs the insurer about $3,442. A single Cologuard test costs about $763, and a single FIT test costs about $91.

Why do doctors prefer colonoscopies?

Many doctors think they are saving patients’ lives with colonoscopies.

“The idea of finding and removing cancer precursor lesions became very attractive to physicians,” Lieberman said.

But there is also a financial incentive for the procedure.

“Colonoscopy is a massive revenue generator for hospital systems,” said Dr. Adewole Adamson, of the University of Texas at Austin, who studies cancer screening.

Doctors profit too, said Dr. Samir Gupta, a gastroenterologist at the University of California, San Diego. “When we do the procedure, that’s part of our income,” he said. “We are all conflicted.”

Many other countries with modern national health systems use FIT tests because they are cheap, and because they lack the capacity for wider use of colonoscopies.

But there are places in the U.S. that don’t emphasize colonoscopies. Most VA centers mail FIT tests to eligible patients every year.

So does Kaiser Permanente, one of the nation’s largest medical care providers. In the company’s lab in Northern California, for instance, testing is done “on an industrial scale,” said Dr. Theodore Levin, a Kaiser gastroenterologist, with 15,000 to 20,000 FIT tests processed each week.

In describing some of Kaiser’s motivation for offering FIT, Levin added, “All the physicians are salaried, so they are not doing screening to support their practice.”

Dr. Amitpal S. Johal, director of gastroenterology at Geisinger, a large health care system in Pennsylvania, says Cologuard is preferred because of its greater accuracy and because it only needs to be done every three years. The test is useful for the system’s large rural population for whom a center that does colonoscopies can be far away.

“Some of these people can’t drive five hours” for the test, he said, while “Cologuard will mail the test to them, and UPS will pick it up.”

When can I get a blood test instead of these options?

The Food and Drug Administration recently approved a blood test called Shield by the company Guardant Health. The test looks for fragments of DNA shed from colon cancers and polyps. If it finds evidence of cancer or large polyps, you need a colonoscopy.

The problem is that the test is not very accurate and does especially poorly at finding large polyps. Still, gastroenterologists say it is better than nothing.

https://indianexpress.com/article/lifestyle/health/youre-due-for-a-colonoscopy-but-what-if-you-dont-want-it-9606019/

Nobel Prize for Medicine awarded to US scientists Victor Ambros, Gary Ruvkin

The 2024 Nobel Prize in physiology or medicine has been awarded to Victor Ambros and Gary Ruvkun for their discovery of microRNA, a new class of tiny RNA molecules that play a crucial role in gene regulation.

The Nobel Prize committee announced the prestigious honour in Sweden on Monday.

The Karolinska Institutet awarded the Prize to the scientists for their groundbreaking discovery in the small worm C. elegans, which has revealed a completely new principle of gene regulation, The Nobel Assembly said in a press release.

This turned out to be essential for multicellular organisms, including humans. MicroRNAs are proving to be fundamentally important for how organisms develop and function.

This year's medicine laureates Victor Ambros and Gary Ruvkun studied a relatively unassuming 1 mm long roundworm, C. elegans.

Despite its small size, C. elegans possesses many specialised cell types such as nerve and muscle cells also found in larger, more complex animals, making it a useful model for investigating how tissues develop and mature in multicellular organisms.

In 1993, this year's Nobel Prize laureates published unexpected findings describing a new level of gene regulation, which turned out to be highly significant and conserved throughout evolution.

The information stored within our chromosomes can be likened to an instruction manual for all cells in our body. Every cell contains the same chromosomes, so every cell contains exactly the same set of genes and exactly the same set of instructions.

This year's Laureates Victor Ambros and Gary Ruvkun were interested in how different cell types develop. How different cell types, such as muscle and nerve cells, have very distinct characteristics and how these differences arise?

The answer lies in gene regulation, which allows each cell to select only the relevant instructions. This ensures that only the correct set of genes is active in each cell type.

If gene regulation goes awry, it can lead to serious diseases such as cancer, diabetes, or autoimmunity. Understanding the regulation of gene activity has been an important goal for many decades, the Nobel committee said.

Incidentally, in the late 1980s, both Ambros and Ruvkun were postdoctoral fellows in the laboratory of Robert Horvitz, who was awarded the Nobel Prize in 2002, alongside Sydney Brenner and John Sulston.

Ambros was born in 1953 in Hanover, New Hampshire, US and received his PhD from Massachusetts Institute of Technology (MIT), Cambridge, MA, in 1979 where he also did postdoctoral research 1979-1985.

He became a Principal Investigator at Harvard University, Cambridge, MA in 1985. He was Professor at Dartmouth Medical School from 1992-2007 and he is now Silverman Professor of Natural Science at the University of Massachusetts Medical School, Worcester, MA.

Meanwhile, Ruvkun was born in Berkeley, California, US in 1952. He received his PhD from Harvard University in 1982 and was a postdoctoral fellow at Massachusetts Institute of Technology (MIT), Cambridge, MA, 1982-1985.

He became a Principal Investigator at Massachusetts General Hospital and Harvard Medical School in 1985, where he is now Professor of Genetics.

The medicine prize has been awarded 114 times to a total of 227 laureates. Only 13 women have won been awarded the prize. Physiology or Medicine was the third prize category that Alfred Nobel mentioned in his will.

Since 1901, the medicine laureates have been selected by the Nobel Assembly at Karolinska Institutet.

Nobel announcements continue with the physics prize on Tuesday, chemistry on Wednesday and literature on Thursday. The Nobel Peace Prize will be announced Friday and the economics award on October 14.

https://www.newkerala.com/news/2024/63183.htm