Posted by ProPortion Foods Blog on Jan 15, 2020 in Research
A group of experts, policy makers, clinicians and citizen representatives from around the world are tackling the pervasive financial conflicts of interest in health research, education and clinical practice, proposing a better way forward.
More than half of medical research in the US is industry funded. Time and time again, it’s been shown that industry-funded trial outcomes favour their products, exaggerating benefits and downplaying harm, compared to independent studies.
Editors of leading medical journals have been scathing of biased research for at least a decade, and yet little has changed.
Former editor-in-chief of the New England Journal of Medicine, Marcia Angell, stood down in 2000, famously saying, “It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines.”
Richard Horton, editor of The Lancet, similarly wrote that “The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue.”
Big pharma’s tentacles spread to medical education with studies finding clear links between funding and promotion of sponsors’ drugs – their influence even extends to advocacy groups.
In clinical practice, sales representatives and direct payments are associated with greater prescribing of drugs from the company’s sponsors, and clinical guidelines are often written by people with financial interests in pharmaceutical companies.
These practices are leading to overdiagnosis and prescription of drugs, impacting people’s health and wasting money. Polypharmacy – taking five or more medicines a day – is common and has been increasing in older adults, with many detrimental outcomes.
Essentially, healthcare needs to become independent, they say.
“If we want to produce trustworthy evidence and tackle the epidemic of medical excess,” says lead author Ray Moynihan from Bond University in Queensland, Australia, “decision-makers at all levels within healthcare need to disentangle themselves from those profiting from that excess.”
To do this, they suggest governments call for independently funded research by scientists with no industry ties on new treatments, tests and technologies, and that public healthcare organisations accept no industry funding.
People and bodies involved in all aspects of medical education need to stop reliance on industry funding.
Marketing interactions between industry and decision makers also needs to be stopped, including healthcare professionals and clinical guideline authors.
The group suggests that research institutions could provide incentives for scientists to collaborate with public agencies and civil society groups.
They hope the reforms will reinstate public trust and improve healthcare outcomes.
“Patients and the public deserve evidence they can trust,” says Fiona Godlee, editor in chief of the BMJ.
“Commercial influence has no place in scientific research, nor in education and guidance of clinicians, nor in decisions about diagnosis and treatment. We hope that people around the world support our call for fundamental reforms.”
By accessing their paper, published online in the BMJ, concerned people can sign to support their call to action.
One in three hospitalised adults in the US is at risk for malnutrition, a major analysis has found. And patients’ poor food intake is having a significant impact on their healing and recovery, compounding their risk of death.
“Nutrition is easily overlooked as healthcare professionals often focus on a patient’s primary diagnosis,” lead author Abby Sauer told NutritionInsight.
“It may come as a surprise to some that when patients don’t get proper nutrition, it can significantly put their health and lives at risk,” she adds, explaining that nutrition is more important than ever when someone is sick or injured.
The researchers screened around 10,000 patients from 2009 to 2015 to assess malnutrition risk and links with mortality.
They found around one in two patients were eating half or less of their meals. This low food intake was linked to higher risk of mortality, and those who ate none of their food had a nearly six-fold higher risk of dying than those who ate at least some.
The findings support previous studies that have identified hospital malnutrition as a global public health problem, including Australian research which also found that this “silent epidemic” affects one in three hospitalised patients.
Despite this growing awareness, it is still not given the attention it deserves.
“Malnutrition can be invisible to the eye and is rampant in US hospitals because it’s not always top of mind,” said Gail Gerwitz, president of nutritionDay, an organisation which was involved in the study.
Loss of muscle mass and strength takes the brunt of poor nutrition, leading to sarcopenia, an age-related disease of accelerated muscle wasting that results in a downward spiral of poor health and mortality.
Some Australian hospitals are taking action by implementing basic malnutrition and sarcopenia screening tools. Relatives can also look for key signs of malnutrition.
These include unexpected weight loss, tiredness, low mood, poor appetite, unhealthy teeth and gums, listless hair and brittle nails, constipation and poor wound healing.
Hospitals and aged care facilities can take several measures to boost patients’ food intake, by using patient-centred service models, introducing mandatory nutrition standards, addressing obstacles to eating like poor dentition, and providing a choice of meals that are tasty and appealing.
High protein, high energy meals are the first line of defence to prevent or address malnutrition and promote healing. This can be achieved by adding extra cream or butter to food. Where necessary – especially with poor appetite – supplements can be used between meals to boost protein and calorie intake.
Posted by ProPortion Foods Blog on Nov 23, 2018 in Research
The number of people with food allergies is rising dramatically around the world. In fact, data suggest that peanut allergies have tripled over the past couple of decades.
Food allergy – an abnormal immune response to specific proteins – affects around 1 in 20 children. The most common triggers are egg, cow’s milk, peanut, tree nuts, seafood, soy, fish and wheat.
Most reactions aren’t severe, and many children will outgrow them. But peanut, tree nut, seed and seafood allergies are more likely to cause lifelong problems. And it is possible to develop an allergic reaction to a food that was previously safe to eat.
By adulthood, around 2 in 100 people suffer from food allergies. Symptoms can include swelling around the face, hives or skin rash, stomach pain and vomiting. In some they can cause anaphylaxis, a life-threatening reaction to suspect foods.
Not everyone with an allergy reacts to the common foods. More than 160 different foods have caused allergic reactions, including meat, sesame seeds, avocados, marshmallows (gelatin), corn, mango, dried fruit, and hot dogs.
Many less common food allergies are caused by oral allergy syndrome (OAS) or pollen-food allergy syndrome. People with OAS react to inhaled allergens like pollen from trees, weeds or grasses, and can develop “cross-reactivity” to foods with similar proteins.
For instance, many people with an allergy to birch and mugwort pollen also react to raw apple, and citrus fruit allergy can cross over to other citrus fruits, grass pollens, Timothy grass, birch and mugwort pollen.
Allergic reactions can impact quality of life. And because of serious and potentially fatal reactions in rare cases, common allergens must be listed on all foods.
Failure to list all ingredients can be tragic, like in the case of 15-year old Natasha Ednan-Laperouse, who died from an allergic reaction to a baguette in 2016. The culprit was sesame seeds, which was not on the ingredient list.
Hospitals and aged care facilities also need to be aware of new laws.
People who are allergic to peanuts (which are legumes, not nuts) might also be allergic to lupin, another type of high protein legume.
Australia’s food standards body, FSANZ, recently changed food labelling laws to require that lupin be declared as an ingredient – even if the food isn’t packaged.
Although lupin is not ordinarily used in Australian foods, it can be found in a range of common food items like bread, bakery products, pasta, sauces, beverages and even meat-based products like burgers and sausages.
Experts are not sure why food allergies are rising, but environmental influences are most likely.
A probable factor is the human microbiome – the 100 trillion bacteria and other microbes that coexist with us, mainly in our gut. These microbes play crucially important roles in immunity.
A host of modern practices has diluted our microbial diversity, including excessive use of antibiotics and disinfectants, and replacing diverse plant food diets with highly processed foods.
Another intriguing link is the higher incidence of food allergies in areas with less sunlight, suggesting a possible role for vitamin D.
Drawing from these observations, experts advise that we increase our exposure to green spaces, natural environments and sunlight, and regularly eat a broad range of plant foods.
Note that food allergies are different to food sensitivities.
Food sensitivities or intolerances are more prevalent than food allergy. They are not caused by an immune response, so the only way to identify them is by eliminating suspect foods then challenging to see if they produce a reaction.
Chronic diseases, impaired mobility and diminished quality of life with aging seem inevitable to most. Although healthy lifestyle habits protect us, researchers say they may have found another way to reverse the aging process.
Aging cells stop working well for several reasons. Researchers have turned the spotlight to ‘senescent cells’ – cells that stop dividing. This process is thought to have several benefits like suppressing tumours, wound healing and more.
But in aging, these cells accumulate and may impact the function of surrounding cells. And animal research suggests that removing these deteriorating cells could thwart or delay age-related physical decline.
Researchers propose that DNA damage, inflammation and erosion of telomeres – protective tips at the end of chromosomes – could all explain why cells become senescent with age.
It now appears that gene regulation might also factor in.
Every cell in the body contains all the information that the body needs to function. But different genes are turned on or off according to that cell’s role – explaining for instance why the heart and brain work differently despite containing the same genes.
Genes are activated by environmental messages, facilitated by around 300 proteins called ‘splicing factors’. With aging, the number of splicing factors drops, so that aging cells are less able to respond to changes in the environment.
Researchers from the University of Exeter, UK, have been able to turn these splicing factors back on and revive old cells – in vitro at least – by treating cells with a chemical that produces small amounts of hydrogen sulphide.
Hydrogen sulphide – the gas that smells like rotten eggs – is found naturally in our bodies. But in high doses it can be toxic. The researchers found a way to send the molecule in small doses to the mitochondria – the cell’s energy powerhouse – where they think it acts.
They hope this procedure could eventually be used in living people and treat age-related diseases.
Can death itself be cured so that people can live forever?
Aubrey de Grey thinks so. He founded the organisation, Strategies for Engineered Negligible Senescence (SENS), focussed on finding ways to remove senescent cells and theoretically keep bodies alive forever.
Do people want immortality? A 2013 national survey of Americans found that 56% would not use technologies that would help them live to 120 or longer. Two-thirds of respondents were concerned about the strain on natural resources.
Jake Dunagan, director of the consulting firm Very Nice and researcher in cognitive bias, says the SENS longevity research is selfish. “’I want mine. I always want mine.’ Well what if everyone had this? What would be the long-term implications of that?”
There is a notable distinction between increasing our “health span” – the primary focus of most aging research – and increasing our life span, say other researchers like biochemist and professor of biogerontology, Judy Campisi.
Most people fear death and discussing it is taboo in many cultures. De Grey calls it “the terrible thing that awaits [us],” disparaging people who simply accept their fate.
But ‘The Art of Dying Well’ suggests that coming to terms with death can help us live more fully. “In fact,” they suggest, “consciousness of our mortality can enable us to cherish every moment of the life we have.”