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IANS Explainer: The role of diet & exercise in managing diabetes

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New Delhi, April 19 (IANS) After the food habits of incarcerated Delhi Chief Minister Arvind Kejriwal stirred up a debate as the Enforcement Directorate (ED) revealed the details of his high glycaemic index diet this week, the lifestyle disease, which results from a combination of genetic and lifestyle factors, is a complex one and diet — along with daily exercise — plays a key role in its management.

A proper healthy and nutritional diet can help aptly manage the incurable condition, which if ignored, can affect nearly all organs.

Uncontrolled diabetes can lead to multiple complications ranging from kidney problems — failure, dialysis, and transplantation, to blindness, amputation, heart attacks, strokes, dementia, nerve problems, and gangrene.

The condition can also affect sexual health and cause infertility, among others.

What is diabetes?

The World Health Organisation (WHO) defines diabetes as a chronic disease that occurs either when the pancreas does not produce enough insulin (blood glucose regulating hormone), or when the body cannot effectively use the insulin it produces.

Both raised glucose levels, called hyperglycaemia, and low glucose levels, called hypoglycemia, can lead to serious damage to many of the body’s systems, especially the nerves and blood vessels.

Globally, diabetes affects more than 50 crore people, according to a study published in the journal The Lancet. It projects the number to more than double to 130 crore people in the next three decades.

In India, a whopping 10.1 crore people suffer from diabetes, while 13.6 crore are pre-diabetic, reveals data from the Indian Council of Medical Research (ICMR).

According to top diabetologist Dr V. Mohan, chairman of Dr Mohan’s Diabetes Specialities Centre, “diet, high calories, weight, increase in obesity are the major drivers, and there is a small genetic factor, which makes Indians a little bit more prone”.

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He also blames rising consumption of junk food — known to be rich in salt and sugar –, no exercise, disturbed sleep patterns, rising pollution levels, adulteration of food, and their contamination with pesticides behind the diabetes epidemic in the country.

Diet management in diabetics

While it is important to eat a healthy diet rich in fruits and vegetables, controlling portion size and carbohydrate levels is key for diabetic patients. Food items can also be classified based on their glycaemic index (GI) levels. GI is a value assigned to foods, especially those rich in carbohydrates, and determines how quickly the foods can spike blood glucose levels in the

body. High-GI food can cause a rapid spike in blood glucose levels, followed by a swift decline. These high-GI foods raise the demand for insulin, leading to the risk of developing Type-2 diabetes and worsening in diabetes patients.

On the other hand, low-GI food helps prevent diabetes, as well as its complications like heart disease, obesity, and cancer.

Researchers at Harvard T.H. Chan School of Public Health, in a recent study, revealed that consuming a low-carbohydrate diet which primarily includes plant-based foods can significantly lower the risk of premature death among people with diabetes.

Dr Sudhir Kumar, a neurologist at Indraprastha Apollo Hospitals, says “carbohydrate restriction” is key.

“This can be achieved by avoiding or restricting sugar, jaggery, honey, etc. Sugar-sweetened beverages (soft drinks, packed fruit juices) and sweets should be avoided,” he said while stressing the need to minimise “intake of rice, roti, idli, dosa, potatoes, and fruits”.

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Can diabetic patients eat fruits, and drink tea, and coffee?

The concern has been that fruits contain sugar. However, most fruits have low to medium GI, compared to other carbohydrate-containing foods like white or wholemeal bread.

Acclaimed celebrity nutritionist Rujuta Diwekar says that “when it comes to local, seasonal fruits, the truth invariably lies beyond the fear of calories, sugar, and weight gain”.

She also vouches for mangoes, known to be rich in antioxidants, fibre as well as Vitamin C, over “green tea, oats, pills” for better nutrients.

But can the same be applied to a person with diabetes? Contrary to popular myth, mangoes do not have a high glycemic index.

According to Rujuta, “mangoes are not only safe for diabetics, but they are also, in fact, recommended for people with diabetes because of their rich profile of nutrients. They are rich in phytonutrients, antioxidants, and fibre”.

Portion size may be key here.

Mayo Clinic’s M. Regina Castro, MD, in a recent paper, revealed that the quantity of carbohydrates in a determines blood sugar levels more than “the source of the carbohydrates or whether that carbohydrate source is a starch or sugar”.

“As you decide what fruit to eat, keep in mind that one serving of fruit should contain no more than 15 grams of carbohydrates. So, the size of the serving depends on how much carbohydrates are in the fruit.”

Diabetes UK explains that a portion of fruit, similar to a slice of bread, contains about 15-20g of carbohydrates on average. On the other hand, a can of cola contains 35g of carbs and a medium slice of chocolate cake contains 35g of carbs.

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Further, while sugar-sweetened beverages like colas and fruit juices can spike blood sugar levels, drinking more coffee, or tea may not be harmful.

A recent study by Harvard T.H. Chan School of Public Health showed that drinking more coffee, tea or plain water may lower Type 2 diabetes patient’s risk of dying prematurely from any cause by about 25 per cent.

But the study, published in the BMJ, calls for diabetics to cut down the intake of fizzy drinks, cakes, biscuits, chocolate, and other snacks; and also to limit the intake of starchy foods, particularly those that are highly processed and contain added fats, sugars and salt.

At the same time, consuming healthy carbohydrates, such as fruits, vegetables, whole grains, legumes, such as beans and peas, and low-fat dairy products, such as milk and cheese, while being mindful of portion size, can help manage diabetes effectively.

Role of exercise

In addition to diet, studies also reveal aerobic exercises and strength training along with abstinence from tobacco and alcohol and medications to fight diabetes.

A recent study published in the American Journal of Medicine Open, reveals that aerobic exercise which includes cycling, swimming, and walking, and resistance exercise such as using dumbbells, resistance bands, or bodyweight exercises, enhances insulin sensitivity, a vital factor in controlling Type 2 diabetes.

Another research from the University of Alberta in Canada shows that a combination of diet and exercise may not stop the progression of diabetes but can also put the disease into remission.

–IANS

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Unicef seeks $16.5 mn for mpox response in Africa

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Unicef seeks .5 mn for mpox response in Africa

Unicef seeks $16.5 mn for mpox response in Africa

Nairobi, Aug 22 (IANS) The United Nations Children’s Fund (Unicef) on Thursday appealed for $16.5 million to scale up mpox response in east and southern Africa.

UNICEF Regional Director for Eastern and Southern Africa, Etleva Kadilli, said in a statement issued in Nairobi, the capital of Kenya, that the new strain of mpox is a serious threat to vulnerable children and families, Xinhua news agency reported.

Children and vulnerable communities are on the verge of an expanding outbreak of mpox in the region as 200 confirmed cases have been detected across Burundi, Rwanda, Uganda, Kenya, and South Africa, the statement said.

“Aside from immediate lifesaving response, risk communication efforts and cross-border collaboration, investments in overall health system strengthening, continuity of essential services and targeted focus on programs that support overall child well-being must be prioritised,” Kadilli said.

The UN children’s agency warned concerns are rising over new public health emergencies as communities grapple with other ongoing crises. It said the new variant of the mpox virus (clade Ib) has been detected in all affected countries except South Africa, which is causing concern due to its potential for wider transmission across age groups, particularly young children.

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Burundi has so far confirmed more than 170 mpox cases in 26 out of the 49 districts in the country, Unicef said.

It noted that children and adolescents aged below 20 years constitute nearly 60 per cent of cases detected, with children under five years old comprising 21 per cent of cases.

Kenya, Burundi, and Uganda have been struggling with multiple emergencies, including drought and floods, in addition to the immediate concerns posed by the virus, Unicef said.

The UN agency also warned concerns remain over the secondary impact of mpox outbreaks on children and adolescents, including stigma, discrimination, and disruptions to schooling and learning.

“Drawing from experiences gained during responses to HIV, Covid-19, and Ebola outbreaks, there must be a collective effort to prioritise plans for supporting survivors, combating stigma, and facilitating continuity of basic social services, especially learning and children’s reintegration into school and community,” Unicef said.

–IANS

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Ozempic and the uncomfortable truth

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Ozempic and the uncomfortable truth

Ozempic and the uncomfortable truth

New Delhi, Aug 22 (IANS) Ozempic, the diet pill that took the world by storm has been under the public scanner for long, is found to be more devastating than what was originally speculated.

A study conducted at St. Vincent’s University Hospital (SVUH) in Dublin has challenged the prevailing belief that weight loss medications like Ozempic, Wegovy, or Monjaro primarily work by promoting satiety and reducing food intake.

The randomised controlled trial, led by Professor Donal O’Shea of SVUH and the UCD School of Medicine, involved 30 patients and focused on medications based on the hormone Glucagon-like peptide-1 (GLP-1).

The findings, published today in the Journal of the Obesity Society, reveal a strong relationship between increased metabolic activity caused by daily GLP-1 treatment and the amount of weight lost.

Interestingly, individuals with lower metabolic activity before beginning treatment experienced the most significant benefits.

“This study challenges the main narrative about these newer treatments, which is that they simply make you eat less and that any action on energy burn is minimal,” said O’Shea.

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“The strength of the association is surprising given the relatively small number of participants, suggesting that this increase in metabolic activity is a significant contributor to how these drugs work.”

O’Shea emphasised the importance of understanding the full mechanism behind these treatments.

“Safe medical treatment for obesity is still in its infancy, and we need to fully understand how the treatment works. Understanding how these agents increase energy burn should be an important part of future research. The diet industry has been long criticised for the bilge and inhumanity it churns out in the name of making people slimmer, with the people in the public eye being the highest targets for it, actors, models etc, some of them being candid about their struggles to maintain the size zero figure. Studies like these throw a light on the uncomfortable part of pop culture.”

–IANS

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Kolkata hospital horror: SC asks WB Police to not disrupt peaceful protests, CBI probe to continue

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Kolkata hospital horror: SC asks WB Police to not disrupt peaceful protests, CBI probe to continue

Kolkata hospital horror: SC asks WB Police to not disrupt peaceful protests, CBI probe to continue

New Delhi, Aug 22 (IANS) The Supreme Court on Thursday asked the West Bengal Police not to disrupt the peaceful protests in the wake of the horrific incident at Kolkata’s R.G. Kar Medical College and Hospital, where a trainee doctor was raped and murdered earlier this month.

“We categorically reaffirm that peaceful protests shall not be disturbed and disrupted. The state shall not take any action against those who are peacefully protesting against the incident at state-run RG Kar Medical College and Hospital,” a bench presided over by CJI D.Y. Chandrachud said.

The Bench, also comprising Justices J.B. Pardiwala and Manoj Misra, told senior advocate Kapil Sibal, representing the West Bengal government, that the apex court has not injuncted the state police from exercising such lawful powers as entrusted in terms of law, clarifying that the protestors should also comply with the requirements of the law.

“Let the investigation continue,” it remarked, taking on record the status report filed by the Central Bureau of Investigation (CBI) as well by the Kolkata Police in relation to the vandalisation of the hospital premises on the night of August 14.

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The Supreme Court also asked the jurisdictional court to decide, by 5 p.m. on Friday, the application of the investigative agency seeking permission for a polygraph test of the accused.

Further, it asked the National Task Force (NTF), set up by the government on its direction, to give a hearing to diverse medical associations while formulating effective recommendations relating to the safety, working conditions and well-being of doctors and medical professionals.

“To facilitate filing of suggestions before the NTF, we direct the Secretary in the Union Ministry of Health and Family Welfare to open a specific portal on the website of the ministry on which associations and different stakeholders may submit their suggestions for consideration before the committee,” the SC ordered.

Urging medical professionals across the country to return to work, the apex court assured the resident doctors and interns that no adverse action would be taken against them for participating in protests.

During the hearing, the CJI-led Bench observed: “Ask them (doctors) first to return to work. Once they return to work, nobody is going to take adverse action against the doctors. Let them first come back to work and then, if there is any difficulty, we will make sure that no adverse action is taken against the doctors.”

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It added that “the poor people coming to hospital cannot be left behind in the lurch” and raised concerns about how public health infrastructure would run if doctors did not resume work.

The SC reiterated: “Let all doctors resume work. Please rest assured that once the doctors resume duty, then we will prevail upon the authorities to not take any adverse action.”

Asking all the state governments to address the safety concerns of doctors and medical professionals, the apex court directed the Union Ministry of Health & Family Welfare to convene a meeting with all the Chief Secretaries and Director Generals of Police within a period of one week.

–IANS

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University doctors probe eye changes in Polaris Dawn mission

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University doctors probe eye changes in Polaris Dawn mission

University doctors probe eye changes in Polaris Dawn mission

New Delhi, Aug 22 (IANS) In order to better understand the changes that astronauts’ eyes undergo during spaceflights, doctors at Augusta University’s Medical College of Georgia (MCG) are working with Polaris Dawn, the first of three human spaceflight missions under the Polaris Program.

More than 70 per cent of astronauts experience these alterations, which are a component of a syndrome known as Spaceflight Associated Neuro-Ocular Syndrome (SANS), according to NASA.

SANS can cause a variety of symptoms, ranging from severe vision loss to the requirement for glasses.

In addition to advancing human spaceflight capabilities, the Polaris Program seeks to raise money and awareness for significant Earthly issues.

As a result of changes in bodily fluids like cerebrospinal fluid (CSF), which can result in structural alterations in the brain, astronauts may suffer changes in their vision as early as their first day in space, according to Dr. Matt Lyon, Director of the MCG Center for Telehealth.

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While CSF floats upward in space and presses against the optic nerve and retina, gravity on Earth aids in its removal from the optic nerve sheath.

By using portable handheld ultrasound scanners, Lyon’s team hopes to identify the astronauts who are most vulnerable to SANS and comprehend the mechanisms underlying these alterations.

A technology first developed to explore the effects of high cranial pressure and mild traumatic brain injuries (TBIs), MCG has trademarked the idea of utilising portable ultrasound to visualise damage from pressure and fluid changes in the optic nerve sheath.

A $350,000 NIH funding enabled the researchers to work with URSUS Medical Designs LLC to build a 3-D ultrasound device.

Currently, astronauts are being screened with this technology to check for optic nerve sheath damage or incompetence, which Lyon believes could predispose them to SANS.

The crew of Polaris Dawn is being trained by the research team to utilise these ultrasonic instruments to assess fluid and pressure in real time while in orbit.

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Determining whether the changes in vision are due to pressure, fluid volume, or both will aid in the development of countermeasures.

Using a lower-body negative pressure device, which draws bodily fluids downward, could be one way to mitigate the danger of SANS during space flights.

–IANS

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Number of COVID-19 patients in S Korea shows signs of abating

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Number of COVID-19 patients in S Korea shows signs of abating

Number of COVID-19 patients in S Korea shows signs of abating

Seoul, Aug 22 (IANS) The number of patients hospitalised for COVID-19 showed signs of abating, health authorities said on Thursday.

Although the weekly number of COVID-19 inpatients grew last week, the growth rate of hospitalisation plunged, according to the Korea Disease Control and Prevention Agency (KDCA), Yonhap news agency reported.

The number of COVID-19 patients in 220 hospitals last week came to 1,444, up 5.7 per cent from a week earlier, the KDCA said.

That compared with 1,366 patients in the second week of this month, up 55.2 per cent from a week earlier, and 880 patients in the first week, up 85.7 per cent from a week ago.

“Considering the current trend, the number of infections is expected to decrease after this week or the next,” KDCA Commissioner Jee Young-mee said during a meeting with related government agencies.

Jee added that the number of infections this week, previously estimated at 350,000, would likely be “smaller than anticipated.”

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The KDCA also announced that it has completed the purchase of 260,000 doses of COVID-19 treatments using a reserve fund of 326.8 billion won (US$244.8 million), with 177,000 doses set to be available at local pharmacies starting Monday next week.

To prevent the spread of the virus among students, the government has issued guidelines to schools ahead of the new semester, including requiring students to take leave if they exhibit severe COVID-19 symptoms, for the last COVID-19 pandemic had rattled the strongest of economies and health care systems, leaving a devastating image in its wake, something that not even the two World Wars could match.

South Korea remains vigilant and in good spirits but it can always look back and realise that it can never be too vigilant.

–IANS

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