Year: 2026

Categories : Expert Opinion Healthcare Politics and RegulationsTags :

Russell Rensburg | Consolidate the Funding of South Africa’s District Health System: Why Reform can’t Wait

On By ModernMedia
The District Health Programme Grant is a mechanism for funding the country’s public health efforts, particularly relating to HIV, TB, and other communicable diseases.

By Russell Rensburg

District managers in South Africa’s public healthcare system currently have to juggle funding from multiple government budget lines, each with different strings attached. To improve district health services, we urgently need to simplify and integrate these funding flows, argues Russell Rensburg.

In his State of the Nation Address this year, for the first time in a long time, President Cyril Ramaphosa focused on the broader determinants of health, delivering the strongest message yet around the importance of prevention.

This included signalling reforms around the taxation and regulation of alcohol as well as announcing broad initiatives to improve child health through good nutrition.

And his announcement that government will be rolling out the HIV prevention injection, lenacapavir, means that South Africa stands at the cusp of a massive healthcare transition. The six-monthly injection will be a game-changer in the country’s ongoing fight against HIV.

His efforts must be applauded.

But to deliver on this, Ramaphosa will need a functioning district healthcare system. The challenge, however, is that the district healthcare system often functions in name, but not in practice. This disconnect is mostly due to how district-level services – and healthcare in general – is funded.

In short, we ask for integrated healthcare services in a system built on siloed funding streams. We task district managers with coordinating care, but the budgets they depend on are split across the provincial equitable share, multiple conditional grants, and hospital-level allocations.

Health is funded from national revenue through two streams: the national department of health and the provincial equitable share. The equitable share, which funds healthcare and education, is calculated using several factors including population size, use of services and potential unmet and future needs. The allocations are unconditional allowing provinces to determine all the allocations relative to provincial realities, cost pressures and needs. With national funding, 85% is transferred to provinces through defined use conditional grants to fund strategic priorities. The challenge is that in recent years these grants have become transfers to provinces with poorly managed conditionalities resulted in fragmented healthcare.

One way to fix these challenges is to consolidate all district health funding — including district hospitals — into a single, nationally coordinated expanded District Health Programme Grant. This reform would align the system with the National Health Act, strengthen accountability, and prepare us for the healthcare transitions ahead.

This shift is not about centralising services. It is about aligning authority with responsibility, and aligning money with the legal design of the health system. Provinces would remain responsible for service delivery. But national government — as required by the Act — would finally have a coherent instrument to guide, monitor, and support the district health system.

A fragmented system

Twenty-three years ago, the National Health Act set out a detailed framework for how healthcare should be structured in the country. Health policy norms and standards are set nationally. Provinces are responsible for coordinating and providing technical and operational support to districts. Crucially, the act locates the delivery of health services within the district health system, which is mandated to plan, coordinate and deliver comprehensive primary healthcare services closest to where people live.

Where the National Health Act falls short, is in providing guidance on how these powers and responsibilities would be financed.

Currently, district health services are funded through three streams:

  • The provincial equitable share, allocated nationally to each province based on population size and demand for health services. This covers most primary healthcare services and all district hospitals.
  • The District Health Programme Grant, which focuses on HIV, TB, community outreach, and some primary healthcare enablers.
  • And thirdly, a patchwork of other conditional grants for training, infrastructure, oncology, and digital systems.

The challenge with this approach is that each of these funding streams has its own rules, reporting requirements, and political histories. None of them were designed to work together.

Making the case for consolidation

Twenty odd years ago, the case for split funding streams made more sense. In the early 2000s, South Africa faced an overwhelming HIV epidemic. We needed targeted programmes, ringfenced funds, and rapid scale-up. Conditional grants was an instrument, that in a specific context, helped save millions of lives. But this instrument has now hardened into permanent architecture. And unfortunately, it is not fit for today’s health challenges.

South Africa is at a critical moment. The population is ageing, rates of non-communicable diseases like diabetes and hypertension are rising, HIV and TB require lifelong, coordinated management, and the pace of technology is rapidly reshaping healthcare.

The system that was built 20 years ago simply cannot carry us through the next 20 years.

At the same time, South Africa’s health budget is tightening. Despite a small increase in last year’s budget, the trend over the last decade or so is clearly toward having to do more with less.

We cannot expect the system to meet these growing demands while the foundational governance and funding architecture is no longer fit for purpose.

How it could work

Under an expanded District Health Programme Grant, national government – as the law mandates – would set the healthcare package, standards, indicators, and information requirements. Provinces would continue to run services, hire staff, manage facilities, and account for performance in line with the provisions of the National Health Act. And districts would finally have a budget that reflects their actual responsibilities.

In simple terms, this means that the expanded district health programme will be structured as a conditional grant. It will be informed by a nationally defined package of district health services, developed in consultation with provinces. Provincial allocations will be informed by strategic priorities and service needs such as essential health services, reproductive, maternal and child health services, as well as infectious diseases and non-communicable diseases. The National Department of Health will be responsible for managing the grant conditions with stronger accountability mechanisms to ensure alignment with strategic aims and constitutional responsibilities. Provinces will continue to control human resources, service delivery networks and district variations. This is what the National Health Act intended.

This is the model used by many countries that have successfully strengthened district health systems: national sets the rules and maintains oversight, while provinces or local governments handle delivery.

As already noted, South Africa does have the legal architecture for this. We just don’t have the financial mechanisms in place to match it.

In practical terms, such reforms will mean that for the first time, a district could budget for clinics, ward‑based outreach teams, HIV and TB services, chronic disease management, district hospitals, laboratory and pharmacy systems, emergency medical services linkages, and digital and information systems.

The artificial lines between primary healthcare and district hospitals would disappear. The system would fund itself as the Act intended, as one. District hospitals would no longer be expected to manage pressures created by primary healthcare gaps they have no control over.

There are several other benefits, such as improved accountability, an easier adaptation to demographic and epidemiological transitions, and more efficient use of limited budgets. These ultimately all develop a realistic pathway to universal health coverage.

A governance correction, not a revolution

There may be concerns that consolidating funding into a single grant means taking power away from provinces. The reality, however, is that this reform would restore coherence, not remove authority.

South Africa has spent decades speaking about equity. This is a practical way to make equity real.

When we underfund the district health system in structure, we undercut the very people who rely on it most. These are rural communities, working class households, and people managing chronic and infectious diseases who require continuity of care, not bureaucratic fragmentation.

A unified District Health Programme Grant will not solve every problem in our health system. But without it, we will continue asking a fragmented system to produce cohesive outcomes, and blaming managers and health workers when it inevitably cannot.

It is time to give the district health system the financial foundation it has always needed. Only then can we build the health system people in South Africa deserve.

*Rensburg is director of the Rural Health Advocacy Project and project director for the TB Accountability Consortium.

Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.

Republished from Spotlight under a Creative Commons licence.

Read the original article.

Categories : Mental HealthTags :

Study Finds Sugary Drinks Linked to Anxiety in Young People

On By ModernMedia

A new study has identified an association between consumption of drinks containing a high amount of sugar and anxiety symptoms in adolescents. 

Photo by Breakingpic on Pexels

Researchers at Bournemouth University were part of a team involved in reviewing the findings of multiple studies that have investigated people’s diets and their mental health, to establish common findings. 

Their results have been published in the Journal of Human Nutrition and Dietetics.

“With increasing concern about adolescent nutrition, most public health initiatives have emphasised the physical consequences of poor dietary habits, such as obesity and type-2 diabetes,” said Dr Chloe Casey, Lecturer in Nutrition and co-author of the study. “However, the mental health implications of diet have been underexplored by comparison, particularly for drinks that are energy dense but low in nutrients,” she added.

Anxiety disorders are a leading cause of mental distress among young people, in 2023 it was estimated that one in five children and young people had a mental health disorder, with anxiety one of the most reported conditions. 

The studies investigated by the research team measured sugary drink consumption and mental health of the young people through surveys. Beverages with high amounts of sugar can include fizzy drinks, energy drinks, sugary juices, squashes, sweetened tea and coffee, and flavoured milks.

The results consistently found a link between high levels of sugary drink consumption and anxiety.

The researchers emphasise that because of the nature of the studies they investigated, the findings do not provide evidence that drinking more sugary drinks directly causes anxiety. It is also possible that experiencing symptoms of anxiety leads to some young people consuming more sugary drinks. Or there could be other common factors – for example family life and sleeping disorders – that lead to both increased consumption and symptoms of anxiety. 

“Whilst we may not be able to confirm at this stage what the direct cause is, this study has identified an unhealthy connection between consumption of sugary drinks and anxiety disorders in young people,” Dr Casey said. 

“Anxiety disorders in adolescence have risen sharply in recent years so it is important to identify lifestyle habits which can be changed to reduce the risk of this trend continuing,” she concluded. 

The study was led by former Bournemouth University PhD student, Dr Karim Khaled, who now works at Lebanese American University, Beirut. 

Source: Bournemouth University

Categories : Lab Tests and ImagingTags :

Study Shows Low-Field MRI Is Feasible for Breast Screening

On By ModernMedia

Mass General Brigham’s evaluation of low-field MRI performance lays potential groundwork for this technology to be a lower-cost, accessible option for breast imaging

Photo by National Cancer Institute on Unsplash

Researchers at Mass General Brigham have demonstrated the technical feasibility of using ultra-low field (ULF) magnetic resonance imaging (MRI) for breast imaging. With further refinement and evaluation, the technology could offer an alternative to existing breast cancer screening methods and may reduce barriers to screening. Results are published in Scientific Reports.

“These results are a very encouraging proof of principle, though larger studies are needed to establish diagnostic performance,” said project principal investigator and co-senior author Matthew Rosen, PhD, an associate professor of Radiology and director of the Low Field MRI laboratory in the Athinoula A. Martinos Center for Biomedical Imaging in the Mass General Brigham Department of Radiology. “They motivate our continued pursuit of safe, comfortable, lower-cost screening approaches that can expand access for patients.”

Current U.S. guidelines recommend screening mammography for women aged 40 to 74 years. Unlike mammography, ULF MRI doesn’t require breast compression, which many patients find uncomfortable. Another benefit of ULF MRI is that it doesn’t use ionizing radiation.

While higher risk patients may receive MRI screening for breast cancer, standard MRI machines are not used in routine breast cancer screening because they are expensive and not widely available. ULF MRI systems cost less than 5% of the price of standard MRI systems and have lower long-term operating costs.

In this study, ULF MRI scans were performed on 14 participants, including 11 women with no history of breast cancer, two women with a prior breast cancer diagnosis, and one woman with a benign mass.

When interpreting the ULF MRI scans, three radiologists could reliably identify essential breast features and distinguish fibroglandular tissue from adipose tissue. The authors note that discrepancies were likely related to the novelty of ULF MRI and may be reduced with additional training and experience.

“This early evidence suggests that ULF MRI can detect essential breast features and some abnormalities without radiation or injected contrast,” said co-first author Neha Koonjoo, PhD, an investigator at the Martinos Center. “These findings point to the potential for ULF MRI as an option that could complement existing screening tools in the future.”

“Even at very low magnetic field, the radiology team was able to make observations about the breast,” said co-principal investigator and co-senior author Kathryn E. Keenan, PhD, from the US National Institute of Standards and Technology. “We attempted this study in hopes that the breast features would be visible, but you don’t always have success. We’re very motivated by this study to continue our work on ultra-low-field MRI for breast screening.”

The researchers note that further study is needed to determine the diagnostic accuracy of ULF MRI for breast cancer screening, including studies in larger cohorts that include patients with benign and malignant lesions. They also emphasize that further refinements in ULF MRI technology are needed to meet clinical resolution standards for breast cancer screening.

“These results will guide the next engineering steps to improve image quality and enable a more comfortable exam and help bring screening to more settings and more patients,” said co-first author Sheng Shen, PhD, of the Martinos Center for Biomedical Imaging.

Source: Mass General Brigham

Categories : General InterestTags :

SA Medical News Roundup 20th February

On By ModernMedia
Photo by Hush Naidoo Jade Photography on Unsplash

This week saw the launch of a new, far-reaching court case against NHI, protest action planned over GEMS premium increases, Gauteng doctors’ complaints over MRI machine purchases, and a new tuberculosis dashboard.

Another NHI Court Case

Yet another court case has been initiated against NHI, this time from AfriForum. Unlike previous court cases which took aim at various parts of the NHI legislation, Afriforum describes theirs as launching a “comprehensive attack” on the NHI Act. This includes summons being served on President Cyril Ramaphosa and Health Minister Aaron Motsoaledi, among others.

According to court documents, Afriforum “foresees material factual disputes” and expects there to be cross-examination and experts. The organisation cited constitutional violations, while the Department of Health contends that NHI has been through the legislation process and cannot be altered. Experts have warned that continuing legal action will bog down NHI, kicking its decades-long implementation even further down the road. Read the full story in BusinessTech.

Public Sector Unions to Protest over GEMS Increases

This weekend, public sector unions are set to take to the streets in protests over the 9.8% increase in Government Employee Medical Scheme (GEMS) premiums. This increase is far above the 3.3% increase recommended by the Council for Medical Schemes (CMS), and above the private sector increases, which range from 4.7% for Genesis to a weighted average of 8.8% for Bonitas, according to Moonstone. All of this comes in the wake of 2025’s unprecedented 10.1% average increase, with a 13.4% increase for GEMS. The nationwide protests are set to culminate in a march to GEMS’ offices next week Thursday. SABC News has more on the protests.

Gauteng Doctors Criticise Choice of MRI Machine

Doctors at Charlotte Maxeke Academic Hospital have questioned a Gauteng Health Department decision to override their choice of a Philips MRI machine. The scanner is part of a R304-million rollout of eight scanners across Gauteng public hospitals. The original choice of a Philips machine is about R10 million cheaper than the Chinese alternative, and the doctors said that it was technically superior. and the head of the hospital’s supply chain management committee warned that the change could increase costs, downtime, and clinical risk. The dispute comes amid mounting diagnostic backlogs at Gauteng hospitals, including some 2600 cancer patients at Charlotte Maxeke. GroundUp covers the story, which has also been republished on QuickNews.

New Tuberculosis Dashboard

Spotlight has launched a new tuberculosis dashboard and graph generator. Based on the latest Thembisa model data, it is the counterpart to the HIV Dashboard which was launched in November last year. Users can look backward and forward in time on a range of TB parameters, with future modelling currently out to 2030. Check out Spotlight’s tuberculosis dashboard here.

Categories : Diet and Nutrition Metabolic DisordersTags :

Vegan Diet Helps People With Type 1 Diabetes Cut Insulin Costs by 27%

On By ModernMedia
Novolog insulin pen. Photo by Dennis Klicker on Unsplash

A low-fat vegan diet that doesn’t limit calories or carbohydrates could help people with type 1 diabetes reduce insulin use and insulin costs, according to new research by the Physicians Committee for Responsible Medicine published in BMC Nutrition.

The new research, which is a secondary analysis of a 2024 Physicians Committee study, compared the effect of a low-fat vegan diet to a portion-controlled diet on insulin use and insulin costs in people with type 1 diabetes. The analysis found that the total dose of insulin decreased by 28%, or 12.1 units, per day in the vegan group, compared to no significant change in the portion-controlled group. The reductions in insulin use in the vegan group likely reflect improved insulin sensitivity, or how well the body responds to insulin. Total insulin costs decreased by 27%, or $1.08 per day, in the vegan group, compared to no significant change in the portion-controlled group.

The 2024 study found that a vegan diet also led to an average weight loss of 11 pounds, improved insulin sensitivity and glycaemic control, and improved cholesterol levels and kidney function in people with type 1 diabetes.

The new research comes as insulin prices in the United States continue to rise. Spending on insulin in the United States tripled in the past 10 years, reaching $22.3 billion in 2022, due to the increased usage and higher price of insulin, according to the American Diabetes Association. The inflation-adjusted cost of insulin increased by 24% from 2017 to 2022.

“As insulin prices continue to rise, people with type 1 diabetes should consider a low-fat vegan diet, which can help improve their insulin sensitivity and reduce the amount of insulin they need, potentially saving them hundreds of dollars a year,” says Hana Kahleova, MD, PhD, the lead author of the study and director of clinical research at the Physicians Committee for Responsible Medicine.

Source: Physicians Committee for Responsible Medicine

Categories : Healthcare Politics and Regulations HospitalsTags :

Doctors Complain About Choice of Equipment at Gauteng Hospital as Thousands Await Cancer Scans

On By ModernMedia

Concern about decision to buy Chinese MRI machine from local company instead of one from Philips

Credit: Pixabay CC0

By Chris Bateman and Raymond Joseph

As thousands of cancer patients wait months for diagnostic scans, senior clinicians at Charlotte Maxeke Academic Hospital have questioned a decision by the Gauteng Health Department to override their choice of MRI machine.

In a letter to Gauteng Health Department’s acting chief financial officer, the head of supply chain management at the hospital, Solly Mokgoko, expressed a concern that a recommendation by the head of radiology and the acting clinical director to buy a Philips scanner had been overridden by the Gauteng health department’s central office. The letter is dated 31 October 2025.

Mokgoko said the doctors had preferred the Philips MRI scanner – at a cost of about R27.4-million – on the grounds of “technological advancement, operational sustainability, and clinical research potential”.

However, the department had chosen a machine from Mamello Clinical Solutions at R38.5-million, they said. The room in which the machine will be installed is currently being prepared.

The letter said the Philips unit’s cost “offers reduced lifecycle expenditure due to minimal helium dependency and extended operational uptime”. The Philips scanner used low-maintenance technology, “requiring minimal or no helium top-ups, thereby reducing lifecycle costs and mitigating downtime risks”.

The Mamello-proposed model, by contrast, “relies on traditional cryogenic technology, which entails higher running costs and environmental exposure”, they said.

They said the decision is inconsistent with value-for-money principles set out in the Public Finance Management Act (PFMA) and Treasury regulations.

The purchase of a Chinese MRI scanner from Mamello is part of a R304-million roll-out of eight scanners across Gauteng public hospitals, in which roughly R190-million has been awarded to Mamello Clinical Solutions (five machines) and the remainder to Philips SA.

The Gauteng Department of Health rejected any suggestion of irregularity, saying the purchase was made under a lawful, competitively awarded contract and that both suppliers met the required technical standards.

In this case, the original procurement contract was drawn up by the Limpopo Health Department, with the Gauteng department piggybacking on it.

Clinicians at Charlotte Maxeke who spoke to GroundUp say the procurement shift occurred without adequate consultation and against explicit technical recommendations — allegations the department disputes.

Approximately 2,600 oncology patients are awaiting MRI scans at Charlotte Maxeke alone, with outpatient bookings extending to December 2026. Similar waiting lists exist at Chris Hani Baragwanath Academic Hospital.

The letter said that besides the external patient scans waiting list, there are over 50 inpatients awaiting scans.

One department head said: “How can the hospital order an MRI that’s over R10-million more expensive in an environment where it can’t even provide decent food, [and where there is] widespread cost-cutting and a dire shortage of doctors?” Late last year, the hospital made headlines for shortages of adequate patient meals.

Mamello Clinical Solutions, a private company based in Polokwane, was established in December 2014, trading as Mamello Development until 2019 when it changed its name. Robert Makhubedu, its sole director, was appointed in June 2023 after two previous directors resigned, according to official company registration records.

Makhubedu previously worked as chief radiographer at Charlotte Maxeke Hospital in the early 1990s, then spent more than two decades as director of business development at Tecmed, before joining Mamello Clinical Solutions.

A Gauteng Health Department spokesperson “categorically” denied any irregular, inflated or non-compliant procurement.

He said the MRI acquisitions had been made under a lawful, competitively advertised contract which had been evaluated in line with constitutional, PFMA and Treasury requirements.

Philips Healthcare and Mamello Clinical Solutions had both met minimum safety, functional and performance specifications, he said.

While acknowledging that Charlotte Maxeke clinicians preferred the Philips MRI, the spokesperson said procurement decisions could not be driven by “brand preference or proprietary technology.” He said over the life of the machine the price difference between the two was about R1.07-million, not R11.1-million.

Treasury rules, he said, did not permit sole-supplier selection where multiple bidders meet approved specifications. Multi-supplier models were standard public-sector practice.

Makhubedu pointed out that the tender had not called for a “helium-free” scanner. He attributed the doctors’ complaints to a combination of “brand bias” and hostility towards emerging black-owned companies, compared to multinationals.

“Some black companies awarded these contracts in the past could not relate to the business and clinical profile of the projects,” he said. “The legacy of that is that you have to prove yourself all the time.”

Makhubedu said that provinces tried to strike a procurement balance between emerging and established companies. He said his scanner was in fact R300,000 cheaper than the Philips machine over the life of the machine, and Mamello was capturing market share because of scanner quality and price.

“We believe we were fairly, legally and transparently awarded the contract. And we were cheaper.”

Republished from GroundUp under a Creative Commons Licence.

Read the original article.

Categories : Diet and NutritionTags :

Too Many Saturated Fats may be More Harmful than Too Many Refined Carbohydrates

On By ModernMedia

Mice who consumed high-fat diets, especially the ketogenic diet, experienced more weight gain, liver damage and other negative health effects than those who ate a high-carbohydrate diet

Photo by Mariana Kurnyk

In recent years, many media reports and social media influencers have emphasised the dangers of eating too many carbohydrates. Though a carbohydrate-heavy diet can be harmful, consuming too many fats may cause more health problems, according to a study in mice led by researchers in the Penn State Department of Nutritional Sciences.

In a study published in the February issue of Journal of Nutrition, the researchers analysed how diets containing different ratios of fats and carbohydrates affected metabolic health and liver function in mice over time. They found, overall, higher-fat diets were more harmful than high-carbohydrate diets, but that fibre supplementation might be able to reduce harm in specific conditions.

Mice consumed one of four diets: high carbohydrate, high fat, ketogenic or a standard chow that was rich in whole grains and served as the experiment’s control group. In mice of normal weight, the keto diet led to weight gain, impaired the use of glucose, disrupted the balance of lipids in the body and increased inflammation and fat deposits in the liver. The high-fat diet also led to weight gain and other health problems not seen in mice who consumed the high-carbohydrate diet. Overall, mice who consumed the standard chow displayed the best markers of health.

“Human beings and mice have very different metabolisms, but there are relevant lessons in this study for people,” said Vishal Singh, associate professor of nutritional sciences and senior author of the study. “Most people are aware that a balanced diet is important, but some people are attracted to diets with very high fat content – like the keto diet – for weight loss. This research points to very real harm to the liver that can occur when these diets are not used appropriately.”

Fats versus carbohydrates

In each experimental diet in the study, the protein level of the food was always 18% of the total calories, so only the fat-to-carbohydrate ratios differed. The high-fat diet contained 42% carbohydrates and 40% fats, the high-carbohydrate diet contained 70% carbohydrates and 11% fat and the ketogenic diet contained 1% carbohydrates and 81% fats.

The fats in these diets were largely saturated fats, which are a group of fats that are typically solid at room temperature. The American Heart Association recommends that saturated fats make up 6% or less of the total calories in a person’s diet.

The carbohydrates in these diets were largely refined, which are processed foods including white flour and added sugars. Scientific research has frequently connected refined carbohydrates to metabolic dysfunction and other harmful physical and mental health outcomes.

These diets were compared to a whole-grain rich chow that is a standard diet for laboratory mice. It contained 29% proteins, 57.5% carbohydrates and 13.5% fats.

The researchers measured blood sugar and a broad array of markers of liver function and health at regular intervals during the 16-week study. Other measurements were gathered after the experimental diets concluded.

“We wanted to understand how altering the balance of carbohydrates and fats would affect health when the diet was maintained for 16 weeks,” said Umesh Goand, postdoctoral researcher in the Penn State Department of Nutritional Sciences and first author of the study.

Keto and high-fat diets harmed liver and increased weight

In the ketogenic or ‘keto’ diet carbohydrate consumption is nearly eliminated. This induces a metabolic state called ketosis, where the body burns fat for fuel instead of glucose, the typical source of energy.

Results from the study demonstrated that the high-fat and keto diets promoted obesity, with the weight of mice on these diets doubling over the 16 weeks of the study. Mice on the control diet increased weight by around 10% – a normal rate for mice of that age – despite all mice in the study consuming roughly the same number of calories. In addition, the high-fat and keto diets impaired glucose tolerance and compromised liver function. Liver damage and elevated levels of blood sugar were observed after only two weeks of both diets.

Mice on the keto diet also developed elevated levels of triglycerides and showed increased levels of systemic inflammation. Additionally, they developed fat deposits in the liver and expressed genes associated with inflammation and liver scarring.

“The keto diet was very damaging to the livers and overall health of mice with regular weights,” Singh said, explaining that the body can utilise fat for energy, but there are metabolic consequences associated with the increase in fat processing. “People who hear about the keto diet’s reputation for weight reduction may be tempted to try it themselves. What this research says is – don’t! This diet should only be considered when properly supervised by a physician and/or dietician.”

Whole grains and carbohydrates

In comparison, mice on the high-carbohydrate diet did not continuously gain weight nor experience liver damage like those on the high-fat diets. Singh emphasized that a highly processed, carbohydrate-heavy diet is not inherently healthy, but it did less damage to the liver than the high-fat diets.

Mice on the whole-grain rich chow diet gained the least weight and demonstrated the best health indicators.

“A whole-grain-based diet is always a win – for mice or people,” Singh said.

The potential of fibre

In a separate experiment in the study involving mice with obesity, the high-fat and keto diets also led to further weight gain. However, when the keto diet was supplemented with fibre – a condition not tested in mice with normal weights – mice with obesity maintained more stable weight and better health indicators in several areas compared to mice on the high-fat diet or the keto diet without extra fibre.

The researchers also found that fibre supplementation did not hinder ketogenesis in mice who ate the keto diet. This is important, Singh said, because the keto diet is used for managing specific medical conditions, like epilepsy.

“Incorporating dietary fibres into the keto diet may reduce gastrointestinal complications associated with very high-fat diets while maintaining the therapeutic benefits of ketogenesis for patients,” Singh said.

Dietary choices are complex, but that does not make them equivalent

The important thing to remember, Singh said, is that diet is complex, and there is no one-size-fits-all solution.

“Over time, researchers have learned a lot about what is healthy or unhealthy based on an individual’s health status, but there is no single dietary magic bullet for weight loss or any other metabolic health concern,” Singh said. “Anyone who experiences health problems or is concerned about their diet should talk to their physician or a registered dietician to develop a plan, based on research, that fits their specific needs and life circumstances.”

Source: Penn State University

Categories : Environmental Effects Neurodegenerative DiseasesTags :

Air Pollution may Directly Contribute to Alzheimer’s Disease

On By ModernMedia

Cohort study finds people with stroke may be extra susceptible to air pollution’s impact on the brain

Photo by Kouji Tsuru on Pexels

People with greater exposure to air pollution face a higher risk of developing Alzheimer’s disease, according to a new study by Yanling Deng of Emory University, U.S.A., and colleagues, published February 17th in the open-access journal PLOS Medicine.

Alzheimer’s disease is the most common form of dementia, affecting about 57 million people worldwide. Exposure to air pollution is a known risk factor for Alzheimer’s disease, and for several common chronic health conditions, such as hypertension, stroke and depression. These chronic conditions are also linked to Alzheimer’s disease, but previously it was unclear whether air pollution causes these chronic conditions, which then lead to dementia, or if these conditions might amplify the effects of air pollution on brain health.

A team at Emory University studied more than 27.8 million U.S. Medicare recipients aged 65 years and older from 2000 to 2018. The researchers looked at individuals’ air pollution exposure level and whether they developed Alzheimer’s disease, while emphasizing the role of other chronic conditions. They found that greater exposure to air pollution was associated with an increased risk of Alzheimer’s disease, and that association was slightly stronger in individuals who had experienced a stroke. Hypertension and depression, however, had little additional impact.

Overall, the findings suggest that air pollution contributes to Alzheimer’s disease mostly through direct pathways rather than through other chronic health conditions. However, people with a history of stroke may be especially susceptible to the harmful effects of air pollution on brain health. The study indicates that improving air quality could be an important way to prevent dementia and protect older adults.

The authors add, “In this large national study of older adults, we found that long-term exposure to fine particulate air pollution was associated with a higher risk of Alzheimer’s disease, largely through direct effects on the brain rather than through common chronic conditions such as hypertension, stroke, or depression.”

“Our findings suggest that individuals with a history of stroke may be particularly vulnerable to the harmful effects of air pollution on brain health, highlighting an important intersection between environmental and vascular risk factors.”

Provided by PLOS

Categories : Injury & TraumaTags :

Stopping Fatal Blood Loss With an Ancient Remedy – Clay

On By ModernMedia

Researchers are developing emergency injectable bandages that could decrease bleeding time by as much as 70% and revolutionise the future of trauma care.

Photo by Mat Napo on Unsplash

A massive number of traumatic injury deaths are the result of uncontrolled bleeding.

“Severe blood loss can rapidly lead to haemorrhagic shock,” said Dr Akhilesh Gaharwar, a biomedical engineering professor at Texas A&M University. “Many patients die within one to two hours of injury. This critical period is often referred to as the ‘golden hour.'”

Thanks to funding from the U.S. Department of Defense and the National Science Foundation, Gaharwar and his fellow researchers in the biomedical engineering department have found a way to extend this golden hour – using clay.

Gaharwar, Dr Duncan Maitland and Dr Taylor Ware are developing a suite of injectable haemostatic bandages – biomedical materials that stop bleeding and promote blood to clot faster. Their research is specifically targeting deep internal bleeding where traditional methods like compression are not possible.

Two papers, recently published in Advanced Science and Advanced Functional Materials demonstrate that these dressings can reduce bleeding time by almost 70%.

“Under normal circumstances, human blood clots within six to seven minutes,” said Gaharwar. “Using these haemostatic dressings, we are able to reduce the clotting time to one to two minutes.”

The goal is a lifesaving device simple enough that a critically injured person could apply it to themselves immediately after injury.

“For a self-applied or in-the-field-applied device, you can’t use the fancy mechanics and apparatus that you would have in the operating room,” said Ware. “There can’t be any special tools. You have to have something that just works and works quickly.”

The research hinges on a class of materials that have been used for wound treatment for thousands of years. Certain naturally occurring clay minerals contain silicate-based particles that can accelerate blood coagulation. The exact mechanics of this effect are still an active area of investigation.

“These clay particles were being used as a haemostat in ancient civilisations in China, Mesopotamia, Egypt, India, Greece and Rome, likely owing to their absorbency and tissue adherent properties” said Gaharwar. “Ancient peoples would make a paste out of water and clay particles and apply it to wounds to stop bleeding faster.”

Fascinated by the particle’s blood clotting properties, Gaharwar began to explore the potential uses of a synthetic particle, which would avoid the potential risk of infection that comes with natural clays.

The challenge is getting this particle to the injury site and keeping it there. High blood flow washes powders and pastes away. Not only does this fail to stop the bleeding, it risks killing the patient in another way. The nanosilicate particles are small enough to easily travel through blood vessels to non-injured areas of the body, causing life-threatening blood clots and embolism.

With the help of Maitland’s lab, the researchers combined the nanosilicate particles with an expanding foam. While completely stable in its applicator device, the particle-laced foam reacts to body heat. Once injected into a wound site, it expands to fill up the entire space, sealing severed blood vessels and holding the blood-clotting nanosilicate exactly where it needs to be. Since the foam forms a single piece, there is no risk of particles breaking away and traveling to form dangerous blood clots in other areas of the body.

In Ware’s lab, the researchers took an entirely different approach: micro-ribbons. This biomaterial is delivered in the form of multiple ribbon-like structures, each covered in coagulation-promoting nanosilicate particles.

Like the foam, the micro-ribbons exploit the patient’s body heat to trigger a reaction once in place. Each ribbon is made of two different materials, only one of which reacts to body temperature. Once in contact with the patient’s body, one side of the ribbon contracts, causing it to curl. As multiple ribbons curl at the injury site, they tangle together to form a single foam-like structure. Even if a single ribbon were able to escape, its size prevents it from traveling through blood vessels, keeping the blood-clotting nanosilicate exactly where it needs to be.

The combined expertise of all three research labs may be responsible for the future of trauma care.

“If these materials get into the first aid kits in an ambulance as well as a soldier’s backpack, they can save a lot of lives,” said Gaharwar. “If you can save 30-40% of haemorrhagic shock victims, that is a big achievement.”

Source: University of Texas

Categories : Cardiovascular DiseaseTags :

Ancient Mind-Body Practice Proven to Lower Blood Pressure in Clinical Trial

On By ModernMedia

Study shows traditional Chinese practice comparable to brisk walking and some medication trials at lowering BP

Pexels Photo by Thirdman

A traditional Chinese mind-body practice that combines slow, structured movement, deep breathing and meditative focus lowered blood pressure as effectively as brisk walking in a large randomised clinical trial published in JACC, the flagship journal of the American College of Cardiology. Blood pressure reductions were seen after three months and sustained for one year.

High blood pressure is one of the leading preventable risk factors for heart disease. Clinical guidelines recommend regular physical activity, yet long-term adherence to exercise programmes is challenging for many people, particularly when routines require equipment, dedicated space, gym memberships or ongoing supervision.

Baduanjin is a widely practised, standardised eight-movement sequence that integrates aerobic, isometric, flexibility and mind–body components. Practised for centuries and commonly performed in community settings across China, the routine typically takes 10–15 minutes and requires no equipment and only minimal initial instruction, allowing it to be performed in a wide range of settings. Because it is low- to moderate-intensity, it is considered safe and accessible for many adults.

“Given its simplicity, safety and ease at which one can maintain long-term adherence, baduanjin can be implemented as an effective, accessible and scalable lifestyle intervention for individuals trying to reduce their blood pressure,” said Jing Li, MD, PhD, senior author of the study and Director, Department of Preventive Medicine, National Center for Cardiovascular Diseases in Beijing, China.

In the first large, multicentre randomised trial to look at the impact of baduanjin on blood pressure, researchers followed 216 participants across seven communities to determine changes in 24-hour systolic blood pressure from baseline to 12 and 52 weeks. Participants were 40 years old or older and had a systolic blood pressure of 130-139mmHg, which according to the ACC/AHA High Blood Pressure Guideline is considered stage 1 hypertension. They were randomly assigned to one of three arms: baduanjin, self-directed exercise alone, or brisk walking for the 52-week intervention.

Compared to self-directed exercise, practicing baduanjin five days a week reduced 24-hour systolic blood pressure approximately 3mmHg and office systolic blood pressure by 5mmHg at both three months and one year, which is comparable to reductions seen with some first-line medications. Baduanjin showed comparable results and safety profile to brisk walking at one year.

Notably, the benefits were sustained even without ongoing monitoring, a key challenge for many lifestyle interventions that struggle to maintain long-term adherence outside structured programs.

“Baduanjin has been practised in China for over 800 years, and this study demonstrates how ancient, accessible, low-cost approaches can be validated through high-quality randomised research,” said Harlan M. Krumholz, MD, FACC, Editor-in-Chief of JACC and the Harold H. Hines, Jr Professor at the Yale School of Medicine. “The blood pressure effect size is similar to that seen in landmark drug trials, but achieved without medication, cost or side effects. This makes it highly scalable for community-based prevention, including in resource-limited settings.”

Source: American College of Cardiology