How Too Much Cholesterol Can Contribute to Alzheimer’s Disease

Millions suffer from Alzheimer’s disease, and the available and foreseeable treatments are disappointing at best. Given the absence of disease-modifying treatments, there has been growing interest in effective strategies for the prevention of the disease in the first place. Even if we were able to just delay the onset by as little as 1 year, we could potentially prevent more than 9 million cases over the next 40 years. Once cognitive functions are lost in Alzheimer’s disease patients, they may be lost forever. Consequently, prevention, rather than a cure for Alzheimer’s disease appears to be a more realistic strategy to offset the catastrophic impact of this dementia.

As I discuss in my video Cholesterol & Alzheimer’s Disease “[c]onsiderable evidence now indicates that Alzheimer’s disease (AD) is primarily a vascular disorder,” based on a number of lines of evidence that point toward impaired circulation of blood to the brain. Vascular risk factors, such as high cholesterol, can be thought of as a ticking time bomb to Alzheimer’s disease. What’s bad for the heart may be bad for the mind.

Traditionally, there have been two competing theories for the cause of Alzheimer’s: the amyloid cascade model, which implicates the buildup of amyloid plaques within the brain, and the vascular model, which argues that it is the lack of adequate blood flow to the brain due to atherosclerosis. We now realize they are not mutually exclusive and that arterial disease can set up a vicious cycle in which atherosclerotic plaques in the arteries may contribute to Alzheimer’s plaques in the brain.

Although cholesterol has been portrayed as “tantamount to poison,” it is an essential structural component of all of our cells, and that’s why our body makes it. But, if there’s too much, it can become a major factor contributing to various diseases, including coronary heart disease, stroke, and neurodegenerative diseases like Alzheimer’s. Too much cholesterol in our blood is universally recognizedto be a risk factor for the development Alzheimer’s disease, and cholesterol may play an active role in the progression of Alzheimer’s as well.

Autopsy studies have found that Alzheimer’s brains have significantly more cholesterol than normal brains, and it specifically appears to accumulate in the Alzheimer brain plaques. We used to think the pool of cholesterol in the brain was separate from the pool we had in our blood, but there is now growing evidence to the contrary. For example, low-density (LDL) cholesterol, the so-called bad cholesterol, may be able to cross the blood–brain barrier into the brain. So, a high-fat diet may not only increase cholesterol levels in the blood, but also the influx of cholesterol into the central nervous system.

In addition, having high cholesterol may even damage the blood-brain barrier itself, and allow for even more cholesterol to flow into the brain, providing the missing link between high cholesterol and Alzheimer’s. “Individuals with higher cholesterol levels at midlife have a higher risk of developing[Alzheimer’s disease].” Cholesterol over 250 could potentially triple the odds of Alzheimer’s.

We now have high-tech PET scanning of the brain that can directly correlate the amount of bad LDL cholesterol in our blood with the amount of amyloid buildup in our brains. You can even do it right in a petri dish. Adding cholesterol makesbrain cells churn out more of the amyloid that makes up Alzheimer plaques, whereas removing cholesterol can decrease the levels of amyloid released from cells.

Amyloid degradation is also less efficient in a high cholesterol environment. Cholesterol can then help seed the clumping of the amyloid. Using an electron microscope, researchers can see the clustering of amyloid fibers on and around little microcrystals of cholesterol.

Once in the brain, cholesterol can also undergo auto-oxidation, causing the formation of highly toxic free radicals. So, having high cholesterol levels in the blood is thought to increase the risk of dementia, not only by inducing atherosclerosis and impairing blood flow, but also by potentially directly affecting neurodegeneration within the brain. In conclusion, excess dietary cholesterol could, in principle, contribute to the development of Alzheimer’s disease, and the evidence linking high cholesterol to Alzheimer’s appears to be steadily mounting.

Some of this work was paid for by drug companies hoping to capitalize on Alzheimer’s with cholesterol-lowering statin drugs. This is ironic, since statins themselves can causecognitive impairment. Though rare, statin side effects may “include short- and long-term memory loss, behavioral changes, impaired concentration and attention, paranoia, and anxiety,” as early as five days after starting the drugs, but sometimes even months later, though folks should recover within a month of stopping the drugs.

A better strategy may be to changethe lifestyle factors that lead to the high cholesterol in the first place—in particular, reducing saturated fat in the diet. It’s not enough for us to just tell our individual patients, though. “Systematic implementation of educational campaigns promoting radical changes in cultural and societal values” may be necessary to adopt Alzheimer’s-defeating strategies by patients in a broader sense, and “such actions may provide potentially huge dividends by preventing both cardiovascular disease and dementia”—two of our leading causes of death.

Source: nutritionfacts.org

Who’s Right in the Salt Debate?

For decades, a sometimes furious battle has raged among scientists over the extent to which elevated salt consumption contributes to death, with one camp calling it a “public health hazard that requires vigorous attack” and another claiming the risks of dietary salt excess are exaggerated, even to the point of calling sodium reduction “the largest delusion in the history of preventive medicine.” The other side calls this denialism ethically irresponsible, especially when millions of lives are at stake every year.

To describe two sides of the debate may be falling into the trap of false equivalency, though. As the superhero-sounding “World Hypertension League” points out, there is strong scientific consensus that reducing salt saves lives, and—like the climate change debate—most authorities are on one side. On the other? Only the affected industry, their paid consultants, and a few dissenting scientists.

As I discuss in Sprinkling Doubt: Taking Sodium Skeptics with a Pinch of Salt, nearly all government appointed bodies and nutrition experts who have considered the evidence have recommended we collectively cut our salt intake about in half—a reduction described as extreme by those defending the industry. After all, just a small fraction of Americans actually get their sodium intake that low. Therefore, the salt skeptics say, the human experience for very low levels of sodium consumption is “extremely sparse.”

Extremely sparse? The reality is the exact opposite. The human experience is living for millions of years without Cheetos or a salt shaker in sight. We evolved to be salt-conserving machines, and when we’re plunked down into snack food and KFC country, we develop high blood pressure. But in the few remaining populations that don’t eat salt and only consume the small amounts of sodium found in natural foods like we had for millions of years, our leading killer risk factor, hypertension, is practically non-existent. When you take people with out-of-control hypertension and bring them back down to the sodium levels we were designed to eat, the ravages of the disease can even be reversed (see my video Drugs & the Demise of the Rice Diet). So, why is there still a debate?                    

If salt hidden in food kills millions of people around the world, why are efforts to cut dietary salt being met with such fierce resistance? Salt is big business for the processed food and meat industry. So, according to the head of the World Health Organization’s Collaborating Center on Nutrition, we get the familiar story. Just like the tobacco industry spent decades trying to manufacture doubt and confuse the public, the salt industry does the same, but the controversy is fake. The evidence for salt reduction is clear and consistent. Most of the “contradictory research” comes from scientists linked to the salt industry. However, it takes skill to spot the subterfuge because the industry is smart enough to stay behind the scenes, covertly paying for studies designed to downplay the risks. All they have to do is manufacture just enough doubt to keep the so-called controversy alive.

The likes of the World Hypertension League have been described as a “mere pop-gun against the weapons-grade firepower of salt-encrusted industries” who look disdainfully at the “do-gooder health associations…who erect roadblocks on the path to profits.” Lest we forget, notes an editorial in the Journal of the Canadian Medical Association, high blood pressure is big business for the drug industry, too, whose blood pressure billions might be threatened should we cut back on salt. If we went sodium-free and eliminated the scourge of hypertension, not only would Big Pharma suffer, what about doctors? The number-one diagnosis adults see doctors with is high blood pressure, at nearly 40 million doctor visits a year, so maybe even the BMW industry might be benefiting from keeping the salt debate alive.

   Written By Michael Greger M.D.

UN Environment and WHO agree to major collaboration on environmental health risks

10 JANUARY 2018 | NAIROBI - 
UN Environment and WHO have agreed a new, wide-ranging collaboration to accelerate action to curb environmental health risks that cause an estimated 12.6 million deaths a year.

In Nairobi, Mr Erik Solheim, head of UN Environment, and Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, signed an agreement to step up joint actions to combat air pollution, climate change and antimicrobial resistance, as well as improve coordination on waste and chemicals management, water quality, and food and nutrition issues. The collaboration also includes joint management of the BreatheLife advocacy campaign to reduce air pollution for multiple climate, environment and health benefits.

This represents the most significant formal agreement on joint action across the spectrum of environment and health issues in over 15 years.

"There is an urgent need for our two agencies to work more closely together to address the critical threats to environmental sustainability and climate – which are the foundations for life on this planet. This new agreement recognizes that sober reality," said UN Environment’s Solheim.

"Our health is directly related to the health of the environment we live in. Together, air, water and chemical hazards kill more than 12.6 million people a year. This must not continue," said WHO’s Tedros.

He added: "Most of these deaths occur in developing countries in Asia, Africa and Latin America where environmental pollution takes its biggest health toll."

The new collaboration creates a more systematic framework for joint research, development of tools and guidance, capacity building, monitoring of Sustainable Development Goals, global and regional partnerships, and support to regional health and environment fora.

The two agencies will develop a joint work programme and hold an annual high-level meeting to evaluate progress and make recommendations for continued collaboration.

The WHO-UN Environment collaboration follows a Ministerial Declaration on Health, Environment and Climate Change calling for the creation of a global "Health, Environment and Climate Change" Coalition, at the United Nations Framework Convention on Climate Change (UNFCCC) COP 22 in Marrakesh, Morocco in 2016.

Just last month, under the overarching topic "Towards a Pollution-Free Planet", the United Nations Environment Assembly (UNEA), which convenes environment ministers worldwide, adopted a resolution on Environment and Health, called for expanded partnerships with relevant UN agencies and partners, and for an implementation plan to tackle pollution.

Fact sheet on H1N1 Influenza

     FAQs  H1N1 Influenza

Q.  What is the (H1N1) Influenza virus?
A.  - The H1N1 Influenza virus  can cause acute infection in the respiratory tract.   It was the  influenza virus that caused the Pandemic Influenza Outbreak in 2009 but after that the H1N1 virus causes Seasonal Influenza

Q. How do people become infected with the virus?
A. - The H1N1 virus is spread from person to person.
- It can be passed to other people by exposure to infected droplets expelled by coughing or sneezing that can be inhaled, or that can contaminate hands or surfaces.
- The time from infection to illness known as the incubation period is about 2 days
- To prevent spread, people who are ill should cover their mouth and nose when coughing or sneezing, stay home when they are unwell, clean their hands regularly, and keep some distance from other people, as much as possible.

Q. What are the signs and symptoms of typical infection?
A. - Signs of the H1N1 influenza includes general body weakness,  fever, cough, headache, muscle and joint pain, sore throat and runny nose, and sometimes vomiting and diarrhoea.
- The majority of people with H1N1 influenza experience mild illness and recover fully without treatment.

Q. When should someone seek medical care?
A. - People should seek medical care if they experience shortness of breath or difficulty breathing, or if a fever, and especially high fever, continues more than three days. For parents with a young child who is ill, seek medical care if a child has fast or labored breathing, continuing fever or convulsions (seizures).
- Supportive care at home - resting, drinking plenty of fluids and using a pain reliever for aches and pains - is adequate for recovery in most cases. A non-aspirin pain reliever should be used for children or adolescents under age 18.

Q. What about Vaccines for H1N1 Influenza?
A. -The most effective way to prevent the disease is vaccination. Safe and effective vaccines are available and have been used for more than 60 years. Among healthy adults, influenza vaccine provides protection, even when circulating viruses may not exactly match the vaccine viruses.
- WHO recommends annual vaccination for pregnant women at any stage of pregnancy, children aged between 6 months to 5 years, elderly individuals (aged more than 65 years), individuals with chronic medical conditions, health-care workers.

Q. Are the vaccines safe for pregnant women?
A. - To date, studies do not show harmful effects from the H1N1 influenza vaccine with respect to pregnancy, fertility, or a developing embryo or fetus, birthing or post-natal development

Q. What about my child's safety from a reaction?
A. The most frequent vaccine reactions in children following influenza immunization are similar to those seen after other childhood immunizations (such as soreness at the injection site, or fever). A child's health care provider or vaccinator can advise on the most appropriate methods for relief of the symptoms. - If there are concerns about a child's safety from a reaction, consult a health care provider as soon as possible. Please note that a child may suffer from a condition not related to immunization, which coincidentally developed after vaccination.

Q. How can I protect myself and family from H1N1 Influenza ?
A. You can prevent getting infected by taking the following measures:
keeping your distance from people who show symptoms of influenza-like illness, such as coughing and sneezing (trying to maintain a distance of about 1 metre if possible);
- clean hands thoroughly with soap and water, or cleanse them with an alcohol-based hand rub on a regular basis (especially if touching surfaces that are potentially contaminated);
- avoid touching your mouth, nose and eyes as much as possible;
reduce the time spent in crowded settings if possible;
- improve airflow in your living space by opening windows;
- practise good health habits (including adequate sleep, eating nutritious food, and keeping physically active); and
- getting yourself (or family members age 6 months and older) vaccinated against H1N1 influenza, if possible.

Q. How do I know if I have H1N1 Influenza?
A. Typical symptoms to watch for include fever, cough, headache, body aches, sore throat and runny nose.

Q. What should I do if I think I have H1N1 Influenza?
A. - If you feel unwell, have a fever, cough or sore throat:
- stay at home and keep away from work, school or crowds;
- rest and take plenty of fluids;
- cover your coughs and sneezes. If using tissues, make sure you dispose of them carefully. Clean your hands immediately after with soap and water or cleanse them with an alcohol-based hand rub;
- if you do not have a tissue close by when you cough or sneeze, cover your mouth as much as possible with the crook of your elbow;

Q. Should I take an antiviral drug now just in case I catch the H1N1 virus?
A. - In general, WHO does not recommend the use of antiviral drugs for prevention of H1N1 Influenza. Antiviral drugs should be taken if your health care provider advises you to do so.
- These drugs are generally available by prescription. 
- Caution should be exercised when buying antiviral drugs over the Internet.

Q. What about breastfeeding? Should I stop if I am ill?
A. - No, not unless your health care provider advises it. Studies on  influenza infections show that breastfeeding is most likely protective for babies - it passes on helpful maternal immunities and lowers the risk of respiratory disease.
- Breastfeeding provides the best overall nutrition for babies and increases their defense factors to fight illness.

Q. Can I travel?
A.  - If you are feeling unwell or have symptoms of influenza, you should delay travel. If you have any doubts about your health, you should check with your health care provider.

Q. Who is more at risk of severe illness from H1N1 Influenza?

A. - Some groups of people appear to be at higher risk of more complicated or severe illness, including:
- pregnant women;
- infants, and young children particularly under age 2;
- people of any age with certain chronic health conditions (including asthma or lung disease, heart disease, diabetes, kidney disease or some neurological conditions);
- people with severely compromised immune systems.

Q. Are there special recommendations for pregnant women or other higher risk groups?
A. - WHO recommends that pregnant women, or others at higher risk of severe illness and their caregivers, be vaccinated against H1N1 influenza and take all the necessary precautions, including hygiene measures, to prevent the spread of illness.

Q. What about risk of death?
A. - The majority of people with H1N1 influenza experience mild illness and the overall risk of dying from this infection is low.

Q. Is it safe to eat pork and pork products?
A. - Yes. The H1N1 Influenza virus has not been shown to be transmissible to people through eating properly handled and prepared pork (pig meat) or other products derived from pigs.

Q. What is the Treatment for H1N1 Flu?
A. - Antiviral drugs for influenza are available and may reduce severe complications and deaths. Ideally they need to be administered early (within 48 hours of onset of symptoms) in the disease.

Source: who.int

Healthcare costs are pushing millions into extreme poverty. This outrage must end

A friend of mine was diagnosed with cancer a few years ago.

He had two options. He could be treated, but it would cost him most or all of the money he had put aside for his family’s future.

Or he could forego treatment, allow the disease to run its course and die knowing his family would have a more comfortable life, even if he was not there to enjoy it with them.

He chose the latter.

He chose death because he could not afford the treatment that could have kept him alive.

This is an outrage. No one should have to choose between death and financial hardship.

But the shocking truth is that this is a reality for millions of people every year. New data from the World Health Organization and the World Bankreveal that at least half of the world’s 7.3 billion people still do not have access to essential health services, such as having a skilled birth attendant, vaccinations for children or treatment for HIV.

As a result, more than 1 billion people live with uncontrolled hypertension, which can kill without treatment. Every day, more than 800 women die from causes related to pregnancy and childbirth. And because nearly 20 million infants do not receive the immunizations they need, they run the risk of dying from diseases like diphtheria, tetanus, pertussis (whooping cough) and measles.

Even when health services are available, using them can mean financial ruin. Every year, 100 million people are pushed into poverty because of health spending, and 179 million people spend more than a quarter of their household budget on health care – a level we consider to be “catastrophic health spending”.

Almost 70 years ago, WHO was founded on the conviction that health is a human right, not a privilege. This is a conviction I share. No one should get sick and die just because they are poor, or because they cannot access the health services they need.

Why should a child die from drinking unsafe water?

Why should a woman die from complications of childbirth that are treated easily even in most middle-income countries?

Why should a family have to choose between buying food and buying medicine?

Universal health coverage (UHC) is the practical expression of the right to health. It means that all people, including the most disadvantaged, can access the quality health services they need, when and where they need them, without facing financial hardship.

But UHC is about more than health insurance, or treating the sick – it’s about protecting the healthy by promoting healthy lifestyles and preventing disease.

The power of UHC is that it doesn’t only result in improved health. It also reduces poverty by eliminating one of its causes; it creates jobs for health and care workers; it drives inclusive economic growth by ensuring people are healthy and able to work; it promotes gender equality, because it is often women who miss out on health services; and it protects people against epidemics by ensuring outbreaks are prevented, detected early and contained.

Image: World Health Organization/The World Bank

UHC is not a new idea. But its inclusion as one of the targets in the Sustainable Development Goals (SDGs) has given new political impetus to the global movement that has been gathering pace for some years. It is also the one target that, if achieved, will catalyze progress towards all the other health targets and many of the other goals.

Far from being a luxury that only rich countries can afford, UHC is achievable and affordable for all countries, at all income levels.

Senegal, for example, is making progress towards a publicly-funded health insurance system.

In Vietnam, more than 60% of the population, and 90% of the poor, are now covered by state-subsidized social health insurance. That’s six times more than 20 years ago.

In Peru, budget-funded health insurance for the poor and those who do not work in the formal sector has led to significant improvements in the health of women and children, and large reductions in the death of newborns and infants.

Similar stories can be told in countries as diverse as the Czech Republic, Indonesia and Rwanda.

A WHO study earlier this year predicted that among 67 low- and middle-income countries that account for 75% of the world’s population, 85% of the costs of achieving the SDG health targets by 2030 could be met with domestic resources.

Yes, some of the most fragile countries will continue to need external assistance. But for most countries, UHC is affordable and achievable.

Ultimately, it’s a matter of political will.

Governments with the determination, courage and foresight to invest in strengthening their health systems towards UHC will reap the benefits long into the future.

This is our vision. We back it up with hard evidence, technical know-how and lessons from around the world about what works and what doesn’t.

At the UHC Forum in Tokyo this week, more countries are committing to making the investments in a future that is healthier, safer and fairer for their citizens.

  - Tedros Adhanom Ghebreyesus (WHO) 

Source: weforum.org 

Global response to malaria at crossroads

WHO report shows gains are levelling

News release

29 NOVEMBER 2017 | GENEVA - After unprecedented global success in malaria control, progress has stalled, according to the World malaria report 2017. There were an estimated 5 million more malaria cases in 2016 than in 2015. Malaria deaths stood at around 445 000, a similar number to the previous year.

“In recent years, we have made major gains in the fight against malaria,” said Dr Tedros Adhanom Ghebreyesus, Director-General of WHO. “We are now at a turning point. Without urgent action, we risk going backwards, and missing the global malaria targets for 2020 and beyond.”

The WHO Global Technical Strategy for Malaria calls for reductions of at least 40% in malaria case incidence and mortality rates by the year 2020. According to WHO’s latest malaria report, the world is not on track to reach these critical milestones.

A major problem is insufficient funding at both domestic and international levels, resulting in major gaps in coverage of insecticide-treated nets, medicines, and other life-saving tools.

Funding shortage

An estimated US$ 2.7 billion was invested in malaria control and elimination efforts globally in 2016. That is well below the US $6.5 billion annual investment required by 2020 to meet the 2030 targets of the WHO global malaria strategy.

In 2016, governments of endemic countries provided US$ 800 million, representing 31% of total funding. The United States of America was the largest international funder of malaria control programmes in 2016, providing US$1 billion (38% of all malaria funding), followed by other major donors, including the United Kingdom of Great Britain and Northern Ireland, France, Germany and Japan.

The global figures

The report shows that, in 2016, there were an estimated 216 million cases of malaria in 91 countries, up from 211 million cases in 2015. The estimated global tally of malaria deaths reached 445 000 in 2016 compared to 446 000 the previous year.

While the rate of new cases of malaria had fallen overall, since 2014 the trend has levelled off and even reversed in some regions. Malaria mortality rates followed a similar pattern.

The African Region continues to bear an estimated 90% of all malaria cases and deaths worldwide. Fifteen countries – all but one in sub-Saharan Africa – carry 80% of the global malaria burden.

“Clearly, if we are to get the global malaria response back on track, supporting the most heavily affected countries in the African Region must be the primary focus,” said Dr Tedros.

Controlling malaria

In most malaria-affected countries, sleeping under an insecticide-treated bednet (ITN) is the most common and most effective way to prevent infection. In 2016, an estimated 54% of people at risk of malaria in sub-Saharan Africa slept under an ITN compared to 30% in 2010. However, the rate of increase in ITN coverage has slowed since 2014, the report finds.

Spraying the inside walls of homes with insecticides is another effective way to prevent malaria. The report reveals a steep drop in the number of people protected from malaria by this method – from an estimated 180 million in 2010 to 100 million in 2016 – with the largest reductions seen in the African Region.

The African Region has seen a major increase in diagnostic testing in the public health sector: from 36% of suspected cases in 2010 to 87% in 2016. A majority of patients (70%) who sought treatment for malaria in the public health sector received artemisinin-based combination therapies (ACTs) – the most effective antimalarial medicines.

However, in many areas, access to the public health system remains low. National-level surveys in the African Region show that only about one third (34%) of children with a fever are taken to a medical provider in the public health sector.

Tackling malaria in complex settings

The report also outlines additional challenges in the global malaria response, including the risks posed by conflict and crises in malaria endemic zones. WHO is currently supporting malaria responses in Nigeria, South Sudan, Venezuela (Bolivarian Republic of) and Yemen, where ongoing humanitarian crises pose serious health risks. In Nigeria’s Borno State, for example, WHO supported the launch of a mass antimalarial drug administration campaign this year that reached an estimated 1.2 million children aged under 5 years in targeted areas. Early results point to a reduction in malaria cases and deaths in this state.

A wake-up call

“We are at a crossroads in the response to malaria,” said Dr Pedro Alonso, Director of the Global Malaria Programme, commenting on the findings of this year’s report. “We hope this report serves as a wake-up call for the global health community. Meeting the global malaria targets will only be possible through greater investment and expanded coverage of core tools that prevent, diagnose and treat malaria. Robust financing for the research and development of new tools is equally critical.”

Source: who.int

RISE FOR OUR RIGHT

FOR IMMEDIATE RELEASE, 12.12.2017

The United Nations Sustainable Development Goals that all UN Member States have agreed to try to achieve Universal Health Coverage by 2030.

Despite dramatic gains–including a substantial reduction in maternal and child mortality, lack of access to essential healthcare for all remains problem in the country.

Observing this year’s Universal Health Coverage Day (five years after the United Nations unanimously endorsed universal health coverage) with the theme: Health for all; Rise for Our Right, the Divine Mother and Child (DMAC) Foundation has called on policy makers and stake holders to strengthen health services at the community level.

 In a statement to the press, Mr. Owurani Charles Oduro (programs manager) called on government to strengthen the idea for the National Health Insurance Scheme (NHIS) in Ghana, which was to abolish the cash and carry system of health delivery and provide affordable, quality health care to every person, everywhere they need without financial hardship.

Basic investigative equipment’s should be made available at the primary clinics for effective diagnosis and referral.

We call on all community opinion leaders, civil society organization and cooperate bodies/institutions to support the health services in mobilization and reaching out communities to make health care at the door step of local communities feasible.

“We Rise for Our Right that every Ghanaian no matter where they are, where they live, or how much money they have should have access to quality basic care they need”

Health for all

Rise for our right

Media contact:

Owurani Charles Oduro

(Programs Manager - DMAC Foundation)

Mobile: +233 50 398 4128

 www.dmacfoundation.org