Prevention is the keyword:

Have a balanced diet, exercise regularly

By Thulasi MUTTULINGAM

Professor Nihal S. de Silva is a Research Scientist and Adjunct Professor at the Washington University, Danforth Campus and Caretech Labs, USA, who is currently in Sri Lanka to share his expertise on the prevention of non-communicable diseases with health professionals and researchers in the country. He has had a long and distinguished career of research and lecturing in various disciplines of science, in the USA. His primary areas of expertise are in Biochemistry, Nutrition and Immunology.

Professor Nihal S. de Silva

Excerpts of an interview he had with the Sunday Observer.

Question: We understand you are here in an official capacity. What exactly is the purpose of your visit?

Answer: When President Rajapaksa was recently in the US, he had asked for help in combating the rise of non-communicable diseases in Sri Lanka from US Scientists. When I came to hear of it, I immediately volunteered my services to the Sri Lankan embassy in the US. I am currently working with the Medical Research Institute and the Health Ministry here, to see what can be done about the issue.

My visit is being sponsored by the Sri Lankan Embassy in the USA. When I heard they wanted help back here, I volunteered my services.

Q: Are non-communicable diseases a major problem in Sri Lanka now?

A: They are on the rise. With changing lifestyles will come such problems as diabetes and hypertension. The fast food culture has crept into Sri Lanka now. Falling prey to it is not the best idea for people who wish to be health conscious. It is a major factor in the rise of NCDs (Non- Communicable Diseases) the world over.

Q: And what can be done to prevent this?

A: That is the key word. Prevention! Prevention is better than cure. So people have to take care of their bodies; have a balanced diet. Exercise regularly - and make sure it's vigorous exercise. Cricket may be a good sport but it's rather slow. I would recommend activities like tennis, basketball, soccer or at least fast walking as exercise.

Q: What constitutes a balanced diet?

A: It can be divided by calories. In this country, an average, healthy person should take in about 1500 - 2000 calories. The saturated fat concentration of this should be reduced to 10 - 15 percent. Proteins should go up to 20 percent. The country is surrounded by fish. Fish is ideal as protein food. Also lentils. If you want more proteins, go lentils.

The rest of the calorie intake should be carbohydrates. And of course, it is essential to have a complete supplement of vitamins and minerals. For example, vitamin D - people should be taking 2000 international units of vitamin D. People in the West get only 50 through sun light, supplementation is needed. Aging people need 5000 units. Vitamin D is a hormone. We have 27 000 - 30 000 genes in our body and according to research done on genomes, Vitamin D has the power to influence 3000 genes.

Q: Does heredity play a part in non-communicable diseases such as hypertension and diabetes?

A: It is not your genes, it is modification of your genes by environmental factors. 'Its called epigenomes or epigenetics. It's not only your genes that matter but also the effect of environmental factors on the gene expression that finally determines your health and disease'. NCDs such as cancer, vascular diseases, pulmonary diseases, hypertension and diabetes all stem from environmental components. Whether a person is prone to or is actually suffering from a disease can best be identified by bio markers.

Q: What are bio markers?

A: Some component of your blood or other body fluids / tissues that indicates some sort of abnormality. For example, glucose in the urine indicates diabetes and homocysteine, an amino acid found in blood indicates heart disease conditions.

I am currently working on a new technique of diagnosis using these bio markers. It's called Raman Spectroscopy and it is being used to diagnose a variety of chronic as well as non-communicable diseases.

The plus point of the technique is that it is non-invasive; unlike X-Rays and MRIs, it will not cause any harm to the body. 'I am a pioneer in this direction and was the first to use it for the

Bronchalveolar lavage fluid of the lung!! this paper was published in Spectroscopy magazine in 1999-2000!'

Q: What exactly is Raman Spectroscopy and how does it work?

A: It is a laser based photonic technique, using the wavelength 785 nm. It gives a vibrational fingerprint of the condition of your cells so that any variation from that of an ideal healthy body could be detected. Now in the West, it is used in the screening of cancer, dental problems, lung diseases, heart diseases and even diabetes.

Right now bio markers such as phlegm, saliva or blood samples are used but over the next five years I anticipate that it could be used on the body itself by developing fibre optic cables.

Traditional histopathologic techniques will be replaced by the Raman Spectroscopy technique soon.

Q: Is it important to eat only organic food?

A: Organic food is costly. So far there is nothing to indicate that biotechnology of food is harmful. I have been eating corn flakes, made from bio-tech corn for a number of years now. Nothing has happened to me. In Europe, they have dubbed this Franken Food, after the human made monster Frankenstein. They are crazy. People are always wary of something new.

Research and development is important and I think it ought to be given a very high priority in Sri Lanka with all our major crops. It will only be to their ultimate good. It will also create many job opportunities for young people.

Also our system of herbal medicine should be researched more. The herbal industry is a billion dollar market in the West now.

Q: Do you believe in herbal medicine?

A: Yes, of course. When we were small, our elders used to tell us to eat Gotu kola if we wanted to be good in mathematics. Now scientific research has found that it contains a high amount of phospholipids which are good for the brain. Gotu Kola is now available in pill form in the West.

We should do more research into the scientific properties of our herbs as well as the knowledge that herbal medicine has to impart and market it properly. This will open up avenues for revenue as well as employment.

Q: Our Immune system plays a critical role in our health and dieases. So do Plant nutrients (Phytonutrients or Phytochemicals) have a role to play in our immune defense?

A: Definitely its an YES! by my research and others in this very exciting field of study! thats why Ayurvedic herbs have a great role to play in the immune defense. that's the important Preventive Strategies we should do in SL, a small country with less money to spend on health care! unlike the West. which today has realized its mistake and clamping down the billion dollar health bill! In addition, we are blessed with a lot of fish. We ought to analyse the oils in the fish to see if we can extract Omega 3 fatty acids from them. It is a necessary diet supplement and is currently extracted mostly from plants.

If we do some proper research and analysis, we might be able to extract and market Omega 3 fatty acids from our fish. The country has a lot of natural resources but careful planning is needed to make the best possible use of it. 'Biomedical and Agro-Biotech, both have to go together to get the best effect for this country! also give employment for the young people of the North, East, West and South!'

Q: Any other advice for our fellow countrymen?

A: Prevention is better than cure. But once ill, it should be remembered that people are individuals and should be treated individually. We all have different genetic make-ups, lifestyles, habits and environments and these should be taken into account in treatments.

Local medical industry to the fore:

Rubella vaccination saves lives

by Nilma DOLE

Vaccinations have been regarded as medical necessities we can't live without but also intricate consequences that could happen when we tamper with Mother Nature. While we're been given the gift of overcoming the world's deadliest of diseases, we should be cautious that every positive comes with its share of negatives. So we should not only survive it out there in a world full of calamities when Pandora opened her box but also cringe our faces when we get that mild injection as a child.

According to epidemiologists, a vaccination is the basically weakened, killed or inactive germs or pathogens that come in the form of bacteria or viruses which could even be proteins that have been enhanced to protect the recipient.

Helm

Either way, vaccination treatments have been at the helm of controversies due to various disputes as experts have been debating scientific, ethical, political, medical safety, religious and even highlighting adverse effects making them a force to reckon with. Countries such as the United States even have National Vaccine Injury Compensation Program to help those who are harmed and suffer as a result of vaccinations.

In Sri Lanka, vaccinations began in 1951 when infected cases such as poliomyelitis, pertussis and tetanus began cropping up significantly. It was then that the Epidemiological Unit was established in 1959 with supervision from the World Health Organization (WHO) to survey communicable diseases.

Dr. Ananda Amarasuriya, Assistant Epidemiologist at the Epidemiological Unit, said, "Sri Lanka is one of the first among developing countries globally to introduce a vaccine safety surveillance system." He said that all reported cases are investigated at different levels according to the severity of the disease, including Adverse Events Following Immunisation (AEFI) with follow-ups done from the grass-root to top level.

What we fail to understand as parents of children is what exactly we know about vaccinations Dr.Sudath Peiris, another reputed epidemiologist, said that Sri Lanka has a high literacy rate and efficient primary health care so naturally, the word about immunisation gets about. "While 1.8 percent of information about immunisation methods are given by the media, about 22 percent is given by a paediatrician where parents rely on their source," he said. Moreover, when reliable sources talk about immunisations, they project the big picture of deadly symptoms and conditions of disease as opposed to a simple injection for the child to prevent such diseases and you can see the results openly.

Adverse

However, about two years ago when 3-year old Asanthi Wasana and 12-year old Peshala Hansini died due to the adverse effects of rubella which was a simple allergy, people didn't hear from it in a long time. "So the media sensationalised reporting and then started attacking the health system and went so far as to create a fear among the public when they were asked to bring their children to be immunised," he said.

Rich people immediately turned to the private hospitals thinking that the services and quality of the vaccines would be better thereby creating a sort of image that the "Those who were poor would reluctantly and fearfully take their children to the general hospitals," he said. Studies showed that there were no cases in 2007 but following the media controversy, there was a sudden outbreak where two cases were reported in 2008, three cases in 2009 and five cases last year.

"The trend shows that there might be a deadly outbreak of the disease if we don't educate the public not to believe fake media reporting and talk to the doctors to see what kind of immunisation is appropriate for their child. We are here 24 hours of the day, 365 days of the week for queries and advice with regard to vaccinations," said Dr. Peiris.

So we should stop rubella by trusting our local medical industry because Sri Lanka is the best country for children to be immunised.

GM lab creates chicken that cannot spread bird flu

by Steve Connor

Norrie Russell, courtesy of Valerie White and The Roslin Institute Scientists have developed a way of curbing the spread of avian flu with the help of genetically modified chickens that do not spread the virus.

The GM rooster could be the first of many such disease-resistant animals Getty Images

The chickens have an extra piece of DNA inserted into their genomes which produces a “decoy” molecule that blocks the replication of the influenza virus and prevents transmission to the rest of the flock.

Researchers believe the breakthrough could eventually lead to the creation of GM poultry, pigs and other livestock that are fully resistant to a range of infectious diseases. They also said that the development could help to lower the risk of transmitting dangerous animal viruses to humans.

While consumers in Britain have been resistant to plant-based products containing GM ingredients, the scientists behind the GM chicken believe that the proposal to develop disease-resistant varieties might become acceptable due to concerns about animal welfare and the transmission of infections to humans. Laurence Tiley of Cambridge University, who was a key member of the research team, said: “We believe the attitude of the UK public to GM food depends on the nature and purpose of the genetic modification.

“Disease resistance is clearly a beneficial characteristic for animal welfare and public health.”

The GM chicken was created by adding a synthetic fragment of DNA to their chromosomes, which causes the chickens to manufacture small lengths of RNA, the genetic molecule used by influenza viruses.

These particular pieces of RNA act as decoys by locking on to the enzyme used by flu viruses to make copies of themselves.

“The decoy mimics an essential part of the flu virus genome that is identical for all strains of influenza A.

“We expect the decoy to work against all strains of avian flu and that the virus will find it difficult to evolve to escape the effects of the decoy. If you’ve got genetically modified chickens that are resistant to the avian flu virus then you don’t in theory have to bother with vaccination anymore,” he added. When scientists carried out tests on the GM chickens they found that although the birds were still vulnerable to being infected with avian flu and that they became sick with flu, but they did not appear to transmit the virus to other members of their flock, even if these birds were normal, non-GM varieties.

Helen Sang of the Roslin Institute at Edinburgh University, another leading member of the team that carried out the study, published in the journal Science, said that the results achieved so far are “very encouraging”.

Courtesy: The Independent