Covid-19 is not an airborne disease, says Dr David Nabarro - The Daily Guardian
Connect with us

Medically Speaking

Covid-19 is not an airborne disease, says Dr David Nabarro

World Health Organization’s special envoy for Covid-19, Dr David Nabarro, says that air is not the primary mode of coronavirus transmission and there is not enough evidence to suggest the same.

Shalini Bhardwaj

Published

on

response has to be modified when it comes to encouraging Covid readiness. There is a need for clear and well-communicated strategic principles, modified in light of new evidence. This should be accompanied by guidance on how the principles can be adapted so they enable all stakeholders to work out for themselves and how they can best contribute to the response in their own localities. Second, those responsible for managing responses should take advantage of opportunities. They have to “convene, coordinate, curate and communicate”. When these elements are prioritised, power and authority at the local level are used to their best effect. We offer four suggestions on how this can be done: l There must be a narrative. It should describe a clear vision and identifiable pathways for societies to move into the Covid-ready state. How to encourage this to emergence from the present situation with widespread movement restrictions? l Information must be locally specific. If people are to be enabled to act at a local level, they depend on high quality and specific information about what is happening in their locations. Where is the virus? How many people are infected? Which groups are most at risk? l Responses must make sense to people. This is about people being able to make sense of the narrative and updates in the news. What are the implications of the latest scientific findings? What does that say about safety in schools, on public transport, the wearing of face coverings? Every effort must be taken to avoid stigmatisation. l Values of decision-makers must be explicit. People are bound together in solidarity, getting ahead of the virus, by a sense of what they hold in common. This includes caring for older people and those who are vulnerable. Our values are known because we state them, but they are believed when we live them. We may not be believed if we say we value care workers if it becomes clear that they are unable to be tested for the virus or to access equipment they need for protection. What we do and how we do it is much more powerful than anything we say. The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) looks like a super mysterious virus throwing googlies even after six months of the pandemic. We as pulmonologists imagine lung fibrosis to happen in chronic phase (after weeks) of any pneumonia or Acute Respiratory Distress Syndrome (ARDS). Some of the observations based on autopsies done in SARS-CoV-2: 1. A total of 159 patients with ARDS, fibrosis was noted in three (4%) of 82 patients with a disease duration of less than a week, 13 (24%) of 54 patients with a disease duration of between one to three weeks, and 14 (61%) of 23 patients with a disease duration of greater than three weeks. 2. The post-mortem also reveals vascular endothelial inflammation with intracellular SARS-CoV-2 virus and disrupted endothelial cell membranes. Electron microscopy showed that there is enhanced intussusceptive angiogenesis (the process whereby a new blood vessel is created) which intrudes the lumen (the cavity or channel within a blood vessel) and further leads to thrombosis (clot inside a blood vessel). This finding is not seen in other ARDS like influenza during acute stages. 3. There is evidence that vascular dysfunction (a disorder of the vascular system characterised by poor function of the blood vessels) is a key component of the switch from ARDS to fibrosis, with VEGF (Vascular Endothelial Growth Factor), Interleukin 6 (IL-6), Interleukin-1 (IL-1), Tumor necrosis factor (TNF) Alfa as main mediators. 4. It remains unclear why certain individuals can recover from it whereas in others there is a shift to unchecked cellular proliferation with the accumulation of fibroblasts and myofibroblasts and the excessive deposition of collagen alongside other components of the extracellular matrix to result in progressive pulmonary fibrosis. Three tips to prevent fibrosis: a) any potential antifibrotic intervention should be considered within the first week of ARDS onset; b) drugs which inhibit IL-1 “Nintedanib” can play a beneficial role. The role of IL-6 inhibitors is still not clear and confusing. An experimental study showed that IL-6 in the early phase of lung injury promotes fibrosis and that inhibition in the later stages of injury at the onset of the fibrotic phase might ameliorate fibrosis; c) older the age and severe the disease (requiring ICU) leads to more chances of pulmonary fibrosis. The writer is a pediatrician at Sir Ganga Ram Hospital in New Delhi. The World Health Organization (WHO) and UNICEF have warned that around 2-3 million children across the world may miss life-saving vaccines and immunisation programmes around the world due to disruptions caused by Covid-19. These vaccines are used to protect children against life-threatening diseases such as measles, smallpox, DTP3, among others. According to new data by WHO and UNICEF, these disruptions are now a threat which can reverse the hard-won progress against deadly diseases through immunisation programmes. “Vaccines are one of the most powerful tools in the history of public health, and more children are now being immunized than ever before. But the pandemic has put those gains at risk. The avoidable suffering and death caused by children missing out on routine immunisations could be far greater than Covid-19 itself,” said Dr Tedros Adhanom Ghebreyesus, Director General, WHO. Several countries are facing disruptions in the delivery and uptake of immunisation services due to the coronavirus outbreak and lockdown. Due to an increase in the number of cases not only in India but in various countries, at least 30 measles vaccination campaigns are at risk of being cancelled, which could result in a further outbreak in 2020 and beyond. In many cases where services for vaccination are offered, people are unable to reach for their kids’ vaccination due to interruptions, economic hardships, restrictions on movement, or fear of coronavirus infection. Most of the cases are from Africa where one of the reasons is lack of access to health services during the pandemic. Two-third of them are concentrated in 10 middle and low-income countries like Angola, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Mexico, Nigeria, Pakistan, and Philippines. Covid-19 has directly affected immunisation which is one of the most cost-effective public health interventions till date. Covid-19 is not an airborne disease, says Dr David Nabarro EXCLUSIVE PRESCRIPTION Medical news DOC TALK World Health Organization’s special envoy for Covid-19, Dr David Nabarro, says that air is not the primary mode of coronavirus transmission and there is not enough evidence to suggest the same. medically speaking the daily guardian 18 july 2020 8 new delhi Covi d and after: Is India prepared for mental health pandemic? SARS-CoV-2: Super mysterious virus causing big damage 3mn kids won’t be vaccinated due to Covid, warns WHO Shalini Bhardwaj New Delhi Dr Srinivas Rajkumar New Delhi

Q. Do you think Covid-19 is airborne?

A. It is primarily dropletborne and most droplets do not travel further than one metre. There is a possibility that in some settings, very small droplets may carry virus further than a metre with transmission being described as airborne. WHO considers that this is not the primary mode of transmission.

 Q. Covid-19 cases in India are rising rapidly and have crossed the 10 lakh mark. What can be done to control the situation?

A. The important thing is to establish basic health infrastructure that can identify and isolate people with Covid. The people and government must maintain efforts to build this capacity everywhere. It is a difficult time. The authorities need data on where the virus is being transmitted to focus containment efforts where they are most needed. The performance of this Covid response is key to determine whether the levels of infection will continue to increase in India. The constant defence against transmission and the buildup of outbreaks is key. It is a continuous process. Detect cases, isolate, trace contacts and isolate them. This is the most effective method to control the spread.

Q. What lessons the world needs to learn from Covid-19?

A. There are lessons to be learned from our experiences of tackling Covid-19 so far. First, the command-andcontrol approach so often favoured in crisis response has to be modified when it comes to encouraging Covid readiness. There is a need for clear and well-communicated strategic principles, modified in light of new evidence. This should be accompanied by guidance on how the principles can be adapted so they enable all stakeholders to work out for themselves and how they can best contribute to the response in their own localities. Second, those responsible for managing responses should take advantage of opportunities. They have to “convene, coordinate, curate and communicate”. When these elements are prioritised, power and authority at the local level are used to their best effect. We offer four suggestions on how this can be done:

  • There must be a narrative. It should describe a clear vision and identifiable pathways for societies to move into the Covid-ready state. How to encourage this to emergence from the present situation with widespread movement restrictions?
  •  Information must be locally specific. If people are to be enabled to act at a local level, they depend on high quality and specific information about what is happening in their locations. Where is the virus? How many people are infected? Which groups are most at risk?
  • Responses must make sense to people. This is about people being able to make sense of the narrative and updates in the news. What are the implications of the latest scientific findings? What does that say about safety in schools, on public transport, the wearing of face coverings? Every effort must be taken to avoid stigmatisation.
  • Values of decision-makers must be explicit. People are bound together in solidarity, getting ahead of the virus, by a sense of what they hold in common. This includes caring for older people and those who are vulnerable. Our values are known because we state them, but they are believed when we live them. We may not be believed if we say we value care workers if it becomes clear that they are unable to be tested for the virus or to access equipment they need for protection. What we do and how we do it is much more powerful than anything we say.

The Daily Guardian is now on Telegram. Click here to join our channel (@thedailyguardian) and stay updated with the latest headlines.

For the latest news Download The Daily Guardian App.

Medically Speaking

GOOGLE ADDS VACCINE INFO PANELS TO SEARCH, MAPS SHOW BEDS AVAILABLE

Published

on

Tech giant Google has made discovering vaccine-related information easier by carrying out a scope of updates across its different services.

The aim of rolling out these features is to support health authorities and affected groups find assistance quicker, as the massive second wave of the pandemic sweeps the country. According to Mashable, to help in searching for vaccine information, Google Search will show the latest updates on vaccine safety, efficacy and side effects.

“You will also find information about prevention, self-care, and treatment under the Prevention and Treatment tab, in easy-to-understand language sourced from authorised medical sources and the Ministry of Health and Family Welfare,” said the search giant in a blog post.

In addition to the testing centres, people can also access the location of 23,000 vaccination centres nationwide in English and 8 other regional languages.

Mashable detailed that another element has been added on Google Maps which will show a user if a hospital has beds and access to medical oxygen, based on crowd-sourced information. This data may not be right on target but it may be convenient for somebody hoping to get a friend or family member hospitalised close by.

Google Pay too has put out a Covid aid campaign where individuals who wish to donate to organisations that help Covid-influenced residents, including GiveIndia and UNICEF India can do so. Reportedly, this campaign has raised over USD 4.6 million (INR 33 crore) to date. (WITH ANI INPUTS)

Continue Reading

Medically Speaking

TAMIL NADU HOSPITAL SUCCESSFULLY REMOVES RARE TUMOUR FROM MAJOR BLOOD VESSEL

Published

on

Kauvery Hospital, one of the leading healthcare chains in Tamil Nadu, successfully removed a tumour from the inferior vena cava (the largest vein in the body that passes through the liver), of a 56-year-old woman from Salem.

Speaking about the patient, Dr K Elankumaran, Head of Liver Diseases Transplantation and Hepatobiliary Surgery, Kauvery Hospital Chennai said, “The woman complained of indigestion and abdominal pain. When an ultrasound scan was done, a tumour was found, growing in a major vein, closely associated with the liver. This was a rare type, measuring 10*10 cm. It required immediate removal to avoid complications which otherwise might turn fatal.”

This rare kind of tumour contributes to 1 in a lakh of adult cancers. When diagnosed, it needs major surgical resection for better outcome and survival. The procedure also involved grafting of the vessel, which demands a deft, delicate and dexterous vascular surgical procedure.

“The patient underwent surgery, and the tumour along with a portion of the inferior vena cava was removed. Since the major vessel was affected by the tumour, we had no option but to remove a portion of it and restore continuity through a vascular graft. The whole procedure took 10 hours, and within a week, the woman was fit for discharge,” explained Prof. Dr N Sekar Natarajan, Senior Consultant Vascular Surgeon, Kauvery Hospital, Chennai.

Co-founder and Executive Director of Kauvery Hospital, Dr Aravindan Selvaraj, congratulated the team for the surgery. (WITH ANI INPUTS)

Continue Reading

Medically Speaking

Nurses are playing a bigger role during Covid

Published

on

Right from Florence Nightingale in the Crimean War to Fatu Kekula who helped treat Ebola patients in Liberia, nurses have been at the forefront of any healthcare crisis. They are the critical link in the healthcare system that not only helps people recover back to health, but become the biggest support for the family of the sick.

During this pandemic, the roles of nurses have changed and brought great responsibilities and a lot of challenges. A typical day in the life of a nurse on the Covid war front is filled with great uncertainty and a constant marathon. Every single shift has the potential to be momentous, exhilarating, exhausting, energizing, or all of the above. On any given day, nurses can see people at their weakest and most vulnerable, or at their strongest and most resolute. Moreover, a single breach in infection prevention practice can cause life-threatening infections to any patient, especially for critical Covid patients who are immune-compromised, considering the use of steroids, raised blood glucose levels, and use of medications that suppress immunity. Nurses acts as patient advocates to ensure that the right treatment reaches the patient in the right manner. They witness the results of life-ending injuries and illnesses with regularity. Yet, this just the tip of the iceberg. The stories and experiences that nurse have had since the pandemic is beyond compare but the lessons learnt are here to stay.

LESSONS FROM THE PANDEMIC

This pandemic has put the entire healthcare community in trial mode – a trial that tested each and every healthcare provider’s endurance and resilience. Nurses were no different. The challenges were many, but amid these challenges, healthcare transformed itself to accommodate the dynamic needs of the community. Infrastructural and process changes like the creation of specialised isolation units, negative pressure areas, availability and efficient utilization of manpower and PPE, frequent mock drills, patient flow management drills, etc. have been implemented to tackle even the most extreme situations smoothly.

CRITICAL ROLE IN EMERGENCY CARE

Nurses are an integral part of the disaster management team. They are the ones who triage (sort) the patients on their arrival which requires the right knowledge and critical thinking, and depending on her assessment the doctors treat those patients first who require urgent attention and treatment. Nurses are vital in mobilizing resources, ensuring appropriate patient monitoring, and providing the right care to needy patients. Nurses are also a major part of decision-making when it comes to risk mitigation.

BUILDING RESILIENCE

Doctors and nurses have braved various crisis situations hand-in-hand with much dedication throughout ages, but it is only after the pandemic that their true worth has emerged. Each young doctor and nurse, despite being overwhelmed with stress and anxiety, witnessing deaths every now and then, getting infected, and even passing on the infection to their families, have not stopped coming back to work.

Nurses have started having bigger roles when it comes to patient care in Covid-19 units. Frequent rounds and monitoring, ensuring patients receive food and medications round the clock, risk prevention and mitigation, attending to doctors and following specific instructions, collecting blood samples, escalating warning signs, etc., such tasks have placed nurses on a higher pedestal in terms of responsibility and accountability.

The biggest challenges faced were to be flexible with changing protocols, nurse training, and wearing PPEs for several hours together. The fear of being infected and infecting near and dear ones added to the anxiety. Despite these, they did not lose spirit; they had to go on. This is one of the biggest healthcare crises the country had ever faced in many years. Most hospitals, although having an Infection Control Unit, were still not prepared for a crisis of this magnitude. They had to be deft in learning and help others learn too. They had to handle patients and extremely frightened relatives who weren’t even sure they would see their people again. Moreover, the burden of short staff and limited resources made matters worse. Having said that, the lessons from the pandemic have also empowered nurses.

ROLE OF THE NURSING HEAD IN INFECTION CONTROL

Infection prevention and control became a priority for healthcare staff across all areas of clinical practice. The nursing staff became a critical link in infection control. They had to formulate new protocols and update skills accordingly. This includes segregation of patients as per their clinical conditions, creating isolation units for Covid-positive and suspected cases, ensuring adequate availability of PPE for all healthcare staff, skilled manpower and resources, and the well-being of all healthcare workers by providing them with prophylaxis, nutritious food, and psychological support. This is one part of the planning and establishing Standard Operating Procedures (SOPs). The next step is preparedness implementation that includes infrastructure and inventory planning to ensure all patients get the required medicines and oxygen or ventilator support. Strict protocols had to be followed by each and everyone entering the Covid units.

NURSES WILL HAVE A BIGGER RESPONSIBILITY IN EPIDEMIOLOGY STUDIES

As part of the community nursing program, we are trained to partake in epidemiology studies. Indirectly in many ways, we do contribute to understanding epidemics, an outbreak which becomes an important element of disease management. But going forward, the role and responsibilities will increase. During this pandemic, nurses have already been involved in data collection and analysis, understand the disease patterns, peaks, and more. They identify and investigate the problem, formulate the causal factors and alternative interventions, and implement to prevent and control the problem, also evaluating the effectiveness of the intervention. They participate in data collection, data analysis, planning, implementation, and evaluation. They have an active role in the prevention and control of communicable diseases which include:

• Identifying sources of infection and methods of spread of infection

• Health education of people in general

• Notification of Covid-19 to the health authority

• Teaching and supervising other workers in surveillance activities

Today, Infection Control Nurses are empowered to collect and analyze the data from Covid patients. They are the ones who collate and send data to local authorizes for notification of Covid patients. Mass sensitization drives are also helmed by nurses by actively taking part in webinars, online sessions in order to create awareness regarding the prevention and management of the infection.

Minimole Varghese is Chief Nursing Officer, Fortis Hospital, Mulund, and Mohini Chandrashekhar is Chief Nursing Officer, Hiranandani Hospital, Vashi, a Fortis associate.

Continue Reading

Medically Speaking

Covid care: FAQs about getting oxygen support at home

When is oxygen support required for Covid patients at home? How to choose between oxygen concentrators and cylinders? What if these are not available? These FAQs answer some common queries which are on everyone’s minds right now.

Dr Sapna Zarwal

Published

on

With oxygen deprivation and lung infections becoming common problems faced by patients during the second wave of Covid-19, many patients have been recommended to use oxygen concentrators and cylinders at home to maintain oxygen levels and avoid fatalities. However, with oxygen therapy, one needs to be doubly careful and be aware of the risks and dangers as well. Here are the answers to some common queries that will help you make the right decision regarding oxygen support.

WHEN SHOULD YOU TAKE OXYGEN SUPPORT?

Oxygenation should be preferred when blood oxygen levels (SpO2) readings drop below 94%. Ideal oxygen levels should be between 95% and 99%. While no oxygen therapy can instantly boost oxygen levels or restore them to normal, Covid-positive patients should aim to achieve a saturation of up to 92%. Experts also advise that achieving 100% saturation shouldn’t be done when the body is sick. More so, this may exhaust your resources quicker, whether it is a concentrator or cylinder that you use.

WHAT IS AN OXYGEN CONCENTRATOR? HOW DOES IT WORK?

An oxygen concentrator is an electronically operated device that separates oxygen from room air. It provides a high concentration of oxygen directly to you through a nasal cannula. These devices work on the principle of ‘rapid pressure swing absorption’ which is where the nitrogen is removed from the air using zeolite minerals which absorb the nitrogen, leaving other gases to pass through and capturing oxygen as the primary gas. The collected oxygen is 92-95% pure.

WHAT IS THE DIFFERENCE BETWEEN OXYGEN CONCENTRATORS AND CYLINDERS?

The difference is that a concentrator purifies the air and makes it available for patients who have low oxygen levels in their blood. It just needs to be pulled into a power source. Cylinders accomplish the same, but the oxygen is already compressed within the tank. That supply is gradually reduced until the tank runs out and needs to be refilled or replaced.

WHAT TO KEEP IN MIND BEFORE BUYING OR RENTING AN OXYGEN CONCENTRATOR?

Normal air will have 21% oxygen. If 1 litre oxygen is provided to the patient through the concentrator, the oxygen percentage (or fraction of inspired air) in the lungs rises to 24%, with 2 litres it rises to 28% and with 10 litres it rises to 60%. Depending on the need, the litres of oxygen per minute must be regulated. There is a need for monitoring this from time to time to ensure that the flow of oxygen is proper and that the patient is not over oxygenated. Seek your doctor’s advice to decide how many litres per minute of oxygen is required for your patient. Keep a pulse oximetre handy to check oxygen levels from time to time. Oxygen concentrators can supply between 0.1 litres per minute (LPM) to 5 to 10 LPM.

WHO IS ELIGIBLE?

Only mild to moderately ill patients, who have an oxygen saturation level between 90% and 94%, should depend on an oxygen concentrator and can use it at home. We must understand that hoarding such life-saving equipment will only worsen the country’s problem. Anyone with oxygen saturation depleting below 80-85% may need a higher flow of oxygen and will have to switch to a cylinder or liquid medical oxygen supply and may eventually need hospitalization.

TYPES OF OXYGEN CONCENTRATORS

There are two types of oxygen concentrators— continuous flow and pulse dose. Continuous flow oxygen will provide the same flow of oxygen every minute unless it is turned off, irrespective of whether the patient is breathing it in or not, while pulse dose oxygen concentrator detects breathing patterns and dispenses oxygen when it detects inhalation. The oxygen dispensed per minute will vary in the second case.

WAYS TO IMPROVE OXYGEN LEVELS FOR COVID PATIENTS

Oxygen delivery can be increased by using prone positioning. Physical position affects the distribution and volume of air in the lungs and can have direct effects on the expansion or collapse of the delicate alveoli that permit the exchange of oxygen and carbon dioxide in the blood. It involves turning a patient with precise, safe motions, from their back onto their abdomen so that the individual is lying face down, to improve breathing and oxygen flow in the body. Having said that, getting the right advice on how proning can be complemented with oxygen supply is significant. Talk to your doctor today to understand when to opt for oxygen support at home, if your patient is eligible for oxygen support at home, and how it can be best utilized.

The author is Consultant, General Physician, Fortis Hospital, Mulund.

Continue Reading

Medically Speaking

Studies find ‘insufficient evidence’ to support herbal, dietary supplements for weight loss

Published

on

London: The first global review of complementary medicines (herbal and dietary supplements) for weight loss in 16 years — combining 121 randomised placebo-controlled trials including nearly 10,000 adults — suggests that their use cannot be justified on the basis of current evidence. The findings of two studies, being presented at The European Congress on Obesity (ECO) held online this year, suggest that although some herbal and dietary supplements show statistically greater weight loss than placebo, it is not enough to benefit health, and the authors call for more research into their long-term safety. “Over-the-counter herbal and dietary supplements promoted for weight loss are increasingly popular, but unlike pharmaceutical drugs, clinical evidence for their safety and effectiveness is not required before they hit the market”, says lead author Erica Bessell from the University of Sydney in Australia.“Our rigorous assessment of the best available evidence finds that there is insufficient evidence to recommend these supplements for weight loss. Even though most supplements appear safe for short term consumption, they are not going to provide weight loss that is clinically meaningful.”

The authors report on herbal supplements, containing a whole plant or combinations of plants as the active ingredient, and dietary supplements containing naturally occurring isolated compounds from plants and animal products, such as fibres, fats, proteins, and antioxidants. They can be purchased as pills, powders and liquids. Between 1996 and 2006, 1,000 dietary supplements for weight loss included on the Australian Register of Therapeutic Goods weren’t evaluated for efficacy. Supplements can be sold and marketed to the public with sponsors (who import, export or manufacture goods) required to have, but not necessarily provide, evidence backing their claims. Just 20 per cent of new listings are audited annually to make sure they meet the requirement. In some countries, the only requirement is that supplements contain acceptable levels of non-medicinal products. Estimates suggest that 15 per cent of Americans trying to lose weight have tried a weight loss supplement, a USD 41 billion global industry in 2020. Despite their increasing popularity, it has been 16 years since the last review of the scientific literature on all available herbal and dietary supplements. To provide more evidence, Australian researchers did a systematic review of all randomised trials comparing the effect of herbal supplements to placebo on weight loss, up to August 2018. Data were analysed for 54 studies involving 4,331 healthy overweight or obese adults aged 16 years or older. Weight loss of at least 2.5kg (5.5lbs) was considered clinically meaningful. They also evaluated study design, reporting, and clinical value. Herbal supplements included in the analysis were: green tea; Garcinia cambogia and mangosteen (tropical fruits); white kidney bean; ephedra (a stimulant that increases metabolism); African mango; yerba mate (herbal tea made from the leaves and twigs of the Ilex paraguariensis plant); veld grape (commonly used in Indian traditional medicine); liquorice root; and East Indian Globe Thistle.

The analysis found that only one single agent, white kidney bean, resulted in a statistically, but not clinically, greater weight loss than placebo (-1.61kg; 3.5Ibs). In addition, some combination preparations containing African Mango, veld grape, East Indian Globe Thistle and mangosteen showed promising results but were investigated in three or fewer trials, often with poor research methodology or reporting, and the findings should be interpreted with caution, researchers say. A new systematic review up to December 2019, also identified 67 randomised trials comparing the effect of dietary supplements containing naturally occurring isolated compounds to placebo for weight loss in 5,194 healthy overweight or obese adults. Dietary supplements included in the analysis were: chitosan; glucomannan; fructans and conjugated linoleic acid.

Continue Reading

Medically Speaking

Combining BMI with body shape better predictor of cancer risk

Published

on

A new research being presented online this year, suggests that a measure of body shape should be used alongside body mass index (BMI) to help determine the risk of obesity-related cancers. The research was presented at the European Congress on Obesity. BMI is a simple way of measuring body fat from the weight and height of a person. But its reliability is often criticised, because it does not distinguish fat from muscle, or consider where body fat is stored or an individual’s sex or age. Similarly, waist circumference takes into account belly fat, which is linked to several health risks including cardiovascular disease, type-2 diabetes and cancer, but fails to account for height. A new metric to measure obesity, called ‘A body shape index’ (ABSI), takes into account an individual’s age, sex, weight, height and waist circumference–and it may provide a more accurate estimate of cancer risk than BMI. To explore this further, researchers from the University of Glasgow and the University of Newcastle, combined data from 442,614 participants (average age 56 years) from the UK Biobank prospective cohort who were followed for an average of 8 years, during which 36,961 individuals were diagnosed with cancer.

Participants were broken down into three groups (tertiles) according to their body shape to examine the associations with the risk of 24 different types of cancer, and to examine ABSI and BMI as predictors of cancer risk. Results were adjusted for age, sex, ethnicity, deprivation, education, income, smoking, alcohol consumption, dietary intake, physical activity, and sedentary time. The analysis found that body shape and BMI predicted different obesity-related cancer risks in adults. Specifically, ABSI was linked with an increased risk for three cancers. Participants in the highest ABSI tertile were 38 per cent more likely to develop liver cancer, 40 per cent more likely to develop lung cancer, and had a 17 per cent increased risk of bowel cancer, compared to those in the lowest ABSI tertile, regardless of BMI.

However, researchers found that high ABSI and high BMI combined were linked with an increased risk for seven different types of cancer–uterine, oesophageal, liver, stomach, kidney, bowel, breast cancer. For example, participants in the highest ABSI tertile who were also overweight or obese were at twice the risk of developing uterine cancer than those with the lowest ABSI and normal BMI.

“Our findings underscore the importance of measuring more than just BMI when predicting cancer risk, and suggest that people’s body shape may increase their risk of certain cancers”, says lead author Dr Carlos Celis-Morales from the University of Glasgow, UK. “Whatever method you use, being overweight or obese is the single biggest preventable cause of cancer after smoking. More urgent actions are needed to help people maintain a healthy bodyweight and shape throughout their lives, starting at an early age.” Having excess body fat can lead to biological changes that alter levels of sex hormones, such as oestrogen and testosterone, cause levels of insulin to rise, and lead to inflammation, all of which have been linked with increased risk of 13 different types of cancer. This is an observational study, so cannot establish cause, and it is not a representative sample of the UK adult population, so the results cannot be generalised to the general population.

Continue Reading

Trending