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The Lancet, one of the most prestigious medical journals in the world, has released a report which prescribes an ideal and healthy diet. The new dietary plan has taken into consideration all the factors of human body as well as meeting UN Conference on Climate Change goals for reducing carbon emissions.

The report has recommended a reduction in consumption of red meat and sugar by almost 50% along with increasing the intake of nuts, vegetables and fruits. The diet is healthy and environment-friendly causing minimum damage to the planet intended for a worldwide adoption.

The report was submitted by EAT-Lancet Commission, a non-profit and independent organization, which involved 18 co-authors, 19 scientists from 16 countries. The group was tasked with providing global scientific targets for sustainable food production and healthy diet.

The commission proposed recommendations for an average man with the average dietary calorie requirement of 2500 calories. Out of the 2500 calories, 800 calories must come from whole grain i.e. corn, wheat and rice, while 204 calories from vegetables and fruits, and fewer than 30 calories from meat (pork, lamb, beef). Additionally, it suggested an avoidance of added fat and added sugar. The report stated that the proposed diet will abate the approximately 11 million premature deaths per year worldwide as unhealthy diet is one of the leading cause of health issues.

The ideal planetary health diet is aimed at achieving the UNFCCC Paris targets to ensure sustainable food production practices. At the same time, the report has recommended to take cultural sensitivities in consideration. The planet will host 10 billion people by the end of 2050 which will put enormous strain on natural resources by the overgrowth in population. This will inevitably urge us to look for healthy alternatives for unsustainable dietary hobbits.  

One of the members of the commission, a professor at Harvard, Walter Willett said that the diet of people across the globe needs to change. While the environmentally conscious diet allows two fish servings and a beef burger per week it specifies that most of the protein must come from non-meat sources. While one third of each food plate of the diet is sourced from wholegrain more than half of it comes from vegetarian sources.

Marco Springman, a commission member from Oxford University, said that the report is based on sound scientific and epidemiological evidence as researchers studied huge data about dietary needs of cohorts of people. The Lancet is one of the most reputed and prestigious medical journals in the world with an experience which exceeds a century as its first issue was published in the year 1823.  

Eli Lilly, an Indianapolis-based global pharmaceutical company has gained approval for its Verzenio drug used for treating breast cancer patients from UK’s National Institute of Health and Care Excellence (NICE). The approval has set stage for a 3 way competition in the CDK4/6 inhibitor drugs segment. The new drug is another addition to other such drugs including Pfizer’s Ibrance and Novartis’s Kisqali.

NICE has recommended in its draft guidance the use of the drug for treating human epidermal growth factor-2 (HER2) negative, hormone receptor positive and metastatic breast cancer as part of initial hormone therapy. NICE said that the drug is cost-effective compared to other CDK4/6 inhibitor class drugs after Lilly revised its price offering by a revised patient access scheme.

Ibrance was the first drug launched which showed blockbuster performance earning close to $4 billion in 2018 worldwide, Kisqali is far behind with expected sales to reach $1.6 billion in 2022. The Verzenio drugs approval will give competition to the Kisqali for the second position in the market. Although Verzenio is far behind Kisqali and Ibrance as they gained their approval in November 2017, but analysts say that the Verzenio will fare better than others as it requires patient to follow a continuous dosing regimen without going on treatment holidays to avoid toxicity such as neutropenia. The UK listed price of Verzenio is same as its rivals costing around £2,950, but NICE made sure that the company gives discounting offers.

Around 40,000 women across UK are diagnosed with breast cancer every year, while 8000 out of them will be eligible to receive treatment by the Verzenio drug. The drug is being appraised by NICE along with fulvestrant. Delyth Morgan, Breast Cancer Now’s chief executive said that the NICE approval will help in improving choices available to breast cancer diagnosed women, giving them greater control over their life.

Lilly’s drug Abemaciclib (Verzenio), which in 2015 was designated as breakthrough therapy for breast cancer by the USFDA, can be used as a replacement for robociclib and palbociclib. The drug which acts as a CDK4 and CDK6 inhibitor can come with some side effects. It is essential that the patients are informed about the benefits and possible side effects of the therapy they are receiving. She further added that they look forward to the use of the drug as part of National Health Service and giving Verzenio in combination with fulvestrant could significantly improve patient’s response to treatment who have already received hormone therapy.

A new blood test which tracks the level of neurofilament light chain, a protein in the blood may be adopted for the detection of Alzheimer’s and other neurodegenerative diseases a decade before first symptoms occur. The blood test developed as part of research study by collaboration of researchers from German Center for Neurodegenerative Diseases in Germany and Washington University School of Medicine in St. Louis, USA.

When neurons are damaged or dying, a structural protein, neurofilament light chain is leaked into the cerebrospinal fluid which later releases into the blood through the blood brain barrier. Researchers used this protein for developing blood test for early detection of Neurodegenerative disorder.

To detect the damage to the neurons in the brain, rise in the levels of neurofilament light chain protein in the cerebrospinal fluids is checked. Although this is an established procedure, patients are often reluctant to undergo spinal tap which is required to extract the fluid from the CNS.

The researchers wanted to overcome this challenge by investigating the possible link between neurological damage and protein levels in the blood. The study was conducted on 400 participants from Dominantly Inherited Alzheimer’s Network or DIAN. The participants of the study include 247 carrying early-onset genetic variant and 162 with unaffected relatives.

The protein levels were high at baseline and showed a rise over time in people with the faulty genetic variant while in people with healthy gene variant it remained largely same from already lower baseline levels. The researchers said that the significant achievement lies in the fact that the difference in the level of neurofilament light chain protein was detectable by the blood test 16 years before the first symptoms of the disease occurred. The researchers are optimistic about the use of the protein as a primary biomarker for early stage detection of neurodegenerative diseases.

It was observed that patients whose blood tests reported a rise in blood protein levels were most likely to develop symptoms of diminished cognitive abilities and brain atrophy. Additional research still has to be conducted before the adoption of the blood test methodology for clinical scale prediction. But the new test has shown hope for early detection of certain neurodegenerative diseases including multiple sclerosis, Huntington’s disease, Lewy body dementia and Alzheimer’s disease.

The Alzheimer’s Association reports that around 5.7 million people in the US suffer from Alzheimer’s disease and it expects that the figure could rise up to 14 million by 2050. 

An advisory panel working for US Food and Drug Administration split evenly on the decision to whether to approve a first of its kind oral medication for treating Type 1 diabetes. The committee is undecided about the approval with a vote 8-8 and has left the decision to the agency by the end of March 2019.

The drug sotagliflozin made by drug makers Lexicon and Sanofi Pharmaceuticals is planned to be sold under the brand name Zynquista. The medication which is to be taken along with insulin came under increased scrutiny owing to certain severe side effects of the medicine. The drug poses a higher risk to patients in developing diabetic ketoacidosis. Diabetic ketoacidosis (DKA) is a condition where the body doesn’t produce enough insulin leading to high blood sugar and highly acidic substances called ketones. It’s a serious life-threatening complication for Type 1 diabetic patients. The risk of developing DKA has led many reviewers to vote against the drugs release.

In Type 1 diabetes the body doesn’t produce insulin, so people with the condition have to regularly monitor their blood sugar levels from rising beyond a certain limit. Type 1 Diabetes often called juvenile diabetes is usually diagnosed early in childhood. People with the condition are treated with insulin but it often leads to fluctuation in blood sugar levels causing much discomfort. The proposed Zynquista drug is a one-time daily drug which helps manage the patient’s blood sugar level, however it reduces the blood sugar levels by excreting excess sugar into urine.

The drugs approval process was based on three clinical trials which involved around three thousand patients. The results found that there were about 56 cases of patients developing DKA among 1,748 patients, or 3.2 percent while the placebo test showed that 5 patients developed DKA among 1,229 patients or 0.4 percent. The drug trials brought significant benefits to the patient including reduced blood sugar, some weight loss and lowered blood pressure.

The panel members were aware of the risk involved in DKA which has often led to serious hospitalization and death and raised concerns about the higher risk involved in real world adoption of the drugs outside the confines a clinical trial. A panel member who voted against the drug, Dr. Jack Yanovski said that the smaller degree of benefits may not outweigh the increased risk it may pose to the patient. Other panel members disagreed by stating that the patients are in desperate need of the Zenquista drug.

There are about 1.25 million people in USA suffering from Type 1 diabetes and 40,000 are diagnosed every year, according American Diabetes Association. The companies said that they would continue to work towards approval of the drug with USFDA.

A London-based digital health startup Kaia Health has raised $10 million in Series-A round of funding which offers app based training for chronic pain management. The startup founded in 2015 provides ‘mind-body therapy’ to patients suffering from musculoskeletal disorders. The idea is to offer mobile technology based alternative therapy which includes medical education, psychological techniques and guided physical exercises.

The CEO and co-founder of Kaia Health, Konstantin Mehl said that the app is useful for chronic pain patients suffering acute pain for 2-3 days. He said that as the physical therapy for pain management is usually expensive because of physiotherapist fees, only 2% of patients suffering acute pain receive any kind of professional help while the rest 98% extensively rely on pain killers and surgery. The treatment is very ineffective as well as expensive.

Mr. Mehl said that the traditional therapy for chronic pain management includes the patient receiving a one-on-one physiotherapy session for weeks. The patient has to visit the physiotherapist personally and has to pay handsome fees. Instead of this hassle, Kaia Health has developed a personal trainer app which uses computer vision technology to provide guided exercise and pain management techniques by a fully autonomous exercise coach. The app visually monitors the user as they are performing the exercises and gives vocal feedbacks if they are wrongly doing a certain move or exercise.

Kaia’s goal is to reduce the use of pharmaceuticals for pain relief as over-prescription of opioid drugs have escalated into a nationwide epidemic and rise in the number of opioid overdose deaths. The app based approach gives flexibility to users for exercise timings. As many people don’t like to go to physiotherapist every time for an exercise session and also don’t find it comfortable to practice at home without instruction, the app based monitoring helps them get live feedback.

The company released an app called Squat Challenge which taught an exercise called squat, only to see how people use the technology. And then the startup tracked all possible body positions to provide improvising suggestions. It took nearly six months to track all body positions and now Mr. Mehl claims that they have successfully added all the body positions. He added that the app now can correct any exercise and movements on millimeter basis.

Competitors in the app-based pain management field includes another startup Hinge Health. Their approach also involves an app along with wearable sensors to monitor body movements, however quite different from Kaia’s automated sensor free AI approach. Mehl said that they have tried working with wearable sensors but found that users are usually disinclined towards putting sensors on body while doing exercises. As a result they decided against the use of sensors and relied more on Artificial Intelligence based personal training.

The Series-A round of investment was led by Balderton Capital. The new funding will be used to scaling up in the USA with new office in New York.  Kaia is currently used by 250,000 users in Europe and USA.

A senior analyst at Future Market Insights (FMI) traces challenges and scope for improvements with the current products in the breast pump market.

Exclusive breast feeding for babies up to 6 months of age has been recommended by healthcare experts, globally. Moreover, babies with congenital defects or premature births also are unable to consume breast milk without difficulty. These difficulties faced by new mothers and the increasing operations of breast milk banks are encouraging the adoption of hospital grade breast pumps around the world.

What shortcomings of conventional breast pumps must manufacturers focus on?

Unlike other equipment that people use on a regular basis, such as automobiles or smartphones, the breast pump has not seen any significant improvements in the recent past. Most breast pumps come with the challenges of having multiple complex components that need to be assembled or taken apart for functioning the right way, while being very noisy. Moreover, conventional breast pumps are usually made with a one size fits all configuration. This approach by manufacturers so far has been detrimental to the growth of the breast pump market, as mothers are often seen choosing the weaning of their baby as opposed to using breast pumps owing to lack of convenience.

What are some notable innovations made by breast pump manufacturers to address such challenges?

Willow Inc. is one of the few breast pump manufacturers that has released breast pump products that makes its operation easy and completely silent. The device is almost completely automated and can work on a single charge for an entire day, without any effort from the user, while analyzing the timing and milk production rate of the woman to optimize its own operation for better results. In addition, the product is also integrated with its own smartphone app, for essential data about the new mother’s health.

On a similar note, the Massachusetts Institute of Technology has developed a number of innovations to change how breast pumps are designed. For instance one prototype makes use of air bladders instead of vacuum systems that enhance noise reduction.

Also, Medela a leader in the breast pump technology has started to experiment with different sucking patterns that imitate the nursing behavior of real babies to optimize performance during different stages of lactation for women.

Are there any significant threats to the current breast pump adoption scenario?

Rapidly improving quality of alternative methods of lactation are anticipated to restrict the production and sales of breast pumps. For instance, galactogogues, which are medications for inducing milk production in new mothers, are increasingly moving away from synthetic ingredients to natural counterparts, which are just as effective in their function. Such efforts are witnessing high preference by mothers, and are expected to pose significant challenges to breast pump manufacturers.

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