Infecting with Sugar

By now, many people have read the popular (and controversial) New York Times article “Is Sugar Toxic?” or have seen the lecture by Dr. Robert Lustig on “Sugar: The Bitter Truth” on YouTube (see below). Without doing either source much justice, the essential argument is that fructose has no nutritional value whatsoever and that it is the key cause of the obesity epidemic in America. Furthermore, it may be a primary contributor to insulin resistance, metabolic syndrome, diabetes, and even cancer. Thus, Dr. Lustig, a persuasive speaker, argues that we should go to such lengths as to even “card” children and teenagers when they try to purchase sodas with the goal of removing all fructose from the American diet.

If we are to accept Dr. Lustig’s proposition, then another issue arises. There is ample evidence that developing nations are increasingly adopting the so-called western (or American) diet while noncommunicable chronic diseases (NCDs) are rapidly on the rise. There is no doubt that there is significant interaction between the two. Then, by exporting our culture and diet, are we infecting other nations with the same chronic diseases that pervade our modern society? What sort of moral or ethical obligation do we have to take our understanding of fructose and help shape global food policy? Many U.S. organizations are now pouring funds into fighting infectious diseases in the developing world (on a related note, Happy World Malaria Day! - 4/25/2011). At the same time, however, food and beverage companies are flooding the up-and-coming nations with advertising and products full of the sugary foods that we enjoy in America. As such, we may be removing the threat of infectious diseases and simply replacing them with the chronic illnesses we bear today.

This “epidemiological transition” is nothing new, but we must stay alert to an issue that can be often ignored in global health. In order to address this growing transition more effectively, we need to understand who and what to target. If fructose, indeed, is the sweet but insidious killer, how we act on this knowledge will determine whether or not countries around the world become mired in the life-threatening, resource-draining quicksand of chronic diseases.

Microbicides–When will they deliver?

The AP recently reviewed current research on the effectiveness of vaginal microbicides, gels that provide prophylactic protection from HIV infection.

These gels promise to be an amazing tool in the fight against HIV, especially in areas of the world where condoms are 1) not easily accessible/available 2) not allowed to be used for a variety of reasons (religious edict, cultural taboo/condemnation, et cetera). Consequently, vaginal microbicides, like the female condom, have promised to provide a “women-controlled protection” believed to be key in fighting the HIV/AIDS epidemic.

However, trials of numerous microbicide continue to end in disappointment, baffling researchers and frustrating activists looking for another preventive measure in their armamentarium against HIV:

“Frankly, blocking transmission of the virus appears to be a lot harder than anyone understood it would be at the beginning,” says meeting co-chair Dr. Sharon Hillier of the University of Pittsburgh and a principal investigator of the Microbicide Trials Network.

Similar trials looking at rectal microbicides have been equally disappointing.

As things stand now, I cannot help but ask “when will the research deliver?” On the Global Campaign for Microbicides website, they have a section describing how microbicides work. Yet, as you read, you get the impression no one knows how they work…because they don’t. There have been no proof-of-concept studies, there has been little date supporting the effectiveness of any of the trials. Essentially, the research seems to be driven by the ideal of a microbicide, by the idea of “how great it would be if we had a preventive gel.” I can’t help but be a little cynical as more and more research dollars are pumped into a preventive measure that continues to not only prove ineffective but also puts people at increased risk of HIV infection.

So, again, I ask, “when will they deliver?” Or perhaps a better question is to ask, “will they ever deliver?”

At some point, we will need to step back, look at the basic science of the immune response and that data that continues to pour in from microbicide trials and see that maybe microbicides won’t be the next magic bullet against HIV. We need to package HIV prevention and not hope for one great prevention.

Nothing But Nets

While walking through DC’s Dupont circle, I got accosted by some young activist in a mosquito outfit. Surreal. I quickly took whatever they were handing out and went on my way–I try to keep my conversations with Anopheles to a minimum.

I’ve finally had a chance to look at the little card my arthropod-friend gave me:

156 of ‘em per inch, to be exact. These holes are part of a bed net–one of the most effective ways to prevent malaria, a leading killer of children in Africa.  The holes are so tiny that mosquitoes can’t get through to bite and spread malaria. It’s a simple, life-saving solution, and all it takes is $10 to buy a bed net, distribute it to a family, and explain its use.

Malaria kills. Send a net. Save a life

NothingButNets.net

Nothing But Nets is a campaign working diligently to prevent malaria infections in at risk populations:

Malaria is a disease caused by the blood parasite Plasmodium, which is transmitted by mosquitoes. Malaria, from the Medieval Italian words mala aria or “bad air,” causes 350 million to 500 million illnesses per year and kills more than one million people – mostly children under the age of five. Malaria is particularly devastating in Africa, where it is a leading killer of children. In fact, there are 10 new cases of malaria every second. Every 30 seconds, a child in Africa dies from a malaria infection.

Consequently, Nothing But Nets is working with the United Nations to provide insecticide-treated bed nets to those living in malaria risk areas:

Studies show that use of long-lasting insecticide-treated bed nets can reduce transmission as much as 90 percent in areas with high coverage rates.

Bed nets prevent malaria transmission by creating a protective barrier against mosquitoes at night, when the vast majority of transmissions occur. Malaria-carrying mosquitoes generally bite between 10:00 p.m. and 4:00 a.m. A bed net is typically hung above the center of a bed or sleeping space so that it completely covers the sleeping person. One bed net can safely last a family for about four years, thanks to a long-lasting insecticide woven into the net fabric.

A net treated with insecticide offers about twice the protection of an untreated bed net and can reduce the number of mosquitoes that enter the house and inhabit the surrounding areas. Currently, bed nets are treated with pyrethroid insecticides. These insecticides have very low levels of toxicity to humans, but are highly toxic to insects.

And the most amazing thing is that it only takes a $10 donation to provide a bed net…from manufacture to bedside, just $10.

So, if you want to prevent malaria infections, please donate at NothingButNets.net