With non communicable diseases taking a sharp upward curve, scientists are now turning to new paths to find ways of reducing, preventing and treating such diseases. Founder Director of the Interdisciplinary Center for Innovation in Biotechnology and Neuroscience (ICIBN), Faculty of Medical Sciences, University of Sri Jayewardenepura, and Research Professor, The Institute for Combinatorial Advanced Research and Education (KDU-CARE), of General Sir John Kotelawala Defence University (KDU), Professor Ranil de Silva tells the Sunday Observer how using natural products can help, based on his research findings.
Excerpts…
Q. The Health Ministry and FAO recently launched the Sri Lankan Food based Dietary Guidelines following recommendations by the Food & Agricultural Organisation and the World Health Organization to help improve healthy eating habits and lifestyles among individuals and populations in the country. With the focus on the reduction of non communicable diseases (NCD), do you consider this a forward step ?
A. NCDs are the leading causes of morbidity and mortality worldwide. Of the global reported deaths of 56.4 million in 2015, 70 percent or 39.5 million, were due to NCDs including 14 million people who died too young before the age of 70. This is a costly outcome in terms of personal morbidity and financial outlay.
Q. How will brain nutrition help?
A. Non-communicable diseases (NCDs) such as cardiovascular diseases, cancer, diabetes, pulmonary, mental disorders and neurodegenerative dementia, are the most common diseases today overtaking communicable diseases which though sometimes acute have a short duration and are mostly curable infections. On the other hand, NCDs cause mostly incurable lifetime illnesses involving the demand for costly medical technologies and long-term care expenditure.
Q. The World Health Organization ( WHO) has given high priority to the prevention of NCDs and has referred to it as a global challenge . Why is this? Is it due to our fast ageing populations?
A. The link in the rise in NCDs’ morbidity to ageing populations has been proved as posing important challenges to health care systems globally. Therefore, an effective early preventive strategy is an ideal approach to slow or even halt lifestyle-linked degenerative processes. Application of such a strategy that places emphasis on disease prevention, rather than just disease management, appears necessary if the burgeoning NCD problem is to be averted.
Q. How can this be done? What are the preventive measures to be taken? What are the Dos and the Don’ts to follow?
A. As far as possible avoid modifiable risk factors from an early age. These include unhealthy lifestyles and habits such as physical inactivity, alcohol intake, cigarette smoking.
Q. What about diet?
A. Low intake of fruits and vegetables has been associated with increased mortality risk of cardiovascular disease (CVD) and cancer. It has been reported that practising healthy lifestyle behaviours including performing physical activity, adhering to healthy dietary principles and not smoking was associated to a lower risk of developing a chronic disease: diabetes, myocardial infarction, stroke and cancer.
Q. What are the symptoms to look out for in a developing NCD?
A. NCDs are diseases of generally slow progression with clinical symptoms only becoming apparent after considerable cellular damage has occurred in target tissues, due to ‘chronic oxidative stress’ and inflammation. Early correction may be useful in arresting NCD development.
Q. I understand you have done some research in providing evidence on the importance of Sri Lankan natural products on preventing lifestyle induced oxidative stress and inflammation in NCDs. Tell us about it. What new light has your research helped to shed on common diseases in this part of the world especially, in Si Lanka?
A. Recent studies have reported that a possible capacity of natural products, fruits, vegetables and spices have a potential in preventing certain age-related neurological disorders. As we were interested in looking into our own natural products and lifestyle factors in the prevention of age-related neurological diseases, we conducted the largest and the most comprehensive study of ageing pathologies in autopsy brains across two countries in South Asia; India and Sri Lanka. The key findings were, pathologies of neurodegenerative diseases such as Parkinson’s disease (PD) and Alzheimer disease (AD) in developed /Western countries and India and Sri Lanka of elderly populations are almost similar to each other, contrary to popular belief that dementia is less prevalent in this part of the world. To elaborate on our discovery regarding diet for certain diseases , it was revealed that green-yellow vegetables brain protected both Alzheimer disease and cerebrovascular (stroke) pathologies.
Q. Some of these diseases can also be inherited. Did your research demonstrate any new light on genes and their risk factors in NCDs?
A. In relation to one’s genes - mainly cardiovascular disease-causing gene risk factors, Folic acid supplementation as one of the preventative approaches against dementia and stroke was demonstrated. We also found consumption of folic acid rich food, leafy green vegetables, such as spinach, beans etc could be beneficial.
Q. What about Cardiovascular diseases?
A. Cardiovascular disease-causing genes have consistently been associated with longevity across populations. Hence reduced life expectancy in the study might be associated due to cardiovascular disease-causing genes interacting with lifestyle factors.
Q. Diabetes and hypertension are also very common NCDs. What did your study show about their link to other diseases?
A. It showed that diabetes and hypertension could contribute to dementia and the prevention of diabetes and hypertension could lead to reduction in cerebrovascular and dementia incidence.
Q. Your study also cast new light on other natural products whose benefits have not been researched well. For example Cinnamon a medicinal spice whose properties are endless. Can you tell us about your research on Cinnamon and how it is linked to the prevention and cure of certain brain diseases?
A. Cinnamon is a multifaceted medicinal plant, the therapeutic effects of cinnamon reported range from antioxidant, anti-inflammatory, antidiabetic, antimicrobial, anticancer, lipid-lowering, and neuroprotection ( Parkinson’s and Alzheimer’s diseases), owing to its phytochemicals. It is crucial to look into the possibility of Ceylon cinnamon based drug, nutraceutical development and medical strategies complementary to western medicines considering the synergistic properties and multisite action of cinnamon phytochemicals. In collaboration The National Institute of Advanced Industrial Science & Technology (AIST), Japan (5th innovation centre worldwide) proved that Ceylon cinnamon stem extracts showed selective cytotoxicity in osteosarcoma cells. This opens up public-private partnership with the leading drug development companies for Cinnamon based drug development.
Q. Explain your rationale behind the use of natural products on stroke prevention?
A. It is reported that natural product-centered antioxidant supplements such as flavonoids, and polyphenols of Ceylon cinnamon, curcumin, green tea may be an excellent prevention and amelioration of the disease progression strategy for stroke due to their antioxidant, anti-neuroinflammatory and antiplatelet properties. Natural products consuming food will help to alter the stroke risk factors, preventing future attacks. We studied that the extraction from Ceylon green tea, using cell culture studies, demonstrated a great potential in the prevention of stroke by drinking Ceylon green tea.
A study done with 772 stroke patients is suggestive that regular consumption of Ceylon black tea is associated with a decreased risk in the onset of stroke. Therefore, our studies show the prevention of stroke by consuming Ceylon green and black tea.
Q. Natural products to prevent Parkinson’s disease?
A. Parkinson’s disease (PD) is a disease of the nervous system that interferes with brain control of body movement by cellular damage in an area of the brain. This leads to the common symptoms of tremor, balance difficulty, and slowed movements. PD convincing disease modifying therapies remain elusive to date.
Therapeutic approach of multifactorial complex disease such as PD is always a challenge. According to previous studies, natural products showed promising treatment outcomes for PD. In a case control study of 229 Parkinsonism patients, 102 controls, we have published the protective effect of coffee and tea.
Q. Illiteracy? Did your study demonstrate any link between illiteracy and increased risk to other diseases?
A. We found a strong association between illiteracy and increased risk of AD pathology. In fact it opened valuable new information on risk factors, genetics, and potential new treatments. Dr. Printha Wijesinghe (nee Kentheeswaran) –was awarded a double doctorate (PhD) for the study, one by the Faculty of Health, Medicine and Life Sciences of Maastricht University, Netherlands which we greatly appreciate.
Q. How do you describe the significance of your findings?
A. Our findings opened a new area on Sri Lankan natural products and lifestyle factors for healthy brain ageing and shed valuable new information on risk factors, genetics, and potential new treatments.
Q. All these drug discovery procedures need to pass through several scientific validation including clinical trials. Your comments?
A. As an initiation, in collaboration with the University of Houston (UoH), USA, we have analysed the signature of serum proteins and metabolites in neurological diseases for the first time in South Asia with the promising results, where we will be able to scientifically validate the efficacy of our nutraceuticals.
Q. Have you a message for the Lankan public?
A. Ageing is a natural process and everyone must undergo this phase of life at their own time and pace. Medication aside, there are many ways people living with NCDs can improve their health and well-being and enhance the quality of life.
With regard to our study and findings we find satisfaction in demonstrating the neuroprotective role of our own natural products; green tea, black tea, coffee, fruits vegetables, green leaf, cinnamon and vegetarian diet. In addition don’t forget the lifestyle factors and avoid habits like smoking and drinking alcohol that can harm you and lead to NCDs such as hypertension, diabetes, and obesity.
These findings have opened a new area to Sri Lankan natural products and lifestyle factors for healthy ageing. A well-balanced diet rich in vegetables and fruit should be the most important part of prophylaxis of age-related diseases such as cardiovascular disease, neurodegenerative diseases, or age-related anorexia, as well as a way to promote healthy ageing with a high quality of life.
Diet affects multiple aspects of human health. It is well documented that improper nutrition patterns, e.g., a Western-style diet or a high-fat diet, are linked to chronic diseases of civilization, such as obesity, type 2 diabetes, and cardiovascular disease. In recent years, there has been a growing interest in the role of gut microbiota and their implications for human health, especially in the context of metabolic disorders (obesity, type 2 diabetes, dyslipidemia), which increase the risk of cardiovascular incidents and thus the number of deaths in developed countries. The human gut microbiome is deeply associated with brain function.
An important factor affecting the state of the microbiota is undoubtedly the diet. There is growing evidence on the impact of different types of diets on the microbiota and the relationship between diet, the state of the intestinal bacterial flora, and the development of selected metabolic disorders.
Regular exercise, healthy diet and adequate hours of sleep are golden rules to follow.