South Africa will halt one of the largest and most advanced HIV vaccine trials ever to be undertaken in the country ahead of schedule after the jab was found to be safe but not effective at protecting against HIV infection.

In 2016, South African researchers embarked on the HVTN 702 study – what they thought might just be the best shot at developing a vaccine to protect people from HIV infection. At the centre of the research? The world’s only experimental HIV jab to ever show a modest result – too modest a result, showed the 2009 results of a Thai trial published in the New England Medical Journal, however for the vaccine to make it to market.

But in South Africa, the vaccine had been packed with a new adjuvant which is an ingredient used to stimulate immune system responses. It had a new booster and had been specially formulated for the HIV strains most common to South Africa. 

“The fact remains that the HIV epidemic is still really, in many respects, out of control and South Africa has more infections than essentially any other country,” said Anthony Fauci at the time. Fauci heads the United States government’s National Institutes of Allergy and Infectious Diseases (NIAID), which funded the trial. 

He reasoned: “A safe and effective vaccine could be the final nail in the coffin for HIV.”

Unsuccessful

Late on Monday, researchers announced that almost four years later, they will stop administering the jab to the 5 400 people who enrolled in the trial at 14 sites across South Africa.

The decision comes after a review of data from almost 5 400 participants found the shot had been unsuccessful in preventing new HIV infections.

As part of the trial, HIV-negative people at 14 sites across the country agreed to receive six shots over 18 months – half of whom will get the vaccine while the other 50% receive a placebo as part of a randomised controlled clinical trial. 

This kind of randomisation means that any characteristics such as age or location that could have a bearing on the study’s outcome should be equally present in both groups. Studies designed in this way – also called randomised controlled clinical trials – are better at determining cause and effect than other types of studies and are often called the “gold standard” in research.

But early results in January showed that whether groups of participants got the real shot or the fake, each cluster – or arm – of the study showed roughly the same number of new infections.  

Well-conducted trial

In short, said the NIAID, there was no difference in the risk of contracting HIV between those that got the vaccine and those who didn’t.

“We always hope that efficacy trials will show positive results that lead to new prevention options,” explained Avac executive director Mitchell Warren in a statement. “It is very disappointing that this vaccine candidate does not work, but the trial was well-conducted and got an answer as quickly as possible.”

Scientists will continue to follow up with participants for up to a year, deputy director of the Desmond Tutu HIV Foundation and one of the lead researchers Linda-Gail Bekker told Bhekisisa. She explained that the trial stopped injections at all sites Monday. 

Participants will get letters asking them to urgently come to their nearest research clinic for more information on the results. 

The trial is just one of three different HIV vaccine studies ongoing in South Africa – each taking a slightly different approach at trying to ward off new infections. Tuesday’s announcement about HVTN 702 study does not affect the other two trials.

Valuable contribution

Glenda Gray is the president of South Africa’s Medical Research Council and one of the trial’s lead researchers. In a statement, she said that regardless of the results, the trial – and the people involved – had still made a valuable contribution to science.  

“The people of South Africa have made history by answering an important scientific question,” said Glenda Gray. “We will continue to explore promising avenues for preventing HIV with other vaccines and tools, both in South Africa and the world.”

Vaccine activist organisation, the Vaccine Advocacy Resource Group (Varg) called the news disheartening but it too believed that the trial had provided valuable data to the “ever-increasing pool of knowledge along the road to find a vaccine for HIV.” 

In a statement, Varg said the trial was a reminder of the need “to push for meaningful, and honest engagement and transparency, which is critically lacking in far too many trials.” 

“We centre, we salute and we honour the 5 400 mostly black South Africans who made this trial possible.”

This story was produced by the Bhekisisa Centre for Health Journalism, http://bhekisisa.org. Subscribe to the newsletter http://bit.ly/BhekisisaSubscribe. 

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Laura Lopez Gonzalez

Sleep disorders expert

Dr Alison Bentley is a general practitioner who has consulted in sleep medicine and sleep disorders, in both adults and children of all ages, for almost 30 years. She also researches and publishes on a number of sleep-related topics both in formal research journals and lay publications including as editor of Sleep Matters, an educational newsletter on sleep disorders for doctors.

Although eliminating bread is the hardest goodbye of all, low-carb diets have been the rage for quite some time now. There are a few different plans you can follow. Keto is a major one that’s yielding quick, drastic weight-loss results for tons of people, and Paleo is another trendy plan. And then there are the tried-and-true low-carb classics, like the Atkins diet (this might be the first time you’ve heard that one in a while).

Both keto and Atkins are actually pretty similar when it comes to the amount of macronutrients (fat, carbs, protein) you should be consuming day to day, but what are the actual differences between the two — and which would be a better fit, nutritionally?

Of course you could just make your choice based on how much pasta you’re able to eat, but nutrition experts do believe that one is a little bit better than the other for a few reasons. Two dietitians — Natalie Rizzo and Susan Piergeorge — give the lowdown on these high-fat, high-protein, low-carb eating styles. Their verdict, ahead.

The keto diet

“The ketogenic diet is a high-fat, low-protein and low-carbohydrate diet that was originally developed to treat epilepsy,” explains Piergeorge. That’s right, historically, it wasn’t prescribed for extreme weight loss but to reduce blood sugar — you can hardly have any sugar on the diet — which during the 1920s was thought to lower the risk of seizures. Now, the diet is a huge trend for weight loss as well as treating type 2 diabetes, Piergeorge adds.

Here’s the basic formula: Fat accounts for 70 to 95 percent of the keto diet, while protein makes up 5 to 20 percent, and carbohydrates just 5 to 10 percent of what you’re eating. It tends to bring on dramatic weight loss because you’re consuming less than 50 grams of carbs a day on keto, ideally.

At this ratio, the body starts to burn fat. “Once the body’s glucose stores become depleted, ketone bodies are produced (these are products of fatty acid oxidation in the liver) and provide an alternate source of energy,” Piergeorge explains. Basically, fat, instead of sugar from carbs, becomes your body’s main energy source — and when you’re burning fat, you lose weight.

READ MORE: Low-Carb Vs. Keto: What’s The Diff And Which Is Better?

What you can and can’t eat on the keto diet

Once you read this, you may be tempted to devour an entire charcuterie platter. But the focus really is on healthy fats and lean meats, and supplementing those with fruits and vegetables in moderate amounts, since those are technically considered carbs.

Keto-friendly foods:

• Eggs
• Seafood
• Lean meats
• Healthy fats (including nuts, olive oil, and avocado)
• Green, leafy veggies
• Lower sugar, high-antioxidant fruits (like dark berries or pumpkin)

Foods to avoid on keto:

• Bread
• Pasta
• Potatoes
• Starchy veggies
• Sugar and other processed foods

Keto pros and cons

There are some potential health benefits you could experience by going keto. At the same time, the diet can have side effects, as explained below.

Health benefits of keto:

1. You may experience weight loss after starting keto.
2. It may also lower your blood sugar in the interim.
3. You’re consuming good fats, which are high in omega-3s (which have proven to be beneficial to heart health, skin and brain health).

Cons of keto:

1. Carbs, which are also found in foods like fruits and veggies, and whole grains, are what fuel you when you work out, for the most part. Because of that, you may experience sluggishness and less motivation to exercise.
2. The keto lifestyle may not be sustainable; it’s difficult to stick with this diet because it’s restrictive.
3. Because you’re consuming less fruits and veggies and whole grains, you may have less fibre in your diet, which can cause constipation.
4. At the beginning of switching to keto, you may not feel like yourself. The “keto flu” is common when your body is going into ketosis, and symptoms include headaches, nausea and fatigue.
5. You may be deficient in certain nutrients, like B vitamins, calcium, iron, magnesium and zinc, because you’re eliminating macros and some fruits and veggies, as well as whole grains.

Who keto might be right for

Well, if you’re trying to lose weight and have tried many other avenues to do so, eating keto may be effective. If you’re diabetic or pre-diabetic, it may also help lower your blood sugar since you’re cutting out all that sugar.

And, Rizzo adds, it could be a fit for some athletes, too. “Certain elements of the keto diet, like the emphasis on healthy fats and protein, is a good recommendation for active individuals who put a lot of wear and tear on their muscles and need more calories,” Rizzo says. You have to make sure the fats you choose are healthy, omega-3-rich fats instead of saturated fats, and that you’re choosing lean sources of protein.

Remember that before making a major lifestyle change, though, it’s best to check it out with your medical professional first. You don’t want to end up feeling worse after making this dietary switch instead of better.

READ MORE: Do You Really Need To Give Up Carbs To Lose Weight?

The Atkins diet

Though the Atkins diet basically peaked in the late ‘90s (didn’t we all?), it was actually developed much earlier by Robert C. Atkins, a doctor who published his first book, Dr. Atkins’ Diet Revolution, in 1972, and then his most popular bestseller, Dr. Atkins’ New Diet Revolution, in 1995. Dr. Atkins intended on it being a way to cut carbs, of course, and reduce high blood pressure.

Basically, with Atkins, you generally have two paths you can choose from: Atkins 20 and Atkins 40, based on the grams of carbs you should be eating per day. It’s also low in carbs, higher in fat and higher in protein, which ideally should prompt the body to burn fat.

If you’re trying to shave off more than 20 kilograms, you’d eat about 60 to 70 percent fat, 20 to 30 percent protein, and 5 to 10 percent carbs on Atkins 20 (you’re allowed 20 grams of carbs a day), Rizzo explains.

If you would like to lose less than 20 kilograms, go with Atkins 40. It consists of 55 to 65 percent fat, 20 to 30 percent protein, and 10 to 15 percent carbs. You’re allowed 40 grams of carbs per day, which is a bit easier when you’re tallying up macros. There’s also Atkins 100, which is a slightly simpler plan that allows for 100 grams of carbs per day.

What you can and can’t eat on the Atkins diet

Like keto, Atkins focuses on lean protein, as well as healthy fats. “Depending on the plan individuals follow, the plan emphasizes consuming protein at least three times per day in 120 to 170-gram portions including meat, seafood, poultry and eggs,” Piergeorge explains. “Fats are encouraged, you want at least 3 tablespoons per day in the form of butter, mayonnaise, or olive or other vegetable oils,” she adds.

Atkins-friendly foods:

• Lean meats
• Eggs
• Seafood
• Nuts
• Cheese (no more than 85-115g per day)
• Non-starchy veggies
• Unsweetened beverages

Foods to avoid or limit on the Atkins diet:

• Fruits (but you can re-introduce them after a while)
• Whole grains
• Legumes
• Eliminate processed foods, sugar and refined grains like bread and pasta
• Starchy veggies

Health benefits and side effects of the Atkins diet

Just like keto, there are potential health benefits of the Atkins diet, as well as side effect you should be aware of before you try it.

Health benefits of Atkins:

1. You may lose weight while following a low-carb diet and eating more protein and fat.
2. It may help lower your blood sugar as well.
3. You have some flexibility with the amount of carbs you can consume — you’ll be able to eat fruits, veggies and whole grains, in moderation, so your fibre intake might be higher than it would be with keto.

Cons of Atkins:

1. It may help you lose weight and lower your blood sugar in the beginning, but might not be sustainable in the long run.
2. You still may have nutritional deficiencies, like you might with keto, in the form of fibre, B vitamins, antioxidants and even calcium, if you’re not eating much dairy on the diet.
3. If you’re following along with Atkins strictly and buying their products (protein bars, breads, etc.), it can get expensive.
4. It’s easy to eat tons of saturated fat when you’re allowed a higher fat diet, which is the opposite of what’s healthy in terms of fat intake.

Who Atkins might be right for

Like keto, it may help an individual drop some serious kilos if it’s done the right way. And it can help lower your blood sugar if you have type 2 diabetes or are pre-diabetic.

Also, counting macros can be a good way to really boost awareness of what you’re putting in your body, especially if you are an athlete and want to make sure you’re fuelling properly for training. But, Piergeorge argues, a highly restrictive diet doesn’t work for everyone, and you should consult a doctor or nutritionist before beginning this strict regimen.

READ MORE: 12 Fasting Tips That’ll Help You Actually Lose Weight (And Not Go Crazy)

Recap: the biggest similarities and differences between keto and Atkins

Keto and Atkins may seem like the same thing when it comes to eating more fat and protein and less carbs and sugar, but there are some nuances you should keep in mind.

Keto and Atkins similarities:

1. The macro ranges you’ll be including in your diet are pretty similar, between fat, protein and carbs.
2. The allowed foods on keto and Atkins are similar: lean meats, seafood, some dairy products and some green, leafy vegetables.
3. Both keto and Atkins cut back majorly on carbs, sugar and processed food in order to send your body into a state of ketosis.
4. They both encourage fat loss and can potentially lower blood sugar.

Keto and Atkins differences:

1. Keto allows on average 70 to 90 percent fat, 5 to 20 percent protein and 5 to 10 percent carbohydrates, while Atkins allows for 55 to 75 percent fat, 20 to 30 percent protein, and 5 to 15 percent carbohydrates. Close, but not identical macros.
2. Atkins allows for more carbs than keto. (Keto tends to eliminate all but 5 percent of carbs and doesn’t allow you to eat much fruit at all.)
3. Keto is higher in fats, while Atkins emphasises proteins as a major macro to focus on.
4. Atkins has different levels based on how many carbs you’re looking to consume per day, while with keto, you have to go all in.

Is keto or Atkins better overall? The verdict…

Both keto and Atkins are highly restrictive diets, the experts point out, so it may be difficult to sustain these major lifestyle changes and cut out carbs for a long period of time.

Keto becomes tricky because it can be an unhealthy diet if you don’t do it correctly, and consume too many unhealthy fats (we’re talking cured meats instead of avocado). “I wouldn’t necessarily recommend the keto diet because it has such a high percentage of fat and a low percentage of carbs. It’s unsustainable in the long run, and there is too much of a tendency to eat a lot more saturated fat than you need,” Rizzo says.

If she had to choose between these two highly restrictive eating regimens, she’d choose Atkins because it allows for more carbs (in the form of fruits, veggies and whole grains) and ultimately more leeway in your eating and more balance in your diet.

Atkins also gives you more wiggle room because you can choose the 20, 40 or 100 option for allotment of grams of carbs per day. That way, you can introduce a little more pasta into the mix if that’s how you want to roll.

But it’s ultimately your decision — you’ll be making the dietary changes so they have to fit with your lifestyle and make you feel happy and healthy. Changing your diet (and especially eliminating the majority of carbs from your diet) is not easy, and may take some trial and error, so it’s important to thoroughly research all of your options.

^{This article was originally published on www.womenshealthsa.co.za}

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Mara Santilli

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Older adults who regularly consume a group of antioxidants called flavonols may have a decreased risk of developing Alzheimer’s disease, a new study suggests.

The compounds exist in many fruits and vegetables, with the richest sources including green vegetables like kale, spinach and broccoli, apples and tea.

Plenty of fruits and vegetables

The researchers found that of over 900 older adults they followed for six years, the one-fifth with the highest flavonol intake were 48% less likely to develop Alzheimer’s than the one-fifth with the lowest intake.

The findings do not prove the antioxidants are a magic bullet against dementia, the researchers stressed. But they add to evidence that a healthy diet – including plenty of fruits and vegetables – may help protect the ageing brain.

While studies have linked healthy eating habits to a lower risk of mental decline, the new findings get closer to one potential reason, according to lead researcher Dr Thomas Holland.

“We’ve understood that fruits and vegetables are great for our health. We wanted to focus more on the ‘why,'” said Holland, of Rush University in Chicago.

Flavonols are known to act as antioxidants and fight inflammation, and animal research has suggested particular brain benefits: In lab mice engineered to have a “model” of Alzheimer’s, flavonols can curb the buildup of abnormal protein deposits in the brain, and improve memory and learning abilities.

In past research, the Rush team has found that an eating pattern they dubbed the “MIND diet” is related to a lower risk of memory decline and Alzheimer’s in older adults.

Leafy greens and berries

They describe the diet as a hybrid of the traditional Mediterranean diet and the DASH diet (Dietary Approaches to Stop Hypertension) – both of which can lower the risks of heart disease and stroke.

The MIND diet emphasises fruits and vegetables – leafy greens and berries, in particular – as well as fibre-rich grains, nuts, beans, olive oil, fish and poultry. It discourages red meat, butter, sweets and highly processed foods.

The new findings, according to Holland, give further support to that type of eating pattern.

For the study, published online in Neurology, the researchers followed 921 older adults in an ongoing project looking at ageing and memory.

At the outset, they were 81 years old, on average, and answered questions on their diet, other lifestyle habits and medical history. Each year, they underwent neurological evaluations to spot signs of dementia.

Over six years, 220 study participants were diagnosed with probable Alzheimer’s. The risk, it turned out, was 48% lower for the one-fifth with the highest flavonol intake, versus the one-fifth with the lowest.

15mg each day

People largely got their flavonols from kale, spinach, broccoli, apples, pears, beans, tomatoes, tea, olive oil and wine. And the 20% percent with the highest intake consumed 15 milligrams (mg) a day, on average – three times more than people with the lowest flavonol intake, the findings showed.

According to Holland, it doesn’t take a full-fledged vegetarian diet to reach the 15mg mark each day: Half a cup of cooked leafy greens (or one cup of raw), a half-cup of berries, and a half-cup of other cooked vegetables should do it.

Of course, there may be other differences between older adults who eat lots of veggies and those who don’t. In this study, people with a high flavonol intake were more educated and more likely to exercise, for example.

But that did not explain their lower Alzheimer’s risk, the researchers found. Nor did factors like overall diet, body weight or depression symptoms.

That said, no one is suggesting people should focus on flavonols alone.

Dr Steven DeKosky is deputy director of the McKnight Brain Institute at the University of Florida, in Gainesville. He said, “This disease is complex, and there’s no one thing that will prevent it.”

It’s like a symphony

Nor is there any evidence that flavonol supplements curb Alzheimer’s risk, stressed DeKosky, who is also a fellow with the American Academy of Neurology.

“But we do think there are things you can do to decrease your risk,” he said.

Studies have linked a number of lifestyle factors to a relatively lower risk of developing dementia – including a healthy diet, regular exercise, staying socially active, and challenging yourself with mentally stimulating activities.

But while studies do statistical adjustments to try to isolate an effect of one thing – like flavonol intake – in the real world, it’s overall lifestyle that’s key, DeKosky said.

“It’s not one thing in isolation,” he said. “It’s more like a symphony.”

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Coughing, sneezing, feeling congested and unable to concentrate at the office? This might all be due to common allergy triggers at work.

Not only can your allergy symptoms affect your job if you were unable to get a good night’s sleep because of a stuffy nose, but you can also be affected by the things surrounding you at work.

Is it an allergy or an irritation?

Allergens can be found in anything from food to dust and are harmless, except when the immune system doesn’t “agree” with them and fights them. This causes a reaction when the body has an inflammatory reaction after coming into contact with an allergen.

Allergic rhinitis occurs when there is inflammation in the nose caused by allergy.

On the other hand, non-allergic rhinitis is caused by things that simply irritate the lining of the nose, without an allergic reaction.

It is important to note that a trigger (such as dust) can be an allergen or irritant and that the symptoms can be very similar.

Allergies can be diagnosed and ruled out through a blood test or skin prick test, and the best way to pinpoint what’s causing your symptoms would be to monitor exactly when they occur at work. Here are common triggers that may cause sneezes and sniffles in an office:

1. Cosmetics such as perfumes, aerosols or hairspray

We understand that body odour is frowned upon in the workplace, but unfortunately taking care of the problem can literally make your colleagues ill. Strong, concentrated perfumes can trigger hay fever symptoms and even migraines.

2. Dust and dander

That construction site next to your office building, or any renovations done in your own building can wreak havoc on your nasal passages. But dust is not only caused by heavy construction – dense carpets, curtains, upholstery or too many ornaments on a desk can also collect dust.

Ensure that your work surface is clean and dust-free at all times and speak up if an open-plan space needs vacuuming.

And while we are not necessarily bringing our furry friends to work, Kittie’s fur may involuntarily trigger your colleagues’ allergies if you’re not careful. Carry a lint roller with you and be mindful of others when giving your animals one last hug in the morning.

3. Pollen

Pollen is a big trigger of allergies, whether you work inside or outdoors. When you work on a construction site, in a garden or near busy roads, you can easily be exposed to pollen. But even when you’re confined to an office, pollen can travel indoors on the soles of shoes and cling to hair or coats.

You can’t avoid going to work altogether, but you can find out when the pollen count will be at its highest and take it from there. Limit pollen exposure by keeping windows closed when pollen levels are at their highest. When you work outside, wear sunglasses and a protective mask or buff.

4. Cleaning products

Industrial cleaning products and air fresheners used in office kitchens and bathrooms can release volatile organic compounds into the air that can trigger allergy symptoms. Be proactive and ask maintenance about the cleaning products used in your workspace.

5. Exhaust fumes

If you work outdoors near a busy highway, exhaust fumes can also trigger allergies.

But even if you work in an office, your daily commute can expose you to exhaust fumes that can trigger allergies.

A few years ago, a study published in the journal Allergy, Asthma & Immunology Research and mentioned in a Health24 article discussed the effect of traffic-related air pollution on asthma and respiratory allergies in young children. While there is a clear link between the prevalence of asthma and allergies in children living near main roads, they’re not the only ones affected by traffic-related air pollution – grown-ups buckling up every day are just as susceptible.

The best way to alleviate the effect of fumes is to wear a protective mask or buff when working outdoors, or to keep your windows closed and the ventilation inside your car in working order.

6. Cigarette smoke

The effect of second-hand smoke has been studied for decades. Research suggests that there could be a link between second-hand smoke and rhinosinusitis. If smokers are allowed to smoke freely outside the building and you walk through a waft of smoke, you may be exposed to second-hand smoke.

In South Africa especially, according to the World Health Organization, more than a third of South Africans could be exposed to dangerous levels of second-hand smoke. 

If you are smoking, start planning your strategy to quit. And if you suffer from allergies, limit your time spent outside with smoking colleagues.

 7. The air conditioner (sort of)

Some of us will not be able to survive the scorching summer months without air conditioning, but it may cause some of your allergy symptoms, even though it’s not an allergen itself.

Health24’s enviro-health expert, Olivia Rose-Innes, stated in a previous article that air conditioning can harbour mould spores that can aggravate symptoms in some people. But that doesn’t mean that the air conditioner is a physical allergen.

Dr Adrian Morris, Health24’s in-house allergy expert, says although there might be a connection between air conditioning and one’s health, one cannot be allergic to air-conditioning systems.

“You can’t be allergic to air conditioning; it’s a machine that cools air just like your fridge, but it can dry the nose and aggravate sinus issues.”

Ensure that air conditioners in your office space are serviced regularly to keep them free of mould spores and dust.  

As the pollen problem worsens, precise and expanded monitoring becomes even more essential. And here’s how you can help.

Amid the highest recorded pollen counts in history, Health24 will be bringing you exclusive weekly pollen count updates courtesy of the UCT Lung Institute’s Allergy and Immunology Unit.

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Marelize Wilke