Biocon Biologics (BBL) launched Hulio, a biosimilars version of Abbvie’s blockbuster drug Humira, in the US, a market that is already getting crowded with several biosimilars.

Analysts, however, feel that together with upcoming Aspart (insulin) and vaccines, Hulio will help drive BBL’s revenues from the current $1 billion to around $1.65 billion by FY25.

The drug is indicated for Rheumatoid Arthritis, Psoriatic Arthritis, Crohn’s Disease, Ankylosing Spondylitis and Ulcerative Colitis, among others.

Humira is estimated to have $21-billion sales in 2022, and Abbvie has indicated that it expects 37 per cent drop in Humira sales with the onslaught of biosimilars.

BBL had earlier launched the biosimilar version of Humira (adalimumab) in the EU about five years back and in Canada around two years ago.

ICICI Direct said, in a May note, that Hulio has maintained its market share at 18.5 per cent in Germany and about 10 per cent in France. It has a 6 per cent market share in Canada.

In the US market, analysts estimate the BBL can corner a 3-5 per cent share of the $18-billion Humira market by FY24-FY25.

IIFL Securities said in a recent note that, “We expect Biologics revenue to increase from $1billion to $1.65 billion in FY25, driven by sales of $300 million, 100million and 200 million from Humira, Aspart and vaccines (respectively). Our estimates assume 3-5 per cent market share for Biocon in Humira by FY24/25.”

Biocon’s Hulio comes at a 5 per cent discount to the current list price of Humira of $6,922/carton. The biosimilar would also be available under another plan at a list price of about 85 per cent below that of Humira.

Analysts said that Biocon’s pricing is similar to Coherus, but Boehringer Ingelheim’s (BI) product is the only interchangeable product so far. Interchangeability implies that the chemist can substitute a Humira prescription with a BI product.

Already, players like Amgen, Coherus Biosciences, BI and Sandoz have launched their biosimilar versions.

Kunal Randeria of Nuvama Research said that Boehringer’s product is the only interchangeable product so far and it expects to be the sole one for at least 12 months.

As such, Biocon’s key products in the US have been gaining market share.

JM Financial noted that Biocon’s Semglee (insulin) market share is around 12 per cent now, while Fulphila (cancer drug) is at 14 per cent and Ogivri (gastric cancer) at 10 per cent.

“The USFDA has accepted BBL’s Corrective and Preventive Action (CAPA) for biosimilar Aspart and they await re-inspection. While the approval is likely in FY24, we believe that they may be delayed for CY24 formulary access. Biocon is confident of gaining market share in Hulio as it saw success in the EU market and has better drug device, citrate-free drug and likely formulary access,” JM Financial said.

In a move aimed at better use of medical equipment, the AIIMS administration on Monday asked its various departments to analyse the utilisation ratio of all medical and diagnostic equipment in their inventory by July 31 this year.

For the equipment whose utilization ratio is less than 0.5 (i.e. 50 per cent), an action plan shall be prepared to increase the utilization to at least 0.80 (i.e. 80 per cent), according to an office memorandum issued by AIIMS Director Dr M Srinivas on Monday.

The director has taken rounds of various areas within AIIMS, and observed that few medical equipment are idling / underutilised and there is potential to increase their utility by sharing them with other departments, the memorandum said.

“Accordingly, it has been decided that all departments shall analyze the utilization ratio (i.e. the ratio of equipment utilized hours and the equipment hours available) for all medical and diagnostic equipment in their inventory by 31 July, 2023,” it said.

For cases, wherein the department is not able to develop a plan for effective utilization of any equipment in its inventory, it shall be reported to the office of the director for sharing / transferring the said equipment to another department where it may have better utilization.

In another office memorandum, the administration has sought minimizing local purchase of drugs and implants, stressing that efforts should be made to target “zero local purchase” for any non-emergent requirements.

In line with good governance practices, it is important to have optimal control of inventory for all types of drugs and implants required at AIIMS, New Delhi to ensure zero unplanned procurement of the same via local purchase even for emergency / EHS patients, the memorandum issued by Dr Srinivas said.

“In continuation of earlier office memorandums dated November 3, 2022 and December 15, 2022 on the issue, it is reiterated that procurement via local purchase system should only be rarely done for emergent requirements of patients/EHS. All efforts should be made to target ‘zero local purchase’ for any non-emergent requirements,” it said.

In case of non-emergent procurement of any drugs due to expiry of rate contract, a comparison should be done by the procuring store between the price offered rate contracted vendor, LP chemist, AMRIT, Jan Aushadhi store, etc, and the procurement shall be done from the source offering the lowest price.

“To minimize local purchase, heads of departments shall on an annual basis send the list of medicines and consumables to the Medical Superintendent by 31st December which are beyond standard hospital formulary but are required for patients admitted under the care of their respective departments.

“For all such additional medicines and consumables, Hospital Store shall execute rate contracts by 31st March as is done for items in the Hospital Formulary or procure them via AMRIT / Jan Aushadhi store,” the memorandum said.

Further, it shall be ensured that AMRIT stores at AIIMS New Delhi keep stock of all required medicines, stents and implants and the same is available to patients on 24×7 basis, it said.

First Published: Jul 03 2023 | 1:06 PM IST

As the world population has grown older, Alzheimer’s disease has become increasingly common. Alzheimer’s disease is the most prevalent form of dementia. Dementia is a term used to describe a range of symptoms linked to the decline in brain function with age. Symptoms include memory loss, communication difficulties, problem-solving struggles, and personality or behavioural changes.

Alzheimer’s disease is an increasingly urgent global issue. The World Health Organization predicts that the number of people with the condition will triple by 2050.

Despite this growing problem, Alzheimer’s disease remains a relatively understudied condition. This is particularly the case in sub-Saharan countries such as South Africa. One major challenge is that Alzheimer’s is a complex condition with no known cure. However, researchers have identified several key risk factors associated with the disease. These include age, genetics, lifestyle factors and underlying medical conditions.

In recent years, one of the most promising areas of research on age-related diseases, such as Alzheimer’s disease, has been the accumulation of harmful proteins in the brain. Specifically amyloid-ß. Amyloid-ß has remained a prominent area of research in Alzheimer’s disease as its build-up is a classic feature in the development of the condition. Understanding its involvement in the disease process is crucial for advancing our knowledge and developing effective strategies to diagnose, prevent and treat the disease.

The accumulation of amyloid-ß can lead to the formation of plaques. These plaques can interfere with communication between brain cells. This ultimately contributes to cognitive decline and other symptoms associated with Alzheimer’s disease.

Amyloid-ß is a large membrane protein that is essential in neural growth and repair. But its corrupted form in later life can destroy nerve cells. This triggers the loss of thought and memory that is associated with Alzheimer’s.

We therefore sought to find out if dietary interventions, particularly intermittent fasting, would counteract the accumulation of amyloid-ß in the brain and potentially safeguard against age-related brain cell death.

In a paper published in 2021, my colleague and I showed that in experiments conducted in mice we found that intermittent fasting counteracted amyloid-ß accumulation in the brain. These findings were further confirmed in a paper published in May of 2022.

Our findings are an important contribution to the search for the potential role of dietary interventions and are consistent with previous studies supporting the idea that intermittent fasting may help counteract amyloid-ß accumulation in the brain and protect against age-related brain cell death. To my knowledge, the most recent study using a variation of intermittent fasting, was published in September 2022. The clinical branch of this study remains ongoing.

Research into the causes of Alzheimer’s has gathered pace in recent years with new ground being broken on a regular basis as scientists search for treatments.

Our study’s findings suggest that intermittent fasting may be an effective way to increase the efficiency of autophagy – the process that breaks down and recycles damaged or unnecessary cellular components, such as organelles and toxic proteins. This process can therefore reduce the risk of amyloid-ß build-up and associated brain cell death.

These findings are particularly significant because they shed light on the relationship between autophagy and the death of brain cells with age, and the potential therapeutic benefits of interventions that target this process.

How it works

Intermittent fasting is a dietary approach that involves regulating food intake by alternating periods of fasting and eating. This dietary regimen comprises periods of restricted food consumption, followed by periods of normal eating.

There are different types of intermittent fasting. One is time-restricted eating, where food is consumed within a specific time window each day. Alternate-day fasting is where food is restricted every other day.

Intermittent fasting has been shown to have various health benefits. Some of the benefits relate to the promotion of brain health.

Our study’s findings suggest that intermittent fasting may be an effective way to increase the efficiency of autophagy, an essential process for removing toxic or misfolded proteins that can build up in cells.

Sometimes autophagy doesn’t work properly to remove harmful proteins or other cellular components from cells. This has been strongly implicated in the development and progression of various age-related diseases, and is a target of research for potential therapies.

What we did

In our study we investigated the effects of intermittent fasting on brain cells in mice, and brain cells isolated from mice with increased amyloid-ß toxicity. Mice cells are frequently used as a model for human cells in scientific research. This is because of the significant genetic similarity between mice and humans. This use of animal models allows researchers to gain valuable insights and test hypotheses. It is generally considered ethically preferable before potentially conducting human studies.

We found that 24 to 48 hours of intermittent fasting by mice provided protection against cell death in specific regions of their brain. We noted increased autophagy levels in cells of fasted mice. Even in the presence of a high amyloid-ß protein load in brain cells, intermittent fasting maintained autophagy activity. And the process remained effective over a 21-day treatment intervention period.

By increasing the efficiency of autophagy, it is possible to maintain the removal of harmful proteins in cells, even as we age.

The findings of this study suggest that interventions such as intermittent fasting could potentially protect against the development of age-related diseases. This has important implications for public health.

Intermittent fasting is a relatively simple dietary intervention: it’s easy to do. It has the potential to be widely adopted as a preventive measure against the onset of age-related diseases. These findings also provide a basis for future research into the mechanisms by which intermittent fasting protects against brain cell death, exploring the potential for additional therapeutic interventions that target autophagy, and examining the effects of different fasting regimens on brain health.

Claudia Ntsapi, Lecturer, University of the Free State

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A recent report by NATHEALTH in collaboration with BCG (Boston Consulting Group) sheds light on the critical skill gap in India’s Allied Health profession. The survey, titled “Allied Healthcare Professionals in India”, emphasises the pressing need to bridge this gap and create new opportunities in the sector.

India’s Allied Health capacity remains much lower than many other economies, resulting in a substantial unfulfilled demand of 30-40 per cent. The report highlights the current penetration of radio imaging tests per 1,000 people, which is 36 in India as of 2022. However, this number is likely torise to 69 by 2027. In comparison, countries like Australia already perform a higher number of radio imaging tests, at 144 per 1000 people.

The report reveals a substantial shortage in this field, which is projected to worsen as demand has already tripled in the past decade and is expected to rise further. With a shortage of professionals and  rapidly growing demand, India’s allied health industry faces majors challenges that require immediate attention, it said. The growth in supply of skilled professionals remains sluggish, while wages offered to these professionals are notably low.

Another alarming finding is the lack of awareness among the school-going population about Allied Healthcare roles with only six per cent of the target population is aware of these career opportunities.The study  also highlights the proliferation of training centres for Allied Health professionals. However, the quality of these training programmes often falls short of expectations. An alarming 77 per cent of colleges fail to meet the quality benchmark in terms of the skills possessed by qualified students.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
India 2012
2
 
 
 
 
 
 
 
 
 
India 2022
7
 
 
 
 
 
 
 
 
 
UK
22
 
 
 
 
 
 
 
 
 
Australia
80
 
 
 
 
 
 
 
 
 
USA
151
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
2

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
3

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
42% Mismatch
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 

Aspartame, one of the world’s most common artificial sweeteners used in popular diet food & beverages, may be labeled as “possibly carcinogenic to humans” for the first time by the International Agency for Research on Cancer (IARC), the World Health Organisation’s (WHO) cancer research arm.

What are artificial sweeteners?

Artificial sweeteners are sugar substitutes that provide sweetness to food and beverages without adding any significant calories. They are commonly used as a sugar alternative for people who want to reduce their sugar intake, manage weight, or control blood sugar levels. Artificial sweeteners are intensely sweet, often hundreds or thousands of times sweeter than sugar, so only small amounts are needed to achieve the desired sweetness. They are popular in “diet” food & beverages and products aimed at people with diabetes.

What is aspartame?

Aspartame is an artificial sweetener that is commonly used as a sugar substitute in various food and beverage products. It is composed of two amino acids: aspartic acid and phenylalanine, which are naturally occurring compounds found in many protein-containing foods.

Aspartame is a low-calorie sweetener because it provides sweetness without adding a significant amount of calories. Compared to sugar, which contains about four calories per gram, aspartame is virtually calorie-free.

It is also approximately 200 times sweeter than sugar according to the United States National Library of Medicine. Due to its intense sweetness, only small amounts are needed to achieve the desired level of sweetness in food and beverages. However, it is not suitable for baking or cooking at high temperatures as the sweetness may diminish when exposed to high temperatures. However, it is a commonly used substance in products including diet sodas, sugar-free or low-sugar beverages, chewing gum, tabletop sweeteners, yogurt, desserts, and various processed foods labeled as “diet” or “sugar-free.”

Popularity of Aspartame

According to an article by the Guardian in December 2022, aspartame was the “first sweetner that could be used to create diet drinks with no bitter aftertaste and no calories.” The article also added that by 2005, it was used in more than 6,000 food and drinks including Diet Coke and Diet Pepsi.

However, the report noted that in the last 20 years or so, doubts regarding the product have been raised, especially with several studies between 2006-10 from the Ramazzini Institute in Italy showing the sweetener causes “malignant tumours in rats and mice.”

Concern for those with Phenylketonuria (PKU)

Phenylalanine, one of the components of aspartame, is a concern for individuals with the rare genetic disorder called phenylketonuria (PKU). People with PKU have difficulty metabolising phenylalanine, and therefore, they need to monitor their intake of aspartame and other sources of phenylalanine.

Overall safety

Aspartame has been extensively studied and approved for use by numerous regulatory agencies, including the US Food and Drug Administration (FDA), the European Food Safety Authority (EFSA), and other authorities around the world.

Some studies have shown the substance to cause tumours when tested on rats and mice.

Now the WHO will be taking a look at all studies published on the substance to decide whether or not it will be labeled as “possibly carcinogenic” to humans.

One of the world’s most common artificial sweeteners is set to be declared a possible carcinogen next month by a leading global health body, according to two sources with knowledge of the process, pitting it against the food industry and regulators.

Aspartame, used in products from Coca-Cola diet sodas to Mars’ Extra chewing gum and some Snapple drinks, will be listed in July as “possibly carcinogenic to humans” for the first time by the International Agency for Research on Cancer (IARC), the World Health Organization’s (WHO) cancer research arm, the sources said.

 

The IARC ruling, finalised earlier this month after a meeting of the group’s external experts, is intended to assess whether something is a potential hazard or not, based on all the published evidence.

 

It does not take into account how much of a product a person can safely consume. This advice for individuals comes from a separate WHO expert committee on food additives, known as JECFA (the Joint WHO and Food and Agriculture Organization’s Expert Committee on Food Additives), alongside determinations from national regulators.

 

However, similar IARC rulings in the past for different substances have raised concerns among consumers about their use, led to lawsuits, and pressured manufacturers to recreate recipes and swap to alternatives. That has led to criticism that the IARC’s assessments can be confusing to the public.

 

JECFA, the WHO committee on additives, is also reviewing aspartame use this year. Its meeting began at the end of June and it is due to announce its findings on the same day that the IARC makes public its decision – on July 14.

 

Since 1981, JECFA has said aspartame is safe to consume within accepted daily limits. For example, an adult weighing 60 kg (132 pounds) would have to drink between 12 and 36 cans of diet soda – depending on the amount of aspartame in the beverage – every day to be at risk. Its view has been widely shared by national regulators, including in the United States and Europe.

 

An IARC spokesperson said both the IARC and JECFA committees’ findings were confidential until July, but added they were “complementary”, with IARC’s conclusion representing “the first fundamental step to understand carcinogenicity”. The additives committee “conducts risk assessment, which determines the probability of a specific type of harm (e.g., cancer) to occur under certain conditions and levels of exposure.” However, industry and regulators fear that holding both processes at around the same time could be confusing, according to letters from U.S. and Japanese regulators seen by Reuters.

 

“We kindly ask both bodies to coordinate their efforts in reviewing aspartame to avoid any confusion or concerns among the public,” Nozomi Tomita, an official from Japan’s Ministry of Health, Labour and Welfare, wrote in a letter dated March 27 to WHO’s deputy director general, Zsuzsanna Jakab.

 

The letter, reviewed by Reuters, also called for the conclusions of both bodies to be released on the same day, as is now happening. The Japanese mission in Geneva, where the WHO is based, did not respond to a request for comment.

 

Debate

 

The IARC’s rulings can have huge impact. In 2015, its committee concluded that glyphosate is “probably carcinogenic”.

 

Years later, even as other bodies like the European Food Safety Authority (EFSA) contested this assessment, companies were still feeling the effects of the decision. Germanyâ€s Bayer in 2021 lost its third appeal against U.S. court verdicts that awarded damages to customers blaming their cancers on use of its glyphosate-based weedkillers.

 

The IARC’s decisions have also faced criticism for sparking needless alarm over hard to avoid substances or situations. It has previously put working overnight and consuming red meat into its “probably cancer-causing” class, and using mobile phones as “possibly cancer-causing”, similar to aspartame.

 

“IARC is not a food safety body and their review of aspartame is not scientifically comprehensive and is based heavily on widely discredited research,” Frances Hunt-Wood, the secretary general of the International Sweeteners Association (ISA), said.

 

The body, whose members include Mars Wrigley, a Coca-Cola unit and Cargill, said it had “serious concerns with the IARC review, which may mislead consumers”.

 

Aspartame has been extensively studied for years. Last year, an observational study in France among 100,000 adults showed that people who consumed larger amounts of artificial sweeteners – including aspartame – had a slightly higher cancer risk.

It followed a study from the Ramazzini Institute in Italy in the early 2000s, which reported that some cancers in mice and rats were linked to aspartame.

 

However, the first study could not prove that aspartame caused the increased cancer risk, and questions have been raised about the methodology of the second study, including by EFSA, which assessed it.

 

Aspartame is authorised for use globally by regulators who have reviewed all the available evidence, and major food and beverage makers have for decades defended their use of the ingredient. The IARC said it had assessed 1,300 studies in its June review.

 

Recent recipe tweaks by soft drinks giant Pepsico demonstrate the struggle the industry has when it comes to balancing taste preferences with health concerns. Pepsico removed aspartame from sodas in 2015, bringing it back a year later, only to remove it again in 2020.

 

Listing aspartame as a possible carcinogen is intended to motivate more research, said the sources close to the IARC, which will help agencies, consumers and manufacturers draw firmer conclusions.

 

But it will also likely ignite debate once again over the IARC’s role, as well as the safety of sweeteners more generally.

 

Last month, the WHO published guidelines advising consumers not to use non-sugar sweeteners for weight control. The guidelines caused a furore in the food industry, which argues they can be helpful for consumers wanting to reduce the amount of sugar in their diet.

 

(Reporting by Jennifer Rigby and Richa Naidu Editing by Michele Gershberg and Mark Potter)

By Emma Court, Robert Langreth and Matthew Griffin

 

Obesity shots like Wegovy are already a cultural phenomenon. Now it’s looking like pill forms of the drugs from Eli Lilly & Co. and Novo Nordisk A/S are just as good at helping people lose weight, setting the stage for even more explosive growth in the years ahead.

 

Novo and Lilly’s experimental obesity pills helped people lose about 15% of body weight, similar to weight-loss shots on the market already, according to findings presented at the American Diabetes Association’s conference over the weekend. Meanwhile, Pfizer Inc. said it will discontinue one of its weight loss pills under development as safety concerns arose. 

Drugmakers have been rushing to develop obesity drugs, angling for a piece of a market that some estimate will one day be worth as much as $100 billion. Novo’s Wegovy injection has been available since 2021 and Lilly’s diabetes shot Mounjaro could be cleared on the US market for obesity soon: now, the next frontier is developing easy-to-take pill versions.

“Lilly and Novo remain at the forefront” in developing pill forms of weight-loss drugs, said Richard DiMarchi, an obesity researcher at Indiana University. He worked at Lilly for more than 20 years and later sold a company he founded to Novo, but has no current ties to either company. For other companies trying to catch up, “It will be hard but not impossible,” he said.

Lilly released its strongest results of any of its treatments yet in a test of retatrutide, a shot that could further boost its efforts to dominate the burgeoning obesity drug market. People with obesity shed an average of 24.2% of their body weight, about 58 pounds, on the highest dose of the drug after 48 weeks, according to a study released Monday by the New England Journal of Medicine. 

All the new drugs mimic GLP-1, a hormone that makes people feel full and eat less. But each company’s pill version takes a different approach.  

Novo’s oral drug is a higher dose of an approved pill, the diabetes medication Rybelsus. Adapting a drug that’s already on the market reduces the risk of a surprise safety problem, said DiMarchi.

Lilly’s pill looks safe and effective so far, but a lot will depend on what come out of larger, late-stage trials.

“It still needs to be proven that this is truly effective and truly safe for long term use,” DiMarchi said.

Pfizer Fumble 

Pfizer had a setback on its road to developing an obesity pill Monday, halting development of an experimental drug called lotiglipron after seeing high levels of liver enzymes in patients on the drug. Few details are known about precisely what level of enzymes Pfizer saw. Evercore ISI analyst Umer Raffat called it a “big setback” for the company. 

Pfizer is continuing to test another pill called danuglipron that outperformed a placebo in a recent study, producing around 9 more pounds of weight loss at the highest dose. “Sure they’ll move ahead with danuglipron,” Raffat said in a note to investors, “but it’s not the best shot they had.”

Experts say what happened with Pfizer’s pill isn’t a sign of trouble ahead for the other companies’ oral treatments. Still Pfizer’s shares were down as much as 5.6% Monday, as investors considered other issues with the therapy. 

Danuglipron currently must be taken twice a day, and that could “prove challenging, assuming all else is equal, leaving Pfizer’s $10 billion peak sales estimate for danuglipron looking optimistic,” Bloomberg Intelligence analysts John Murphy and Mila Bankovskaia said. Pfizer said it sticks by its estimate for peak sales. 

The company is also looking at developing a once-daily version that could be moved into late-stage testing, a Pfizer spokesperson said.

Wall Street analysts don’t expect Lilly and Novo’s pills to have the same problems as Pfizer’s drug. And all the oral drugs are likely years away from becoming commercially available. But major differences already emerging between the two could set Lilly’s medicine up for greater success. 

Lilly’s pill, for instance, helped patients lose as much as 15% of their body weight after around eight months of treatment. Longer use could help patients slim down even more, perhaps losing as much as 20% of their body weight, said Daniel Drucker, a co-discoverer of the GLP-1 hormone who’s a professor of medicine at the University of Toronto.

Drucker called the drug “the star of the show” at the conference. He said it was unprecedented for a pill to produce so much weight loss so quickly.

‘Thumbs Up’

“In terms of hot new data that was not previously disclosed before, thumbs up to Lilly,” he said. 

Read More: Lilly’s Mounjaro Gives Positive Results in Obese Diabetic People

The Lilly medication also helped reduce levels of certain liver enzymes, Bloomberg Intelligence analyst Michael Shah said. It’s difficult to compare its findings with Pfizer’s given the lack of detail in company releases. 

Novo’s drug, meanwhile, has other limitations. Oral semaglutide uses high doses of a main ingredient, so it’s likely to be harder and more expensive to manufacture large amounts. Also, in studies of Novo’s pill, patients had to fast before taking the drug and then a half an hour afterwards, issues that don’t affect Lilly’s pill. 

First Published: Jun 26 2023 | 11:31 PM IST

Taking a “food is medicine” approach, according to a new study undertaken by experts at the Mass General Brigham hospital system, could increase nutrition security for families while simultaneously lowering children’s body mass index (BMI).

Researchers from Massachusetts General Hospital and Boston Children’s Hospital explored if providing weekly plant-based snacks to families seeking food assistance during the epidemic affected children’s weight.

The team found an association between increasing receipt of food packages and decreased BMI. The findings, published in the journal Preventing Chronic Disease, add to a growing body of evidence that providing plant-based foods could be a useful strategy to prevent childhood obesity in children from food-insecure families.

“It’s important to encourage healthy eating habits during childhood to help prevent co-morbidities associated with obesity later in life, but many families to do not have access to expensive healthy foods, such as produce,” said senior author Lauren Fiechtner, MD, MPH, Director of the Pediatric Nutrition Center at Mass General for Children and Health and Research Advisor at The Greater Boston Food Bank. “Food pantries like MGH Revere that can provide families with healthy foods are a huge help in making sure that kids have a long, healthy future and have the best cardiovascular and metabolic health possible from a young age.”

Food insecurity increased by 55% percent in the United States in 2020, affecting 42% of households with children. This increase was driven by a variety of factors, such as the economic impacts of the pandemic, the closure of schools, and disruption of food supply chains. As food insecurity increased, so did the prevalence of childhood obesity, rising from 19.3% to 22.4% between August 2019 and August 2020.

For families dealing with food insecurity, the challenge is usually one of food quality as much as food quantity.

“Children in families with food insecurity are frequently skipping meals or skipping food for a whole day because their family does not have enough money for food,” said Fiechtner. “One way for parents to stretch a tight food budget and make sure their children are at least eating something is to buy the cheapest foods available, which are often not nutritious and contribute to obesity and other health problems.”

To help mitigate the impacts of pandemic-related food insecurity on childhood obesity, the MGH Revere Food Pantry provided weekly plant-based food packages to families seeking food assistance. The packages contained fresh fruits and vegetables, nuts, and whole grains, and were adjusted to family size to provide enough for three meals per day for each member of the household. Between January 1, 2021, and February 1, 2022, 107 children from 93 families, received weekly food packages, averaging about 27 packages per family for the whole study period.

The food packages were provided by the Massachusetts General Hospital (MGH) Revere Food Pantry, a partnership between MGH and The Greater Boston Food Bank. The MGH Revere Food Pantry has provided healthy food and nutritional education to families in the greater Boston area since it opened its doors in 2020.

“For dozens of families, the MGH Revere Food Pantry was a literal lifeline during the pandemic by providing free weekly packages of healthy food for the entire household,” said study co-author Jacob Mirsky, MD, MA, DipABLM, Medical Director of the MGH Revere Food Pantry.

The researchers examined BMI during a baseline period prior to receiving food packages and then during a follow-up period using the Mass General Brigham electronic health record. At the start of the study, 57% of children in the study aged 2-18 years had a BMI at or above the 85th percentile. At follow-up, this number was reduced to 49%. The researchers also saw a decrease in BMI with each additional food family package received and estimated that children in households who received 27 weeks or more of packages may have had a BMI decrease of 1.08 kg/m2 or more.

While the study focused specifically on the pandemic, the research suggests that these findings could carry over into strategies to address broader issues of food insecurity in the future.

“There was an immediate value to providing these food packages to support families during the pandemic, but we also enabled families and children to make healthier food choices, which we know is important to introduce when children are young,” said first author Allison Wu, MD MPH, Attending Physician in Pediatric Gastroenterology, Hepatology & Nutrition at Boston Children’s Hospital. Wu is a research collaborator and former research fellow in the Harvard-Wide Pediatric Health Services Research Program. “This kind of support is not only important for their BMI in childhood, but also in informing how they choose foods and influencing what foods their families are preparing for them to promote overall health.”

This research, as well as the MGH Revere food pantry, are part of a larger Mass General Brigham ‘food as medicine’ strategy. In collaboration with the 2022 White House Conference on Hunger, Nutrition, and Health, Mass General Brigham committed $8.4 million to promote nutrition equity and security, support food as medicine programs to tackle diet-related diseases, and fund food-related programming at local community-based organizations across Massachusetts.