Doctors refuse red envelope pledge | Online pharmacies to be allowed | Chinese diabetes patients don't adjust diet

Famous doctor won't sign bribe pledge
One of China's leading doctors has refused to sign the government's anti-bribery pledge against accepting red envelopes, saying it is an ineffective and damaging document. SARS hero Professor Zhong Nanshan said the no red envelopes pledge was not a legally-binding document and its ethical pledges were already contained in the Hippocratic Oath that doctors already swore when they graduated from medical school. He said that if doctors signed the pledge it would be a tacit admission of guilt that all doctors were accepting bribes for preferential treatment, which was not the case. He added that signing the pledge also sent the wrong signal that doctors were to blame for the high costs of medical bills, which he said were actually driven by systemic problems such as the linking of hospital doctors incomes to overservicing and the lack of government funding for government hospitals.

Online pharmacies permitted from 2015
Online sales of prescription medicines in China may begin within months, according to the China Food and Drug Administration. The regulatory agency is expected to announce new policies that will allow  online prescription medicine sales as early as January 2015. Pharmaceutical retailers have said the opening up of online medicine sales will open up a potential 10 billion yuan market for drugs. However, the expected increase in  online pharmacies will have a major impact on bricks and mortar pharmacies, they have warned.

Diabetes patients don't adjust diet
Chinese people with diabetes have little idea how to manage their diet so as to better control their condition, a new study shows. A survey of 100 people with type 1 diabetes by researchers at Peking University People's Hospital found that less than half had ever seen a dietician and few monitored or adjusted their diet to help control their blood glucose levels. The study found that while 64% were aware of carbohydrate counting', only 12% ever used the technique

Salt reduction success in northern China

People in rural northern China reduced their salt intake after participating in a community-based sodium reduction program and having access to salt substitutes, researchers reported in a late-breaking clinical trial at the American Heart Association's Scientific Sessions 2013.  
"We identified a low-cost, practical intervention that was effective in reducing sodium intake," said Nicole Li, Ph.D., study author and research fellow at The George Institute for Global Health in Sydney, Australia. "The WHO and other groups have identified population-based approaches to salt reduction as among the most cost-effective possible strategies for vascular disease prevention in both developed and developing countries."

Researchers with the China Rural Health Initiative - Sodium Reduction Study assessed 120 villages in which the average sodium consumption is 4.7 to 5.9 grams per day—far more than the World Health Organization's recommended 2 grams per day maximum. Americans eat an average of 3.4 grams per day.

Sixty villages receive no intervention and continued with their usual practices.

Citizens of the remaining villages received community health education advising lower sodium intake, with special messages for residents at high risk of heart disease. In addition, a potassium-containing, reduced sodium salt substitute was promoted through a health education program and in village convenience stores. These 60 villages were further divided at random with 30 receiving a price subsidy for the salt substitute, and 30 getting the substitute at full price, which is about twice that of regular salt.

After 18 months, researchers examined 24-hour urine samples of 20 people from each village for sodium and potassium intake.

Those in villages who received the intervention reduced daily sodium intake by 13 mmol (millimoles) compared with non-intervention villages. Seventeen mmol equals about 1 gram of salt.

The intervention also decreased daily sodium by 17 mmol in villages with price-subsidized salt substitutes, increased daily potassium intake by 7 mmol on average across all villages with the intervention and increased daily potassium intake by 9 mmol in villages with price-subsidized salt substitutes.

"The study findings could be applied in similar settings around the world in which salt added during food preparation at home comprises a significant proportion of daily sodium intake," Li said.

The researchers are conducting a larger, five-year study in the same region to determine whether this sodium-reduction intervention impacts incidence of high BP and stroke.

The American Heart Association recommends a diet with less than 1,500 mg (1.5 g) of sodium per day to reduce the risk of cardiovascular diseases. 

Source: Medical Express

Full study: American Heart Journal

No link between MSG and asthma, Nanjing study shows

Large study found no link between MSG consumption and asthma

by Michael Woodhead
The first major population study to look at the possible role of MSG and asthma has found no link between the consumption of monosodium glutamate and asthma rates.
Dr Shi Zumin, a researcher from the Department of Nutrition and Foodborne Disease Prevention at Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, undertook a study of MSG and asthma because emerging evidence shows that diet is related to asthma.
In a study of data from 1486 Chinese men and women who participated in the Jiangsu Nutrition Study, MSG intake and dietary patterns were assessed in 2002. Information on asthma history was collected during followed-up in 2007.
Of the study population, 1.4% reported ever having asthma. MSG intake was not positively associated with asthma. However, there was a significant positive association between ‘traditional’ (high loadings on rice, wheat flour, and vegetable) food pattern and asthma. No link with asthma was seen with a diet rich in meat and alcohol, nor for a 'sweet tooth' diet high in cake, milk, and yoghurt, or a ‘vegetable rich’ diet high in whole grain, fruit, and vegetables.
Dr Shi says a MSG was first reported  to be linked to asthma attacks in 1981 after a person developed asthma after ingesting a meal in a Chinese restaurant. However, small clinical trials on MSG and asthma have yielded inconsistent results, with some suggesting that MSG intake was a trigger factor for asthma, while others showing no  link.
He notes that the prevalence of asthma in the Chinese population is lower than Western populations, and the prevalence of asthma (1.4%) in the study was consistent with that of other studies
"In our [study], even though the mean MSG intake is high compared with many developed countries, we did not observe a significant increased risk of asthma," he concludes.
Source: PLOS One