Dhari al-Fadli, a patient being treated at a diabetes clinic in Kuwait, is a victim of the dark side of his country's economic boom.

After his weight hit a peak of 123 kg (271 pounds), Fadli developed such serious diabetes that he had to inject himself with insulin before every meal. Helped by the insertion of a gastric balloon into his stomach to reduce hunger, he has now lost enough weight to stop the injections, but still has to take diabetic medication.

"We're all overweight in my family...We have a saying that if you don't have diabetes, you're not a Kuwaiti," said Fadli, a 49-year-old father of five.

In fact, more than one in five Kuwaitis suffer from the disease.

Oil wealth has given Kuwait and nearby countries in the Gulf some of the highest per capita incomes in the world. But it has also created lifestyles - overeating, high-sugar diets, cushy jobs and heavy reliance on automobiles for transport - that are leading to an explosion of diabetes in the region, experts say.

Five of the 10 countries where diabetes is most prevalent are located in the six-nation Gulf Cooperation Council, according to the International Diabetes Federation (IDF), an umbrella organisation of more than 200 national associations.

Kuwait is No. 3 while Qatar is sixth, Saudi Arabia seventh, Bahrain eighth and the United Arab Emirates No. 10. The rest of the top 10 are Pacific island nations with much smaller populations, apart from Lebanon which comes in fifth.

A staggering 21.1% of people in Kuwait are diabetes sufferers while prevalence rates are around 20% in other GCC countries, IDF figures show. In the United States, the rate is 9.6%; worldwide, it is 8.5%.

The problem is so widespread in Kuwait, said Abdulmuhsen al-Shammari, an endocrinologist working at Mubarak al-Kabeer Hospital in the country, that "it is now normal for half a dinner party to be diabetic and for them to ask for each other's medication after they eat".

Lifestyles
Genetic factors apparently contribute to the Gulf's high incidence of diabetes, an incurable disease in which the body has difficulty absorbing sugars and which is closely associated with obesity, scientists say. It can lead to cardiovascular problems, blindness, strokes and kidney disease.

"Research suggests that people (in the Gulf) have a lower set-point at which their body-mass index levels trigger the onset of diabetes," said Maha Taysir, endocrinologist at the Imperial College London Diabetes Clinic (ICLDC) in Abu Dhabi. However, even expatriates living in the Gulf have a higher incidence of diabetes than they do in their home countries, Taysir said. This suggests lifestyles are a major reason for the region's problem. Just two or three generations ago, many inhabitants of region made their living through strenuous work such as fishing, goat-herding and pearl-diving.

The development of the Gulf's oil riches changed lifestyles drastically, luring tens of thousands of people into comfortable jobs at lavishly funded state enterprises, or allowing them to live on ample unemployment benefits. Physically tough jobs in the GCC, such as construction and oil field operation, are almost entirely done by millions of foreign workers.

Gulf rulers responded to last year's political unrest in the Middle East by increasing welfare benefits for their citizens to buy social peace, which some officials in the Gulf have conceded privately risks further reducing the pressure on people to work.

"Exercise is the single most important factor for reducing diabetes ... but it takes a lot of work to get patients here to follow a lifestyle they really don't want to," Taysir said. Some Gulf residents believe the first Gulf War against Saddam Hussein in 1990-1991 may have contributed indirectly to the spread of obesity by fostering a junk food culture.

Fast food outlets blossomed in Kuwait, Saudi Arabia and other countries where thousands of US troops were stationed, and remained part of daily life after the troops withdrew.

"The lifestyle, the luxury we live in, the lack of activity and our fatty junk food culture are all contributing factors... Food is delivered, kids play sitting down at their computers... even physical education is a written exam," said Fadli.

Costs
Even for the wealthy Gulf oil exporters, the financial costs of diabetes are unwelcome. Medical care is heavily subsidised, and the UAE spends $272 million on diabetes treatment annually. A study by Abu Dhabi health authority estimated the overall social costs of the disease at about $1.9 billion.

"Now people are getting in to the later stage of the disease where it really begins to cost money, which is why governments are now pushing for prevention and early intervention," said Andrew Miles, Gulf regional director at global medical products and services supplier MSD.

Beyond the immediate financial costs, diabetes may threaten Gulf countries' long-term plans for development. Aware that their dependence on oil leaves them vulnerable to global markets, the countries are trying to diversify their economies and bring more of their people into the workforce. "How can you develop your economy if one-fifth of your people are sick?" Miles said.

Governments are reacting to the problem by launching public awareness campaigns to encourage healthy diets, exercise and early medical testing. Since 2007, the ICLDC has worked on a national campaign in the UAE which includes a series of public talks, free blood tests, an annual walkathon and arranging sports activities in workplaces. In Kuwait, Qatar, Saudi Arabia and the UAE, MSD has worked with authorities to introduce a training programme for nurses on counselling diabetics, a diabetic cookbook, and a Ramadan iPhone application to advise diabetics who fast during the Muslim holy month.

But it may take many years to change the culture which is fostering diabetes, experts acknowledge.

"You need greater coordination between the different government ministries so that the road traffic authority is thinking about pavements to facilitate walking at the same time as the health authorities are thinking about encouraging activity to decrease obesity and diabetes," said Miles.

"There is more awareness of the need to coordinate between the various ministries and planners, but this will undoubtedly take some time to come into effect... In the meantime, we need as much exposure and awareness of this disease as possible."

They grow in a secret location in northern Israel. A tall fence, security cameras and an armed guard protect them from criminals. A hint of their sweet-scented blossom carries in the air: rows and rows of cannabis plants, as far as the eye can see.

It is here, at a medical marijuana plantation atop the hills of the Galilee, where researchers say they have developed marijuana that can be used to ease the symptoms of some ailments without getting patients high.

"Sometimes the high is not always what they need. Sometimes it is an unwanted side effect. For some of the people it's not even pleasant," said Zack Klein, head of development at Tikun Olam, the company that developed the plant.

Cannabis has more than 60 constituents called cannabinoids. THC is perhaps the best known of those, less so for its medical benefits and more for its psychoactive properties that give people a "high" feeling. But cannabis also contains Cannabidiol, or CBD, a substance that some researchers say has anti-inflammatory benefits. Unlike THC, it hardly binds to the brain's receptors and can therefore work without getting patients stoned.

"CBD plants are available in different forms all over the world," said Klein, adding that the company's plant is free of THC and very high in CBD. Tikun Olam began its research on CBD enhanced cannabis in 2009 and about six months ago they came up with Avidekel, Klein said, a cannabis strain that contains 15.8 percent CBD and only traces of THC, less than one percent.

Marijuana is an illegal drug in Israel. Medicinal use of it was first permitted in 1993, according to the health ministry. Today cannabis is used in Israel to treat 9,000 people suffering from illnesses such as cancer, Parkinson's, multiple sclerosis, Crohn's disease and post traumatic stress disorder, according to Israel's health ministry. Drug companies have also been interested in cannabis as a medicine. Britain's GW Pharmaceuticals, with Bayer and Almirall, sells an under-the-tongue spray called Sativex that is designed to minimise highs by manipulating ratios of active ingredients.

Raphael Mechoulam, a professor of medicinal chemistry at the Hebrew University in Jerusalem, said Avidekel is thought to be the first CBD-enriched cannabis plant with no THC to have been developed in Israel. "It is possible that (Avidekel's) CBD to THC ratio is the highest among medical marijuana companies in the world, but the industry is not very organised, so one cannot keep exact track of what each company is doing," he explained.

Although there have been no clinical trials in humans, Mechoulam, who is a leading researcher of cannabinoids, said that Avidekel showed promise as a potent anti-inflammatory. Ruth Gallily of the Hebrew University who works for the company and has been studying CBD for more than 12 years, said she has found that the substance has impressive anti-inflammatory qualities. She has been testing the effects of Tikun Olam's CBD-enhanced cannabis on mice and expects clinical trials to begin in a few months.

Avidekel is a new strain of a plant that is already permitted for medical use so there is nothing stopping patients who are already being treated with marijuana from trying Avidekel. About 10 patients began using it in the past six months, Klein said.

"The cannabis plant, enriched with CBD, can be used for treating diseases like rheumatoid arthritis, colitis, liver inflammation, heart disease and diabetes," she said, adding there are no side effects.

"It's a huge advantage," said one 35-year-old patient who asked not to be identified, "I can smoke during the day, function with a lot less pain and still be focused, work and drive. It is a great gift."

The woman began suffering chronic pains after a tumour was removed from her spine. She began treatment with regular THC-containing marijuana eight months ago. Two months ago she started smoking Avidekel.

"The difference is huge. Before, I would only smoke at the end of the day and stay in pain." Now, she said, with the highless marijuana "my life is so much better."

Despite Avidekel's highless benefit, Klein does not see regular marijuana disappearing any time soon. THC has its own unique effects that alleviate illness symptoms. "Don't worry, I think that cannabis with THC will still be (around)," he said.

India is likely to miss the Millennium Development Goal (MDG) related to maternal health as one maternal death is being reported every 10 minutes in the country now.

India recorded around 57,000 maternal deaths in 2010, which translate into a whopping six every hour and one every 10 minutes, UN data in this regard says.

The current Maternal Mortality Rate (MMR) of India is 212 per one lakh live births, whereas the country`s MDG in this respect is 109 per one lakh live births by 2015.

The MMR challenge for India was highlighted today at the launch of the Millennium Development Goals Report of the UN Secretary General. The 2012 report, which assesses the regional progress on eight MDGs the world promised to meet, states that although progress has been made on improvements in maternal health, actual targets remain far from sight.

"India is moving well on MMR. We have made progress in this regard. The MMR recorded a 38 per cent decline in maternal deaths between 1999 and 2009. There has been progress but we are not there just yet. The Government needs to ensure the availability of Auxiliary Nurses and Midwives closer to the homes of women who are delivering", Frederika Meijer, India Representative for United Nations Population Fund said.

Meijer said almost 150 women were dying daily in India, as per 2010 data on maternal deaths. "This means one woman is dying every minute. The Government must work to address the issue of unmet need for contraception of women. They need to be counseled to space their children better," Meijer said.

Maternal deaths are defined as the number of women who die during pregnancy or within 42 days of the termination of pregnancy.

India has reduced MMR significantly from 437 per one lakh live births in 1999 to 212 now, but needs to hasten the pace under National Rural Health Mission to achieve related MDG.

The MDG Report 2012 points out that an estimated 2,87,000 maternal deaths occurred in 2010 worldwide. This represents a decline of 47 per cent from 1990 when the MDGs were set.

"Of the total maternal death burden worldwide, the sub- Saharan Africa accounts for 56 per cent and South Asia accounts for 29 per cent. Together the two regions made up for 85 per cent of the global maternal death burden in 2010", states the Report released by noted economist Jayati Ghosh of Jawahar Lal Nehru University.
Ghosh flagged another important issue on the health front saying poor child nutrition remained a massive challenge for India where 42 per cent children under five years of age were underweight.

"This is the largest proportion of underweight children anywhere in the world. Nutrition deprivation is a huge issue which the Government must address because it affects a child`s ability to study and lead a productive life later, Together with food insecurity and employment insecurity, nutrition deprivation to me is a big problem for India. The situation is alarming", she said.

As many as 237 million Indians are still living in hunger though India has managed to meet the first MDG of reducing people in extreme poverty by half between 1990 and 2015. Poverty has declined in India from 51 per cent in 1990 to 37 per cent now, but hunger remains a challenge, especially when it affects child nutrition.

On infant health, though, India has done much better and is well within reaching the MDG of reducing IMR to 42 per 1000 live births. As per the latest estimates, India`s IMR stands at 47. It is a little higher for rural areas.

India`s progress on the MDG of combating HIV/AIDS, malaria and TB is also satisfactory, said UN officials.

They said it was heartening that India had managed to do well on the health MDGs despite the fact that food insecurity in the country was growing.

Meijer, however, warned "At the current pace, India is unlikely to meet the MDG on maternal health. It needs to focus on such huge pockets where the mother mortality rate is still high. The states where MMR is still high are Assam, Bihar, Madhya Pradesh, Uttar Pradesh and Rajasthan, besides others".

To achieve this MDG 5 (on maternal health) India needed to reduce maternal mortality (MMR) from 437 deaths per 100,000 live births in 1991 to 109 by 2015. It has only reached the 212 mark just yet.

The UN MDG Report 2012 points out that overall, three important targets on poverty, slums and water have been met three years ahead of the 2015 deadline. The share of people living on less than 1.25 USD a day has reduced to less than half as compared to 1990.

The proportion of people with improved access to drinking water has risen from 76 per cent in 1990 to 89 per cent in 2010.

The world has also achieved parity in primary education between girls and boys. There were 97 girls enrolled per 100 boys in 2010 - up from 91 girls per 100 boys in 1999.

The UN MDG Report warns Governments against allowing the current economic crisis to reverse the progress in reducing poverty.

People who keep fidgeting could live longer than those who sit still for long periods, a new study has revealed.

Spending too much time on sedentary activities like working at a computer or watching television can shorten a person's lifespan and raise the risk of conditions like heart disease and stroke. But breaking up your "sitting time" throughout the day with simple activities like walking or stretching your legs even for a minute or two at a time could counteract the harmful effects of being a couch potato and lead to better overall health, researchers said.
"People are watching television for up to four hours a day and spending 60-70 per cent of their time being sedentary, and that is because of our lifestyle and occupations," said Dr Wilby Williamson, an NHS expert in sports medicine.
"Reducing our sitting time makes us better at breaking sugars and fats down, which can help reduce our risk of metabolic diseases like diabetes and cardiovascular disease," Dr Williamson was said.
Studies have shown that the amount of time we spend sitting down is associated with reduced lifespan and a higher incidence of heart disease and stroke.
Dr Williamson said: "The risk factors for cardiovascular disease and longevity start to increase above two hours of television watching per day. If you can make your TV watching or screen time more active that could be beneficial.
"Also, make sure your are not sitting for long chunks of time. Some studies show there is a beneficial effect of breaking it up every 20 to 30 minutes."

Ageing, surprisingly, may have little to do with a gradual drop in testosterone levels, but is more likely to result from a man's behavioural and health changes, says a new study.

"It is critical that doctors understand that declining testosterone levels are not a natural part of aging and that they are most likely due to health-related behaviours or health status itself," said study co-author Gary Wittert, professor of medicine at the University of Adelaide, Australia.

"Men who had declines in testosterone were more likely to be those who became obese, had stopped smoking or were depressed at either clinic visit," Wittert said.

"While stopping smoking may be a cause of a slight decrease in testosterone, the benefit of quitting smoking is huge," added Wittert. This hormone is important for many bodily functions, including maintaining a healthy body composition, fertility and sex drive.

Few population-based studies have tracked changes in testosterone levels among the same men over time, as their study did, Wittert said, according to an Aadelaide statement.

Wittert and his co-authors analysed testosterone measurements in more than 1,500 men recorded at two clinic visits five years apart. All blood testosterone samples underwent testing at the same time for each time point, said Wittert.

Researchers included 1,382 men in the data analysis, aged between 35 and 80 years, averaging 54 years, after screening out those who were taking medicines or had medical conditions known to affect hormones.

On average, testosterone levels did not decline significantly over five years; rather, they decreased less than one percent each year, the authors reported. However, when the investigators analysed the data by subgroups, they found that certain factors were linked to lower testosterone levels at five years than at the beginning of the study.

Unmarried men in the study had greater testosterone reductions than did married men. Wittert attributed this finding to past research showing that married men tend to be healthier and happier than unmarried men. "Also, regular sexual activity tends to increase testosterone," he explained.