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The hidden dangers of chronic inflammation

“Unless you get diagnosed with a chronic condition, you might be unaware of inflammation,” says Yalda Alaoui

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Yalda Alaoui

The prevalence of inflammatory bowel disease is increasing dramatically. Yalda Alaoui explains why chronic inflammation can affect us all.

We become familiar with inflammation from a very young age. When you cut your finger, to heal the cut, your body sends inflammatory cells to the injury.

Inflammation refers to your body’s process of fighting against things that harm it such as infections, injuries, and toxins, in an attempt to heal itself. When something damages the cells, like cutting your finger, your body releases chemicals that trigger a response from your immune system. This is known as acute inflammation.

Chronic inflammation, however, happens when this response lingers, leaving your body in a constant state of alert and can have symptoms harder to spot such as abdominal pain, chest pain, fatigue and fever.

Yalda Alaoui found that she was suffering from chronic inflammation after she was diagnosed with ulcerative colitis – an inflammatory bowel disease (IBD) in which the lining of the colon becomes inflamed and develops tiny open sores or ulcers.

“I had an acute case for many years where my body did not respond positively to medication. I was pretty much in a constant flare,” Yalda tells me. Despite not experiencing remission, doctors assured her multiple times that there was no link between nutrition and her condition.

“Because I didn’t see any results, I set myself on a path of research on lifestyle and nutrition. I was looking at everything, not just dietary changes,” she says. “I changed a few things in my diet and I started working out again. But I later found out that some workouts can increase inflammation.”

Yalda was also diagnosed with a disease called autoimmune haemolytic anaemia – a rare blood condition that causes the antibodies of a person’s immune system damage some of their red blood cells. “It was almost fatal for me a couple of times. But it sparked a conversation with my doctor that made me realise that the link between my two conditions was actually inflammation.”

Subsequently, she extended her research and started talking to other people on forums with similar conditions. “We would exchange phone numbers and I would talk to other people and try to understand the mechanisms of those diseases through their experiences,” she explains.

Analysing the common symptoms of chronic inflammation is what helped Yalda to improve her lifestyle – from sleep and nutrition to exercise, mental health, strengthen immunity and body composition. “I was trying to put all the pieces of this puzzle together through others to truly understand the inflammatory processes and the links to other diseases much further than just autoimmunity,” she says. “So, I developed a method to improve my symptoms, and finally be free of pain.”

After retraining as a nutritional therapist, Yalda launched Eat Burn Sleep – an online platform that helps people reduce inflammation, restart their gut microbiome and promote optimum immune and liver health.

Yalda was diagnosed with ulcerative colitis in 2007

“70 per cent of your immune system cells sit in you gut,” she points out. “So, the reason why gut health is so important is because it influences your immune system and your inflammation as a result.”

Yalda’s platform is based on three pillars: nutrition, movement and mental wellness. “Very few people realise that if you’re really stressed, it’s hard for inflammation to be reduced because your cortisol levels are high,” she tells me. “When you have high cortisol levels, what it does is it switches on the sympathetic nervous system, your fight or flight response, and it switches off the parasympathetic nervous system, your rest and digest side.”

Eat Burn Sleep encourages a better lifestyle rather than adopting restrictive diets. Yalda says that she wants people to be social and have fun with their friends, cautioning that most diets can be extremely unhealthy mentally, physically and physiologically.

“My method is very moderate,” she adds. “Cutting out a certain food group entirely increases the chances of losing the good bacteria to digest it. Instead, I want to show people how much of that food to reduce and for how long.

“When it comes to exercise, for example, being sedentary is linked to heart disease, metabolic syndrome, diabetes and obesity. But high intensity exercise is also linked to chronic inflammation. So, I have a library of anti-inflammation workout videos along with a mental wellness section where I help people not only stay calm and meditate, but also rewire the subconscious brain and tap into neuroplasticity – the brain’s ability to form new neural connections throughout life.

“We also have about 20 doctors backing my method. They have used it for themselves and now share it with their patients,” she says. “My aim is to put people together – gastroenterologists, GPs, osteopaths, immunologists – and share interesting findings or observations that can help others with their practice.”

The prevalence of inflammatory bowel disease (IBD) increased between 2006 and 2016 by 33.8 per cent and globally, more than six million people are affected by IBD.

Yalda thinks that Deborah James’ case will help more people understand chronic inflammation, but she also says that: “The food has changed a lot. Many healthy organic processed foods are packed with additives that lead to inflammation, metabolic syndrome, unhealthy weight gain, and irritable bowel syndrome (IBS).

“Unfortunately, with chronic inflammation, unless you’re diagnosed with a chronic disease, you don’t get any signs,” the nutritionist explains. “But one of the first things to pay attention to is excess fat. Although I know everyone talks about body positivity, it is not helping our health, because a high BMI means that your body produces more inflammatory cells.

“So, things like a high BMI or bloating may suggest that you probably have inflammation in your body. I would say do something about it. A doctor cannot sleep for you. A doctor cannot eat for you. A doctor cannot think positively for you. Take steps to improve your health today, which will improve your mental well-being. You’re going to have a sharper brain, a better mood, you’re going to enjoy your life better, and prevent diseases later.

“Also, when you do that, you start shopping for healthier foods,” she adds. “And guess what, healthier foods are better for the planet. So, from an ecological standpoint, sustainability helps the environment and you become less of a burden on the healthcare systems in the future.”

I ask Yalda why she thinks it is harder to maintain a healthy lifestyle now. “I think there’s a lot of confusion. You hear so many mixed health messages and you don’t know which one to follow and I also think that we have such a perfectionist mindset.

“Everything’s black and white. People feel that they either have to be really good or if they eat one bad thing, they’re going to go for all the unhealthy foods. So, in my method, it’s about damage limitation, not perfection. I developed this because I wanted to continue having fun. Life was so boring when I was sick. What I tell people now is skip the sandwich on your lunch break and go for a salad. Then if you want to enjoy some prosecco with your friends, do it well, so you produce the enzymes to digest it and enjoy it guilt-free.”

Alongside improving Eat Burn Sleep, the nutritionist is also working on an app that will be available soon and will help more people on the path of recovery.

“I want to continue helping people and I want to keep raising awareness,” she says. “In the long run, my goal is to help introduce nutrition in the curriculum in medical schools because I really want to bridge the gap between holistic treatment and allopathic medicine and truly make a difference.”

For more information, visit eatburnsleep.com.

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Could femtech tackle period poverty? Here’s what campaigners think

Women’s health campaigners have their say on period poverty after study unveils lack of access to menstrual products

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Period poverty, defined as a lack of access to menstrual products, hygiene facilities and education, affects more than 500 million women and girls globally every month.

While it impacts many on low income, researchers from the University of Southampton have looked at an often-forgotten group: homeless women.

The research, published last month, showed that homeless women experience practical challenges in managing menstruation, alongside feelings of embarrassment and shame, with many “making do” due to inadequate provision.

The review, the first to explore homeless women’s experiences of menstruation, concluded that it’s time to address the provision of menstrual health resources as a basic human right.

Femtech World sat down with charities and women’s health organisations to find out how policymakers and femtech organisations could tackle the issue.

Jennifer Gaines, manager of national engagement at Alliance for Period Supplies

Homeless individuals face unique challenges when it comes to managing their periods, including limited access to period supplies, adequate restroom facilities and stigma associated with managing menstruation.

The femtech industry has a significant role to play in addressing the menstrual needs of the most vulnerable populations, including homeless individuals, and developing unique solutions to the challenges faced, such as lack of access to clean facilities and products.

The industry could address the issue by educating the general public and policymakers, establishing donation initiatives to local organisations that distribute period products to homeless populations and investing in research initiatives to better understand the specific challenges faced by homeless individuals regarding menstruation and the lack of access to period products.

Organisations can also advocate for policy reform on local, state and national levels to address period poverty and homelessness.

In the United States, there are more than 70 million individuals, girls and people who menstruate between the ages of 12 to 44. Of these more than 70 million, one in six lives below the federal poverty line. That means there are millions of people who menstruate in our country who live in poverty and are unable to afford the material basic necessities they need to thrive.

People who live in poverty often face food insecurity, housing insecurity, transportation issues and other struggles every day. Period poverty is yet another obstacle that prevents people who menstruate from reaching their full potential.

Petchara Newson, business development coordinator at the period poverty charity Freedom4Girls

We wholeheartedly agree with the findings of the University of Southampton, which shed light on the urgent issue of period poverty among homeless women. This research reaffirms the observations we’ve made at Freedom4Girls, especially as the period poverty crisis escalates amidst the current recession.

To support homeless women effectively, it’s imperative to ensure they have access to safe and clean spaces where they can use menstrual products. Menstrual hygiene should be prioritised not only in spaces traditionally targeted towards women, like women’s refuges, but also in places where women experiencing poverty exist, such as homeless organisations or food banks.

Increasing representation of menstruators on the boards of diverse organisations and providing training to non-menstruators can help identify gaps in support for menstrual hygiene.

Organisations serving those in poverty should ensure they have clean and safe restrooms equipped with a range of free period products and proper waste disposal facilities.

Furthermore, when supporting homeless menstruators, it’s essential to provide a variety of free period products, including heavier flow options, as many experience heavy periods.

Manjit Gill, founder and CEO of the period charity Binti

In the femtech space, we have some amazing products to manage menstrual health but how much funding is provided for “women’s health?”

Menstrual matters have to include all facets of health which include options of products best suited to the needs of women be it disposable or reusable pads or tampons cups or pants.

The cost of living crisis means people can’t afford food but how many address the unaffordable cost of period products for women?

Period products mandated as essential products in everyday life and menstruation becoming a word that is not shrouded in shame is the only way we can create a world where all women have menstrual dignity.

Terri Harris, education and communication manager at Bloody Good Period

Nearly one and a half million people in the UK can’t currently afford period products, and for those who are unhoused or in unstable accommodation, the additional barriers to accessing and using period products are far worse.

Periods aren’t a luxury, they’re a necessity. Everyone should be able to access period products whenever they need them, for free.

At Bloody Good Period, we’re campaigning for period products to be freely available and accompanied by education, normalisation, and practical support. Without this, we cannot hope to achieve menstrual equity.

Laura Rathbone, founder of Sisters on the Streets

We witness first-hand how the lack of access to menstrual supplies among individuals experiencing homelessness perpetuates a cycle of disadvantage. Without adequate period products, people are not only forced to endure physical discomfort and health risks but also face significant barriers in accessing opportunities crucial for escaping homelessness.

Imagine someone missing out on housing, employment, or education opportunities simply because they bled through their only pair of pants just before a crucial job interview or apartment viewing, rendering them unable to attend.

Addressing menstrual equity is not just about hygiene; it’s about dignity, access to basic rights, and creating pathways to stability and independence for those most vulnerable in our society.

To receive the Femtech World newsletter, sign up here.

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The slippery slope of presumed consent in post-humous reproductive health cases

By Bethany Corbin, healthcare innovation and femtech attorney

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It sounds like something out of a sci-fi film: A young man, on the cusp of starting a family with his wife, suffers a serious accident that renders him brain dead.

His wife, longing for the family they never started, requests access to his post-humous sperm to become pregnant and build the family she was denied.

After a long and arduous battle with the court system, the wife is granted permission to use her dead husband’s sperm to create her family, even though her husband never stated his family-building preferences in a will or otherwise provided consent to the use of his sperm.

If the situation seems fantastical (and a bit scary), beware: This is a true and landmark case that has shifted the consent paradigm for reproductive health on its head in the UK.

While the Human Fertilisation and Embryology Act of 1990 (as amended in 2008) requires written, informed consent to the use of a person’s reproductive materials, the case of Y v A Healthcare NHS Trust [2018] EWCOP18 (affirmed by the Court of Protection in Re X (Catastrophic Injury: Collection and Storage of Sper) [2022] EWCOP 48) departed significantly from this requirement to allow “presumed consent” as an alternative to informed consent.

This trend by the UK courts does not align with the strict letter of the law and is more akin to an opt-out organ donation framework for reproductive health. It begs two questions: (1) What is really in the best interests of a patient who lacks capacity to procreate? (2) Should gametes be treated the same as all other organs?

These are heavy questions that have sparked global debate. On one end of the spectrum, a 2016 article published in the journal Reproductive Biomedicine & Society Online argues that gametes, similar to organs, are resources that should be considered for use after death, given their life-creating properties.

The authors contend that once an individual is dead, they no longer have a meaningful interest in the use of their reproductive material and post-humous conception should follow a framework of presumed consent.

The authors base their argument in large part on studies conducted showing that the majority of men support their partners accessing their sperm for post-humous conception.

On the other end of the spectrum, however, is the fundamental need to protect the best interests of the patient, who is no longer capable of understanding or consenting to the creation of life.

Numerous situations may arise where a partner seeks to exploit a vulnerable individual for their reproductive materials. For example, imagine the situation where a husband has repeatedly said “no” to creating a family. If he then suffers a life-threatening accident, his spouse could claim that he had agreed to start a family and that his consent should be presumed.

The same rationale could apply to an abusive boyfriend seeking to exploit his girlfriend’s reproductive materials and demanding the post-humous harvesting of her eggs to be used in the future. This creates an environment that can easily result in exploitation of incapacitated individuals who do not have the ability to defend their own interests.

The rights and wishes of the deceased must have meaning if we are to respect human autonomy. These individuals are vulnerable, unable to protect their own interests, and at the mercy of others who may try to exploit them.

This becomes particularly concerning when we add in the scenarios of abusive relationships, suicide, and reproductive coercion. If the law does not protect the rights of the vulnerable, who will? In essence, the trending case law prioritises the interests of the living over the rights of the dead.

Presumed consent for post-humous conception is an incredibly slippery slope. Reproductive material is fundamentally different from other organs in that it is not lifesaving, but rather life-creating. If we allow an individual’s partner or family to make their post-humous reproductive choices, where do we draw the line?

In the case of Y v A Healthcare NHS Trust, the court relied on circumstantial evidence to presume the husband’s consent – such as the early fertility treatments undertaken by the husband. But what about cases in which such evidence is fabricated or in which consent has been withdrawn prior to the accident?

The fact of the matter is, there will always be factual permutations and attempts by individuals to manipulate existing legal frameworks to obtain the outcome they want. It won’t always be clear what the deceased wanted or whether the evidence of their desires has been forged.

As a society, our laws have historically protected the most vulnerable. Any decision to depart from this history should be made by a body of elected representatives that can carefully consider the broader ethical implications of this decision and its downstream impacts, not the courts.

Bethany Corbin is a healthcare innovation and femtech attorney on a mission to help thought-leading companies revolutionise women’s health. Through her company, FemInnovation, Corbin partners with emerging companies at the forefront of healthcare transformation to ensure they are building robust, scalable, and legally compliant businesses focused on enhancing health equity. 

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The future of women’s health is in collaboration

By Jessica Aird, manufacturing manager at Abingdon Health

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Jessica Aird, manufacturing manager at Abingdon Health

Abingdon’s Health’s manufacturing manager, Jessica Aird, takes a look at all things women’s health with a particular focus on how the organisation in which she operates so effectively – an expert lateral flow CRO & CDMO business –  works together to deliver innovation and change in this area on a daily basis.

On March 8, 2021, the government launched a call for evidence to inform the development of England’s first Women’s Health Strategy, with two main aims:

  1. First, to improve the way in which the health and care system listens to women, and to reset our approach to women’s health by placing women’s voices at the centre of this work.
  2. Second, to improve women’s health outcomes.

As part of this launch, the government called for organisations with expertise in women’s health to submit written evidence into the following:

  • Current medicines and medical devices.
  • Geographical differences in women’s life expectancy and access to services.

Women’s specific health can be categorised in two main stems of health needs: general and reproductive specific. The diagram below explores these two stems and how these needs change during the course of a woman’s life.

Two main stems of women’s health needs (Department of Health and Social Care, 2021)

Abingdon Health’s vision is to become the leading rapid test business globally and share our mission – to improve life by making rapid testing accessible to all – with all industries. This includes improvement to current women’s health testing solutions through the development and manufacture of new, innovative, and creative medical devices.

The role of Abingdon Health in the improvement of women’s health strategy does not just lie within the manufacturing process.

There are many supporting departments working in unison to ensure any devices which successfully enter the market are the best solution available for women to further improve their knowledge and understanding of their health and wellbeing.

R&D

Abingdon’s R&D team are either approached by commercial on behalf of a customer with a bespoke women’s health testing solution, or the idea comes from within the organisation.

The process of progressing the idea from a concept to small scale manufacture relies heavily on R&D. The team must develop the device with key focuses on:

  • Selecting the most efficient and appreciate materials
  • Testing for cross-reactivity
  • Optimisation and repeatability of performance
  • Scalability considerations are also considered at this stage.
Technical transfer

The key role of the technical transfer department is to take each R&D-proven small-scale manufacturable assay to a full-scale production batch; this could be up to 30,000 devices per batch run. This is achieved through the following processes:

  • Understanding potential failure modes, risk to assay performance and what current controls are in place in order to mitigate the risks. This is done predominantly by the technical transfer team, but also reviewed and adjusted collaboratively through input of many departments, including production, quality control, quality assurance and technical specialists.
  • Transferring the processes from small scale equipment to large production equipment within the production laboratories whilst understanding the how the process parameters must change to keep product performance optimised and results, sensitivity and specificity within range at scale.
  • Robustness testing of assay capacity and the assay performance in terms of scaling up the batches. This is done in order to understand the limitations of an assay. Robustness testing typically includes studies of treated materials, stability on part-processed components and stacked tolerances to determine optimal performance going forward.
Regulatory

Product regulatory compliance plays a significant role in bringing the concept of a new product in women’s health to reality and onto the market as fully reproducible manufactured product.

The regulatory team are part of development of the new assay from the very beginning; this is crucial as it helps the team to understand the regulatory requirements and anticipate where potential Quality Assurance and Regulatory Affairs (QARA) issues may arise.

The implications of a non-conformance at any stage of product development can cause significant timing delays, product redesign requirements and increased costs, so it is essential for QARA functions to have input at all stages of development of a new product.

Regulatory approvals are the last step before product launch to market. Obtaining official approval for a product to go to market, particularly in the case of a medical device, requires immense planning with manufacturing, quality assurance and commercial to ensure the product to be launched is viable and has the best chance of success in its newly obtained distribution regions and channels.

Customer services and commercial

Keeping the customer intimately involved in the product development process is essential to successful project and product performance and launch onto market.

The commercial team and customer services functions work hand in hand with both the new product development internal project team members and customer stakeholders to ensure direct interaction between both parties is maintained and expectations are managed.

Ensuring customers sign off at project stage gates, review quality control data and approve operating procedures and product process parameters all require commercial and customer service organisation.

Production and shipping

Once the product is ready for launch, customer service work closely with our quality, regulatory and warehousing teams to ship products to customer on time and in full. This can involve booking shipments with couriers, completing the product release process, and managing customer expectations of timelines.

In summary, the future of women’s health is indeed in collaboration: working closely cross-departmentally to take a concept or idea through to developing a product ready for marketing which can improve women’s access to healthcare, all the way through the research and development to technical transfer and production, is critical to success.

Working collaboratively will ensure better access to healthcare for women and inspire others to come forward with innovative solutions to everyday issues in women’s healthcare today and throughout the course of our lives.

To find out more, visit abingdonhealth.com.

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