Health

Decline in Birth Rate in the UAE

Dr. Ramya Raj, Specialist Obstetrician and Gynecologist

International Modern Hospital Dubai

Official statistics released by the Ministry of Health and Prevention show a significant decline in the number of births among Emirati citizens over the past decade, prompting concern from a parliamentary committee about the long term demographic and social implications.

Data obtained by Emarat Al Youm indicate that the number of births to UAE citizens fell by 13.55 per cent between 2014 and 2023, from 34,618 in 2014 to 29,926 in 2023.

1)Reasons

1.Later marriages-“Behind every data point is a young couple making decisions about marriage … A working mother balancing ambitions with nurturing. A father wanting to give more time but stretched by economic pressures. These are not only social realities – they are policy challenges, and more importantly, national opportunities.”

2.Health issues- “Even among younger patients, we’re seeing low ovarian reserves, obesity, diabetes and poor nutrition. These all impact fertility. We’re also seeing a sharp rise in secondary infertility among men, often linked to smoking or the use of unregulated performance-enhancing substances.”

3.Lifestyle changes-including increased consumption of processed foods, widespread vitamin D deficiency associated with limited sun exposure, and lifestyle patterns that contribute to hormonal imbalance and conditions like PCOS,Endometriosis.

4.Thoughts on Family size-very personal andcan vary alot depending on values,circumstances,lifegoals. In the past, most Emirati families had five or more children. Now, most couples want two or three. It may seem reasonable, but if you compare it to previous generations, the demographic impact is significant,”

2)yes for sure-“Ten years ago, most of our patients were under 35 and already married,” he said. “Today, we see women in their late thirties and early forties coming in to freeze eggs – not necessarily because they have fertility issues, but because they’re not ready to marry. They’re busy with work or studies.”

3)Fertility declines with advancing age, beginning as early as the middle of the third decade. Women who do conceive at an advanced maternal age (traditionally defined as age 35 years or older) are at greater risk of early pregnancy-related complications including miscarriage, aneuploidy, and ectopic pregnancy. Other obstetric complications linked to older age include gestational diabetes, hypertension, preeclampsia, placenta previa, placental abruption, dysfunctional labor, cesarean delivery, postpartum hemorrhage, and maternal mortality; fetal complications include congenital anomalies, prematurity, growth restriction, macrosomia, and stillbirth. Increased paternal age is also associated with lower fertility, an increase in pregnancy-associated complications and an increase in adverse outcome in the offspring.

4)US data on delayed motherhood are the effect of a strong social pressure: a constant economic and social pressure to delay pregnancy without any perspective to invert this trend . This is a paradox. On one side scientific literature more and more clearly says that the less risky range of maternal age to bear babies is 20-30 years as it is associated with a lower likelihood of non-chromosomal problems in babies and on the other side, people perceive they should postpone pregnancy.Thus, the best age to become parents is a compromise between two poles, and women as well as couples find it hard defending their right to having babies when young.

5)Modern lifestyle refers to the contemporary ways of living, characterized by factors such as sedentary behavior, poor dietary habits, stress, and exposure to environmental pollutants, which can impact reproductive health and fertility.1.A poor diet can significantly impact female fertility. Consuming low amounts of fruits and vegetables can disrupt hormone regulation and ovulation due to the lack of essential nutrients, antioxidants, and fiber. Additionally, a high intake of processed foods can lead to insulin resistance, inflammation, and hormonal imbalances, all of which can negatively impact fertility. Inadequate omega-3 fatty acids can also affect hormone production, ovulation, and embryo implantation. Furthermore, excessive caffeine and sugar intake can disrupt hormone balance, ovulation, and fertility.2. A sedentary lifestyle can lead to insulin resistance and metabolic disorders, which can disrupt hormone regulation and ovulation. However, physical inactivity can lead to chronic inflammation, which can negatively impact fertility and reproductive health.3. Stress can also significantly impact female fertility. .4 .Exposure to environmental pollutants can also significantly impact female fertility. Endocrine-disrupting chemicals (EDCs), such as BPA and phthalates, can mimic or interfere with hormones, disrupting ovulation and fertility. Air pollution, particularly particulate matter (PM), has also been linked to reduced fertility, increased risk of miscarriage, and birth defects. Furthermore, exposure to heavy metals, such as lead and mercury, can disrupt hormone regulation, ovulation, and fertility

6) yes, Long working hours can significantly have impact on fertility by disrupting harmonal balance and leading to various reproductive health issues. Chronic Stress can disrupt hormone production, including cortisol, insulin, and thyroid hormones, which can impact ovulation and fertility. Chronic stress can also delay or prevent ovulation, making it challenging to conceive. Stress can also disrupt the balance of the gut microbiome, which is essential for hormone regulation, immune function, and fertility. In Men its associated with low sperm quality.

7). Despite medical progress, Misinformation around natural conception keeps many couples from conceiving naturally. Busting these misconceptions can help couples identify real pregnancy delay reasons and take the right steps early.

1.Many couples think that having sex at any time can lead to pregnancy. This misunderstanding can lead to disappointment when pregnancy does not happen, even with regular sexual activity.

Fact: Conception only occurs during ovulation, about 12 to 14 days before the next period begins. The fertile window lasts about six days: the five days before ovulation and the day of ovulation.

2.Couples often assume that increasing intercourse frequency directly increases conception probability. This leads to scheduled sexual activity that creates stress and reduces spontaneity.

Fact: Daily intercourse may lower sperm quality and reduce sperm count per ejaculation. Sperm concentration and motility remain optimal with intercourse every two to three days during the fertile window.

3.Popular culture suggests that some positions, especially those that allow deeper penetration or gravity assistance, can increase the chances of fertilisation. Couples often spend time and energy trying these methods that lack clear evidence.

Fact: No medical evidence links sexual positions to conception rates. Sperm reaches the cervix within seconds of ejaculation, regardless of position during intercourse.

4.The common advice to “just relax” implies that psychological stress is the primary pregnancy dilemma. This oversimplification dismisses legitimate medical causes of infertility.

Fact: Stress can affect hormones, but rarely causes infertility on its own in healthy individuals. Managing stress through rest and balanced living supports overall well-being, but does not guarantee conception.

5.Cultural biases and old beliefs place most of the responsibility for fertility on women. This leads to women undergoing extensive testing, while their male partners face little to no evaluation.

Fact: Male factors account for up to 50% of infertility cases. Common male issues include low sperm count, poor sperm motility, abnormal sperm morphology, and complete absence of sperm in the ejaculate. Both partners should undergo evaluation when conception delays occur beyond the expected timeframe.

6.Women experiencing a delayed period no pregnancy often assume conception has occurred. This leads to confusion when pregnancy tests return negative results.

Fact: A delayed period could stem from hormonal imbalance, stress, thyroid issues, or diet changes that affect the menstrual cycle, Polycystic ovary syndrome ,Premature ovarian insufficiency, excessive exercise, substantial weight fluctuations, and certain medications also disrupt menstrual regularity.

7.The widespread belief that fertility ends abruptly at 35 causes panic and hasty decisions. Women abandon attempts at natural conception prematurely based on this arbitrary age marker.

Fact: Fertility decreases with age, but pregnancy is still achievable naturally with healthy habits and timely medical guidance. Egg quantity and quality decline progressively from the late 20s onward, with acceleration after 35 and more decline after 40. Many women achieve successful pregnancies in their late 30s and early 40s without medical intervention.

8.Internet sources promote various home remedies to get pregnant quick, from specific foods to herbal supplements. Couples invest money and hope in unproven methods based on anecdotal claims.

Fact: Remedies like herbal teas or special diets can support reproductive health, but do not guarantee conception on their own. No natural fertility remedies have rigorous scientific evidence proving they cause pregnancy or increase conception rates. While good nutrition supports overall reproductive health by providing sufficient vitamins and minerals, supplements

8)couples advised to Consult Specialist for Medical evaluation is important for couples who experience delay in getting pregnancy longer than 12 months, or six months for women over 35.

9)Assisted reproductive technologies (ARTs):

The landscape of ARTs has undergone transformative changes driven by innovations such as in vitro fertilization (IVF) and egg freezing. These advancements have emerged as powerful tools, granting individuals unprecedented control over their reproductive timelines. ARTs can sometimes inadvertently contribute to a delay in childbearing.

1. For instance, IVF combines eggs and sperm outside the body, enabling fertilization before transferring embryos to the uterus. It can also assure individuals that they can conceive at a later age. This confidence may lead some people to delay starting a family, believing they can always turn to IVF when ready.

2.Similarly, Egg Freezing technique involves extracting a woman’s eggs, freezing them, and storing them until a later time. This innovation is particularly significant for individuals facing medical treatments that may compromise their fertility, such as chemotherapy, or those navigating career trajectories that necessitate delaying childbearing. Egg freezing, a pivotal aspect of ARTs, empowers women by allowing them to preserve their eggs at a younger age when fertility potential is higher. These preserved eggs can be thawed, fertilized, and implanted, offering women a means to extend their childbearing years and pursue life goals before embracing. However, this option can inadvertently encourage women to postpone childbirth while focusing on career advancement or other life pursuits, assuming their fertility remains preserved. In practical terms, consider a scenario where a woman in her late twenties decides to freeze her eggs to ensure her fertility.

With this safety net in place, she may delay starting a family and instead invest more time in her career or personal development, knowing she can rely on her preserved eggs later. While this is a valuable choice, it exemplifies how ARTs, like egg freezing, can influence the timing of childbearing decisions.

By leveraging the advances in reproductive science, these technologies have allowed individuals to conceive beyond what nature’s timeline might otherwise allow. This extension of the biological clock is flexible, as fertility naturally declines with age. However, technological strides have created an avenue for individuals to pursue parenthood later in life, blurring the lines of traditional age-related constraints and offering new horizons for those who wish to optimize their reproductive potential.

10)Early Screening and Medical Consultation to Protect Future Fertility

For individuals planning to delay pregnancy, early screening and medical consultation are crucial to protect future fertility.

• 1.Fertility Testing: It’s recommended to seek fertility testing if you have been trying to conceive for a year or more without success. Early diagnosis can lead to quicker solutions and reduce emotional stress.

• 2.Signs to Seek Evaluation: Look for signs such as irregular or absent periods, painful periods or intercourse, or a history of miscarriages. These could indicate issues with ovulation, hormonal imbalances, or other reproductive conditions.

• 3.Preconception Counseling: Preconception counseling can help women prepare physically, emotionally, and medically for a future pregnancy. It includes a detailed medical review, fertility and cycle discussion, condition management, lifestyle and nutrition guidance, vaccination and infection screening.

• 4.Genetic Testing: Mandatory genetic testing will be introduced as part of the premarital screening program for Emiratis planning to marry, starting early January 2025. This will help identify potential risks of passing on genetic disorders.

• 11)Health awareness before marriage is essential for several reasons:

• 1.Preventive Measures: It allows couples to take preventive measures for potential health risks, ensuring a healthier future together.

• 2.Family Planning: It aids in informed decisions about family planning, including the use of assisted reproductive technologies.

• 3.Early Detection: It enables early detection of health issues, which can lead to prompt medical intervention and management.

4.Genetic Testing: In some regions, genetic testing is part of the premarital screening process, which can significantly improve family planning by reducing congenital disabilities.

• 5.Public Health: In the UAE, premarital screening is mandatory to protect public health by detecting and addressing infectious and hereditary diseases before marriage.

Couples should consider these factors when deciding to undergo premarital health screening to ensure a healthy and informed marriage.

• 12)Young couples trying to balance work and starting a family can benefit from the following advice:

• 1.Communicate openly: Discuss work and family needs with your partner, listen with empathy, and create joint routines that deepen trust.

•

• 2.Prioritize quality time: Make time for regular, quality time together and small, shared moments that reinforce love, safety, and closeness.

•

3.Set boundaries: Establish boundaries for work to avoid being overwhelmed and to ensure both partners feel supported.

4.Limit nonessential activities: Minimize time spent on activities that do not contribute to your work or family responsibilities.

5.Learn to say no: Be prepared to say no to tasks that may take away time from work or family.

By implementing these strategies, young couples can create a harmonious balance that allows both to thrive in their careers and personal lives.

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Health

Obesity drug shows promise in reducing belly and liver fat

Boehringer Ingelheim said on Sunday its experimental obesity drug cut visceral and liver fat while minimizing loss of lean mass in ‌a late-stage study, data showed, bolstering its case for benefits beyond weight loss as competition in obesity drugs intensifies.

The drug, survodutide, was licensed from Denmark’s Zealand Pharma (ZELA.CO), opens new tab. An injectable that mimics the proteins GLP-1 and glucagon to create a feeling of fullness, its weight-loss trial results were announced in April, showing patients lost an average of 16.6% over 76 weeks.

Analysis of a group of patients who had MRI measurements at the start and end of a 76-week trial showed that survodutide reduced harmful ⁠abdominal fat by up to 34% and liver fat by up to 63.1% from the baseline, Boehringer said.

Analysts have said the weight-loss numbers were broadly comparable to existing GLP-1 injections from Novo Nordisk (NOVOb.CO), opens new tab and Eli Lilly (LLY.N), opens new tab and below newer rivals in development, and that the company needed to differentiate the drug’s benefits.

Lean mass accounted for no more than 10.8% of the change in body composition at the highest dose of 6 milligrams, suggesting the weight loss was driven mainly by fat reduction.

The drug’s effect on liver-fat reduction and preservation of lean mass are central to whether it will be able to stand out commercially, alongside tolerability and how long patients stay on the drug. Detailed data from the study could help Boehringer make a ‌stronger case ⁠that survodutide should be judged not only by pounds lost but by where weight is lost.

“We believe survodutide will become an important new option at the intersection of obesity and liver disease, two conditions that are deeply connected but rarely addressed together,” said Boehringer executive Shashank Deshpande, who leads the company’s human medicines business.

Boehringer acquired the rights in 2011 to solely develop and commercialise survodutide from Zealand, which is ⁠entitled to royalty payments on global revenue.

PATIENTS WITH LIVER DISEASE BENEFIT

In a separate late-stage study of overweight or obese patients with a fatty liver disease called MASLD, survodutide met both its main goals.

After 48 weeks, up to 84.2% of patients on the drug showed ⁠a liver fat reduction of at least 30%, compared with 24.3% for those on placebo. Patients on survodutide also lost up to 12.2% of their body weight, versus 1% for placebo.

In 61% of the patients the drug helped achieve liver fat ⁠normalization, or a liver fat content below 5%, compared with 5.7% on placebo.

U.S. biotech Altimmune (ALT.O), opens new tab is also developing a drug that targets both the appetite-suppressing gut hormone, GLP-1, and glucagon.

Survodutide is also being tested in other late-stage studies, including for patients with fatty liver disease and fibrosis.

REUTERS

Health

Millions with breast cancer could safely skip chemotherapy

Millions of people with breast cancer could safely avoid chemotherapy as scientists have developed a DNA test that can distinguish between patients who are likely to benefit from the treatment and those who are not, according to trial results.

The international study found that more than two-thirds of its participants could be spared the side of effects of chemotherapy and treated with hormone therapy alone.

Chemotherapy can cause fatigue, nausea, hair loss, a weakened immune system and fertility issues.

The study, led by University College London (UCL), involved more than 4,000 newly diagnosed patients over the age of 40 in the UK, Norway, Sweden, Australia, New Zealand and Thailand.

Scientists used a gene test called Prosigna to measure the activity of 50 genes involved in breast cancer growth and calculate a patient’s risk of the disease returning.

Those who received a low score – two-thirds of the group – were not treated through chemotherapy. The five-year survival rate of their group was 93.7%, compared with a 94.9% rate among patients who received chemotherapy as part of their care.

The primary treatment for breast cancer is usually surgery to remove tumours. Chemotherapy is often recommended afterwards to diminish the risk of return.

It is also regularly offered to people with early-stage breast cancer that has spread to the nearby lymph nodes.

Clinicians are concerned the treatment provides little benefit to those with the most common type of breast cancer, UCL said.

The university said more than 5,000 NHS patients a year could avoid chemotherapy as a result of the trial.

Karen Bonham, from Cardiff, took part in the trial and said the results are an “immense relief” and feel “like Christmas”.

The 64-year-old avoided chemotherapy thanks to the Prosigna test and has instead received radiotherapy and hormone therapy over eight years.

“Cancer diagnosis and treatment can be shocking,” she said.

“It certainly propels you into a world of uncertainty. Life priorities realign – you simply want to survive.”

The findings of the study will be presented at the world’s largest cancer conference, the American Society of Clinical Oncology’s annual meeting, in Chicago, United States, on Saturday.

Professor David Miles, a leading cancer specialist, described the findings as “practice-changing”.

“We can now confidently predict many patients will get no benefit at all, and therefore there’s no need for them to have the chemotherapy,” he told BBC’s Newshour.

He added that the test would allow doctors to “confidently define a large population of women who simply aren’t going to benefit and don’t need to go through all that unpleasantness for no benefit at all.”

“We used to give chemotherapy to 100 women to benefit 10, knowing that 90 didn’t need it,” he said.

Tanya Hutson, who was diagnosed with breast cancer in 2022 and had chemotherapy as part of her treatment, called the new DNA test “absolutely amazing”.

“It just proves what happens when money is put into research,” she said, adding that chemotherapy had been “brutal”.

“For all these people out there who don’t need it but are still getting it – it’s an absolute game changer.”

It is not known whether the findings apply to people under the age of 40, with a result still several years away, according to UCL.

BBC

Health

How to stay healthier in your 70s by starting in your 30s

By the time you reach your eighth decade of life, the chances are that you’ll probably be feeling weaker, stiffer, and perhaps a little less cognitively sharp than in your younger years. Your sleep patterns might have changed so that you feel drowsier in the evenings and then wake earlier. Most concerningly, going by population averages, it’s likely that you will be dealing with at least one chronic health condition.

Yet researchers, now more than ever, are convinced that this is not an inevitability. “Based on what we now know, most people could expect to live to 90 or even 95 in good health if they were to optimise their lifestyle,” says Eric Verdin, president and chief executive of the Buck Institute for Research on Ageing in California. “And that’s very far from where we are, where most people live to 65 or 70 in good health, and then become ill and suffer all the indignities of old age.”

While Verdin says that it’s never too late to improve your health at any age through making positive lifestyle adjustments, whether that’s exercising more, eating better or cutting back on alcohol, you will likely fare best if you start sooner. In particular, researchers have highlighted your 30s as a key decade when a number of physiological systems, whether that’s muscle mass and strength, bone density or metabolic regulation, begin to show the first subtle age-related changes.

“It does highlight this period as an important opportunity to reinforce behaviours that build long-term resilience,” says João Passos, a professor of physiology at the Mayo Clinic’s Kogod Center on Ageing, based in Minnesota.

To understand what might be possible, researchers studying the ageing process like to focus on groups of people who buck the ordinary trends. One example is masters athletes, individuals aged over 35 who still compete regularly in sporting competitions, whether that’s running, cycling or other sports, often continuing into their 60s and beyond.

Paul Morgan, a senior lecturer in nutrition and metabolism at Manchester Metropolitan University, notes that many of these athletes display a very different ageing trajectory to the rest of us, characterised by a higher peak in cardiovascular function and muscle strength and function, followed by a delayed decline. As a result, he says that many of them manage to avoid loss of mobility and independence for much longer in later life. “They have this additional reserve which acts as a protective barrier through the middle stages of life,” says Morgan.

We can all learn from this. To give us the best chance of ageing well, Morgan says that we should aim to hit the highest peak that we can in our 30s, particularly when it comes to aerobic capacity (the maximum amount of oxygen your body can use during exercise), flexibility, and muscle strength.

One of the biggest risks for anyone over the age of 70 is tripping and falling, which is linked to a loss of agility and a decreased range of motion in the joints. “I always see the muscle groups in the lower limbs that are responsible for locomotion as having the biggest role to play in maintaining independence, and with that, good health in later life,” says Morgan. “So that’s especially important to focus on.”

Playing sport is an excellent way to achieve this. Research has shown that taking part in racquet sports such as tennis or badminton has a consistent association with extended lifespan, while a 2025 Japanese study highlighted the benefits of cycling, with older adults who cycle regularly being less likely to need long-term care or die prematurely.

Running for more than 75 minutes per week has also been found to slow certain aspects of the ageing process, but you might want to think again when it comes to running marathons. There is some evidence that pushing your body to extremes can actually accelerate some aspects of biological ageing, although this remains less well understood.

On the other hand, one study found that as little as five minutes of moderate to vigorous physical activity per day can help slow brain ageing, and according to Aditi Gurkar, an assistant professor of medicine at the University of Pittsburgh in the US, we can all get some of the healthy ageing benefits through following relatively simple steps. “Even a brisk 15-minute walk after a meal can make a meaningful difference,” she says.

Building your brain’s reserve

Just as we can protect and strengthen our muscles and cardiovascular system in our 30s, we can also do the same for our brain. Maintaining good dental health through regular checkups, a good brushing routine, not smoking, and limiting intake of sugary foods can make a surprising difference.

This is based on numerous studies which have repeatedly linked the development of periodontal disease, a gum condition characterised by elevated inflammation, with a heightened risk of cognitive decline in later life. This is thought to be due to the chronic impacts of systemic inflammation on the brain.

Your 30s could also be the decade to begin reducing your alcohol consumption. Drinking alcohol is linked to changes in gene expression in the body which accelerate ageing. Alcohol is also a key disruptor of sleep, and Verdin highlights consistent sleeping patterns as being key for avoiding age-related brain shrinkage and lowering dementia risk in decades to come. This includes making sure you go to sleep and wake up at the same time every day, known as sleep regularity. Not only does sleep allow the body to focus on repairing cells, it also gives people the energy and motivation to pursue a healthy lifestyle.

“Even if you’re lacking sleep for one night, your metabolism changes, and your willpower to do all the things that are keeping you healthy goes away,” he says.

Because of the importance of maintaining a regular sleeping pattern, Verdin says he now uses an alarm clock each night – not to wake himself up, but to remind him to go to bed. “The reason for this is we’re circadian beings,” he says. “Our whole biology, from gene expression to metabolism is in synchrony with the 24-hour cycle, and so I tell people, going to bed at the same time each day helps your body to stay really well synchronised to all of this.” A good night’s sleep may not always be possible, however, as anyone raising young children in their 30s will know.

Finally, your 30s is probably a good time to begin taking nutrition a little more seriously. Verdin says that one of the best things we can do is to give our bodies more time during the day when we’re not actually eating, for example through intermittent fasting.

While many proponents of intermittent fasting recommend a so-called 16:8 split, where you fast for 16 hours of the day and compress your eating into an eight-hour window, Verdin says that we can achieve plenty of benefits through a more manageable 12:12 split. “Essentially when you’re fasting, that allows your body to focus not on digesting but on repairing,” he says. “I tell people, when you are eating, you are building. When you’re fasting, you are repairing.”

Consuming more fruit and vegetables at the expense of ultra-processed foods could also make a difference. Gurkar points to work that she and others have carried out showing that people who ingest higher amounts of dietary carotenoids – plant chemicals found in vegetables such as sweet potatoes and carrots, and fruits like mango and apricots – age more slowly, possibly because these chemicals can play a role in protecting our cells from a form of damage called oxidative stress.

Overall, Passos is convinced that the choices we make in early adulthood can have a lasting impact on how we age. He points to large studies which have tracked tens of thousands of people in the US for decades, such as the Framingham Heart Study and the Nurses’ Health Study, which reveal that people who maintain healthier lifestyles in midlife have lower risks of cardiovascular disease, cognitive decline and frailty – even decades later.

“By maintaining healthier behaviours in our 30s, we may prevent or delay subtle molecular and cellular changes that, if left unchecked, accumulate over time and contribute to functional decline in our 70s,” says Passos. “While I don’t believe that by doing this we can stop ageing, we can certainly shape its trajectory.”

While you may still feel somewhat invincible in your 30s, the steady tick of the ageing clock ultimately impacts us all. But if you cut out excessive alcohol, find a sport which you can keep playing into your latter years, set a regular sleeping pattern and give your body more breaks from constant eating, your heart, muscles, joints, and brain will all thank you in years to come.

BBC