A dialogue with Prof. SO Kwok-fai, PAIR IAC Member, on embracing active health

Active Health is a new conceptual model for improving human health. The idea of Active Health emphasises individual responsibility in making informed choices about exercise, diet, lifestyle, etc., for attaining health holistically. It has emerged as an attractive conceptual framework for public health systems worldwide. For example, China explicitly underscores the role of Proactive Health in its Healthy China 2030 Plan; Singapore has introduced the Active Health initiative, which provides a range of science-backed technologies and services to citizens; and the United Kingdom launched the Change4Life in the early 2000s as a national behavioural change programme to prevent obesity.

Knowing is one thing; doing is another. Health literacy is one thing; health action is another. The attainment of active, holistic health requires knowledge about health and translation of this knowledge into health decision-making. What kinds of superfoods should we eat? Why and for how long should we run? Are there any ways to improve our sleep?

Active Health is an interdisciplinary field, requiring systematic, coordinated scientific knowledge of the interactions among foods, environments and humans. The field represents an interesting and rich area for researchers, holding profound theoretical and practical importance. In this issue of the newsletter, Prof. SO Kwok-fai, PAIR International Advisory Committee Member, expounds on Active Health and sheds light on its potential in PAIR’s interdisciplinary research development. Prof. So is a pioneer in the field of neural regeneration with a focus on vision recovery and proactive factors against depression, including exercise, light and wolfberry.

Shifting from passive health to active health: Need for ownership in gauging one’s health

Good Health and Well-being comprise a core area of PAIR’s research. Under this theme, the Academy has set up constituent research units covering future food, smart ageing, sports and technology, Chinese medicine, mental health, sharp vision, etc. What can be done by PAIR to take our health research further?

I believe that Active Health, or Preventive Health, is a very important area to which we can pay more attention. These concepts encompass all populations in society and are highly relevant to the current efforts at PAIR. The Academy may consider establishing Active Health as a new research theme, or even setting up a unit dedicated to this area.

In approaching Active Health research, I think there are three directions which PAIR can explore. The word “active” emphasises a person’s ownership and self-driven behaviours in caring for his/her health. These include exercise, food, and health preservation.

First of all, many chronic diseases are associated with a lack of physical activity. We all know that exercise is good for our brains, hearts, and vascular and liver health. But the benefits are more than these. The human skeletal muscles, for example, make up a very important endocrine organ, producing endocrine factors that reduce the risks of a wide range of issues, such as inflammatory conditions, metabolic syndromes including diabetes, neurodegenerative disorders, etc. We need empirical evidence for the health benefits of physical activity. This requires research on the specific type and duration of exercise suitable for various age groups, so that our understanding can be translated to encourage exercise behaviours in the community.

The same lens should be applied to the other two directions—food, and health preservation. The substances we take into our body directly affect our functioning. What should we eat, what should we avoid, and what should we take from the perspective of traditional Chinese medicine? Thus, all research on Active Health is really rich and down-to-earth. The idea of “yang sheng”—preserving our bodies for the sake of strong health, disease prevention and longevity, as well as developing conducive lifestyle habits—is very suitable for the Chinese population context. I trust that Active Health will stand out as a very appealing area to everyone, with ample funding potential. There is a need for PAIR to explore further the importance of traditional Chinese medicine in modern health research.

Sunshine makes us happy, but why and how?

PAIR researchers have made remarkable strides in vision research. In particular, the PolyU-patented Defocus Incorporated Multiple Segments (DIMS) spectacle lens, which can slow down myopia progression by 60% in children, is now available on the market. Our research on repeated low-level red light (RLRL) therapy has demonstrated efficacy in slowing down and even reversing myopia. Apart from myopia control, what other areas can PAIR researchers explore more extensively?

One interesting area which PAIR can investigate further is the use of light for subthreshold depression. I think it is particularly important in modern times when suicide cases in Hong Kong are reaching an alarming peak. People with subthreshold depression may be unaware of their conditions, or reluctant to take antidepressant drugs owing to side effects and mental health stigma. In this regard, PAIR may look into the potential of light therapy in treating depression. This is one interdisciplinary field which PAIR can consider.

The human eye is linked not only to vision, but also to our emotions and brains. At Jinan University, my teammates and I successfully demonstrated the efficacy of light therapy in reducing depression and anxiety symptoms in a college student sample. We have already worked out the underlying biological mechanism, and have built a light box for therapeutic use. Going forward, PAIR can explore these benefits of light in addition to myopia control, and may even consider collaboration with us.

New drugs and treatments take time to develop

In health research, a clinical trial is a lengthy process. At the same time, universities now highly value research commercialisation, i.e., the generation of commercialisable products, services and solutions from research. It takes years to turn findings from fundamental mechanistic research into health interventions. What are some important considerations on the part of the university management in evaluating and encouraging research success?

In measuring research impact and excellence, there are many other aspects including international collaborations, patenting and industry partnerships which university management should also consider.

The commercialisation of clinical research takes time. However, giving credit at various stages of clinical trials is very important. As an example, in my work on stem cell drugs for knee arthritis, the funding body provides research teams with funding after each phase of the trials. No doubt, we all wish to complete all three phases of clinical trials with success—but the idea is that each phase of research is an accomplishment that deserves recognition.

Resources are the limit? Grow the pie.

PAIR is growing fast. The Academy now has 18 constituent research units and anticipates that more will be established, covering diverse research fields. University research largely depends on injections of government funding. However, centralised resources are limited. This may dilute the resources available to each unit. What is your advice? How can PAIR better leverage the opportunities in the Greater Bay Area (GBA) in addressing this need for resource?

Make the pie bigger! PAIR certainly has the prerequisites to achieve this. Universities can explore ways to attract funding—not only from governments, but also from external bodies—to support research ideas and initiatives in which the donors and universities share common values, whether projects or new research units. Using Active Health as an example, there is one large charitable foundation in Hong Kong providing significant funding to support a new health institute which focuses on vaccine research. As I shared earlier, preventive medicine is equally important. PAIR’s thematic research on Good Health & Well-being is in fact an entity in which philanthropy and government have common interest. PAIR may bring several existing research units together to work on Active Health research, or even set up a new unit dedicated to this.

Another key issue is the need for effective governance. The allocation of resources at PAIR should not operate like a distribution of funding where every unit gets an equal share. Rather, there should be an incentive system aimed at encouraging well-performing units to do more, as well as an exit mechanism for underperforming units. This is crucial for PAIR’s organisational health.

In growing the pie, one possible solution is to collaborate with Mainland China on science and technology through hosting and operating State Key Laboratories (SKLs) in Hong Kong. The Ministry of Science and Technology (MOST) of China has an SKL scheme. It funds Hong Kong universities as they submit applications for setting up SKLs in order to carry out studies that are in line with the Nation’s technological development and strategic objectives. Each of the SKLs represents a niche research area. This is a very attractive opportunity for PAIR. The Academy should consider its competitive edge and may engage several PAIR research units to collaborate in identifying its research niche and emerging research areas for SKL applications. In addition, the Academy should consider doing research supported by the Ministry of Education (MOE) of China. Both approaches are important recognitions of PAIR.

Young people and recognitions matter

To date, PAIR has implemented several flagship programmes. They include a fellowship scheme for appointing a select number of top scholars outside PolyU to contribute to PAIR; a young fellowship scheme for appointing outstanding PhD graduates as Research Assistant Professors to pursue interdisciplinary research at PAIR units; knowledge-sharing activities (e.g., distinguished lectures, seminars, conference); and an industry engagement programme. What is your advice about PAIR initiatives? What can we do better?

Attracting new blood to the team is of high importance. As PAIR expands, this requires more manpower and innovations. Certainly, the Academy must ensure that these new participants are of high quality and are provided with good compensation packages for their efforts.

The Nation has placed great emphasis on young talent development. The National Natural Science Foundation of China (NSGC), for example, has established the Excellent Young Scientists Fund and the National Science Fund for Distinguished Young Scholars, both of which are open to Hong Kong applicants. PAIR may encourage its researchers to apply for competitive schemes like these, or may even recruit top research talents who have already been bestowed with distinguished titles. The Academy may also invite young researcher awardees of these types of fellowships or talent programmes in Mainland China and overseas to come to PAIR for knowledge sharing and presentation of lectures. Forging closer, wider networks with researchers in Mainland China and abroad is beneficial to PAIR’s long-term development.

Another area for enhancement is PAIR’s communication with the community. I’m referring not just to the communication of science using technical terms within the academic community, or communication of research to the industry, but also communication about PAIR outputs to the general public in layperson’s terms. Doing so will help society better understand how PAIR research relates to and impacts them. This can be achieved through greater visibility on public media channels, such as social media, press, etc. Such efforts may help attract potential donors, too.

Finally, I highly recommend setting up more research awards. These prizes might not entail large amounts of money. But recognition matters. In this regard, PAIR needs to identify what the Academy values and set up prizes that reward outstanding performance in these areas. There may already be similar research prizes at the university level. Additional internal prizes exclusive to PAIR researchers would provide additional incentives, and help convey a clear message to PAIR members about what the Academy firmly embraces and values.