Weekend binges as bad as regular junk food

Weekend binges as bad as regular junk food

 you are strict with your diet during the week and eat junk over the weekend, then maybe you are undoing all the good work done during the week.

Yo-yoing between eating well during the week and bingeing on junk food over the weekend is likely to be just as bad for your gut health as a consistent diet of junk, a new study warned.

The human gut consists of up to 100 trillion microbial cells that influence metabolism, nutrition and immune function. Disruption to the gut microbiota has been linked with gastrointestinal conditions such as inflammatory bowel disease and obesity.

"The study was the first to compare how continuous or intermittent exposure to an unhealthy diet can impact the composition of the gut microbiota," said lead author Margaret Morris from the University of New South Wales in Australia in the journal Molecular Nutrition and Food Research.

"The findings indicate that intermittent exposure to junk food three days a week is sufficient to extensively shift the gut microbiota towards the pattern seen in obese rats consuming the diet continuously," Morris added.

"A reduction in the diversity of the gut's microbiota and a loss of some of the beneficial biota is clearly not a good thing for health," Morris stated.

Blood banks asked to put real-time availability online

Blood banks asked to put real-time availability online

All blood banks across the country have been asked to put their stock availability status online, a move that could end the frantic search for blood or donors during a medical emergency.

The National Blood Transfusion Council (NBTC) recently issued the order, which promises to provide realtime information through a mobile application and make blood distribution more transparent. An Android app called NHP Service' (National Health Portal Service) developed last year, provides users information about the location of hospitals and blood banks in their vicinity. NBTC now wants to add the availability feature to the app that will tell a user which bank has how much blood, of which group, at any given point.

"We want to make it easy for a patient to get blood at the right time without having to run helter skelter during an emergency . It will eventually ensure more transparency," an official from the NBTC told TOI. In the same circular, the NBTC has also directed the blood banks to prominently display their stock information in the premises for the viewing of general public. "It is not very difficult. Whatever information is online should also be accessible offline as soon as a user walks into the bank," the official said adding that they want the banks to implement it with immediate effect. The information will be collated centrally, he said.

While activists have hailed the move, most blood banks in the city are unhappy with the idea of baring it all.The Federation of Bombay Blood Banks (FBBB), a body of 49 prominent banks attached to major hospitals in the city , has contested the move saying a real-time system will add to the chaos in distribution and allocation of blood and its components.They have already made a representation before the NBTC.

Pre-Pregnancy Obesity And Infant Deaths Strongly Related

 

Pre-Pregnancy Obesity And Infant Deaths Strongly Related

Pre-Pregnancy Obesity And Infant Deaths Strongly Related

Pre-pregnancy obesity is strongly linked with infant mortality and compliance with weight-gain guidelines during pregnancy have limited impact on that mortality risk, warns a new study.

"The findings suggest that primary care clinicians, OB-GYNs (Obstetrics and gynaecology) and midwives need to have conversations about weight as part of well-woman care and when women are contemplating getting pregnant," said lead author Eugene Declercq from Boston University School of Public Health in the US.

"There is a need for more open, honest discussions about avoiding the possible risks of maternal obesity on infant health," Declercq added.

The study, published online in Obstetrics and Gynecology, claims to be the largest study to date of the relationship between pre-pregnancy obesity, prenatal weight gain and infant mortality.

It used birth and death records of more than six million newborns in 38 states from 2012-2013, which included information on the mother's height and pre-pregnancy weight, needed to compute BMI (Body Mass Index).

The researchers examined overall infant mortality in three major categories: Infants who died from preterm-related causes, congenital anomalies and sudden unexpected infant death.

Infant mortality rates from preterm causes increased at higher BMIs, with rates twice as high for obese women than for normal-weight women, the study found.

Rural India too battles hypertension

Rural India too battles hypertension

The number of people suffering from hypertension in rural India is, in many cases, higher than in urban parts. File photo

Higher stress levels in rural India and faulty diet in cities have thrown up two most disturbing health concerns in the National Family Health Survey (NFHS), the data for which was released on Wednesday. While obesity levels have shot up in the country since the last NFHS survey in 2005-06, the number of people suffering from hypertension in rural India is, in many cases, higher than in urban parts.

The NFHS on Wednesday released the data for 15 States and each State, with the exception of Puducherry, showed a sharp rise in obesity levels among both men and women.

In Andhra Pradesh, for instance, where over 10,000 households were surveyed, 45.6 per cent of the total women surveyed in urban areas were found to be overweight — the highest in the country. Obesity among rural women in AP was found to be 27.6 per cent, which may not appear alarming, but is still high compared to other rural parts.

Among women, obesity levels shot up from 13.92 per cent in 2005-06 to 19.56 per cent in 2015-16. For men, the rise from the last decade has been from 10.35 per cent to 18.04 per cent.

While rural Bihar recorded the fewest number of women suffering from obesity among the 15 States, but more women in rural parts here were found to have hypertension compared to urban parts of Bihar — a trend seen in other parts of the country as well. In Andaman and Nicobar, more men and women in rural parts were found to be suffering from hypertension than in urban centres. This trend was found in Meghalaya too.

As for blood sugar levels, most States have maintained the traditional difference between urban and rural areas, with urban centres recording more cases of high blood sugar. The few exceptions have been recorded in Goa where the number of women in rural areas with high blood sugar was more than in urban Goa. The same trend was mapped in Puducherry. In Tripura and also in Haryana, more men in rural areas had high blood sugar than men in urban parts.

Health experts said the overall obesity in urban India and rising hypertension in rural India was indicative of the faulty diet of people and also of the stress levels of women in rural India.

“High stress levels in rural areas are rooted in income, agriculture and high cost of healthcare. Also on the food front, there is lack of potassium-rich food like fruits and vegetables,” said health expert Veena Shatrugna, former deputy director of the National Institute of Nutrition, Hyderabad.

Bigwigs have big ideas for cutting our food waste in half

Bigwigs have big ideas for cutting our food waste in half

 

People are spectacularly good at throwing things away — recyclables, dreams, reputations (lookin’ at you, Ben Carson) all come to mind. And then there’s the mother of all landfill fillers: food. Up to 40 percent of food in the U.S., for example, is wasted. But Thursday sounded a new rallying cry: Two initiatives — both announced at the World Economic Forum in Davos, Switzerland — aim to target humanity’s tendency to throw away the stuff that keeps us alive.

The first, dubbed Champions 12.3, is run by a patchwork coalition of 30 heavy-hitters from the likes of Nestlé, WWF, Unilever, and the African Union. The coalition, which aims to cut global food waste in half and reduce food loss by 2030, is named after U.N. Sustainable Development Goal (SDG) 12.3, which encourages countries to, er, do exactly that. To that end, Champions 12.3 is largely a communications project that will “inspire action” by “leading by example,” “motivating others,” and “showcasing successful food loss and waste reduction strategies,” according to a press release. The coalition also includes a former White House chef, the U.S. secretary of agriculture, and the CEO of British grocery giant Tesco.

The second initiative announced in Davos, a separate $130 million project of the Rockefeller Foundation (also a member of Champions 12.3), will largely target post-harvest spoilage of food in sub-Saharan Africa. The New York Times reports that the YieldWise initiative has already struck partnerships and begun work with “private sector partners in Africa, including Coca-Cola and mango farmers in Kenya, and the West African conglomerate Dangote Group for its tomato orders in Nigeria.”

The two initiatives’ focus on farm-to-fork food waste — that is, food that’s lost or discarded along supply chains — represents a shift away from the classic finger-wagging approach to food waste reduction that targets consumers. This approach may represent an easier sell, since wasted food is wasted expenditure for companies. In an interview with the Times, Rockefeller Foundation President Judith Rodin called the foundation’s initiative “a people play, a profits play and a planet play.”

The new initiatives can be also understood as a sneaky form of climate action. (Never mind that a new survey finds climate change fails to register as a particularly pressing threat in the minds of Davos-level CEOs.) Food waste accounts for 7 percent of annual global greenhouse gas emissions — that’s more than twice as much as India emits each year. Any successful effort to cut food waste is an emissions cut, too.

Champion 12.3’s focus on a specific SDG line item represents one of the first large-scale initiatives that will attempt to break down the mammoth list of 169 targets into discrete efforts. If the SDGs are to succeed, that’s the kind of focused public–private effort we’ll need to see in the coming years, especially as countries scramble to define metrics to track and figure out how to track them. And hey, if the coalition’s focus on a single target is any indication of the Davos crowd’s approach to the rest of the goals, I’ll be employed for at least another 168 more articles.

In any case, close to a third of all food that is produced is never eaten, and Rodin estimates that something on the order of 40 percent of food in developing countries is lost before making it to market. In the words of John Oliver, commenting on perfectly good, discarded peaches: “That should not be how we treat our fruit. It should only be how we treat our celebrities.”

 

Chickenpox vaccine may cause eye inflammation

Chickenpox vaccine may cause eye inflammation

Although rare, a vaccine for chickenpox and shingles which has been in use for more than 20 years and is considered an essential medicine by the World Health Organization, can cause corneal inflammation in some patients, says a new study.

The finding suggests that primary care physicians should be aware of possible vision side-effect of the varicella zoster virus vaccine on patients with a history of eye inflammation.

However, the researchers recommended that the majority of patients still be regularly vaccinated against chickenpox and shingles.

"Keratitis, or inflammation of the clear layer on the front of the eye, is a vision issue that can cause serious complications or even permanent damage to your vision if left untreated," said Frederick Fraunfelder, chair of the department of ophthalmology at University of Missouri School of Medicine in the US.

"By studying case reports from national and international registries, we found at least 20 cases of keratitis occurred in children and adults within a month of administration of the chickenpox and shingles vaccine,” Fraunfelder said.

 

"While this is a rare occurrence, it is important for physicians to know when giving the vaccine to individuals who have a history of the condition because it could be reactivated by the vaccine," Fraunfelder noted.

Fraunfelder is the director of the National Registry of Drug-induced Ocular Side Effects, an international effort to gather information on adverse ocular events associated with drugs, chemicals or herbs. 

The registry collects data from the US Food and Drug Administration spontaneous reporting database, the WHO spontaneous reporting database and reports from physicians who submit to the registry.

A review of the database and previously published reports found 20 cases of keratitis with a close relationship to administration of the vaccine. 

For adults, symptoms of keratitis developed within 24 days of vaccination. For pediatric patients, symptoms of inflammation developed within 14 days.

The study was presented at the 2015 meeting of the American Academy of Ophthalmology in Las Vegas.

Corporate makeover in the pipeline for state hospitals?

Corporate makeover in the pipeline for state hospitals?

HYDERABAD: Taking a leaf out of corporate hospitals, the state health department has now decided to restrict the functions of superintendents in government teaching hospitals to "the clinical side of administration and service matters of health staff ".

The rest of the routine but essential functions like sanitation, security , canteen service, rentals, maintenance of civil infrastructure, medical equipment and electrical equipment will be handled by a separate hospital administration wing headed by a qualified general manager, said an order issued by the health department recently .

To begin with, the new system will be implemented at the state-run Gandhi Hospital. Later, it will be replicated in other similar teaching ho spitals, the order stated.

"Provided there is coordination between clinical and non-clinical officials on the ground, this move will definitely bring in positive changes as sanitation, security , infrastructure are aspects that can be handled better by professionally qualified people," said Dr J V Reddy , superintendent, Gandhi Hospital, adding that the process of appointing staff for the new wing will take some time to complete.

The government teaching hospitals have never had trained staff with MBA or graduate degrees in hospital administration. They made use of class IV employees to attend to administrative responsibilities.

For instance, almost all government teaching hospitals in the state -Osmania Medical College, Gandhi Medical College or Kakatiya Medical College -still depend on untrained and unqualified lower rung class IV employees as `health inspectors' for maintaining sanitation, unlike in corporate hospitals.

"The ideal scenario for a hospital is to have a medical professional paying undivided attention to treatment, while all other administrative, logistical, operational aspects in the day to day running of the hospital being left to a professional manager.This will be a win-win situation for the patient," said Y Subramanyam, chief operating officer, Apollo Hospitals.

However, to what extent this objective will be realised in state-run hospitals remains to be seen with government sources claiming that the functions that are sought to be handed over to the newly-created health administration wing are the ones that are doled out by politicians to their favourites.

Indoor air pollution causing low birth weight: Doctors

Indoor air pollution causing low birth weight: Doctors

 One of the major reasons for low weight among newborns in rural India was the continuous exposure of pregnant women to indoor air pollution, according to doctors.

Doctors have said indoor air pollution caused by the 'chulhas' burning wood, coal and animal dung as fuel was the major factor behind the occurrence of a slew of diseases including respiratory diseases among women.

They said that apart from low birth weight, the continuous exposure of pregnant women to air pollution can also lead to brain deformity, asthma and improper growth among newborns.

"For a woman, the time between conception and birth is perhaps one of the most vital life stages.

"If a pregnant woman is exposed to too much of air pollution, carbon monoxide in the air causes interference in the passage of oxygen, which leads to oxygen insufficiency and hence results in low birth weight or even death," said Bandita Sinha, an obstetrics and gynaecology specialist at Apollo Hospital and Fortis.

As per data released by the All India Institute of Medical Sciences (AIIMS), 5 lakh lives are lost in India every year due to indoor air pollution. Most of them are women and children.

The Indian Council of Medical Research (ICMR) recently said that one of its focus areas in 2016-17 will be to raise awareness among rural women regarding the use of electricity or LPG stoves, in a bid to curb indoor air pollution.

Stating that during pregnancy, women mostly have to stay indoors, Sinha said the smoke caused by cooking gas also makes newborns prone to catching diseases like pneumonia after birth because of a weak immune system caused by indoor air pollution.

Nilesha Chitre, gynaecologist at SRV Hospital, said: "People in rural parts of the country have to understand that the total suspended particles present inside a kitchen has 1,000 times greater chance to penetrate deep into the lungs than the suspended particles outside.

"Women are constantly exposed to chulha smoke in India due to several cultural mindsets."

"There have been various cases where due to the continuous exposure to indoor air pollution, the nervous system of newborns also gets damaged. The pollutants are extremely poisonous for newborns, even leading to deaths."

Providing Real-Time Data Is Key to Controlling Air Pollution

Providing Real-Time Data Is Key to Controlling Air Pollution

One of the biggest spinoffs of the 15-day number plate experiment in the capital is that it has made people aware of air pollution.

As the adage goes, ‘if you can’t measure it, you can’t manage it.’ However, the information has to be standardised and made available in real-time, rather, like temperatures.

Pollution levels have increased to astonishing numbers. (Photo: Reuters)

The media is already publishing continuous data for some cities daily from the US embassy and SAFAR – System of Air Quality and Forecasting and Research – from the Pune-based Indian Institute of Tropical Meteorology.

The latter is available for air quality in six cities – Delhi, Ahmedabad, Pune, Mumbai, Chennai and Kolkata – in real-time and carries forecasts for the following three days.

Gauging Air Quality

Planners need to know the extent of pollution of various contaminants, their location and source of pollutants. (Photo: Reuters)

In October 2014, India adopted international practice by colour-coding urban air quality – green for good, yellow for moderate, orange for poor, and red for worse. This is called the Air Quality Index (AQI), comprising key pollutants.

At a recent meet in Bangalore of the Indian Society of Ecological Economists, Sarath Guttikunda, Director of the independent research group UrbanEmissions.Info, outlined how speedy and reliable information was key to solving air pollution in our cities.

Planners need to know the extent of pollution of various contaminants, their location and source of pollutants.

Some Futile Efforts

As an example of what shouldn’t be done, a giant vacuum cleaner costing Rs 2.5 crores was installed at Connaught Place in 2010 under the mistaken impression that it would suck out the pollutants in this city centre.

This cost was equivalent to setting up of two monitoring stations, which alone could provide real-time information.

Beijing, which has roughly the same number of people as New Delhi, though with a far lower density, has 35 such stations, as compared to only 11 in the capital.

The pollutants that need to be tracked are particulate matter below 10 microns in diameter or PM₁₀, smaller PM2.5, sulphur dioxide or SO₂, nitrogen dioxide or NO₂, ozone and carbon monoxide or CO.

In many countries in the global North and Australia, the media informs the public of ozone levels because excessive amounts can cause skin cancers. These, typically, only affect white-skinned people.

Providing Pollution-Related Data

Currently, obtaining information is hamstrung by the fact that there are 450 monitoring stations which collect data manually.

Instead of getting discontinuous information for ten pollutants, it will be more effective to get data on one pollutant like PM2.5, at ten locations.

A simple solution is to collate the Pollution Under Check (PUC) data, which is available every three months which can reveal the age of vehicle.

Gathering data shouldn’t be restricted to vehicular pollution alone, for instance, standards are now being established for pollution from coal-fired thermal power stations.

Air Pollution, the Killer

In this country, sources – which vary from city to city include power plants, industries, construction, road dust, burning garbage, domestic fuels and vehicle exhausts.

According to a World Health Organisation (WHO) global burden of disease study in 2010, there were as many as 6,27,000 premature deaths in India due to outdoor air pollution, of which 1,00,000 can be attributed to residential (indoor) fuel combustion contributing to outdoor pollution.

In Asia, air pollution was the sixth biggest cause of preventable deaths, accounting for 3.1 million deaths.

Since the WHO has now listed Delhi the world’s most polluted city, and 13 out of the 20 worst cities are in India, it is self-evident that the biggest toll of health will be in this country.

A Heath Ministry report this year (2016) has confirmed that vehicle emissions and pollutants cause asthma. But many citizens, particularly slum dwellers, may not be aware that respiratory diseases are caused by air pollution.

Monitoring Air Quality

Currently, obtaining information is hamstrung by the fact that there are 450 monitoring stations which collect data manually. In a week, from each station, one can only get three or four readings, not continuous data.

Instead of getting discontinuous information for ten pollutants, it will be more effective to get data on one pollutant like PM2.5, at ten locations.

For 30 continuous monitoring stations in 50 cities for ten operating years, it would cost Rs 7,500 crores, less than 1 per cent of the smart cities budget. Air pollution doesn’t even get a mention in this initiative.

There isn’t any time to lose in getting such data. In Delhi, it is estimated that 55 per cent of the population is exposed to daytime outdoor pollution.

There are a number of low-cost alternatives for individuals to get information, for example hand-held monitors like Dust-Traks for PM. With smartphones, it is now possible to monitor what are pollution levels in real time.

What is the Way-Out?

By knowing where the major traffic snarls are, it is possible to avoid the most congested junctions and thereby avoid exposure to pollution.

A simple solution is to collate the Pollution Under Check (PUC) data, which is available every three months. It can tell how old a vehicle is and how much it has been driven.

Traffic crawls bumper-to-bumper on road in New Delhi. (File photo: Reuters)

An elementary three-minute survey can also be conducted at petrol stations to collect data on types of vehicle, fuel, age and mileage.

Gathering data isn’t restricted to vehicular pollution but has nation-wide applications. For instance, standards are now being established for pollution from coal-fired thermal power stations.

Data can reveal the age of such plants, what fuel they use and their emissions. Once this is obtained, the authorities can decide what steps to take from a health perspective. These can also be compared with standards in China, a competing trading country.

Finally, since 800 million Indians use smoky cook stoves, it is possible to obtain census data on the type of devices, the type and amount of fuel, and so on.

Controlling such indoor pollution can dramatically improve people’s health – or more correctly, that of women and children – in the country.

Ultrasound may disrupt the balance centres of the inner ear

Resting bradycardia not associated with worse outcomes in middle-aged and older adults

1. Based on data from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, resting heart rate (HR) lower than 50 beats per minute was only associated with worse outcomes if patients were taking HR-lowering medications. In contrast, HR greater than 80 beats per minute (bpm), regardless of HR-lowering medications, was associated with poorer outcomes.

2. While patients taking HR-lowering medications had significant medical comorbidities compared to those not taking such medications, HR seemed to be an independent risk factor, with lower HR conferring a benefit. There was, however, a ‘J-curve’ observed amongst those taking HR-lowering medications, and a very low HR (<50 bpm) was associated with worse outcomes.

Evidence Rating Level: 2 (Good)

Study Rundown: Bradycardia, defined as a resting heart rate (HR) under 60 beats per minute, is often seen in asymptomatic young-adults with strong cardiovascular fitness. However, this can be a sign of conduction disease in the elderly, and can be associated with symptoms. Whether bradycardia, either in the setting of medications or not, confers a higher, independent risk for cardiovascular events is unknown. This study, which used data from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, sought to evaluate this relationship. The results of the study showed that a resting heart rate (HR) lower than 50 beats per minute was only associated with worse outcomes if patients were taking HR-lowering medications. In contrast, HR greater than 80 beats per minute (bpm), regardless of HR-lowering medications, was associated with poorer outcomes. While patients taking HR-lowering medications had significant medical comorbidities compared to those not taking such medications, HR seemed to be an independent risk factor, with lower HR conferring a benefit. There was, however, a ‘J-curve’ observed amongst those taking HR-lowering medications, and a very low HR (<50 bpm) was associated with worse outcomes.

The strength of the study was the diversity of the cohort studied and the long-term follow up, which was needed to study CVD events and mortality. The weakness of the study was the major differences between groups taking HR-lowering medications versus those who were not, so the two sub-groups could not be compared to one another. Although comorbidities within the two subgroups were controlled, there was still risk for bias.

Relevant Reading: Relation of heart rate at rest and long-term (>20 years) death rate in initially healthy middle-aged men.

In-Depth [retrospective cohort]: The purpose of this study was to evaluate the relationship between bradycardia and incident cardiovascular disease (CVD) and mortality. The study population was the Multi-Ethnic Study of Atherosclerosis (MESA) cohort, which was a population based cohort of over 6,000 people consisting of four ethnic groups (38% white, 28% African American, 22% Hispanic, and 12% Chinese). The age groups represented were 45-84 year olds. The group was recruited between 2000 – 2002 and followed for about 10 years. The major outcomes evaluated were cardiovascular events and mortality. Just under 15% percent of the study population was taking medications to decrease heart rate.

Among patients not taking HR-lowering medications, the mean (SD) HR was 63 (9.5) bpm. Among patients taking HR-lowering medications, the mean (SD) HR was 60 (9.7) bpm. There was higher mortality associated with HR <50 bpm amongst patients taking HR-lowering medications (HR 2.42; 95%CI 1.39–4.20), but outcomes were not worse amongst those not taking any such medications. Amongst both subgroups, incident CVD and mortality were lowest in HR 50-59 bpm range, and highest in the HR >80 bpm range. For patients not taking HR-lowering medications, the increased risk in those with HR >80 bpm was as follows: for incident CVD, hazard ratio 1.55 (95%CI 1.08–2.22); for mortality, hazard ratio 1.49 (95%CI 1.08–2.05). For patients taking HR-lowering medications, the increased risk in those with HR >80bpm was as follows: for CVD events, no statistically significant; for mortality, hazard ratio 3.55 (95%CI 1.65–7.65).