Morning MEDtalks with Dr KK Aggarwal 8th September 2018

Decriminalization of Section 377 IPC provides access of health care facility to LGBT (Dr KK Aggarwal & Ira Gupta). Vide judgment dated 06.09.2018, the Hon’ble 5 Judges Bench of the Supreme Court of India has held that Section 377 IPC, so far as it penalizes any consensual sexual relationship between two adults, be it homosexuals (man and a man), heterosexuals (man and a woman) or lesbians (woman and a woman), cannot be regarded as un-constitutional.

However, if anyone, both a man and a woman, engages in any kind of sexual activity with an animal, the said aspect of Section 377 is un-constitutional and it shall remain a penal offence under Section 377 IPC. Any act of the description covered under Section 377 IPC done between two individuals without the consent of any one of them would invite penal liability under Section 377 IPC…https://www.emedinexus.com/post/7198/

Hypertensive patients do not reduce their salt intake as recommended and instead rely only antihypertensive drugs to control their high BP and to reduce their risk of heart attack, stroke and heart failure. In an observational study, patients were categorized into three groups (one, two, three or more) based on the number of antihypertensive drugs prescribed. BP levels and patients maintaining the target BP of less than 140/90mmHg improved during the seven-year study across all groups, but an increase in individual salt intake was also observed, especially in patients who were taking multiple antihypertensive drugs. In these patients, salt intake was higher than those who were prescribed only one antihypertensive drug.

According to lead author Dr Kazuto Ohno, Enshu Hospital, Hamamatsu, Japan, who presented these findings at the recently concluded European Society of Cardiology Congress 2018 at Munich in Germany, lack of adherence to recommended lifestyle changes is leading to increased salt intake for hypertensive patients due to which more drugs are needed with potentially more side effects from those medications.

Longer daily fasting times improve health and longevity in mice. If you eat once a day you are ‘yogi’, if you eat two times a day you are ‘bhogi’ and if you eat three times a day you are a ‘rogi’, is an old Vedic saying. Now a study published in the Sept. 6, 2018 issue of Cell Metabolism has shown that increasing time between meals made male mice healthier overall and live longer compared to mice who ate more frequently. Mice who ate one meal per day, and thus had the longest fasting period, seemed to have a longer lifespan and better outcomes for common age-related liver disease and metabolic disorders.

The scientists randomly divided 292 male mice into two diet groups. One group received a naturally sourced diet that was lower in purified sugars and fat, and higher in protein and fiber than the other diet. The mice in each diet group were then divided into three sub-groups based on how often they had access to food. The first group of mice had access to food around the clock. A second group of mice was fed 30 percent less calories per day than the first group. The third group was meal fed, getting a single meal that added up to the exact number of calories as the round-the-clock group. Both the meal-fed and calorie-restricted mice learned to eat quickly when food was available, resulting in longer daily fasting periods for both groups.

Meal-fed and calorie-restricted mice showed improvements in overall health, as evidenced by delays in common age-related damage to the liver and other organs, and extended longevity. The calorie-restricted mice also showed significant improvement in fasting glucose and insulin levels compared to the other groups. Interestingly, the researchers found that diet composition had no significant impact on lifespan in the meal fed and calorie restricted groups.

Increasing daily fasting times, without a reduction of calories and regardless of the type of diet consumed, resulted in overall improvements in health and survival in male mice. Perhaps this extended daily fasting period enables repair and maintenance mechanisms that would be absent in a continuous exposure to food.

Cigarette butts have become world’s most discarded waste, says WHO-FCTC. About 4.5 trillion are thrown away every year, representing 1.69 billion pounds of toxic trash annually. The World Health Organisation Framework Convention on Tobacco Control (WHO-FCTC) said various studies indicated that this was compounded and accelerated as bans on indoor smoking took effect in many of the world’s cities and countries over the past two decades. Apart from deforestation to soil degradation and pollution, tobacco production and its use by consumers is “tremendously destructive” for the environment.

Dr Vera e Silva, the Head of the WHO FCTC Secretariat, said, “People often immediately think of the health impact that tobacco has, but there is not enough awareness of how tremendously destructive it is for the environment too, on land, underwater and in the air… Studies indicate that tobacco growing could be up to 10 times more aggressive than all other deforestation factors.”

‘Swachhata Hi Seva 2018’ a jan andolan for Swachhata to be observed in the run-up to the 4th anniversary of the Swachh Bharat Mission (SBM), i.e. from September 15th to October 2nd 2018 will be launched by the Prime Minister on 15th September. The campaign aims at accelerating the Jan-Andolan for realizing the vision of a Clean India, further reinforcing the belief that ‘Sanitation is everyone’s business’ (PIB)

Hospital doctors in England and Wales are increasingly choosing to take early retirement, figures released to The BMJ by the NHS Business Services Authority in response to a freedom of information request show. The number of hospital doctors claiming their NHS pension on voluntary early retirement grounds increased from 164 in 2008 to 397 in 2018. The number retiring on ill health grounds rose from 12 to 79 over the same period. The figures also show a greater proportion of doctors claiming their pensions now do so on health grounds or are taking voluntary early retirement. The total number of hospital doctors choosing to take their pension (whether on grounds of age, voluntary early retirement, or ill health) rose from 1,205 in 2008 to 1,475 in 2018, representing a 22% increase over this period… (BMJ, Sept. 4, 2018).

19-day-old Karishma, born at Kalpana Chawla government hospital in Karnal on August 15, has become the first newborn beneficiary of Prime Ministers Ayushman Bharat Yojana (National Health Protection Scheme) (ET Healthworld, Sept. 3, 2018).

WHO Tweet: Urbanization is severely impacting opportunities to #BeActive. We need cities and urban environments that enable

Harvard: Yes you can reverse diabetes. We know an unhealthy diet and lifestyle can cause type 2 diabetes, but can adopting a healthy diet and lifestyle prevent it? 

Researchers from the Diabetes Prevention Program (DPP) took people at risk for type 2 diabetes and gave them a 24-week diet and lifestyle intervention. The diet and lifestyle intervention was incredibly effective. After three years, the diet and lifestyle group had a 58% lower risk of developing diabetes than the placebo group. Participants aged 60 and older had an even better response, with a whopping 71% lower risk of developing diabetes. The diet and lifestyle effect lasted: even after 10 years, those folks had a 34% lower risk of developing diabetes compared to placebo. Men, women, and all racial and ethnic groups had similar results (and almost half of participants represented racial and ethnic minorities). Meanwhile, the medication group had a 31% lower risk of diabetes after three years, and an 18% lower risk after 10 years, which is also significant.

The program

1. Decrease intake of added sugars and processed foods, including refined grains like white flour and white rice. This especially includes sugary drinks, not only sodas but also juices. The best drinks are water, seltzer, and tea or coffee without sugar.
2. Swap out refined grains for whole grains. Whole grains are actually real grains that haven’t been stripped of nutrients in processing. Foods made from 100% whole grain (like whole wheat) are okay, but intact whole grains (like farro, quinoa, corn, oatmeal, and brown rice) are even better. Swapping out grains for starchy veggies (like potatoes) is also okay, as long as these veggies aren’t in the form of French fries!
3. Increase fiber intake. High-fiber foods include most vegetables and fruits. Legumes are also high in fiber and healthy plant protein. Legumes include lentils, beans, chickpeas, peas, edamame, and soy. People who eat a lot of high-fiber foods tend to eat fewer calories, weigh less, and have a lower risk of diabetes.
4. Increase fruits and vegetables intake. At least half of our food intake every day should be non-starchy fruits and vegetables, the more colorful the better. Cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts, and high-fiber fruits like berries of all kinds, are especially healthy. All fruits and vegetables are associated with living a significantly longer and healthier life!
5. Eat less meat, and avoid processed red meat. Many studies have shown us that certain meats are incredibly risky for us. People who eat processed red meat are far more likely to develop diabetes: one serving a day (which is two slices of bacon, two slices of deli meat, or one hot dog) is associated with over a 50% higher risk of developing type 2 diabetes. Eating even a small portion of red meat daily (red meat includes beef, lamb, and pork), like a palm-sized piece of steak, is associated with a 20% increased risk of type 2 diabetes. This may be because of the iron in red meats, and the chemicals in processed meats. As a matter of fact, the less meat you eat, the lower your risk of diabetes. People who don’t eat red meat at all, but do eat chicken, eggs, dairy, and fish, can significantly lower their risk of developing type 2 diabetes, by about 30%; those who eat only fish, 50%; those who eat only eggs and dairy, 60%; those who are vegan, 80%.
6. Eat healthier fats. Fat is not necessarily bad for you. What kind of fat you’re eating really does matter. Saturated fats, particularly from meats, are associated with an increased risk of diabetes and heart disease. Plant oils, such as extra-virgin olive oil and canola oil, carry less risk. Omega-3 fats, like in walnuts, flax seeds, and some fish, are actually quite good for you.

Resources

1. New CDC report: More than 100 million Americans have type 2 diabetes or prediabetes. CDC Newsroom, July 18, 2017.
2. Reduction in the incidence of type 2 diabetes with lifestyle intervention or with metformin. New England Journal of Medicine, February 7, 2002.
3. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. The Lancet, November 14, 2009.
4. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality—a systematic review and dose-response meta-analysis of prospective studies. International Journal of Epidemiology, June 1, 2017.

Video to watch: TEDx Talks 

Dr KK Aggarwal: Modern day doctor-patient relationship: https://www.youtube.com/watch?v=i9ml1vKK2DQ

Dr KK Aggarwal

Padma Shri Awardee

Vice President CMAAO

President HCFI