Morning MEDtalks with Dr KK Aggarwal 6^th November, 2018

Marathon runners can also donate blood. According to a 2016 meta-analysis published in the Journal of Blood Transfusion, the haemoglobin (Hb) concentration in our bodies is reduced by 7 per cent after a blood donation. The Hb concentration in our bodies then gradually returns to normal over the next two weeks. A reduced Hb concentration will result in lower oxygen-carrying capacity affecting the running.

In 1995, a study published in the American Heart Journal evaluated 10 male cyclists before and after donating blood to test the effect of blood donations on exercise performance. Results showed a decrease in the maximal performance of all the cyclists for at least a week.

More recently, in 2016, a randomised controlled trial published in the Sports Medicine Journal found that maximal power output, peak oxygen consumption and Hb mass decreased for up to four weeks after making a blood donation.

Interestingly, both studies found that the submaximal performance of their test subjects was not affected.

If you are a recreational athlete exercising at submaximal intensity, you should not have any negative experiences other than a higher-than-usual heart rate.

To recover faster after a blood donation, you may consider taking iron supplements. A randomised controlled trial was conducted to investigate the effectiveness of iron supplements following a blood donation. The results were published in the highly-regarded Journal of American Medical Association in 2015 and it was found that with iron supplementation, Hb recovery time was halved from a mean of 78 days to 31 days. More drastically, for people who usually have low iron levels, their Hb recovery time dropped from a mean of 158 days to just 32 days.

Food labelling: The focus of the most recent FDA changes are sugars, total calorie count and vitamin reporting. Sugars are a huge concern.

The calorie counts will now clearly reflect the total calories in the packaging, eliminating the nebulous use of “per serving.” Vitamins A and C will no longer be listed on the labels, because research shows Americans rarely are deficient in those vitamins anymore. Tracking Vitamin D and potassium levels is presently more important, so those will be tracked on food labels.

Replacing saturated fats with polyunsaturated fats or high-fiber carbohydrates is the “best bet for reducing the risk of heart disease" but that also “could do the opposite.”

The UN Intergovernmental Panel on Climate Change warned that coal-fired electricity must end by 2050 if we are to limit global warming rises to 1.5C. If not, we may see a major climate crisis in just 20 years.

The history of WHO air quality guidelines: The first WHO publication to deal with air pollution and its effects on health was “Air pollution”, published in 1958. It accepted the fact that air pollutants could damage health, and represented the first step in establishing the case for setting air quality standards to safeguard health.

WHO has published 3 editions of its air quality guidelines since 1987, the most recent in 2006. HO/Europe has led the work in this area: while the first 2 editions included the words “for Europe” in the title, they achieved the task of setting guidelines at a global level.

Since 2006, WHO has worked on developing separate guidelines for indoor air quality. It published a series of 3 indoor-specific air quality guidelines that provide health-based recommendations on selected chemical air pollutants commonly found in indoor environments, biological agents (dampness and mould) and household fuel combustion.

Today is the International Day for Preventing the Exploitation of the Environment in War and Armed Conflict: War casualties have always been considered in terms of dead and wounded soldiers and civilians, destroyed cities and livelihoods, the environment has often remained the unpublicized victim of war. Water wells have been polluted, crops torched, forests cut down, soils poisoned, and animals killed to gain military advantage. Over the last 60 years, at least 40 percent of all internal conflicts have been linked to the exploitation of natural resources, whether high-value resources such as timber, diamonds, gold and oil, or scarce resources such as fertile land and water. Conflicts involving natural resources have also been found to be twice as likely to relapse. On 27 May 2016, the United Nations Environment Assembly adopted resolution UNEP/EA.2/Res.15, which recognized the role of healthy ecosystems and sustainably managed resources in reducing the risk of armed conflict.

AAP announces first policy statement on the short- and long-term effects of armed conflict on children: The American Academy of Pediatrics (AAP), seeking to raise awareness of the immediate and long-term harm done to children affected by violent conflict and war, will present its first policy statement on the topic, "The Effects of Armed Conflict on Children," during its 2018 National Conference & Exhibition in Orlando, Florida. The AAP recognizes children of all ages, including preschool children, suffer both direct and indirect effects of armed conflict, which is defined as any organized dispute that involves the use of weapons, violence, or force. Armed conflict is considered both a toxic stress and a significant determinant of child health.

“Children today are not only considered collateral damage in some war zones, they are being targeted by attackers, exploited and recruited to participate in the conflict. The impact of armed conflict on children is among the most critical health issues affecting children worldwide. We must advocate for children in conflicts that, for many of them, started long before they were born.” said Dr. Goldhagen, one of the authors of the report

Zika Update: Zika virus strain that causes microcephaly not found in Rajasthan, India. 

The Indian Council of Medical Research (ICMR) - National Institute of Virology (NIV), Pune has sequenced 5 Zika virus strains collected at different time points of the Jaipur outbreak. Advanced molecular studies of Zika virus strains, carried out through Next Generation Sequencing suggest that the known mutations linked to fetal microcephaly and high transmissibility of Zika virus in Aedes mosquitoes are not present in the current Zika virus strain that has affected Rajasthan. However, the Government is maintaining high vigil of the possibility of adverse pregnancy outcomes in women exposed to Zika virus as the strain may mutate in future or some other unknown/host factors may play a role in microcephaly /other birth defects… (Press Information Bureau, Ministry of Health and Family Welfare, Nov. 3, 2018).

Video to watch: TEDx Video: Doctor-patient relationship www.youtube(dot)com/ watch?v=i9ml1vKK2DQ

Dr KK Aggarwal

Padma Shri Awardee

President Elect CMAAO

President Heart Care Foundation of India