Editorial 1: Finding proof for the axiom that nutrition aids recovery
Introduction
- It would seem that optimal nutrition, essential for all biochemical processes to function properly, is an axiom. Naturally, it will then also be an accepted truth that appropriate nutritious food will have to be consumed, in order for the body to recuperate and heal even as it is treated by medicines when under assault. Strangely though, nothing can be as far apart in practice, as this axiom and its corollary.
Appropriate diet
- The nutritional and environmental factors that influence disease and wellness are now part of a solid study of the human body.
- While conventional medicine treats and advances cure by drugs and/or surgery, the doctor seldom forgets to mention an appropriate diet to be followed.
- The problem, however, occurs when there’s a piecemeal handling of the condition, with no insight into the patient’s culture or food affordability.
RATIONS trial
- Latest in this trend, is the RATIONS trial by Anurag Bhargava et al, which tries to address nutrition and tuberculosis within a syndemics framework.
- The researchers studied the effect of improving nutrition with a combination of a food basket and micronutrients on recovery of patients with TB, and preventing TB in close family members of those who are infected.
- Prof. Bhargava explains that undernutrition was the leading risk factor for TB Incidence in India and addressing it could lead to substantial decline in TB incidence.
Major findings
- Prevalence of undernutrition in household members was high and one-third were undernourished, in the study.
- It is also believed that a sub-optimal diet is also an important risk factor, preventable in good measure,for non- communicable diseases, an epidemic of which seems to be holding India in its grip.
- An emerging and compelling body of research points to the potential of food and nutrition playing a prominent role in prevention, management and treatment, even reversal of disease.
- Such interventions in heath care system might be associated with improved health outcomes and reduced healthcare usage and costs.
- One of every five deaths across the globe is attributable to a suboptimal diet, more than any other risk factor including tobacco.
- Another area in which the role of nutrition in recovery has been well documented is in the HIV/AIDS sector. HIV infection and poor nutritional status are interlinked.
- The impact of HIV infection on nutrition was identified early in the epidemic, with wasting one of the most visible signs of malnutrition in patients who progress to acquired immune deficiency syndrome (AIDS).
- Malnutrition impairs immune function and reduces the body’s resistance to infection.
- HIV and malnutrition have a cumulative effect in damaging the immune system and worsening nutritional status.
Initiatives
- It was in response to such averments that the World Food Programme initiated a pilot phase of distribution of nutrition supplements combined with nutrition counselling for People Living with HIV (PLHIV) on Anti-retroviral Therapy (ART), in Tamil Nadu.
- In a mid term assessment, researchers found improvements in both BMI level and haemoglobin in the experiment group, versus the control group.
- Both BMI and HB were considered key indicators for comparative assessment and as impact indicators.
Way forward
- In a welfare state, the task of ensuring adequate nutritional status undoubtedly rests with the government.
- At any rate, any lapses in doing so, must be set right,if an opportunity arises, with a comprehension of the relevant political and social contexts.
- Supporting delivery of health care along with with nutritional supplements must be guaranteed, wherever necessary, in order to ensure the best chances of recovery are available for patients.
Editorial 2: Are natural disasters man-made?
Introduction
- Torrential rains in several parts of north India, particularly Himachal Pradesh and Uttarakhand, damaged highways and buildings, and took hundreds of lives. While a warming Arctic is said to be a cause for the unusually heavy rains, years of haphazard planning and construction have multiplied the tragedy.
Natural calamities
- Every year, particularly in the monsoon, we witness extreme natural calamities.
- The scale of natural disasters that we now see across the world are definitely man-made.
- Some sections of the population are more vulnerable to them and more at risk than others.
- We need to figure out systems and solutions that can be channelised specifically towards this large pool of people. We need to build stronger systems from the bottom up and learn to do it collectively.
Role of humans
- Humans have played an important role in enhancing the risk from climate hazards.
- The frequency and intensity of hazards have increased, and anthropogenic climate change has played a major role in that.
- We have built on floodplains, encroached water bodies, and planned our cities without thinking about sustainability. So, humans are responsible.
- Not fully, but we have played a considerable part in increasing the problem. But we should find solutions and learn from our failures.
Disaster preparedness
- There are a few different ways in which the landscape of disasters in India has changed.
- We are constantly talking about the importance of urban planning and how the movement of people to urban centres has affected natural landscapes.
- Some [landscapes] have changed drastically and exceeded their carrying capacity and this has exacerbated the extent of loss and damage in these areas.
- If we consider the historical development of cities everywhere, it is the story of urbanisation.
- Increased population density means greater dependence on fossil fuel and greater climate-disruptive anthropogenic forces.
Suggestions
- Development translates to infrastructure growth. However, we don’t pay enough attention to whether our development pathways are sustainable.
- Sustainability means emphasising not only economics, but also society and environment. Any sustainable development will consider the environmental implications.
- So far, we have just run behind the economics, you know, the land holdings, finding cheaper land, filling the water bodies, removing palaeochannels (deep underground stores of groundwater) and destroying natural drainage systems.
- The only solution is adopting the Sustainable Development Goals, implementing careful urban planning, and creating roads and streets keeping these in mind.
- It comes down to understanding that there are no quick-fix solutions to what we are going through; we will have to think about long-term risk assessments, vulnerability assessments, and understand how socioeconomic drivers are worsening the problem in certain communities compared to others in the city.
Way forward
- Often, we don’t have a complete record that informs planners about current and upcoming disasters.
- Data sets are often pretty old and do not directly provide sufficient information about the future.
- There are excellent institutions even within the government that are constantly monitoring and understanding the scale of the climate crisis in terms of rainfall patterns, trends, and the ways in which risk is becoming more pronounced in certain regions versus others.
- We have to analyse the implications of imposing a strict carrying capacity in certain regions and not allowing for more urbanisation to happen in certain areas or restricting certain ways in which infrastructure is built.
