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Fabric masks don’t protect yourself or others from COVID-19



We have been receiving queries pertaining to wearing of masks, particularly fabric masks and their efficacy in absorbing particles that cause respiratory infection.

It is common knowledge now that cloth face masks are a preventive measure with moderate efficacy in preventing the dissemination of respiratory infections caused by particles with the same size or smaller than those of Coronavirus.1 Therefore, the  claim that fabric masks do not work is false. Fabric masks also protect you and people around you from Covid-19.

The type of fabric used, number of layers and frequency of washings influence the efficacy of the barrier against droplets. Low coverage cloth face masks made of 100% cotton, scarf, pillowcase, antimicrobial pillowcase, linen, tea towel, and vacuum cleaner bag presented moderate protection in the process of absorbing the particles analyzed2, while high coverage cloth masks3made of HEPA washable vacuum bag, thick felted wool, cotton, heavy fabric, folded sock, cotton quilt, felt crafts, 100% nylon, denim, cotton jersey mesh, lycra, fusible interface, and lightweight shirt presented high protection.4,5

Studies have shown that most cloth masks present moderate absorption of micrometric and nanometric particles, therefore the filtering efficacy observed in these studies has been found to be similar to viral particles causing COVID-19.1

It is therefore true that use of masks – cloth and fabric ones as well, is recommended to the population, especially high coverage masks (more than one layer) due to their ability to provide greater protection in absorbing nanometric and micrometric particles, similar to the SARS-CoV-2 structure. Another recommendation is to discard and replace masks after the fourth washing cycle.1


1 De Souza L, et al. Rev Lat Am Enfermagem. 2020; 28: e3353. doi: 10.1590/1518-8345.4537.3353
2 MacIntyre CR, et al. BMJ Open. 2015 Apr;5(4):e006577. doi: 10.1136/bmjopen-2014-006577.
3 O’Kelly E, et al. MedRxiv. 2020 Apr; doi: 10.1101/2020.04.14.20065375.
4 Ngonghala CN, et al. MedRxiv. 2020 Apr; doi: 10.1101/2020.04.15.20066480.
5 Rodriguez-Palacios A, et al. Medrxiv. 2020 Apr; doi: 10.1101/2020.04.07.20045617.

UIN: 75HP33F

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Fact Check

Carbohydrates make you gain weight



Weight gain is associated with many factors besides just a high fat or high carbohydrate diet. We have carried numerous stories on maintaining an ideal weight and what factors affect weight – weight gain and weight loss.  Just as fat has been blamed for promoting weight gain and heart disease, carbohydrates have been shunned by many people over fears that consuming this macronutrient will cause obesity, diabetes, and other adverse health effects. However, in reality, eating a moderate amount of nutritious (or good) carbohydrates that are high in fiber, vitamins, and minerals like starchy root vegetables, grains, and legumes benefit health and not harm it.

However, what is also important to understand is that diabetes is one of the most prevalent health conditions in Indians. Dietary carbohydrates form the major source of energy in our diets. The carbohydrate quantity and quality play a vital function in the prevention and management of diabetes and higher carbohydrate diets are linked to higher prevalence and incidence of diabetes.

Complex carbohydrates such as brown rice, whole wheat bread, legumes, pulses and green leafy vegetables are good carbohydrates. Conversely, highly polished rice or refined wheat, sugar, glucose, highly processed foods such as cookies and pastries, fruit juice and sweetened beverages and fried potatoes or French fries are obviously ‘bad’ carbohydrates. Ultimately, it is all a matter of balance and moderation in diet. For Indians who currently consume about 65-75% calories from carbohydrates, reducing this to 50-55% and adding enough protein (20-25%) especially from vegetable sources and the rest from fat (20-30%) by including monounsaturated fats (e.g., groundnut or mustard oil, nuts and seeds) along with a plenty of green leafy vegetables, would be the best diet prescription for the prevention and management of non-communicable diseases such as diabetes and heart diseases.

Similarly, knowledge of ‘bad’ carbohydrates is also important—for e.g., carbohydrate-rich foods like cakes, cookies, sweetened beverages, and white bread should be restricted, as these foods can increase weight gain and disease risk when eaten in excess.

Therefore, it is safe to conclude that including healthy carbohydrate choices in your diet won’t make you gain weight. However, following unhealthy eating patterns and overindulging in carb-rich sugary foods will lead to weight gain.


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Fact Check

Breakfast is the most important meal of the day



“Breakfast like a king, lunch like a prince and dinner like a pauper”, was a common saying used until the late 90s. However, with changing times, more awareness around food intake patterns and their effects on metabolism, research now shows that breakfast may not really be the most important meal for adults, specifically healthy adults with no comorbid conditions such as heart ailments, diabetes, etc. For e.g., skipping breakfast automatically reflects on a low-calorie intake for the day, which in some cases, might be required for calorie checks and restricting calorie intake.

Similarly, people follow a trend called ‘intermittent fasting’, which is an eating pattern where you cycle between periods of eating and fasting. It does not say anything about which foods to eat, but rather when you should eat them. There are several different intermittent fasting methods, all of which split the day or week into eating periods and fasting periods. It is also known as intermittent energy restriction and is an umbrella term for various meal timing schedules that cycle between voluntary fasting and non-fasting over a given period. Methods of intermittent fasting include alternate-day fasting, periodic fasting, and daily time-restricted feeding. Breakfast is more often than not skipped in this pattern and this has been linked to a plethora of benefits, including improved blood sugar control and reductions in inflammatory markers.

However, as specifically mentioned, skipping breakfast may be beneficial for healthy adults only. This fact does not apply to growing children and teens or those with increased nutrient needs, such as pregnant or lactating women and those with certain health conditions such as diabetes, as skipping meals may lead to negative health effects in these people.

Therefore, eating breakfast is not necessary for everyone. Health benefits are associated with both eating breakfast and skipping it. Some studies say skipping breakfast is associated with the increased risk of heart disease and support the benefits of eating breakfast in promoting cardiovascular health, while others say the results are inconsistent. 

The take-home message here is that eating healthy and as per your energy requirements and schedule is important. Skipping any or all meals may not be ideally recommended, but it is always advisable to keep a regular calorie and food intake check and get regular health check-ups done to ensure your daily routine works for your particular metabolic type. Children should never be allowed to skip meals as they and pregnant and lactating women fall in the additional nutritional needs category of individuals and therefore have specifically higher needs than the general population.

UIN: 218HP61F

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Fact Check

Only calories matter for weight loss



Weight loss is a burning issue for almost 75% of people across the globe. Some have problems shedding the extra kilos, some find it difficult to maintain the ideal weight – luckily weight loss is an extensively researched subject area and a lot of good data is available for reference of every individual. One of the key areas which have been successful in proven weight-loss strategies is calorie count. There are apps such as MyFitnessPal, etc. that enable one to keep a close watch on the calorie intake through the day by simple input of data from the users. But are these effective strategies? The good news is YES—but are they sufficient for effective weight-loss – the unfortunate answer is NO.

Though creating a calorie deficit by burning more energy than you take in is the most important factor when it comes to weight loss, it is not the only thing that matters. Weight gain, obesity or a high BMI can occur due to a number of reasons besides a high calorie food intake. For e.g., hormonal imbalances, conditions such as polycystic ovarian disease, health conditions like hypothyroidism, metabolic adaptations, the use of certain medications, and genetics are some of the many important factors that may adversely affect weight loss on a calorie restriction diet.  

Another important aspect of calorie count that people often miss, is the nutrient value of foods. For e.g., counting calories fails to emphasize the importance of sustainability and diet quality for weight loss. This can lead to choosing low calorie, nutrient-poor foods like rice-based dishes such as poha, upma, etc. which are popular Indian breakfast snacks compared to nutrient-dense foods like whole eggs, ghee, etc. which may not always be the best for overall health. According to the Mayo Clinic, skipping one or two high-calorie items is a good place to start when cutting calories. For example, you could skip your morning latte, soda at lunch or that bowl of ice cream you always have after dinner.

Therefore, think about what you eat and drink each day and identify items you could cut out. If you think that skipping your indulgence will leave you with a craving, try a low-calorie substitution.

Remember a few things about weight loss because there is no short cut to weight loss. Any weight loss method, measure or technique that ensures a quick and permanent way to lose weight should be thoroughly checked. Start what you can sustain. Crash diets, complete calorie deficit, etc. can leave one with deficiencies which can harm the body more in the long run, therefore it is extremely important to balance nutrition with calorie count and maintain a healthy weight loss goal instead of short cuts or effortless remedies. And last but not the least, before starting any weight loss exercises, diets or regimens, get a thorough health checkup done to ensure your parameters are in excellent health. In case of excess or deficient states, consult your family physician for advice on weight loss and calories along with medications for your condition.

UIN: 215HP60F

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Fact Check

Prolonged use of masks can cause CO2 intoxication



This is not true. According to the World Health Organization, the prolonged use of medical masks can be uncomfortable. However, it does not lead to carbon dioxide (CO2) intoxication nor oxygen deficiency. Dr. Gregory Schmidt from University of Iowa Hospitals & Clinics also emphasizes that face masks do not decrease the oxygen intake and neither do they make you retain more CO2 than usual. Because oxygen and CO2 are very small, they can easily pass through a face mask compared to infectious droplets that are much larger in comparison and cannot pass easily through a face mask.

A study published in the journal Annals of the American Thoracic Society also contradicts statements linking wearing face masks CO2 poisoning by trapping CO2.

The CDC recommends wearing cloth masks while in public, and this option is very breathable. There is no risk of lower oxygen levels in healthy adults and CO2 will freely diffuse through your mask as you breathe.  If wearing a mask is uncomfortable or if you have trouble breathing properly, it is recommended to limit your talking and try and breathe through your nose.

While wearing a medical mask (the ones that are flat or pleated and affixed to the head with straps and have ear loops), make sure it fits properly and that it is tight enough to allow you to breathe normally. Do not re-use a disposable mask and always change it as soon as it gets damp.

Additional key points regarding mask usage include the following:

  1. Surgical masks should not be reused. Most face masks available for public use, especially the surgical ones, are disposable and are for one-time use only. Ideally, face masks should not be used once they are soiled, or the inner lining gets moist. This is also important to note because masks can rarely be sterilized to a permissible extent. Read here.
  2. Fabric masks are good and protect you and others from COVID-19. use of masks – cloth and fabric ones as well, is recommended to the population, especially high coverage masks (more than one layer) due to their ability to provide greater protection in absorbing nanometric and micrometric particles, similar to the SARS-CoV-2 structure. Another recommendation is to discard and replace masks after the fourth washing cycle. Read here.
  3. You need a mask even if you have had COVID-19. Universal public masking is recommended during the COVID-19 pandemic as one of the most important pillars of disease control. This is based on the likelihood of masks reducing the viral inoculum to which the mask-wearer is exposed, leading to higher rates of mild or asymptomatic infection with COVID-19. Read here.
  4. Masks should be avoided during exercise. It is better to avoid wearing masks for long hours of exercise and the important preventive measure during exercise is to maintain physical distance of at least 6 feet from others. Read here.

UIN: 214HP59F

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The resurgence of cases is not preventable



In a high-level meeting held by the Government of India with the State Government representatives, non-compliance of COVID-19 precautions including appropriate behavior, use of masks, hand hygiene and physical distancing were the primary reasons cited for the surge in the number of COVID-19 cases across the country. Another reason cited has been a term called ‘pandemic fatigue’ which as the term suggests, reflects upon the response of the general public when the numbers started rising again. To top it all, the lack of implementation of containment measures has also been quoted as one of the top 3 reasons why the number of cases is on a meteoric rise currently.

Prime Minister Mr. Narendra Modi said the five-fold strategy of testing, tracing, treatment, COVID-appropriate behavior and vaccination if implemented with utmost seriousness and commitment would be effective in curbing the pandemic’s spread, according to an official statement. In the meeting it was decided that a special campaign for Covid-appropriate behavior with an emphasis on 100% mask usage, personal hygiene and sanitation at public places /workplaces and health facilities will be organized from April 6 to April 14.

It is very important to continue with the preventive measures. To prevent the spread of COVID-19:

  • Clean your hands often. Use soap and water, or an alcohol-based hand rub.
  • Maintain a safe distance from anyone who is coughing or sneezing.
  • Wear a mask when physical distancing is not possible.
  • Don’t touch your eyes, nose or mouth.
  • Cover your nose and mouth with your bent elbow or a tissue when you cough or sneeze.
  • Stay home if you feel unwell.
  • If you have a fever, cough and difficulty breathing, seek medical attention.
  • Calling in advance allows your healthcare provider to quickly direct you to the right health facility. This protects you and prevents the spread of viruses and other infections.
  • Universal masking i.e., correct, continuous use of 3-layered masks is a must. Masks not only protect other people from the infection, but they also protect the person who is wearing the mask. However, masks alone do not protect against COVID-19 and should be combined with physical distancing and hand hygiene. Follow the advice provided by your local health authority.

UIN: 211HP58F

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