“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.
It hasn’t affected kids till now – it won’t affect them ever
Schools reopening across the globe has brought about a sense of panic in some parents and a sense of confidence in others because vaccination for children is yet to come and unvaccinated children are both at direct risk for COVID as well as at risk of transmitting the virus to others.
According to the World Health Organisation (WHO), data suggests that children under the age of 18 years represent about 8.5% of reported cases, with relatively few deaths compared to other age groups and usually mild disease. However, cases of critical illness have been reported. As with adults, pre-existing medical conditions have been suggested as a risk factor for severe disease and intensive care admission in children. Further studies are underway to assess the risk of infection in children and to better understand transmission in this age group.
Although research has shown that children develop severe disease from COVID-19 far less commonly than adults, and therefore, the risk of death due to severity of COVID-19 is also much lower in children. However, they are not immune. There are reports of children dying due to COVID-19. But even when children do not get seriously ill with COVID-19 or show symptoms, they can still transmit the virus to other children and adults. The rate of child-to-adult transmission of SARS-CoV-2 is roughly half the rate of adult-to-child transmission. So even when the risk is low for children, transmission to other unvaccinated kids and adults is still a serious concern.
Vaccination can help us tide over the third wave
The second wave is declining, although up to 30-40,000 daily new cases continue to be recorded. India is far from being a COVID-19 free nation. Moreover, the looming third wave and alerts released by different State heads to be prepared for a third wave or to make adequate arrangements for the third wave in terms of oxygen cylinders, beds, critical care wards, etc. has kept us all on our toes and inside homes for fear of expediting the arrival of the third wave.
Eminent virologist and retired professor (CMC Vellore), Dr. T Jacob John, in a recent media interview said if the Government can do justice to the vaccination, in terms of making it available in abundance and everywhere, even the unlikely probability of a third wave can be mitigated, adding that in other words, the third wave can be and must be prevented with vaccination. Dr. John also believes that the two strong waves of COVID-19 pandemic in India would have created high herd-immunity, which is why even a moderate level of vaccination will surely avert the third wave.
We should continue to follow physical distancing protocols and avoid crowding indoors or outdoors as much as possible.
Complete vaccinated individuals three times less likely to get COVID-19
In what comes as more evidence to back completing the (two-dose or one-dose) mandated course for vaccinations for COVID-19, a recent update published by the Imperial College London has shown that people who have received both doses of their coronavirus vaccine are three times less likely to get infected with COVID-19. These results from the 13th round of the Imperial-led REACT-1 study, a major coronavirus monitoring programme, are based on swab tests taken by almost 100,000 people in England between 24 June and 12 July.
According to their website, REACT (REal-time Assessment of Community Transmission) is a series of studies that are using home testing to improve the understanding of how the COVID-19 pandemic is progressing across England. This major research programme was commissioned by the Department of Health and Social Care (DHSC) and is being carried out by Imperial College London in partnership with Ipsos MORI and Imperial College Healthcare NHS Trust.
The analysis by Imperial College London and Ipsos MORI, which had almost 100,000 volunteers taking part in the study in England between June 24 and July 12, suggests that double vaccinated people are also less likely to pass on the virus to others. Results have also indicated that people who were fully vaccinated were less likely to be carriers of infection to pass the virus on to others, because they have a lower viral load on average and therefore shed less virus.
In his statement to the Press post release of study results, the UK Vaccines Minister Mr. Nadhim Zahawi also stated, “these results show the positive impact of the vaccination program with those who are double jabbed three times less likely than unvaccinated people to get the virus and less likely to pass on this awful disease to those around them”.
It is important to note that no vaccine has 100% efficacy but benefits outweigh the risks and therefore vaccination is an important step towards curbing the pandemic. Vaccination however, must also be complemented by COVID appropriate behavior.
Hepatitis symptoms differ as per hepatitis type
Viral hepatitis is mostly caused by the hepatotropic viruses ranging from A to E. Of these, hepatitis A and hepatitis E cause acute hepatitis, but not chronic hepatitis. Hepatitis B and C, on the other hand, can cause either an acute infection or a chronic infection. They are an important cause of liver cirrhosis and hepatocellular carcinoma.
Viral hepatitis is a silent disease as it is mostly asymptomatic in its early stages. This means that the infected persons are not taking the treatment that they need to and are also “silently” transmitting the infection to others. It therefore helps to understand the different clinical symptoms that each type of Hepatitis shows so that if a family member, friend, or you are seeing these symptoms, you should get checked immediately.
While Hep-A infection is an acute and self-limited illness, symptoms can include low grade fever, anorexia, nausea and vomiting, fatigue, malaise, arthralgias, myalgias, headache, photophobia, pharyngitis, cough and coryza. These symptoms may precede onset of jaundice by 1-2 weeks. Dark urine and clay-colored stools appear 1-5 days before the onset of clinical jaundice and these symptoms may decrease when jaundice becomes evident. The liver becomes enlarged and tender and there may be right upper quadrant pain and discomfort. Hepatitis A in children younger than six years is usually asymptomatic, whereas older children and adults are generally symptomatic.
In Hep-B, rashes, fever, or muscular and bony pains may develop in some cases followed by anorexia, nausea, jaundice, and right upper quadrant discomfort. Most patients with chronic hepatitis B are asymptomatic, while some patients have nonspecific symptoms such as fatigue.
Hepatitis C virus causes both acute and chronic hepatitis. Acute hepatitis C virus infection is the presence of clinical signs or symptoms of hepatitis within 6 months of exposure to the hepatitis C virus. Symptoms of acute hepatitis C are jaundice, nausea, dark urine, and right upper quadrant pain. However, most patients with acute hepatitis C are asymptomatic. Most patients with chronic hepatitis C infection have non-specific symptoms such as fatigue, nausea, anorexia, myalgias, arthralgias, weakness and weight loss.
In Hep-E, some patients may be asymptomatic while others may present with symptoms such as jaundice accompanied by malaise, anorexia, nausea, vomiting, abdominal pain, fever and hepatomegaly. Diarrhea, arthralgia, pruritus and urticarial rash may also be present in some patients.
Acute liver failure can occur; it occurs more frequently during pregnancy, mostly in the third trimester. The mortality rate is high and ranges from 15-25%.
Breastfeeding post vaccination can kill your baby
There isn’t any research to support this claim, and based on how vaccines work, there is no reason to believe that the vaccine could harm mom or baby. In fact studies support the fact that the vaccines are not excreted into the breast milk, but antibodies produced by mothers in response to the COVID-19 vaccine do — providing hope that breastfed babies might have some level of protection.
A report published in the journal Nature states that COVID-19 vaccines do not carry a risk of igniting an active infection and that they are extremely unlikely to cross into breast milk. The report further elaborates how the fragile messenger RNA used in the Pfizer–BioNTech and Moderna vaccines, is designed to break down so quickly that it should never leave the cells where it was injected. Therefore, it cannot get into the bloodstream and then the breast. In fact, experts believe none of the current vaccines will be excreted into breast milk.
The World Health Organisation (WHO) Strategic Advisory Group of Experts on Immunization (SAGE) Guidance also recommends that mothers continue to breastfeed after vaccination. The Centre for Disease Control (CDC) and the UK Joint Committee on Vaccination and Immunisation issued statements shortly after the first vaccines were authorized in both countries recommending COVID-19 vaccination for breastfeeding women.
Australia’s Department of Health has indicated that breastfeeding women can get an approved COVID-19 vaccine and don’t need to stop breastfeeding before or after.
Therefore, in conclusion, no safety concerns have been identified in lactating women who have been vaccinated. Women can continue to breastfeed pre and post COVID-19 vaccination.