Analysis of Consumer Protection Bill, 2018 as passed in Lok Sabha on 20.12.2018

Dr KK Aggarwal & Advocate Ira Gupta

The Consumer Protection Bill, 2018 was introduced in Lok Sabha on 05.01.2018 and the same was passed in the Lok Sabha on 20.12.2018. Before introducing the said Bill, the same would have been open for public discussions and suggestions. It is very astonishing that when the Bill was open for public discussions and suggestions, no association objected to the same. Even after the introduction of the Bill in Lok Sabha, none of the association of any field objected to the said Bill and now when the same has been passed by Lok Sabha, everybody is criticizing it.

Even if any association or any individual want to raise objection to the said Bill, then the same should be done collectively by all industries as Consumer Protection Bill is not only confined to medical or health care sector. It applies to all industries and sectors and if all sectors raise their objections collectively, only then will the Government consider their objections and suggestions.  

One still has time before the Bill is passed in Rajya Sabha.

Composition of the Commissions could violate the principle of separation of powers

·         The District, State and National Consumer Disputes Redressal Commissions will adjudicate complaints on defective goods and deficient services of varying values.  (Section 28, Section 42 and Section 53 of the Consumer Protection Bill, 2018).

·         District Commissions have been given the powers of a civil court under Section 38 of the Bill, 2018.  The State and National Commissions act as appellate bodies on the decisions of the District and State Commissions, respectively under Section 41 and Section 52 of the Bill, 2018. 

·         Appeals from the National Commission will be heard by the Supreme Court under Section 67.  Therefore, these Commissions are quasi-judicial bodies with the National Commission being on par with High Courts.

·         The Bill specifies that the Commissions will be headed by a ‘President’ and will comprise other members. However, the Bill delegates to the Central Government the power of deciding the qualifications of the President and members.  In particular, the Bill does not specify that the President or members should have minimum judicial qualifications. This is in contrast with the existing Consumer Protection Act, 1986, which states that the District Commission will be headed by a person qualified to be a District Judge. Similarly, the State and National Commissions are headed by a person qualified to be a High Court or a Supreme Court judge, respectively. The 1986 Act also specifies the minimum qualification of members. The earlier 2015 Bill too specified judicial members to head the State and National Commissions, though it permitted the District Commission to be headed by the district magistrate in addition to a person qualified to be a district judge.

·         If the Commissions were to have only non-judicial members, it may violate the principle of separation of powers, which is against the basic structure of the Constitution of India.

Jurisdictions of the Commissions have been increased

·         These Commissions will be set up at District, State and National level, with pecuniary jurisdiction up to Rs one crore, Rs one crore to Rs 10 crore, and above Rs 10 crore, respectively. In case of unfair contracts, the State Commissions will hear complaints where the value is up to Rs 10 crore, and National Commissions will hear complaints above that value. These Commissions can declare unfair terms of such contracts to be null and void.

·         Increase in the pecuniary jurisdictions of the Commissions is with the purpose to allow consumers to file complaints in district commissions as many small consumers find it difficult and costly to file a complaint in State Commission and National Commission.

·         Though this is in correlation to the pecuniary jurisdiction of the District Courts and High Courts of the States but at the same time, this may lead to many complaints being filed for each and every surgery and treatment undertaken by the doctor or hospital as filing the complaint at the District Commission is still cheaper than filling the complaint at the State Commission and National Commission.

Commissions will dispose the complaint within 3 months

·         The Commissions will attempt to dispose a complaint within three months, if the complaint does not require analysis or testing of commodities. If analysis and testing is required, the complaint will be disposed within a period of five months.

·         There is no provision as per which it is mandatory for the Commissions at all levels (District, State and National) to have any judicial member and any medical experts for scrutinizing medical negligence cases or any other case relating to healthcare, in that situation there will be conflicting judgments and mostly all judgments will suffer from understanding of the medical procedure and treatment undertaken by the doctor.

·         Moreover, the period of 3 months and 5 months, in case of inquiry, is too less for any person to understand the medical treatment and procedure, the medical literature relating to the case, standard operating procedures followed by the doctors etc.

·         In such a situation, State Commissions and National Commissions will be folded with more appeals as compared to present day.

·         This may in turn affect the health sector drastically as the doctors and hospitals will be more occupied with the complaints and appeals under the new Bill thereby neglecting their other patients which is against the Constitution of India as Right to health is a fundamental right under Article 21.

No provision for frivolous and vexatious complaints

·         There is no provision in the Bill w.r.t. filling of the frivolous and vexatious complaints which was present in 1986 Act under Section 26 of the Consumer Protection act, 1986 as per which the frivolous and vexatious complaints were to be dismissed with penalty.

·         In the present Bill, 2018 there is provision for vexatious search being conducted by Director General or any other officer but there is no provision for frivolous and vexatious complaints.

·         As there is no provision against frivolous and vexatious complaints, all the commissions i.e. District, State and National Commission will be flooded with many frivolous and vexatious complaints as complaints does not have any fear of penalty being imposed upon them for such frivolous and vexatious complaints.

Composition and role of the Consumer Protection Councils

·         The Bill establishes Consumer Protection Councils (CPCs) at the district, state and national levels, as advisory bodies.  The Councils will advise on promotion and protection of consumer rights.  Under the Bill, the Central Council and the State Council will be headed by the Minister-in-charge of Consumer Affairs at the central and state level, respectively.  The District Council will be headed by the District Collector. 

·         The Bill states that these bodies shall “render advice on promotion and protection of consumer rights”.  It is unusual for a body headed by a Minister or the District Collector (who are implementing authorities) to be given an advisory role.  Further, the Bill does not specify whom the CPCs will render the advise to whom.

·         The 1986 Act provides for such Councils but their role is to promote and protect consumer rights (which is not an advisory role).  The Bill has vested the Central Consumer Protection Authority with this duty.

Some Definitions need to be more explanatory

·         Definition of deficiency has changed which can invite more cases against doctors for even small or post - surgery ailments on the point that doctor did not informed about the post - surgery precautions or risks to the patients and his relatives.

(11) “deficiency” means any fault, imperfection, shortcoming or inadequacy in the quality, nature and manner of performance which is required to be maintained by or under any law for the time being in force or has been undertaken to be performed by a person in pursuance of a contract or otherwise in relation to any service and includes— (i) any act of negligence or omission or commission by such person which causes loss or injury to the consumer; and (ii) deliberate withholding of relevant information by such person to the consumer;

·         The term “illegally” has to be explained as whatever doctors do and practice as per books and standard operative procedures, then he cannot be said to have acted illegally which deciding whether injury has been caused to the complainant or not under Section 2(23) of Bill, 2018 which is reproduced as:

(23) “injury” means any harm whatever illegally caused to any person, in body, mind or property;

·         The definition of “service” includes healthcare which means every type of health care is under the purview of Bill. 2018. 

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Health should be one of the topmost priorities for the government

On New Year’s Day, the Prime Minister gave an interview to ANI, wherein he touched upon various matters of interest to the country. But, a subject that was glaringly missing in his 90 minute conversation was that of Health.

The questions dealt more with current political issues, which will invariably crop up in the coming parliamentary election and the answers seemed to be aimed at reassuring the electorate.

The Prime Minister talked about political violence and also strongly condemned it.

It would have been indeed heartening to further know his views also on violence against doctors and how his government plans to tackle the escalating incidents of violence against doctors across the country.

He also spoke about “economic health” but not “health”, despite several prevailing health issues in the country.

Pollution has become a major public health problem and there seems to be no respite from it. Evidence has documented an association between air pollution and many acute health events such as heart attack, stroke, acute asthma and chronic diseases such as cancer, heart disease, lung diseases (asthma, COPD). But neither harm prevention nor harm reduction due to pollution was addressed by the PM.

There is a wide gap in the availability of healthcare service in the country. On one hand, India is fast becoming the hub of medial tourism, but in a sharp contrast, healthcare including essential healthcare is still out of reach for many people.

India is far from attaining universal health coverage, which is affordable, accessible, available, appropriate and accountable. This is because the public expenditure on health is very less.

Currently, India spends just 1% of its gross domestic product (GDP) on health. Without spending at least 5-6% of the GDP on health, the basic healthcare needs of the population cannot be fulfilled. Although the National Health Policy 2017 has provided for increasing public expenditure on health to 2.5% of GDP from the current ~1% by 2025, it is still very inadequate to provide universal healthcare.

The budgetary allocation of Rs 52,800 crore for health in 2018/19 was merely 5% higher than the revised estimate of Rs 50,079.6 crore, in 2017/18 (Business Today, Feb 19, 2018).

Also, very few people in the country have health insurance coverage. At more than 60%, India has one of the highest out of expenditures on health globally. Poverty arising out of exorbitant health expenses further contributes to the widening inequity in health services. Ayushman Bharat scheme was launched last year as an answer to reduce this gap. We hope that it will be implemented across the country.

India faces a twin burden of diseases: Communicable diseases (endemic + emerging and re-emerging) and non-communicable diseases (NCDs). Diseases that are endemic in the country rear up every year.

The Gorakhpur tragedy last year, where several children lost their lives due to acute encephalitis syndrome (AES) had stirred a debate in the country. But this was not the first AES outbreak in this area. Many such outbreaks have been occurring for several years now and each epidemic has taken a heavy toll of lives.

Similarly, flaring up of Dengue and Chikungunya is an annual feature now. Last year, outbreaks of Nipah virus and Zika virus – both emerging infectious diseases - were reported from Kerala and Rajasthan, respectively. They are now here to stay.

The huge population in the country, lack of education and awareness as well as global travel leave us vulnerable to many such outbreaks. We need to be in a state of constant alert and preparedness to prevent an epidemic in advance instead of responding once an epidemic has occurred. We need to find answers to such continuing epidemics.

Doctors should have been involved in the efforts to address the health issues; but, their autonomy has been dissolved.

Doctors across the country see more than 2 crores of patients every day. Hence, they represent the collective consciousness of people, so they should be part of the solutions for the prevailing health problems and concerns in the country.

India continues to bear the highest burden of tuberculosis (TB) cases globally, including MDR-TB. Many of India’s citizens continue to grapple with lack of adequate sanitation and safe drinking water.

The Prime Minister spoke about Ayushman Bharat as his “biggest achievement”. But, aside from this it was disheartening to note that health appears to be a low priority issue for the government as well as ANI.

If in a 90-minute interview, health could not be a part of the agenda, it’s a sorry state of affairs. Apparently, health will not feature in the manifesto of the upcoming elections.

If India aspires to be a global superpower and become one of the largest economies in the world, health of her citizens needs to be improved. Healthy citizens can contribute much more to the growth of a nation.

We hope the Prime Minister will take up these issues in his next “Mann ki Baat” and allay these concerns.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

FDA says certain antibiotics could rupture main artery

As per new US FDA warning fluoroquinolones antibiotics "can increase the occurrence of rare but serious events of ruptures or tears in the main artery of the body," the aorta and lead to dangerous bleeding or even death.

The FDA is requiring drug makers to add a new warning to the packaging, saying "fluoroquinolones should not be used in patients at increased risk unless there are no other treatment options available." The FDA says those patients are ones with "a history of blockages or aneurysms" of blood vessels, high blood pressure, certain genetic disorders and the elderly. 

This is the latest warning about fluoroquinolones.

In 2015, some patients and doctors blamed the antibiotics for devastating side effects, including ALS, Alzheimer's, Parkinson's and even death.

In 2016, the FDA required drug makers to include warnings the drugs could have disabling effects on tendons, muscles, joints and nerves. Later that year, the FDA added more warnings about the risks of mental health side effects and serious blood sugar disturbances.

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Is not notifying TB punishable? If yes, should positive XDR patients be isolated?

A few days back a police complaint was filed by the Ahmedabad Municipal Corporation (AMC) against a doctor couple who have a clinic in Vejalpur in Ahmedabad for failing to notify tuberculosis to the AMC, as reported in TOI. This is the first such complaint in the state against any doctor for suppressing information about tuberculosis. According to government statistics for 2018, Gujarat was among the top five states in reporting tuberculosis after Uttar Pradesh, Rajasthan, Madhya Pradesh, and Maharashtra.  According to medical health officer Bhavin Solanki, the AMC had in April 2018 directed all doctors to inform it about tuberculosis cases. Solanki said 100 doctors were issued such notices. However, it was observed that private doctors were not reporting all tuberculosis cases. The AMC found during an investigation that a patient from Srinand Nagar was undergoing treatment at Akshar Hospital in Vejalpur. The AMC had issued a notice to Dr Nilesh Makkani and Dr Pragni Makkani of the hospital on April 21. However, despite getting the notice, the couple did not inform the AMC about the Srinand Nagar case.

TB has been a notifiable disease since 2012 (notification Z-28015/2/2012-TB ) and “all healthcare providers (clinical establishments run or managed by the Government (including local authorities), private or NGO sectors and/or individual practitioners) are required to notify every TB case to local authorities i.e. District Health Officer/Chief Medical Officer of a district and Municipal health Officer of a Municipal Corporation/Municipality every month in a given format.

In a notification issued on March 16 this year, the Health Ministry also made it mandatory for all Pharmacies, Chemists and Druggists dispensing anti-tubercular medicines to notify respective TB patients along with details of medicines. They are also required to maintain a copy of the prescription and submit to the appropriate local authority. As per this notification, failure on the part of the doctor, Pharmacy, Chemist and Druggist to notify a TB patient to the Ministry of Health and Family Welfare would invite punishment in the form of imprisonment and fine or both, under sections 269 and 270 of the Indian Penal Code.

Section 269 IPC: “Negligent act likely to spread infection of disease dangerous to life. - Whoever unlawfully or negligently does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to six months, or with fine, or with both”.

Section 270 IPC: “Malignant act likely to spread infection of disease dangerous to life. - Whoever malignantly does any act which is, and which he knows or has reason to believe to be, likely to spread the infection of any disease dangerous to life, shall be punished with imprisonment of either description for a term which may extend to two years, or with fine, or with both.”

Besides the IPC, India also has other regulatory Acts such as the Epidemic Diseases Act 1987, which also provide for the control of communicable diseases such as TB. The Act empowers state and central government to take special measures and prescribe regulations that are to be observed by public to contain the spread of disease. It gives legal protection to persons acting under the act and has also defined penalty - a punishment under Section 188 IPC (disobedience of order duly promulgated by public servant) of either description for a term which may extend upto 6 months imprisonment or 1,000 rupees fine or both, for violating the regulations.

In most of the municipal corporation acts for example DMC Act (Delhi) TB is defined as a dangerous disease under 2 (9) "dangerous disease" means— (a) Cholera, plague, chicken-pox, small-pox, tuberculosis, leprosy, enteric fever, cerebrospinal meningitis and diphtheria; and (b) any other epidemic, endemic or infectious disease which the Commissioner may, by notification in the Official Gazette, declare to be a dangerous disease for the purposes of this Act; Prevention of dangerous diseases. The DMC act also mandates reporting under section 371. " Obligation to give information of dangerous disease: Any person being in charge of, or in attendance, whether as a medical practitioner or otherwise, upon any person whom he knows or has reason to believe to be suffering from a dangerous disease, or being the owner, lessee, or occupier of any building in which he knows that any such person is so suffering shall forthwith give information respecting the existence of such disease to the Municipal Health Officer. Under Section 482 DMC, the person shall be fined as penalty for breaches for bye-laws.

India launched a TB Free India Campaign on March 13, 2018 and set itself a target of eliminating TB from the country by the year 2025, five years before the global target at the Delhi End TB Summit. The global target for eliminating TB is 2030.

Certainly, notification is important to know the prevalence and incidence of TB cases in the country. A strategy can be then drawn up to eliminate the disease from the country to meet the target.

It is equally important to ensure that patients complete the full course of treatment. Those who discontinue treatment may become infectious, or the period of infectiousness may be extended if currently infectious, and also are at risk of developing drug resistance. 

But, a question then arises “Is it enough to only notify TB?” without ensuring that they are not spreading the infection to close contacts or the community?

TB spreads by airborne droplet infection.

Open cases are considered contagious and just being within close proximity of an infected person who had just coughed, sneezed or spat (even if only while speaking) may expose a person to the risk of acquiring the infection.

The risk of disease transmission is particularly high in overcrowded conditions.

Such open cases could be found anywhere in all walks of life and could be anybody. And they may expose a large number of people to the TB bacteria in day to day life.

So, “Shouldn’t TB patients (especially NDR and XDR), especially open cases, be isolated?”

“Shouldn’t persons who have been exposed to the TB bacteria be quarantined?”

Isolation means separating sick persons with a contagious disease from those who are not sick. Quarantine, on the other hand, means separating and restricting the movement of people who have been exposed to a contagious disease, but are not yet ill, to see if they become sick.

The CDC has defined the “minimum period of isolation of the patient – pulmonary tuberculosis (also includes mediastinal, laryngeal, pleural, or miliary). Until bacteriologically negative based on three appropriately collected and processed sputum smears that are collected in eight – 24 hour intervals (one of which should be an early morning specimen), and/or until 14 days after the initiation of appropriate effective chemotherapy, provided therapy is continued as prescribed, and there is demonstration of clinical improvement (i.e., decreasing cough, reduced fever, resolving lung infiltrates, or AFB smears showing decreasing numbers of organisms.” (Available at: https://www.cdc.gov/tb/programs/laws/menu/isolation.htm)

In its “Guidelines for the prevention of tuberculosis in health care facilities in resource-limited settings” published in 1999, the WHO says, “Ideally, infectious TB patients should be isolated from other patients so that others are not exposed to the infectious droplet nuclei that they generate.”

On discontinuing isolation, it further says that “In settings where MDR-TB is uncommon, those with a diagnosis of sputum-positive pulmonary TB can be considered to be non-infectious and eligible for transfer from isolation or discharge for outpatient management when two criteria are met: they have received appropriate anti-tuberculosis chemotherapy directly observed for a minimum of two weeks and they have shown clinical improvement.”

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

What is IMC Ordinance, its Passage by Lok Sabha and Validity

The Indian Medical Council (Amendment) Bill, 2018, which seeks constitution of a Board of Governors that will exercise the powers of the Medical Council of India (MCI) was passed in the Lok Sabha on Monday. 

The Bill was introduced on December 14 in the Lok Sabha by Union Health and Family Welfare Minister, which was earlier brought in as an ordinance on September 26 this year when the Parliament was not in session. Under the new amendment, the Bill provides for the supersession of the MCI for a period of one year. 

Running the government has now become a new way of ‘ ruling the country via ordinance”. UPA government did the same thing by ruling the MCI through a series of ordinances till they lasted. Once BJP came to power, they again tried bringing NMC (with total administrative control) as an alternative to MCI. They have failed miserably till today and have not been able to pass it in the parliament. So, they decided to go the UPA way by bringing an ordinance on 26^th September, 2018.

Once this is done they are not interested whether NMC Bill gets passed or not. As they have opened the doors of ordinances and its promulgation to do what they want to do. Whoso ever comes back to power they will use the same gateway to run the MCI.

Let’s talk about loopholes in the legal system

An ordinance is an executive order issued by the President of India that holds the same force and effect as an Act passed by the Parliament. The President has the power to issue ordinances under Article 123 of the Constitution. It is the Union cabinet that forwards proposals for issuing ordinances to the President who merely gives his assent.

An ordinance is normally issued only when both Houses of Parliament, Lok Sabha and Rajya Sabha, are not in session. It is meant as a last resort and not a tool to replace the power or functioning of Parliament. Also, ordinances should, generally, be issued only on pressing issues or issues that require immediate consideration but cannot wait for Parliament to assemble and consider the bill.

What was the urgency in this case? NMC bill was already in the Parliament. They could have extended the tenure of the present MCI.

But we all know most ordinances are issued by the government for lack of consensus in Parliament like in the present MCI issue when NMC bill was already in the parliament. If there is a possibility of a bill not being passed in the current session of Parliament, government may choose to take the ordinance route pending its approval by the Parliament during a later session.

An ordinance, once issued, is valid for six weeks from the date of ordinance when the next session of Parliament starts. During this period, Parliament can either pass the ordinance turning it into an Act or disapprove the ordinance. If the ordinance is not passed by Parliament, it can be re-promulgated or re-issued by the President (meaning government).

Lok Sabha has passed in the present case. Now the bill will go to Rajya Sabha and if gets passed, then BoG ruling for one year becomes an act. But if it is not passed in Rajya Sabha it will be re-promulgated or re-issued by the President (meaning government).

There is no limit on how many times an ordinance can be re-issued but as per ruling of the Supreme Court, it cannot be re-promulgated endlessly without getting it to vote in the Parliament or Legislature. President has the power to withdraw the ordinance any time.

An ordinance is only a temporary executive measure. It should not replace the power and function of Parliamentary process and has to be introduced as a bill in the Parliament for its consideration.

Once both houses of Parliament pass the bill, it turns into an Act. This is how a bill that was previously an ordinance becomes an Act of Parliament. However, if one house passes the bill while other disapproves it or sits on it without voting on the bill, a joint session of the Parliament can be called to vote on the bill (this is another alternative with the government but we doubt will happen).

But taking the ordinance route is not on merit as it implies dysfunctional polity where law makers are not able to arrive at a consensus on important national issues.

Personally I feel they will be able to get it passed even in Rajya Sabha because UPA did not have any problem when they were in power. 

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

“You must be the change that you wish to see in the world”

A very Happy New Year 2019

“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”, says the Constitution of the World Health Organization (WHO).

More than seven decades have passed since the WHO Constitution came into force on April 7, 1948; yet, the significance of these words remains undiminished.

Article 25.1 of the Universal Declaration of Human Rights also states: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services …”

Healthcare is a birth right of every citizen of India, as enshrined in Article 21 “Right to life” of the Constitution of India and providing quality health care services to its citizens is the primary responsibility of governments. But, as individuals, we too have a responsibility toward our own health. “We have to be active participants in our own care” (WHO)

Our health is not just determined by eating healthy or regular check-ups or even taking the right medications or vaccinations at the right time.

Health is a product of our environment. This means that the conditions we live in also affect our health. This is why health has been defined as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” by the WHO.

The conditions of day-to-day life i.e. the conditions in which we live, learn, work and age are called the social determinants of health or “the causes of the causes”, which also form important aspects of health.

As individuals, we are not isolated units, but are a part of the society we live in. And, because we live in a community, we are also responsible for the health and well-being of others living in that community. The health of people, plants, animals and environment are interdependent. This is the concept of “One Health”.

Our Vedas teach us that “the whole world is one family” or “Vasudhaiva kutumbakam”. 

This means keeping our neighborhood clean and working to improve the environment that may affect the health of others. Let’s take the example of air pollution, a burning public health issue today. Several studies have demonstrated the association of poor air quality with diseases such as heart disease, chronic airway diseases.

Most of existing pollution levels is man-made, so we also must make individual efforts to control pollution. It is our duty as active members of the society, to adopt measures to help control pollution. We must respect laws of the state in place and abide by them.

Every little step taken at the individual level will only work towards the goodwill of the society as a whole.

So, while I seek better health care from the government as my fundamental right, it is my duty to also contribute to it by being a responsible citizen.

Mahatma Gandhi, the Father of our Nation said, “You must be the change that you wish to see in the world.”

So, on this New Year day, let’s make a resolution to live a healthier life, not only for ourselves, but also for the community.

Here is a resolution we all can make:

“I have a fundamental right to health sans discrimination and taking into consideration all my social determinants of health and respecting my decision to opt for harm prevention or harm reduction. I recognize that I too have a duty to keep pollution levels under control, both indoor and outdoor. I will work towards the health of the environment, plants and animals and consequently my health.”

I wish you good health and happiness in the New Year and in the years to come…….

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Calorie labelling plus public education help to make healthier food choices

Calorie information may alter brain responses to food cues by simultaneously reducing reward system activation and increasing control system activation. Therefore, combining an awareness of calories with the motivation to control them may be more effective in inducing behavioral change with regard to diet.

For the first time, a study has examined the influence of calorie information on brain responses to food images. 

Study participants were randomized into dieting and non-dieting groups. During functional magnetic resonance imaging (fMRI) scanning, the two groups were then showed pictures of food with and without calorie information and they were asked to rate their desire to eat the food.

Researchers observed that the self-reported desire to eat the food decreased when the subjects were shown pictures of food with calorie information. The reward system activation also decreased and the control system activation (the frontoparietal control system) increased.

Whole brain multivariate pattern analysis (MVPA) revealed patterns of activation in the orbitofrontal cortex (a region of the reward system) that were more similar for food images presented with and without calorie information in dieting than non-dieting participants, suggesting that dieters i.e. individuals with greater experience or stronger motivations to consider calorie information may spontaneously consider calorie information when viewing food.

These findings from a new first-of-its-kind study published in the journal PLoS One has demonstrated how the brain makes food choices when calorie information is also presented and thus shows the way for encouraging individuals to maintain a healthy body weight.

(Source: PLos One. 2018;13(11):e0204744; Science Daily, 20 December 2018)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA