Adults can continue to eat their current levels of red meat, as well as processed and unprocessed meats, unless they feel inclined to change their habits for non-nutritional reasons, according to a panel of reviewers who conducted several recent studies and developed a new guideline on the topic.

An editorial accompanying the studies and guideline stated, “This is sure to be controversial, but it is based on the most comprehensive review of the evidence to date. Because that review is inclusive, those who seek to dispute it will be hard pressed to find appropriate evidence with which to build an argument.”

Unprocessed red meat and processed meat are unlikely to be causal factors for adverse health outcomes, although it is possible they have a very small causal effect, the guideline stated. The guideline, editorial, and reviews were published by Annals of Internal Medicine on Oct. 1.

The guideline stated, “Our weak recommendation that people continue their current meat consumption highlights both the uncertainty associated with possible harmful effects and the very small magnitude of effect, even if the best estimates represent true causation, which we believe to be implausible.”

The guideline was developed by a panel based on four de novo systematic reviews that considered evidence on consumption of meat, as well as one review that addressed consumers' beliefs and values about consuming it. The reviews included data from millions of patients.

The first review was a meta-analysis of cohort studies that focused on how dietary patterns, including the amount of red or processed meat consumed, affected all-cause mortality, cardiometabolic outcomes, and cancer incidence and mortality. More than 100 studies including more than six million participants were analyzed. The overall conclusions were that dietary patterns, including differences in meat consumption, may result in only small differences in outcomes over long periods.

The next study was a meta-analysis that looked specifically at cohort studies examining how reductions in red and processed meat might affect cancer incidence and mortality. It included 118 studies with more than six million participants, and it, too, found that the possible impact of reduced meat intake was very small.

The third study was a meta-analysis of cohort studies that looked specifically at meat consumption and its relationship to all-cause mortality and cardiometabolic outcomes and found that any link was very small.

In the fourth analysis, researchers examined randomized controlled trials that compared diets with differing amounts of red meat for at least six months. They found 12 eligible studies, but one of them—the Women's Health Initiative—was so large (almost 49,000 women) that it dominated the analysis. The authors concluded that diets restricted in red meat may have little or no effect on major cardiometabolic outcomes and cancer mortality and incidence, although the certainty of the evidence was low.

Finally, a review of consumers' beliefs about meat consumption found that reasons for eating meat included enjoyment, the belief that meat was essential to a healthy diet, cultural reasons, and disbelief about potential negative health effects.

The editorial said that nutritional epidemiology research often has methodological problems and that it may be time to stop producing observational research in this area. “These meta-analyses include millions of participants. Further research involving much smaller cohorts has limited value,” the editorial said. “High-quality randomized controlled trials are welcome, but only if they're designed to tell us things we don't already know.”

Instead, the editorial continued, a major overhaul of the methods for communicating nutritional data is needed to reach target populations and change health outcomes. One potential takeaway from these studies is that there are many reasons other than health to reduce meat consumption, the editorialists said.

“Ethical concerns about animal welfare can be important, as can concerns about the effects of meat consumption on the environment,” they wrote. “Both of these issues might be more likely to sway people, and they have the added benefit of empirical evidence behind them. And if they result in reducing meat consumption, and some receive a small health benefit as a side effect, everyone wins.” 

courtesy: acpinternist.org

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New Delhi: The Supreme Court Thursday directed refund of air tickets, domestic and international, for travel during the COVID-19 lockdown period from March 25 to May 24 within three weeks from the date of the cancellation of flights.

Accepting the Centre's proposal, the top court directed that if the tickets have been booked through an agent for travel within the lockdown period, in all such cases full refund shall be given by the airlines immediately and the amount shall be passed on immediately by the agent to the passengers.

It said: If on account of financial distress, any airline/airlines are not able to refund then they shall provide credit shell, equal to the amount of fare collected, in the name of passenger when the booking is done either directly by the passenger or through travel agent so as to consume the same on or before March 31, 2021 .

It is open to passengers either to utilise such credit shell up to March 31, 2021 on any route of choice or transfer the credit shell to any person including the travel agent concerned, and the airlines shall honour such a transfer, the top court said.

A bench of Justices Ashok Bhushan, R Subhash Reddy and M R Shah said the suggestions and formulations arrived at the meeting held by the Ministry of Civil Aviation (MCA), Director General of Civil Aviation (DGCA), which are acceptable to the majority of stakeholders have to be implemented in letter and spirit.

We also feel that such formulations are workable solutions in these peculiar circumstances which are prevailing in the country, the bench said, while passing a slew of directions for refund of air tickets to the hassled passengers, whose flights were cancelled due to the pandemic induced lockdown.

The top court's verdict came on a batch of petitions, including by NGOs and passengers associations, seeking complete refund of ticket fare for the flights cancelled.

It said that the court cannot lose sight of the present situation prevailing in the country and across the globe with regard to the effect of the COVID-19 pandemic and any strict enforcement action of Civil Aviation Requirement (CAR) (aviation norms) against the airlines would further restrict their operations.

It cannot be disputed that the civil aviation sector, which is one of the important sectors, is seriously affected in view of the ban imposed for operating flights. Added to the same, air passenger traffic has come down heavily and which is gradually being restored, the top court said.

It added that any such enforcement action may further jeopardise the possibilities of generation of cash by airlines which can further adversely affect/delay the refund cycle.

Strict enforcement of Civil Aviation Requirements at this moment may not yield any meaningful result for any stakeholder, the bench said.

It said that the passengers who booked tickets at any period of time but for travel after May 24, then the refund of fares to the passengers covered under this category shall be governed by the provisions of CAR.

Even for international travel, when the tickets have been booked on an Indian carrier and the booking is ex-India (flights originating from India), if the tickets have been booked during the lockdown period for travel within the lockdown period, immediate refund shall be made, the bench said in its order.

If the tickets are booked for international travel on a foreign carrier and the booking is ex-India during the lockdown period for travel within the lockdown period, full refund shall be given by the airlines and said amount shall be passed on immediately by the agent to the passengers, wherever such tickets are booked through agents, it added.

In all other cases airline shall refund the collected amount to the passenger within a period of three weeks, the bench emphasised and added that the credit shell issued in the name of the passenger shall be transferable which can be utilized up to March 31, 2021 and the concerned airline shall honour such a transfer by devising a mechanism to facilitate such a transfer.

It is also made clear that such a credit shell can be utilized by the concerned agent through whom the ticket is booked, for third party use. It is also made clear that even in cases where the credit shell is transferred to a third party; same is to be utilized only through the agent who has booked the ticket at the first instance, it directed.

Justice Reddy, who penned the verdict on behalf of the bench, said that in cases where passengers have purchased the ticket through an agent, and credit shell is issued in the name of passenger, such credit shell is to be utilized only through the agent who has booked the ticket.

It said that in cases where tickets are booked through agent and credit shell is issued in the name of the passenger remains unutilized till March 31, 2021, then the refund of the fare collected shall be made to the same account from which account amount was received by the airline .

The bench said that in all cases where credit shell is issued there shall be an incentive to compensate the passenger from the date of cancellation up to June 30, 2020 in which event the credit shell shall be enhanced by 0.5 per cent of the face value (the amount of fare collected) for every month or part thereof between the date of cancellation and June 30, 2020.