How to stop dieting, according to people who have done it | CNN

Editor’s Note: This is part of an ongoing series that takes a closer look at eating disorders, disordered eating and relationships with food and body image.



CNN
 — 

Ending cycles of dieting and learning to accept the body you are in sounds great, but it may feel a bit like a fairytale.

How can you control how you eat without counting calories? How should you stop planning for the day when you are thinner? How do you wake up one day without those shameful, mean thoughts knocking at the door to your brain?

It’s hard, said Bri Campos, a body image coach based in Paramus, New Jersey. The goal might not be fully celebrating your body or releasing yourself from all the negative thoughts about weight that comes from diet culture, she said. It could mean just making progress toward feeling less shame or self-criticism.

Diet culture is the widespread societal messages that small bodies are better, larger bodies are shameful and restricted eating is the key to an “acceptable” body. Ascribing to those messages is harmful to people of all body types, especially considering it can encourage eating disorders and make recovery therefrom even more difficult, according to the National Eating Disorder Association.

The promise of attaining (and retaining) the ideal body is hollow, as dropping weight drastically in a short period is likely to be followed by a person gaining it back again. Slow, sustained changes are often more successful, according to a 2017 study. And while some studies do recommend losing weight to reduce the risk of conditions such as heart disease and cancer, it’s also true that health is determined by many factors — shame doesn’t help.

There are ways to unlearn diet culture, Campos said. The process is different for each person, but it can help to find community with other people with similar goals, she added.

Here are several stories of people trying to reject diet culture and what they have found in their journeys along the way.

Shanea Pallone started to question her experience with diet culture after a doctor body-shamed her at an appointment. It’s been hard to be a patient in a medical system that has caused her great harm. “I am actively being harmed by providers who don’t see me as more than my weight on the scale,” Pallone said.

But Pallone, who lives in Houston, Texas, also works as a nurse; her job has required her to assess her patients’ weights, mark if they were considered obese on their medical charts and teach them the same dieting tactics she was trying to unlearn herself, she said.

Pallone recalled constantly asking herself, “How do I navigate my own care and giving good care and still work on unpacking some of the ways diet culture still sinks in?” Her answer included going back to research that showed that dieting wasn’t effective — and confirmed she could live healthfully and provide care without shame.

Learning about intuitive eating — an eating philosophy that relies on the body’s natural hunger and fullness cues — helped her in both her personal and professional journeys.

Changing her thinking doesn’t mean that intrusive thoughts about food and diet completely truly go away, but it has gotten easier to see them and try to quiet them, Pallone said. Now Pallone works to help her patients meet their health goals in a way that doesn’t keep them from the foods they love eating or make them feel like they’ve failed, she said.

But while she has been able to have some meaningful impacts on her patients, she had to accept she could not rescue everyone from diet culture.

“It is really hard to walk away from a woman in her 80s, who is moving toward hospice, who (is) like, ‘It’s really ok that I’m losing weight, I’ve always been a little chunky,’” Pallone said.

Amanda Mittman said the process of shedding diet culture is ongoing.

Amanda Mittman, a registered dietitian in Amherst, Massachusetts, began moving away from diet culture after her son was born. She couldn’t bring herself to return to a restrictive way of eating as a new mother, but still felt shame around the weight she hadn’t lost postpartum, she said.

“We’re all still swimming in the same toxic soup,” she said.

Mittman’s first step was to learn to identify diet culture around her, across entertainment media, in advertisements and even in conversations with friends and family, she said.

And once she saw it — like pulling the curtain back on the Wizard of Oz — she found she couldn’t go back to how she saw things before.

This didn’t mean she was ready to give up on dieting and completely accept her body. Diets had always offered her a magical solution: lose weight and you can have everything you’ve ever wanted. It was scary to give up on that dream — and to face the possibility that, in living differently, she might gain weight instead of losing it.

But as she found a community free of diet culture and moved her social media feeds to not value weight loss, Mittman said accepting the grief and mourning that comes with giving up on those goals became a big part of her process.

“I still have the thoughts of ‘wouldn’t it be great if I could lose weight?’” she said. But she reminds herself, “We have been down that road and that’s just not available to me anymore.”

The work to accept her body and love herself isn’t glamorous, she said. There’s “no cap and gowns, you don’t graduate — this is constant work,” Mittman said. “But it gets easier all the time.”

Sandra Thies' mirror was a big trigger and now is part of her healing.

After years on her college varsity rowing team and trying to shape her body to fit expectations, Sandra Thies found herself a little lost without a strict diet and exercise routine.

“The easy way out is to go on another diet, to buy into diet culture online, to restrict your eating,” Thies said. “It’s the easy way to feel that you have control.”

Much of that desire for control would come out around reflective surfaces, she said.

Whether it was the windows she walked by, mirrors in her work bathroom or even at home when she got out of the shower – all were places for Thies to poke and prod at her body, to see if she needed to work out or if she could give herself a little extra at dinner. And days wrestling with her reflection would lead to nights spent staring up at the ceiling, thinking about what she could do better the next day to get closer to her “ideal” body.

Thies, now an intuitive eating counselor in Kelowna, British Columbia, came across the concept in college and remembers thinking, “wouldn’t it be nice to be at peace with food and your body?” Four years later, she feels like she’s still learning how to move in a way that feels good, how to eat what her body needs and how to stand in front of her reflection without picking it apart.

But the mirror has actually become part of her solution, she said.

She has questions now written on her mirror at home: “What is the feeling? Where do you feel it in your body? How bad is it? Can we sit in this discomfort? What do you need in the moment?”

She now tries to take time to sit with those feelings. Sometimes, she can get through answering all the questions. But on the days she can’t, Thies said she gives herself permission to do what she can to keep her self-talk positive.

“I think about my body and food very frequently,” Thies said. “But the voice that I use has really changed. It leaves me feeling confident and empowered rather than broken down.”

Dani Bryant said she saw her own body in the women that came before her.

Dani Bryant thought her experiences with her body would threaten to her creative dreams, but instead they turned out to be an avenue to get there.

As a kid passionate about theater, Bryant heard similar messages from her directors, chorus teachers and costumers: You are so talented, but your body has to be smaller if you want to make it big.

She was only a 9-year-old when she first showed signs of disordered eating. By her sophomore year of college pursuing a career in theater, she had developed anorexia, Bryant said.

As part of Bryant’s recovery, she began writing and developed a theater company in Chicago centered around the experiences of body issues and disordered eating, Bryant said. There she found the support she felt was key to her developing relationship with her body.

“My healing is so much in sharing the lived experience, building community around it and that slow unlearning,” she said.

Bryant said finding a photo of her family coming to the US gave her better perspective on her own body.

One big moment in Bryant’s healing journey came when she went with her mother on a trip to Ellis Island in New York City, where they happened across a photograph of her family arriving in the United States generations ago.

In the photo, she saw her great grandmother, whose body was shaped just like her grandmother’s, her mother’s and her own, Bryant said.

There she realized her body was more than her choices or her dieting — it was the result of her family, genetics and her history.

She wished she could go back to the little girl she once was to show her that picture and ask her to stop fighting the “unwinnable war” for a smaller body she was never meant to have, she said.

Source link

#stop #dieting #people #CNN

High-quality bone broth comes ready-made. Here’s why you should make it yourself | CNN

Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



CNN
 — 

After everyone at your table has devoured the juiciest pieces of a roast chicken and you’ve treated your canine to the edible rejects, hold off on sliding that picked-over carcass into the trash. Your bird has another gift for you: broth.

Making homemade broth requires only a few minutes of your time, and the benefits extend far beyond sensory pleasure: to your health, wealth, and even the world around you.

For centuries, humans have been simmering otherwise inedible animal parts in water, sometimes for days, extracting maximum flavor and nutrients from those bones for nourishing meals to come. Thrifty grandmas and chefs the world over have refined that technique, adding vegetables and seasonings reflecting their cultures and customs. Traditional recipes earned reputations for purported healing powers.

Over the last few decades, followers of the Paleo diet have incorporated 24-hour broth-making into their everyday kitchen routines, often sipping on their extra-strength broth as a gluten-free pick-me-up in place of coffee and tea — both of which are off-limits on their regimen.

New York City chef and Food Network personality Marco Canora turned to bone broth — which was regularly available to him at his popular restaurant, Hearth — to help him combat the effects of years of poor lifestyle habits. In 2014, he opened a takeout window called Brodo (Italian for broth) to sell to-go cups of his chef-crafted potions as beverages. He went on to write a book about it and sell it prepackaged and frozen nationwide.

Breathless testimonies from celebrity influencers of bone broth’s purported magical powers — from easing joint pain to reducing wrinkles to improving gut health — flooded the internet. Products labeled “bone broth” popped up on supermarket shelves. The trend shows no sign of abating. When last checked, TikTok videos with the hashtag #bonebroth had received more than 158 million views.

Some dietitians and medical professionals agree that bone broth can be a worthy addition to a balanced diet — supplying collagen and other important nutrients. But given that every bone broth recipe and human body are different, specific health claims linked to bone broth should be taken with a grain of salt.

I had been skeptical of the hype all along, and uninterested in exploring it for myself, until I made a batch last fall by accident while cleaning up after Thanksgiving dinner. Unable to find room in the fridge for the half-eaten turkey, I sawed off the remaining sandwich-worthy slices and dumped the picked-off carcass and grisly parts into my slow cooker, along with half an onion and a few odds and ends from the crisper.

I set the cooker to low and left it alone for a full 24 hours, giving me time to recuperate from the previous festivities while basking in the tantalizing fragrances wafting from the kitchen.

The first taste of the finished broth blew me away — richer and more complex than any packaged product or broth I’d made from scratch on top of my stove in a fraction of the time. I could practically feel the nourishment coursing through my bones. I placed the strained broth in the fridge and was happy to find it congealed to a jiggly consistency the next day, a clear sign that those picked-off turkey parts had done their job. And now I had the foundation for restaurant-quality gumbo made almost entirely with remains of the feast: a win-win all the way around.

My curiosity was piqued. So what if bone broth wasn’t the cure-all it was cracked up to be. It was wholesome, grocery-stretching and most importantly to me, freaking delicious. I wanted to figure out how to reap the full spectrum of advantages bone broth had to offer. I turned to experts for guidance.

Linton Hopkins, a James Beard Award-winning chef who helms the newly reopened Holeman & Finch Public House in Atlanta along with other high-profile spots in the South, learned the craft the classic way at the Culinary Institute of America.

“As a chef and a cook, I don’t feel good without a stock going. It’s one of my things,” Hopkins said. “We make all our stocks at our restaurants. And I do it all the time at home for me and my wife, Gina. They’re the easiest thing in the world. I’ll roast a whole chicken, we’ll eat what we can, and the rest will go right into the Instant Pot. I did the same thing with the bones from a beef roast last night. I’m no doctor, but I know good food is good for your life.”

Besides taste and nutrition, broth-making  can be a sound economic decision for the budget-conscious.

The terms “stock” and “broth” are often used interchangeably, Hopkins noted. But stocks typically indicate a higher bone-to-meat ratio. Broths can even be made with just the meat. “But as a whole-animal, whole-vegetable cook, all my stocks and broths are essentially bone broth. I see stock as an ingredient I cook with. Broth to me is a finished word — meaning it’s ready to serve in a bowl as is.”

Aside from taste and nutrition, he views stock- and broth-making as both an economic decision and an ethical responsibility.

“In the restaurant business, the margins are very thin, so we have to strive for zero waste,” he said. “We ask a lot of an animal to give its life for our diets. If we’re going to bring these items into our kitchens and throw them away after a single use, then we’re part of the problem.”

Michelle Tam grew up in a traditional Cantonese American household in California’s Bay Area where her mother served multicourse meals that always ended with soup.

“And she would always throw a bone in there. I remember as a kid we would walk down to the neighborhood butcher, and he would step out of the freezer with this giant plastic bag of bones for 25 cents,” Tam said. “We would get a variety of different kinds of bones with some meat left on them that would flavor the soup, and it was really delicious.”

But it wasn’t until she and her husband began eliminating processed foods from their diets and replacing them with wholesome ones as part of a fitness regimen that she considered making broth from scratch herself. “I don’t know that it’s some magical elixir,” said Tam, a former clinical pharmacist who now creates recipes full time for her popular Nom Nom Paleo blog and spin-off cookbooks. “But it’s a great source of collagen, which most people don’t get enough of and is really important for joints and gut health and all that stuff.”

Chicken feet can be among the tasty bone broth ingredients, providing a great source of collagen.

Collagen is the main constituent of connective tissue fibrils and bones that releases gelatin into liquid as it cooks. It’s most abundant in skin, feet, joints, marrow and knuckles. Tam may mix parts from different animals — lamb, pork, beef, chicken. The results, she said, are inevitably tasty.

“I’m always collecting chicken thigh bones, and I buy chicken feet when I see them at the butcher,” she said. Chicken feet contain tons of collagen, she said. But she warned not to go overboard, or you may wind up with a rubber ball. “I tried that, and it wasn’t delicious. One or two should do the trick. I also like to include something meaty for flavor, like a chicken leg. And chicken wings are excellent.”

Because bone broth can be “a spectacular growth medium for bacteria,” Tam refrigerates hers as soon as it reaches room temperature, and whatever isn’t consumed within a few days goes into the freezer. She offers ways to store bone broth conveniently and safely in usable portion sizes (she’s tried muffin tins, ice cube trays and silicone baking molds) and recipes for her favorite ways of using broth in a super-simple egg drop soup and slow cooker Korean short ribs on her blog.

With her multi-cooker, Tam can now produce collagen-rich bone broth in as little as an hour. But she’s not above buying bone broth ready-made when time is short or personal bone supplies are low, now that she’s found several brands she can trust. Roli Roti, which began as a food truck in the Bay Area selling rotisserie chicken, contains only a couple of ingredients and is “super high quality and super gelatinous.” Bonafide Provisions, found in many supermarket freezer sections, has become another standby.

Cassy Joy Garcia, a certified holistic nutritionist and New York Times best-selling cookbook author, became a fan of bone broth more than a decade ago during her marathon-running days and writes about it regularly on her healthy lifestyle blog, Fed + Fit.

“I think bone broth is getting some new attention now with grocery prices on the rise and people wanting to do more with less,” Garcia said. “I feel like it’s an easy entry point for some good DIY kitchen basics. If you’ve already roasted a chicken, just go ahead and throw that carcass in your pot or pressure cooker along with that random onion in the pantry and scraggly carrot in the fridge, and lo and behold, you’re going to save yourself some money and have broth that tastes better and is better for you than anything you’d buy.”

Toss in vegetable scraps from your fridge such as carrots and celery when preparing a bone broth.

She collects leftover bones from roasted meats and chicken in silicone freezer bags and keeps a veggie bowl at the forefront of her fridge for tossing in vegetable scraps, peels and all that could go into a homemade broth.

Now with more mouths to feed as a mother of three preschoolers, she does allow herself to take a shortcut from time to time with a quality premade product. One of her favorites is Fond sipping broth made of grass-fed beef and pasture-raised chicken bones, which come in flavor combinations such as ginger and cayenne, and shiitake and sage.

“They’re definitely a luxury product,” she said. “But they’re really a cool way to show what a broth can be and can open our eyes to exploring different flavors we can play with at home.”

On her blog, Garcia offers a detailed guide to making beef and chicken bone broth, and a slightly more complex one boosted with turmeric and ginger, which she uses for making her favorite chicken soup.

She gives you the options for making the broth in various vessels but makes no bones about her preference for her high-speed pressure cooker.

As for myself, I’m sticking to my slow cooker for now, content to inhale those 24-hour aromatics all day and allow them to soothe me to sleep.

Since Thanksgiving, I’ve made several more batches of bone broth following advice from the experts and falling down many rabbit holes of online research along the way.

I’ve been patronizing the nearby international farmers market more often to seek out a variety of bones from animals that have been responsibly raised without harmful chemicals that could negate my broth’s potential health benefits.

Freeze whatever hasn't been consumed of your bone broth within a few days of making it.

Some purists only use bones and water, giving them more flexibility to add layers of flavor later. But I can’t resist throwing in a few extras to amp up the nutritional and flavor profile (roasted mushrooms and a splash of red wine for beef, fresh ginger and turmeric for chicken, and always extra cloves of garlic).

I’ve made a habit of stashing yogurt containers of my finished products, along with baggies of leftover bones and trimmings, so long as space permits in my freezer.

Serious chefs boil the bones first to rid them of some of the impurities and then caramelize them in a 400- to 450-degree oven to deepen their flavors before proceeding. One day maybe I’ll find the motivation to give that a try.

I have quickly learned that, as easy and satisfying as bone broth is to make, I’m lucky if I can produce 2 quarts at a time — barely enough for one batch of soup or gumbo. But I wasn’t planning to replace my morning coffee with steaming broth anyway. And if I’m really hankering for the real deal before I get around to making another batch, I’m happy to have discovered I can buy Roli Roti, the brand Tam recommended, in the meat department of my neighborhood Publix.

You don’t have to follow any recipe to make bone broth. But it does help to have some guidance until you get the hang of it. Here’s the basic formula I’ve been loosely going by based on several recipes I’ve studied. Feel free to deviate with what the local butcher needs to dispense of, or what’s soon to go south in your fridge. Mother Earth will be grateful.

Susan Puckett’s recipe for bone broth is highly flexible. If you have no leftover bones, chicken or turkey wings, drumsticks, necks and gizzards also work great. For extra collagen, a few chicken feet will do the trick. For beef broth, follow the same procedure as for chicken. Or feel free to use bones from other animals as well — lamb, pork, game. Larger bones will take longer to break down so you may want to allow more simmering time.

Makes roughly 2 quarts (or more, if you have a larger vessel)

2-3 pounds roasted or raw chicken or beef bones, or a combination

2 carrots, cut up

2 celery stalks, cut up

1 medium unpeeled onion, halved

5 unpeeled garlic cloves, smashed

2 bay leaves

1 teaspoon salt

1 teaspoon peppercorns

2 tablespoons cider vinegar

Water

1. Place the bones, carrots, celery, onion, garlic, bay leaves, salt, peppercorns and vinegar in a slow cooker (mine holds 6 quarts) and add enough water so bones are submerged but not floating.

2. Cover with the lid and let simmer on low setting for 12 to 24 hours.

3. Skim off any scum that’s collected on the surface. Turn off the heat and let it cool slightly. Discard the solids (picking out edible meat bits for yourself or the dog.)

4. Set a large fine-mesh sieve over a large bowl, strain and let it cool to room temperature. Cover and refrigerate. Scrape off the fat that congeals on the surface.

5. Use within four to five days or transfer to jars or plastic containers, label and freeze for up to five months. (Or pour the broth into ice cube trays, muffin tins or silicone molds, and freeze and pop them out into freezer bags.)

Source link

#Highquality #bone #broth #readymade #Heres #CNN

What’s the magic number of steps to keep weight off? Here’s what we know | CNN

Editor’s Note: Sign up for CNN’s Fitness, But Better newsletter series. Our seven-part guide up will help you ease into a healthy routine, backed by experts.



CNN
 — 

Taking 8,600 steps a day will prevent weight gain in adults, while already overweight adults can halve their odds of becoming obese by adding an additional 2,400 steps — that’s 11,000 steps a day, according to an October 2022 study.

Studies show the average person gains between 1 and 2 pounds (0.5 to 1 kilograms) each year from young adulthood through middle age, slowly leading to an unhealthy weight and even obesity over time.

“People really can reduce their risk of obesity by walking more,” said study author Dr. Evan Brittain, associate professor in the division of cardiovascular medicine at Vanderbilt University Medical Center in Nashville.

The study also found key benefits for chronic diseases and conditions: “Diabetes, sleep apnea, hypertension, diabetes, depression, and GERD showed benefit with higher steps,” said Brittain via email.

“The relationship with hypertension and diabetes plateaued after about 8,000 to 9,000 steps but the others were linear, meaning higher steps continued to reduce risk,” he said. “I would say that the take home messages are that more steps are better.”

It’s yet another study illustrating the powerful impact that walking and other forms of exercise have on our health. In fact, if you get up and move for 21.43 minutes each day of the week, you cut your risk of dying from all causes by one-third, according to the US Centers for Disease Control and Prevention.

Current physical activity recommendations for adults are 150 minutes of moderate-intensity exercise, such as brisk walking, dancing, bicycling, doubles tennis and water aerobics, and two days of muscle-strengthening activity each week.

“Physical activity is just absolutely magnificent,” Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, told CNN in an earlier interview.

“And when if you blend that with eating a more plant-based diet, de-stressing, sleeping enough and connecting with others — that’s your magic recipe,” Freeman said. “It’s the fountain of youth, if you will.”

Activity trackers allow researchers to get more accurate data that can be compared with health records.

The study analyzed an average of four years of activity and health data from more than 6,000 participants in the National Institutes of Health’s All of Us Research Program, dedicated to research on ways to develop individualized health care.

Participants in the study, published on October 10, 2022, in the journal Nature Medicine, wore activity trackers at least 10 hours a day and allowed researchers access to their electronic health records over multiple years.

“Our study had an average of 4 years of continuous activity monitoring. So, we were able to account for the totality of activity between when monitoring started and when a disease was diagnosed, which is a major advantage because we didn’t have to make assumptions about activity over time, unlike all prior studies,” Brittain said.

People in the study ranged in age from 41 to 67 and had body mass index levels from 24.3, which is considered in the healthy weight range, to 32.9, which is considered obese.

Researchers found that people who walked 4 miles a day — about 8,200 steps — were less likely to become obese or suffer from sleep apnea, acid reflux and major depressive disorder. Sleep apnea and acid reflux respond well to weight loss, which can reduce pressure on the throat and stomach, while exercise is a cornerstone treatment for depression.

The study also found that overweight participants (those with BMIs ranging from 25 to 29) cut their risk of becoming obese by half if they increased their steps to 11,000 steps a day. In fact, “this increase in step counts resulted in a 50% reduction in cumulative incidence of obesity at 5 years,” the study found.

Applying the data to a specific example, the authors said individuals with BMIs of 28 could lower their risk of obesity 64% by increasing steps from about 6,000 to 11,000 steps per day.

This research echoes results from a recent study in Spain in which researchers found health benefits rose with every step until about 10,000 steps, when the effects began to fade. Counting steps may be especially important for people who do unstructured, unplanned physical activity such as housework, gardening and walking dogs.

“Notably, we detected an association between incidental steps (steps taken to go about daily life) and a lower risk of both cancer and heart disease,” study coauthor Borja del Pozo Cruz told CNN in an earlier interview. Del Pozo Cruz is an adjunct associate professor at the University of Southern Denmark in Odense and senior researcher in health sciences for the University of Cadiz in Spain.

The same research team also published a similar study in September 2022 that found walking 10,000 steps a day lowered the risk for dementia by 50%; the risk decreased by 25% with as few as 3,800 steps a day.

However, if walking occurred at a brisk pace of 112 steps a minute for 30 minutes, it maximized risk reduction, leading to a 62% reduction in dementia risk. The 30 minutes of fast-paced walking didn’t have to occur all at once either — it could be spread out over the day.

Researchers found the association between peak 30-minute steps and risk reduction to be dependent on the disease studied: There was a 62% reduction for dementia, an 80% decline for cardiovascular disease and death, and about a 20% drop in risk for cancer.

The study also found an association between step intensity and health benefits as well, “although the relationships were less consistent than with step counts,” researchers said.

A major limitation of all studies using step trackers is that people who wear them tend to be more active and healthier than the norm, the researchers said. “Yet the fact that we were able to detect robust associations between steps and incident disease in this active sample suggests even stronger associations may exist in a more sedentary population,” they said.

Source link

#Whats #magic #number #steps #weight #Heres #CNN

Restrict calories to live longer, study says, but critics say more proof is needed | CNN



CNN
 — 

People of normal weight may be able to extend their life span by restricting calories, according to a new study that attempted to measure the pace of aging in people asked to cut their calorie intake by 25% over two years.

“We’ve known for nearly 100 years that calorie restriction can extend healthy life span in a variety of laboratory animals,” said senior author Daniel Belsky, an associate professor of epidemiology at Columbia University Mailman School of Public Health.

“It does this by changing biology in ways consistent with a slowing of the process of aging, although the specific mechanisms of how this occurs are still under investigation,” said Belsky, who studies longevity. “We decided to drill down to the cellular level in people to see if the same is true.”

The study used what are commonly known as “biological clocks” to determine the pace of aging in its participants. Bioclocks are designed to measure how old people are biologically compared with their real ages chronologically.

“Our study found evidence that calorie restriction slowed the pace of aging in humans,” said colead author Calen Ryan, an associate research scientist at the Robert N. Butler Columbia Aging Center at Columbia.

“Our findings are important because they provide evidence from a randomized trial that slowing human aging may be possible,” Ryan said in a statement.

But longevity scientist Dr. Peter Attia dismissed the study results as “noise.”

“I just don’t see any evidence that any of the biologic clocks have meaning,” Attia, who was not involved in the study, said via email. He hosts “The Drive,” a podcast dedicated to explaining and applying longevity research to everyday life.

“The only validation that matters — which to my knowledge has not been done, but hopefully will be — is to see if ‘biologic age’ can predict future life better than chronological age,” he said.

Biological age predictors are controversial, said calorie restriction researcher Pankaj Kapahi, a professor at the Buck Institute for Research on Aging in Novato, California.

“At best, they’re telling you something about a very small aspect of aging,” said Kapahi, who was not involved in the study. “For example, grip strength is also a biological age predictor, how active you are is a predictor, and we all know people who fall apart physically but are cognitively all there, so you also need to test cognitive aging.

“Some researchers are trying to boil it down with bio-aging tests,” he added. “This is a much more complex problem, and I think it’s an overstatement to say the tests really predict biological age.”

Decades of research in animals have shown that calorie restriction produces health benefits, even slowing the pace of aging. Would the same be true in people?

A study in the 1950s asked people to reduce 50% of their calories, leading to malnutrition or a lack of key micronutrients in participants. Later research often focused on calorie reduction in people whose body mass index would be considered medically obese.

The first clinical trial of calorie restriction in people at normal weight (a BMI of about 20 to 25) started in 2007. It was called CALERIE, or the Comprehensive Assessment of Long-Term Effects of Reducing Intake of Energy.

Because of the malnutrition found in the earlier study that cut calories drastically, CALERIE asked 143 adults between the ages of 21 and 50 to cut 25% of the calories they typically ate for a two-year period. Another group of 75 people maintained their normal diets, serving as a control group.

During the trial, all manner of tests were done at six-month intervals to gather information on weight loss, change in resting metabolic rate, impact on cognitive function and markers of inflammation, cardiovascular health and insulin sensitivity.

The results of CALERIE, published in 2015, found that on average people in the restricted group were able to cut 14% of their calories, or about half of the 25% goal. However, that amount reduced their fat mass by about 10% and decreased their cardiometabolic risk factors with no adverse effects on quality of life, researchers said. There were also reductions in tumor necrosis factor alpha, a protein that promotes insulin resistance and obesity-induced type 2 diabetes.

A number of other studies have used blood samples and other data collected on the CALERIE participants to explore other ways modest calorie restriction might benefit the body. For example, Yale University researchers found restricting calories increased the health of the thymus, an organ that produces immune system T cells — one of the body’s key warriors against invaders.

The new study, published Thursday in the journal Nature Aging, culled DNA sequences from white blood cells taken at 12-month intervals from participants in CALERIE. Belsky’s team then analyzed methylation marks — signs of epigenetic changes — on the DNA, looking for symptoms of aging.

Epigenes are proteins and chemicals that sit like freckles on each gene, waiting to tell the gene “what to do, where to do it, and when to do it,” according to the National Human Genome Research Institute.

“Increasingly, changes to our cells’ epigenomes, the systems that control which genes in the genome are turned on and off, are being recognized as drivers of the aging process,” said anti-aging expert David Sinclair, a professor of genetics in the Blavatnik Institute at Harvard Medical School and codirector of the Paul F. Glenn Center for Biology of Aging Research.

“Clocks that measure these changes are proving to be indicators of future health and what interventions might slow and even reverse the aging process,” said Sinclair, who was not involved in the study.

In the new study, researchers used two epigenetic clocks — PhenoAge and GrimAge — and a new tool Belsky recently invented in conjunction with Duke University. This third bioclock, called DunedinPACE, attempts to determine the pace of aging from a single blood test, Belsky said.

The PhenoAge and GrimAge bioclocks showed no signs of reduced aging in the blood samples of participants in CALERIE, said Belsky, who is also a scientist with Columbia’s Robert N. Butler Aging Center.

However, DunedinPACE, the clock created by Belsky’s and Duke’s teams, did find a 2% to 3% reduction in the pace of aging, “which in other studies translates to a 10-15 percent reduction in mortality risk, an effect similar to a smoking cessation intervention,” according to a statement from Columbia.

Critics of the study, however, were not impressed. The performance of the DunedinPACE test was “mediocre at best,” Attia said, finding only a weak association with biological aging.

The fact that the two other bioclocks found no anti-aging benefits was no surprise, said the Buck Institute’s Kapahi: “These biological age predictors don’t agree with each other and don’t necessarily agree with other biological measures.

“It’s going to confuse the public, and unfortunately people are buying these tests when there’s very little useful information that comes out of them.”

While it’s true epigenetic biomarkers are not yet ready to be used in clinical trials, “many different studies in many different datasets and populations have shown these algorithms are predictive of differences between people in who gets sick and who lives or dies,” Belsky countered.

“This is not a game over moment. It’s more like game on,” Belsky said. “What we have now is a proof of concept — a methylation biomarker that shows faster aging in people we know to be at higher risk for disease, disability and death, and slower aging in people who we know to be at lower risk.”

Putting aside the debate over how slower aging is measured, there is a role for caloric restriction in extending life, especially in “overnourished” individuals, Attia said.

“I don’t want a reader to think this intervention (calorie restriction) is of no value, only that (the study) does not ‘prove’ a reduction in the pace of aging,” he said in an email.

Time-restricted eating and dietary restriction of certain foods are two additional ways to curb “overnutrition,” which Attia believes is the biggest driver of insulin resistance, type 2 diabetes and other chronic diseases.

“I am not aware of any evidence that one ‘strategy’ or method is superior. The best one is the one that works for a person, but calorie restriction certainly works for some, and therefore is clearly beneficial,” Attia said. “All of these interventions will lead to a longer and better life, but these aging clocks tell us less than zero about that process.”

There are many other ways to curb aging as well, Kapahi said.

“We’re trying to learn more about aging and we are, but calorie restriction is just one intervention,” he said. “You likely need to do that in combination with exercise, with good sleep, with a positive attitude and good mental health. All these things combined will likely play a much bigger role in slowing aging.”

Source link

#Restrict #calories #live #longer #study #critics #proof #needed #CNN

For the first time, US task force proposes expanding high blood pressure screening recommendations during pregnancy | CNN



CNN
 — 

The US Preventive Services Task Force has released a draft recommendation to screen everyone who is pregnant for hypertensive disorders of pregnancy, by monitoring their blood pressure throughout the pregnancy, and the group is calling attention to racial inequities.

This is the first time the task force has proposed expanding these screening recommendations to include all hypertensive disorders of pregnancy, which are on the rise in the United States.

It means the average person might notice their doctor paying closer attention to their blood pressure measurements during pregnancy, as well as doctors screening not just for preeclampsia but for all disorders related to high blood pressure.

The draft recommendation statement and evidence review were posted online Tuesday for public comment. The statement is consistent with a 2017 statement that recommends screening with blood pressure measurements throughout pregnancy.

It was already recommended for blood pressure measurements to be taken during every prenatal visit, but “the difference is now really highlighting the importance of that – that this is a single approach that is very effective,” said Dr. Esa Davis, a member of the task force and associate professor of medicine at the University of Pittsburgh.

The draft recommendation urges doctors to monitor blood pressure during pregnancy as a “screening tool” for hypertensive disorders, she said, and this may reduce the risk of some hypertensive disorders among moms-to-be going undiagnosed or untreated.

“Since the process of screening and the clinical management is similar for all the hypertensive disorders of pregnancy, we’re broadening looking at screening for all of the hypertensive disorders, so gestational hypertension, preeclampsia, eclampsia,” Davis said.

The US Preventive Services Task Force, created in 1984, is a group of independent volunteer medical experts whose recommendations help guide doctors’ decisions. All recommendations are published on the task force’s website or in a peer-reviewed journal.

To make this most recent draft recommendation, the task force reviewed data on different approaches to screening for hypertensive disorders during pregnancy from studies published between January 2014 and January 2022, and it re-examined earlier research that had been reviewed for former recommendations.

“Screening using blood pressure during pregnancy at every prenatal encounter is a long-standing standard clinical practice that identifies hypertensive disorders of pregnancy; however, morbidity and mortality related to these conditions persists,” the separate Evidence-Based Practice Center, which informed the task force’s draft recommendation, wrote in the evidence review.

“Most pregnant people have their blood pressure taken at some point during pregnancy, and for many, a hypertensive disorder of pregnancy is first diagnosed at the time of delivery,” it wrote. “Diagnoses made late offer less time for evaluation and stabilization and may limit intervention options. Future implementation research is needed to improve access to regular blood pressure measurement earlier in pregnancy and possibly continuing in the weeks following delivery.”

The draft recommendation is a “B recommendation,” meaning the task force recommends that clinicians offer or provide the service, as there is either a high certainty that it’s moderately beneficial or moderate certainty that it’s highly beneficial.

For this particular recommendation, the task force concluded with moderate certainty that screening for hypertensive disorders in pregnancy, with blood pressure measurements, has a substantial net benefit.

Hypertensive disorders in pregnancy appear to be on the rise in the United States.

Data published last year by the US Centers for Disease Control and Prevention shows that, between 2017 and 2019, the prevalence of hypertensive disorders among hospital deliveries increased from 13.3% to 15.9%, affecting at least 1 in 7 deliveries in the hospital during that time period.

Among deaths during delivery in the hospital, 31.6% – about 1 in 3 – had a documented diagnosis code for hypertensive disorder during pregnancy.

Older women, Black women and American Indian and Alaska Native women were at higher risk of hypertensive disorders, according to the data. The disorders were documented in approximately 1 in 3 delivery hospitalizations among women ages 45 to 55.

The prevalence of hypertensive disorders in pregnancy was 20.9% among Black women, 16.4% among American Indian and Alaska Native women, 14.7% among White women, 12.5% among Hispanic women and 9.3% among Asian or Pacific Islander women.

The task force’s new draft recommendation could help raise awareness around those racial disparities and how Black and Native American women are at higher risk, Davis said.

“If this helps to increase awareness to make sure these high-risk groups are screened, that is something that is very, very important about this new recommendation,” she said. “It helps to get more women screened. It puts it more on the radar that they will then not just be screened but have the surveillance and the treatment that is offered based off of that screening.”

Communities of color are at the highest risk for hypertensive disorders during pregnancy, and “it’s very related to social determinants of health and access to care,” said Dr. Ilan Shapiro, chief health correspondent and medical affairs officer for the federally qualified community health center AltaMed Health Services in California. He was not involved with the task force or its draft recommendation.

Social determinants of health refer to the conditions and environments in which people live that can have a significant effect on their access to care, such as their income, housing, safety, and not living near sources for healthy food or easy transportation.

These social determinants of health, Shapiro said, “make a huge difference for the mother and baby.”

Hypertensive disorders during pregnancy can be controlled with regular monitoring during prenatal visits, he said, and the expectant mother would need access to care.

Eating healthy foods and getting regular exercise also can help get high blood pressure under control, and some blood pressure medications are considered safe to use during pregnancy, but patients should consult with their doctor.

Source link

#time #task #force #proposes #expanding #high #blood #pressure #screening #recommendations #pregnancy #CNN

Cancer is striking more people in their 30s and 40s. Here’s what you need to know | CNN



CNN
 — 

It’s World Cancer Day, and the outlook for winning the war against this deadly disease is both good and bad.

In the United States, deaths from cancer have dropped 33% since 1991, with an estimated 3.8 million lives saved, mostly due to advances in early detection and treatment. Still, 10 million people worldwide lost their lives to cancer in 2020.

“During the last three years, the No. 1 leading leading cause of death in the world was actually cancer, not Covid-19,” said Dr. Arif Kamal, chief patient officer for the American Cancer Society.

Symptoms of cancer can mimic those of many other illnesses, so it can be difficult to tell them apart, experts say. Signs include unexplained weight loss or gain, swelling or lumps in the groin, neck, stomach or underarms and fever and night sweats, according to the National Cancer Institute.

Bladder, bowel, skin and neurological issues may be signs of cancer, such as changes in hearing and vision, seizures, headaches and bleeding or bruising for no reason, the institute said. But most cancers do not cause pain at first, so you can’t rely on that as a sign.

“We tell patients that if they have symptoms that do not get better after a few weeks, they should visit a doctor,” Kamal said. “It doesn’t mean the diagnosis will be cancer, however.”

Rather than wait for symptoms, the key to keeping cancer at bay is prevention, along with screenings to detect the disease in its early stages. That’s critical, experts say, as new cases of cancer are on the rise globally.

A surprising number of new diagnoses are in people under 50, according to a 2022 review of available research by Harvard University scientists.

Cases of breast, colon, esophagus, gallbladder, kidney, liver, pancreas, prostate, stomach and thyroid cancers have been increasing in 50-, 40- and even 30-year-olds since the 1990s.

That’s unusual for a disease that typically strikes people over 60, Kamal said. “Cancer is generally considered an age-related condition, because you’re giving yourself enough time to have sort of a genetic whoopsie.”

Older cells experience decades of wear and tear from environmental toxins and less than favorable lifestyle choices, making them prime candidates for a cancerous mutation.

“We believed it takes time for that to occur, but if someone is 35 when they develop cancer, the question is ‘What could possibly have happened?’” Kamal asked.

No one knows exactly, but smoking, alcohol consumption, air pollution, obesity, a lack of physical activity and a diet with few fruits and vegetables are key risk factors for cancer, according to the World Health Organization.

Add those up, and you’ve got a potential culprit for the advent of early cancers, the Harvard researchers said.

“The increased consumption of highly processed or westernized foods together with changes in lifestyles, the environment … and other factors might all have contributed to such changes in exposures,” the researchers wrote in their 2022 review.

“You don’t need 65 years of eating crispy, charred or processed meat as a main diet, for example,” Kamal added. “What you need is about 20 years, and then you start to see stomach and colorectal cancers, even at young ages.”

So how do you fight back against the big C? Start in your 20s, Kamal said.

Many of the most common cancers, including breast, bowel, stomach and prostate, are genetically based — meaning that if a close relative has been diagnosed, you may have inherited a predisposition to develop that cancer too.

That’s why it’s critical to know your family’s health history. Kamal suggests young people sit down with their grandparents and other close relatives and ask them about their illnesses — and then write it down.

“The average person doesn’t actually know the level of granularity that is helpful in accessing risk,” he said.

“When I talk to patients, what they’ll say is, ‘Oh, yeah, Grandma had cancer.’ There’s two questions I want to know: At what age was the cancer diagnosed, and what specific type of cancer was it? I need to know if she had cancer in her 30s or 60s, because it determines your level of risk. But they often don’t know.”

The same applies to the type of cancer, Kamal said.

“People often say ‘Grandma had bone cancer.’ Well, multiple myeloma and osteosarcoma are bone cancers, but both of them are relatively rare,” he said. “So I don’t think Grandma had bone cancer. I think Grandma had another cancer that went to the bone, and I need to know that.”

Next, doctors need to know what happened to that relative. Was the cancer aggressive? What was the response to treatment?

“If I hear Mom or Grandma was diagnosed with breast cancer at 40 and passed away at 41, then I know that cancer is very aggressive, and that changes my sense of your risk. I may add additional tests that aren’t in the guidelines for your age.”

Cancer screening guidelines are based on population-level assessments, not individual risk, Kamal said. So, if cancer (or other conditions such as heart disease, diabetes, Alzheimer’s, or even migraines) runs in the family, you become a special case and need a personalized plan.

“And I will tell you the entire scientific community is observing this younger age shift for different cancers and is asking itself: ‘Should guidelines be more deliberate and intentional for younger populations to give them some of this advice?”

closeup of a young caucasian doctor man with a pink ribbon for the breast cancer awareness pinned in the flap of his white coat; Shutterstock ID 724387357; Job: CNN Digital

Report: Black women more likely to die from breast cancer

If your family history is clear of cancer, that lowers your risk — but doesn’t remove it. You can decrease the likelihood of cancer by eating a healthy, plant-based diet, getting the recommended amount of exercise and sleep, limiting alcohol consumption and not smoking or vaping, experts say.

Protecting yourself from the sun and tanning beds is key, too, as harmful ultraviolet rays damage DNA in skin cells and are the prime risk factor for melanoma. However, skin cancer can show up even where the sun doesn’t shine, Kamal said.

“There’s been an increase of melanoma that’s showing up in non-sun-exposed areas such as the underarm, the genital area and between the toes,” he said. “So it’s important to check — or have a partner or dermatologist check — your entire body once a year.”

Skin check: Take off all your clothes and look carefully at all of your skin, including the palms, soles of feet, between toes and buttocks and in the genital area. Use the A, B, C, D, E method to analyze any worrisome spots and then see a specialist if you have concerns, the American Academy of Dermatology advised.

Also see a dermatologist if you have any itching, bleeding or see a mole that looks like an “ugly duckling” and stands out from the rest of the spots on your body.

Get vaccinated if you haven’t: Two vaccinations protect against cervical and liver cancers, and others for cancers such as melanoma are in development.

Hepatitis B is transmitted via blood and sexual fluids and can cause liver cancer and cirrhosis, which is a scarred and damaged liver. A series of three shots, starting at birth, is part of the US recommended childhood vaccines schedule. Unvaccinated adults should check with their doctor to see if they are eligible.

The HPV vaccine protects against several strains of human papillomavirus, the most common sexually transmitted infection, according to the US Centers for Disease Control and Prevention.

Human papillomavirus can cause deadly cervical cancer as well as vaginal, anal and penile cancer. It can also cause cancer in the back of the throat, including the tongue and tonsils.

“These HPV-related head and neck cancers are more aggressive than the non-HPV-related cancers,” Kamal said, “so boys as well as girls should be vaccinated.”

Since the vaccine’s approval in 2006 in the US for adolescents ages 11 to 13, cervical cancer rates have declined by 87%. Today, the vaccine can be given through age 45, the CDC said.

Breast self-exams: Breast cancer is the most common type of cancer diagnosed worldwide, according to the WHO, followed by lung, colorectal, prostate, skin and stomach cancers.

Both men and women can get breast cancer, so men with a family history should be aware of the symptoms as well, experts say. These include pain, redness or irritation, dimpling, thickening or swelling of any part of the breast. New lumps, either in the breast or armpit, any pulling in of the nipple and nipple discharge other than breast milk are also worrisome symptoms, the CDC said.

Women should do a self-exam once a month and see a doctor if there are any warning signs, the National Breast Cancer Association advised. Choose a time when the breasts will be less tender and lumpy, which is about seven to 10 days after the beginning of the menstrual flow.

Screenings and tests: At-home exams and vaccinations can save lives, but many cancers can only be detected through laboratory tests, scans or biopsies. The American Cancer Society has a list of recommended screening by ages.

Getting those done in a timely manner increases the chance for early detection and treatment, but it’s still each person’s responsibility to know their risk factors, Kamal said.

“Remember, guidelines are only for people at average risk,” he said. “The only way someone can know whether the guidelines apply to them is to really understand their family history.”

vital signs WFIRM 01

Could lab-grown organs and cancer vaccines be the future of medicine?

Source link

#Cancer #striking #people #30s #40s #Heres #CNN

Proposed changes to school lunches aim to reduce sugar and sodium, but flavored milk stays | CNN



CNN
 — 

If new US Department of Agriculture school food guidelines stand as proposed, chocolate milk is in, but for the first time ever, at least some added sugars will be out – and sodium levels will be reduced gradually.

Agriculture Secretary Tom Vilsack publicly announced the changes on Friday.

“The purpose of this is to improve the health and welfare of our children. And I think everybody who comes to this issue shares that goal and hopefully, collectively, we can make sure it happens,” Vilsack told CNN in an interview Thursday ahead of the announcement.

The federally assisted school meal program provides nutritionally balanced meals at school at low or no-cost.

More than 15.3 million kids every day get breakfast at school in the US and 29.6 million get a school lunch, Vilsack said. The numbers were higher earlier in the pandemic, when meals were offered free to all children regardless of their family’s income, but in June, Congress did not extend the Covid-19 pandemic waivers that had expanded the program.

While school meals are paid for by local and federal funding, the standards for what goes on a kids’ cafeteria tray are set by the USDA. The agency’s job is to make sure any meal served at school is nutritious and falls in line with the US Dietary Guidelines.

Flavored milk with “reasonable limits on added sugars” would be allowed under the proposal. Vilsack said school meal administrators tell the USDA that kids just won’t drink much no-fat skim milk or unflavored milk. “That’s not what they get at home,” Vilsack said. “We want to encourage kids to drink milk because there are there’s tremendous nutritional value in milk.”

However, the proposed standards would limit added sugar in certain high-sugar products like prepackaged muffins, yogurt, and cereal. Eventually, the guidelines would then limit added sugars across the weekly menu.

The standards would reduce sodium limits, but that would happen gradually over several school years.

“The [US Food and Drug Administration] provided some insight and direction by suggesting that it is easier for people to accept and adopt to reduced sodium if you do it over a period of time in small increments,” Vilsack said.

A gradual reduction would also give industry time to reformulate their products, said Dr. Lauren Au, an assistant professor at UC Davis’ Department of Nutrition who studies the effectiveness of school nutrition programs.

The guidelines would also place a bigger emphasis on whole grains, but still leave options open for an occasional non-whole grain product.

“Maybe a biscuit can be instituted for a little variety, or grits can be provided where that may make sense from a geographic standpoint. You are sensitive to cultural demands and needs,” Vilsack said.

The proposed rule would also strengthen the Buy American requirements encouraging schools to use more locally grown food.

The USDA will invest $100 million in the Healthy Meals Incentives initiative which offers farm-to-school grants and grants to buy equipment. In the 1980s, schools around the country tore out kitchens and bought prepackaged processed food. To make more nutritious meals, schools have had to rebuild or update kitchens.

“A lot of schools have outdated ovens, freezers, fridges, and that puts limitations on how they can prepare food, so grants that have helped with equipment have been really successful,” Au said.

The money would also reward schools that do a good job providing nutritious meals. Grants would also be aimed at small and rural districts and training.

Vilsack said the USDA created these proposed standards after the USDA received thousands of comments and held 50 listening sessions with parents, school food administrators, the food industry, public health and nutrition experts.

“Establishing these standards are difficult because you have to follow the science you have to follow the dietary guidelines, but you also have to understand that they need to be implemented in the real world which is which is which is tough,” Vilsack said in an interview with CNN.

Real world circumstances are tough already with the higher cost of food, staff shortages and supply chain problems.

Au hasn’t seen all of the proposed policies, but she said what she has seen look good.

“It’s a step forward in terms of promoting healthy nutrition in schools,” Au said. The reduction of added sugar, she added is a big deal.

“Reducing added sugars for this age range is so important,” AU said.

Megan Lott, deputy director for the Robert Wood Johnson Foundation program Healthy Eating Research, said that the policies seem to be heading in the right direction.

“There are a couple of things we would probably like to see strengthened, but it also seems like there are plans to do that over time,” Lott said.

The sugar standard is a good start, she said, but she’d prefer the proposal instead say that no more than 10% of calories should come from added sugars across the meal plan.

“But we recognize that schools might need a little bit of time for implementation,” Lott said.

Lott had also hoped they would take flavored milk off the menu. Research shows that schools that have gotten rid of flavored milk show a drop in milk consumption for a year or two, but milk sales eventually rebound.

School food has become a proverbial hot potato.

After decades of bipartisan support for school meals, the program has been politicized in about the last 10 years Lott says, meaning there is bound to be some pushback.

Friday’s proposed changes would be the first large scale reform of school meal standards since President Barack Obama signed the 2010 Healthy, Hunger-Free Kids Act into law.

The law that went into effect in 2012, championed by first lady Michelle Obama, really did improve US kids’ diet, studies show. The law raised the minimum standards and required schools to serve more whole grains, fruit, vegetables, and fat-free and/or low-fat milk more frequently and serve fewer starchy vegetables and foods high in trans fat and sodium.

Meals that were eaten by students – not just served to students and then tossed into garbage cans – were much healthier and had better overall nutritional quality, the study showed. Students who didn’t participate in the national program did not see an improvement in their diets.

Despite the program’s success, in 2018, the Trump administration announced a proposal to roll back many of the policies in the name of “flexibility,” including ones that involved sodium and whole grains. Trump’s policy would essentially create a loophole letting schools sell more burgers, pizza and french fries and reduce the fruit and vegetables sold. A federal court struck down the rule in April 2020.

During the pandemic, some of the polices were relaxed, like for whole grains, because it was difficult to find products, Lott said.

Studies show kids who eat meals at school ate more fruits, vegetables, whole grains and dairy, compared with those who ate at school less frequently.

Better nutrition can help prevent obesity. About 20% of the US population ages 2 to 19 live with obesity, which can cause kids to have high blood pressure, breathing problems and type 2 diabetes, and lead to lifelong health problems, according to the US Centers for Disease Control and Prevention.

Hungry kids have a hard time paying attention in class. Students who ate healthy meals at school scored better on end-of-year academic tests, studies have shown.

The new standards are just a proposal. The USDA will ask for additional feedback.

Vilsack is hopeful the standards will incentivize more schools to offer more healthy options.

“In terms of future of this program,” Vilsack said, “we want to see more and more school districts push themselves not only to meet the standards, but in some cases to exceed them.”

Source link

#Proposed #school #lunches #aim #reduce #sugar #sodium #flavored #milk #stays #CNN

Weight loss surgery extends lives, study finds | CNN



CNN
 — 

Weight loss surgery reduces the risk of premature death, especially from such obesity-related conditions as cancer, diabetes and heart disease, according to a new 40-year study of nearly 22,000 people who had bariatric surgery in Utah.

Compared with those of similar weight, people who underwent one of four types of weight loss surgery were 16% less likely to die from any cause, the study found. The drop in deaths from diseases triggered by obesity, such as heart disease, cancer and diabetes, was even more dramatic.

“Deaths from cardiovascular disease decreased by 29%, while deaths from various cancers decreased by 43%, which is pretty impressive,” said lead author Ted Adams, an adjunct associate professor in nutrition and integrative physiology at the University of Utah’s School of Medicine.

“There was also a huge percentage drop — a 72% decline — in deaths related to diabetes in people who had surgery compared to those who did not,” he said. One significant downside: The study also found younger people who had the surgery were at higher risk for suicide.

The study, published Wednesday in the journal Obesity, reinforces similar findings from earlier research, including a 10-year study in Sweden that found significant reductions in premature deaths, said Dr. Eduardo Grunvald, a professor of medicine and medical director of the weight management program at the University of California San Diego Health.

The Swedish study also found a significant number of people were in remission from diabetes at both two years and 10 years after surgery.

“This new research from Utah is more evidence that people who undergo these procedures have positive, beneficial long-term outcomes,” said Grunvald, who coauthored the American Gastroenterological Association’s new guidelines on obesity treatment.

The association strongly recommends patients with obesity use recently approved weight loss medications or surgery paired with lifestyle changes.

“And the key for patients is to know that changing your diet becomes more natural, more easy to do after you have bariatric surgery or take the new weight loss medications,” said Grunvald, who was not involved in the Utah study.

“While we don’t yet fully understand why, these interventions actually change the chemistry in your brain, making it much easier to change your diet afterwards.”

Despite the benefits though, only 2% of patients who are eligible for bariatric surgery ever get it, often due to the stigma about obesity, said Dr. Caroline Apovian, a professor of medicine at Harvard Medical School and codirector of the Center for Weight Management and Wellness at Brigham and Women’s Hospital in Boston. Apovian was the lead author for the Endocrine Society’s clinical practice guidelines for the pharmacological management of obesity.

Insurance carriers typically cover the cost of surgery for people over 18 with a body mass index of 40 or higher, or a BMI of 35 if the patient also has a related condition such as diabetes or high blood pressure, she said.

“I see patients with a BMI of 50, and invariably I will say, ‘You’re a candidate for everything — medication, diet, exercise and surgery.’ And many tell me, ‘Don’t talk to me about surgery. I don’t want it.’ They don’t want a surgical solution to what society has told them is a failure of willpower,” she said.

“We don’t torture people who have heart disease: ‘Oh, it’s because you ate all that fast food.’ We don’t torture people with diabetes: ‘Oh, it’s because you ate all that cake.’ We tell them they have a disease, and we treat it. Obesity is a disease, too, yet we torture people with obesity by telling them it’s their fault.”

Most of the people who choose bariatric surgery — around 80% — are women, Adams said. One of the strengths of the new study, he said, was the inclusion of men who had undergone the procedure.

“For all-causes of death, the mortality was reduced by 14% for females and by 21% for males,” Adams said. In addition, deaths from related causes, such as heart attack, cancer and diabetes, was 24% lower for females and 22% lower for males who underwent surgery compared with those who did not, he said.

Four types of surgery performed between 1982 and 2018 were examined in the study: gastric bypass, gastric banding, gastric sleeve and duodenal switch.

Gastric bypass, developed in the late 1960s, creates a small pouch near the top of the stomach. A part of the small intestine is brought up and attached to that point, bypassing most of the stomach and the duodenum, the first part of the small intestine.

In gastric banding, an elastic band that can be tightened or loosened is placed around the top portion of the stomach, thus restricting the volume of food entering the stomach cavity. Because gastric banding is not as successful in creating long-term weight loss, the procedure “is not as popular today,” Adams said.

“The gastric sleeve is a procedure where essentially about two-thirds of the stomach is removed laparoscopically,” he said. “It takes less time to perform, and food still passes through the much-smaller stomach. It’s become a very popular option.”

The duodenal switch is typically reserved for patients who have a high BMI, Adams added. It’s a complicated procedure that combines a sleeve gastrectomy with an intestinal bypass, and is effective for type 2 diabetes, according to the Cleveland Clinic.

One alarming finding of the new study was a 2.4% increase in deaths by suicide, primarily among people who had bariatric surgery between the ages of 18 and 34.

“That’s because they are told that life is going to be great after surgery or medication,” said Joann Hendelman, clinical director of the National Alliance for Eating Disorders, a nonprofit advocacy group.

“All you have to do is lose weight, and people are going to want to hang out with you, people will want to be your friend, and your anxiety and depression are going to be gone,” she said. “But that’s not reality.”

In addition, there are postoperative risks and side effects associated with bariatric surgery, such as nausea, vomiting, alcoholism, a potential failure to lose weight or even weight gain, said Susan Vibbert, an advocate at Project HEAL, which provides help for people struggling with eating disorders.

“How are we defining health in these scenarios? And is there another intervention — a weight neutral intervention?” Vibbert asked.

Past research has also shown an association between suicide risk and bariatric surgery, Grunvald said, but studies on the topic are not always able to determine a patient’s mental history.

“Did the person opt for surgery because they had some unrealistic expectations or underlying psychological disorders that were not resolved after the surgery? Or is this a direct effect somehow of bariatric surgery? We can’t answer that for sure,” he said.

Intensive presurgery counseling is typically required for all who undergo the procedure, but it may not be enough, Apovian said. She lost her first bariatric surgery patient to suicide.

“She was older, in her 40s. She had surgery and lost 150 pounds. And then she put herself in front of a bus and died because she had underlying bipolar disorder she had been self-medicating with food,” Apovian said. “We as a society use a lot of food to hide trauma. What we need in this country is more psychological counseling for everybody, not just for people who undergo bariatric surgery.”

Managing weight is a unique process for each person, a mixture of genetics, culture, environment, social stigma and personal health, experts say. There is no one solution for all.

“First, we as a society must consider obesity as a disease, as a biological problem, not as a moral failing,” Grunvald said. “That’s my first piece of advice.

“And if you believe your life is going to benefit from treatment, then consider evidence-based treatment, which studies show are surgery or medications, if you haven’t been able to successfully do it with lifestyle changes alone.”

Source link

#Weight #loss #surgery #extends #lives #study #finds #CNN

Making the case for an underappreciated but full-of-flavor ingredient | CNN

Editor’s Note: Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



CNN
 — 

Among foods that spark a strong reaction, anchovies are at the top of the food chain.

Whether they’re adored or abhorred, it’s difficult to find someone who doesn’t have a strong opinion about these small silvery swimmers.

Food writer Alison Roman wants the haters to think differently. Anchovies are more versatile than most people think and deserve to be approached with an open mind, according to Roman.

She might be biased — anchovies are one of her all-time favorite foods — but she has a strategy to change cooks’ minds.

“They’re more of a condiment than an ingredient,” Roman said. “To cook with them, you don’t need to eat them whole.” She incorporates anchovies into many of her dishes in the same way that she would add garlic, herbs or other flavorful aromatics. “Most of the time when I’m eating (anchovies), I can’t even see them.”

Even if you think your taste buds will rebel if you try an anchovy, your brain and heart will be happier if you do. “Anchovies are a small but mighty fish,” said Michelle Dudash, registered dietitian, nutritionist and author of “The Low-Carb Mediterranean Cookbook.”

“They’re packed with the omega-3 fatty acids DHA and EPA, which are important for brain, cardiovascular and skin health,” she added. Anchovies are on par with salmon and tuna as one of the fish with the highest amounts of omega-3s per serving, and are a good source of protein, niacin and vitamin B12.

Following Roman’s lead of using anchovies as one of many elements in a dish instead of as the spotlight ingredient, cooks who want to incorporate anchovies into meals “can start small,” Roman suggested. “They don’t have to dump a whole jar into their salad.”

Here are three ways Roman likes to introduce anchovies to the wary but curious. Ready to change your “anchoview”? Read on.

Move over, ranch dressing — there’s another dip in town. Bagna cauda, the Italian dipping sauce made from anchovies, garlic, butter and olive oil, is traditionally served with crudités as an appetizer.

Roman loves using bagna cauda as a vehicle to introduce unsuspecting dinner guests to anchovies because it hits the taste trifecta of “salty, buttery, garlicky” flavors. “It’s mostly about garlic and vegetables,” Roman said. In addition to the traditional accompaniment of raw, crunchy vegetables, she likes to include steamed artichoke hearts and tender cooked potato slices.

Bagna cauda is also an answer to the ever-present question about anchovies: What about the bones? “They are so tiny, they mostly all melt” and dissolve into the dish when heat is applied, Roman said. “They’re not going to choke you.”

“High-quality anchovies shouldn’t have many bones,” she added, and they should not be noticeable like they would be in larger fish, such as a salmon fillet. If you happen to see many bones in your anchovies, “spring for a more expensive tin,” Roman said.

If the presence of whole anchovies resting atop a bed of romaine in a Caesar salad has been historically too much to handle, Roman’s Caesar-adjacent salad will be a refreshing revelation.

Roman likes to pair bitter greens from the chicory family, such as radicchio, with a dressing that can stand up to their strong flavors. “I put anchovies in my salads all the time,” she said, but when hidden in the dressing, they add body and nuance without overpowering any of the other ingredients with which they’re paired.

Anchovies in a dressing can add body and nuance to a salad without overpowering other ingredients.

Her preferred dressing blends finely chopped anchovies and capers with lemon, whole grain or Dijon mustard, and good quality olive oil. “It’s anchovy-heavy but more about the mustard and the garlic,” Roman explained, which she finds “meatier and saltier and more interesting” than the usual Caesar dressing.

Finally, the same strategy of dissolving the umami flavors of anchovies in a sauce comes into play when making a rich and comforting pasta. Based on the Venetian dish bigoli in salsa, in which long strands of thick bigoli pasta are tossed with slow-simmered onions and anchovies, Roman’s version can be used with any long, thin pasta.

Pasta alla puttanesca features garlic, olives, capers, tomatoes and anchovies.

Roman adds whole anchovies and chopped dried chili pepper to a skillet of sliced onions, garlic and fennel caramelized in olive oil. The whole fillets might look intimidating, but as with the bagna cauda, the anchovies melt and dissolve as the sauce simmers, leaving only a rich and meaty undertone. Finishing the dish with freshly squeezed lemon juice and parsley brightens up the intense sauce.

A free-form pasta sauce such as this lets you adjust the flavor balance based on what you like best. If you love lemon, squeeze more on. If fennel isn’t your favorite, use more onions instead. If you like it spicy? Amp it up with more chili pepper. “Gauge your own personal preferences,” Roman recommended.

When choosing a tin or jar of anchovies, Roman said to make sure the anchovies are oil-packed, salt-cured anchovy fillets, not brined, pickled or whole anchovies. The former is the most common style of jarred or canned anchovies on the market, but it always pays to double-check the label.

Second, “always try a bunch of brands. They really are all different,” Roman said. Though the ingredients in each container should be the same — anchovies, salt and olive oil — the fillets will vary in saltiness, taste and texture. “Ortiz and Cento are available nationally,” she said, and many other brands are available in brick-and-mortar and online specialty food stores.

One note on the salt-curing: “The only downside of anchovies is the sodium,” Dudash noted, since they are packed in salt during the curing process. “If you are concerned about your sodium intake or if you simply prefer less salty food, briefly rinse the anchovies and pat dry with a paper towel” before using them.

Source link

#Making #case #underappreciated #fullofflavor #ingredient #CNN