After Breast Cancer: Fitness and Nutrition Tips

After Breast Cancer: Fitness and Nutrition Tips

Post By Health breast cancer, cancer prevention, fitness, nutrition

When you finish treatment for breast cancer, you might have a mix of feelings. Going through treatment is physically and mentally exhausting, with many side effects from chemotherapy, radiation, surgery, and immunotherapy. Once the treatment phase is over, is there anything you can do to boost your odds of staying cancer-free?

The answer is YES. There’s a lot you can do in your everyday life — in addition to taking any meds your doctor prescribes to help prevent recurrence and keeping up with your screenings.

Cancer experts have long advised breast cancer survivors that the same healthy lifestyle habits that have been shown to lower your chance of developing breast cancer in the first place are also likely to cut the risk of breast cancer recurrence. In the past, that advice was based mostly on expert opinion.

But more recently, studies specifically done on breast cancer survivors have added weight to that opinion. These findings suggest that regular physical activity and a healthy diet that is high in vegetables, fruits, whole grains, and beans and low in processed carbohydrates and high in fiber can help guard against breast recurrence and death.

You’ve Got to Move It, Move It

Being physically active has clear benefits.

Women who got regular physical activity before their cancer diagnosis and after treatment are less likely to have their cancer come back or to die compared with those who were inactive. That’s according to a 2020 study from researchers at Roswell Park Comprehensive Cancer Center in Buffalo, NY.

The study focused on 1,340 women with breast cancer and the Department of Health and Human Services (HHS) physical activity guidelines for adults, which are to get at least 150 minutes of moderate-intensity physical activity and 2 days of muscle-strengthening activity every week. In the study, women who did that were less likely to have their cancer come back than those who were inactive. They also were less likely to die over the 2 years of the study period. Even those who were considered to be “low active,” meaning that they came close to meeting the recommended activity levels but didn’t quite get there, had improved survival, as well.

Fitness Tips for Breast Cancer Survivors

Your body has been through a lot – from the cancer itself to the treatments for it. No one is expecting you to run a marathon unless you want to. But don’t underestimate the power of regular movement.

Start small. Even a daily 15-minute walk has benefits. “You don’t have to do a lot of intense workouts to benefit,” says Karen Basen-Engquist, PhD, the director of the Center for Energy Balance in Cancer Prevention and Survivorship at The University of Texas MD Anderson Cancer Center. “It can be hard to begin exercising when you’re experiencing fatigue related to cancer treatment, but moving just a small amount most days can help you reach the point where you can do more.”

Tell your doctor. You may have glossed over the guidance you often see in fitness magazines: “Consult your doctor before starting any exercise program.” Don’t ignore that advice this time. Check with your treatment team to see how much exercise they feel you can handle at this point in your recovery.

Set realistic expectations. If you were running an 8-minute mile before you started chemotherapy, don’t expect to be able to match that pace 3 or 4 months after your last dose. And that’s OK.

Don’t stress your bones and joints. This is especially important if you’ve had bone loss related to chemotherapy. Instead of running or high-impact aerobics, which could add to your risk of fractures, start with walking. Or try swimming, a no-impact way to work your muscles and your cardiovascular system.

Be aware of your ability to balance. If you have neuropathy (tingling or numbness) in your feet or hands after chemotherapy, that can affect your balance. Be careful about activities where you might risk falling. Instead of running on a treadmill, for example, you might prefer to work out on an exercise bicycle.

Make time for strength training. It can make a difference in your daily life. “While we can’t say whether or not it improves overall survival, the evidence shows that breast cancer survivors who do strength training see improvements in their fatigue, quality of life, and physical functioning,” Basen-Engquist says.

What to Eat: Leafy Greens and Smart Carb Intake

What about food? The good news is that the general principles of healthy eating are also beneficial for breast cancer survivors.

Two recent studies suggest that a healthy diet can help breast cancer survivors live longer. Both studies involve data from about a quarter of a million women who took part in two large observational studies called the Nurses’ Health Studies. The studies followed these women, all of whom were under 55 and cancer-free when they began, for up to 30 years. By 2011, about 9,000 of the study participants had been diagnosed with breast cancer.

The first study found that women who ate the greatest amounts of fruits and vegetables after their breast cancer diagnosis had an overall lower risk of dying during the course of the study compared to those who ate the least amounts.

When the researchers dug deeper, they found that it was leafy greens and cruciferous vegetables like broccoli, cauliflower, and Brussels sprouts that were driving most of the benefits. Women who ate almost a full serving of cruciferous vegetables daily had a 13% lower risk of dying from any cause during the study, compared to those who ate almost none of these vegetables. And women who ate almost two servings of leafy greens daily were 20% less likely to die, compared to those who ate almost no greens.

Carbs were key in the second study – specifically, what kinds or types of carbs women ate. It found that high glycemic load carbs — those that cause your blood sugar to spike, like sugary beverages, processed foods like chips and doughnuts, and fast food like cheeseburgers and french fries — posed an increased risk. Breast cancer survivors with high glycemic load diets were more likely to die of breast cancer than those who ate lower glycemic load diets. They also found that women who ate high-fiber diets had a lower risk of death than those who ate diets low in fiber.

The bottom line: Eat more fruits, vegetables, and whole grains.

“Taken together, the research suggests that women diagnosed with breast cancer may benefit from eating a diet high in fruits and vegetables and eating less rapidly digested foods sources, such as whole grains and non-starchy vegetables,” says Nigel Brockton, PhD, vice president of research for the American Institute of Cancer Research (AICR).

And there was good news for fans of tofu and edamame: Despite past concerns that the estrogen-like properties of soy might contribute to breast cancer, evidence now shows that the opposite is true. “If anything, soy has a beneficial effect and may even reduce the risk of breast cancer recurrence,” Brockton says.

Maintaining a Healthy Weight

In general, getting regular physical activity and eating a healthy diet can help keep you from gaining too much weight, something that researchers have also found is important after breast cancer.

“There is strong evidence that a higher body mass index after diagnosis is associated with poorer outcomes in breast cancer,” Brockton says. “Avoiding weight gain and doing your best to stay at a healthy weight is important.”

Overall, Brockton says that the AICR’s recommendations about diet and physical activity for cancer prevention are still wise advice for breast cancer survivors to avoid a recurrence. These include:

Maintain a healthy weight.
Be physically active.
Eat more whole grains, vegetables, fruits, and legumes (like beans).
Avoid sugary drinks and limit your intake of fast foods and processed foods high in fats, starches, and sugars.
Limit red meats like beef, pork, and lamb.
Avoid processed meats and alcohol.

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For Heart’s Sake: Lifestyle Changes I Had to Make

Post By Health activity, exercise, Health, nutrition, strength

By Bouba Diemé as told to Keri Wiginton

I started to get coughs and chest pain that seemed to come out of nowhere. Exercise got a lot harder. I was 26 and ran a fitness boot camp, so I was relatively fit. But one day, I couldn’t keep up with the group during a warm-up run.

That was 2012, when I found out that I have dilated cardiomyopathy. That means my heart is bigger than normal and doesn’t pump blood very well. That led to advanced congestive heart failure. Later on, my doctor told me my heart condition — left ventricular non-compaction cardiomyopathy (LVNC) — is congenital.

My diagnosis came as a shock. But my mindset shifted when I learned I was born with a heart problem. I hadn’t been living with heart disease for 3 years. I’d been living with it my whole life. That’s when I stopped fighting my condition and learned to embrace it.

Here’s how.

Finding My Calm

I needed to adjust to my medication, of course. But my first real challenge was mental. I was young. I had big plans and ideas. And my diagnosis felt like I was facing death.

Independence comes naturally to me, so I tried to regroup within myself. I’d go quiet when I got stressed or tired. I had to learn to share what was going on, which was a challenge. I was used to being the one who helped others. Sometimes I didn’t need anyone to do anything for me. But it was important that my family or others knew why I needed space or a break.

I also had to learn how to say no to myself. It’s OK to be in my head every now and then. But there was a time when I needed to force myself to get out of bed, to socialize, to make friends, and to be a part of the community. In time, I realized those things made me happier.

My two therapists have also been a big help. I see a social worker from the hospital, who’s taught me how to reframe life with a chronic illness. And I meet with a Black counselor, who’s helped me from a cultural standpoint.

I’m also Muslim, and I try to pray once a day. On top of that, I do a lot of guided meditations. I’ll do a session in the morning and before I go to sleep at night. I’ll take a moment in the middle of the day if I need to.

My goal is to keep my stress levels low, which is why I mediate often. But when I do get overwhelmed, the tools and habits I’ve learned — through therapy and meditation — come naturally. It’s almost a reflex.

A New Exercise Routine

Early on, I still wanted to do things like play soccer with my friends. But then I’d be tired for the rest of the day. One of my biggest symptoms was low energy, so this up and down wasn’t working. But I wanted to stay as physically fit as possible. And not just for my body. Exercise was, and still is, a good way to ease stress and decompress.

I learned to work out safely with a personal trainer. They taught me how to exercise in a more stable way. For example, I started to build muscle by doing more reps with light weights, instead of heavy lifting. In my case, this kind of approach helped. My energy started coming back.

Here’s what my physical activity looks like these days:

I exercise regularly. I try to do 30 to 60 minutes of strength training twice a week. And I aim for 8,000 to 10,000 steps a day. But I mix up my aerobic activity up, so I don’t get bored.

For cardio, I might:

Walk along the river
Ride my bike in or outdoors
Pace around my basement
Use the treadmill in my house — my least favorite

I measure and track my activity. This helps me meet my goals and stay within my physical limits. I use a wearable fitness tracker. But you could use your phone.

I set realistic goals. When I was very sick, it didn’t make sense to walk 30 minutes a day. Instead, I’d walk up and down the stairs. Then I’d rest. I needed to give my body time to heal. As I got better, I added more activity — maybe I’d load the dishwasher and go up and down the stairs a few times.

I use my cardiac rehab lessons. I learned my safety zones. And one day, the physical therapist pointed out that I hold my breath when I do certain exercises. Those are the kinds of things I needed to be more mindful about, and coaching helped.

I do group activities. I challenge myself with martial arts. We meet twice a week. The class helps me understand my stamina and helps my flexibility.

Nutrition Changes

I never drank alcohol or smoked. And I’m not big on juice, soda, or caffeine. But I wanted to be as healthy as possible. I reached out to a nutritionist to find the best way to approach my condition.

The first thing I learned was to go easy on the salt. Luckily, that wasn’t hard for me. I didn’t go for a low-salt diet, but I stopped adding extra sodium to my food. And I tried to minimize how much I ate out.

Now, I get medical meals delivered weekly. I also keep other essentials stocked. That includes lots of fruits and vegetables, along with eggs, oatmeal or muesli, or heart-healthy ingredients for a sandwich. And I don’t skip meals because I don’t want to get too hungry. For starters, that’s when you can’t think clearly. But that’s also when you end up eating whatever you can find.

How much water I drink is also important. I measure it out. Everyone is different, but my limit is about 84 ounces a day. During hot days, my health care team says I should drink more. I might go up to about 105 ounces a day.

I stick with my healthy diet as much as possible, and I avoid added sugar or salt most of the time. That leaves me with some space for the less healthy stuff — fast food, chocolate, cake — and I don’t worry too much when I splurge.

Going Forward

There was a time when I wasn’t sure what caused my heart problems. I felt guilty that maybe I’d done something wrong. But my heart muscle never really formed the right way. It’s not possible for me to get physically better. I’m still on the list for a heart transplant. But right now, I’m living with a left ventricular assist device (LVAD).

Along with my LVAD, my lifestyle changes have boosted my energy and mood. When I feel good — mentally, physically, and spiritually — I can keep up with my kids and be a better husband and brother.

I also have bi-weekly calls with people in the heart disease community. We talk about what it’s like to personally live with a heart condition or to have family members or friends who do. Sometimes there are tears. But there’s also laughter and even singing. Those moments remind us that we’re more than patients. We’re here to help each other heal.

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Helping consumers snack mindfully

Post By Politics beverages, Companies, data, Environment, Guide, Labeling, Markets, nutrition, Recycling, research

Can Buharali, senior director global public affairs at Mondelēz International

Every day, people seeking a healthier lifestyle can encounter different recommendations about what foods and beverages they should have or avoid. However, little guidance may be seen on why and how to eat or drink to get the most out of the eating experience. One approach is shifting the thinking from the what, to the why and how — this approach is called mindful eating.

Rimi Obra-Ratwatte, European lead nutrition strategy at Mondelēz International

As one of the largest snacking companies in the world, we at Mondelēz International embrace the important role we have to play in empowering consumers to snack more mindfully. This is integral to our purpose of ‘helping people to snack right’.

Snacking is part of everyday living. It can provide fuel for energy or a boost to jump-start your day. It can also simply be a treat. People are looking for snacks that fit their busy lifestyles. They want convenient and delicious snacks they feel good about eating, while also seeking balance when making their snack choices.

Our own extensive consumer data shows that 74 percent of consumers want snacking tips and visual indicators of portion size on pack. Indeed, we believe consumer information needs to be meaningful, actionable, consistent across markets and provide clear portion guidance at the point of purchase and consumption.

Our own extensive consumer data shows that 74 percent of consumers want snacking tips and visual indicators of portion size on pack.

So, what does mindful snacking really mean?

Over the past eight years we’ve worked with mindful eating experts to develop and validate our global Mindful Snacking program.

Mindful Snacking is the application of mindfulness to eating and can be practised by anyone, anywhere and by all ages. It can help people to manage their relationship with all food and to do so in moderation.

It is about paying attention to why you want to eat before you choose what to eat.

It is about paying attention to why you want to eat before you choose what to eat. Are you hungry? Are you simply bored, distracted or seeking a break from what you are doing?

Thinking through your reasons can help you to be more deliberate about what you eat and more conscious about the reason why you want a snack. And it’s also about how you snack, taking your time to taste the flavors and textures, leaving distractions aside, and slowing the pace of eating so that you really enjoy what you’re eating and know when you’re full or satisfied. Tasting the subtlety of the flavors for example in chocolate will allow you to get the most satisfaction out of even a small portion.

It’s also about how you snack, taking your time to taste the flavors and textures, leaving distractions aside.

Moreover, mindful snacking has been shown to lead to a more positive relationship with food (1) by making more deliberate and conscious food choices, more satisfaction and pleasure from food by savoring with all your senses (2) and being less likely to overeat (3) by paying attention to feelings of satisfaction.

In fact in some countries such as Germany, Australia and Brazil practices regarding mindful eating are included in national dietary guidelines — that by eating slowly and consciously, there is a greater enjoyment and promotion of the sense of satiation.

Tasting the subtlety of the flavors for example in chocolate will allow you to get the most satisfaction out of even a small portion.

This approach is also supported by the British Nutrition Foundation, which emphasizes that healthy eating is not only about what we eat, but also how we eat it. Time of day, speed, portion size, our emotional state and the food environment may all influence our relationship with food and healthy eating.

Mind your portion?

Scientific research shows that eating mindfully leads to better management of food portions and less tendency to overeat by paying attention to feelings of hunger and satiety (4). It is about being intentional when choosing a portion according to the emotional and hunger needs in the moment.

Providing visual indicators of portion sizes on packaging can help consumers, especially for products like snacks. Snacks are often consumed in much smaller amounts than per 100g, which is what many food labelling regulations are based on, so portion size indicators can be used to help educate and guide consumers on appropriate servings. Portion control packaging formats can also be helpful, as individually packaged portions can help support more mindful eating and control calorie consumption.

Providing visual indicators of portion sizes on packaging can help consumers, especially for products like snacks.

What is Mondelēz International doing on mindful snacking?

At Mondelēz International, we want to educate consumers about how to snack mindfully and inspire satisfying snacking experiences. Satisfying portion sizes and detailed labeling help consumers understand that snacks like chocolate can fit into balanced and mindful lifestyles.

We’re helping people to snack mindfully in many ways.

We aim to add information on pack across all of our European brands by 2025 and our Snack Mindfully website provides resources, tips and information on mindful snacking. This will empower our consumers by making them more aware of portion sizes through visual images of a portion along with the calories it provides, alongside tips on how to snack mindfully. We have also partnered with renowned mindful eating experts to provide consumer-friendly videos that explain mindful snacking and how to practice it, which are also available on the website.

And in the U.K., we have piloted QR codes on pack, to provide consumers with further information. By scanning the QR code on the outer packaging, consumers can access our new online platform https://www.snackingright.com/ which provides information about the company’s global Snacking Made Right programs, including its cocoa sourcing program Cocoa Life, tips on mindful snacking and recycling information.

How to practice mindful snacking?

Mindful Snacking is based on six, practical and accessible behaviors that anyone can practice, anytime and anywhere. Taking these behaviors and bringing them to life in the right occasion through our brands is what makes it authentic and real with consumers. Learn more on our website and find out how to practice mindful snacking.

Sources:
⁽¹⁾ Alberts et al., 2012; Katterman et al., 2014; Hendrickson et al., 2017; Camillieri et al., 2015; Gravel et al., 2014

⁽²⁾ Hong et al., 2014; Arch et al., 2016; Cornil & Chandon, 2015; Hetherington et al., 2018

⁽³⁾ Oldham-Cooper et al., 2011; Higgs et al., 2011; Mittal et al., 2011; Robinson et al., 2014; Daubenmier et al., 2016

⁽⁴⁾ Gravel et al., 2014; Hong et al., 2014; Arch et al., 2016; Cornil & Chandon, 2015; Oldham-Cooper et al., 2011; Higgs, 2015; Mittal et al., 2011; Higgs et al., 2011, Robinson et al., 2014

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Top Risk Factor to Good Health Is Probably Not What You Think

Post By Health diabetes, diet, Food packaging, healthy eating, nutrition, weight loss

March 7, 2023 — If you think the biggest risk factor to good health is smoking or genetics, think again.

According to Stephen Kopecky, MD, a preventive cardiologist at the Mayo Clinic, “nutrition is now the number one cause of early death and early disease in our country and the world.” Moreover, he says that while having genes for disease will increase your risk by 30% to 40%, having a bad lifestyle for disease will increase your risk by 300% to 400%.

About 20 years ago, Kopecky says, the cause of death worldwide changed from infection to non-infection (like non-communicable diseases). “In those last 20 years, that’s grown in terms of what kills us and what gets us sick,” he says. “The three big non-communicable diseases are heart disease, cancer, and rapidly rising is Alzheimer’s. But there’s also diabetes, obesity, and high blood pressure — all those things are also related to diet.”

Forty-eight-year-old James, of Fredericksburg, VA, knows this all too well. James asked that his last name not be printed, to protect his privacy. For the last 30 years, he’s been managing type 1 diabetes and complications of insulin resistance, along with high blood pressure, high cholesterol, thyroid disease, and low testosterone. As a former Division 1 college athlete, James exercised regularly and ate what he believed to be a responsible diet.

“Those weirdos in the gym at 5 a.m. who eat chicken salads for every lunch? Yeah, that’s me,” says James.

But he went from a playing weight of 202 pounds to 320 pounds, despite continuing to lift weights and do cardiovascular exercise at least 5 days a week. “Whenever I went to the doctor and stepped on the scale, I got skeptical looks when I made claims of ‘exercising and eating right.’ In all honesty, I thought I was,” says James, noting he followed a low-carb, high-protein diet. “But I didn’t count calories or consider the impact of fat on my already insulin-resistant body,” he says.

After visiting many health professionals, James finally found success with Nancy Farrell Allen, a registered dietitian nutritionist.

Previous doctors applauded his diet, but Allen explained that his insulin resistance was linked to the amount of fat James consumed. “The more fat in my system, the more insulin I needed to inject,” he says. “The more insulin I injected, the more weight I’d gain. The more weight I’d gain, the more insulin I’d inject, continuing this regrettable cycle.”

Allen suggested he shift his diet to a more balanced approach, with a strict eye on fat. “She completely changed my way of thinking about food, broke my belief that all carbs are bad, helped me identify my daily caloric needs, and focused me on eating a balanced diet enriched with fiber,” says James, who then lost 45 pounds in 3 months. “I found myself having more energy, sleeping better, focusing better, and taking less insulin than I had in nearly 20 years,” he says.

Another patient, Sheila Jalili of Miami, took a proactive approach to her health when she turned 40, getting some tests and lab work done for a baseline comparison. “My BMI was around 20, I exercise every day, and I don’t have any diseases in my family,” Jalili says, noting everything checked out fine.

She continued her annual checkups and tests, noticing her triglycerides and cholesterol numbers increasing. When her cholesterol reached alarming levels and her triglycerides skyrocketed to 1,230, she met with Kopecky, the Mayo Clinic cardiologist, who prescribed fish oil and asked about her diet. Jalili started tracking what she ate and did an exhaustive review of her fridge contents, noting the sodium levels, cholesterol levels, and fat levels in the foods.

To her surprise, she discovered she ate a lot of unhealthy carbs and fats. “I went into overload. I changed everything. I did so much research,” she says. After 42 days of eating extremely healthy, she dropped her total cholesterol by about 100, halved her HDL, and reduced her triglycerides from 1,238 to 176.

A bad lifestyle often starts with what you eat — and what you don’t. Even if you think you’re eating healthy, you might want to revisit your diet. In particular, reconsider ultra-processed foods (like doughnuts, hot dogs, and fast-food burgers). Though convenient and affordable, they’re inflammatory and, over time, can cause many health issues.

“It bothers our tissues, our heart, our arteries, our brains, our pancreas, our liver, and our lungs, and that leads to disease,” Kopecky says. “It could be in the brain with Alzheimer’s, the heart with coronary artery disease, or cancers elsewhere.”

Ideally, you’d immediately overhaul an unhealthy diet. But that’s not a reality for most people. Making sweeping changes all at once can feel overwhelming. Take small steps instead.

Baby-Step Your Way to a Healthier Diet

Before making any dietary changes, Selvi Rajagopal, MD, MPH, advises having a conversation with your health care provider to figure out your specific health status. Rajagopal, assistant professor of medicine at Johns Hopkins University, says that, generally speaking, everyone will benefit from eating a balanced, healthy diet filled with a variety of nutrient-rich foods.

That includes fruits, vegetables, whole grains, lean protein, low-fat/fat-free dairy, and healthy fats. However, talking with your doctor can help you identify any specific nutrient deficiencies, health issues, and lifestyle factors that need to be addressed. Then you can devise a healthy eating plan that works specifically for your needs.

Revamp how you organize your refrigerator. Most refrigerators put two opaque drawers labeled “Fruits” and “Vegetables” at the bottom, where you’re least likely to see them. Kopecky advises moving your produce to eye level and put the less-healthy options in those bottom drawers. “When we open the fridge, that’s what we see, and that’s what we tend to eat,” he says.

Change your perspective. “There isn’t one healthy weight or one healthy size,” says Rajagopal. Don’t aim for a number on the scale or a certain BMI or certain clothing size. Every body is different, not only in shape and size, but in health risk factors. Also, many people feel really overwhelmed trying to “be healthy.” Rajagopal says, “Healthy is just trying to do something to improve your health, and that improvement can be really small.”

Understand how to read food labels. Allen takes every patient to the grocery store to read and understand food labeling and to highlight different foods. She shares the guidelines below with her patients.

Fat: Low-fat foods contain 3 grams of fat or less per serving.
Sugar: Four grams equal 1 teaspoon. When a serving of sugar lists 12 grams of sugar in a 2/3-cup serving, that means it contains roughly 3teaspoonsof sugar.
Fiber: A naturally high-fiber food can contain about 5 grams of fiber per serving.
Sodium: A low-sodium food contains less than or equal to 140 milligrams of sodium per serving.
Protein: Seven grams of protein equal about 1 ounce of protein.

This approach is particularly important as the FDA is exploring a change in which foods can be labeled as healthy. The agency in September unveiled a proposed rule to try and counter the fact that, as the agency claims, more than 80% of people in the U.S. aren’t eating enough vegetables, fruit, and dairy. And most people consume too much added sugars, saturated fat, and sodium.

Under the proposed rule, in order to be labeled “healthy” on food packaging, products must contain “a certain meaningful amount” of food from at least one of the food groups or subgroups (e.g., fruit, vegetable, dairy, etc.) recommended by the agency’s dietary guidelines.

They must also stick to specific limits for certain nutrients, such as saturated fat, sodium, and added sugars.

Breakfast cereals, for example, would need to contain 0.75 ounces of whole grains and contain no more than 1 gram of saturated fat, 230 milligrams of sodium, and 2.5 grams of added sugars to qualify, the agency said.

Don’t fear carbs or fat! Your body needs both to survive, as carbs help fuel your body and fat helps your body absorb fat-soluble nutrients like vitamins A, D, and E. But not all carbs or fats are equal. Choose complex carbohydrates found naturally in plant-based foods (like fruits, vegetables, and whole grains) over simple carbohydrates often found in processed foods (like white bread, enriched pasta, and white rice).

Similarly, strive to include healthy, unsaturated fats (including polyunsaturated and monounsaturated fats) found in foods such as fatty fish, vegetable oils, avocadoes, and some seeds and nuts. Avoid foods with unhealthy saturated and trans fats found primarily in animal products (such as meat, eggs, high-fat dairy) and highly processed foods (frozen pizza and microwave popcorn). “Having a baseline understanding of what this means makes you a much savvier consumer,” says Rajagopal, who suggests going to the U.S. Department of Agriculture’s website to learn about these food components.

Adopt healthier cooking methods. Maybe you’re buying healthy foods but preparing them in unhealthy ways. That lean, skinless chicken breast just got a lot less healthy once you breaded it, deep-fried it, and smothered it with cheese. Allen suggests lighter, leaner techniques such as baking, roasting, grilling, and steaming. “Frying, sautéing, breading, au gratin, buttery, and Alfredo all add additional calories to burn off,” says Allen.

Start small. Eliminate the all-or-nothing thinking, such as, “I want to cut out all sugar” or “I want to cook all my meals at home.”

If you’ve been eating sugar your whole life or eating dinner out 5 nights a week, eliminating this bad habit at once is a huge undertaking. Instead, start small. For instance, reduce one sugary food item you frequently eat.

“Maybe it’s soda,” says Rajagopal. “Maybe you go from four cans of soda a day to two cans. Make one change and see how it goes for a week or two.”

Ditto for cooking — aim to add one more home-cooked meal a week rather than trying to cook at home 7 days a week. She also advises bringing in an accountability buddy to help you stay on track.

Take one bite. “If you take a bite of a ground meat or sausage and replace that with a bite of something that’s a little healthier — like black beans or a vegetable — then, after doing this for a couple of years, that actually reduces your risk of heart attack and reduces your risk in the long-term of cancers and Alzheimer’s,” advises Kopecky. “Literally one bite difference.”

By making small, consistent changes, they can have a big impact over time. Pick one tip that resonates most, implement it, and stick to it until it becomes second nature. Once mastered, move on to another tip, building on that foundation of success.

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Bempedoic acid improved heart health in patients who can’t tolerate statins, study finds | CNN

Post By Health brand safety-nsf death, brand safety-nsf health issues, brand safety-nsf sensitive, business, business and industry sectors, cardiology, cardiovascular disease, cholesterol, Death and dying, diet, diet and nutrition, diseases and disorders, domestic alerts, domestic-health and science, economy and trade, health and medical, heart disease, iab-bereavement, iab-business and finance, iab-diseases and conditions, iab-family and relationships, iab-food & drink, iab-healthy cooking and eating, iab-healthy living, iab-heart and cardiovascular diseases, iab-industries, iab-medical health, iab-nutrition, iab-pharmaceutical drugs, iab-pharmaceutical industry, international alerts, international-health and science, medical fields and specialties, nutrition, nutrition and fitness, pharmaceutical industry, pharmaceuticals, pharmaceuticals and prescription drugs, society

CNN
—

Bempedoic acid may be an alternative for people who need to lower their cholesterol but can’t or won’t take statins, according to a large study published Saturday in the New England Journal of Medicine.

Statins are the most commonly prescribed cholesterol-lowering drugs that help lower what’s known as the “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol in the blood; more than 90% of adults who take a cholesterol-lowering medicine use a statin, according to the US Centers for Disease Control and Prevention.

Statins are considered safe and effective, but there are millions of people who cannot or will not take them. For some people it causes intense muscle pain. Past research has shown anywhere between 7% and 29% of patients who need to lower cholesterol do not tolerate statins, according Dr. Steven Nissen, a cardiologist and researcher at the Cleveland Clinic and co-author of the new study.

“I see heart patients that come in with terrible histories, multiple myocardial infarction, sometimes bypass surgery, many stents and they say, ‘Doctor, I’ve tried multiple statins, but whenever I take a statin, my muscles hurt, or they’re weak. I can’t walk upstairs. I just can’t tolerate these drugs,’ ” Nissen said. “We do need alternatives for these patients.”

Doctors have a few options, including ezetimibe and a monoclonal antibody called a proprotein convertase subtilisin/kexin type 9, or PCSK9 inhibitors for short.

Bempedoic acid, sold under the name Nexletol, was designed specifically to treat statin-intolerant patients. The FDA approved it for this purpose in 2020, but the effects of the drug on heart health had not been fully assessed until this large trial. The new study was funded in part by Esperion Therapeutics, the maker of Nexletol.

For the study, which was presented Saturday at the American College of Cardiology’s Annual Scientific Session with the World Congress of Cardiology, Nissen and his colleagues enrolled 13,970 patients from 32 countries.

All of the patients were statin intolerant, typically due to musculoskeletal adverse effects. Patients had to sign an agreement that they couldn’t tolerate statins “even though I know they would reduce my risk of a heart attack or stroke or death,” and providers signed a similar statement.

The patients were then randomized into two groups. One was treated with bempedoic acid, the other was given a placebo, which does nothing. Researchers then followed up with those patients for up to nearly five years. The number of men and women in the trial were mostly evenly divided, and most participants, some 91%, were White, and 17% were Hispanic or Latino.

The drug works in a similar way that statins do, by drawing cholesterol out of a waxy substance called plaque that can build up in the walls of the arteries and interfere with the blood flow to the heart. If there is too much plaque buildup, it can lead to a heart attack or stroke.

But bempedoic acid is only activated in the liver, unlike a statin, so it is unlikely to cause muscle aches, Nissen said.

In the trial, investigators found that bempedoic acid was well-tolerated and the percent reduction in the “bad” cholesterol was greater with bempedoic acid than placebo by 21.7%.

The risk of cardiovascular events – including death, stroke, heart attack and coronary revascularization, a procedure or surgery to improve blood flow to the heart – was 13% lower with bempedoic acid than with placebo over a median of 3.4 years.

“The drug worked in primary and secondary prevention patients – that is, patients that had had event and patients who were very high risk for a first event. There were a lot of diabetics. These were very high risk people,” Nissen said. “So the drug met its expectations and probably did a lot better than a lot of people thought it would do.”

In the group that took bempedoic acid, there were a few more cases of gout and gallstones, compared with people who took a placebo.

“The number is small, and weighing that against a heart attack, I think most people would say, ‘OK I’d rather have a little gout attack,’ ” Nissen said.

Bempedoic acid had no observed effect on mortality, but that may be because the observation period was too short to tell if it had that kind of impact. Earlier trials on statins showed the same; it was only after there were multiple studies on statins that scientists were able to show an impact on mortality.

Dr. Howard Weintraub, a cardiologist at NYU Langone Health who did not work on this study, said that while he knows some people will not consider a medication successful unless it reduces mortality, he thinks that is short-sighted.

“I think there’s more to doing medicine then counting body bags,” Weintraub said.”Preventing things that can be life changing, crippling, and certainly change your quality of life forever going forward, and your cost of doing things going forward, I think is a good thing.”

He was pleased to see the results of this trial, especially since the people in this study are often what he called “forgotten individuals” – the millions who could benefit from lowering their cholesterol, but can’t take statins.

“It’s not like their LDL was 180 or 190 or 230, their LDL was 139. This is about average in our country,” Weintraub said. He said often doctors will just tell those patients to watch their diet, but he thinks this suggests they would benefit from medication.

“Both groups primary and secondary prevention got benefit, which I think is impressive with the modest amount of LDL reduction,” Weintraub said.

There are some limitations to this trial. It was narrowly focused on patients with a known statin intolerance. Nissen said the trial was not designed to determine whether bempedoic acid could be an alternative to statins.

“Statins are the gold standard. They are the cornerstone. The purpose of this study was not to replace statins, but to allow an alternative therapy for people who simply cannot take them,” Nissen said.

Bempedoic acid is a much more expensive drug than a statin. There are generic versions of statins and some cost only a few dollars. Bempedoic acid, on the other hand, has no generic alternative and a 30-day supply can cost more than $400, according to GoodRx.

“I think what insurance companies need to recognize that even though this drug is going to cost more than statins, having a heart attack or a stroke or needing a stent is expensive. A 23% reduction in (myocardial infarctions) is a considerable reduction,” Weintraub said.

In an editorial in the New England Journal of Medicine that accompanied the study, Dr. John H. Alexander, who works in the division of cardiology at Duke Clinical Research Institute, Duke Health, Durham said that doctors should take these results into consideration when treating patients with high cholesterol who can’t take statins.

“The benefits of bempedoic acid are now clearer, and it is now our responsibility to translate this information into better primary and secondary prevention for more at-risk patients, who will, as a result, benefit from fewer cardiovascular events,” Alexander wrote.

Dr. Manesh Patel, a cardiologist and volunteer with the American Heart Association who was not a part of the study, said that providers are already prescribing bempedoic acid for some patients, but with this new research, he thinks they will quickly be used with more statin-intolerant patients.

“We continue to see that if we can lower your LDL significantly, we improve people’s cardiovascular health. And so we need as many different arrows in our quiver to try to get that done,” Patel said.

Heart disease is the No. 1 killer for men and women in the world. One person dies every 34 seconds in the US from cardiovascular disease, according to the CDC. About 697,000 people in the US died from heart disease in 2020 alone – about the same number as the population of Oklahoma City.

“Given the number of people that are eligible for statins, which are tens of millions of patients already, the number of people who cannot tolerate statins is in the millions,” Nissen said. “This is a big public health problem and I think we’ve come up with something that directly addresses this.”

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

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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.)

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

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CNN
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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.

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

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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.”

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

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

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—

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.”

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Chairman FAO: Western powers pressure China’s UN food boss to grip global hunger crisis

Post By Politics agriculture, Aid and development, Cameroon, Canada, China, Conflict, Cooperation, Crisis, diplomacy, Environment, farmers, Food crisis, food security, foreign policy, France, Germany, Italy, Japan, Markets, Nigeria, nutrition, Policy, research, Russia, Security, Society and culture, The Netherlands, Transparency, Ukraine, United Kingdom, United States, War, War In Ukraine

ROME, Italy — The Chinese head of a crucial U.N. food agency has come under intense scrutiny by Western powers, who accuse him of failing to grip a global hunger crisis exacerbated by Russia’s war in Ukraine.

Qu Dongyu, director general of the Food and Agriculture Organization, has alienated the Western powers that are the agency’s main backers with his technocratic leadership style and connections to Beijing that, in their view, have damaged its credibility and capability to mitigate the crisis.

POLITICO has interviewed more than a dozen U.N. officials and diplomats for this article. The critical picture that emerges is of a leader whose top-down management style and policy priorities are furthering China’s own agenda, while sidelining the U.N.’s Sustainable Development Goals.

Russia’s invasion of Ukraine in February was met with weeks of eerie silence at the FAO, and although the messaging has since changed, Qu’s critics say FAO should be showing stronger political leadership on the food crisis, which threatens to tip millions more people into hunger.

“Nobody actually takes him seriously: It’s not him; it’s China,” said one former U.N. official. “I’m not convinced he would make a single decision without first checking it with the capital.”

In his defense, Qu and his team say a U.N. body should not be politicized and that he’s delivering on the FAO’s analytical and scientific mandate.

Chairman FAO

Qu Dongyu was elected in 2019 to run the Rome-based agency, handing China a chance to build international credibility in the U.N. system, and punishing a division between the EU and the U.S after they backed competing candidates who lost badly. The election was clouded by allegations of coercion and bribery against China.

Now, as he prepares for a likely reelection bid next year to run FAO until 2027, Qu — who describes himself as a conflict-averse “humble, small farmers’ son” — is under intensifying scrutiny over his leadership during the crisis.

After three years of largely avoiding the headlines, Qu drew criticism from countries like France and the U.S. for his sluggish and mealy-mouthed response to Russia’s invasion of Ukraine, a massive exporter of food to developing countries.

The EU and U.S. forced an emergency meeting of the FAO’s Council in the spring in order to pressure the FAO leadership into stepping up to the plate, with Ukraine demanding he rethink his language of calling it a “conflict” and not a war. The communications division was initially ordered to keep schtum about the war and its likely impacts on food supply chains. In May, Ukrainians protested outside FAO HQ in Rome demanding Russia be kicked out of the organization.

At a meeting of the FAO Council in early December, countries like France, Germany and the U.S. successfully pushed through yet another demand for urgent action from FAO’s leadership, requesting fresh analysis of impact of Russia’s war on global hunger, and a full assessment of the damage done to Ukraine’s vast farm system.

China has not condemned Russia outright for invading Ukraine, while the EU and the U.S. use every opportunity in the international arena to slam Moscow for its war of aggression: Those geopolitical tensions are playing out across the FAO’s 194 member countries. Officials at the agency, which has $3.25 billion to spend across 2022 and 2023, are expected to act for the global good — and not in the narrow interest of their countries.

Qu is said still to be furious about the confrontation: “[He] is still upset about that, that really annoyed him,” said one ambassador to the FAO. “He sees the EU as an entity, a player within the FAO that is obstructing his vision.”

Qu featured on a TV screen inside the FAO headquarters in Rome | Eddy Wax/POLITICO

Though Qu has now adapted his language and talks about the suffering being caused by Russia’s war, some Western countries still believe FAO should respond proactively to the food crisis, in particular to the agricultural fallout from Russia’s invasion of Ukraine. The FAO’s regular budget and voluntary funds are largely provided by EU countries, the U.S. and allies like Japan, the U.K. and Canada. The U.S. contributes 22 percent of the regular budget, compared to China’s 12 percent.

Qu is determined to stick to the mandate of the FAO to simply provide analysis to its members — and to steer clear of geopolitics.

“I’m not [a] political figure; I’m FAO DG,” he told POLITICO in October, in an encounter in an elevator descending from FAO’s rooftop canteen in Rome.

FAO’s technocratic stance is defended by other members of Qu’s top team, such as Chief Economist Máximo Torero, who told POLITICO in May: “You are in a war. Some people think that we need to take political positions. We are not a political entity that is the Security Council — that’s not our job.”

Apparatchik

Qu can hardly be said to be apolitical, as he is a former vice-minister of agriculture and rural affairs of the Chinese Communist Party.

On top of his political background he has expertise in agriculture. He was part of a team of scientists that sequenced the potato genome while he was doing a PhD at Wageningen University in the Netherlands. In an email to POLITICO his professor, Evert Jacobsen, remembered Qu’s “enthusiasm about his country,” as well as is “strategic thinking” and “open character.”

Yet Western diplomats worry that many of the policy initiatives he has pushed through during his tenure map onto China’s foreign policy goals.

They say that the U.N. Sustainable Development Goals have been eclipsed by his own initiatives, such as his mantra of the Four Betters (production, nutrition, environment, life), and Chinese-sounding plans from “One Country, One Priority Product” to his flagship Hand-in-Hand Initiative.

Some Western diplomats say these bear the hallmarks of China’s Global Development Initiative, about which Qu has tweeted favorably.

Detractors say these are at best empty slogans, and at worst serve China’s foreign policy agenda. “If the countries that are on the receiving end don’t exercise agency you need to be aware that these are policies that first and foremost are thought to advance China, either materially or in terms of international reputation, or in terms of diplomacy,” said Francesca Ghiretti, an analyst at the Mercator Institute for China Studies (MERICS).

Insiders say he’s put pressure on parts of the FAO ecosystem that promote civil society engagement or market transparency: two features that don’t go down well in Communist China. The former U.N. official said Qu had subjected the G20 market transparency dashboard AMIS, housed at FAO, to “increased pressure and control,” causing international organizations to step in to protect its independence earlier this year.

The diplomat said Qu was trying to suffocate the Committee on World Food Security, which invites civil society and indigenous people’s groups into FAO’s HQ and puts them on a near-equal footing with countries. “What has he accomplished in two-plus years? You can get Chinese noodles in the cafeteria,” they said.

Flags at the entrance to the FAO headquarters in Rome | Eddy Wax/POLITICO

But at a U.N. agency that has historically been deeply dysfunctional, Qu is popular among staff members.

“Mr. Qu Dongyu brought a new spirit on how to treat staff and established trust and peace between staff and management,” said one former FAO official.

Even his sharpest critics concede that he has done good things during his tenure. He made a point of shaking every staff member’s hand upon his election, even turning up occasionally unannounced to lunch with them in the canteen that he’s recently had refurbished. There’s also widespread appreciation among agriculture policymakers of the high quality of economic work turned out by FAO, and support for his climate change and scientific agenda.

“The quality of data FAO produces is very good and it’s producing good policy recommendations,” one Western diplomat acknowledged.

FAO play

Three years into his term, there’s a much stronger Chinese presence at FAO and Chinese officials occupy some of the key divisions, covering areas such as plants & pesticides, land & water, a research center for nuclear science and technology in agriculture, and a division on cooperation between developing countries. A vacant spot atop the forestry division is also expected to go to a Chinese candidate.

Experts say those positions are part of a strategy. “China tries to get the divisions where it can grow its footprint in terms of shaping the rules, shaping the action and engaging more broadly with the Global South,” said Ghiretti, the MERICS analyst.

The EU Commission is closely monitoring trends in staff appointments and data collection. “He’s hired a lot of young Chinese people who will fill [the] ranks later,” said an EU diplomat.

Mandarin is heard more than before in the corridors of the Rome HQ, a labyrinthine complex built in the 1930s by Fascist dictator Benito Mussolini to house its ministry of overseas colonies.

Western diplomats and staffers past and present describe Qu as a poor communicator, who displays little care about engaging with or being accountable to countries and who tends to leave meetings after delivering perfunctory remarks, all of which leaves space for rumor and suspicion to grow.

Even those who acknowledge that Qu has made modest achievements at the helm of FAO still see his leadership style as typical of a Chinese official being kept on a tight leash by Beijing. The EU and U.S. criticized Qu’s move to push back an internal management review that was meant to be conducted by independent U.N. inspectors, and will now likely not emerge until after the next election.

And although FAO is still receiving bucketloads of Western funding, its fundraising drive specifically for rural families and farmers in war-torn Ukraine is still $100 million short of its $180 million target, a pittance in an international context — especially amid deafening warnings of a global food supply crisis next year.

That’s partly because the U.S. and EU prefer to work bilaterally with Kyiv rather than going through FAO. “This is the time for FAO to be fully funded,” said Pierre Vauthier, a French agronomist who runs the FAO operation in Ukraine. “We need additional money.”

A plaque outside Qu’s fourth floor office at the FAO headquarters in Rome | Eddy Wax/POLITICO

There’s no love lost on Qu’s side, either. In June, he went on a unscripted rant accusing unnamed countries of being obsessed with money, apparently in light of criticism of his flagship Hand-in-Hand Initiative.

“You are looking at money, I’m looking to change the business model because I’m a farmer of small poor, family. You from the rich countries, you consider the money first, I consider wisdom first. It’s a different mentality,” Qu said, before complaining about his own salary being cut.

Asked repeatedly, Qu did not confirm to POLITICO whether he would stand for a second four-year term, but traditionally FAO chiefs serve at least twice and he is widely expected to run. Nominations officially opened December 1. The question is whether the U.S., EU or a developing nation will bother trying to run against him, when his victory looks all but inevitable.

There’s competition for resources between the World Food Programme (WFP), a bastion of U.S. development power, and FAO. A Spaniard, Alvaro Lario, was recently appointed to run the third Rome-based U.N. food agency, the International Fund for Agricultural Development, while WFP’s chief David Beasley is expected to be replaced by another American next year.

In any case, the countries that Qu will likely count on to be re-elected are not so interested in the political machinations of the West or its condemnation of the Russia’s war in Ukraine, which it seeks to impress upon FAO’s top leadership.

“Our relations with the FAO are on a technical basis and not concerned by the political positions of the FAO. What interests us is that the FAO supports us to modernize our agriculture,” said Cameroon’s Agriculture Minister Gabriel Mbairobe.

Other African countries defend FAO’s recent track record: “They’ve been very, very active, let’s be honest,” said Yaya A.O. Olaniran, Nigeria’s ambassador to the FAO. “It’s easy to criticize.”

This story has been updated.

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