Worried about your drinking? Use Dry January to check it | CNN

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There are lots of great reasons to decide to go “dry” in January and give up alcohol. Perhaps you imbibed a bit too much over the holidays or want to start a healthy routine and can’t afford the calories or the zap in energy and motivation that drinking can bring.

“Or it may be someone who truly is starting to wonder or question their relationship with alcohol, and this is an opportunity to really explore that,” said Dr. Sarah Wakeman, medical director of the Substance Use Disorders Initiative at Massachusetts General Hospital.

“For some people saying, ‘I’m not going to drink this entire month,’ might be really hard, so trying to do so may show you how easy or difficult it is for you,” said neuropsychologist Dr. Sanam Hafeez, who conducts classes at Columbia University’s Teachers College.

What is the advice from experts on how to have a successful “dry January”? Read on.

It helps to be clear about your goal to make it a habit, said Wakeman, an associate professor of medicine at Harvard Medical School.

“The research we have on goal setting says goals are more likely to be achieved if they’re really relevant to you as an individual and not abstract like ‘I should stop drinking because drinking is bad,’ ” she said.

Concrete goals such as embracing new sleep habits or an exercise routine will help make giving up drinking easier, she said.

“I really want to stop drinking because I know when I drink heavily I don’t get up the next morning and I don’t work out is a very specific goal,” Wakeman said.

Additional motivation can come from the health gains you can make from reducing or eliminating alcohol, experts say.

“Drinking less over time can have really measurable benefits in your health in terms of your blood pressure, your risk of cancer, your risk of liver disease and other conditions,” Wakeman said.

“Over the course of a month, you may notice some short-term benefits like better sleep, a better complexion due to improvements in your skin, feeling more clearheaded and having more energy,” she added.

READ MORE: Why my ‘Sober October’ lasted a year

Many of us may be familiar with SMART goals from work or school settings. They are used to help people set attainable goals. The acronym stands for:

  1. Specific: Set an achievable goal, such as cutting back on drinking three days a week. You can add days until you reach your final goal.
  2. Measurable: How many drinks will you cut — and what are the drink sizes? A beer is 12 ounces, a glass of wine is 5 ounces and a serving of spirits is 1.5 ounces.
  3. Achievable: Make sure there are not a bunch of social engagements where alcohol is likely to be served during your month of abstention.
  4. Relevant: How is not drinking going to help me with my life and health?
  5. Time based: Set a reasonable time frame to finish your efforts. If you like, you can set another goal later.

“If you set a bar too high, you may fail, so it’s better to set smaller goals to achieve it,” Hafeez said. “Nothing starts without an honest conversation with yourself.”

Informing a few friends or family members of your goal can help you reach it, experts say. For some people it may work to announce their plan on social media — and invite others to join in and report back on their progress.

“That’s where I think ‘dry January’ has kind of caught on,” Wakeman said. “If you publicly state you’re going to do something, you’re more likely to stick with it than if you keep it to yourself.”

READ MORE: How much you drink could have an influence on how your teen drinks

Drinking is often associated with social gatherings or fun times. That can train your brain to see alcohol as a positive. You can combat those urges by replacing your drink of choice with something equally festive or flavorful, experts say.

“For some people it can be just sparkling water, and for other people it’s actually having a mocktail or some sort of (nonalcoholic) drink that feels fun and celebratory,” Wakeman said.

“Substituting one behavior for another can work because you’re tricking your brain,” Hafeez said. “That can absolutely help you avoid temptation.”

An entire industry is devoted to making nonalcoholic drinks that taste (at least a bit) like the real thing. Some even claim to have added ingredients that are “calming” or “healthy.”

“I’m skeptical of anything that claims to relax you or have amazing health benefits that comes in a glass regardless of what it is,” Wakeman said. “But if it’s an alternative that allows you to feel like you’re not missing out on a social situation and helps you make the changes that you want to your alcohol consumption, I don’t think there’s any downside to that.”

READ MORE: How to stop using alcohol as a confidence crutch

5. Track your progress, goal and feelings

Even if you don’t end up cutting out all alcohol, tracking your emotions and urges to discover your triggers can be helpful, Wakeman said.

“Even just measuring your behavior, whether it’s alcohol or exercise or your diet, can be an intervention in and of itself,” she said.

“Even if someone’s not yet ready to make changes, just keeping a diary of when you’re drinking, what situations you’re drinking more and how you’re feeling at those times, can really help you identify sort of trigger situations where you may be more likely to drink,” Wakeman added.

There’s an additional piece that’s important in accomplishing a “dry January,” experts say. It’s important to notice if you — or a loved one — are showing any negative symptoms from cutting back or eliminating alcohol. It could be a sign that you need professional help to reach your goal.

“The first thing to be mindful of is whether or not you actually have an alcohol use disorder,” Wakeman said. “If someone’s been drinking very heavily ev

ery single day and is at risk for withdrawal symptoms, then it can actually be dangerous to stop abruptly.”

A person with an alcohol use disorder, who has gotten used to having a certain level of alcohol in their body every day, can go into withdrawal and experience severe physical symptoms such as shakiness, sweating, rapid heart rate and seizures.

“That would be a real indication that you need to talk to a medical professional about getting medical treatment for withdrawal and not stopping on your own,” Wakeman said.

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Don’t use sugar substitutes for weight loss, World Health Organization advises | CNN



CNN
 — 

Don’t use sugar substitutes if you are trying to lose weight, according to new guidance from the World Health Organization.

The global health body said a systematic review of the available evidence suggests the use of non-sugar sweeteners, or NSS, “does not confer any long-term benefit in reducing body fat in adults or children.”

“Replacing free sugars with non-sugar sweeteners does not help people control their weight long-term,” said Francesco Branca, director of WHO’s department of nutrition and food safety. “We did see a mild reduction of body weight in the short term, but it’s not going to be sustained.”

The guidance applies to all people except those with preexisting diabetes, Branca said. Why? Simply because none of the studies in the review included people with diabetes, and an assessment could not be made, he said.

The review also indicated that there might be “potential undesirable effects” from the long-term use of sugar substitutes such as a mildly increased risk of type 2 diabetes and cardiovascular diseases.

However, “this recommendation is not meant to comment on safety of consumption,” Branca said. “What this guideline says is that if we’re looking for reduction of obesity, weight control or risk of noncommunicable diseases, that is unfortunately something science been unable to demonstrate,” he said. “It’s not going to produce the positive health effects that some people might be looking for.”

Non-sugar sweeteners are widely used as an ingredient in prepackaged foods and beverages and are also sometimes added to food and drinks directly by consumers. WHO issued guidelines on sugar intake in 2015, recommending that adults and children reduce their daily intake of free sugars to less than 10% of their total energy intake. Following that recommendation, interest in sugar alternatives intensified, the review said.

“This new guideline is based on a thorough assessment of the latest scientific literature, and it emphasises that the use of artificial sweeteners is not a good strategy for achieving weight loss by reducing dietary energy intake,” said nutrition researcher Ian Johnson, emeritus fellow at Quadram Institute Bioscience, formerly the Institute of Food Research, in Norwich, United Kingdom.

“However, this should not be interpreted as an indication that sugar intake has no relevance to weight-control,” Johnson said in a statement.

Instead, one should cut back on using sugar-sweetened drinks, and try to use “raw or lightly processed fruit as a source of sweetness,” Johnson added.

Dr. Keith Ayoob, scientific adviser for the Calorie Control Council, an international association representing the low-calorie food and beverage industry, told CNN via email the WHO’s “insistence on focusing only on prevention of unhealthy ‎weight gain and non-communicable diseases is at the very least, misguided.”

Robert Rankin, president of the Calorie Control Council, said “low- and no-calorie sweeteners are a critical tool that can help consumers manage body weight and reduce the risk of non-communicable diseases.”

The guidance is meant for government health organizations in countries who may wish to use the scientific analysis to implement policy changes for their citizens, Branca said.

“That will likely depend on the way that which sweeteners are consumed in a specific country,” he said. “For example, in a country where consumption patterns are high, those countries might decide to take action in a way or another.”

A total of 283 studies were included in the review. Both randomized controlled trials, considered the gold standard of research, and observational studies were included. Observational studies can only show an association, not direct cause and effect.

Results from randomized trials found the use of non-sugar sweeteners had a “low” impact on reducing body weight and calorie intake when compared with sugar, and no change in Intermediate markers of diabetes such as glucose and insulin, according to the report.

Observational studies also found a low impact on body weight and fat tissue, but no change in calorie intake. However, those studies found a low increase in risk for type 2 diabetes, high blood pressure, stroke, heart disease and death from heart disease, the report noted. A very low risk was also found for bladder cancer and an early death from any cause.

WHO said that the recommendation was “conditional” because the identified link between sweeteners and disease outcomes might be confounded by complicated patterns of sweetener use and the characteristics of the study participants.

In an emailed statement, the International Sweeteners Association, an industry assocation, said “it is a disservice to not recognise the public health benefits of low/no calorie sweeteners and is disappointed that the WHO’s conclusions are largely based on low certainty evidence from observational studies, which are at high risk of reverse causality.”

However, observational studies that follow people over time are important, Branca said. “To show that overweight people can reduce their body weight requires a long-term study. And we’re not seeing that impact from the research we have.”

The recommendation included low or no calorie synthetic sweeteners and natural extracts, which may or may not be chemically modified, such as acesulfame K, aspartame, advantame, cyclamates, neotame, saccharin, sucralose, stevia and stevia derivatives and monkfruit, the report said.

“Stevia and monkfruit are newer sweeteners so so there’s less published research in the scientific literature,” Branca said. “However they probably work in the body with a similar physiological mechanism as other sweeteners. We cannot say they are different from the others based on the data we have — they play the same role.”

Many people consider stevia products to be more “natural,” since they are derived from the stevia plant. Some natural and artificial sweeteners add bulking sugars to their products to cut their sweetness and add bulk to the product for baking.

A recent study by researchers at the US-based Cleveland Clinic found erythritol — used to add bulk or sweeten stevia, monkfruit and keto reduced-sugar products — was linked to blood clotting, stroke, heart attack and early death.

People with existing risk factors for heart disease, such as diabetes, were twice as likely to experience a heart attack or stroke if they had the highest levels of erythritol in their blood, the study found.

Just as many people have learned to eat and cook without salt, they can learn to reduce their dependence on free sugars and non-nutritive sweetners, Branca said.

“We need to target children in early life,” he said. “For example, why do parents typically use sweeteners as a reward for children and after almost every meal? We need to recommend to parents to avoid building that sweetness Interest in young children — that’s a very important action to take.”

Even if you are a true sugar “addict,” the good news is that you can tame your sweet tooth, registered dietitian Lisa Drayer said in an article for CNN. She provides the following steps:

Train your taste buds. If you gradually cut back on sugar — including artificial sweeteners — and include more protein and fiber-rich foods in your diet, that can help you crave less sugar, Drayer said.

“When we consume protein and fiber, it slows the rise in blood sugar if we consume it with a sugar-containing food. It can help satisfy us and help us reduce our sugar intake as well,” she said in a previous interview.

Choose no-sugar-added foods and avoid all sugar-sweetened drinks. For example, choose whole-grain cereal or Greek yogurt with no sweeteners. The sugar-sweetened drinks to take off your grocery list should include sodas, energy drinks, sports drinks and fruit punch. Choose water instead.

“If you like sweet carbonated beverages, add a splash of cranberry or orange juice to seltzer or try flavored seltzers. You can also flavor your own waters with fruit slices for natural sweetness or try herbal fruit teas,” Drayer said.

Drink coffee and tea with no or fewer sugars. Be careful at coffee shops, Drayer suggested. All those lattes and flavored coffees can have as much sugar as a can of soda, or more.

Enjoy fruit for dessert. Try cinnamon baked apples, berries or grilled peaches instead of cookies, cake, ice cream, pastries and other sweet treats, Drayer said.

Watch for stealth sugars. Added sugars are often present in foods that you might not think of as “sweet,” like sauces, breads, condiments and salad dressings, Drayer said.

“Pre-packaged sauces — like ketchup, BBQ sauce and tomato sauce — tend to be some of the biggest offenders of hidden added sugars in the diet,” Kristi King, senior pediatric dietitian at Texas Children’s Hospital and a national spokesperson for the Academy of Nutrition and Dietetics, told Drayer in a prior interview.

Check nutrition facts labels. All foods and beverages must list the amount and kind of sugar on the label.

Added sugars can go by other names such as “agave, brown sugar, corn sweetener, corn syrup, dextrose, evaporated cane juice, fructose, fruit juice concentrate, fruit nectar, glucose, high-fructose corn syrup, honey, invert sugar, lactose, malt syrup, maltose, molasses, maple syrups, raw sugar, sucrose, trehalose and turbinado sugar,” Drayer said.

The higher up these added sugars are on the ingredients list, the greater the amount of added sugar in the product, she said.

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