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  1. Surgeons withdraw support for heart disease advice European clinical guidelines on how to treat a major form of heart disease are under review following a BBC Newsnight investigation. Europe's professional body for heart surgeons has withdrawn support for the guidelines, saying it was "a matter of serious concern" that some patients may have had the wrong advice. Guidelines recommended both stents and heart surgery for low-risk patients. But trial data leaked to Newsnight raises doubts about this conclusion. Thousands of people in the UK and hundreds of thousands worldwide will be treated for left main coronary artery disease each year. This is a narrowing of one of the main arteries in the heart. The guidelines on how to treat it were largely based on a three-year trial to compare whether heart surgery or stents - a tiny tube inserted into a blocked blood vessel to keep it open - was more effective. The trial called Excel started in 2010 and was sponsored by big US stent maker, Abbott. It was led by eminent US doctor Gregg Stone and aimed to recruit 2,000 patients. Half were given stents and the other half open heart surgery. Success of the treatments was measured by adding together the number of patients that had heart attacks, strokes, or had died. The research team used an unusual definition of a heart attack, but had said that they would also publish data for the more common "Universal" definition of a heart attack alongside it. There is debate around which is a better measure and the investigators stand by their choice. In 2016, the results of the trial for patients three years after their treatments were published in the prestigious New England Journal of Medicine. The article concluded stents and heart surgery were equally effective for people with left main coronary artery disease. But researchers had failed to publish data for the common, "Universal" definition of a heart attack. Newsnight has seen that unpublished data and it shows that under the universal definition, patients in the trial that had received stents had 80% more heart attacks than those who had open heart surgery. The lead researchers on the trial have told Newsnight that this is "fake information". But Newsnight has spoken to experts who say they believe the data is credible. Prof Rod Stables, clinical lead for research at the British Heart Foundation, said this information should have been published and knowing it would have made a "substantial contribution to our ability to appreciate the nuances of the results". Shortly after Excel was published, the professional bodies for heart surgeons and cardiologists got together to write a new set of guidelines. But they had not seen the unpublished Universal definition data. Currently, European guidelines recommend either a stent or open heart surgery for people who have less severe forms of this disease. The European Association for Cardio-thoracic Surgery (EACTS), which helped draw up the guidelines, told Newsnight if the information on the trial is proven to be correct, "the recommendation is unsafe". "It is a matter of serious concern to us that some results in the Excel trial appear to have been concealed and that some patients may therefore have received the wrong clinical advice," Prof Domenico Pagano, EACTS secretary general, said. Newsnight has also learned that as the guidelines were being drawn up, the trial's Data Safety Monitoring Board - an independent body that looks after the interests of patients - was raising concerns. Newsnight has seen emails where they raised concerns about the higher mortality rate amongst those patients who were receiving stents. The board thought this information should be made public, as they were aware new guidelines were being drawn up that would recommend stents or surgery. However, the main investigators chose not to do so at the time. They point out that the board allowed the trial to continue unchanged. Prof Nick Freemantle worked on the guidelines. He told Newsnight he would "never" have agreed the treatments were interchangeable if he had seen the leaked data. He said that the result of making the "wrong recommendation" is that "patients who have received stents [for left main coronary artery disease] will have died who otherwise would have lived for longer, survived for longer, if they'd had open heart surgery". The European Society of Cardiology, the other professional body involved in writing the guidelines, rejected the claim that the guidelines may have caused harm to patients. They stand by the guidelines, which they say were based on more than the Excel trial. 'Dangerous for patients' This year the trial published a further set of its results, showing what had happened to the patients five years after their treatment. This found for every 100 who died after having open heart surgery, 135 people with stents died. Overall, 10% of people who had surgery died in the trial compared with 13% who had stents. Prof David Taggart, a surgeon at Oxford University, resigned from the trial. He says he "had no choice" as he believed the academic paper describing the five-year results did not give enough prominence to the mortality data in the trial. The NEJM had recommended that the researchers should give it greater prominence too. Prof Taggart said he believed the paper's final paragraph, which concluded that there was "no significant difference" between stents and open heart surgery was "dangerous for patients". When challenged by Newsnight, the trial's principal investigator, Dr Gregg Stone, said he believed that it had been given sufficient prominence and had been considered to meet NEJM's standards. Sponsors of trials like this are also responsible for making sure all results are published. When Newsnight contacted Abbott, the sponsors of the trial, they directed the BBC towards the trial's main researchers. The EACTS has now urged their members to "disregard the guidelines relating to left main disease for the time being". "We recommend that patients seek the advice of the multidisciplinary heart team at their hospital before deciding which treatment option is most appropriate for them," said Prof Domenico Pagano. Conflicts of interest In the course of the investigation, Newsnight found a larger debate within the medical community about the way that conflicts of interest are handled. There is one school of thought that says they raise questions and need to be carefully managed because of potential bias - conscious or unconscious. Others say that interactions between research and business are vital and there is a real public good to be gained by them. In the Excel trial, the four main investigators all declared conflicts of interest. Lead investigator Prof Gregg Stone declared he had received personal fees or held equity in 20 private medical companies, several of which made tools that helped with putting in stents. He's also the course director for TCT, an annual medical conference where the results were presented. TCT makes money from exhibitors including some of the biggest stent makers - Abbott, who sponsored the trial, Boston Scientific and Medtronic. Prof Pieter Kappetein, who worked on the trial and on the body that worked on the guidelines, declared that he had left the guidelines body to go and work for Medtronic, a medical device manufacturer that makes stents. Newsnight found that he'd become chief medical officer of Medtronic Structural Heart. By Newsnight's count, around half of the investigators on the trial had declared personal fees from companies that made stents, and around a third of those on the taskforce writing the guidelines. These relationships are all within the rules. https://www.bbc.com/news/health kalip
  2. How to Fit Meditation into Your Day Sometimes the biggest challenge in learning a new skill or practice like meditation is learning how to fit it into your routine. Most everyone has those days when it is a feat to even have showered, let alone setting time aside to sit quietly and meditate. Here you will learn how to fit your meditation practice into your busy day—perhaps when you need it the most. Give the skills outlined below a try for one week. Consider it a one-week experiment in learning how to take what you've learned into the "real world." Make a commitment to follow these simple steps every day of the week. What You’ll Do A good meditation practice does not end when the timer goes off. Too often, once a meditation session stops, it may only take moments before you get caught up in the stresses and routines of the day and many of the benefits of having had meditated are erased. Meditation should not be seen as a temporary break, but rather a transformative process that enriches your life and the lives around you. This week, we’ll work on bringing meditation “off the cushion” and into the rest of your life. How It Works By adding brief “reminder” or "mini" practices into your day, you can maintain some of the benefits of meditation all day long. By using a few simple techniques to achieve a brief meditative state, you’ll be able to work your meditation practice into your daily activities to achieve lasting calm and focus. Get Motivated for Week 4 With these practices, you’ll be able to evoke a meditative state—however brief—whenever you need some calm or creativity in your life. Doing meditations in a variety of environments will help you stay focused and in control of your mind. You won’t be as influenced by impulsive emotions and will be able to focus more on what you would like to do. The Steps to Meditate Every Day Below are six techniques for working meditation and the mindfulness that comes with it into your daily life. Try at least one of these each day this week to find what works best for you: Chore Meditation: Any repetitive chore can be turned into a meditation simply by adding a focusing element. You can count your breaths while cleaning counters, folding laundry, or washing windows, for example. Any chore that is automatic in nature and does not require decision-making while you are doing it works well. Take a moment for mindfulness. Walking Meditation: While taking a walk, link your breathing with your steps. A traditional walking meditation practice (made popular by Vietnamese monk Thich Nhat Hanh) is to take a step with each breath. This slow walking meditation practice can be very powerful. If you don’t have the time or place for slow walking, then just take a breath with every two or three steps while walking down the hall, across a parking lot, or in a store. Exercise Meditation: Turn exercise into meditation by focusing your mental energy on your body. Picture the push and pull of your muscles. Feel how your body gracefully adjusts to your movements. Be amazed at your balance. Even better, try out an exercise program that is rooted in breath and mindfulness like tai chi or yoga. Two Breaths: Taking two simple, mindful breaths can engage your meditative state at any point in the day. Take two breaths before making a phone call, answering an e-mail, or starting your car. This is a great way to bring meditation into your day dozens of times, particularly in the midst of a busy or stressful day when you need it the most. Sound Cue: Choose a particular sound, and take two breaths every time you hear it. Traditionally, monks would do this when they heard the wind chimes and bells of the temple. Choose a sound that occurs frequently in your setting. You could take a five-second pause in your thinking whenever you hear someone else’s cell phone, for example. Transitions: Transitions are times when you move from one setting to another. Coming home from work, for example, is a transition from your professional self to your private self. Going into some meetings, you may transition into a different personal style in order to get something done. Lunchtime may be a transition for you as well. Traditionally, monks would pause every time they crossed a threshold and transitioned from one room to another. Pick a few transitions in your daily life (like getting into your car, walking into your workplace, and opening your front door), and take a five-second meditative pause before entering the new setting. Perhaps you will even make opening a certain computer program or checking your e-mail a transition. Your Meditation Commitment This Week: "This week I will try at least one of these brief meditation practices every day." Tips Don’t be tempted to substitute these practices for your daily meditation. You must maintain your daily habit of sitting and focusing. That habit will allow you to use these practices effectively. You develop your “meditation muscles” by sitting and focusing. These new applications are about using that new strength in your daily life for an extra boost. In the beginning, try to pick practices that you can do when you are alone. It is difficult to take two mindful breaths while talking to someone, or even when you are in a situation where other people can watch you. Your car is a great place for a bit of privacy. While you are working on your computer or doing laundry are also good times for these meditation moments. Look at an anatomy book and marvel at the human body. As you go through your day, you can do an “exercise meditation” that focuses on whatever your body is doing. You could simply be walking, typing, or going up the stairs. Picture how the muscles and nerves work. Be awed by your own body. Ready for More? If you want to do more, try developing a mindfulness practice. In mindfulness, the idea is to be aware of whatever you are doing. The opposite of mindfulness is an automatic action. Pick something you do often during the day, like opening a door. Can you be aware of yourself opening the door each time? Are you really present as you open the door? Are you aware of your hand on the door, the door opening, your body crossing through and the door closing behind you? Or is it an automatic process without awareness? Develop your mindfulness skills by picking something that you do often and trying to be aware of yourself doing it each time. It is a lot harder than it sounds, and it takes practice. https://www.verywellmind.com/ kalip
  3. The Risks of Having an Exercise Addiction While it may not necessarily sound like a bad thing to everyone, exercise addiction can lead to real problems, so you may be wondering, what is exercise addiction? After all, numerous studies have demonstrated the physical and emotional health benefits of regular exercise — it is essential to our well-being. Unlike many other addictive behaviours, we are encouraged to exercise more. However, there is such a thing as exercise addiction — and it can have harmful consequences. Characteristics of Exercise Addiction Several characteristics distinguish healthy regular exercise from exercise addiction. Firstly, exercise addiction is maladaptive, so instead of improving a person’s life, it causes more problems. Exercise addiction can threaten health, causing injuries, physical damage due to inadequate rest, and in some instances (particularly when co-occurring with an eating disorder), malnutrition and other problems. Secondly, it is persistent, so an exercise addict exercises too much and for too long without giving the body a chance to recover. We all overexert ourselves on occasion and usually rest afterward. But people with exercise addiction exercise for hours every day, regardless of fatigue or illness. As the individual’s principle way of coping with stress, they experience anxiety, frustration, or emotional discomfort if they are unable to do so. The Confusion and Controversy About Exercise Addiction Exercise addiction is probably the most contradictory of all the addictions. As well as being a widely promoted health behaviour, important for the prevention and treatment for a range of ailments, exercise can be an effective part of treatment for other mental health problems. Exercise is even promoted as part of a complete program of recovery from other addictions. It forms part of new and effective approaches to treating mental health problems which commonly co-occur with or underlie addictions such as depression and borderline personality disorder (BPD). It's understandable how some are confused by how exercise could be an addiction itself. Like other behavioural addictions, exercise addiction is a controversial idea. Many experts balk at the idea that excessive exercise can constitute an addiction, believing that there has to be a psychoactive substance that produces symptoms — such as withdrawal — for an activity to be a true addiction. Although there is considerable research showing that exercise releases endorphins (opioids produced within the body), and excessive exercise causes tolerance to the hormones and neurotransmitters released, these physiological processes are often not considered comparable to other substance addictions. Exercise addiction is not currently included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the gold standard for the diagnosis of mental disorders, although several authors have suggested diagnostic criteria. Excessive exercise is included in the DSM-5 as one of the criteria for the eating disorder bulimia nervosa, along with other “compensatory behaviours” used to prevent weight gain, such as self-induced vomiting, fasting, and misuse of laxatives. How Is Exercise Addiction Like Other Addictions? There are several similarities between exercise addiction and drug addiction, including effects on mood, tolerance, and withdrawal. Neurotransmitters and the brain's reward system have been implicated in exercise and other addictions. For example, dopamine has been found to play an important role in overall reward systems, and regular, excessive exercise has been shown to influence parts of the brain involving dopamine. Like other addictive substances and behaviours, exercise is associated with pleasure and social, cultural or sub-cultural desirability. People who develop exercise addiction tend to be inflexible in their thinking, similar to people with other addictions, and this can reinforce the pattern of addiction by helping them to exercise regularly. In addition, research shows that even people at high risk of developing exercise addiction are supported in exercising by family and friends. Healthy Fitness vs. Exercise Addiction Only 8% of gym users meet the criteria for exercise addiction. In the classic pattern of addiction, exercise addicts increase their amount of exercise to re-experience feelings of escapism or the natural high they had previously experienced with shorter periods of exercise. They report withdrawal symptoms when they are unable to exercise, and tend to go back to high levels of exercise after a period of abstinence or control. Three percent of gym users feel they cannot stop exercising. While many reasons for exercising are shared among exercisers whether or not they are addicted — health, fitness, weight management, body image, and stress relief — exercisers who are not addicted cite other reasons that exercise addicts do not share, such as social enjoyment, relaxation, and time alone. People at risk for exercise addiction have difficulties in other areas in their lives that drive them to exercise to dangerous levels. They feel strongly that exercise is the most important thing in their life, and they use exercise as a way to express emotions including anger, anxiety, and grief, and to deal with work and relationship stress. Some know that their excessive exercising has caused conflicts with their family members. A central function of exercise addiction is the sense of control — over mood, the body, the environment — that exercise provides. It also provides a sense of structure. Ironically, as with other addictions, the attempt to exert control eventually leads to a loss of control over the ability to balance the activity with other priorities in life. What to Do If You Think You May Be Addicted to Exercise Exercise is a great way to manage stress and to address negative feelings. If your need for exercise is greater than your ability to manage your relationships and feelings, you may need more help, both to overcome your addiction and to find healthier ways of coping. Speak with your doctor about the best way to treat your addiction. https://www.verywellmind.com/ kalip
  4. 7 Blue Zone Foods to Include in Your Diet For a long life and better health, try boosting your intake of foods that people living in Blue Zones have in their diet. A concept developed by National Geographic Fellow and author Dan Buettner, Blue Zones are areas across the globe where people tend to live the longest and have remarkably low rates of heart disease, cancer, diabetes, and obesity. With their strikingly high concentrations of individuals who live to be over 100-years-old, Blue Zones include the following regions: Ikaria, Greece; Okinawa, Japan; the province of Ogliastra in Sardinia, Italy; the community of Seventh-Day Adventists in Loma Linda, California; and Costa Rica’s Nicoya Peninsula. Although food choices vary from region to region, Blue Zone diets are primarily plant-based, with as much as 95 percent of daily food intake coming from vegetables, fruits, grains, and legumes. People in Blue Zones typically avoid meat and dairy, as well as sugary foods and beverages. They also steer clear of processed foods. A wholesome diet isn’t the only factor thought to lead to longevity for those living in Blue Zones, however. Such individuals also have high levels of physical activity, low stress levels, robust social connections, and a strong sense of purpose. Still, sticking to a vibrant, nutrient-rich eating plan appears to play a key role in the exceptional health of Blue Zone dwellers. Here’s a look at seven foods to include in your own Blue Zone-inspired diet. Legumes From chickpeas to lentils, legumes are a vital component of all Blue Zone diets. Loaded with fibre and known for their heart-healthy effects, legumes also serve as a top source of protein, complex carbohydrates, and a variety of vitamins and minerals. Whether you prefer pinto beans or black-eyed peas, aim for at least a half-cup of legumes each day. Ideal for any meal, legumes make a great addition to salads, soups and stews, and many veggie-based recipes. "If you want to make a three-bean chili for dinner, use dry beans and soak them, cooking them with your own spices and fresh veggies," recommends registered dietician Maya Feller, owner of Maya Feller Nutrition. Dark Leafy Greens While vegetables of all kinds abound in each Blue Zone diet, dark leafy greens like kale, spinach, and Swiss chard are especially prized. One of the most nutrient-dense types of veggies, dark leafy greens contain several vitamins with powerful antioxidant properties, including vitamin A and vitamin C. When shopping for any kind of veggie, remember that people in Blue Zones generally consume locally grown, organically farmed vegetables. Nuts Like legumes, nuts are packed with protein, vitamins, and minerals. They also supply heart-healthy unsaturated fats, with some research suggesting that including nuts in your diet may help reduce your cholesterol levels (and, in turn, stave off cardiovascular disease). "Nuts are a high-fibre food," says Feller. "Almonds, for instance, provide about 3.5 grams of fibre in a one-ounce serving." For healthier snacking, borrow a habit from Blue Zone residents and try a handful of almonds, walnuts, pistachios, cashews, or Brazil nuts. Olive Oil A staple of Blue Zone diets, olive oil offers a wealth of health-enhancing fatty acids, antioxidants, and compounds such as oleuropein (a chemical found to curb inflammation). Many studies have shown that olive oil may improve heart health in a number of ways, such as by keeping cholesterol and blood pressure in check. What’s more, emerging research indicates that olive oil could help protect against conditions like Alzheimer’s disease and diabetes. Select the extra-virgin variety of olive oil as often as possible, and use your oil for cooking and in salads and vegetable dishes. Olive oil is sensitive to light and heat, so be sure to store it in a cool, dark area like a kitchen cabinet. Steel-Cut Oatmeal When it comes to whole grains, those in Blue Zones often choose oats. One of the least processed forms of oats, steel-cut oats make for a high-fibre and incredibly filling breakfast option. Although they’re perhaps best known for their cholesterol-lowering power, oats may also provide plenty of other health benefits. For instance, recent research has determined that oats may thwart weight gain, fight diabetes, and prevent hardening of the arteries. "Oats are known for their fibre content, but they also provide plant-based protein," says Feller. "Oatmeal made with 1/4 cup of steel-cut oats provides 7 grams of protein." Blueberries Fresh fruit is the go-to sweet treat for many people living in Blue Zones. While most any type of fruit can make for a healthy dessert or snack, foods such as blueberries may offer bonus benefits. For example, recent studies have demonstrated that blueberries may help shield your brain health as you age, and fend off heart disease by improving blood pressure control. For other Blue Zone-friendly but sweet-tooth-satisfying eats, look to such fruits as papayas, pineapples, bananas, and strawberries. Barley Another whole grain favoured in Blue Zones, barley may possess cholesterol-lowering properties similar to those of oats, according to a study recently published in the European Journal of Clinical Nutrition. Barley also delivers essential amino acids, as well as compounds that may help stimulate digestion. To get your fill of barley, try adding this whole grain to soups or consuming it as a hot cereal. https://www.verywellhealth.com/ kalip
  5. The sweet danger of sugar Too much added sugar can be one of the greatest threats to cardiovascular disease. Here's how to curb your sweet habit. Sugar has a bittersweet reputation when it comes to health. Sugar occurs naturally in all foods that contain carbohydrates, such as fruits and vegetables, grains, and dairy. Consuming whole foods that contain natural sugar is okay. Plant foods also have high amounts of fibre, essential minerals, and antioxidants, and dairy foods contain protein and calcium. Since your body digests these foods slowly, the sugar in them offers a steady supply of energy to your cells. A high intake of fruits, vegetables, and whole grains also has been shown to reduce the risk of chronic diseases, such as diabetes, heart disease, and some cancers. Consuming too much sugar However, problems occur when you consume too much added sugar — that is, sugar that food manufacturers add to products to increase flavour or extend shelf life. In the American diet, the top sources are soft drinks, fruit drinks, flavoured yogurts, cereals, cookies, cakes, candy, and most processed foods. But added sugar is also present in items that you may not think of as sweetened, like soups, bread, cured meats, and ketchup. The result: we consume way too much added sugar. Adult men take in an average of 24 teaspoons of added sugar per day, according to the National Cancer Institute. That's equal to 384 calories. "Excess sugar's impact on obesity and diabetes is well documented, but one area that may surprise many men is how their taste for sugar can have a serious impact on their heart health," says Dr. Frank Hu, professor of nutrition at the Harvard T.H. Chan School of Public Health. Impact on your heart In a study published in 2014 in JAMA Internal Medicine, Dr. Hu and his colleagues found an association between a high-sugar diet and a greater risk of dying from heart disease. Over the course of the 15-year study, people who got 17% to 21% of their calories from added sugar had a 38% higher risk of dying from cardiovascular disease compared with those who consumed 8% of their calories as added sugar. "Basically, the higher the intake of added sugar, the higher the risk for heart disease," says Dr. Hu. How sugar actually affects heart health is not completely understood, but it appears to have several indirect connections. For instance, high amounts of sugar overload the liver. "Your liver metabolizes sugar the same way as alcohol, and converts dietary carbohydrates to fat," says Dr. Hu. Over time, this can lead to a greater accumulation of fat, which may turn into fatty liver disease, a contributor to diabetes, which raises your risk for heart disease. Consuming too much added sugar can raise blood pressure and increase chronic inflammation, both of which are pathological pathways to heart disease. Excess consumption of sugar, especially in sugary beverages, also contributes to weight gain by tricking your body into turning off its appetite-control system because liquid calories are not as satisfying as calories from solid foods. This is why it is easier for people to add more calories to their regular diet when consuming sugary beverages. "The effects of added sugar intake — higher blood pressure, inflammation, weight gain, diabetes, and fatty liver disease — are all linked to an increased risk for heart attack and stroke," says Dr. Hu. How much is okay? If 24 teaspoons of added sugar per day is too much, then what is the right amount? It's hard to say, since sugar is not a required nutrient in your diet. The Institute of Medicine, which sets Recommended Dietary Allowances, or RDAs, has not issued a formal number for sugar. However, the American Heart Association suggests that men consume no more than 150 calories (about 9 teaspoons or 36 grams) of added sugar per day. That is close to the amount in a 12-ounce can of soda. Subtracting added sugar Reading food labels is one of the best ways to monitor your intake of added sugar. Look for the following names for added sugar and try to either avoid, or cut back on the amount or frequency of the foods where they are found: • brown sugar • corn sweetener • corn syrup • fruit juice concentrates • high-fructose corn syrup • honey • invert sugar • malt sugar • molasses • syrup sugar molecules ending in "ose" (dextrose, fructose, glucose, lactose, maltose, sucrose). Total sugar, which includes added sugar, is often listed in grams. Note the number of grams of sugar per serving as well as the total number of servings. "It might only say 5 grams of sugar per serving, but if the normal amount is three or four servings, you can easily consume 20 grams of sugar and thus a lot of added sugar," says Dr. Hu. Also, keep track of sugar you add to your food or beverages. About half of added sugar comes from beverages, including coffee and tea. A study in the May 2017 Public Health found that about two-thirds of coffee drinkers and one-third of tea drinkers put sugar or sugary flavourings in their drinks. The researchers also noted that more than 60% of the calories in their beverages came from added sugar. Yet, Dr. Hu warns against being overzealous in your attempts to cut back on added sugar, as this can backfire. "You may find yourself reaching for other foods to satisfy your sweet cravings, like refined starches, such as white bread and white rice, which can increase glucose levels, and comfort foods high in saturated fat and sodium, which also cause problems with heart health," he says. Where does your added sugar come from? Rank Food group Proportion of average intake 1 Soda/energy/sports drinks 42.2% 2 Grain-based desserts 11.9% 3 Fruit drinks 8.5% 4 Dairy desserts 5.5% 5 Candy 5.0% 6 Ready-to-eat cereals 2.9% 7 Sugars/honey 4.1% 8 Tea 3.8% 9 Yeast breads 2.3% 10 Syrups/toppings 1.4% Source: CDC, National Health and Nutrition Examination Survey, 2005–06. https://www.health.harvard.edu/ kalip
  6. Low-dose aspirin 1. About low-dose aspirin Daily low-dose aspirin is a blood thinning medicine. Aspirin is also known as acetylsalicylic acid. Low-dose aspirin helps to prevent heart attacks and strokes in people at high risk of them. Your doctor may suggest that you take a daily low dose if you have had a stroke or a heart attack to help stop you having another one. Or, if you're at high risk of heart attack - for example, if you have had heart surgery or if you have chest pain caused by heart disease (angina). Only take daily low-dose aspirin if your doctor recommends it. Low-dose aspirin comes as tablets. It's available on prescription. You can also buy it from pharmacies, shops and supermarkets. Children are sometimes treated with low-dose aspirin after heart surgery or to treat a rare illness called Kawasaki disease. Children should only take low-dose aspirin if their doctor prescribes it. Taking low-dose aspirin to prevent heart attacks and strokes is not the same as taking aspirin as a painkiller. Read our information on aspirin for pain relief. 2. Key facts • Daily low-dose aspirin makes the blood less sticky and helps to prevent heart attacks and stroke. • It's usual to take a dose of 75 mg once a day. Sometimes doses may be higher. • It's best to take low-dose aspirin with food so it doesn't upset your stomach. • Taking low-dose aspirin isn't safe for everyone. Only take low-dose aspirin if your doctor recommends it. • Low-dose aspirin is also called by the brand names Caprin, Danamep, Micropirin and Nu-seals. 3. Who can and can't take low-dose aspirin Most people aged 16 or over can safely take low-dose aspirin if their doctor recommends it. Low-dose aspirin isn't suitable for certain people. It's sometimes called baby aspirin because of the small dose, but it's not safe for children. Never give aspirin to a child younger than 16, unless their doctor prescribes it. There's a possible link between aspirin and Reye's syndrome in children. Reye's syndrome is a very rare illness that can cause serious liver and brain damage. To make sure low-dose aspirin is safe for you, tell your doctor if you have: • an allergy to aspirin or similar painkillers such as ibuprofen • ever had a stomach ulcer • high blood pressure • indigestion • heavy periods - taking daily aspirin can make them heavier • recently had a stroke (low-dose aspirin isn't suitable for some types of stroke) • asthma or lung disease • ever had a blood clotting problem • liver or kidney problems • gout - it can get worse if you take daily aspirin • Check with your doctor that it's safe for you to take low-dose aspirin if you're pregnant, trying to get pregnant, or if you want to breastfeed. 4. How and when to take it Take low-dose aspirin once a day. Don't take it on an empty stomach. It's best to take it with or just after food. This will make it less likely to upset your stomach. How much should I take? Your doctor will discuss what dose is right for you. It's important to take low-dose aspirin exactly as recommended by your doctor. The usual dose to prevent a heart attack or stroke is 75 mg once a day (a regular strength tablet for pain relief is 300mg). The daily dose may be higher - up to 300 mg once a day - especially if you have just had a stroke, heart attack or heart bypass surgery. Different types of low-dose aspirin tablets Low-dose aspirin comes as several different types of tablet: • standard tablets - that you swallow whole with water • soluble tablets - that you dissolve in a glass of water • enteric coated tablets - that you swallow whole with water. These tablets have a special coating that means they may be gentler on your stomach. Do not chew or crush them because it'll stop the coating working. If you also take indigestion remedies, take them at least 2 hours before or after you take your aspirin. The antacid in the indigestion remedy affects the way the coating on these tablets works. You can buy low-dose enteric coated aspirin and low-dose soluble aspirin from pharmacies, shops and supermarkets. What if I forget to take it? If you forget to take a dose of aspirin, take it as soon as you remember. If you don't remember until the following day, skip the missed dose. Do not take a double dose to make up for a forgotten dose. If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine. What if I take too much? Taking 1 or 2 extra tablets by accident is unlikely to be harmful. The amount of aspirin that can lead to overdose varies from person to person. 5. Side effects Like all medicines, aspirin can cause side effects, although not everyone gets them. Common side effects Common side effects of aspirin happen in more than 1 in 100 people. Talk to your doctor or pharmacist if the side effects bother you or don't go away: • mild indigestion • bleeding more easily than normal - because aspirin thins your blood, it can sometimes make you bleed more easily. For example, you may get nosebleeds and bruise more easily, and if you cut yourself, the bleeding may take longer than normal to stop. Serious side effects It happens rarely, but some people have serious side effects after taking low-dose aspirin. Call a doctor straight away if you get: • red, blistered and peeling skin • coughing up blood or blood in your pee, poo or vomit • yellow skin or the whites of your eyes turn yellow - this can be a sign of liver problems • painful joints in the hands and feet - this can be a sign of high levels of uric acid in the blood • swollen hands or feet - this can be a sign of water retention Serious allergic reaction In rare cases, it's possible to have a serious allergic reaction to aspirin. 6. How to cope with side effects What to do about: • mild indigestion - take your aspirin with food. If the indigestion still doesn't go away, it could be a sign that the aspirin has caused a stomach ulcer. Talk to your doctor - they may prescribe something to protect your stomach or switch you to a different medicine. • bleeding more easily than normal - be careful when doing activities that might cause an injury or a cut. Always wear a helmet when cycling. Wear gloves when you use sharp objects like scissors, knives, and gardening tools. Use an electric razor instead of wet shaving, and use a soft toothbrush and waxed dental floss to clean your teeth. See a doctor if you're worried about any bleeding. 7. Pregnancy and breastfeeding Pregnancy and low-dose aspirin It's generally safe to take low-dose aspirin during pregnancy, as long as your doctor has said it's OK. Your doctor may advise you to take low-dose aspirin during pregnancy: • to help prevent heart attack and stroke • to help prevent pre-eclampsia (pregnancy-related high blood pressure) • if you're having fertility treatment • if you have had several previous miscarriages For more information about how low-dose aspirin can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website. Breastfeeding and low-dose aspirin Aspirin is not generally recommended while you're breastfeeding. But your doctor may suggest that you take low-dose aspirin while you're breastfeeding if they think the benefits of the medicine outweigh the possible harm. 8. Cautions with other medicines Some medicines interfere with the way aspirin works. Tell your doctor if you're taking these medicines before you start taking aspirin: • medicines to thin blood or prevent blood clots, such as clopidogrel and warfarin - taking them with aspirin might cause bleeding problems • medicines for pain and inflammation, such as ibuprofen and prednisolone • medicines to prevent organ rejection after a transplant, such as ciclosporin and tacrolimus • medicines to treat high blood pressure, such as furosemide and ramipril • digoxin, a medicine for heart problems • lithium, a medicine for mental health problems • acetazolamide, for an eye problem called glaucoma • methotrexate, a medicine used to stop the immune system overreacting and sometimes to treat some types of cancer • diabetes medicines, such as insulin and gliclazide Mixing low-dose aspirin with painkillers It's safe to take paracetamol with low-dose aspirin. But don't take ibuprofen at the same time as low-dose aspirin without talking to your doctor. Aspirin and ibuprofen both belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). If you take them together, it can increase your chances of side effects like stomach irritation. Mixing low-dose aspirin with herbal remedies or supplements Aspirin may not mix well with quite a lot of complementary and herbal medicines. Aspirin could change the way they work and increase your chances of side effects. For safety, speak to your pharmacist or doctor before taking any herbal or alternative remedies with aspirin. https://www.nhs.uk/ kalip
  7. Life Expectancy Shrinks for America's Working-Age Adults Despair, as evidenced in rising rates of drug abuse and suicide, may be eroding the average life expectancy of Americans, a new study finds. Deaths among working-age adults, especially, have been increasing in the United States for decades, particularly in economically struggling parts of the nation such as the "Rust Belt" and Appalachia, the researchers reported. These early deaths are causing average life expectancy to decline in the United States. U.S. life expectancy dropped between 2014 and 2017, even while citizens in more than a dozen other industrialised nations continue to enjoy ever-longer lives. The U.S. trend is being driven not just by the widely publicised "deaths of despair" -- drug overdoses, alcoholism and suicide -- but also by a diverse list of diseases affecting organs throughout the body, said lead researcher Dr. Steven Woolf. He's director emeritus of the Virginia Commonwealth University School of Medicine's Centre on Society and Health. The root cause of all this illness and death could be economic stress. Woolf and his colleagues suspect that the decline of the middle class in America is contributing to an average shorter lifespan across the country. "It might turn out that investment in the middle class, and helping to bring jobs and economic development to those communities, might do more to save lives than adding another wing onto the hospital," Woolf said. Average U.S. life expectancy stood at 78.6 years in 2017, down from a peak of 78.9 in 2014, the researchers said in background notes. The increase in working-age death rates has tracked closely with major shifts in the U.S. economy dating back to the 1970s and 1980s, when the country began to lose manufacturing jobs and the middle class started shrinking, Woolf said. The largest relative increases in midlife mortality rates have occurred in the Ohio Valley (West Virginia, Ohio, Indiana, Kentucky) and in northern New England (New Hampshire, Maine, Vermont), according to the researchers' analysis of federal data. "In our analysis, we estimated how many excess deaths occurred in the United States due to this problem between 2010 and 2017," Woolf said. "One-third of those deaths occurred in those four states in the Ohio Valley." Life expectancy in the United States rose at a steady rate in the 1960s and 1970s, but began to lose pace in the 1980s, Woolf said. "By 1998, we had fallen below the average increase of the other industrialised countries. We plateaued in 2011, and now we're falling," Woolf said. "That it's decreasing at all speaks volumes, because it continues to climb at a healthy rate in other industrialised countries." Declining life expectancy has been fuelled by a "sharp increase in deaths among the working-age population," Woolf said. There's been a 6% increase in death rates among people 25 to 64, and in young adults 25 to 44 it's more like a 25% increase, Woolf said. "It's noteworthy that the Rust Belt is where we're seeing the largest number of excess deaths in this pattern," Woolf said. "You have people and communities that have gone through a long period of economic stress. If you're a family that's been struggling for many years with these kinds of stresses, that might lead on a set of consequences that could affect your health in multiple ways." It's not just that economic stress makes one more likely to turn to drink, drugs or suicide, Woolf said. People struggling financially might not be able to pay for health care or prescriptions, afford healthy food, or be able to effectively manage chronic conditions like diabetes or high blood pressure. This falls in with a school of thought called the "social determinants of health," said Dr. Howard Koh, a professor at the Harvard T.H. Chan School of Public Health, in Boston. "I like to say health starts where people live, labour, learn, play and pray," said Koh, co-author of an editorial accompanying the new study. "You can't be healthy if you're living in poverty. You can't really be healthy if you don't have stable housing. It's difficult to be healthy without stable employment. Spirituality and social engagement are critical to well-being," Koh explained. "We are really in an important point in our public health history where medical experts are realising that health is much more than what happens to you in the doctor's office," he continued. Woolf pointed out that this decline has occurred even though the United States spends more than any other nation on health care. That could mean this nation needs to consider a solution outside medicine for its poor health. "Policies we don't typically think of as health policies -- like living wages and affordable housing and broadening access to a good education -- actually may be more effective in improving our health than investments in medical care," Woolf said. Koh noted that without a broader view of health, people in the United States are likely to continue to die at younger and younger ages on average. "It has long been assumed that rising life expectancy would always be the norm. The nation now risks life expectancy going downward as a troubling new norm. That's something we desperately need to avoid," Koh said. The findings were published Nov. 26 in the Journal of the American Medical Association. More information The U.S. Centres for Disease Control and Prevention has more about U.S. life expectancy. healthday. kalip
  8. Roasted Cauliflower and Lentil Tacos with Creamy Chipotle Sauce INGREDIENTS Cauliflower 1 large head of cauliflower, sliced into bite-sized florets 2 to 3 tablespoons olive oil Salt and freshly ground black pepper Seasoned lentils 1 tablespoon olive oil 1 cup chopped yellow or white onion 2 large garlic cloves, pressed or minced 2 tablespoons tomato paste 1/2 teaspoon ground cumin 1/2 teaspoon chili powder 3/4 cup brown lentils, picked over for debris and rinsed 2 cups vegetable broth or water Chipotle sauce 1/3 cup mayonnaise (vegan) 2 tablespoons lime juice 2 to 3 tablespoons adobo sauce (from a can of chipotle peppers) or chipotle hot sauce to taste Salt and freshly ground black pepper, to taste Everything else 8 small, round corn tortillas 1/2 cup packed fresh cilantro leaves (cilantro haters, substitute some fresh spring greens instead) INSTRUCTIONS To roast the cauliflower: Preheat oven to 220°C . Toss cauliflower florets with enough olive oil to cover them in a light, even layer of oil. Season with salt and pepper and arrange the florets in a single layer on a large, rimmed baking sheet. Roast for 30 to 35 minutes, tossing halfway, until the florets are deeply golden on the edges. Warm the olive oil in a medium-sized pot over medium heat. Sauté the onion and garlic with a dash of salt for about 5 minutes, until the onions are softened and turning translucent. Add the tomato paste, cumin and chili powder and sauté for another minute, stirring constantly. Add the lentils and the vegetable broth or water. Raise heat and bring the mixture to a gentle simmer. Cook, uncovered, for 20 minutes to 45 minutes, until the lentils are tender and cooked through. Reduce heat as necessary to maintain a gentle simmer, and add more broth or water if the liquid evaporates before the lentils are done. Once the lentils are done cooking, drain off any excess liquid, then cover and set aside. To prepare the chipotle sauce, just whisk together the ingredients and set aside (if you have no choice but to use whole chipotle peppers from the can, use a blender to purée it all). Warm tortillas individually in a pan over medium heat. Stack the warm tortillas and cover them with a tea towel if you won’t be serving the tacos immediately. Once all of your components are ready, you can assemble your tacos! Top each tortilla with the lentil mixture, cauliflower, a drizzle of chipotle sauce and a generous sprinkle of chopped cilantro https://cookieandkate.com/ kalip
  9. Study Casts Doubt on Angioplasty, Bypass for Many Heart Patients Bypass operations, angioplasty and the placement of artery-opening stents: For decades, millions of Americans have undergone these expensive, invasive procedures to help treat clogged vessels. However, the results of a large and long-awaited clinical trial suggest that, in most cases, these procedures may not have provided any benefit over medications and lifestyle changes. In fact, people treated with meds and healthy changes in lifestyle wound up about as healthy as those who underwent an invasive procedure to open their hardened arteries, researchers reported Saturday at the American Heart Association (AHA) annual meeting in Philadelphia. Only a subgroup of patients who suffered from frequent angina appeared to receive any benefit from an invasive procedure, and that benefit was in their quality of life, not in lowering their odds of death or future heart problems. "Based on the trial results to date, I as a clinician would feel comfortable advising my patient not to undergo the invasive strategy if their angina was absent or controlled or it was tolerated," said Dr. Alice Jacobs, director of the Cardiac Catheterisation Laboratory and Interventional Cardiology at Boston Medical Centre. She wasn't involved in the new research. Still, doctors are often uncomfortable limiting their treatment of clogged arteries to drugs, diet and exercise alone because they're worried the patient will wind up suffering a heart attack or other heart-related illness, according to past AHA president Dr. Elliot Antman. The new findings are expected to give physicians more confidence in saying no to invasive treatments, the experts said. The study did not focus on people who are admitted to a hospital with a heart attack -- these patients often receive bypass, angioplasty or stenting to quickly open a blocked artery. Instead, the trial focused on patients with stable but severe heart disease. A typical patient in this group might be a 71-year-old grandmother who has noticed during the past two months some chest heaviness walking from the parking lot to her grandkids' soccer game, the AHA presenters said. Stress testing and imaging scans could reveal some moderately c logged arteries leading to her heart. The new trial was very comprehensive, involving nearly 5,200 patients across 37 countries. Half were randomly assigned to undergo an invasive procedure: About three-quarters underwent angioplasty (most receiving a stent as well), while the others had a bypass operation. The other half of patients were treated with medications and lifestyle changes alone. Researchers mainly focused on whether the invasive procedure would reduce a patient's risk of heart-related death, heart attack, hospitalisation with unstable angina, heart failure or cardiac arrest. Overall, an invasive strategy "did not demonstrate a reduced risk over a median 3.3 years" compared with the more conservative, drugs/lifestyle therapy, said trial co-chair Dr. Judith Hochman, a cardiologist and senior associate dean of clinical sciences at NYU Langone Health, in New York City. However, invasive procedures did have a positive impact on one patient subgroup: People who regularly suffer the chest pain and shortness of breath associated with angina, said co-researcher Dr. John Spertus. He directs health outcomes research at Saint Luke's Mid-America Heart Institute in Kansas City. "For a patient who has weekly angina, there would be 15% of them who would be expected to be angina-free with the conservative approach, while 45% would be expected to be angina-free with the invasive approach," Spertus said. "This is such a large difference that you would only have to treat about three patients with weekly angina for one to be angina-free at three months." On the other hand, patients who did not regularly have angina received only minimal quality-of-life or symptom benefits after undergoing an invasive procedure, Spertus added. A smaller set of trials -- this time focused on patients with chronic kidney disease -- revealed even less promising results, researchers said. Patients didn't ain any health benefits and didn't have any improvement in their quality of life after getting an invasive treatment. Angioplasty might even help put them on dialysis earlier or increase their risk of stroke, the study found. Dr. Glenn Levine, a professor of cardiology with Baylor College of Medicine in Houston, said that when it comes to kidney patients with clogged arteries, he "will treat them with medical [drug] therapy alone" unless they have marked or uncontrolled angina. Experts said the main message from these studies is that doctors shouldn't feel pressured to immediately send patients with clogged arteries into a catheterisation lab, especially if they aren't suffering any symptoms. That could free up physicians to focus on getting patients to take their medications, Jacobs said. If drug therapy helps relieve their occasional angina or other symptoms, then angioplasty might be avoided in two out of every three patients, she estimated. The trials were funded by the U.S. National Heart, Lung, and Blood Institute. For more information: There's more on common heart procedures at the American Heart Association. healthday kalip https://www.youtube.com/watch?v=LOMesWPenSU
  10. Are Low-Calorie Sweeteners Bad for You? Marquita Adams, 46 of Alexandria, VA, whips out her little bottle of Splenda Zero from her pocket and squirts it twice into her coffee. She also squirts Crystal Light into her water a few times a week for “a little pizazz.” These products contain no-calorie sweeteners that are hundreds to even thousands of times sweeter than regular table sugar. Consumers turn to them for weight loss and/or to control their blood sugar. Type 2 diabetes runs in Adams’ family. “When I learnt 2 years ago that I was prediabetic, I switched from using natural sweeteners like agave and Sugar in the Raw to artificial ones.” Chris Brown, 64, of Aurora, OH, made the switch to artificial sweeteners when she was diagnosed with Type 2 diabetes 6 years ago. “I was drinking at least two cans daily of regular Coke [with high-fructose corn syrup] and then switched to Diet Coke with aspartame before discovering Coke Zero. I now drink about two cans daily of Coke Zero, which tastes more like regular Coke than Diet Coke.” Adams and Brown are not alone in their use of these low-calorie sweeteners (LCS). A quarter of children and 41.4 % of adults reported using them in the 2009-2012 National Health and Nutrition Examination Survey (NHANES). This represents a 200% jump in their use for children from 1999 and a 54% increase in use among adults. The majority of children and adults said they ate or drank one or more sweeteners daily, according to a 2017 study. Drinks accounted for the most common source of low-calories sweeteners, followed by food, and then sweetener packets, according to the study. Besides beverages, the faux sugars appear in breads, cereals, snacks, yogurt, no-sugar ice cream, reduced-sugar cookies, and condiments. They may not always be easy to spot. Many parents do not want their children eating or drinking low-calorie sweeteners, but often they do not recognize them when the shop for groceries. “They may buy items that say no sugar added, sugar-free, or light, thinking they are healthier options,” says Allison Sylvetsky, PhD, lead investigator of the study and assistant professor of exercise and nutrition sciences at the George Washington University Milken Institute School of Public Health. The highest users of low-calorie sweeteners were obese college-educated women with type 2 diabetes who had higher family income. “People are now more educated and aware of the negative health effects of sugar and seek out products labelled sugar-free or no sugar added,” Sylvetsky says. She attributed the increasing use to several recent things, including obesity prevention campaigns focused on cutting added sugars and calories from diets; how the sweeteners are used more in foods, including a trend toward blending them to improve the taste of some products; combining the sweeteners with sugars that have calories; and falling costs. The Research Is Contradictory The FDA has approved eight “high-intensity sweeteners.” Six are approved as food additives: saccharin, aspartame, sucralose, acesulfame potassium, neotame, and advantame. Stevia extracted from chemical compounds in the plant’s leaves was the first natural sweetener the FDA approved as “generally recognised as safe,” followed by monk fruit (luo han guo) found in China, with compounds extracted from the plant’s fruit. The FDA also has approved sugar alcohols as sugar substitutes because they are low-calorie carbohydrates with a sweetness of 25% to 100% of regular sugar. Examples include sorbitol, xylitol, lactitol, mannitol, erythritol, and maltitol. But there is evidence to suggest that frequent use of the sweeteners, especially in diet sodas, raises the risk of several chronic diseases, including obesity, metabolic syndrome, type 2 diabetes, and heart disease. A large long-term study published in October found that drinking at least an additional half-serving daily of artificially sweetened beverages was associated with a 16% higher risk of diabetes. Interestingly, when people replaced one daily serving of a sugary beverage with water, coffee, or tea, but not an artificially sweetened beverage, it was associated with a 2% to 10% lower diabetes risk. Other studies have linked artificially sweetened beverages with stroke and heart disease. For example, after controlling for lifestyle factors, a February study found that women who drank two or more artificially sweetened beverages each day were 31% more likely to have a clot-based stroke, 29% more likely to have heart disease, and 16% more likely to die from any cause than women who drank diet beverages less than once a week or not at all. Yet another study from 2017 tied drinking diet soft drinks to a higher risk of ischemic stroke. But low-calorie and no-calorie sweeteners have been considered healthy sugar substitutes because they provide sweet taste without calories or glycaemic effects on blood sugar that have contributed to obesity and diabetes. Some older studies have shown that these sweeteners can aid weight loss. One concluded that “overall, the balance of evidence indicates that use of low-calorie sweeteners in place of sugar, in children and adults, leads to reduced caloric intake and body weight, and possibly also when compared with water.” Another study found that when 318 overweight and obese adults replaced caloric beverages with no-calorie ones during a 6-month period, they lost an average of 2% to 2.5% of their weight. Where Do Nutritionists Stand? The position of the Academy of Nutrition and Dietetics since 2012 is that people can safely enjoy a range of sweeteners, including non-nutritive sweeteners with few or no calories, as part of an eating plan that takes into account federal nutrition guidelines, personal health goals, and preferences. “I think these low-calorie sweetener products are great. Consumers can have the sweetness they want and drink it too,” says Debbie Petitpain, a media spokesperson for the academy and a wellness director in the Office of Health Promotion at the Medical University of South Carolina. She also thinks they are safe, based on the numerous studies the FDA reviews as part of its approval process of these food additives. The FDA website says human studies, along with animal studies, were done for saccharin, advantame, and neotame. Advantame is 20,000 times sweeter than table sugar, and neotame is 7,000 to 13,000 times sweeter. “It makes sense to cut back on calories, given that there is mounting evidence that sugar contributes to chronic disease such as obesity, type 2 diabetes, and heart disease,” Petitpain says. She referred to the recommendation in the 2015-2020 Dietary Guidelines for Americans that people take in less than 10% of calories per day from added sugars. But a 2017 report indicated that only 42% of adults from 2013-2014 were able to meet that recommendation. The American Heart Association and American Diabetes Association took the position in 2012 that non-nutritive sweeteners can be part of a diet that aims to cut added sugars. But they also said it would be premature, based on the research, to conclude that they definitely reduced added sugars, body weight, metabolic syndrome, and diabetes -- all things that can lead to heart disease. One concern researchers expressed was whether people make up for the calories they save in other ways. Petitpain advises clients to look for the low-hanging fruit to cut back on added sugars. Most added sugars are in what people drink. or clients who rather not drink plain water and still want something sweet-tasting, using LCS [low-calorie sweeteners] is a good choice.” Although Petitpain doesn’t steer clients toward any specific sweetener, she does take into account their health history, goals, and personal preferences, which may be to avoid low-calorie sweeteners altogether. If people have phenylketonuria (PKU), a rare genetic disorder, the FDA recommends that they avoid or restrict their use of aspartame because they have a difficult time metabolizing phenylalanine, which is in aspartame. Petitpain also says some clients may be put off by saccharin because they recall a warning label of bladder cancer after studies in rats in the 1970s linked the sweetener to this cancer. After several studies done in humans showed that saccharin is safe for humans, the warning label was no longer required. The Academy of Nutrition and Dietetics also says the sweeteners are safe for kids and are not linked to cancer, birth defects, or behaviour problems. But it cautioned that kids shouldn’t overdo eating foods or drinking beverages with them as they often contain “empty calories. ” The American Academy of Pediatrics agrees there is no scientific evidence linking them to those health concerns. But the organization calls for more research, saying it is not clear whether the sweeteners have long-term health effects. Without other diet and lifestyle changes, using them is not likely to lead to significant weight loss, it says. Petitpain is also cautious about recommending low-calorie sweeteners to women during pregnancy, because there is no safety data to know for sure. Another consideration is how the sweeteners will be used -- some perform better at high temperatures than others. Sucralose, acesulfame potassium, neotame, and advantame are considered “heat stable,” meaning they stay sweet at high temperatures. Aspartame, on the other hand, “loses its sweetness when heated, so it typically isn’t used in baked goods,” according to the FDA. Sandra Arevalo, a media spokesperson for the Academy of Nutrition and Dietetics and director of community and patient education at Montefiore Nyack Hospital in Nyack, NY, prefers natural sweeteners to artificial ones, which may be easier to digest for people with sensitive stomachs. Stevia and monk fruit extract shouldn't aggravate sensitive bowels, she says, but Truvia might, because it blends Stevia with the less digestion-friendly erythritol. Sugar alcohols can also cause digestion problems, says Arevalo. “It’s based on the digestion process and chemical reaction of the sugar alcohols. These aren’t fully absorbed and get fermented, causing bloating and gas and, in some instances, diarrhoea.” Too Much of a Good Thing A large long-term study published in April found that only the highest intake of artificial sweeteners was associated with a higher risk of heart disease and death among women. In general, Petitpain recommends that clients use a variety of sweeteners to avoid consuming too much of one. “For example, if your favourite diet soda is sweetened with aspartame, consider using sucralose in your iced tea.” To know whether foods or drinks have low-calorie sweeteners, look for phrases like “sugar-free,” “no sugar added,” or “light.” But to be sure, look at the names of the ingredients on the back of the package. Sugar alcohols are in some products like Truvia. To find out, look at the Nutrition Facts label under carbohydrates. Food makers may voluntarily list the amount in grams (g) per serving. Specific names of sugar alcohols may also be listed under Ingredients. Brown thinks switching to artificial sweeteners in her daily Coke has helped her cut back on sugar, although she still has diabetes. “I really loved regular Coke and would drink it even in the middle of the night.” Adams was surprised that her blood sugar didn’t fall after she switched to artificial sugars in her drinks. When her doctor suggested she just use one Splenda packet in her coffee and tea, which has a few carbs and calories due to other ingredients, she started using the little bottle of Splenda Zero, which has no carbs or calories. Adams hopes to see a decrease in her blood sugar when she goes for her next annual physical. In the meantime, she plans to continue using artificial sweeteners, which she views as the “lesser of the two evils,” compared to diabetes. WebMD Health News https://www.webmd.com/ kalip
  11. Understanding Heart Disease -- Diagnosis and Treatment How Do I Know If I Have Heart Disease? In diagnosing heart disease, a doctor will first ask you for a description of symptoms and your medical history. Your physical condition also will be assessed through a standard medical exam. Listening to the heart for swishing or whooshing sounds, collectively known as heart murmurs, may provide important clues about heart trouble. If heart disease is suspected, further te sts are done to find out what is actually happening inside the heart. An electrocardiogram, or ECG, is usually the first test to be performed. By recording electrical activity within the heart, the ECG quickly reveals any electrical abnormalities that may be a source of trouble or may indicate that the heart muscle has been or is being injured by ischaemia (lack of oxygen-rich blood). Further details can be gathered by taking images of the heart using X-rays, a variety of of other scans using CT, MRI or nuclear technology, or via angiography, a special technique that allows for detailed imaging of blood vessels. Echocardiograms (ultrasound evaluations of the heart) can also determine how well the heart and valves are working. Other tests may include stress testing, with or without additional imaging of the heart, and sophisticated testing for arrhythmias (such as electrophysiology testing or EP testing). What Are the Treatments for Heart Disease? Medical care is essential once heart disease is diagnosed. The goals of treatment are stabilizing the condition, controlling symptoms over the long term, and providing a cure when possible. Stress reduction, diet, and lifestyle changes are key in managing heart disease, but the mainstays of conventional care are drugs and surgery. Lifestyle and Your Heart If you smoke, quit. You should also get in the habit of exercising, because exercise strengthens the heart and blood vessels, reduces stress, and has been shown to reduce blood pressure while also boosting HDL (good) cholesterol levels. Numerous studies done in recent decades indicate that drinking alcohol in moderation may actually reduce the risk of heart disease. But more than one drink a day for women, or more than one to two a day for men, is not recommended. Learning to relax may help prevent and treat heart disease. While success varies from person to person, stress-reduction techniques have been shown to reduce high blood pressure, heart arrhythmias, and emotional responses such as anxiety, anger, and hostility that have been linked to coronary heart disease, angina, and heart attack. The choice of relaxation technique is up to you. Some that have proved beneficial are meditation, progressive relaxation, yoga, and biofeedback training. Nutrition, Diet, and Your Heart Even modest changes in diet and lifestyle can significantly reduce the risk of heart disease. Being overweight, especially in the mid-section, can lead to high blood pressure and diabetes. If you are 20% or more over the ideal weight for your age, height, and @@@, you put a strain on your heart's ability to pump blood efficiently. Although lowering sodium and trans fat consumption are important for lowering blood pressure and reducing the risk of coronary heart disease, equally vital is increasing intake of fresh fruits and vegetables, and healthy sources of fats and proteins (as from fish, nuts, seeds, soy-based items, avocados, etc.) whole unprocessed high-fibre grains, and healthy sources of fats and proteins such as those from fish, nuts, seeds, soy-based items, and avocados. A number of studies have found that a high intake of total , from foods or supplements, lowers the risk of heart disease. Although it’s best to get fibre from food sources, fibre supplements can also help you get the daily fibre you need. Examples include psyllium and methylcellulose. Increase your fibre intake slowly to help prevent gas and cramping. It’s also important to also increase the amount of liquids that you drink. Treatment for Coronary Artery Disease Drug treatments may include daily aspirin, and drugs such as ACE inhibitors and beta-blockers. Treatments may also target high blood pressure and high cholesterol -- two major risk factors for coronary disease. In addition, your doctor may recommend surgical treatments such as balloon angioplasty (usually using a stent to prop open the vessels) or open heart surgery to bypass blocked heart arteries. Treatment for Heart Failure Treatment usually depends on the cause of heart failure, but often includes drugs to help control symptoms, such as diuretics or water pills to flush the body of fluids, beta-blockers to block adrenaline’s action, and ACE inhibitors to help modulate sodium and potassium balance and improve blood pressure levels. Devices such as pacemakers and defibrillators are sometimes implanted to improve the heart's function and/or prevent deadly arrhythmias. In very advanced cases, heart transplantation may be a consideration. Treatment for Heart Arrhythmias Treatment depends on the type of arrhythmia you have, but can include drugs to normalize the heart rate, such as beta-blockers, many newer drugs to help convert your rhythm to normal, drugs to prevent blood clots (such as warfarin and dabigatran), and "cardioversion," a treatment that involves sending a strong electrical shock to the heart to convert the heart rhythm back to normal. Treatment for Heart Valve Disease In severe cases, patients may require medications to deal with heart failure, or surgery to repair or replace the abnormal valve. Treatment for Pericardial Disease Pericarditis often subsides on its own, but it also can be treated with anti-inflammatory drugs such as aspirin or, in severe cases, corticosteroid hormones. Occasionally, fluid must be drained from the pericardium using a long, thin needle inserted carefully through the chest. If a chronic condition develops, a pericardial window may need to be created surgically to permit this fluid to drain. In the rare circumstance that pericarditis becomes a chronic condition, surgery may be needed to either create a pathway for the extra fluid to drain internally or remove the pericardial sac altogether. Treatment for Cardiomyopathy (Heart Muscle Disease) Treatment for cardiomyopathy will depend upon the underlying cause, but often includes the same measures used for patients with heart failure. The outcome is also dependent upon the underlying cause. In selected cases, heart transplant surgery may be recommended. Treatment for Congenital Heart Disease Some minor conditions can actually clear up on their own, or can be treated easily with medications. Those that are more complex can often be treated surgically, if necessary. Very rarely, the heart problem is so severe that it cannot be corrected. Dietary Supplements for Heart Disease Several dietary supplements are being studied to determine if they effectively treat coronary heart disease. They include L-carnitine, coenzyme Q10, and garlic. So far, these are not recommended for use in treating or preventing heart disease. Vitamins E and C have been studied extensively and do not appear to lower the risk of developing heart disease. In general, a person will derive the greatest benefits from vitamins and other micronutrients if they are consumed as part and parcel of whole foods. https://www.webmd.com/heart-disease/default.htm kalip
  12. Vegan Tofu Lasagne with Spinach Recipe Ingredients 450 grams lasagne noodles 2 300 grams packages frozen chopped spinach, thawed 450 grams soft tofu 450 grams pound firm tofu 1 tbsp sugar 1/4 cup soy milk 1/2 tsp garlic powder 2 tbsp lemon juice 3 tbsp minced fresh basil 2 tsp salt 1 900 grams jar of tomato sauce Steps to Make It Prepare the lasagne noodles according to package directions. Drain carefully and set aside on a towel. Pre-heat oven to 176°C Squeeze the spinach as dry as possible and set aside. Place the tofu, sugar, soymilk, garlic powder, lemon juice, basil, and salt in a food processor or blender and blend until smooth. Cover the bottom of a 23 cm by 33 cm baking pan with a thin layer of tomato sauce, then a layer of noodles. Follow that with a layer of half the tofu and half the spinach. Continue in the same order, using half the remaining tomato sauce and noodles and the rest of the tofu mixture and spinach. End with the remaining noodles covered by the remaining tomato sauce. Bake for 25 to 30 minutes, or until tomato sauce bubbles. https://www.thespruceeats.com/ kalip
  13. Alternative Treatments for High Cholesterol There are many alternative treatments proposed for lowering cholesterol. But before you add any supplements or alternative therapies to your diet, talk to your health care provider. Few natural products have been proven in scientific studies to reduce cholesterol, but some might be helpful. But also, some supplements may interact with other medication you're taking or have the potential for dangerous side effects. Supplements for Lowering Cholesterol Some of the herbal and nutritional supplements that may help lower cholesterol include: Garlic: According to some studies, garlic may decrease blood levels of total cholesterol by a few percentage points, but only in the short term. Other studies, however, suggest that it may not be as beneficial as once thought. Garlic may prolong bleeding and blood clotting time, so garlic and garlic supplements should not be taken prior to surgery or with blood-thinning drugs such as Coumadin. Fibre: Taking a fibre supplement to help meet your daily fibre intake can help lower your overall cholesterol level and your LDL (bad) cholesterol. Examples include psyllium, methylcellulose, wheat dextrin, and calcium polycarbophil. If you take a fibre supplement, increase the amount you take slowly. This can help prevent gas and cramping. It’s also important to drink enough liquids when you increase your fibre intake. Guggulipid: Guggulipid is the gum resin of the mukul myrrh tree. It has been used in traditional Ayurvedic medicine, which originated in India more than 2,000 years ago. In clinical studies done in India, guggulipid significantly reduced blood levels of total cholesterol and LDL cholesterol. But most of these studies do not meet the criteria for scientific validity. In addition, the enthusiasm for using guggulipid as a cholesterol-lowering herbal agent diminished after the publication of negative results from a clinical trial in the U.S. Further research is necessary to determine the safety and effectiveness of this herb. Red yeast rice: Red yeast rice has been found to lower cholesterol in studies and was previously found in the over-the-counter supplement Cholestin. However, in 2001, FDA took Cholestin off the shelf because it contained lovastatin, a compound found in the cholesterol prescription medication Mevacor. Reformulated "Cholestin" no longer contains red yeast rice. Other red yeast rice-containing supplements currently available in the U.S. can only contain very small levels of lovastatin. The FDA does not allow promotion of red yeast rice for lowering cholesterol. Policosanol: Produced from sugar cane, policosanol was found to be effective in lowering LDL cholesterol in several studies. Most policosanol supplements found in the U.S., including the reformulated Cholestin, contain policosanol extracted from beeswax and not the sugar cane policosanol. There is no evidence that policosanol extracted from beeswax can lower cholesterol. Additional studies on sugar cane policosanol are needed to determine its effectiveness and safety in lowering cholesterol. Other herbal products: The results of several studies suggest fenugreek seeds and leaves, artichoke leaf extract, yarrow, and holy basil all may help lower cholesterol. These and other commonly used herbs and spices -- including ginger, turmeric, and rosemary -- are being investigated for their potential beneficial effects relating to coronary disease prevention. Dietary Approaches to Lowering Cholesterol Increased consumption of dietary fibre, soy foods, omega-3 fatty acids, and plant compounds similar to cholesterol (plant stanols and sterols) can significantly reduce LDL cholesterol, or bad cholesterol. Fibre: Only plant foods (vegetables, fruits, legumes, unrefined grains) contain dietary fibre. The soluble fibre found in foods such as oat bran, barley, psyllium seeds, flax seed meal, apples, citrus fruits, lentils and beans are particularly effective in lowering total and LDL cholesterol. Nuts: Many nuts such as almonds, walnuts, pecans, and pistachios can reduce cholesterol. According to the FDA, eating a handful (1.5 ounces) of walnuts daily can reduce the risk of heart disease. You can replace foods high in saturated fats with nuts and they are a good source of fibre. Soybeans: Substituting soybeans or soy protein for other proteins have been shown to prevent coronary heart disease by lowering LDL cholesterol and triglycerides. Soy protein is present in tofu, tempeh, soy milk, soy yogurt, edamame, soy nuts, and many other food products made from soybeans. Phytosterols: Phytosterols (plant sterol and stanol esters) are compounds found in small amounts in foods such as whole grains as well as in many vegetables, fruits, and vegetable oils. They decrease LDL cholesterol, mostly by interfering with the intestinal absorption of cholesterol. Phytosterols can be found in spreads (like the cholesterol-lowering margarines Benecol, Promise, Smart Balance, and Take Control), dressings for salads, and dietary supplements. Additional phytosterol-fortified foods include Minute Maid Heart Wise orange juice, Nature Valley Healthy Heart chewy granola bars, CocoVia chocolates, Rice Dream Heartwise rice drink, and Lifetime low-fat cheese. Omega-3 fatty acids: Eating foods rich in omega-3 fatty acids may also help reduce heart disease and lower triglycerides. Omega-3 fatty acids decrease the rate at which the liver produces triglycerides. Omega-3 fatty acids also have an anti-inflammatory effect in the body, decrease the growth of plaque in the arteries, and aid in thinning blood. Aim for at least two servings of fatty fish like salmon, mackerel, herring, tuna, and sardines per week. Other dietary sources of omega-3 fatty acids include flax seed and walnuts. Supplement sources include fish oil capsules, flaxseed and flaxseed oil. If you are considering taking omega-3 fatty acids, first discuss with your health care provider if omega-3 fatty acid supplements are right for you, especially if you are currently taking blood-thinning medication. Dietary fibre, nuts, soybeans, and phytosterols decrease cholesterol levels by different mechanisms. Therefore, it is not surprising that the combined dietary intake of these foods and other plant substances along with a low intake of saturated fats is more effective at reducing cholesterol levels than each individual substance alone. Avoid Trans Fats Avoid partially hydrogenated and hydrogenated vegetable oils. These man-made oils are sources of trans fatty acids known to increase LDL cholesterol. They lower heart-protecting HDL (good) cholesterol and increase the inflammatory response in the body. You can now find trans fats listed on the Nutrition Facts panel of packaged foods. Minimise consumption of trans fatty acid-containing food. If diet and regular exercise isn't effective at reducing your cholesterol levels, talk to your doctor about taking cholesterol-lowering medications. https://www.webmd.com/cholesterol-management/ kalip
  14. 10 Things to Do When You’re Overwhelmed Life can be challenging. But with the right strategies, you can find calm in the chaos. Here are 10 tools to manage feeling emotionally overwhelmed. Life can be challenging. With all the demands put upon you by work, family, relationships, external circumstances, and even yourself, it often feels as if you are Atlas, supporting the entire world upon your shoulders. The modern world is moving faster than ever, and it seems as if you will never catch up to all the competing priorities and challenges for your time. This experience can be best summed up in one word: overwhelm. Treading water in an endlessly uncompassionate sea of concerns eats away at your time, health, and happiness, robbing you of a fulfilling life. If you feel this way, understand that you are not alone. The experience of moderate to extreme overwhelm is in no way uncommon. More importantly, however, is the understanding that in all likelihood, it’s not your fault. Feeling overwhelmed with life is essentially systemic in society—in other words, it’s a built-in given of modern life. This is because the fast-paced, technologically driven, high-achievement society has created what in Ayurveda is considered an environment of Vata derangement. Vata is the principle of movement, activity, change, and transition. And while this concept is an essential component of life, when taken to its extreme, too much Vata creates a state of hyperactivity and imbalance. This atmosphere rattles your nerves, agitates your mind, and makes stability elusive. Understanding this is an important first step in coping with overwhelm; when you sense that the odds are stacked against you, you can have more self-compassion as you explore the following strategies to find calm in the chaos. Here are 10 tools to manage feeling emotionally overwhelmed. 1. Prioritise Self-Care When the signs of overwhelm begin to show up in your life, an important first step is to recognise the need to put self-care high on your list of priorities. Don’t wait until your ship has begun to sink before taking concerted action to see to your well-being. At the first hint that your boat has sprung a leak and you’re starting to feel a little swamped in workload, family, or personal concerns, you need to pause, assess the situation, and make a commitment to finding coping skills that will help you remain balanced and centred. 2. Shift Your Perspective It’s important to remember that the stress of overwhelm begins with a perception. Perceptions are subjective interpretations of situations and events. How you perceive things determines how the situation will affect you. When you feel overwhelmed, try to focus on reframing the experience and see it from a different angle. Considering different interpretations of the situation often helps you take things less seriously. Also, recall the wise saying, “This too shall pass.” Everything on the material level of existence as a beginning, middle, and ending. Your thoughts and feelings of being emotionally overwhelmed by life—no matter how exhausting— have an expiration date, and one day it too will pass. 3. Breathe Deeply The feeling of overwhelm and Vata-induced anxiety by their nature get you “amped up”, and in so doing, rattle the cage of your body’s stress response. This increases your heart rate, blood pressure, respiration, stress hormones, muscle tension, and a host of other physiologically damaging effects to your mind-body system. One of the best ways to counteract this sensation is to take slow deep breaths. Known as Pranayama in Yoga and Ayurveda, these breathing techniques help you to regulate your body’s energy levels and can profoundly sooth your mind and body when you’re feeling overwhelmed. Two techniques in particular, Ujjayi Breath (the Success Breath) and Nadi Shodhana (Alternate Nostril Breathing) can have a deeply soothing effect on your system when you’re feeling overwhelmed by life. 4. Meditate Meditation has countless benefits when it comes to countering the effects of overwhelm. First, similar to Pranayama, it is a powerful antidote to the body’s stress response. Second, in addition to slowing your breathing, it also calms the overactivity of your mind and emotions that are so common during periods of overwhelm. As your mind becomes increasingly calm, your body eavesdrops on that stillness, creating a feedback loop of tranquillity and balance that lasts long after the meditation itself. Third, as you become more of an observer of your thoughts rather than being owned by them, your perspective shifts away from being a victim of your overwhelm to being the witness of it. 5. Slow Down and Manage Your Time By its nature, being emotionally overwhelmed often feels as if you are running out of time. Therefore, managing your time wisely is a very practical step to staying ahead of the anxiety and turmoil caused by too many competing priorities. Make a commitment to create a clear and efficient to-do list of tasks ranked by importance and tackle each one in a clear and methodical manner. In addition, as counterintuitive as it sounds, try to slow down whenever possible. Rushing frantically only stirs up more activity, which degrades the quality of your work and relationships. Act deliberately and with awareness, and you’ll find that you are controlling your perceptions of time, rather than feeling like time is controlling you. 6. Move Mindfully Another way to both lower the feeling of overwhelm and shift your perception of time is to practice mindful movement. Activities such as Qi Gong or Yoga can shift your awareness and your emotions into a much more settled and grounded state. This grounding works directly to counteract the “swirly” energy of displaced Vata and help you feel rooted in your body and the earth. The conscious movements of these similar practices also help to create the experience of “time dilation” in which you feel like you have more time due to the deepened quality of your awareness. 7. Unplug–Go On a Digital Fast The modern world has become increasingly technologically dependent. Information is everywhere. Unfortunately, the digital age with all its devices, screens, social medial, and 24-hour accessibility is only driving more activity into your already overwhelmed minds. The high-information diet you keep yourself on can often starve you of the stability and balance you truly need. Therefore, commit to a few hours, a day, week, or even longer of cutting the digital cord. Since you are probably so deeply plugged in, it may feel challenging at the start. But with time, you’ll be pleasantly surprised as to how much more settled your awareness is when it’s not bombarded daylong with unnecessary information. 8. Get Plenty of Sleep Overwhelm can be mentally and physically exhausting. The inefficient use of mind-body energy brought about by prolonged chronic stress leaves you feeling wiped out; therefore, be sure to get plenty of quality sleep to restore and heal. Seven to eight hours of sleep per night is generally recommended for adults, but when you feel overwhelmed, longer periods may be needed. In addition to regular meditation, consider adding a 20-minute mid-afternoon nap into your routine. Also, be sure to set the stage for restful sleep by creating a routine that helps your mind and body to get optimum benefit from your time in bed. 9. Know When to Walk Away Sometimes the most nourishing choice for body, mind, and soul is to simply walk away. You cannot be everything to all people, and it’s important to know when you have reached your limit. Be willing to draw a clear line for yourself and know when to say no. Doing so can sometimes be a defining and courageous moment in which you assert your need to no longer feel victimised by external circumstances and situations. In doing so, you reclaim your power to manage your life and awareness in a way that is nourishing and supportive for you, without the need to defend nor explain yourself to others. Or as Richard Bach light-heartedly puts it in Illusions: The Adventures of a Reluctant Messiah: “The best way to avoid responsibility is to say, 'I've got responsibilities.” 10. Surrender Lastly, be willing to surrender the situation completely. This doesn’t mean giving up, but rather detaching from any particular outcome and turning everything over to universal intelligence, God, the nonlocal mind, or your higher self. Surrendering is an act of humility in that you’re willing to turn things over to a power greater than yourself. You recognise that you don’t have to do everything and sometimes the greatest act of strength is the willingness to let go of your need to control all the things. In Yoga, this is known as Ishwara Pranidhana or surrender to the divine. In this surrendering, you are stepping into the unknown and trusting that everything will be all right, because as A Course in Miracles reminds us, “There is no order of difficulty in miracles. One is not ‘harder’ or ‘bigger’ than another. They are all the same. All expressions of love are maximal.” Feeling overwhelmed with life is normal. These tips are meant to help manage and overcome the thoughts and feelings so that you can focus on living a happy, healthy, and positive lifestyle. https://chopra.com/articles kalip
  15. Exercise Can Lower Older Women's Fracture Risk Older women who get even light exercise, like a daily walk, may lower their risk of suffering a broken hip, a large study suggests. A number of studies have linked regular exercise to a lower risk of hip fracture -- a potentially disabling or even fatal injury for older adults. Each year, more than 300,000 people in the United States aged 65 or older are hospitalized for a broken hip, according to the U.S. Centers for Disease Control and Prevention. The new study, of more than 77,000 older U.S. women, took a deeper look at the types of exercise that are related to the risk of hip fracture and other bone breaks. The researchers found that, on average, women who regularly exercised at any intensity -- from walking, to doing yard work, to jogging -- had a lower risk of hip fracture over 14 years, compared to inactive women. It all suggests that even light activity is enough to curb the risk of these serious injuries, said study leader Michael LaMonte, a research associate professor at the State University of New York at Buffalo. "We were happy to see a strong relationship between walking and lower hip fracture risk," he said. "As we get older, we naturally do less-strenuous physical activity. This suggests that to lower your risk of hip fracture, you don't need to do anything fancy. It can be as simple as walking." The findings "strongly support" longstanding recommendations for people to fit physical activity into their daily routine, according to Dr. Richard Bockman. "Get out there and walk," said Bockman, chief of the endocrine service at the Hospital for Special Surgery, in New York City. Lower-impact activities do not have a big effect on bone density. But Bockman, who was not involved in the study, said that while bone density matters in hip fracture risk, other factors are also involved. They include muscle strength in the lower body, balance and agility, since broken hips are almost always the result of a fall. The findings, published online Oct. 25 in JAMA Network Open, come from the Women's Health Initiative -- a study begun in the 1990s at 40 U.S. medical centers. It involved more than 77,000 women who were between the ages of 50 and 79 when they enrolled. At the outset, the women reported on their usual physical activities, among other lifestyle factors. Over an average of 14 years, one-third of the women suffered a bone fracture. When it came to hip fractures, women who'd reported higher amounts of physical activity at the study's start typically had a lower risk. For example, women who regularly got moderate to vigorous exercise, such as brisk walking or jogging, had a 12% lower risk of hip fracture than those who were less active. But there was also a link between "mild activity" -- like slow dancing, bowling or golfing -- and lower hip fracture risk. And the more often women walked, at any speed, the lower their risk of a broken hip. The news wasn't all good: Women who exercised at moderate to vigorous intensities had a relatively higher risk of a wrist or forearm fracture, compared to less-active women. It's not clear why, but LaMonte offered a guess: When women with more "functional ability" do fall, they may be more likely to stretch out an arm to break the fall, which is how wrist and forearm fractures often happen. One question the study cannot address, LaMonte said, is whether starting exercise at an older age reduces hip fracture risk. Study participants who were physically active may have been active their whole lives. But, he said, it is clear that "sitting less and moving more" is key in older adults' overall health, with benefits such as better control of blood pressure and diabetes, and a lower risk of heart disease. Besides exercise, older adults can take other steps to reduce their hip fracture risk, LaMonte noted. They include getting bone mass measurements as recommended by your doctor, and following a healthy diet with adequate amounts of calcium and vitamin D. https://consumer.healthday.com/ kalip
  16. Here's a Good Reason to Have Another Cup of Coffee Could More Coffee Bring a Healthier Microbiome? Debating whether or not you should have that second cup of coffee? new research that links caffeine consumption to a healthy gut microbiome -- the trillions of microorganisms that live in your digestive tract and affect your overall health-- may prompt you to pour generously. In recent years, numerous studies have demonstrated associations between coffee consumption and lowered health risks of all sorts -- from type 2 diabetes to certain cancers to Parkinson's disease. Simultaneously, accumulating evidence suggests that the makeup of your gut microbiome can affect your health, either by promoting or reducing the risk of diseases. Connecting the dots between these two health premises, a new study found the microbiomes of regular coffee drinkers were considerably healthier than those who consumed little to no coffee. "We still need to learn more about how the bacteria and the host [our bodies] interact to impact our health," said lead study author Dr. Li Jiao, an associate professor of medicine-gastroenterology at Baylor College of Medicine in Houston. But her advice for now? "If you love coffee, enjoy it. Follow your gut." The new findings were to be presented Monday at the American College of Gastroenterology annual meeting, in San Antonio, Texas. In the study, scientists for the first time ever took gut microbiome samples directly from various parts of the colon during colonoscopies. (Other studies have examined just stool samples). Overall, the 34 participants who drank two or more cups of coffee daily throughout the previous year exhibited better gut microbiome profiles than those who consumed less or no coffee, Jiao's team reported. Heavy coffee drinkers' bacterial species were more abundant and more evenly distributed throughout the large intestine, richer in anti-inflammatory properties, and considerably less likely to include Erysipelatoclostridium, a type of bacteria linked to metabolic abnormalities and obesity. Jiao said it remains uncertain why coffee exerts such a positive influence on the gut microbiome. But she suggested that caffeine or other nutrients in coffee may impact the metabolism of bacteria and, in turn, how the bacterial metabolites -- the end products of that metabolism -- affect your body. While scientists may not completely understand the mechanisms behind coffee's impact on the microbiome, they are becoming increasingly convinced of the importance of gut contents to overall health. "The gut microbiome seems to be the missing link between diet and the incidence of chronic diseases," said Dr. Hana Kahleova, director of Clinical Research at the Physicians Committee for Responsible Medicine. She was not involved with the study. For instance, explained Kahleova, individuals who eat a typical Western diet high in fat and processed foods tend to house in their gut more endotoxins, toxic components of "bad" bacteria associated with obesity, insulin resistance and cardiovascular disease. Conversely, she suggested that coffee's polyphenols and other antioxidants, compounds naturally found in plant foods, are likely what's providing a healthier microbiome. But you don't have to rely on coffee for your gut to absorb these health benefits. "All plants in their natural state are rich in fiber, polyphenols and antioxidants that help us fight cancer, diabetes and cardiovascular disease," Kahleova said. That's good news for people who don't drink coffee, and don't plan to start. Benefits notwithstanding, coffee isn't for everyone. It can aggravate a sensitive stomach, worsen insomnia or pose a danger to individuals with certain heart conditions. But for the countless number of people who love coffee and can't imagine cutting it out of their diet, this study may come as a relief. It turns out that drinking one or two cups of coffee a day probably won't induce any harm, and may even provide some protective health benefits. Because this research was presented at a medical meeting, it should be considered preliminary until published in a peer-reviewed journal. https://consumer.healthday.com/ kalip
  17. First drug that can slow Alzheimer's dementia A US drug company says it has created the first therapy that could slow Alzheimer's disease, and it is now ready to bring it to market. Currently, there are no drugs that can do this - existing ones only help with symptoms. Biogen says it will soon seek regulatory approval in the US for the "ground-breaking" drug, called aducanumab. It plans to file the paperwork in early 2020 and has its sights on Europe too. Approval processes could take a year or two. If successful, the company aims to initially offer the drug to patients previously enrolled in clinical studies of the drug. The announcement is somewhat surprising because the company had discontinued work on the drug in March 2019, after disappointing trial results. But the company says a new analysis of a larger dataset of the same studies shows that higher doses of aducanumab can provide a significant benefit to patients with early Alzheimer's, slowing their clinical decline so they preserve more of their memory and everyday living skills - things that the disease usually robs. Big hope Aducanumab targets a protein called amyloid that forms abnormal deposits the brains of people with Alzheimer's. Scientists think these plaques are toxic to brain cells and that clearing them using drugs would be a massive advance in dementia treatment, although not a cure. There haven't been any new dementia drugs in over a decade. Biogen's chief executive Michel Vounatsos said: "We are hopeful about the prospect of offering patients the first therapy to reduce the clinical decline of Alzheimer's disease." Hilary Evans from Alzheimer's Research UK said: "People affected by Alzheimer's have waited a long time for a life-changing new treatment and this exciting announcement offers new hope that one could be in sight. "Taking another look at aducanumab is a positive step for all those who took part in the clinical trials and the worldwide dementia research community. As more data emerges, we hope it will spark global discussions about the next steps for delivering much-needed treatments into people's hands." Prof Bart De Strooper, Director of the UK Dementia Research Institute at University College London, said: "It is fantastic to hear of these new positive results emerging from the aducanumab trials. We currently have no effective treatments to slow or halt the progression of Alzheimer's disease and I hope this signifies a turning point." What is Alzheimer's? Dementia is not a single disease, but is the name for a group of symptoms that include problems with memory and thinking. There are lots of different types of dementia and Alzheimer's is said to be the most common and most researched. There are currently 850,000 people with dementia in the UK. It's been a long and tortuous journey to find new drugs for the disease and recent attempts have ended in failure. Experts hope a treatment is in sight, but they are cautious and will need to closely scrutinise these aducanumab trial findings. https://www.bbc.com/news/health kalip
  18. How Vitamin B12 Deficiency Affects the Body Vitamin B12 deficiency is one of the most prevalent nutritional deficiencies. It causes a range of symptoms, such as fatigue, forgetfulness, and tingling of the hands and feet. The reason for the wide variety of symptoms is that vitamin B12 plays a principal role in numerous body functions. B12 Function Vitamin B12 has an important function in the production of DNA, which is the body's genetic code. DNA directs proper formation of every part of the body. Vitamin B12 also reduces homocysteine, one of the body’s naturally occurring chemicals. If homocysteine is not properly metabolised, then it causes inflammation and toxic damage to the body. Symptoms and Effects Anemia is a diminished function of the red blood cells (RBCs). The chief clinical manifestation of B12 deficiency is megaloblastic anemia, which is a type of anemia that often produces fatigue and tachycardia (rapid heart rate), and sometimes dizziness. Vitamin B12 is a nutrient required for normal red blood cell production. RBCs deliver energy-producing oxygen throughout the body to power all of the body’s needs. Megaloblastic anemia can be diagnosed by a blood test. Peripheral neuropathy is a type of nerve impairment. This means that nerves themselves may be damaged or that there is a deficiency of myelin. Myelin is a protective covering of the peripheral nerves. Vitamin B12 is a co-factor in myelin formation, and thus a vitamin B12 deficiency prevents myelin from forming as needed. With B12 deficiency, direct nerve damage combined with a decrease of myelin interferes with normal nerve function. The peripheral nerves control movement and sensation of the body. Symptoms of peripheral neuropathy usually affect the feet and hands and may extend to include the arms and legs as well. The most common symptoms include: Tingling Numbness Weakness Dementia is a disease characterised by memory loss and behavioral changes. There are many causes of dementia, and vitamin B12 deficiency is one of the more recently recognised causes. Scientific research suggests that the dementia associated with vitamin B12 deficiency may be a result of elevated homocysteine levels. Symptoms of dementia include: Forgetfulness Absentmindedness Problem-solving difficulties Inability to concentrate Loss of ability to take care of oneself Apathy Hallucinations Depression is a possible manifestation of vitamin B12 deficiency and may be accompanied by anemia or dementia. Stroke is a medical condition characterised by interruption of blood flow to the brain, causing a physical or mental handicap. Vitamin B12 deficiency may increase the risk of stroke among young people who are not otherwise at risk of stroke. Whether or not there is a link is highly controversial, and the risk may result from excess homocysteine levels. Myelopathy means disease of the spinal cord. Vitamin B12 deficiency causes a type of spine disease called subacute combined degeneration of the spinal cord, which is loss of the protective myelin of certain areas of the spinal cord that control moment, balance and sensation. Symptoms of subacute combined degeneration of the spinal cord include: Weakness Numbness, tingling Spasticity Balance problems Tongue swelling also results from vitamin B12 deficiency. Glossitis is the name used to describe a painful, unusually smooth tongue that can result from this nutritional deficiency. Associated Conditions Thyroid disease and multiple sclerosis (MS) are both conditions believed to be related to an autoimmune process. An autoimmune disease is a condition caused by the body attacking itself. Intrinsic factor deficiency is an autoimmune disease that results from a ‘self’ attack on the region of the stomach that is involved in vitamin B12 absorption. Often, individuals who have thyroid disease or MS also have intrinsic factor deficiency and its associated vitamin B12 deficiency. Causes Low Dietary Intake The most common cause of vitamin B12 deficiency is a lack of vitamin B12 in the diet. Vitamin B12 is a nutrient that is only found in animal products such as meat, chicken, fish, eggs, and dairy. Therefore vegans are at especially high risk of low nutritional vitamin B12, as are non-vegan individuals who do not eat enough of these vitamin B12 rich foods. Some foods are fortified with vitamin B12, and if you want to get your vitamin B12 through vegan foods, you have to make an effort to seek out those types of foods. Low Absorption Vitamin B12 is absorbed by the small intestine, but it requires some preliminary processing in the stomach first. Therefore, some conditions that affect the stomach or the small intestine can interfere with proper vitamin B12 absorption. Intrinsic factor is a protein produced in the stomach that combines with vitamin B12 before it can be absorbed in the small intestine. Autoimmune disease, gastric bypass surgery, and inflammation of the stomach are all situations that interfere with the production and function of intrinsic factor, and thus the vitamin B12 in the diet may not be adequately absorbed into the body, and instead, it is eliminated through bowel movements. Heavy alcohol use causes changes in the lining of the stomach, interfering with production of intrinsic factor, causing B12 deficiency. Intestinal disease such as Crohn’s disease and celiac disease can prevent the proper absorption of vitamin B12 in the small intestines, causing a deficiency even if there is enough vitamin B12 in the diet. Pernicious anemia is an autoimmune disease that reduces or eliminates intrinsic factor, the protein in the stomach that binds dietary B12 so that it can be absorbed. This leads to B12 deficiency through malabsorption. This type of B12 deficiency cannot be treated with oral B12 replacement and requires treatment with vitamin B12 shots. Symptoms of pernicious anemia include: Fatigue Lack of energy Lightheadedness Depression Headaches Rapid heartbeat Ringing in the ears Medications can interfere with vitamin B12 absorption. The most common medications that can cause low vitamin B12 levels include: Metformin: a medication used to treat diabetes Colchicine: a medication used to treat gout Chloramphenicol: an antibiotic used to treat infections Many medications used for the treatment of heartburn A Word From Verywell If you have vitamin B12 deficiency, many of the effects can be reversed, particularly at the early stages. In general, if your vitamin B12 deficiency is caused by a nutritional deficiency, supplements or fortified foods can help improve your vitamin B12 levels. If impaired absorption is the reason for your vitamin B12 deficiency, it is generally considered more effective to get your vitamin B12 supplementation through injections rather than by mouth, as this allows the nutrient to enter into the body’s tissue directly. https://www.verywellfit.com kalip
  19. Fat found in overweight people's lungs Fatty tissue has been found in the lungs of overweight and obese people for the first time. Australian researchers analysed lung samples from 52 people and found the amount of fat increased in line with body mass index. They said their findings could explain why being overweight or obese increased asthma risk. Lung experts said it would be interesting to see if the effect could be reversed by weight loss. Increased risk In the study, published in the European Respiratory Journal, scientists looked at post-mortem samples of lung donated for research. Fifteen had had no reported asthma, 21 had asthma but died of other causes and 16 died of the condition. The scientists used dyes to carry out detailed analyses of almost 1,400 airways from the lung samples under the microscope. The researchers found adipose (fatty) tissue in the walls of airways, with more present in people with a higher body mass index, And they say the increase in fat appears to alter the normal structure of the airways and cause inflammation in the lungs - which could explain the increased risk of asthma in overweight or obese people. Direct pressure Dr Peter Noble, an associate professor at the University of Western Australia, in Perth who worked on the study, said: "Being overweight or obese has already been linked to having asthma or having worse asthma symptoms. "Researchers have suggested that the link might be explained by the direct pressure of excess weight on the lungs or by a general increase in inflammation created by excess weight." But, he said, their study suggested "another mechanism is also at play". "We've found that excess fat accumulates in the airway walls, where it takes up space and seems to increase inflammation within the lungs," Dr Noble said. "We think this is causing a thickening of the airways that limits the flow of air in and out of the lungs and that could at least partly explain an increase in asthma symptoms." 'Major importance' Prof Thierry Troosters, president of the European Respiratory Society, said: "This is an important finding on the relationship between body weight and respiratory disease because it shows how being overweight or obese might be making symptoms worse for people with asthma. "This goes beyond the simple observation that patients with obesity need to breathe more with activity and exercise. "The observation points at true airway changes that are associated with obesity." He said more research was needed to find out if this build-up of fatty tissue could be reversed through weight loss but asthma patients should be helped to achieve a healthy weight. Dr Elizabeth Sapey, chair of the science committee at the British Thoracic Society, said this was the first-time body weight had been shown to impact the structure of the airways in the lungs. "Given the increasing incidence of obesity nationally and across the globe, the study could be of major importance in helping us understand why asthma remains a major health issue and identify new ways to improve asthma treatment," she said. "It is only a small study though, and we need to assess this in larger groups of patients and in other lung diseases," Dr Sapey added. https://www.bbc.com/news/health- kalip
  20. Study Spanning 40 Years Finds Odd Link Between Being a Slow Walker and Ageing Faster Being a slow walker doesn't just signify you enjoy a leisurely stroll. According to new research, walking with a slow gait could be a symptom of significant deficits in physical and cognitive health. New findings from a longitudinal study of just over 900 New Zealanders that began back in the 1970s has found that people in their 40s who walk with a slow gait are more likely to show signs of accelerated biological ageing and compromised brain integrity. "The thing that's really striking is that this is in 45-year-old people, not the geriatric patients who are usually assessed with such measures," says biomedical researcher Line J.H. Rasmussen from Duke University. Rasmussen and fellow researchers examined participants from the Dunedin Study, an exceptionally long longitudinal health study that began almost five decades ago with a cohort of over 1,000 three-year-olds. In new research assessing the health of 904 of the remaining participants at the age of 45, the team found walking speed at mid-life seems to offer a unique window into life-long ageing processes that go back all the way to childhood. "This study covered the period from the preschool years to midlife, and found that a slow walk is a problem sign decades before old age," says Duke psychologist and neuroscientist Terrie E. Moffitt. In the study, the 45-year-old participants that had their walking speed measured were assessed on a number of measures of everyday physical function. They were also assessed for signs of accelerated ageing – encompassing 19 different biomarkers ranging from blood pressure to dental health – and had their brains scanned via MRI. Historical data from the longitudinal study were also considered, such as measures of neurocognitive ability based on tests conducted since the participants were children. The results are an eye-opener, revealing that a slower walking speed in your mid–40s is associated with poor physical function and accelerated ageing – indicated by "more rapid deterioration of multiple organ systems" (based on the biomarker readings) and aligning with a separate visual analysis of participants' facial ages conducted by a panel. Additionally, slow gait at mid-life was associated with poorer neurocognitive functioning – and not just at the time of testing. "Remarkably, in our study, gait speed was associated not only with concurrent neurocognitive functioning in adulthood but also with neurocognitive functioning in early childhood," the authors explain in their paper. While the Dunedin cohort did not undergo brain scans when the study began, based on today's tests, slow walkers showed on average reduced brain volume and reduced cortical thickness. Despite limitations that the researchers acknowledge (including a lack of gait speed measurements in previous tests with the cohort, along with a lack of historical brain imaging data from the participants), the researchers say there's a lot to "unpack" in examining the link between childhood neurocognitive functioning and gait speed at midlife in future research. "We should not assume that poor results of cognitive testing in three-year-old children in any way doom them to lifelong problems," explains geriatric medicine researcher Stephanie Studenski from the University of Pittsburgh, who wasn't involved in the study but is the author of a commentary on the research. "But rather, look broadly at what might be contributing to poorer performance and explore strategies to ameliorate these contributors." If we can learn to understand the nature of the links that this almost five-decades-old study seems to show, we might stand to potentially positively influence social factors that could boost biological longevity and neurocognitive function, and potentially help arrest cognitive decline. These are, of course, very big problems to solve – but assessing gait speed even in middle-aged people could turn out to be an overlooked and important part of the solution, Studenski says. "The human brain is dynamic; it is constantly reorganising itself according to exposures and experience," Studenski writes. "Perhaps in this sense, brain health, reflected in brain structure, cognition, and gait speed, is not necessarily a first cause, but rather may be a consequence or mediator of lifelong opportunities and insults." The findings are reported in JAMA Network Open. https://www.sciencealert.com/ kalip
  21. Garbanzo Grain Bowl With Green Tahini Sauce Ingredients 1 sweet potato 1 tablespoon olive oil 1/8 teaspoon cumin 1/8 teaspoon paprika 1/4 teaspoon black pepper 1/4 teaspoon chili powder 1 cup chickpeas 1/4 cup quinoa (dry) 3 cups of arugula 2 tablespoons pumpkin seeds, shelled 2 tablespoons tahini 1 tablespoon lemon juice 1 clove of garlic ¼ teaspoon salt ¼ cup fresh parsley ¼ cup fresh cilantro Water to thin, about 2 tablespoons Preparation Pre-heat oven to 204.°C Chop sweet potato into bite-sized pieces and toss with half of the olive oil, half of the cumin, half of the paprika, half of the black pepper, and all of the chili powder. Drain and rinse the chickpeas. Toss with the other half of the olive oil, cumin, paprika, and black pepper. Roast both the sweet potato and the chickpeas at 204.°C for 25 minutes, turning halfway through. Cook quinoa according to package directions. If you bought in bulk, bring quinoa and 1/2 cup of water to a boil. Once boiling, turn down to a simmer and cook for 10-12 minutes until water has absorbed. While the quinoa is cooking, make the green tahini sauce. Measure all ingredients into a small blender or food processor and blend until smooth. Slowly add in water until sauce is to your desired consistency. Layers bowls with a base of arugula. Top with quinoa, sweet potatoes, chickpeas, pumpkin seeds, and green tahini. Ingredient Variations and Substitutions Other whole grains such as barley, farro, or couscous would also work well with this dish. You can also use baby spinach or kale in place of arugula. Parsley and cilantro are a good base, but you can also use chives, scallions, or any other leftover fresh herbs that you have on hand. Cooking and Serving Tips Serve hot for dinner or cold leftover for lunch. Wait until serving to add the tahini sauce. https://www.verywellfit.com/recipes-4157077 kalip
  22. Mediterranean Grilled Eggplant Salad Recipe Ingredients ¼ cup pine nuts 1 medium red bell pepper 1 ¾ pounds unpeeled eggplant 1 medium tomato, diced ¼ cup scallions, green part only 3 tablespoons olive oil 2 tablespoons fresh lemon juice ½ cup chopped fresh parsley 2 tablespoons chopped mint leaves ¾ teaspoon salt ¼ teaspoon freshly ground black pepper ½ teaspoon crushed red pepper flakes (optional) 1/8 teaspoon smoked paprika Preparation In a small heavy skillet, toast pine nuts over medium heat, stirring constantly for about 5 minutes or until they become shiny and turn golden brown in spots. Supervise them closely, as nuts burn easily. Halve and seed the red peppers. Cut the eggplant lengthwise into 2.5 cm slabs. Grill the vegetables over medium heat on a propane or charcoal grill until tender, about 15 minutes. When they are cool enough to handle, coarsely chop the grilled vegetables and transfer them to a medium serving bowl. Add the tomato, scallion greens, olive oil, lemon juice, parsley, mint, salt, black pepper, red pepper flakes, and smoked paprika. Toss lightly to combine ingredients and serve warm or cold. Ingredient Variations and Substitutions The eggplant and bell pepper can also be oven-roasted. Arrange them on a foil-lined baking sheet and bake at 218°C for 30 minutes, until vegetables are soft and beginning to brown in places. https://www.verywellfit.com/vegan-recipes-4157052 kalip
  23. 'Save your money': no evidence brain health supplements work, say experts Worldwide panel says it cannot recommend healthy people take ‘memory supplements’ Dietary supplements such as vitamins do nothing to boost brain health and are simply a waste of money for healthy people, experts have said. According to figures from the US, sales of so-called “memory supplements” doubled between 2006 and 2015, reaching a value of $643m, while more than a quarter of adults over the age of 50 in the US regularly take supplements in an attempt to keep their brain in good health. But while bottles, packets and jars line the shelves of health food shops – with claims that they help maintain brain function or mental performance – a worldwide panel of experts says at present there is little evidence that these supplements help healthy older people, and that they could even pose a risk to health. “There is no convincing evidence to recommend dietary supplements for brain health in healthy older adults,” they write. “Supplements have not been demonstrated to delay the onset of dementia, nor can they prevent, treat or reverse Alzheimer’s disease or other neurological diseases that cause dementia.” However, the team note a lack of certain nutrients, such as vitamins B9 and B12, appear to be linked to problems with cognitive function or rain health, and that supplements might prove useful in people with deficiencies. About 20% of people over the age of 60 in the UK are thought to be lacking in vitamin B12. But the experts stress it is important to consult a doctor before starting any supplements, and that it is better to get nutrients from a healthy diet. At present, the team say, they cannot recommend healthy people take supplements for brain health – although they stress further research is needed. Their top recommendation is simple. “Save your money,” they write. The report by the Global Council on Brain Health looks at the evidence for a range of supplements, including B vitamins, omega-3 fatty acids, vitamin D, caffeine, coenzyme Q10 and ginkgo biloba. The team found that few supplements which make claims about brain health have actually been tested for their impact. Where studies do exist they offer little or mixed evidence that supplements improve brain function or prevent dementia. “The big problem is that these things are being marketed to people as if they have evidence,” said Linda Clare, professor of clinical psychology of ageing and dementia at the University of Exeter and a member of the team behind the report. The team advise taking a sceptical view of such products, saying many are marketed with exaggerated claims about their impact on mental functions. They also stress that such pills, powders and capsules are usually not subject to the same safety and efficacy tests as medications. However, Clare stressed the report only looked at the impact of supplements on brain health. “The message is not that all supplements are wrong for everything,” she said. The report echoes recent findings by the Cochrane collaboration. Their study, looking at evidence for effects of vitamin and mineral supplements on cognitive function in over-40s, found no convincing effect for B vitamins, selenium, zinc, vitamin E, omega-3, and only tentative evidence of any benefit from long-term use of beta‐carotene or vitamin C supplements. Caroline Abrahams, charity director at Age UK, said of the new report: “These eminent experts have concluded it doesn’t do any good to take supplements to promote your brain health in later life so our advice to older people is to save your money and spend it on a healthy diet, full of delicious fruit and vegetables instead.” David Smith, professor emeritus of pharmacology at the University of Oxford, said that while the report was sensible, there were debates about what constituted a vitamin deficiency – for example, low “normal” levels might still have a negative impact on brain health. He also noted that while consuming a Mediterranean diet was good for the brain, as people got older they might not be as able to absorb nutrients from food, while medications could potentially lead to deficiencies. What’s more, plants contain no vitamin B12, so people on a vegan diet should consider fortified foods or supplements. Smith added that while the report called for more high-quality research to improve the evidence base, there was a significant stumbling block. “The problem is that the authorities and drug companies seem to be reluctant to support such trials on vitamins, partly because there is no obvious financial benefit and because no patents can be filed,” he said. Experts say there are many other steps individuals can take to keep sharp as they age – including not smoking, sleeping well, exercising and keeping socially engaged and mentally stimulated. Prof Gill Livingston of University College London added that people should also get their blood pressure and hearing checked to prevent dementia. “Drugs for high blood pressure are currently the only known effective preventive medication for dementia,” she said. https://www.theguardian.com/science kalip
  24. Inequalities in heart attack care 'costing women's lives' Women who suffer heart attacks are dying needlessly because they fail to recognise their symptoms and receive poorer care than men, says a British Heart Foundation report. Over 10 years, more than 8,000 women in England and Wales died unnecessarily after a heart attack, it found. Experts say there are inequalities in diagnosis, treatment and aftercare. "Unconscious biases are limiting the survival chances of women," the report warns. It found that some commonly held myths - such as heart disease and heart attacks only affecting men - meant women were unaware of their risk, and slow to seek medical help. There is also a misperception that men and women experience completely different heart attack symptoms, but studies suggest that although symptoms can vary from person to person, chest pain is the most common symptom in both men and women. And younger women do have heart attacks, the report says, which should be taken seriously. 'Seen as a man's disease' Esther Stanhope was 45 when she had a heart attack but says her symptoms were not obvious. "I had a feeling over a number of weeks, over a six-week period. I thought it was stress. I just had a slight shortness of breath a few times. "I had a few feelings in my chest... I wouldn't say it was even painful," she says. She carried on with her daily life, but felt very ill during a fitness class that she attended. "I broke out in a sweat and at that particular moment I thought 'wow I really feel faint, I can't get my breath back and I think I might collapse in a minute.'" Shortly afterwards, she called her GP who advised her to go to A&E. Seek urgent help There have been significant improvements in how heart attacks are treated. In the 1960s, seven out of 10 heart attacks in the UK proved fatal. Today, seven out of 10 people who have a heart attack will survive. But women are missing out, says Dr Sonya Babu-Narayan, associate medical director of the British Heart Foundation (BHF). "Heart attacks have never been more treatable. "Yet women are dying needlessly because heart attacks are often seen as a man's disease, and women don't receive the same standard of treatment as men." She said studies had "revealed inequalities at every stage of a woman's medical journey, and although complex to dissect, they suggest unconscious biases are limiting the survival chances of women". The BHF report says that each year around 35,000 women are admitted to hospital following a heart attack in the UK each year - an average of 98 women a day, or four per hour. In the UK, women are twice as likely to die from coronary heart disease as from breast cancer. The situation is even more dramatic in Scotland, which has the highest rate of heart disease in the UK. Cardiovascular disease, which includes heart attacks and angina, kills around 2,600 women in Scotland each year - roughly seven every day. The report found that: women often delayed seeking help they were more likely to receive an incorrect diagnosis and substandard treatment compared to men risk factors, such as smoking and high blood pressure, increase heart attack chances more in women the quality of aftercare was also substandard Chris Gale, professor of cardiovascular medicine at the University of Leeds, led a study which found that thousands of women's lives were needlessly lost in England and Wales after heart attacks, between 2002 and 2013. "This problem is not unique to the UK," he said. "Studies across the globe have also revealed gender gaps in treatment, suggesting this is a deeply entrenched and complex issue. "On their own, the differences in care are very small, but when we look at this across the population of the UK, it adds up to a significant loss of life. "We can do better." What are heart attack symptoms? Heart attack symptoms can vary from person to person, but the most common signs of a heart attack are: Central chest pain or discomfort in your chest which suddenly occurs and doesn't go away It may feel like pressure, tightness or squeezing Pain which radiates down your left arm, or both arms, or to your neck, jaw, back or stomach Feeling sick, sweaty, light-headed or short of breath Call 999 if you recognise these symptoms. NHS advice says the pain can often be mild and mistaken for indigestion. Other less common heart attack symptoms include: A sudden feeling of anxiety that can feel similar to a panic attack Excessive coughing or wheezing https://www.bbc.com/news/health kalip
  25. Is red meat back on the menu? A controversial study says cutting down on sausages, mince, steak and all other forms of red or processed meat is a waste of time for most people. The report - which disagrees with most major organisations on the planet - says the evidence is weak and any risk to people's health is small. Some experts have praised the "rigorous" assessment. But others say "the public could be put at risk" by such "dangerously misguided" research. What counts as red or processed meat? Red meat includes beef, lamb, pork, veal and venison - chicken, duck and game birds do not count. Processed meat has been modified to either extend its shelf life or change the taste - and the main methods are smoking, curing, or adding salt or preservatives. Pure mince does not count as processed, but bacon, sausages, hot dogs, salami, corned beef, pates and ham all do. Are they bad for health? One of the main concerns has been around bowel cancer. The World Health Organisation's International Agency for Research on Cancer created headlines around the world when it said processed meats do cause cancer. It also said red meats were "probably carcinogenic" but there was limited evidence In the UK alone, it is thought processed meat leads to about 5,400 cases of bowel cancer every year. Links with heart health and type 2 diabetes have also been suggested. The scientific consensus is eating a lot is bad for your health. What does the study say? The researchers - led by Dalhousie University and McMaster University in Canada - reviewed the same evidence others have looked at before. The findings, published in Annals of Internal Medicine, suggest if 1,000 people cut out three portions of red or processed meat every week for: a lifetime, there would be seven fewer deaths from cancer 11 years, there would be four fewer deaths from heart disease And if every week for 11 years, 1,000 people cut out three portions of: red meat, there would be six fewer cases of type 2 diabetes processed meat, there would be 12 fewer cases of type 2 diabetes The risks reported are broadly similar to what has been suggested before - but the interpretation of what they mean is radically different. The researchers say: the risks are not that big the evidence is so weak, they could not be sure the risks were real "The right choice for the majority of people, but not everyone, is to continue their meat consumption," one of the researchers, associate professor Bradley Johnston, told BBC News. "We're not saying there is no risk, we're saying there is only low-certainty evidence of a very small reduction of cancer and other adverse health consequences of reducing red meat consumption." How has the study been received? Statisticians have broadly supported the way the study has been conducted. Kevin Mc Conway, emeritus professor of applied statistics at the Open University, called it an "extremely comprehensive piece of work" . And Prof David Spiegelhalter, from the University of Cambridge, said: "This rigorous, even ruthless, review does not find good evidence of important health benefits from reducing meat consumption "In fact, it does not find any good evidence at all." What about its conclusions? This study has, quite frankly, gone down like a lead balloon, with many in the field disagreeing with how the findings have been interpreted. Public Health England officials told BBC News they had no intention of reviewing their advice on limiting meat intake. Dr Marco Springmann, from the University of Oxford, said the "dangerously misguided" recommendations "downplay the scientific evidence", which, in any case, comes from a "small number of meat-eating individuals from high-income countries". The World Cancer Research Fund's Dr Giota Mitrou said the "public could be put at risk" if they concluded they could eat meat to their heart's content, as "this is not the case". Prof Nita Forouhi, from the University of Cambridge, said: "They stated that the magnitude of the link is small, is it?" The study suggests there would be 12 fewer cases of type 2 diabetes as a result of 1,000 people cutting three servings of processed meat a week for a just over a decade. And she said: "For a common condition such as type 2 diabetes, at a population and country level, that is not trivial." Why is the quality of the evidence so poor? Welcome to the challenging and difficult world of nutrition research. As you can't lock people up for a lifetime and force-feed them to determine the health impact of different foods, you have to rely on imperfect research. There are two main types of scientific study in this field: observational studies randomised control trials In observational studies, you can follow huge numbers of people for decades, record how they behave and see what happens to their health. But teasing apart the role of one foodstuff out of all the things they eat and all the other things they do is a challenge. In a randomised trial, you set people different diets. But they don't stick to them forever and you need them to follow them for years before diseases such as cancer or a heart attack emerge. "The scientific community needs to acknowledge that doing clinical trials of specific food interventions, unlike pharmaceutical products, and following people up over long periods till disease or death occurs are simply not feasible," said Prof Forouhi. We live in a world of imperfect data and it's not about to change. How does anyone make sense of this? The weight of scientific opinion falls on the side of reducing red and processed meat consumption. This analysis and those that have gone before have highlighted similar risks and it is worth noting the report's authors point out: "We're not saying there is no risk." But the question of whether reducing red meat is going to make a difference to any one individual is very difficult. For example, about six out of every 100 people in the UK develop bowel cancer at some point in their lives. If they all ate an extra 50g (1.7oz) of bacon a day, then the estimate is the figure would go up to seven in 100. But what no-one can tell you is whether you will be that one extra case. How much red meat should people eat? The NHS advises anyone who eats more than 90g of red or processed meat a day to cut down to 70g a day, on average. "Globally, the evidence indicates that people who eat red and processed meat should limit their intake, Public Health England head of nutrition science, Prof Louis Levy said. "While it can form part of healthy diet, eating too much can increase your risk of developing bowel cancer," Is this the full picture? Meat is only one aspect of diet - previous studies have suggested vegetables can have a big impact on health. And health is only one reason for assessing how much meat to eat. Diets that cut down on meat or eliminate it all together - from flexitarian to vegan - are becoming more popular. But the reasons involve health benefits, environmental concerns and animal welfare issues. There have been attempts to reconcile all these things and come up with a "planetary health diet". And it recommends most protein should come from nuts and legumes (such as beans and lentils) instead of meat. https://www.bbc.com/news/health kalip
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