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Tens of thousands of kilograms of white carp, rohu, stinging catfish, eel, red snapper, grouper, snakehead, gagata, breamthe list goes onsurround fish broker Ko Thar Gyi at the San Pya wholesale fish market in Myanmars colonial capital, Yangon. The scent is overpowering. Hes been here since 4 a.m., which is when he and his fellow brokers arrive each day to meet the fishers in their lantern-lit, smile-shaped wooden boats. The fishersarriving from the Yangon Rivernose their boats up to shore, engines gurgling and heavy with fish. Each vessel carries up to 10,000 kilograms of product, says Thar (Ko and Gyi are honorifics in the Burmese language).

San Pya is the largest fish market in Myanmars largest city and commercial center, and the key point in the supply chain of fish for human consumption in the region, also called Yangon. Dozens of seafood processors and exporters operate in and around the market and its smaller cousin, Shwe Padauk, a few kilometers up the river. San Pya has become so busy, Thar says, that he has opened a second branch of his operation at Shwe Padauk.

San Pya and Thars business are thriving despite the decline of wild fisheries in much of Asia and indeed the worldglobally, only two-thirds of fish stocks are within biologically sustainable levels, down from 90 percent in 1974, according to the Food and Agriculture Organization of the United Nations (FAO). San Pyas bustle continues unabated because while the oceans bounty has faltered, a growing share of the product is supplied by fish farmsfrom almost nothing when the market opened in 1991 to 60 to 75 percent in 2014, when researchers from Michigan State University and Myanmars Centre for Economic and Social Development polled sellers. This mirrors a global trend: fish consumption has more than doubled per capita since 1961, with nearly the entire increase coming from aquaculture in the past three decades. People are eating much more fish, but the difference isnt coming from wild catches.

Aquaculture now accounts for more than half of the fish we eat, worldwide, increasing from only four percent in 1950. Its become so lucrative in Myanmar, Thar says, that companies from China are buying paddy fields for more than market price and turning them into fish farms.

Boats deliver hundreds of thousands of kilograms of fish to the San Pya wholesale fish market in Myanmar via the Yangon River, arriving by 4 a.m. Photo by Htoo Tay Zar

An astute business person, Thar also operates a fish farm in the township of Pantanaw, around 95 kilometers northeast of the market, where he raises mainly rohu, white carp, and prawns in freshwater ponds. But the San Pya business is his main focus, he says, and with good reason: he grosses around US $5,800 each workday, buying fish and selling it to processors, exporters, and local residents. Its an enormous figure in a country where per capita income is about a quarter of that per year. He says most of his product comes from the regions of Myanmar that collectively form the seat of the countrys aquaculture production. The acreage of cultivated fishponds there expanded between 2003 and 2014, in some regions by more than 250 percent. The vast majority of the fish is consumed domestically, and three of the five big brokers inside San Pya specialize in farmed fish. Business is good these days, Thar says.

Though Thar doesnt seem to mind, aquaculture has a bad reputation in some circles. The narrative in North America and Europe among environmentalists and those concerned with global development is that it damages ecosystems and saps poor countries of their natural resources, with much of the product exported, leaving little of the wealth or nutrition it generates in the communities that actually grew and tended the fish. And for certain species, in certain places, thats true: salmon farming in Chile and North Americas Pacific Northwest has been linked to outbreaks of parasitic diseases and the introduction of non-native species into wild populations. In Vietnam and other places, shrimp farmingoften for export to wealthy countries in North America and Europeincentivized destruction of mangroves, which are among the most carbon-rich forests in the tropics, sequestering more planet-warming carbon dioxide per hectare than the Amazon rainforest. Reading media accountsmany of them based on academic literature that until recently often focused on shrimp and salmon, and the negative impacts of aquaculture exports on poor countriesfew people can be faulted for concluding that aquaculture is deeply problematic for the environment, sustainable development, and equity. But the story is far more complex.

The binary viewpointaquaculture is bad, sustainable wild capture is goodfrustrates Ben Belton, a developmental economist in Michigan State Universitys Department of Agricultural, Food, and Resource Economics. His research indicates that as the Earths population closes in on 10 billion, aquacultureparticularly medium-scale freshwater operations such as those abundant in the area Thar buys fromcould be an important and sustainable supplier of food. Over 15 years of researching aquaculture in Southeast Asia, Belton has witnessed what researchers, including himself, call a quiet revolution, a fundamental change overlooked by much of the Global North: aquaculture in Southeast Asia is growing fast and driven mainly by medium-sized enterprises on a few inland hectares.

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Many of the biggest fish brokers at the San Pya market trade in farmed fish. Video by Maung Nyan

Theres this bias thats been shaped by what people in the Global North perceive to be important, because what do they see? They go to the supermarket and they see [farmed] shrimp and salmon, says Belton.

In North Americas biggest market, the United States, two of the top three consumed fishdefined by the FAO as finfish, crustaceans, mollusks, and other aquaculture animalsare shrimp and salmon. But these species are a tiny portion of the volume of fish produced by aquaculture. In 2018, 90 percent of fish farmed globally were species other than shrimp and salmon, according to the FAO. Shrimp accounts for virtually none of the aquaculture in Myanmar, and only about four or five percent in neighboring Bangladesh, the worlds fifth-largest aquaculture producer. (Salmon cant survive at their latitude.) In Myanmar, and in the five countries with the highest aquaculture production, pond-based freshwater aquaculture dominatesand pond aquaculture tends to have a much lower environmental impact than marine fish farming.

Other researchers, such as Simon Bush, a professor and chair of the Environmental Policy Group at Wageningen University and Research in the Netherlands and a member of the technical advisory board of the Monterey Bay Aquarium Seafood Watch program, share Beltons critique of the predominant narrative. You cant just take that image of those two species and then say that all aquaculture has this environmental impact, Bush says. And a 224-page report the FAO put out this year, The State of World Fisheries and Aquaculture: Sustainability in Action, backs them up, calling fish some of the less impactful [foods] on the natural environment.

Although malnutrition has been on the rise since 2015 after decades of retreat, paradoxically, incomes worldwide have grown during the same time. An expanding, wealthier population will mean unprecedented demand for protein because as peoples spending power grows, they seek more protein in their diets. Alongside growing fish consumption, in the past two decades meat production has risen by 35 percent, milk by 32 percent, and soy by 73 percentall outpacing population growth.

This is not sustainable. Cattle produce problematic amounts of greenhouse gas emissions. Carbon-sequestering rainforests are cleared to provide them with pasture. Soymuch of it grown to feed those cattlealso contributes to the depletion of carbon dioxidestores (at a rate second only to the cattle themselves, according to the World Wildlife Fund).

So, to feed a growing, wealthier population without ruining the ability of its only home to produce food, there will need to be a role for fish. Proper management of fisheries can maintain ecosystem healthand even rebuild itbut fisheries are not always properly managed. That leaves aquaculture. When the alternative to protein from fish is land-based meat, Bush says, per unit of production, aquaculture comes out at the better end of the spectrum, environmentally speaking. Especially the freshwater systems.

The wholesale fish market distributes the fish raised in converted rice paddies in areas far from Myanmars commercial center, Yangon. Photo by Htoo Tay Zar

Intensification of freshwater aquaculture is growing. But as practiced in Myanmar and its neighbors India, China, Bangladesh, Laos, and Thailand, it is less reliant on manufactured feed and has nowhere near the same level of environmental impacts as shrimp and salmon. With technology and mechanization making it more efficient, the plentiful harvest has driven down the price of fish, making the protein- and micronutrient-rich food available to more consumers. People in low-income, food-deficit countries such as those in Southeast Asia are the ones who need such food the most, and aquaculture is more likely to provide affordable protein than other foods. The fishponds of smallholders are not supplying the luxury fish sold in upscale North American and European markets; theyre feeding their neighbors. One survey of 10 countries in Africa, Asia, and South America showed that were it not for aquaculture, the poor would eat far less fish of any kind, wild or farmed. And Belton and his colleagues estimate 70 to 80 percent of farmed fish moving through San Pya is for the domestic market, and not for export. Across the border in Bangladesh, 94 percent of the total market in aquaculture is consumed domestically. Its very clear the vast majority [of Southeast Asian aquaculture] is being consumed in the same places its being produced, Belton says.

Southeast Asia has no monopoly on the potential of aquaculture to feed a growing population of humans while conserving the planet. The practice is expanding in West Africa, one of the areas of the globe where populations are expanding fastest. And Beltons work shows that a lot of the methods used in Myanmar and Bangladesh can readily be exported to Nigeria, Gabon, or virtually anywhere else with a reliable supply of fresh water.

Workers shout to clear the path ahead of them as they lug red, orange, and blue laundry baskets full of fish packed in ice from the 10 docks outside San Pya to Thars operation and others. They strain to be heard over the engine noise of the boats behind them and the rain hitting the tin roof above. Once emptied of their cargo, the boats return upriver to gather another load from aquaculture farms. Some of their haul could well come from the farm of Ko Kyaw Sein Tun, who operates ponds in northwest Pantanaw township, where Thar sources some of his farmed product.

Workers unload fish as loaded boats arrive at the wholesale fish market. Photo by Htoo Tay Zar

Growing up, none of Kyaws family worked in farming or fish farming, but, seeing an opportunity when he finished school 20 years ago, he went into business for himself with a single small pond. Today, he owns or operates 10 pondsthe largest one covers the same area as 16 Olympic-sized poolsfilled with rohu, prawns, and white carp. A dozen or so men stand waist-deep in a nearby pond, pulling a net full of Kyaws shimmering, silvery product to shore, where the laundry baskets wait, ready to be filled and taken to the scales.

A typical way to start an inland aquaculture business in Southeast Asia is to convert a rice paddy. The government tightly controls the use of agricultural land in Myanmar, but that hasnt stopped many enterprising individuals from risking fines and switching to freshwater aquaculture instead, either converting their own paddies or leasing land from others. Land already in use for rice is actually best suited for freshwater ponds, so growth of aquaculture in rice-producing regionswhich stretch from Asia to Egypt to West Africa to Californiainvolves little destruction of relatively pristine habitat for the small- and medium-sized farms, Belton found in his research.

When Kyaw was starting out, a legion of workers with strong backs constructed most ponds, and even today teams of diggers travel from village to village offering their services. The most common route from paddy to pond, though, is to hire a backhoe. A trench is dug around the rice field, with the excavated soil used to build up dikes beside itits not so much digging a hole as removing soil and banking it on the sides. Lime is added before water, which sometimes means waiting for rain. Depending on the ponds location relative to a water source and how much it would cost to rent and fuel the machine, however, farmers might pump in some groundwater and let the rain fill the rest. The lime, a calcium-rich mineral, disinfects the pond bed and changes the pH of the water to make it more suitable for the growth of phytoplankton, one food source for farmed fish. The practice is essentially the same as a farmer fertilizing grass to create a pasture for cattle.

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At Ko Kyaw Sein Tuns fish farm about 70 kilometers from Yangon, the aquaculture economy is bustling, providing many locals with employment. Video by Maung Nyan

Once theres a plankton-rich environment, its time to fill the pond with fish. Kyaw stocks his ponds with what he calls babies, three-to-five-day-old fish acquired from a hatchery run by the government. We are lucky that we are near the township office of the Department of Fisheries, he says. After two months, the fish will have grown to two to four centimeters or so, at which point Kyaw moves them into the largest pond for the next year. Hell shift them between ponds as needed over the three years it takes to raise the fish.

Wearing rubber boots, swim trunks, and a short-sleeved button-down shirt, Kyaw, sporting a bit of the belly that comes with middle age, surveys his ponds from a dike that separates them. When he started his farm, just out of school, business was tough. Today, however, its thrivingKyaw and his wife have raised four children and sent them all to school on his income, with the oldest now in the third year of university. Thats not uncommon: aquaculture is so lucrative in Southeast Asia that few farms start with help from the government or international NGOs. Existing demand, market infrastructure, and local know-how are all they need. And their success creates a spillover effect: Kyaw employs about 10 people, a figure that can double seasonally. Research from the University of Georgia published in 2018 suggests that this is common, and significant since aquaculture performs better than terrestrial farming in terms of the income per hectare generated for the local economy. Aquaculture work typically pays better than agriculture work (though, as in virtually every other industry, women earn less than men), and is generally labor intensive. Operations employ a variety of laborers to dig the ponds; to feed, harvest, and transport the fish; to manufacture the fish food; and even to provide security. (Thieves are a continual menace, Kyaw says.) The FAO estimates that 20.5 million people worldwide work on fish farms, most of them for smallholders. Consumers come from surrounding towns to buy on the days Kyaw harvests, indicating that most of his production stays in Myanmar. My product quality is well known, he boasts.

Kyaw and one of his employees rowing around his fishpond in Pantanaw township, about 70 kilometers from Yangon. Photo by Htoo Tay Zar

One of the controversies that has dogged aquaculture is the issue of fish feed. A trade group, the Marine Ingredients Organisation, reports that about 12 percent of fish harvested from the wild goes to aquaculture. If fish from the ocean are going to feed those grown inland or in ocean pens, then aquaculture is contributing to the depletion of wild fish stocks, rather than diverting demand from them. But Kyaw feeds no marine products of any kind to his fish. Instead, his stock receives rice bran, a byproduct from one of the many local grain mills, which he mixes with beans. He supplements the mix with vitamins to promote growth, and antibiotics to prevent illness, which can sap his revenue. Antibiotic use is a dangerous practice in both aquaculture and agriculture. The World Health Organization has called their use in food production a significant threat to human health, fostering drug-resistant bacteria. Often, however, in a semi-intensive system, many farmers dispense with antibiotics, Belton says. He and his colleagues have found little use of antibiotics in Myanmar, based on their interviews with smallholders, while more intensive fish farming tends to see higher use of antibiotics.

Some fish farmers will rely on antibiotics, regardless of what theyre feeding their animals. Yet, few of the producers in countries with the most, and fastest-growing, aquaculture operations need much fish meal anymore. Although, according to scientific studies, Atlantic salmon can still get around 25 percent of their diet from fish meal, the formulation is generally falling out of favor. Fish meal is becoming more expensive and advances in feed manufacturing have enabled plant proteins to be included in the diets of carnivorous species. In places like Myanmar and Bangladesh, farmed fish eat mostly agricultural byproducts. Species commonly grown theresuch as carp, tilapia, and catfishare either omnivorous or herbivorous, and dont need fish meal in their diet at all, Belton says. One common practice is to house poultry sheds over ponds, so the droppings can fertilize the ponds. Rice bran is abundant throughout Asia, as is oil cake, a byproduct from the manufacture of peanut or other oils. Anything with caloric value can be used, Belton says. Waste from noodle manufacture, waste from MSG manufacture, canteen waste, brewery waste. Meanwhile, processing waste from both capture fisheries and aquaculture is a growing ingredient in fish meal, potentially alleviating demand for wild-caught fish. Aquaculture, it turns out, can be a form of recycling.

Though the temperature is still above 25 C and the sun high above the horizon, Kyaw sheds his straw hat for a moment as he oversees his employees. They are todays link in a chain of fish farmers dating as far back as 6,600 years, when archaeological evidence suggests the Gunditjmara, an Indigenous people in Australia, were engineering channels from lakes and streams to raise eels. Around 475 BCE, a Chinese renaissance man named Fan Li wrote a guide to raising carp. Hundreds of years later, an emperor by the name of Lithe same word as common carp in Chinesebanned the farming of that species, which only served to spread the practice to other species. Romans and Egyptians also developed aquaculture techniques. By the 12th century CE, fish farming had expanded to India.

Employees at Kyaws fish farm drag nets to harvest fish in one of the operations 10 ponds. Photo by Htoo Tay Zar

Today, aquaculture is practiced on every continent save Antarctica. This is not without environmental impact, whether its shrimp and salmon or carp and tilapia. While closed, land-based aquaculture systems avoid some of the problems of ocean net-pen farms, their greenhouse gas emissions are greater (though still far below those of land-animal production). And, says Ruud Huurman, senior media advisor for anti-poverty NGO Oxfam Novib in the Netherlands, value continues to accumulate mainly with upstream producers and retailers in the Global North, where many retailers fail to answer for the environmental and working conditions of farms producing fish for export in southern or developing countries.

Whether these problems can be stemmed will be among the lines of inquiry of Beltons next project. With funding from the US Agency for International Developments Fish Innovation Lab, he will combine on-the-ground surveys of farmspainstaking work requiring hundreds of hours of interviews with farmers, some in remote locationswith remote sensing and artificial intelligence. Belton and his colleagues at WorldFish, a nonprofit research organization headquartered in Penang, Malaysia, where Belton lives, plan to analyze satellite photographs to look for known fish farms, and their characteristics, then feed the information into a computer capable of learning how to find farms in other images from around the world. Combining the data from the two sources, Belton and his team will develop the most accurate estimates yet of aquaculture production, employment, and economic value. The COVID-19 pandemic delayed the survey component, but Belton expects to conduct the necessary travel later this year.

The projects aim is for policymakers and multilateral organizations, such as the FAO, to leverage the data collected to help them assess the potential of aquaculture to sustainably feed a growing population thats becoming wealthier and seeking more protein. Whatever Belton finds, it seems freshwater aquaculture is here to stay. Demand is too great, and the return too alluring for new entrants. Operations like Kyaws could be one of the myriad of solutions that will be needed to feed 9.7 billion people in the coming decades.

Reporting from Myanmar by Htoo Tay Zar.

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Hold the Salt: The Promise of Little Fresh Fishes - Hakai Magazine

There is no avoiding it we have to eat every day. And as the effects of climate change become increasingly evident, the choices we make about what were eating are more significant than ever.

With many of us cooking at home these days, there is more of an opportunity to use food to fight climate change. With these ingredient swaps and tweaks to your eating habits, you can help make a more positive impact on your health as well as the Earths.

If you only make one switch in the service of the planet, cutting out red meat and animal proteins will have the greatest immediate impact.

A diet without meat products can reduce greenhouse gas emissions by 49 percent and water-scarcity weighted water footprint by 19 percent, said Galen Karlan-Mason, founder and CEO of GreenChoice, a grocery shopping app that helps consumers make informed choices about sustainability and nutrition, citing a 2018 study in the journal Science.

Karlan-Mason cited a number of factors that make industrial agriculture one of the most environmentally taxing processes in global food production. We monocrop corn and soy and process it into feed, ship the feed to the cattle, provide land and water, and repeat for the life of the cattle, all while the cattle release methane gas daily.

Plant-based meats, however, arent a one-to-one replacement for burgers and sausages. If we look at soy production, its second to beef in environmental damage were replacing first degree murder with second degree murder, said Douglas Murray, associate professor and chair of the nutrition and food studies department at Montclair State University in New Jersey.

From a nutritional perspective, these processed patties can still be just as high in saturated fat as a beef burger and contain higher levels of sodium, according to Harvard Medical School. So if youre choosing to cancel beef, exchanging it for a meatless option isnt a free pass to eat a soy burger every day.

Beyond engineered substitutes, vegetarian protein sources are the obvious swap-in for meat. Most vegetables, as noted in the 2018 Science study, have less of a carbon footprint than even the least impactful animal protein sources, like fish, eggs and dairy.

The phrase plant-based diet is a wide-ranging term that encompasses high-protein vegetarian foods like beans, lentils, leafy greens, quinoa and other unprocessed ingredients.

Replacing beef with one of these in your chili, for example, is a small change that can also have a positive effect on your health. There is a correlation between vegetarian diets and sustained weight loss as well as lower risks for certain types of cancer and heart disease, multiple studies have shown.

And incorporating plant-based proteins into everyday meals is easier than ever, thanks to a shifting popular mindset thats embracing meal-planning resources and recipes that incorporate these ingredients. Prepared items like grain bowls, cauliflower rice and veggie noodles are also more prevalent on menus and in supermarkets.

As a bonus, keeping foods like beans and quinoa on hand lets you cook from your pantry more often, enabling you to skip frequent trips to the store during a pandemic.

Though not as environmentally sustainable as vegetarian proteins, eggs are also a more climate-friendly swap, especially when they come from a local farm. They pack a lot of protein punch, and chicken and egg production is much less environmentally damaging than beef production, Murray said.

If youd also like to switch to nondairy milk, Karlan-Mason recommended oat, soy and hazelnut milks as the best alternatives.

Eat local has long been a sustainability mantra, and community farmers markets have proliferated over the past 15 years. The number of farmers markets nationwide skyrocketed from 1,755 in 1994 to 8,771 in 2019, according to the USDA.

But surprisingly, fuel, transport and packaging dont have as much of an impact on emissions as you might think.

It pales in comparison to the impact of the way land is used, said Shyla Raghav, vice president of climate change at Conservation International, with land use and farm emissions accounting for 80 percent of a foods carbon footprint and transport averaging 5 percent.

While supporting local producers is an important part of the equation from an economic perspective, its not necessary to beat yourself up for indulging in pineapple, avocadoes or other treats that dont grow in your neck of the woods.

Even almonds, which require a lot of water to produce, can be considered carbon-neutral because their trees store carbon instead of emitting it. And the trees water consumption per gallon is much lower than the amount of water needed to produce beef and other livestock. As a source of protein that replaces more intensive sources of protein, its positive, Raghav said.

Like any other ingredient, local and sustainable options are always the best choice when it comes to seafood. Theres a lot of rampant overfishing thats affecting fish stocks around the world, Raghav said, so doing research before buying and eating fish is more important than ever.

Farmed shrimp is the one item you should skip to have the greatest environmental impact in this category. Shrimp farming is the largest driver of mangrove deforestation, said Raghav, noting that mangroves are one of the most carbon-rich ecosystems on the planet. Their deforestation releases carbon dioxide and methane into the atmosphere, a process that makes farmed shrimp more environmentally damaging than pork or poultry.

Instead, turn to smaller fish like anchovies and sardines, which dont take as much fuel or energy to process, especially in comparison to larger fin fish like tuna. And in terms of sustainable aquaculture, farmed bivalves like oysters and mussels can help clean up waterways through their natural filtering and feeding habits.

If all of this sounds overwhelming or too complicated to truly make a difference, remember that what consumers can do is drive the demand, according to Murray.

He cited the examples of organic certification and the removal of synthetic growth hormones from milk as two instances where purchasing choices made a lasting change in the food supply chain.

If enough consumers try meatless Monday, it would have a real significant impact, he said.

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Try this Earth-friendly diet: How to shop, cook and eat to fight climate change - KRDO

5 foods to include in your diet as you try to lose weight with intermittent fasting  |  Photo Credit: iStock Images

New Delhi: Losing weight is not just about the vanity reasons, but it is about being and feeling healthy. Being overweight or being obese has been linked with various health issues, that can cause chronic diseases such as cancer, and type 2 diabetes. However, losing weight is not a cake walk, and one can find themselves confused with so many tips and options marketed as ways to lose weight.

Perhaps, losing weight in an unhealthy way, with fad and crash diets, and over-exerting yourself with workouts is even worse. Intermittent fasting is a diet method that people follow around the world. It has been proven to be healthy, not just for weight loss, but also generally for the body.

This method focuses more on when you eat, instead of what you eat. There are many ways to practice intermittent fasting, but two of the most popular ones are 16:8 and 5:2.

During intermittent fasting, one is supposed to eat during certain times, and fast the other times. For instance, in the 16:8 diet pattern, people eat for the 8 hours during the day and fast themselves for the other sixteen. Similarly, in 5:2, people eat normally during the 5 days of the week, and fast during the other two.

Even as you follow intermittent fasting for weight loss, it is important to note that eating junk, or unhealthy food during the hours that you can eat will not lead to weight loss. It is also not healthy for your body generally. Here are 5 foods you must add to your diet during intermittent fasting to stay healthy and lose weight quickly.

Disclaimer: Tips and suggestions mentioned in the article are for general information purpose only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

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5 foods to include in your diet as you try to lose weight with intermittent fasting - Times Now

Tamara Willner, nutritionist at NHS-backed healthy eating plan Second Nature, revealed why you shouldnt give up if you hit a plateau. In fact, these stints are important for overall weight loss.

Tamara said: "The weight-loss plateaus are important to allow time for our body to reset before we can continue losing weight again. This is explained through the set-point theory.

"Everyone has a natural set point which is the weight range that our body hovers at when were eating healthily. Our set point is determined by our DNA and our environment.

"Slow, gradual weight gain over many years can cause our body to resettle at a new, higher weight.

"However, going below our set-point range can be extremely challenging. Our body will do everything to maintain it.

"Everyone is unique, so some of us will naturally have a higher weight set point, and some of us will have a lower one."

READ MORE: Weight loss: Drink ginger tea to lose weight fast and burn hundreds more calories a day

How can you kick-start weight loss again?

Tamara detailed her tips to get out of a plateau.

1) Check your portions

Aim to build balanced meals with a portion of protein, healthy fats, and plenty of non starchy vegetables. If youre adding some carbohydrate, opt for complex carbs (e.g. oats, rye bread, or brown pasta) over refined carbs (e.g. white bread, white rice, or sugary cereals)

2) Manage your carb intake

Evidence suggests that the best diet for weight loss is a lower-carbohydrate approach.

Reducing our intake of refined carbohydrates can help kickstart weight loss.

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3) Stay hydrated

Our body often mistakes thirst signals for hunger. Consider setting a reminder on your phone every hour to have a glass of water, or having a glass of water before each meal.

4) Consider when youre eating

Early research suggests time-restricted feeding (TRF) (keeping our eating window to 10 hours or less, e.g. 9am-7pm, or 8am-6pm) could promote weight loss.

Larger, well-controlled studies are needed to draw solid conclusions, but it may help some of us feel better and kickstart our weight loss.

5) Vary your exercise routine

To get the benefits of exercise we dont necessarily need to be exercising harder. Instead, its about looking at the type and frequency of our exercise.

Changing up the exercise we do is a good way to build up different types of muscles in our body and optimise the amount of fat we burn.

Consider trying some new exercises at home or fitting in small bursts of exercise into your daily routine.

6) Manage stress and sleep

If were determined to lose weight, keep it off in the long term, and improve our overall health, managing our stress and sleep is vital.

Poor sleep and high stress can, directly and indirectly, impact our weight and health.

Consider practising two minutes of deep breathing or meditation each day. Improving our bedtime routine can increase the quality of our sleep, for example reducing screen time before bed, keeping our bedrooms dark and cool, and avoiding alcohol in the evening.

Second Nature is an NHS-backed healthy eating plan that also aims to reverse type 2 diabetes. See http://www.secondnature.io for more info.

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Weight loss: The real reason your diet plan stops working and how to fix it - Express

1. Diet alone had nearly identical benefits on insulin sensitivity compared to gastric bypass surgery.

2. The metabolic benefits from diet and gastric bypass surgery were related to weight loss.

Evidence Rating Level: 2 (Good)

Study Rundown: Previous studies have demonstrated that bariatric surgeries are far more effective than medical therapy to treat type 2 diabetes. However, many of these studies have results which are confounded by the difference in weight loss among the participants undergoing these procedures. Because of this, the effects of bypass surgery independent of weight loss on major factors in type 2 diabetes pathogenesis such as beta-cell function and insulin resistance is unclear. As such, this study evaluated whether gastric bypass surgery provided metabolic benefits, independent of weight loss, in participants with obesity and type 2 diabetes. The results of the study demonstrated that both diet and gastric bypass surgery confer metabolic benefits, which were actually related to resulting weight loss from the interventions. This prospective cohort study was limited by the assessment of metabolic outcomes after weight loss between 16 to 24%. Therefore, the study results could not be extrapolated for weight loss above or below that range. Nonetheless, this study was strengthened by matching participants based on weight loss to control for the confounding variable.

Click to read the study in NEJM

Relevant Reading: Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity

In-Depth [prospective cohort]: This prospective cohort study followed 33 participants at a single center in the United States. Participants included in the study were diagnosed with type 2 diabetes and obesity. Participants unable to achieve the target weight loss, defined as 16 to 24% of the participants original weight, were excluded from this study. The participants underwent a comprehensive metabolic function assessment before and after weight loss from gastric Roux-en-Y bypass surgery or low-calorie diet therapy. The diet group received weekly education on dietary practices and prepackaged meals. Prior to analysis, the participants were matched between the two intervention groups based on percentage of weight loss. Once the participants achieved the target weight loss, the body weight was maintained for three weeks before conducting the final comprehensive metabolic function assessment. The primary outcome was the change in hepatic insulin sensitivity. The mean weight loss in the diet group was 17.81.2% (range, 16.1 to 20.4) and 18.72.5% (range, 16.0 to 24.4) in the surgery group. Insulin sensitivity in the liver increased after weight loss in the diet group (31.0 mol/kg; 95% confidence interval [CI], 22.5 to 39.6) and the surgery group (25.1 mol/kg; 95% CI, 16.4 to 33.8). There was no significant difference between the two group (-6.5 mol/kg; 95% CI, -15.7 to 2.7). Additionally, beta-cell function increased after weight loss in the diet group (1.83; 95% CI, 1.22 to 2.44) and in the surgery group (1.11; 95% CI, 0.08 to 2.15); however, there was no significant difference between the two groups (-0.71; 95% CI, -1.75 to 0.34). Interestingly, weight loss in both groups resulted in a decrease in plasma bile acids, plasma branched-chain amino acid, and C5 acylcarnitine concentrations. However, the decrease in these plasma components were greater for the surgery group than the diet group. Taken together, weight loss resulting from diet or gastric bypass surgery provided near identical benefits for insulin sensitivity in participants with type 2 diabetes and obesity.

Image: PD

2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

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Diet and gastric bypass have similar metabolic benefits in diabetic patients - 2 Minute Medicine

Among the many celebritiesthat have played a role in inspiring us to go vegan, we have to say the uplifting words of Ariana Grande reverberate in our ears often.

Back in 2014, when The Mirrorasked her why she went vegan, she said, I love animals more than I love most people, not kidding. But I am a firm believer in eating a full plant-based, whole food diet that can expand your life length and make you an all-round happier person.

Though Ariana Grande is of Italian heritage, it doesnt seem like shes big on eating staples from the Mediterranean countrys culinary playbook. In The Mirror interview, Grande conceded that even though shes very proud of her lineage, ...I dont eat a lot of Italian things, because Im vegan. I was raised on meat and cheese, so Ive had enough for anyones normal life span.

According to Grandes trainer, Harley Pasternak, the pop star is all about Japanese eats. "Ariana Grande, she's vegan, and she loves daikon, lotus, adzuki beansalmost like a macrobiotic Japanese [diet]," Pasternak told Glamourin 2015. A macrobiotic diet also focuses on nutrient-dense whole grains like brown rice, barley, millet, and oats, as well as fresh vegetables, sea vegetables, and miso, a fermented soy paste. (Sign us up for this quick and easy vegan pho with creamy miso broth).

Though Pasternak doesnt say whether or not Grande has a sweet tooth for macrobiotic desserts, we hear sweet potatoes and pumpkinsboth go-to's in the macrobiotic realmtaste really, really good in pie form.

Ariana Grande has never met a berry she didnt like, it appears. Whether posting her blueberry haul on Instagramor tweetingthat shes eaten at least five strawberries a day since she can remember (theyre my favorite food!), its clear the star gets some of her sky-high energy and glowing skin from all the fruit she consumes.

"Ariana eats incredibly well and she always had a healthy diet. I think what I've gotten her to do now is to create a more balanced diet and feel OK about indulging and celebrating sometimes, said Pasternak of Grandes eating MO in a 2017 PopSugararticle. She has widened the ingredients she puts into her diet. She makes a lot of my smoothies, so for the body-reset smoothies she'll make the white smoothie, red smoothie, and green smoothie, notes Pasternak, referencing healthy smoothie recipes from his book The Body Reset Diet.

Here at The Beet, we cant ever get enough tantalizing smoothie recipes. Thats why we deliver a healthy Smoothie of the Day recipe to you each day. Sign up here. Want to kick the day off with a smoothie right up Grandes lane? Try this Berry-Fun and Refreshing Smoothie Everyone Will Love.

In addition to talking to the media about how going vegan has helped her health and happiness, Grande also takes a stance when it comes to animal rights issues. This spring, she took to Twitter to disapprove of Tiger Kings Carle Baskin from appearing in her music video Stuck with U, a duet with Justin Bieber.

She shared her dismay of the clip and ensured it didnt appear in the music video, publicly stating, "for the record, I did not allow or approve this clip to be in the actual video. but. nonetheless. it exists and thats ..... unique.

Named one of peta2s sexiest vegetarian celebrities of 2014, were glad to see that Grande is still keeping her plant-based game strong a few years later. Heres to many more happy and healthy years of strawberries, macrobiotic culinary delights, and of course, loving animals more than people (were joking here, kind of).

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Ariana Grande is Vegan: Here's What She Eats in a Day - The Beet

Dietary potassium restriction appears prudent in normokalemic patients with chronic kidney disease (CKD) to keep serum potassium levels in check and reduce mortality risk, but this advice is based on very low-quality evidence, according to the authors of a new review published in the Journal of Renal Nutrition.

Andrew Morris, MRes, of Coventry University in Coventry, United Kingdom, and colleagues performed a systematic review and meta-analysis of 2 randomized trials and 5 observational studies involving 3489 normokalemic patients with CKD stages 3 to 5D. A restricted (1295 mg/d) versus unrestricted (1570 mg/d) potassium diet lowered serum potassium by just 0.22 mEq/L, although the absolute differences in potassium intake between cohorts seemed small.

In further analyses, a relatively low dietary potassium intake of 1670 mg/d was associated with a 40% reduction in mortality compared with a high potassium intake of 4414 mg/d. Low dietary potassium intake did not significantly correlate with slower CKD progression, however.

Our meta-analyses also offer support to the current opinion that dietary potassium intakes should be limited to 2,000-2,500 mg/d (50-65 mmol/d) in those with CKD stage 5 on maintenance hemodialysis to help maintain normokalemia, Morris team wrote.

The reviewers found no studies supporting potassium supplementation to reduce blood pressure in patients with nondialysis CKD.

Morris and colleagues deemed the quality of the evidence very low according to GRADE criteria. They encouraged future high-quality trials in this area that include patients with hyperkalemia.

In a recent paper in Kidney International, the authors reported specific areas for future research based on a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference on the management of dyskalemia. Investigators should:

The authors of the paper observed: Generalized dietary [potassium] restriction in people with CKD may deprive them from other beneficial effects and nutrients of [potassium]-rich diets.

Morris A, Krishnan N, Kimani PK, Lycett D. Effect of dietary potassium restriction on serum potassium, disease progression, and mortality in chronic kidney disease: a systematic review and meta-analysis. J Renal Nutr. 2020; 30(4):276-285. doi:10.1053/j.jrn.2019.09.009

Clase CM, Carrero JJ, Ellison DH, et al. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference. Kidney Int. 2020;97(1):42-61. doi:10.1016/j.kint.2019.09.018

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Dietary Potassium Restriction in CKD Challenged - Renal and Urology News

Keith Roach, To Your Health Published 8:47 p.m. ET Aug. 23, 2020

Dear Dr. Roach: Ive never smoked, drank alcohol or used illegal drugs. My doctor says Im in great health. My only vice is drinking diet soda, and I drink three or four cans a day. Id like to know what you think about it. I know its not great for me, but I figure its better than the other vices.

P.V.

Dear P.V.: Im not sure vice is the correct term.

Compared with sugar-sweetened soft drinks, diet sodas are probably less harmful in several ways. Compared with plain water, they probably have some drawbacks. The effects vary by person, and the literature on this subject is mixed and controversial.

For your teeth, less sugar means less cavities. However, diet sodas are acidic and drinking too many can weaken the enamel on your teeth.

The effect of diet sodas on weight is complicated. Paradoxically, many people will gain weight when switching to diet soda. Scientists believe this is due to effects on the bacteria in the intestines (the microbiome). Consuming sweet beverages may also stimulate the desire for other sweets and less-healthy foods.

Some of the sweeteners in diet sodas can cause intestinal problems in susceptible people, especially diarrhea and gas. If you have no symptoms from drinking diet sodas, have no weight issues, get your teeth checked regularly and have good oral hygiene, then the risk from three or four daily cans of diet soda is modest. Its still better to drink plain water.

Dear Dr. Roach: I have read numerous articles regarding the use of marijuana but have not seen a reference to cannabinoid hyperemesis syndrome. This is a condition that was recently identified and is increasing in frequency due to legalization and potency. I would appreciate your thoughts on this syndrome.

D.L.

Dear D.L.: Cannabis use is indeed increasing, and one unusual side effect is the hyperemesis (literally, too much vomiting) syndrome. This most often occurs in daily users of cannabis, usually after years of use. The vomiting tends to occur in cycles: nausea, abdominal pain and vomiting, which can be severe, occur without warning and last 24-48 hours. This is followed by a recovery phase lasting weeks or months, where people feel generally well. The diagnosis can be confused with cyclical vomiting syndrome, and the correct diagnosis is often missed for years.

Physicians sometimes fail to think of the diagnosis or have never learned of it -- it was first described in 2004. Cannabis users are sometimes highly resistant to the idea that the cannabis is causing these symptoms, as they have often been using for years with no problems. Further, cannabinoids are sometimes used to relieve nausea, so the mechanism of cannabinoid hyperemesis syndrome is not understood. The patients I have seen with this syndrome -- including one yesterday, coincidentally -- often have had very extensive evaluations, such as CT scans and endoscopies.

One clue that points toward cannabinoid hyperemesis syndrome is that most people learn that taking a hot shower temporarily relieves symptoms, and they will take several hot showers or baths during the day.

During the acute phase, treatment is supportive care, sometimes including anti-nausea drugs. However, the long-term treatment is cannabis cessation. It may take months before it is clear that the symptoms have resolved with cannabis cessation. Unfortunately the risk of relapse is high if the patient returns to cannabis use.

Readers may email questions to ToYourGoodHealth@med.cornell.edu

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Dr. Roach: Where does diet soda fall on the vice spectrum? - The Detroit News

Kidney health: Diet, medication and psychological tips for a person on dialysis during COVID-19 pandemic  |  Photo Credit: iStock Images

New Delhi: Health experts have warned that people living with certain chronic health conditions such as chronic kidney (CKD) disease, chronic obstructive pulmonary disease (COPD), type 2 diabetes, cancer are at an increased risk of severe illness due to COVID-19, the disease caused by the novel coronavirus or SARS-CoV-2. Current available data suggest that people living with kidney disease, particularly those on dialysis and transplant recipients might be at risk of severe infection and mortality from COVID-19.

As the coronavirus pandemic persists all over the world, doctors, health agencies and governments are engaging in several activities to educate, inform the public with kidney disease and other chronic health issuesto reduce their exposure to this dreaded virus and how to respond to a potential infection. Yet, before we list some COVID-19 guidance for patients with chronic kidney disease, let us try to understand what happens to the body when a person with CKD reaches the end-stage of renal disease.

When a person with chronic kidney disease reaches the end-stage (stage V) of renal disease, the kidneys no longer essay the role or function as healthy kidneys do. The kidneys are unable to remove the toxins, metabolic wastes and excess fluid from the bloodstream effectively. At this point, one of the treatment modality is dialysis, which flushes out unwanted toxins, excess fluid and waste products by filtering the blood.

Dialysis is one of the treatment methods for these patients, apart from preventing the accumulation of excess waste in the body, the purpose of dialysis is also to help control blood pressure and regulate levels of chemical elements in the blood, including sodium and potassium. Without dialysis, salts and other waste products continue to accumulate in the blood which eventually damages other important organs of the body, said Dr A S Mathur, Nephrologist, NephroPlus Dialysis Center.

As we pass through the tough times of a pandemic and have been isolated due to intermittent lockdown restrictions in many parts of the country, dialysis patients need to grapple with certain unique challenges with regards to their diet, medication as well as mental health. Below are a few tips suggested by the nephrologist that will help kidney patients, especially those on dialysis, stay healthy amid the pandemic:

Food and Nutrition

Diet is fundamental and, therefore, dialysis patients must make note of their dietary needs:

Medication

People with chronic kidney disease undergoing dialysis face unique health challenges and, thus, it is important to manage all their medication and take them as prescribed. Here are a few tips for managing medication at home:

Mental Health

Your mental health affects your physical health, it is, therefore, common for chronic kidney disease patients and their caretakers to experience mental health issues caused by lifestyle changes especially when living in isolation nowadays.

As a kidney patient, you may feel overwhelmed making decisions surrounding your treatments in these difficult times. However, its important to realise the fact that you have many rights and options when it comes to your care, helping you live a longer and healthier life.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a professional healthcare provider if you have any specific questions about any medical matter.

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Kidney health: Diet, medication and psychological tips for a person on dialysis during COVID-19 pandemic - Times Now

Banana apricot smoothie recipe is a must-try.

Highlights

Smoothie is a full package of 'health' and 'taste'. Made with fruits, milk and/or curd, water with the additional goodness of nuts and seeds, smoothie is as refreshing as it is nutritious. Perfect to quench you thirst and hunger at the same time, this drink can be easily made at home with foods of your choice. Here we have an extremely useful recipe of banana apricot smoothie that just doesn't taste great; it may also accelerate weight loss and boost immunity.

Banana apricot smoothie brings together two highly nutritious fruits and creates a magical melange of sweet and tangy flavours. Both banana and apricot boast of high fibre content and are rich in antioxidants like vitamin C, making them perfect for your weight loss and immunity-boosting diet. The mushiness and sweetness of banana and milk, mixed with tanginess and sourness of apricot and curd, creates a wholesome drink that simply tastes superb. Dried apricots are available all year round and can be easily found in grocery stores and fruits and vegetable markets. If you can use fresh apricots, it's even better.

(Also Read: 7 Recipes To Stay Hydrated In Monsoon)

Banana is a fibre-rich fruit.Photo Credit: iStock

(Makes 1 glass)

Ingredients -

1 banana

3 dried apricots

2 tbsp curd

1 cup milk

Half glass cold water

1 tbsp honey

A pinch of cinnamon powder

Method -

Step 1 - Peel and cut banana into small pieces. Chop apricots into small pieces. If you are using fresh apricots, de-seed them.

Step 2 - Toss the fruits in the blender jar. Add water and blend till the fruits are fully mashed.

Step 3 - Add curd, milk, cinnamon powder and honey, and blend again. Pour the smoothie in a glass, top it with ice cubes or refrigerate for some time and serve.

You may add dry fruits, nuts and seeds of your choice and blend them with the fruits, or you may sprinkle nuts and seeds later on the top of the smoothie before serving. If you don't want to add anything else except the fruits, it's okay; this smoothie already comes with the goodness of the two fruits proffering various health benefits.

Make this delicious smoothie for weight loss and strengthen your immunity too.

About Neha GroverLove for reading roused her writing instincts. Neha is guilty of having a deep-set fixation with anything caffeinated. When she is not pouring out her nest of thoughts onto the screen, you can see her reading while sipping on coffee.

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Banana Apricot Smoothie Can Be A Refreshing Part Of Your Weight Loss And Immunity-Boosting Diet - NDTV Food