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Letters to the editor for July 24 – The Spectrum

Posted: July 24, 2022 at 1:59 am

St. George Spectrum & Daily News

Record heat waves in America and Europe endanger millions, as wildfires rage, in a brutal manifestation of man-induced global warming.

Each of us can reduce our personal contribution by cutting back on consumption of animal foods, which account for a whopping portion of greenhouse gases. Carbon dioxide is released by burning forests to create animal pastures. Methane and nitrous oxide are released from digestive tracts of cows and sheep and from animal waste pits.

In an environmentally sustainable world, vegetables, fruits, and grains must replace animal food products in our diet, just as wind, solar, and other renewable energy sources replace fossil fuels. The next trip to our favorite supermarket provides a great opportunity to explore the delicious, healthful, eco-friendly plant-based meat and ice cream products in the frozen food section.

Strat Gonzalez

St. George

It has taken me 21 years to appreciate the amazing work your community angels accomplished in coming to our rescue after our plane made a middle-of-the-night emergency landing at your airport on September 18, 2001.

From my point of view as a passenger back then, all I could appreciate was my own and my fellow passengers trauma as our plane made an extremely precipitous descent into your airport after there was a fire in the cabin. What I realize only now is that your communitys emergency services people acted quickly, inventively, and safely to get us all off the disabled plane and into the terminal where we sheltered for the next 12 hours.

Living moment-to-moment in the emergency I was blind to the effort it must have taken to awaken a probably closed airport and mobilize a construction lift to remove us from the aircraft. As our big plane had landed quite far from your small terminal, you also found school buses and drivers to transport us to the terminal. In the morning I saw the pick-up trucks (who organized those?) filled with our luggage, awaiting a replacement plane to complete our journey to Chicago.

One week after 9/11 everyone in this country was experiencing some degree of trauma. I am so thankful that your community arose to help rescue strangers who dropped out of the sky that night.

Marie Shakespeare

Bloomington, Indiana

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Letters to the editor for July 24 - The Spectrum

Swimming: What It Is, Health Benefits, and Getting Started – Everyday Health

Posted: July 24, 2022 at 1:59 am

Do I need to warm up before a swimming workout?

Warming up before a workout is always a good idea. Taking 5 to 10 minutes to warm up the muscles you plan to use before starting your workout can help loosen your joints and prime those muscles for exercise, Koleber says. Before swimming, perform a few sets of push-ups and planks on dry land, and then spend a few laps swimming at a slow, easy pace to warm up.

The number of calories youll burn when swimming varies depending on your age, sex, body weight, and the intensity and duration of the exercise. However, as mentioned above, a 150-pound person may burn 216 calories from 30 minutes of general swimming (not vigorous), according to Harvard Medical School. If that same person increases the intensity, the expected calorie burn can jump to 360 calories in 30 minutes.

When youre first starting out, any number of laps youre able to do is a good swimming workout. For those who need concrete numbers, however, four laps of any basic stroke is a good distance to start with, Slabaugh says. (For reference, standard-sized pools tend to be 25 yards long, according to U.S. Masters Swimming.) From there, the number of laps you do will depend on your goals, intensity, fitness level, and how much time you have to exercise.

Swimming is a full-body workout. It works the large muscles in your back (latissimus dorsi and trapezius), chest (pectoralis major), shoulders (deltoids), hips (glutes), legs (quadriceps and hamstrings), and midsection (abdominals), Buckingham says.

Many groups of people, including beginners, kids, older adults, pregnant women, people with chronic conditions, and those with joint pain or injuries, can all potentially benefit from swimming. However, its a good idea to consult with your physician if you have any medical condition or injury that may make exercise and swimming in particular unsafe. In addition, Slabaugh recommends avoiding swimming if youre recovering from surgery, have open wounds, or cant complete the strokes.

A comfortable swimsuit and a pair of goggles may be all you need. However, some people may want to wear a swimming cap to protect their hair from damage from pool chemicals or salt water.

Aside from a swimsuit, goggles, and a swim cap (if you prefer to use one), most other swim gear is optional. However, if youre swimming in a natural body of water, its a good idea to get a safety buoy to increase your visibility and give you something to hang onto if you get tired, Koleber says.

Optional gear includes:

While swimming is low-impact, the repetitive motions can still cause pain and injuries, if youre not careful. The most common swimming-related issues include swimmers shoulder, lower back pain, breaststroke knee, and foot and ankle tendonitis, according to the Hospital for Special Surgery(HSS).The best way to avoid all of these injuries is to use proper swimming technique, build strength in the muscles that support your stroke, include a warm-up and cooldown in every workout, and progress your routine gradually, per the HSS.

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Swimming: What It Is, Health Benefits, and Getting Started - Everyday Health

What We Know About the Historic Heat Wave in 2022 – Stay Safe in Extreme Heat – Prevention Magazine

Posted: July 24, 2022 at 1:59 am

The National Weather Service is warning about a dangerous and record-breaking heat wave that will impact most parts of the Great Plains and Mississippi Valley, as high temperatures continue across many areas of the southwestern U.S. Nearly 35 million people are under excessive heat warnings or heat advisories, the agency says, noting that the oppressive heat is expected to continue.

There are also high temperatures expected in many parts of the east coast this week. The National Weather Service shared on Twitter that heat-related advisories and warnings are likely throughout the week.

Temperatures are currently soaring in Europe, too, including in the U.K., where the thermostat is predicted to reach 104 degrees on Monday.

If you live in an area thats under a heat warning or facing high temperatures, its understandable to have questions about why whats been dubbed the Historic Heat Wave of 2022 is such a big deal and how to stay safe. Heres what you need to know.

A heat wave is a period of unusually hot weather that usually lasts two or more days, according to the National Oceanic and Atmospheric Administration (NOAA). In order for something to be considered a heat wave, temperatures need to be outside the historical averages for an area.

Heat waves usually happen because of trapped air that gets warmed like air inside an oven, NOAA explains. High-pressure systems force air downward, preventing air near the ground from rising and hot air just gets hotter.

Heat waves can cause heat illnesses, which include heat cramps, heat exhaustion, and heat stroke, according to the Centers for Disease Control and Prevention (CDC). Symptoms of those illnesses can include:

Heat illness can be incredibly serious, says Lewis Nelson, M.D., chair of emergency medicine at Rutgers New Jersey Medical School. As our body temperature rises due to persistence in a hot environment, our vital body functions, such as enzymes and organs, begin to malfunction, he says. This leads to organ failure, and if untreated, can be lethal.

While everyone is at risk for heat illness, some are more vulnerable than others, says Nicholas Kman, M.D., emergency medicine physician at The Ohio State University Wexner Medical Center. "Those at greatest risk for heat-related illness include infants and children up to four years of age, people 65 years of age and older, people who are overweight, and people who are ill or on certain medications." Theres also greater risk with greater exposure, he says. Meaning, if you're going to be outside in high heatand especially if you're going to be active while doing ityou're more likely to get sick.

If you have time to prepare for a heat wave, the Department of Homeland Security (DHS) recommends taking a few steps to minimize the odds youll have issues when temperatures soar:

And, if the heat has already hit, the Red Cross has a laundry list of suggestions for how to stay cool. Those include:

Dr. Nelson also recommends carrying water with you. Maintaining adequate hydration is important, but it is equally important not to overdo it, he says. When we sweat, we lose salt and water, and if we only drink water without electrolytes, we run the risk of lowering our body sodium to concerning levels. Thats why he suggests eating regularly, along with drinking water or drinking electrolyte-containing beverages like sports drinks.

Overall, Dr. Nelson says keeping cool and safely hydrated is most important. And, if you need to be outside in high heat, he recommends keeping tabs on how you feel and heading into cooler temperatures if you start to feel off.

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What We Know About the Historic Heat Wave in 2022 - Stay Safe in Extreme Heat - Prevention Magazine

Weight Loss Mistakes: 5 Reasons Why Intermittent Fasting is Not Helping You – India.com

Posted: July 24, 2022 at 1:58 am

Weight Loss Mistakes: When you think of losing weight or shedding a certain number of kilos, you first make a list of diets and exercises that you can do. One of the most popular weight-loss plan is intermittent fasting, which is more of a lifestyle than a diet. Basically intermittent fasting is balancing cycles between periods of fasting and eating. Intermittent fasting restricts ones food intake to a shorter time, which aids in calorie reduction. However following this diet plan, people tend to make a lot of mistakes which hinders their weight loss process.Also Read - Weight loss Diet: 5 Super Foods That Will Help You Shed Those Extra Kilos

Your diet is deficient in nutrients: When fasting, it is important to maintain a healthy diet. While fasting, make sure to eat plenty of vegetables, fish, and lean protein. Before beginning an intermittent diet, make sure your body can use fat as an energy source efficiently. Maintain a proper fasting routine. If youre new to this or have diabetes, keep a close eye on your health. Consume plenty of fruits and vegetables along with proteins such as chicken breast, fish, or eggs. Dont starve yourself; instead, eat smaller portions throughout the day to train your body well. Also Read - 5 Food Items You Are Not Supposed to Eat After 8 pm Even if Getting For Free

You are following the wrong Intermittent fasting plan: Choosing the right IF plan is important. As previously stated, beginners should take it slowly and not attempt a 24-hour fast right away. If you are unable to keep up, you may end up eating more calories than usual, resulting in unhealthy weight gain. Also Read - Weight Loss Mistakes: 5 Habits That Can Ruin Your Fat Loss Journey

You are skipping meals which you shouldnt: If your fasting window falls during breakfast, this will be especially difficult. We tend to consume more calories from food later in the day, so if you skip meals during that time, you may end up consuming too many calories. It is most likely the reason why skipping breakfast is not advised. Remember that if you dont eat enough calories while intermittent fasting, your bodys metabolism will be seriously hampered.

You are not drinking enough water: Dehydration can cause a variety of health issues, including brain fog, constipation and fatigue. It is therefore important to stay hydrated while fasting. As per experts, its essential to dink 7-8 glasses of water everyday. Drinking plenty of water will also help you avoid headaches and constipation.

You are being impatient: If you are following this diet plan, remember that are not being impatient and taking a lot of stress. Intermittent fasting is a slow and steady process. To avoid unhealthy weight gain, take it slowly when fasting by gradually adjusting to it and following a proper intermittent diet plan.

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Weight Loss Mistakes: 5 Reasons Why Intermittent Fasting is Not Helping You - India.com

Leonard Fournettes trainer acknowledges weight gain, says hell be in top shape for the season – NBC Sports

Posted: July 24, 2022 at 1:58 am

Getty Images

Buccaneers running back Leonard Fournette reportedly angered the teams coaching staff by showing up to mandatory minicamp weighing nearly 260 pounds. But Fournettes trainer says that will be a distant memory when the season starts.

Trainer Jordan Bush, who has been working with Fournette since minicamp, acknowledged to Greg Auman of TheAthletic.com that Fournette came in heavy, but said Fournette is putting in the work.

Honestly, he did return to us a little bit bigger than we wanted, Bush said. He was also in the sauna every day, getting extra cardio every single day. We called it fat camp, just to mess around with him, but he was doing that type of stuff every single day. We could see the weight coming off.

Bush said that after spending a month training in Texas, Fournette was down to the low 240s.

The thing about Lenny, he gains weight fast, Bush said. Hes a big human in general. Leonard has a big frame. Hes not a small guy by any means. His legs are huge, not in a bad way. Learning his body and how he works, we understand what it takes, if he needed to lose five pounds, what he needs to do. Its triple-digit [temperatures] every day out here.

Bush called Fournettes weight blown out of proportion. If he performs when the season starts, no one will care what he weighed in the offseason.

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Leonard Fournettes trainer acknowledges weight gain, says hell be in top shape for the season - NBC Sports

Is fat freezing the coolest way to lose inches quickly? Why some think so – WSAV-TV

Posted: July 24, 2022 at 1:58 am

SAVANNAH, Ga. (WSAV) Working hard and not seeing results could be discouraging, especially for those who are actively trying to lose a few inches. Today, many people who struggle with having areas of unwanted diet and exercise-resistant fat, have more options to remove excess fat and improve body contours noninvasively.

Cryoskin is a nonsurgical fat reduction procedure that uses a cold temperature to destroy fat cells in certain areas of the body. Cryoskin is offered at gyms, salons, and spas in Savannah.

I get a lot of moms who just had a baby. I also get a lot of calls from military people who need to lose a couple of inches because theyre having an upcoming PT test or whatever, said Ashley Lawton, owner of Heavenly Body Studio & Spa in Savannah.

We help a lot of people when theyre just trying to get rid of fat that they cant get rid of on their own.They exercise, they eat right, but they just cant get rid of that pudge or those few little inches of fat that just wont come off.So, thats what we do, we take care of that.

All in all, Lawton says she has hundreds of clients, which includes Savannah resident and mom of two Arielle Merlow who said, After my last daughter I had the pooch and I just gained so much weight.

Deciding to embark on a weight loss journey Merlow, started making changes so that she could see results after having two children.

I did a lot of running, walking, a lot of cardio. I also did aerobics and weight lifting. I wouldnt say I was on a specific diet, I just tried to eat a lot better. I cut out a lot of juices, carbonated beverages, sweet beverages and just drank a lot of water. I wasnt really on a diet, I was more careful about the way I ate.

Merlow said she didnt have any underlying health issues and worked out of for months before she decided to have Cryoskin procedures. Its noninvasive, its not painful and it doesnt take long at all, so those were the perks of why I wanted to get it done.

Although Cryoskin is not yet approved by the U.S. Food and Drug Administration and it does not prevent illness nor disease, a study suggested with the increased risk of complications from more invasive methods such as liposuction, Cryoskin presents a promising method for nonsurgical fat removal and body contouring.

The method involves using a machine with either a paddle or a wand that basically targets fat cells in the body by freezing them or bringing them down to a very low temperature.

Concerning the cold temperature, Lawton said, They actually do experience the cold.Fortunately, because its targeted, it doesnt really affect your whole body. People pretty much get used to the temperature. I tell people its like when you walk into a cold pool, at first its like really cold but then you get used to the water and then youre fine, same thing happens when we do that treatment.

After the freezing or low temperatures, heat is applied to the cells again and thats when the change begins to take place.

Once we put heat to those cells again they then liquefy and your lymphatic system takes over and helps to remove them from your body through your urine or bowel movements, said Lawton. Usually after were done I have them go to the bathroom right away because a lot of time the fat cells are coming out pretty quickly so they need to go ahead and use the restroom and then I usually have them get on this machine that shakes them up really fast and helps the body release those fat cells as well.

Lawton said results can usually be seen after one session and that inches lost depends on the body part because the stomach tends to lose weight a lot faster with the Cryoskin process.

If you get the arms done, you may not lose a 1 on your arms but around the stomach, you can definitely lose an 1 , even 2 inches around the stomach in one session, it just depends on the person.

When youre trying to lose weight, it takes forever to see results. You might have to wait a week before you see anything on the scale but actually being able to see that you lost inches like that day made me feel a lot better and it kept me motivated to stay on my weight loss journey, said Merlow.

Like invasive targeted fat reduction procedures, there are potential side effects to noninvasive options like Cryoskin, which might include temporary localized redness, muscle soreness, itching that is often due to the reactions of certain cosmetic products used by clients and increased urination.It is important to consult with your physician before getting an invasive or noninvasive procedure done.

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Is fat freezing the coolest way to lose inches quickly? Why some think so - WSAV-TV

6 Scientifically Proven Health Benefits of a Plant-Based Diet – SciTechDaily

Posted: July 24, 2022 at 1:57 am

A plant-based diet could be helpful if you want to lose weight, avoid diabetes, or reduce your risk of Alzheimers.

According to a recent commentary in the American Journal of Lifestyle Medicine, all doctors should be aware of the advantages of a plant-based diet for six different health conditions, including COVID-19, diabetes, cancer, cardiovascular disease, and weight loss.

The field of medicine, despite its prominent influence in society, has invested little to promote healthy lifestyle choices, says the commentary co-authored by Saray Stancic, MD, FACLM, director of medical education for the Physicians Committee for Responsible Medicine. The consequence of this is reflected in our ever-rising chronic disease statistics, most notably obesity and diabetes rates.

The authors claim that medical schools only provide a meager level of nutrition education throughout the course of four years and that this situation is not improved during postgraduate study. They point out that 90 percent of cardiologists who participated in a recent study of over 600 cardiologists said they had not obtained the necessary nutrition education during training.

The commentary accepts that not all doctors need to be nutrition specialists, but asserts that they should at the very least have a basic understanding of the advantages of a plant-based diet for these six conditions, for which they present detailed evidence, including the following:

It is time for all physicians across the globe to speak to the importance of diet and lifestyle in health, concludes the commentary, which recommends that physicians do this by counseling patients, assuring hospitals provide healthy menus, lecturing in the community, writing articles, using social media, and providing commentary to media.

Reference: Six Applications of Plant Based Diets for Health Promotion by Saray Stancic, MD, Josh Cullimore, MD and Neal Barnard, MD, 26 May 2022, American Journal of Lifestyle Medicine.DOI: 10.1177/15598276221104023

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6 Scientifically Proven Health Benefits of a Plant-Based Diet - SciTechDaily

Decoding the Indian DASH diet and its benefits – NewsBytes

Posted: July 24, 2022 at 1:57 am

Decoding the Indian DASH diet and its benefits

Jul 24, 2022, 07:15 am 2 min read

Indians are prone to developing high blood pressure by the time they hit 40. This could be due to stress, pollution, or even genetics. The Dietary Approaches to Stop Hypertension, or DASH, diet attempts to prevent hypertension and is followed all over the world. The Indian DASH diet uses the same principles but with an Indian twist, making it a more easy approach.

Hypertension or high blood pressure occurs when the force exerted by the blood while pushing against the walls of arteries is too high. It can damage the walls of arteries and increase the risk of heart and kidney diseases. The normal blood pressure is below 120/80 mm Hg. When systolic pressure is over 130 and diastolic is over 80, it's the first stage of hypertension.

Foods involved in Indian DASH diet

The Indian DASH diet encourages the intake of methi water, fruits and vegetables, dal paratha without oil, grilled paneer, moong sprouts, palak paneer, oats upma, green salad, curd, low-fat chapati, and brown rice. These are beneficial for reducing blood pressure levels and must be eaten in moderation. You can also add pork, beef, or bacon in controlled portions to your diet.

Remove these foods from your diet

Salt must be completely eliminated from your diet. Along with this, sugary snacks like cookies, pastries, and sodas should be avoided. Alcohol, caffeine, processed foods, and dairy products, along with some types of meats, should also be removed from your diet. Usage of oils must be minimal to none, as excessive oil can ruin the diet plan and affect your health.

Additional habits and precautions

It is vital to maintain regular physical exercise alongside the DASH diet. Forms of intoxication like smoking and alcohol consumption must be stopped entirely as they pose a threat to heart health and cause blood pressure levels to fluctuate. Reducing stress is essential to reducing hypertension, which can be done through hobbies, sports, or mindfulness and meditation.

Other benefits of DASH diet

There are many more benefits of the Indian DASH diet apart from maintaining blood pressure levels as this diet greatly promotes your overall health. This diet strengthens your bones, reduces uric acid levels in the body, prevents metabolic disorders, reduces bad cholesterol levels, and is also said to lower the risk of cancer. The DASH diet also promotes healthy weight loss.

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Decoding the Indian DASH diet and its benefits - NewsBytes

Research Shows a Lower Protein Diet Could Be the Key to Healthier Eating Habits – SciTechDaily

Posted: July 24, 2022 at 1:57 am

By The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)July 18, 2022

By the time they were 18 months old, infants who began receiving taster portions of the new Nordic diet were eating 46% more vegetables than those who were fed a conventional diet.

Introducing infants and toddlers to a lower-protein Nordic-style diet that places an emphasis on plant-based foods could allow them to obtain healthy eating habits

New research recently presented at the 54th Annual Meeting of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)suggests that the key to healthier eating habits may be to introduce babies and toddlers to a lower protein Nordic-style diet with a greater focus on plant-based foods.

By the time they were 18 months old, infants who began receiving taster portions of the new Nordic diet, which includes fruit, berries, roots, and vegetables, along with breast or formula milk, were eating nearly twice as many vegetables (a 46 percent increase) as those who were fed a conventional diet.

As part of the OTIS experiment, researchers from the University of Umein Sweden, the Stockholm County Council Centre for Epidemiology, and the University of California in the United States studied two groups of infants from 4-6 months to 18 months. 250 infants in total participated, and 82% of them completed the study.

A graphic explaining the benefits of a Nordic-style diet. Credit: The European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)

The toddlers in the 2 groups had quite different eating patterns, according to the study. Those who followed the new Nordic diet, who received Nordic home-made baby food recipes, protein-reduced baby food products, and social media support from other parents, ate 4245% more fruit and vegetables at 1218 months of age than those who followed the traditional diet currently advised by the Swedish Food Agency.

Although in the traditional diet group, fruit consumption remained constant, but between 12 and 18 months, infants receiving the traditional diet consumed 36% fewer vegetables.

Babies on the Nordic diet had an average protein intake 17-29% lower than those on the conventional diet at 12-18 months of age. This was still within recommended protein intake levels and the overall calorie count between the two groups was the same. The protein reduction in the Nordic diet group was replaced by more carbohydrates from vegetables, not more cereals, together with some extra fat from rapeseed oil.

Lead researcher Dr. Ulrica Johansson, a Medicine Doctor in pediatrics and registered dietitian at the University of Ume, Sweden, said there did not appear to be any negative effects from having a lower protein intake.

Commenting on the findings, Dr. Johansson says: A Nordic diet with reduced protein introduced to infants naive to this model of eating, increased the intake of fruit, berries, vegetables, and roots, establishing a preferable eating pattern lasting over a 12-month period.

There were no negative effects on breastfeeding duration, iron status or growth.

A Nordic diet reduced in protein is safe, feasible, and may contribute to sustainable and healthy eating during infancy and early childhood, she added.

The novel research could pave the way to broadening the taste spectrum in infants and potentially provide an effective strategy for instilling healthier eating habits early in life.

The Nordic diet has a higher intake of regionally and seasonally produced fruit, berries, vegetables, herbs, mushrooms, tubers, and legumes, as well as whole grains, vegetable fats and oils, fish and eggs, and a lower intake of sweets, desserts and dairy, meat, and meat products.

Typical Nordic fruits include lingonberry, buckthorn berry, cranberry, raspberry, and blueberry, as well as fiber-rich vegetables such as turnip, beets, swede, root celery, carrots, parsnip, cabbage, broccoli, cauliflower, and kale.

Chair of the ESPGHAN Nutrition Committee, Professor Jiri Bronsky, stated: The authors have shown a significant effect of the diet in 12 and 18 months of age of the children. The Nordic diet group consumed more fruit and vegetables and less protein than the control group. The Nordic diet was well tolerated and did not negatively affect the growth of the child or breastfeeding duration. Importantly, this research demonstrates that this diet is safe, feasible and exposes infants to a variety of flavors which may influence long-lasting food preferences.

Meeting: 54th Annual Meeting of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)

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Research Shows a Lower Protein Diet Could Be the Key to Healthier Eating Habits - SciTechDaily

Forget Fad Diets, Here’s the One You Need – Medscape

Posted: July 24, 2022 at 1:57 am

This transcript has been edited for clarity.

Hello. I'm Dr David Johnson, professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia. Welcome back to another GI Common Concerns.

All of us routinely see diet recommendations on the Internet like TikTok or in new books. Every possible diet seems to receive this promotional push, although the evidence behind them is often lacking.

So what do we mean when we talk about a "healthy diet"?

Today, I'd like to spend a few minutes updating you on the current evidence and how I discuss it with my patients so that you can perhaps do the same in your own patient discussions.

The Western diet has really cannibalized the health of the United States and Western civilizations.

This diet is typically characterized by high intakes of processed and prepacked food items, red meat, dairy, and grains, consisting of high-fat, high-protein, and low-fiber components. These food items have become diets of convenience as opposed to diets potentially promoting health.

They've led to an associated increase in so-called "diseases of civilization," including cardiovascular disease, obesity, and a variety of metabolic diseases and cancers.

Western diets have been also associated with a variety of microbial and gut integrity changes, which in turn, are associated with an assortment of bad outcomes. Specifically, they're associated with decreases in microbial diversity in the gut; upregulation of proinflammatory mediators, cytokines, and chemokines; and several changes to gut integrity, immunity, and pathways that are derivatives toward diseases and even promoting translocation of gut bacteria.

In contradistinction, we have the Mediterranean diet, which is often proffered as the good or healthy diet for most patients. This comprises a diet that's high in fiber and low in animal protein and saturated fat, and is characterized by a higher ingestion of vegetables, fruits, and healthy fat and a lower intake of red meat and dairy. The Dietary Guidelines for Americans recommend a Mediterranean diet for promoting health and minimizing disease.

The high fiber content of Mediterranean diets is a key reason behind that recommendation. Fiber comes in soluble and insoluble forms. Soluble fiber gets digested, whereas insoluble fiber moves through the gastrointestinal tract, bringing components of water absorption and promoting gut motility, particularly in the colon.

Insoluble fiber has a variety of ascribed benefits, particularly related to the changes in the gut production of short-chain fatty acids, which are incredibly important for optimizing intestinal function.

We know that short-chain fatty acids increase secretion of immunoglobulins, induce regulatory T-cell tissue repair, promote antimicrobial peptides and mucus production, and basically optimize intestinal function and the intestinal barrier integrity. This is all critically important in promoting health.

There are also some data on short-chain fatty acid production as it relates to crossing the blood-brain barrier. This association with the brain-gut axis potentially changes gut-related derivatives, driving mood and behavioral activities in the brain. Therefore, we can say that the short-chain fatty acid derivative from the intestinal microbiome does have central nervous systemrelated effects.

There are also some very interesting data in this area related to the progression of COVID to severe disease or long-haul COVID, or even the development of COVID. Enhanced microbial diversity seems to be somewhat protective and, if infected with COVID, predictive of a rapid response and resolution. Short-chain fatty acids also serve as a marker, particularly when they're reduced. Branch-chain shorty acid called L-isoleucine has been shown to be predictive of longer-term consequences and more-severe COVID. So diet may have a significant role in even in the COVID world.

There are other elements in the diet that may contribute to disease.

Some things commonly added to diets have been shown in animal models to have a significant impact in changing gut integrity. In particular, this is observed in prepacked foods that are often found in the Western diet, which incorporate things such as emulsifiers and food additives with a goal toward enhanced aesthetics and taste.

Some that we see routinely in popular food items are carboxymethyl cellulose and polysorbate-80. These are derivatives in a variety of dairy products. Interestingly, they decelerate the melting of ice cream. That may be good for your kids eating an ice cream cone in the backseat in the summer, but not so good potentially for the intestine.

The same is true as it relates to maltodextrin, which is a very common thickener and sweetener, but again decreases the mucosal layer thickness and increases gut permeability.

Carrageenan, which is made from red seaweed, is added to increase texture, primarily in dairy products and sauces. It also decreases gut integrity and permeability changes and antigenic translocation.

Another common food additive is high-fructose corn syrup, something we're seeing more and more data about. Its use in sugary beverages was once implied to have, and now clearly is associated with, an increased risk for nonalcoholic fatty liver disease, early colon cancer, and a variety of other cancer pathways. Recent animal model data have shown mechanistically how it contributes to colon cancer. It was also most recently associated with liver cancer in postmenopausal women ingesting one sugary beverage a day.

Almost all sugary beverages have shifted from using cane sugar to high-fructose corn syrup because it's cheaper and sweeter. Interestingly, as data have become more onerous regarding its disease associations, in 2012 the corn industry went to the US Food and Drug Administration and petitioned to change the name from high-fructose corn syrup to corn sugar. That term sounds a lot easier and maybe even sweeter when it comes to possible health implications, but the FDA said no.

Since then, the widespread use of high-fructose corn syrup has been described as a food public health crisis. High-fructose corn syrup is something that is very easy to avoid when you talk about sugary beverages.

When it comes to artificial sweeteners, the top three that have been studied to date are aspartame, saccharin, and sucralose (Splenda). They are not absorbed but rather are fermentable sugars that get to the gut and change the gut microbiome. In animal models, they have been shown to promote obesity and diabetes, which is very much paradoxical to what their advertised intent is. Again, this has only been studied for these three agents, and we also don't have data in lower-threshold exposures.

I think it's common sense to minimize the use of these things and instead ask patients to use natural sugars, consume water, and incorporate other strategies; that's what I discuss with my own patients.

We can go the wrong way and make our patients too rigid about reading nutritional labels. I want to caution you about emerging food restrictive disorders that very much can become an eating disorder. So we don't want to go the opposite way.

I tell my patients to be a good, conscientious thinker, look at your food, minimize the processed foods, and build your meals. The Western diet needs to go. The more we can use the Mediterranean diet, the better off we are. You can still have your occasional cheeseburger and French fries but use common sense.

The Mediterranean diet really is simple. I routinely recommend this to my patients with inflammatory bowel disease, obesity, nonalcoholic fatty liver disease, along with other inflammatory disease conditions. But I do think we can make this a general recommendation across all patients in our attempt to promote health and thereby prevent disease.

I hope this has been helpful.

I'm Dr David Johnson. Thanks for listening.

David A. Johnson, MD, a regular contributor to Medscape, is professor of medicine and chief of gastroenterology at Eastern Virginia Medical School in Norfolk, Virginia, and a past president of the American College of Gastroenterology. His primary focus is the clinical practice of gastroenterology. He has published extensively in the internal medicine/gastroenterology literature, with principal research interests in esophageal and colon disease, and more recently in sleep and microbiome effects on gastrointestinal health and disease.

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Forget Fad Diets, Here's the One You Need - Medscape


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