Because the gluten-free diet is based around eliminating all foods that contain gluten, it generally involves nixing the big three: wheat, barley, and rye. While that sounds easy enough, it also involves avoiding any derivatives of these grains, such as semolina, spelt, triticale (a hybrid of wheat and rye), malt, brewers yeast, and wheat starch.

Unfortunately, these grains and their derivatives can be found in what seems like everything, so it can be helpful to know exactly what foods to avoid. The good news is there are many gluten-free alternatives to the favorites on this list. According to the Celiac Disease Foundation, these are gluten heavy hitters:

Even foods that dont naturally contain gluten, such as oats, can be risky if theyve potentially been cross-contaminated. Regular oats are highly contaminated with gluten from growing and processing, so one can only consume oats that are labeled gluten-free, Smith says.

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At first glance, a celiac disease diet can seem really restrictive (really, no bread?!), but you might be surprised to learn just how many foods are naturally gluten-free. In fact, the Celiac Disease Foundation points out that people with celiac disease can still enjoy plenty of eats.

While the main action item on this diet is to avoid gluten, its still equally important to eat a diverse range of foods to get all your essential nutrients, Dr. Jossen says. Lets dive into what that might look like with these four naturally gluten-free food groups.

Fruits and vegetables

In general, the U.S. Dietary Guidelines for Americans recommend eating at least 2.5 cups of vegetables and 2 cups of fruit per day.2 Heres the even better part: Not only are fruits and vegetables naturally gluten-free, but they are chock-full of important nutrients, so feel free to fill your plate with as many as possible. Throw some broccoli into your egg scramble, mix some cauliflower rice into your taco bowl, or roast some Brussels sprouts to have with your dinner for a little veggie boost.

Meat, poultry, and seafood

When it comes to protein choices, meat, poultry, and seafood are all naturally gluten-free. These animal products are great sources of essential nutrients, especially protein and B vitamins. That being said, if youre gluten-free and also vegetarian or vegan, youll want to fill your protein needs from plant-based sources like beans, tofu, legumes, nuts, and seeds instead.

Milk, eggs, and dairy

According to an older study published in the journal Digestion, lactose intolerance is often associated with celiac disease.3 However, not everyone with celiac disease is lactose intolerant, and milk, yogurt, and cheese are great sources of B vitamins, vitamin D, and calciumespecially if youre on a gluten-free diet. If you cant tolerate milk and dairy, still consider the humble egg. Not only are eggs naturally gluten-free, but they are a great source of protein.

Legumes, beans, nuts, and seeds

Even if youre not vegetarian or vegan, diversifying where you get your starches from can help boost the nutrition of your meals. You may be surprised by how many gluten-free starches are out there too. Choose gluten-free products made from a variety of grains when you can, this includes not just rice and corn but also quinoa, buckwheat, amaranth, and teff, Dr. Jossen says. Lets not forget legumes, like black beans, chickpeas, and peas, all varieties of potatoes, and nutrient-rich nuts and seeds, either.

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Celiac Disease Diet: How to Go Gluten-Free Safely | SELF

Are you contemplating adding intermittent fasting to your low-carb, keto routine with the hope of intensifying your weight loss or speeding up your metabolic improvements?

Then you just might be wondering how best to break your fasts. What should you eat first? What gives the best results? What do you need to watch out for?

If you are new to fasting, or have had trouble in the past coming out of a fast, this guide can help you plan and execute the best ways to begin eating again after short or longer-term fasts.

Check out Diet Doctors Coaching Intermittent Fasting course its not just for coaches!

Historically, the word breakfast described the first meal of the day no matter when that meal occurred. It wasnt until the 15th century that the word started being recognized as the meal you consume shortly after waking.

Nowadays, with intermittent fasting gaining popularity, the meaning of the word breakfast is going back to its original roots. Breakfast for the intermittent faster is the meal consumed when you choose to break your fast, be it 6:00 AM or 6:00 PM.

Fasting, especially for religious purposes, has been a common occurrence for centuries. And generally, throughout most of human history, not much concern was given to how to break the fast.

However, in an age of poor dietary advice, when we are told to eat all day long and when hyper-palatable highly processed food abounds it can take a little more planning to resume eating in a way that achieves the most physical comfort and most effective results for your long-term health and weight loss goals.

Every night when we stop eating and then go to bed, we go through a short-term fast until our first meal of the next day. Depending on when you ate dinner and when you consume your first meal after you wake up, you can easily go through a 12 to 16-hour fast with no physiologic change to digestive functions.

Although there is no clear consensus or accepted definition about what the cut off is between a short and a long-term fast, Diet Doctor defines anything less than 24 hours as time-restricted eating, fasts between 24 and 36 hours as a short-term fast, and anything longer than 36 hours a long-term fast.

Time-restricted eating and short-term fasts dont require specific precautions when breaking the fast. Just remember it is a good idea not to binge on highly-processed, sugary, or high-carb foods because you will undo the advantages of the fast. Plan to eat a wholesome, low-carb, high-fat meal, such as any of the meals featured in the Diet Doctor recipes, and you will be just fine.

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Longer-term fasts are different. Resuming eating after a longer fast takes more planning and care.

As we start to incorporate fasting into our routines, our bodies physiologically take a bit of time to adjust to the new regimen, especially if we used to eat constantly. As chronic eaters, our bodies are constantly spending metabolic energy producing digestive enzymes to process the food were consuming. This changes when we first start fasting. The digestive enzymes are not needed or produced.

If youve been fasting long enough for your body to slow down its production of digestive enzymes, then you may experience some gastrointestinal distress when you start to eat again. This often comes in the form of:

Apart from shortening the duration of your fast, the best way to minimize side effects is to plan the best food to eat when you break the fast.

Until your body understands that youre not in a state of stress but rather just eating less often, you might want to avoid eating foods that are tough on your system. Some people know that certain foods bother their digestive tract more than others. If you have problem foods, you should avoid them initially when you resume eating.

In general, weve found that these foods (and drinks) are the most problematic foods for people to consume when breaking their fast, although some tolerate them just fine:

Weve found in our Intensive Dietary Management Program the following protocol works best for those who experience distress while breaking their fasts:

If you follow this protocol and still experience problems, you can consider a tablespoon of psyllium husk in a cup of water. Some find this can help while others may find it increases bloating. If it helps you, the next time you are fasting and are about to resume eating, you may want to try the above protocol but add in a tablespoon of psyllium in water at the start.

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Avoiding alcohol, especially binge drinking, is very important when coming out of a fast of more than 36 hours. Heavy consumption of alcohol could trigger alcoholic ketoacidosis, in which ketones are very high in the blood, but unlike diabetic ketoacidosis, blood glucose is usually dangerously low.

The main symptoms are vomiting and abdominal pain. It is most common in people with alcohol addictions or strong dependence on alcohol who do not eat for a number of days and then drink heavily. However, it has been reported in individuals of all ages who have drunk heavily with little or no food intake.

Refeeding syndrome is a very rare side effect of resuming food consumption after periods of malnutrition or extended times without eating. Its defined as the potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients.

The key clinical markers of this are very low blood phosphorus levels, or hypophosphatemia, as well as low blood serum levels of potassium, calcium and magnesium. These shifts can cause heart rhythm abnormalities, cardiac failure, respiratory problems, convulsions or coma.

Refeeding syndrome was first described among the severely malnourished North Americans who were held as Japanese prisoners of war during World War II. It has also been observed upon the treatment of long-standing anorexia nervosa and alcoholic patients in recovery.

During the refeeding period, insulin and counter regulatory hormones such as cortisol and noradrenaline are suddenly re-activated. This causes the movement of the major intracellular ions like phosphorus, potassium, calcium and magnesium into our cells. However, due to the overall depletion of our body stores, this becomes quite excessive and leaves us with too little of these ions in the blood. This is what causes the major symptoms of refeeding syndrome:

These symptoms typically appear within two to four days of the start of refeeding.

Currently, most of us are over-nourished rather than under-nourished. But that doesnt mean you shouldnt exercise caution. Certain groups of individuals are at a higher risk for developing refeeding syndrome than others:

There are several ways you can reduce your risk of developing refeeding issues when you do break your fast:

When doing short fasts less than 36 hours, you dont need to worry too much about what you eat when you break your fast.

Stick to low-carb, high-fat meals such as any of the recipes on the Diet Doctor site that seem appealing to you. Try not to eat too much. Fasting is never an excuse to gorge yourself when you resume eating.

For longer fasts, plan how you are going to end them. Resume eating with a small meal and eat slowly. Start with a nourishing bone broth or some psyllium husk in water. Eat a small fresh salad of tomato and cucumber and keep your protein on the light side, such as fish or chicken, and small about the size of your palm or a deck of cards.

For more resources on intermittent fasting check out the other Diet Doctor guides and videos below.

/ Megan Ramos

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Intermittent Fasting: How to Break Your Fast Diet Doctor

Eating too much sugar may be the most apparent dietary faux pas you can make after all, your body immediately feels the after effects of a sugar rush, and the inevitable dreaded crash that follows. Over time, however, your body may become accustomed to the copious amounts of sugar you consume, maybe without you even realizing it; added sugar has a funny way of sneaking into everyday items that you don't even associate with being sweet. And since items high in added sugar are often lacking nutrients, eating sugary foods can often lead to uncontrolled weight gain over time. Before you know it, you may be unconsciously reaching for sugary sweet treats at the end of every meal (even if you are full!) as a love of sweets turns into an unhealthy sugar habit and extra pounds.

Want to tame your sweet tooth? Join our exclusive GH+ Club to unlock access to Good Housekeeping's 21-day sugar detox plan, which will ease you out of your sugar cravings and help you form a healthy relationship with the sweet stuff.

Stefani Sassos, MS, RD, a registered dietitian within the Good Housekeeping Institute, explains that excessive sugar can spike your blood sugar levels... and then turn into a sudden drop off afterwards. This is why you may feel super fatigued in the moment, or push through a huge mood swing, in any given afternoon. Over the long run, however, eating too much sugar can greatly influence your risk for heart disease and type 2 diabetes, chronic dietary inflammation, and severe fatigue, among other physical risks. "There's a ripple effect on your body, as it can get accustomed to lots of sugar," she adds, citing habits like a daily office donut or sugary sweet coffee drink. "Over time, it becomes this difficult thing to decipher: Am I addicted to this, did I train my body to crave this food?"

You may believe that cutting out all sugar entirely from your diet is the best solution. Sassos, however, says this isn't the case for those with years of unhealthy sugar habits under their belt: Simply cutting out sugar or cycling through compensatory behaviors (like "running it off" after eating third helpings of dessert) can lead to even more unhealthy eating patterns down the line. Whether you like to call it a detox or think of it more like a "reset," she argues a long term lifestyle change is the surest way to kick the bad habit.

A sugar detox may help you bring your sugar consumption into moderation, away from the levels that average Americans consume in any given day. While Sassos notes that the American Heart Association recommends less than 25g (about six teaspoons) of sugar daily for women, and 36 grams (about nine teaspoons) for men, the organization notes that the average American consumes 77g; an immediate block on all sources of added sugar would be hard to sustain for most anyone, Sassos points out. You'll need to work on reducing your intake slowly,targeting packaged foods that can be swapped with better-for-you alternatives.

It's important to discuss any long-term changes to your diet with your primary healthcare provider before implementing lifestyle changes.

Below, we're exploring the best ways to effectively "reset" your system in the short term, and encouraging more sustainable ways to wean off a sugar habit for those who need long term change.

Discover the root of your endless sweet tooth by adapting your daily routine first; you may find your body responds immediately (goodbye afternoon sugar crashes!) "You want to prioritize food that can anchor sugar in your diet, so that it's not releasing into your blood stream so fast (hence the crashing)," Sassos explains. "Protein and fiber are two things that can help you avoid a sugar rush and crash in a given day, especially if you know you've overdone it... incorporating those two things in your daily routine can stabilize your blood sugar."

Here are other ways to change your daily habits right now:

Interested in seeing if cutting back on sugar more drastically may improve your day? A good way to get started, especially for those who have never targeted sugar in their diets before, is following a 7-day program. The experts behind Sugar Shock: The Hidden Sugar in Your Food and 100+ Smart Swaps to Cut Back have crafted a day-by-day guide that won't deprive you of all sugar at once.

You'll focus on targeting bad behaviors and examine the items that you routinely reach for in your kitchen. Each day, you'll focus on pairing back added sugar in your beverages, breakfasts, lunches, and dinners, plus a few smart tips for better snacking moments.

Regardless of whether you follow the book or not, you should reevaluate these staples currently in your diet, among others:

A 7-day plan can help you optimize your diet to be closer to the ADA's recommended daily sugar intake, and also to make better choices after you've eaten too much sugar (it happens!). If you find yourself feeling more energized and better, you may think about a longer diet change in the future Sugar Shock also provides a 21-day meal plan and shopping list. That plan could help you grow into good lifelong diet habits with targeted recipes, meal plans, and shopping lists.

Deciding to do a longer detox or adopting a prolonged low-sugar or no-sugar diet (after speaking with your healthcare provider first) could help you improve your health beyond simply targeting sugar. You may realize that you finally need to correct other lifestyle choices that cause fatigue, like poor sleep hygiene, or even take a look at your hormone levels in a screening with your doctor.

Restructuring your daily meals for longer than a week can help you realize that sugar might not be totally to blame for all of your sluggish behavior. Sassos says making a longer diet change can push you to also prioritize getting enough sleep each night, and also work on ensuring you're properly hydrated each and every day. "Getting enough sleep and drinking enough water are often neglected," Sassos says. "No one prioritizes this in their routine, and yet they're the simplest things that you can do for your body for overall health and to wardoff sugar cravings."

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Lots of fad diets pop up from time to time, claiming to be an easy way to shed pounds. The problem is fad diets are rarely based in science, and they fade with time, such as the famous 1977 wine and eggs diet from Vogue. Basically, the diet consisted of eating nothing but boiled eggs, black coffee, steak for dinner and lots of white wine starving yourself plus getting the jitters.

Being a college student, I struggled with frequently visiting the gym. There was always a mountain of homework to overcome and plenty of other things to occupy my time, but Id try my best to sneak in a high intensity interval training (HIIT) workout. During the summer, my frequent HIIT workouts helped me slim down a bit. I felt freer, healthier, alive and confident. Coming back to school, I gained some of my muffin top back and struggled to find a solution. Thats when I stumbled across intermittent fasting and raised my eyebrow. Surely, this was some fad diet or trend not based in science, not realistic and not going to work for me.

For me, it all began with a YouTube video titled Intermittent Fasting TESTED 30 Days Before & After from a channel called the Goal Guys. The YouTuber in the video wanted to test intermittent fasting since it has become so popular. He tested the 16:8 version, which means 16 hours of fasting with an eight-hour window for eating. There are other types of intermittent fasting, but this is one of the most common versions that seems to also yield fast results. At the end of the thirty days, the YouTuber had lost six pounds and gained muscle mass. He was more toned, especially in his chest and arms, and that was after only 30 days of the 16:8 alongside exercise.

I was stunned after watching the video and begun doing some more research. I couldnt believe it was thateasy just fasting.

Turning the Scientific American, I learned about two studies done with 100 overweight women. One group held the 5:2 intermittent fasting (IF) method any two days a week of eating only 500 calories and eating normal the other of the five days while the other group cut their daily calories by 25%. The studies found that the two diets led to the same weight loss over three to six months; however, the IF followers had better blood sugar control and a greater reduction in body fat.

Additionally, a 2019 study with 43 overweight people showed that alternate-day fasting improved the bodys response to insulin by more than twice as much as a typical calorie-cutting diet, according to the Scientific American.

John Hopkins Medicine explains in its article Intermittent Fasting: What Is It, and How Does It Work?that its not always about what you eat but when you eat. The article features neuroscientist Mark Mattson, who has studied intermittent fasting for 25 years. According to him, our bodies have evolved to be able to go without food for many hours, or even several days or longer. In prehistoric times, before humans learned to farm, they were hunters and gatherers who evolved to survive and thrive for long periods without eating. They had to: It took a lot of time and energy to hunt game and gather nuts and berries.

According to Harvard Health Publishing, IF makes intuitive sense. Our bodies process food, specifically carbohydrates like sugars and refined grains, by breaking it down into sugars to be used for energy or else it gets stored into fat. The trick to weight loss is unlocking how to use that stored energy, the fat. The key just might be insulin. Insulin is a hormone made in the pancreas that is triggered every time food enters the body, bringing sugar into the far cells for storage. Thus, the less times you eat, the less insulin is triggered, the less sugar is stored into fat. The entire idea of IF is to allow the insulin levels to go down far enough and for long enough that we burn off our fat, according to Harvard Health Publishing.

After having done all this research, I decided I wanted to try it out for myself and conduct my own experiment. First, I had to pick a method of IF. The two approaches to IF are a daily fasting routine and a week-based one. Doctors dont recommend longer periods or days of fasting since that can lead to starvation or even eating disorders. The point of fasting is not starvation; its a time schedule of when to eat. Theres a healthy balance to all of this, and a process of discipline.

I picked the 16:8 method since it would work best for my lifestyle as a busy college student. In fact, it would ease my routine since I set the eight-hour eating window to 12 p.m. 8 p.m., meaning I didnt have to worry about breakfast. For the experiment, I decided to try it for four weeks straight, a total of 28 days. I started on Feb. 20, and my last official day of the experiment was March 19.

When I began the experiment, I weighed approximately 140 pounds, and Im 5 feet 4 inches. This means my BMI (body mass index) is 24.0, which classifies me as normal body weight but on the cusp of overweight, which begins at 25.0. My hope was to lose a few pounds and tone out, especially for the upcoming summer.

The first week wasnt too bad. I knew going into it that the first two weeks were going to be the hardest with the hunger cravings, so I was prepared. I didnt know, however, about the other symptoms with starting IF. I was fatigued and had some horrible headaches. I even took a couple COVID-19 tests to make sure my symptoms didnt stem from the coronavirus. I looked up symptoms for IF, and, sure enough, that was it: headaches and fatigue. It was going to take time for my body to adjust to the new eating schedule, and by the start of the third week those symptoms went away.

However, problems started arriving in the third week, my birthday week. I was not planning or expecting my birthday to be so disruptive, but sometimes life is like that. On a few nights, I celebrated late with coworkers, friends and boyfriend, enjoying cake and pizza rolls past my eating window. To make matters worse, during this whole process, I was not being very strict with the 16:8 rule with one thing: coffee. I knew you could drink water and black coffee during the fasting time, so I figured an iced latte wouldnt be a big deal. As it turns out, it isnt exactly fasting if youre consuming sugary, caffeinated calorie-filled beverages.

Despite drinking iced coffees in the morning, before my birthday week I was noticing some weight loss. Things changed after the birthday weekend. My late-night celebratory eating was definitely having an effect. My final week of IF was full of travel, which didnt help matters either. I ended up gaining a couple pounds by the time I returned home, the end of my IF. My heart sank and my stomach turned yet I wasnt surprised. I had failed my own experiment: I ate outside my fasting window and consumed a lot of junk food over my week of travels.

On the bright side, however, I did learn something through the botched 28-day experiment. I realized the 16:8 window didnt terribly disrupt my college lifestyle and worked for me, so long as I kept diligent. I now know I cant have a morning latte. Ive found a zero-calorie vitamin drink instead for the mornings. Also, I know more exercise would be helpful in using my bodys calories whats stored in the fat. Plus, exercise is just good for you!

During the process of IF, I gained a deeper appreciation for the foods I ate, as I only ate lunch and dinner. I became very choosey about what I wanted to eat and was eating healthier. I had robust salads of kale, spinach, cabbage, and lots of vegetables. I had eggs, fruit smoothies and fish. It was an enjoyable process for me, something I plan to continue.

While it was disheartening to realize I failed my own experiment, I am glad I tried it out for four weeks. Now I have a better understanding of my strengths, weaknesses, and a desire to do better, especially since I was seeing results before utterly ruining it. Ive already begun my new experiment for IF, as of March 27, and I plan to continue it for 12 weeks. With 12 weeks, Ill have more time to see how the IF has affected me.

At the end of the day, though, my reasons for losing a few pounds are about feeling confident, happy, healthy, energetic, and loving life. Realistically, it takes effort to gain that kind of lifestyle. It takes discipline, self-acceptance, and action to reach ones goals. While IF sounds too good to be true and isnt a replacement for seeing the gym, it may prove to be a good way to reach ones goals safely and healthily I guess Ill have to find out!

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Lessons from Intermittent Fasting The Threefold Advocate - Three fold Online

With the right medical support, people with narcolepsy can have healthy, complication-free pregnancies. However, it is vital to discuss pregnancy plans with a doctor, as a person may need to change or stop their medication.

Certain narcolepsy medications may increase the risk of congenital abnormalities (also known as birth defects). This means that people who are trying to conceive or who are already pregnant may need to manage their symptoms in other ways.

Narcolepsy symptoms can also change or intensify during pregnancy. Most pregnant people experience fatigue due to hormonal changes. These hormonal changes could make narcolepsy symptoms more difficult to manage.

A doctor who specializes in narcolepsy can work with a pregnant person and their obstetrician or midwife to manage symptoms and contribute to a safe pregnancy. Keep reading to learn more about narcolepsy and pregnancy.

Most research to date suggests narcolepsy itself does not negatively affect pregnancy outcomes. A 2013 study of 249 pregnant people in Europe found similar rates of pregnancy complications in those with narcolepsy as in the general population.

However, narcolepsy can affect pregnancy in other ways. For example, people who experience cataplexy may be at risk of falls or injuries, which could affect pregnancy.

Additionally, a 2021 study reports that 94.2% of pregnant people experience fatigue. This fatigue can be intense and may affect daily functioning.

In people with narcolepsy, their symptoms may be more intense than usual. Because of this, pregnant people with narcolepsy require frequent monitoring by a doctor or midwife.

There is not much research on the impact pregnancy has on narcolepsy symptoms. The biggest impact may come from stopping narcolepsy medications, as doing so may make symptoms worse during the pregnancy.

In a 2019 study of pregnant people with narcolepsy, 78.7% stopped taking their medication. To manage the consequences of this:

It is unclear if pregnancy makes any long-term difference to someones narcolepsy symptoms once the pregnancy is over.

The most common narcolepsy medications increase the risk of congenital abnormalities. The risk may be especially high during the first trimester. For this reason, a person may need to stop taking narcolepsy medications before they try to become pregnant.

In a 2020 study of people who took modafinil and armodafinil during pregnancy, the risk of congenital abnormalities in the medication group was 13%, compared with 3% in the general population. Some congenital abnormalities may require pregnancy interventions or a change in delivery plans to keep the baby as safe as possible during birth.

The most common congenital abnormalities included:

In the 2019 study of people with narcolepsy, most participants said they stopped taking medication during past pregnancies, with 82.9% citing fears of harming the fetus as a motivation. 58.5% said their doctor recommended they stop taking medication.

However, some medications may be safe to take during pregnancy, so it is important to discuss all the options with a doctor either before becoming pregnant or at the earliest opportunity after conceiving.

A 2017 study suggests that people who have narcolepsy with cataplexy might have higher rates of gestational diabetes. However, the study was fairly small, involving 25 people who had narcolepsy with cataplexy and 75 who did not have narcolepsy.

Of the participants, 13.6% of people with narcolepsy had gestational diabetes, compared with 4.3% who did not have narcolepsy.

Gestational diabetes may increase the risk of having a very large baby, which in turn can increase the likelihood of:

However, even with the difference in rates, there were no significant differences in pregnancy outcomes between the two groups in the study.

Managing blood sugar levels with diet, lifestyle, and, if necessary, insulin can reduce the risk of complications.

People with narcolepsy can give birth in the same way as others. There is a possibility of cataplexy happening during or after the birth, but medical care and support can ensure people do not fall.

Some people with narcolepsy may choose to have a C-section so that the birth is more controlled, according to 2012 research. This allows people to schedule when birth takes place and may relieve some fears about what will happen if they experience cataplexy during labor.

No specific guidelines suggest that a C-section is the best delivery method for people with narcolepsy or that it leads to better outcomes. Pregnant people should discuss their options with a doctor.

Newborns can wake frequently from sleep and do not sleep according to adult schedules. As a result, many new parents experience periods of sleeplessness and exhaustion. For a person with narcolepsy, this may be even more challenging.

It may help to have a plan in place to ensure that parent and baby are both getting what they need. This may involve:

People with narcolepsy often have healthy pregnancies, and research suggests they are no more likely to experience complications than the rest of the population. However, pregnancy with narcolepsy does come with some unique considerations and challenges.

To make pregnancy and birth as safe as possible, it is best to speak with a doctor before trying to conceive. They can explain the types of support a person might need and whether someone should stop taking their narcolepsy medication. If a person is already pregnant, they should speak with a doctor about this as soon as possible.

Developing a pregnancy and postpartum plan can also be helpful. Try working with a partner, family members, close friends, or a doula to devise and implement strategies to manage the transition to parenthood.

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Narcolepsy and pregnancy: Risks and what to expect - Medical News Today

Allergy to cats is no laughing matter.

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Ever wondered why someone may have a severe reaction to exposure to cats? Their allergic reaction is caused by their own body's response to a small protein called Fel d 1 that cats secrete through their salivary and skin glands.

You have seen how cats clean themselves up. Or so they seem to be up to - licking their own coat of fur. When these furry felines clean themselves, the allergen is spread all over their fur and can become airborne when their coat dries, reports Michael Le Page for New Scientist.

Your doctor may also warn you against exposure to a cat's dander, or dried skin flakes, that can trigger allergic reactions.

Today being World Health Day, Prime Minister Narendra Modi has greeted the medical fraternity with gratitude for keeping the nation's people safe.

A noble thought, indeed. Ever since the COVID-19 pandemic began to spread across the world from Wuhan in China (where it was first noticed/originated) in early 2020, it has been the medical fraternity that has been the shield to the lives of the general public. It's gratitude that is being expressed timely.

We thought of posing the cat lovers' concerns to medical experts as to why some people are allergic to cats?

Who can and cannot safely have cats as pets?

We asked that question to Dr Harish Chafle, Senior Consultant - Pulmonology and Critical Care at Global Hospital, Parel, Mumbai.

Dr Harish Chafle said, "Allergy symptoms may appear on one's body when the immune system reacts to the allergic substance that has entered the body. Cat allergies are caused by specific substances produced by cats, such as saliva, skin flakes called dander, or urine. If a person's immune system reacts to a cat's saliva, skin flakes, or urine, keeping a cat as a pet is not recommended at all."

But really, how serious can a cat allergy complication get? Does it go beyond the reactionary fits of sneezing, congestion, itchiness, and watery eyes?

Dr Harish Chafle said, "Normally at the beginning very mild allergic symptoms can be seen on ones body but further cat allergies can cause anaphylaxis, which is a life-threatening allergic reaction. Anaphylaxis makes it difficult to breathe, can cause dangerously low blood pressure, and can put the body into shock. Cat allergy can also cause exacerbation of underlying asthma. It can cause severe Asthma attacks which can be life-threatening if not managed in time."

Oops! Does that mean someone who loves the idea of adopting a feline friend should forget about it?

After analyzing the DNA of 50 domestic cats, researchers identified regions along with the two genes that code for Fel d 1 that the team could cut and edit with CRISPR. Thanks to CRISPR gene-editing technology, truly hypoallergenic cats could soon steal people's hearts and safely curl up on their laps without triggering sneezes, itchy eyes or other allergy symptoms.

What is CRISPR?

It is claimed that some cat breeds are less likely to produce allergens, but no scientific studies have confirmed this, per New Scientist.

Study author Nicole Brackett, a geneticist at InBio, told Heather McKenzie for BioSpace in 2021. "An essential gene, one that would be required for survival or viability, generally doesn't change much over evolution, and we're seeing change between the exotic and domestic cat that suggests that maybe those sequences are not conserved, and maybe the protein is not essential."

McKenzie and her colleagues then used the gene-editing tool, CRISPR, to delete either CH1 or CH2 in cat cells in a Petri dish. The researchers' next step is to delete copies of the two genes at once and confirm that this process eliminates the Fel d 1 protein from the cat cells. If this process is successful, only then will scientists try to create felines without these genes, per New Scientist.

Apart from gene editing, certain pet foods also help reduce the amount of allergen in dander on the fur by almost half. Purina is one such brand that claims to reduce it to 47 per cent on average after three weeks of use.

Vaccination is another method some companies claim to have nailed. A vaccine developer says their inoculation shots train the cat's immune system to reduce levels of the protein. But the researchers argue that these methods won't eliminate the allergen completely, so gene-editing could be a tool to make truly hypoallergenic cats, per Gizmodo.

Meanwhile, all ye cat lovers, you must exercise caution so that the love for those cute fur balls does not land you in the ERs of hospitals. Have a great World Health Day!

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 dietician before starting any fitness programme or making any changes to your diet.

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When you have diabetes, insulin is vital to helping you keep your blood sugar levels in check.

If you have type 1 diabetes, you must inject insulin daily. Those with type 2 diabetes may also require insulin injections to maintain their blood sugar levels.

Not all insulin types are the same. Pharmaceutical manufacturers make long-acting, intermediate-acting, and short-acting insulin options. If you do inject insulin, the best way to start a treatment plan is to contact your doctor.

In people who do not have diabetes, their bodies release insulin in response to the foods they eat. This is because many foods contain carbohydrates. Some examples include bread, sweets, fruits, and even vegetables.

Your body breaks carbohydrates down into smaller building blocks, like glucose. You need insulin to use this glucose for energy. If your body cannot make or use insulin effectively, youll need to inject it to process your food for energy.

Calculating how much insulin to take is usually based on two considerations:

Anticipating a bolus dose is where insulin administration can get tricky. When you give yourself insulin, you are estimating how many units of insulin it will take to process the carbohydrates you eat.

The University of California, San Francisco states that, as a general rule, 1 unit of insulin will process anywhere from 12 to 15 grams of carbohydrates and lower your blood sugar by about 50 milligrams per deciliter (mg/dL).

Since the human body is so complex, not all people will process insulin the same way. Factors like time of day, stress levels, and physical activity can make these numbers more difficult to predict.

Because of this, youll probably start off giving yourself insulin based on numbers for the average person. After seeing how these numbers help you manage your blood sugar, you may have to adjust based on how your body uniquely responds to the insulin you administer.

Now that you know the how and why behind insulin dosing, lets consider how you may calculate your insulin needs.

Youll usually give yourself an insulin dose around your meals since thats when you take in carbohydrates. You also will typically check your blood sugar to see if youre meeting your premeal target dose.

To calculate your insulin needs:

You may find that if you generally eat about the same amount of carbohydrates each day, you may be able to consistently inject the same amounts of insulin outside of special occasions. It takes time to find out how your body best responds to insulin.

Remember, there are two components to insulin correction:

Combine both of these when considering how much insulin to inject.

For this chart, well assume that your premeal blood sugar target is 120 mg/dL and that 1 unit will decrease your blood sugar by 50 points.

If your blood sugar is below 60, do not administer insulin. Instead, you should immediately consume 15 grams of carbohydrates.

If your blood sugar is 300 and above, check your ketones and contact your doctor immediately.

For this chart, well assume that you take 1 unit of insulin for every 10 grams of carbohydrates.

How diabetes affects your body can vary greatly from person to person and day to day.

When establishing your insulin routine with your doctor, be sure to discuss your lifestyle honestly so they can help create the best plan for you. Your doctor might advise different calculations than those listed above to help fine-tune your dosage.

Many things can affect how your body processes carbohydrates and insulin. According to the American Diabetes Association, these include:

Insulin has a narrow therapeutic index, which means there is a fine line between a beneficial dose and a harmful one.

Its possible to overdose on insulin. In a review of insulin overdoses, excess dosages were reported as being anywhere from 26 to 4,800 units. Some of these were administered accidentally, which helps explain why the number is so high.

Its important to know the symptoms of hypoglycemia in case you ever inject too much insulin. These include:

Contact your doctor if youve over-administered your insulin.

Ideally, you should be able to correct your blood sugar with an appropriate insulin dose. How much insulin is too much varies based on how sensitive your body is to insulin.

If you have higher-than-expected blood sugar (over 300), you should check your urine for ketones. The presence of ketones suggests your bodys cells are having trouble getting enough glucose. You could be at risk for a serious condition called diabetic ketoacidosis (DKA) if you have ketones in your urine.

In this instance, you need extra help correcting your blood sugar. You should seek emergency medical attention instead of trying to keep injecting insulin to lower your blood sugar.

Insulin will lower your blood sugar. If your blood sugar is already low, you shouldnt inject more insulin.

Signs that your blood sugar is too low include sweating, dizziness, blurred vision, and significant fatigue. If this happens, try to consume rapid-acting carbohydrates, like sugared sodas, fruit juice, or glucose tablets, to get your blood sugar levels back up quickly.

You can calculate the amount of insulin you take before meals by considering your blood sugar before you eat and the number of carbohydrates you take in during your meal. Scroll up to see our sample calculation and example.

The average person will take about 1 unit of insulin for every 12 to 15 grams of carbohydrates consumed.

There is some variation to this, depending on how sensitive you are to insulin. For some people, this range is 1 unit for every 6 grams of carbohydrates, while for others, its 1 unit for every 30 grams of carbohydrates.

You will typically inject a longer-acting or basal insulin at night. This insulin will work as you sleep for (ideally) seven to eight hours. You should establish your basal insulin dose with your doctor.

You may adjust this dose on a regular basis depending on your blood sugar before bed.

Injecting insulin is not a safe approach to weight training. However, some bodybuilders will inject it as a performance-enhancing drug. They believe injecting insulin will allow energy in the form of glucose to enter their cells so they can build more muscle.

This practice is unsafe and can lead to severe and potentially life threatening hypoglycemia, according to 2019 research.

You should not take insulin unless you have diabetes. If you do have diabetes, talk with your doctor about how your training regimen may affect your blood sugar levels.

Human growth hormone (HGH) is another hormone that bodybuilders may inject in an attempt to gain muscle. Some bodybuilders will inject both HGH and insulin, according to 2017 research. This is an unsafe practice that doctors do not recommend.

It can take time to understand how your body best responds to insulin correction when you have diabetes.

Having a plan for regular dosage and knowing the signs of high and low blood sugar can help you safely manage your diabetes. If you have questions, contact your doctor to ensure you have the best plan for keeping your blood sugar under control.

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The prescription for wellness and being able to live an active and independent life is to keep moving.

Health is not just the absence of sickness, but it is an optimal balance of mental, physical, emotional and spiritual wellness. Most times, being healthy is a choice. While it is true that some have larger obstacles such as family history of chronic disease or obesity, lingering effects from past illness, or an accident or injury that may cause long-term deficits, we can and should take control of our own health.

A healthy lifestyle is a proactive approach to taking control of your health in an effort to improve your quality of life. Whether you are recovering from an illness, an accident, or working toward prevention and maintenance of good health, understanding the role physical activity and other healthy habits play is important.

Research from the Centers of Disease Control and Prevention suggests up to 80 percent of chronic disease cases can be prevented through healthy living. The CDC says we should strive to meet the following healthy-living factors:

Maintain a healthy weight: A BMI of less than 30 is considered healthy.

Refrain from tobacco use: Do not start smoking, and quit if you actively engage in tobacco use.

Be active: Get 30 minutes or more of moderate to intense exercise to equal at least 150 minutes a week.

Diet: Include fruits and vegetables, whole grains and lean protein sources in your diet

Following this guidance can decrease risk for diabetes, heart attack, stroke and cancers. Aside from prevention, exercise can also be used to rehab many illnesses, improve mental health, maintain weight, ease osteoporosis or arthritis, and much more. Exercise can also help those suffering from lingering effects of COVID-19 such as fatigue, shortness of breath or difficulty breathing, fast or pounding heartbeat, anxiety or depression, concentration, memory loss and joint discomfort.

As you begin to exercise, remember to start slow and monitor your progress while being aware of how the movement makes you feel. Start with a slow walk and gradually progress. Walking, biking and swimming are great ways to improve your cardiovascular condition and breathing. Once you feel comfortable with light to moderate exercise, more intense movement such as running, hiking or cardio classes might be appropriate.

Muscle strengthening exercises are also important. Sit to stands, squats, basic upper extremity movements and core conditioning is especially beneficial. Remember to stretch each muscle through its range of motion as this will ease joint discomfort and help improve general movement.

The Sam B. Cook Healthplex has a team of professionals that can help you get started in the right direction. Cardiac nurses, occupational therapists, physical therapists, athletic trainers and exercise specialists will work together to get you safely on your way to improved health through exercise and movement.

Whatever your reason, exercise is right for you! Think about it as insurance for good health.

Kay Benward is an exercise specialist and supervisor at the Sam B. Cook Healthplex Fitness Center in Jefferson City. She has been with Capital Region Medical Center for 30 years and inspired many people to lead healthy lives through exercise. She continues to teach classes and enjoys training the mature adult for balance, posture and functional strength, as well as educating her clients, staff and community on exercise as medicine.

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