For decades, technology has relentlessly made phones, laptops, apps and entire industries cheaper and betterwhile health care has stubbornly loitered in an alternate universe where tech makes everything more expensive and more complex.

Now startups are applying artificial intelligence (AI), floods of data and automation in ways that promise to dramatically drive down the costs of health care while increasing effectiveness. If this profound trend plays out, within five to 10 years, Congress wont have to fight about the exploding costs of Medicaid and insurance. Instead, it might battle over what to do with a massive windfall. Todays debate over the repeal of Obamacare would come to seem as backward as a discussion about the merits of leeching.

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Hard to believe? One proof point is in the maelstrom of activity around diabetes, the most expensive disease in the world. In the U.S., nearly 10 percent of the population has diabetes, around 30 million people. Within a decade, some experts say, the number of diabetics in China will outnumber the entire U.S. population. Most people who suffer from the disease spend $5,000 to $10,000 a year on medication, and diabetics with complications can spend hundreds of thousands of dollars on doctor and hospital bills. That and the lost wages of diabetics cost the U.S. alone more than $245 billion a year, according to the Centers for Disease Control and Prevention.

Thats an enormous problem to solve and a pile of potential cash and customers to be wonwhich is why diabetes is attracting entrepreneurs like ants to a dropped ice cream cone. One of those entrepreneurs is SamiInkinen. He was a co-founder of the real estate site Trulia and has long been an endurance athlete, competing seriously in triathlons and Ironman events. In 2014, he and his wife rowed from California to Hawaii. None of this fits the typical profile of a diabetic, yet in 2011, soon after yet another triathlon, Inkinen was diagnosed with Type 2 diabetes. And like many driven, super-smart data geeks, he dove into research to understand everything about his condition.

Soila Solano injects herself with insulin at her home in Las Vegas on April 18. Solano was diagnosed with Type 2 diabetes six years ago. Nearly 10 percent of the U.S. population has diabetes, the most expensive disease in the world. John Locher/AP

That journey led him to Dr. Stephen Phinney, a medical researcher at the University of California, Davis, and Jeff Volek, a scientist at Ohio State. Phinney and Volek wrote two books together about low-carbohydrate diets and published scientific papers describing how constant adjustments to diet and lifestyle can reverse diabetes in many patients. Diabetes is almost never treated that way because the program is too hard for most people to stick to. It requires so much coaching and scrutiny by medical professionals, youd pretty much have to hire a live-in doctor.

Inkinen convinced Phinney and Volek that technology could essentially re-create a live-in doctor and diabetes coach in a smartphone. Together, the three founded Virta Health in 2014. The company stayed in stealth mode until now, launching in March. It felt like a duty to do this, Inkinen tells Newsweek . Here is an epidemic of epic proportion, and nothing is working. We can combine science and technology to solve the problem at much lower cost and do it safely.

Heres how Virta works and why its approach is so important to the future of health care. On the front end, Virta is software on a smartphone. Diabetics who sign up agree to regularly enter data: glucose levels, weight, blood pressure, activity. Some do this by manually entering information; others use devices like a Fitbit or connected scales to automatically send it in. The app also frequently asks multiple-choice questions about mood, energy levels and hunger more data that the AI software crunches to learn about the patient, look for warning signs and symptoms and guide Virtas doctors.

On the back end, Virta hires doctors who get streams of updates from Virtas software and use the data to help them make decisions about how to adjust each patients diet and medications or anything else that might affect that persons health. Any clinical decision is always made by a doctor, Inkinen says. But the software increases productivity by 10-X. (Thats 10 times, in Silicon Valleyspeak.) When all this works and the patient follows the programs strict dietary and medical controls, diabetes can be reversed, clinical trials of Virtas system have shown. Around 87 percent of patients who had been relying on insulin to control their condition either decreased their dose or eliminated their use of insulin completelya success rate that matches that for bariatric surgery, which is an expensive, invasive, last-ditch effort for severe diabetics.

Virta leverages AI software, smartphones and cloud computing to allow its doctors to continually interact with many times more patients than they can in a clinic or hospital, and it gives its diabetic patients a cross between a pocket doctor and a guardian angel. The result is a promising treatment for diabetes that could get many sufferers off medication and keep them out of doctors offices and hospital emergency rooms. And that, in turn, would greatly lower the overall cost of diabetes.

Virta is just one startup of many attacking diabetes. Livongo is a more automated but less doctor-oriented version of Virtas program. The company, which raised $52.5 million in March, makes a wireless glucose-reading device that uploads the diabetics data. AI software learns about the patient and sends a stream of tips and information intended to help the diabetic manage the disease and stay out of hospitals. Yet another new startup, Fractyl, takes a more medical approach. It invented a type of catheter that seems to cause changes in the intestines that result in reversing diabetes.

Startup tracker Crunchbase lists about 130 new tech-oriented companies (the number changes constantly) involved in some aspect of diabetes. While many of these startups will fail, its hard to imagine that some wont have a significant impact.

These efforts matter to all of us because diabetes is such an enormous drain on health care resources. Venture capitalist Hemant Taneja, who helped start Livongo, says technology could take $100 billion out of the annual cost of diabetes in the U.S. Imagine if even 20 percent of diabetics could get off medication and have little need for a doctors care. All of those medical resources would get freed up for other patients and other conditions, which should help lower prices of health care for all. If we want to massively lower health care costs, we need to figure out how to address metabolic health issues [like diabetes] at their core, Inkinen says. I would bet my house that in 15 years, the future health care company looks like what were doing todaynot treating diseases at the end of the road but catching them along the way and reversing them.

A user checks blood glucose with the Livongo system. Livongo

Over the past decade, medical records in the U.S.long kept on paper in doctors horrible handwritinghave been digitized and fed into software. That hasnt helped lower health care costs yet, and in fact it is adding to them as systems get installed and medical professionals learn to use software that can be clunky. Epic Systems, the biggest electronic medical records company, handles 54 percent of patients records in the U.S. but gets bad marks for being so hard to use that it eats up doctors and nurses time. One report from Beckers Hospital Review said that almost 30 percent of Epic clients wouldnt recommend it to their peers. A survey by Black Book Market Research found that 30 percent of hospital personnel were dissatisfied with their EMR systems, with Epic getting the strongest dissatisfaction.

But theres a larger gain from the pain of EMRs: Enormous amounts of medical information are now digitized. As more medical interaction happens onlineas with Virta or Livongothe more kinds of data well collect. Internet of Things devices, whether Fitbits or connected glucose meters or potential new devices like Apple AirPods that take biometric readings, will add yet more data. All this data can help AI software learn about diseases in general, and about individual patients, opening up new ways for technology to be applied.

Some of the new applications of AI will simply improve a tragically inefficient health care industry. Qventus is a startup using AI to take all the data flowing through a hospital to learn how to free up doctors and nurses to see more patients and improve outcomes. Were creating efficiency out of seemingly nothing, Qventus CEO Mudit Garg tells me. Two years ago, work like this was so unsexy. But this is where the rubber meets the road.

One of his clients, Mercy Hospital Fort Smith in Fort Smith, Arkansas, has been able to treat 3,000 more patients a year with the same resources, an increase of 18 percent. Here again, technology is increasing the supply of medical services, potentially changing the cost equation that keeps forcing health care prices higher.

AI is also starting to automate some of the work of doctors. IBMs Watson, which uses machine learning and massive computing power to reason its way through questions, is on its way to becoming the best diagnostician on the planet. Its software can soak up all manner of available (and anonymized) patient data, plus the tens of thousands of medical research papers published every year (far more than any human could read). The system can even keep up with the news, learning, for instance, which regions are affected by a certain contagious disease, which might help diagnose someone who recently traveled to one of those areas. By asking patients a series of questions spoken into any kind of computer or connected device, Watson can quickly narrow down the possible causes of a medical problem. Today, IBM works on test projects with major hospitals like the Cleveland Clinic to put Watson in the hands of doctors, who are learning how to use the technology like a brilliant assistant.

But the day will come when Watson or something like it is available to everyone through a smartphone or some other device. Amazon is starting down that path by partnering with HealthTap to offer what it calls Dr. A.I. on Alexa, Amazons voice-activated AI gadget for consumers. Its not nearly as robust as Watson but works on the same idea. Just tell it your medical problem, and it will ask you questions to help narrow down what it might be.

A clerk works in the medical records department at Clinica Sierra Vista's East Bakersfield Community Health Center in Bakersfield, California on October 20, 2009. As medical records increasingly become digitized, their data will help AI learn more about diseases and how to help patients. Phil McCarten/Reuters

As health care AI develops, startups are also creating new kinds of genomics-based medicine. Just 16 years ago, the Human Genome Project and geneticist Craig Venters startup, Celera Genomics, published the results of their human genome sequencing within a day of each other in 2001. Venter said his project took 20,000 hours of processor time on a supercomputer. This year, startup Color Genomics is offering a $249 genetic test that can sequence most of the pertinent genes in the human body. Colors goal is to make genetic sequencing so cheap and easy that every baby born will have it done, and the data will inform his or her health care for life.

Combine genetic data about a person with all the kinds of data Watson can ingest, and were close to being able to build AI software that can at least supplant that first visit to a doctor when youre sickwhich, of course, is when you least want to travel to a doctors office. Instead, people will increasingly speak to a smartphone or to something like Dr. A.I. on Alexa about their health problems and, if necessary, send in photos of that rash or funky toe. If the system has your health care records and genetic data, it can gain more insight into your condition than any doctor operating on an informed hunch.

An early prototype of Watson in Yorktown Heights, NY. The cognitive computing system was originally the size of a master bedroom in 2011. Clockready

On many occasions, the app might tell the user the problem is nothing seriousa robot equivalent of Take two aspirin and call me in the morning. Other times, the app might send the user to a clinic to get a test or X-ray. If thats how it plays out, a large chunk of the traffic into doctors offices and hospitals will fade away.

Add it up, and in these next few years were going to see a parade of tech applications that reduce demand on the health care system while giving all of us more access to care. Doctors should be freed up to do a better job for patients who truly need their attention. Theoretically, all of this will help keep more people healthier. And if were all healthier and using health care less, the laws of supply and demand should kick in, sending the overall cost of health care tumbling.

However, there are bumps ahead because, as our erudite president recently said, nobody knew that health care could be so complicated.

The economics of health care are weird. First of all, the usual forces dont apply to highly regulated industries, and health care is perhaps the most regulated in the U.S. and around the world because lives are at stake. In most countries, regulators prevent AI software from crossing the line into independently offering a diagnosis or clinical advicethats strictly the purview of doctors. New medical devices, like Fractyls, have to get approval from the Food and Drug Administration. Lobbyists often slow regulatory change to maintain the status quo and benefit incumbents charging inflated prices.

Personal health care decisions in the U.S. often get influenced by insurance companies, employers who pay for health benefits, and Medicare. Unlike most industries, consumers in health care dont have much information about pricing or quality, so they cant weigh options and make rational choices. Moreover, we think about health differently from anything else we buy. Many of us are never satiated with health carewe always want more and better health care, if we can afford it. One study published in March showed that telehealth making doctors available by video callprompted people to seek care for minor illnesses they otherwise wouldve ignored. Only 12 percent of telehealth visits replaced in-person visits, and the other 88 percent was new demand.

Until recently, most new medical technology has been high-end products that give doctors and hospitals a reason to charge more for something that couldnt have been done in the past. Think MRI machines or robotic limbs. These improve quality of life but add to costs. In 2008, the Congressional Budget Office concluded, The most important factor driving the long-term growth of health care costs has been the emergence, adoption, and widespread diffusion of new medical technologies and services.

A doctor and patient demonstrate how they use Virta for diabetes monitoring and treatment. Virta Health

The next wave of health care technology is different. The combination of data and AI was not available until the past year or two, and it can lead to the kind of automation that has disrupted so many other industries. Many health care entrepreneurs are focused precisely on the win-win-win prospect of lowering the cost of care while making it better and available to more people. Of course, there will be challenges to address, such as making sure our highly sensitive medical data stays protected and private, even as it flies around various networks and systems.

As startups bring these technologies online, theyre often doing an end run around insurance companies, instead finding demand among consumers or employers who offer health coverage. Livongo, for instance, points out to companies that each diabetic employee costs thousands of dollars a year in care. Pay for the Livongo service, the pitch goes, and your company will save money as those employees better manage their conditions. By last year, Livongo had signed up more than 50 large customers, including Quicken, Office Depot, Office Max and S.C. Johnson & Son.As the thinking goes among health care startups, once employers and consumers embrace new technology, insurance companies, regulators and health care incumbents will have to follow.

As that happens, the technologists promise, economic forces will finally stall or reverse the climbing cost of health care in the U.S. and around the world, a development that would, if were lucky, leave the president and just about every member of Congress speechless.

Jon-Paul Pezzolo

Excerpt from:
How Artificial Intelligence Will Cure America's Sick Health Care System - Newsweek

Paula Vogel (playwright, Indecent)

My pre-preview ritual: Eat light. Drink water. A small pad for notes. Cellphone charged.

My ritual when press comes in: Eat more substantially. Order a double vodka martini, slightly dirty, straight up. Walk around the block until fifteen minutes to curtain. Stand in the lobby in animated discussion, with the vodka running through my veins.

J.T. Rogers (director, Oslo)

Whenever Im at a play of mine, I like to drift around backstage starting at half hour, quietly watching the cast and crew going about their pre-show business. Its during this magic time, when everyone is collectively preparing, doing the secret work that only those of us in the tribe know about, that I feel most connected to the theater. And the most happy to be a part of it.

Jack Cummings III (director, Picnic)

During previews, I dont allow myself to walk into the theater without a medium coffee from Dunkin Donuts whether I want the coffee or not. I sit in the exact same seat every time. In fairness, I sit in every imaginable seat during rehearsals and tech so I know what it looks like from all sides. Also, I choose the seat where I can safely give notes to my assistant without driving audience members crazy. I am known to be a bit of a neat freak, so often, as my nerves escalate, I can be found anywhere from the theater to the lobby to the hallway to the bathrooms, cleaning, straightening, and picking things up off the ground.

Angela Pierce (cast, Oslo)

My pre-show ritual for Oslo has become: At the five-minute call to places I go backstage and listen to the audience, go check my props (I make sure Ive touched every one of them), give a quick nod and a good show! to Jefferson Mays as hes on his way to places for his start of show and Im on the way back to my dressing room to finish getting ready for the show. Whats become my fave food while working on Oslo I dont do it all the time because its more of a special treat for me is the gluten-free turkey sandwich with an additional side of pesto at Indie Food and Wine next door to Lincoln Center. It is absolutely scrumptious! And the staff knows me by name now. Big bonus!

Mia Barron (cast, The Wolves)

Actors I really admire always say that they can barely eat anything before going onstage, but Im a hungry person and if I dont eat a meal, Ill be too distracted thinking about food. So, I eat a good meal. But I dont tell anybody for fear of sounding like a hack.

Jenna Dioguardi (cast, The Wolves)

My absolute favorite part of doing eight shows a week is how much I focus on taking care of my body. I often describe my body as that of a ninety-year-old man trapped inside a twentysomething woman, so my pre- and post-show rituals are centered around transforming from that old man into a much more limber, younger person. I have a duffel bag full of physical-therapy gadgets that lives in my dressing room when Im working. Ill crack that open and begin my warm-up, which is very ritualistic. Its about 45 minutes and has been the same for years. And I always make a playlist tailored to the character Im playing, which Ill listen to very loudly while I warm up. After the show, I cover my body in ice packs and eat popcorn while watching The West Wing or Parks and Recreation. Sometimes Ill even put on an episode of Friends that Ive seen three thousand times and just stare at the wall. You know, to unwind.

Heather MacRae (cast, Come Back, Little Sheba)

I would say that like many actors I like to be at the theater early about an hour and a half before curtain. I do like to have a cup of English Breakfast tea, from whatever deli is nearby. I like it quite strong with half-and-half and two Splendas. I did have a particular craving after playing Lola in Transport Groups production of Come Back, Little Sheba: I had to have a Coke; not diet, the real thing. It was the only thing that quenched my thirst after doing the play. And I am a potato chip junkie. So Coke and chips is usually a must for me. I know, so healthy, right? And, occasionally, Cheetos!

Lizzy Jutila (cast, The Wolves)

Yes, before a performance I drink bone broth daily. When I dont have time to grab some from home, Ill go to Springbone or Brodo in the West Village. They also make a powder form where you can just add hot water. Bone broth is so good for your joints and tummy. I am always active so I have to make sure my body is running smoothly to prevent injury. Also, I love to work out before a show. It gives me more energy. When I was in The Wolves this last year I would usually take a kickboxing class prior to the performance to get my blood racing and my endorphins going. Post-shows, I will drink magnesium to help me sleep and replenish my muscles so that I can keep going the next day!

Amy Ryan (cast, Love, Love, Love)

Before the first entrance, I put one hand on my heart and one on my stomach. I find thats the only way to calm my nerves. If theres not enough time for a full vocal warm-up, a Fishermans Friend does the trick.

Matthew Broderick (cast, Evening at the Talk House and Shining City)

I usually bring a soup to the theater to eat before a performance. Sometimes half a sandwich. It might come from Green Symphony or somewhere else, depending where the theater is. What I liked most of all was the Edison caf, but its been closed for two years. I still miss it terribly.

More here:
Amy Ryan's Cough Drops (And Other Performance Rituals) - Village Voice

Every year more money is being spent studying the now-infamous plant protein gluten. The studying raises more questions. That leads to more money being spent. And then more questions.

If there was more than one lecture in medical school where gluten came up, I dont remember it. The one I remember was in 2007, in the context of celiac disease. After the lecturer mentioned gluten, a classmate raised a hand and asked him to repeat himself. People who eat what?

Of course gluten, which comes from wheat, rye, and barley, was all around us then, as it is now. Its a sort of mortar in the walls of the modern food system, in so much of what we eat or otherwise ingest and apply to ourselves. But we were barely, if at all, aware of it.

When someone with celiac disease eats gluten, it causes an immune reaction that destroys the lining of the small intestine. But as long as people with celiac disease avoid gluten, theyre fine. Got it. And like most medical doctors, thats what I remember learning about gluten.

Cut to a decade later, and this month there is a headline that says eating gluten doesnt cause people to develop heart disease.

Heart disease. I dont actually have a no shit folder but my trained impulse was to commandeer a file cabinet and start one. Id also put a study there that said gluten doesnt cause rickets or global warming. Why or how would gluten cause heart disease?

In fact, not only does gluten not cause heart disease in the general population, but people who go gluten-free seem to actually be putting themselves at an increased risk of heart disease, insofar as it means eating fewer whole grains. This discovery is among those slowly painting a picture of a diverse array of harms that come with blindly avoiding gluten. The finding comes from a group of prominent nutrition and gastrointestinal researchers at Harvard and Columbia. In a prospective cohort study in the latest BMJ, they concluded that people without celiac disease should not be encouraged to adopt gluten-free diets.

In the language of academia, thats a stern admonition. Its coming late, though, and its less compelling than the myriad promises in glossy magazines and miracle books and celebrity-endorsed facial creams. The scientists advice is at odds with the fact that gluten-free diets are promoted everywhere and Googled more frequently than any other diet. By my own rough estimate, in April some $700 quadrillion in gluten-free products were sold in California alone.

Still, the new research is among the most meaningful to date on the relationship between gluten intake and health outcomes in people without celiac disease. It is based on data from more than 100,000 people over almost two decades.

Outside of this, the few small trials that have been done to study the effects of gluten intakein which blinded participants are divided into gluten-free and gluten-containing diets and then monitored for symptomshave been short-term and small. A study like this new one can look at dietary patterns in real life and health outcomes over the course of decades. The strongest evidence in glutens favor is that the longest-lived, healthiest populations on Earth have long eaten diets that include grain products. No study has yet suggested that gluten causes heart disease.

So why was this being studied at all?

The lead researcher is Benjamin Lebwohl, a gastroenterologist with the Celiac Disease Center at Columbia University. He has spent more time thinking about the societal role of gluten than anyone Ive met before. If were going to consider science as orthogonal to whatever the public is doing, its just going to worsen polarization, he said. Well just continue to talk past each other.

In talking to patients, he notes an important difference between saying that theres no proof that gluten has health effects in the general population and saying that there is proof that gluten has no health effects in the general population. To a concerned patient, that distinction can be huge.

I talked with Lebwohl one morning recently in the hours before he started scoping, as he put it, or performing endoscopies and colonoscopies, looking through a fiberoptic tube at the parts of us most of us never see. There he has come to understand that celiac diseaseand the effects of glutenare still largely mysterious.

The textbook take on celiac disease is still that its an autoimmune condition. It is usually diagnosed by testing for antibodies called tissue-transglutaminase, and by taking a biopsy of a persons small intestine after the person has eaten gluten. If a person has celiac disease, then Lebwohl expects to see that the finger-like villi of the intestinal wall have been obliterated, flattened like a mowed lawn.

But sometimes things get strange. Some of the people Lebwohl sees who have severe atrophy of their intestinal villi eat gluten and feel totally fine. Its only when they stop eating gluten, and then are exposed to it at some later point, that symptoms arise.

He and the rest of the celiac team at Columbia also see many, many cases of the inverse: people with normal-looking bowel walls who feel horrible when they eat gluten.

Why is gluten making people without celiac disease ill? Lebwohl asks rhetorically. And why is there such variability in symptoms among people with celiac disease when they eat gluten? There are people that appear to have symptoms that are triggered by gluten, but they definitely do not have celiac disease. This is likely because its a new disorder, one for which we dont have good biomarkers [lab tests] and dont have an understanding of its mechanism.

The condition likely involves some degree of placebo and nocebo effects, and variations in intestinal flora probably also play a part. He also notes that symptoms may actually be related to FODMAPsan increasingly popular acronym for a group of carbohydrates that some believe are actually the cause of the symptoms that many people attribute to gluten (or to dairy or soy, et cetera, or simply chalk them up to irritable bowel syndrome). And nothing about these explanations is mutually exclusive.

Theres also a good chance that theres a distinct clinical entity out there we just havent discovered yet, he said. If thats the case, we have a choice. We can roll our eyes and say this isnt in the medical textbooks, which often then drives patients to alternative practitioners, and they start taking multiple supplements, or we can listen and study these patients.

Lebwohl spent his undergraduate years at Harvard studying music. After four years of medical school, four years of residency, and three years of fellowship, he did a masters degree in patient-oriented research at Columbia, and a post-doctoral fellowship in cancer-related population sciences. He came out the other end less developed than he imaginedless prepared to care for people who exist in the real world than he imagined.

After all that, I realized that people were asking me about leaky gut and candida, he said. I had zero exposure to any of these concepts, or how to approach patients who are coming to you with concepts that are totally foreign to medical training.

Ive felt the same, and I know my classmates have. When I write about these things that people ask aboutlike cryotherapy or chelation therapy or lectin-free dietingI inevitably hear from science-minded readers who are concerned that these subjects are not worthy of any coverage at all. The best course is to simply ignore them.

Lebwohls teamwhich includes veteran researchers like Harvards Walter Willettsee it otherwise. They decided to devote their time and money to studying the relationship between gluten and heart disease not because it seemed that they could be plausibly related, but simply because people believe them to be. And they believe this because of a monstrously popular 2011 book called Wheat Belly, which includes the implication that eating gluten has adverse cardiovascular effects.

The book was written by William Davis, who is a cardiologist based in Milwaukee, but whose concern about grains is substantially out of proportion to that of academic medicine on the whole. For example, he has likened eating wheat to smoking. One post on his blog warns: Whole grains are indeed healthier than white flour productsjust as filtered cigarettes are healthier than unfiltered cigarettes.

Though blindly avoiding gluten is not recommended by any body of cardiologists or preventive-medicine experts, the outsider status of Daviss alarmist hypothesis was promoted as the angle that seems to have made his book enormously successful. He promised readers secrets that few others were willing to tell them, and superiority to the sheep who had been played by the system. This narrative tends to sell. Ive previously traced the modern multi-billion-dollar gluten-free obsession to Wheat Belly, which is published by Rodale, along with subsequent spinoff books in the franchise. (Wheat Belly Total Health: The Ultimate Grain-Free Health and Weight-Loss Life Plan; Wheat Belly 30-Minute (Or Less!) Cookbook: 200 Quick and Simple Recipes to Lose the Wheat, Lose the Weight, and Find Your Path Back to Health; Wheat Belly 10-Day Grain Detox: Reprogram your body for rapid Weight Loss and Amazing Health, and Wheat Belly Cookbook: 150 Recipes to Help You Lose the Wheat, Lose the Weight, and Find Your Path Back to Health.)

In all, five books to tell people to stop eating grains. The accomplice to Wheat Belly was the comparably fictive 2012 Grain Brain, the author of which has called gluten this generations tobacco, and which also became a number-one bestseller by promising secrets that no one else was willing to tell us, namely that avoiding grains would prevent and reverse dementia. Its also based on the idea that gluten sensitivity causes inflammation throughout a persons body, which has not been shown to be true. The idea has been picked up by theorists and presented as certainty, though, even the founder of The Ultrawellness Center and embattled doctor to the Clintons, Mark Hyman, who has written that even in the absence of celiac disease, gluten creates inflammation throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. According to his web site, he has written ten books that were number-one bestsellers.

Daviss publicist said he was unavailable for comment in time for this story, as he was doing a radio interview and then driving to Cleveland as part of a press tour for his new book. This new one is a break from the franchise in name, but not in subversive tone. Its called Undoctored: Why Health Care Has Failed You and How You Can Become Smarter Than Your Doctor. The title is not hyperbolic. The text literally sells superiority: Lets be absolutely clear: I propose that people can manage their own health safely and responsibly and attain results superior to those achieved through conventional health carenot less than, not on par with, but superior.

This is the same anti-establishment, outsider spirit that sent Daviss first book to the number-one spot on The New York Times bestseller list and brought gluten free to such a pitch that it can now be found as one of very few nutritional distinctions on restaurant menus around the world. At a time when some best-selling books sell just a few thousand copies, Wheat Belly has sold more than a million.

In that book, a lot of the science from celiac disease has been sort of co-opted and extrapolated into the general population, said Lebwohl. Like the notion that gluten is intrinsically pro-inflammatory. Thats something for which we have very shaky data.

But since people believe the story, these ideas are now the topics of serious study. They came to popularity among crowds that felt alienated and unheard, and so were susceptible to demagoguery, and now a medical establishment that has long been seen as elitist and closed-minded is paying for the power dynamic it created.

The funding for the new gluten-heart-disease study came from grants from the American Gastroenterological Association, Massachusetts General Hospital, and the National Institutes of Health. Any entrenched system is going to have a backlash; in the case of gluten, the rebellion is now leading the discourse. The team at Columbia is now working on another study looking for any relationship between gluten and cancer. (They have no reason to think that gluten causes cancer. But some people do believe this.)

I believe we need to research and study rigorously the things that patients are interested in, said Lebwohl. This is, in my view, a necessary part of sciences missionto go to where the public is interested and provide sound analysis. If the public is barking up the wrong tree, we shouldnt ignore that.

Some find this concerningthat weve entered a cycle of buying and belief that will require so much research that science will never catch up, but only ever be chasing whatever people have already chosen to believe gluten is doing to them. Others say this is exactly how science is supposed to work.

In the meantime, Lebwohl tells gluten-wary patients to be wary, rather, of any practitioner who is telling people that the problem is that their gut is leaking. And as a general rule, beware of any lab tests that tell you what foods you cant tolerate. If there is a lab that does tests that cant be paid for by conventional meansinsurance companiesmaybe that lab is testing things that are totally unproven. There are countless people who will take advantage of those who are looking for answers right now.

See the original post here:
Science Has Begun Taking Gluten Seriously - The Atlantic

Pope Francisbroke the ice with First LadyMelaniaat theVatican on Wednesday by asking ifa traditional Slovenian dish contributed to President Donald Trumps large stature.

As Melania shook hands with the pope during the visit, Pope Francis saidin Spanish through his interpreter pointing toward Trump, What do you give him to eat?! Potica?

Potica, yes, the Slovenian-born first lady said with a laughbefore stepping aside.

The pontiff was referring to a sweet bread usuallyfilled with nuts (but can also include poppyseed, cottage cheese, hazelnut, chocolate, honey or other ingredients)from her homeland and not pizza, as some onlookers mistakenly heard.

One of the popes attendants also gave Melania a small object, which she hadPope Francis bless.

The presidents eating habits have been the talk of Twitter before, notably when Trump shared a photo of himself using silverware to eatan eight-piece bucket meal from KFC with a side of mashed potatoes and gravy. Hesalso known to eattwo scoops of ice cream during dessert, while his guests receive just one.

WATCH:Oprah Shares Some Of Her Favorite Foods For Weight Loss

During a September interview withDr. Mehmet Oz, a health exam from a doctorshowed that Trump is overweight for his heightat63 and 236 pounds.

I think I could lose a little weight, Trump admitted. Ive always been a little bit this way. I think that if I had one thing, Id like to lose weight. Its tough because of the way I live. But the one thing I would like to do is be able to drop 15 to 20 pounds. It would be good.

Despite the joking exchange with the first lady,onlookers described the meeting between Pope Francis and the president as stiff. In the first minutes of the meeting, the pope did not say anything to Trump and did not smile.

Melaniaand First DaughterIvankastrictly stuck tothe dress code,wearing long-sleeved black dresses and veils for thevisit to the Vatican just days after they ditched headscarvesin Saudi Arabia.

Per Vatican protocol, women who have an audience with the pope are required to wear long sleeves, formal black clothing, and a veil to cover the head, Stephanie Grisham, the first ladys communications director, told CNN.

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Pope Francis Questions Melania About President Trump's Diet: 'What Do You Give Him to Eat?' - PEOPLE.com

Spring is in the air, and so are new diet plans. Everyone wants that certain body type or to get rid of a few extra pounds before its time to pull out that summer wardrobe, and there are hundreds of diets out there promising results.

Most focus on weight loss, but weight loss alone isnt always an indicator of health. And diets that call for extreme eating changes arent always healthy or palatable long-term. You may be able to eat only cabbage soup for a week, but not for the rest of your life!

Related: 10 Seriously Selfish Reasons to Be Vegan

And often the fast weight loss these diets promise is gained back just as quickly, a phenomenon thats well-documented andmay be the result of diets that are too restrictive.

It might be time for something new on the diet scene. U.S. News and World Report has released its diet rankings for 2017, and a diet youve never heard of has taken the fourthslot in the overall rankings, is thirdin heart-healthy diets, and ranks 18thin weight loss. Its called the TLC diet, and its initials stand for Therapeutic Lifestyle Changes. It doesnt sound trendy, and thats because its not.

Though weight loss is often a byproduct of the diet, it doesnt promise a supermodel body or results within a certain time frame. It was developed to combat heart disease the number-one killer of Americans by tackling high blood cholesterol with healthy lifestyle changes, but by adjusting your caloric goals you can target healthy weight loss, too.

Cut saturated fat to less than 7 percent of your calorie intake. For a 1,500-calorie diet, thats less than 10 grams of saturated fat.

Theres a lot of flexibility within the diet that allows people to eat things they enjoy. Like most effective plans for weight loss, the TLC diet involves counting calories and staying close to the range recommended for your height, weight, and activity level. You might have to get out your calculator for the first few weeks, but the guidelines are simple and quickly become habit.

Cut saturated fat to less than 7 percent of your calorie intake. For a 1,500-calorie diet, thats less than 10 grams of saturated fat, which often means less full-fat dairy and fatty meats. Trans fat, found mostly as hydrogenated oils, in products such asmargarine and packaged foods, should be avoided if at all possible and is one of very few ingredients the TLC diet tries to cut out entirely. Theres no limit on unsaturated fats, but keep in mind that foods high in fat tend to be high in calories, so keep that calorie limit in mind when choosing foods that are high in healthy fats.

Related: The Stress Fighters That Can Save Your Life

Saturated fat actually has a bigger impact on blood cholesterol levels than dietary cholesterol, but cholesterol should still be kept under 200 mg a day. Full-fat dairy products, shrimp, egg yolks, and organ meats are all high in cholesterol. These foods arent forbidden, though. A 3.5-ounce serving of shrimp contains 189 mg of cholesterol. Just ditch the cream sauce and opt for olive oil and herbs instead to stay under your cholesterol limit.

The TLC diet also recommends getting a lot of soluble fiber, at least five to 10grams a day but preferably 10to25 grams a day. While insoluble fiber passes through the digestive tract pretty much undigested (giving your colon a nice workout), soluble fiber dissolves into a substance that actually coats the walls of your intestines and keeps them from absorbing dietary fat and cholesterol. Cereal grains such asoatmeal, whole fruits, and beans are all good sources of soluble fiber.

Because of research that shows heart benefits for omega-3 fatty acids, the diet recommends two fish meals a week. It also recommends avoiding foods high in sodium and restricting alcohol intake to one drink a day for women and two a day for men.

Related: Most Americans Eat Too Much of This

The last key part of the TLC diet is an important one get 30 minutes of moderate-intensity activity most days of the week, preferably every day. Gardening, golfing (without a cart), playing tennis, biking, and brisk walking are all examples of moderate-intensity activities, and its important to pick something you enjoy. Join a group, class or club to stay motivated!

Always check with your doctor before starting a new diet, and you can check out the complete guide to the TLC diethere.

Dr. Manny Alvarez serves as Fox News Channels senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey.This Fox News article is used with permission; it first appeared on AskDrManny.com.

Read more at Fox News: Hardball Health Care Option May Cost Trump and Taxpayers Utah Man Initially Denied Lung Transplant Over Pot Use Dies After Complications, Family Says Why Your Brain Has Two Halves

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The 'Therapeutic' Diet That's Turning Heads - LifeZette

Photograph by Ben Watts

Gear up for the homestretch.

At last, after a long and unforgiving winter during which you occasionally wondered if you would ever feel warmth again, Memorial Day is upon us, which means that it's almost time for that pre-summer diet and exercise regimen to which you've adhered with such discipline to pay off. Since this last week is what really separates the Globo Gym physical specimens from the Peter LaFleurs of the world, we asked a couple of registered dietitians for their advice on what you should eat in order to finish on a high note. Whether you choose to celebrate this weekend by launching yourself headlong into a sea of perfectly-grilled hamburgers and sunscreen-laced light beer afterwards, though, is entirely up to you.

Protein and produce. This may come as a shock, but lean proteins are really, really good for you. Maria Bella of Top Balance Nutrition explains that protein produces a hunger hormone called ghrelin and requires a bit more energy to digest than other nutrients, which makes these foods the bedrock of a smart diet. Vegetables should also be a major part of what you eat this weeka good rule of thumb, according to Bella, is that produce should take up about half of your plate's surface area at any given meal.

Cut starches, not carbs. Don't get confused! Carbohydrates are found in pretty much everything that we eat, and cutting them altogether would be both unnecessary and wildly impractical. But you can get all the carbohydrates you need from a few servings of fruit combined with your intake of foods that are sources of lean protein, like beans or dairy. It's the elimination of starchesfoods with high energy density and minimal nutritional value like breads and pastasthat will have the most significant impact on your precise degree of shirtless season-readiness.

Timing matters. You are probably going to feel hungry as you work off those last few pounds, but Pam Nisevich Bede of EAS Sports Nutrition is here to reassure you: It's going to be okay. Most people today prefer to eat frequently and graze throughout the day, but Nisevich Bede urges her dieting clients to reacquaint themselves with their satiety and hunger signals. As a rule of thumb, she suggests scheduling four nibbling-free hours between mealsno matter what the voices in your head say.

Eat things in order. When eating meals this week, Bella offers a simple suggestion for limiting intake of starches: Eat them last. If you've already eaten your servings lean proteins and produce, she points out, you're going to be less likely to go back for those second and third helpings of spaghetti that threaten to torpedo all your best-laid plans.

Size matters, too. You've heard it before, but it's still true: Breakfast and lunch, in that order, should be your largest meals of the day. Nisevich Bedepoints out that eating adequately during those meals will help you to avoid being tempted by myriad mid-afternoon snacks or making poor choices of the all-you-can-eat variety when dinnertime finally rolls around.

Drink water. Not just because it's hot. Nisevich Bede cautions that a principal symptom of dehydration is fatigue, which in turn makes you more likely to resort to sugary drinks or snacks for a pick-me-up. Many people also confuse the sensations of thirst and hunger, and end up eating when all they really need to do is hydrate. Bella recommends starting meals with a water-heavy course, like a broth-based soup or a green salad topped with lemon juice. You probably won't love these dishes, unless you're astoundingly boring and/or a psycho, but they'll help take the edge off of hunger.

Eating out? Don't despair. Just because you're on a mission doesn't mean you have to skip nights out and eat at home alone while contemplating the depths of your loneliness. Simple salads, lean filets, and roasted vegetables are dependable and healthy mainstays that are almost certainly available at your American restaurant of choice. If you're going out for Thai, for example, Bella recommends dishes like chicken satay and spring rolls wrapped in rice paper; if your friends are in the mood for sushi, sashimi is a no-brainer, and most rolls can be wrapped in cucumber instead of rice to save yourself the starch.

Do dessert the smart way. If you absolutely cannot go without a little treat at the end of the meal, Bella suggests that you have three bites of it. Why three? The first and last bites taste the best. Everything in between, though, tastes exactly the same.

MORE STORIES LIKE THIS ONE

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A Last-Minute Summer Diet to Get Your Body Ready(ish) for the Sun - GQ Magazine

By Serena Gordon

HealthDay Reporter

TUESDAY, May 23, 2017 (HealthDay News) -- Fiber helps lower cholesterol, stabilize blood sugar levels and keep the bowels running smoothly, but a new study suggests it can also reduce knee pain from arthritis.

Researchers found that people who ate the most fiber reported reduced osteoarthritis knee pain by up to 60 percent. However, X-rays did not show any difference in their knees compared to those who consumed less fiber.

A second study looked at the effects of the dietary supplement chondroitin on knee pain. That study -- sponsored by a maker of the supplements -- found that taking chondroitin daily was linked to less knee pain and improved function.

But at least two bone specialists noted that the potent type of chondroitin used in the study probably isn't available in the United States, and the safety of long-term daily use of the supplement is unknown.

Both studies were published online May 23 in the Annals of the Rheumatic Diseases.

"With both of these studies, the danger is that people are thinking they're making a change in their arthritis, but they may only be masking the pain. Neither study has proven a change in the natural history of osteoarthritis," explained Dr. Victor Khabie, who was not involved with the studies. He is co-director of the Orthopedic and Spine Institute at Northern Westchester Hospital, in Mount Kisco, N.Y.

Fiber is found in fruits, vegetables, nuts and whole grains. It helps to make people feel full and reduce calorie intake. Fiber is also believed to reduce inflammation, the researchers said.

The fiber study looked at data from two other studies. One included nearly 5,000 people who had or were at risk of osteoarthritis. Their health has been monitored since at least 2006, when their average age was 61.

The second set of data came from the Framingham Offspring study, and included just over 1,200 people. That study began in 1971, and includes data from 1993 to 1994, when the average age of participants was 54. They were followed until 2002-2005.

In the first group, median fiber intake ranged from 21 grams a day to 9 grams a day. In the Framingham group, the highest group ate a median of 26 grams daily. The lowest group had nearly 14 grams daily.

People who ate the most fiber were at lower risk of developing osteoarthritis knee pain, the study found. For those in the first group who ate the most fiber, the risk went down by 30 percent. For those in the Framingham group who ate the most fiber, the risk was 61 percent less than those who ate the least fiber.

The researchers also found that people who ate more fiber were less likely to have worsening knee pain.

Lead researcher Zhaoli Dai, a postdoctoral researcher at Boston University, said, "There is a strong link among obesity, inflammation and painful knee osteoarthritis. We speculate that eating more fiber increases satiety and therefore reduces total caloric intake and reduces body weight."

But Dai added that because the study is an observational one, it can't prove a cause-and-effect relationship.

Dr. Matthew Hepinstall is associate director of the Lenox Hill Hospital Center for Joint Preservation & Reconstruction in New York City.

He agreed that the study cannot prove a causal relationship.

"Nevertheless, when combined with recently published data suggesting lower rates of osteoarthritis progression in patients who lose weight -- also only an association -- a picture is emerging that healthy lifestyles may have measurable effects on the risk of progressive osteoarthritis pain," Hepinstall said.

But he noted that plenty of people who maintain healthy and active lifestyles also develop painful osteoarthritis. So, Hepinstall added that "a high-fiber diet should not be seen as a proven strategy for preventing arthritis."

Dai said: "As the average intake of fiber is about 15 grams per day among Americans. This amount is way below the recommended nutritional goal according to the Dietary Guidelines for Americans 2015-2020, which recommends 22.4 grams/day for women and 28 grams/day for men aged 51 years and above."

According to the Dietary Guidelines for Americans 2015-2020, a usual serving of high-fiber cereal contains 9 or more grams of fiber. A cup of navy beans provides nearly 10 grams, and an apple has about 5 grams of fiber.

The second study looked at chondroitin sulfate. It's a chemical found naturally in the cartilage of the knee, according to the U.S. National Library of Medicine.

The study included more than 600 people from five European countries who had been diagnosed with knee osteoarthritis. The patients were randomly assigned to one of three treatment groups.

One group was given 800 milligrams (mg) of "pharmaceutical grade" chondroitin daily and one placebo pill to mimic 200 mg of the pain reliever celecoxib (Celebrex). Another group was given a 200-mg celecoxib pill and a placebo to mimic the chondroitin pill. The third group was given two placebo pills.

The study lasted six months. Doctors assessed the study participants at one, three and six months.

Reductions in pain and improvements in joint function were greater in people treated with chondroitin or celecoxib at three and six months. The researchers said that chondroitin provided similar relief to celecoxib.

Khabie said, "It looks like there's an anti-inflammatory or pain-relieving effect when chondroitin is taken in a very purified, very well-controlled state, but that's probably not what's available off-the-shelf [in the United States]." He noted that chondroitin is a supplement, and in the United States supplements aren't regulated in the same way that drugs are.

Khabie also said that the safety of taking chondroitin long-term isn't known.

Hepinstall echoed Khabie's concerns about the chondroitin study, but also said chondroitin might be "particularly well-suited for patients who cannot take NSAID medications." NSAIDs, or non-steroidal anti-inflammatory drugs, include ibuprofen (Motrin, Advil), naproxen (Aleve) and aspirin.

WebMD News from HealthDay

SOURCES: Zhaoli Dai, Ph.D., postdoctoral researcher, Boston University; Victor Khabie, M.D., chief, department of surgery, chief, sports medicine, and co-director of the Orthopedic and Spine Institute, Northern Westchester Hospital, Mount Kisco, N.Y.; Matthew S. Hepinstall, M.D., associate director, Lenox Hill Hospital Center for Joint Preservation and Reconstruction, New York City; May 23, 2017, Annals of the Rheumatic Diseases, online

Originally posted here:
Studies Spotlight Diet, Supplements for Knee Pain - WebMD

Not all public health experts say you must cut out diet sodas completely, however. In response to the recent Stroke study, Rachel K. Johnson, Ph.D., M.P.H., R.D., past chair of the American Heart Associations Nutrition Committee and professor of nutrition at the University of Vermont, said that limiting sugars is still important for health, and until we know more, people should use artificially-sweetened drinks cautiously.

In a statement following the Stroke study, The Calorie Council, an organization representing the diet food and beverage industry, said theres no reason to give up your diet soda habit just yet, because artificial sweeteners have been reviewed by the Food and Drug Administration and are deemed safe, and that evidence of their health impacts is still limited.

In the end, the occasional sodawith sugar or artificial sweetenersis probably fine. But your best bet the vast majority of the time, says Avitzur, is to stick with water, plain or sparkling. If you find unflavored water boring, add a splash of bitters with a slice of lemon or lime.

Originally posted here:
The Mounting Evidence Against Diet Sodas - ConsumerReports.org

Brent Herrig Photography

With summer right around the corner, now just might be thetime to give in to the program everyone has been talkingabout Whole30.

The purpose of the dietis not specifically to lose weight, but rather to reset your relationship with your health and with food, according to the co-creator and the Whole30 Cookbook author Melissa Hartwig.

For 30 days, you eliminate foods deemed problematic by researchsuch as additives, sugar and refined carbs then you slowly reintroduce those foods to track changes in how you feel.

The program has taken the social media world by storm, withpeople posting their recipes, tips and encouraging each other to stick to it for the whole month.

If you havent jumped on board just yet, here are a days worth ofrecipes to help get you started. As youll notice, the key to sticking to the diet whilestaying full is hearty proteins (yes, even bacon) balanced with large portions of fruits and veggies.

RELATED:5 Tips to Jump Start Summer WeightLoss

2 tbsp. extra-virgin olive oil, divided 1 medium-size sweet potato, peeled and cut into 8 (-in.-thick) rounds tsp. table salt, divided tsp. black pepper, divided 2 tsp. white vinegar 4 large eggs 1 garlic clove, minced 4 oz. baby spinach 4 Whole30-compliant bacon slices (such as Wellshire), cooked crisp and broken in half Whole30-compliant hot sauce (such as Tabasco)

1. Heat 1 tablespoon olive oil in a large skillet over medium. Add sweet potatoes in a single layer, and cook until fork-tender and browned on both sides, 3 to 5 minutes per side. Transfer to a plate, and sprinkle with 1/8 teaspoon each salt and pepper.

2. Fill a wide saucepan with 3 inches of water. Add vinegar, and bring to a boil over high. Crack each egg into a separate small bowl. Gently slide each egg into boiling water. Remove pan from heat, cover, and let stand 3 minutes for soft yolks or 5 minutes for firm yolks. Using a slotted spoon, remove eggs from pan, and place on a plate lined with paper towels.

3. Heat remaining 1 tablespoon oil in skillet over medium. Add garlic, and cook, stirring constantly, until fragrant, about 30 seconds. Stir in spinach, and cook, stirring, until wilted, about 1 minute. Stir in remaining 1/8 teaspoon each salt and pepper.

4. Stack 2 sweet-potato rounds, and top evenly with spinach, bacon and poached egg. Top with a dash of hot sauce.

Serves: 2 Active time: 5 minutes Total time: 25 minutes

RELATED:These Main Dish RecipesAre All Under 350 Calories and So Satisfying

3 tbsp. white wine vinegar 1 tsp. Whole30-compliant Dijon mustard (such as Annies) 10 pitted kalamata olives, finely chopped 1 anchovy fillet, minced 1 garlic clove, minced 1/3 cup extra-virgin olive oil tsp. black pepper 4 small Yukon Gold potatoes 1 tsp. table salt 6-8 fresh asparagus stalks, trimmed 8 oz. baby arugula 2 (5-oz.) cans water-packed wild albacore tuna, drained and flaked 2 hard-cooked eggs, peeled and quartered 1 large tomato, cut into wedges Small fresh basil leaves (optional)

1. Whisk together vinegar, mustard, olives, anchovy and garlic in a small bowl. Slowly drizzle oil into bowl, whisking constantly until emulsified. Sprinkle with pepper.

2. Cover potatoes with water in a large saucepan over high; add salt. Bring to a boil, and reduce heat to medium low. Simmer, uncovered, just until tender, about 10 minutes. Drain potatoes, reserving 1 inch of water in pan. Transfer potatoes to a small bowl, cut in half, and drizzle with 2 tablespoons vinaigrette. Bring reserved water to simmer over medium. Add asparagus to pan; cook until crisp-tender, about 3 minutes. Immediately place in ice water to cool. Drain.

3. Divide arugula between 2 plates. Divide tuna, eggs, tomato, potatoes and asparagus evenly between servings. Drizzle with remaining vinaigrette; sprinkle with basil if desired.

Serves: 2 Active time: 20 minutes Total time: 30 minutes

WATCH THIS:Half Their Size: Diana Anguh Maintains Her Weight Loss While Working as a Chef

2 tsp. chili powder tsp. table salt, divided 3/8 tsp. black pepper, divided 3 tbsp. extra-virgin olive oil, divided 3 tbsp. fresh lime juice, divided 4 (1-in.-thick) boneless pork loin chops (about 6 oz. each) 4 cups cubed seedless watermelon, chilled cup thinly sliced red onion 2 tbsp. chopped fresh cilantro, plus more for serving Lime wedges

1. Preheat a grill to medium (350 to 400). Combine chili powder, tsp. salt and tsp. pepper in a small bowl. Whisk in 2 tbsp. each of the olive oil and lime juice. Brush both sides of pork chops with oil mixture. Grill chops on oiled grates, uncovered, turning once, until internal temperature reaches 145, 7 to 9 minutes. Let rest 3 to 5 minutes.

2. For the salad, combine watermelon, onion and cilantro in a medium bowl. Drizzle with remaining 1 tbsp. each olive oil and lime juice. Sprinkle with tsp. salt and 1/8 tsp. pepper; toss gently to coat.

3. Serve pork chops with watermelon salad. Serve with lime wedges, and sprinkle with additional cilantro.

Serves: 4 Active time: 15 minutes Total time: 25 minutes

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How to Follow the Whole30 Diet for Breakfast, Lunch and Dinner Without Feeling Hungry - PEOPLE.com

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Jinder Mahal stunned WWE fans worldwide Sunday night at Backlash in Chicago, where he defeated Randy Orton to become the new WWE World Champion.

Mahal'srise to the top of the SmackDown Live roster has occurred seemingly overnight,and his victory over Orton was historic. He became the first Indian WWE Champion, a decade afterThe Great Khali held the World Heavyweight Championship.

Prior to his first appearance on SmackDown as a champion Tuesday night, Mahal spoke to Fox Sports about the reaction to Backlash, his relationship with Vince McMahon, and his workout regimen.

Via WWE.com

Jinder Mahal: Very crazy, you know, Ive just been so busy. I havent taken the time to really let it sink in. Im sure when I go home tomorrow itll all sink in. But right after I won I was in the gym the next day training, [had] a live event yesterday, trained again today and Im on SmackDown.

That moment when I won and when I came back through Gorilla the best thing thats ever happened to me. 15 years Ive put in work, hard work to get to this point. Obviously I went through being released from WWE being signed at a young age to debut when I was 24. So, you know, its been quite the roller coaster but at that moment it was all worth it. I look forward to once I get home and have a minute to reflect and some alone time.

Via WWE.com

Jinder Mahal: I think the response has been great from the rest of the boys. You know, Im an example that in the WWE there are opportunities for people who work hard, improve constantly. I think its great for morale, too, for guys who are lower on the card. Sometimes you get unhappy with your position. I was there with them. I was in the opening match, losing to El Torito in the opening match in 30 seconds - and now Im WWE Champion just through coming back every week and being relentless and wanting to improve everything. My promos, my look, my physique. I think, all in all, its a great change in WWE it showed theyre willing to reward hard work.

Via WWE.com

Jinder Mahal: He was very happy, shook my hand. He was standing up when I came back through Gorilla. I get a lot of advice from Vince. I believe hes a genius, so a lot of promos and everything the last couple weeks after a match or a promo, Vince is the first person that I come to talk to. He was very happy, he could see that I was improving, and Vince is one of those guys if you care, he cares about you. I have a great relationship with Vince now, which is one of those things I never had before, because I would kind of avoid him. But now I come back and Vince is the first person that I see every week.

Via WWE.com

Jinder Mahal: That building, just the way the acoustics are its a taller arena, but it gathers a large capacity. It is one of the rowdiest crowds.

Leading up to this match, I had no idea what the reaction was going to be. Whether they were going to be silent, whether they were going to boo me or cheer, its just so unpredictable. Chicagos one of those places where truly dont know, but once I was out there the reaction was great.

Via WWE.com

Jinder Mahal: He is right. I was 23, I was right out of college, and then I debuted, I was on the SmackDown roster when I was 24. So it was a little bit too much too soon. Ill be the first to admit that I wasnt quite ready for the responsibility inside the ring and outside the ring. I got sidetracked.

Now, looking back, being released was one of the best things that ever happened to me because I developed so much as a performer and as a person outside the ring. Inside of the ring, I got my confidence back. I had lost my confidence just working short matches, losing in like three minutes. I had to wrestle in these 20-minute long matches, main-event style matches, and I got my confidence back. So that was very important.

Via WWE.com

Jinder Mahal: Everybody here aspires to be world champion. Its like all football players aspire to win the Super Bowl.

Yeah, at a certain point I had kind of maybe given up on the dream. Maybe it wont happen. But I saw when I got back, as soon as I started caring, as soon as I started putting in more effort, things just started happening in a positive way, so it just motivated me to work even harder. Writing down my goals is one of the things I started to do about a year ago. Every day I write down [goals], I have my organizer.

I messed up, I didnt write become WWE Champion, I would write become a champion in WWE.

Its one of those things that I put it out there and I worked at it and now Im WWE Champion.

Via WWE.com

Jinder Mahal: Maharaja means the grand king. Maha means grand, and raja, is king.

Fox Sports: What does it mean for you personally to refer to yourself as the Maharaja?

Jinder Mahal: Its just an attitude that I have I believe in my mind that Im one of the best in WWE, and now I have the WWE Championship, so it kind of cements it. If you believe it, you can achieve it.

If I aspire to be the king of WWE, one day if I keep working at it, I will be the king of WWE.

Via WWE.com

Jinder Mahal: That moment actually came before I signed back with WWE. I was kind of in a slump and I was eating junk food every day, drinking too much, and I actually weighed about 260. Just kind of real soft.

So one day I just decided that enoughs enough. I stopped drinking, I still dont drink. Its been almost a year now, itll be a year next week. I just ordered [from] a meal prep company called Nutrition Solutions, I ordered a meal prep and thats virtually all I ate. And I started training again, and just, you know, caring about myself. Two months later I was signed back to WWE. Whereas I sat out for two years, nobody called me, nobody cared about me. As soon as I started caring, two months later I was signed back to WWE. It just sparked something in me, if I keep working If I care, they care. And doors start to open.

I havent eaten a cheat meal in months, but Im not even tempted to because I see the results that Im getting and its giving me confidence, which in return [makes] me more aggressive in the ring, and helps make me more believable as a superstar. Its motivating me even more. Diet hard, train hard.

After the world championship, no cheating, just had chicken and rice and I was in the gym the next day early in the morning. Im going to keep working hard, and hopefully this is just the beginning.

Via WWE.com

Jinder Mahal: Its not hard, you just have to make it a priority.

So, first thing I do when I wake up in a hotel room or at home is I do empty-stomach cardio. Sometimes 45 minutes, sometimes 20 minutes, sometimes half and hour, just before I eat. I drink some water and I just do the elliptical trainer. So that kind of puts me in a fat-burning state for the rest of the day.

What I do normally is I do the cardio, then Ill eat - protein shake, oatmeal, banana - then Ill hit the gym, and Ill be in the gym for two hours.

Ill train for about an hour and a half, stretch for 30 minutes, and thats it for exercise. Cardio, stretch and train six days a week, one day rest day.

Via WWE.com

Jinder Mahal: Hes a powerhouse. You could see he whipped me so far back my head hit the rope. Hes strong, hes a big boy. If WWE is something that he wants to pursue, Im sure he could easily do it. He could become a great WWE superstar.

Via WWE.com

8

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WWE Champion Jinder Mahal opens up on his life-changing diet and workout regimen - FOXSports.com