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Hypertension: Could herbs and spices lower blood pressure? – Medical News Today

Posted: November 19, 2021 at 1:59 am

According to the Centers for Disease Control and Prevention (CDC), nearly half of adults in the U.S. have hypertension.

Untreated hypertension increases the risk of cardiovascular disease, such as heart attack, stroke, heart failure, kidney disease, vision loss, and damage to blood vessels.

Dietary guidance on reducing blood pressure includes reducing salt intake. The Dietary Guidelines for Americans recommend using herbs and spices instead of salt to flavor food.

Experts know less about the health effects of herbs and spices than they do about those of salt. However, some studies have shown that herbs and spices can reduce lipemia the excess of lipids in the blood hyperglycemia, and oxidative stress.

To dig a little deeper, researchers at Pennsylvania State University recently conducted a randomized controlled trial investigating the effect of longer-term consumption of herbs and spices on risk factors for cardiovascular disease.

They found that a higher level of herbs and spices in food reduced 24-hour blood pressure readings.

The findings appear in the American Journal of Clinical Nutrition.

Prof. Penny Kris-Etherton, one of the lead authors of the study, told Medical News Today, Indeed, the blood pressure-lowering effects of herbs and spices in an average Western diet were surprising to me.

We [already know] about the effects of many lifestyle factors, especially dietary factors, that can increase blood pressure such as sodium, alcohol, and caffeine and others that can decrease blood pressure, such as potassium, magnesium, and calcium, [] weight loss, physical activity, and some vitamins, including folate and vitamin D when intake is low, but the blood pressure-lowering effects of herbs and spices are new!

In terms of herbs and spices, she continued, there hasnt been a clinical trial showing benefits on blood pressure lowering until our study.

A total of 71 participants aged 3075 years joined the study. All participants had one or more risk factors for cardiovascular disease and had overweight or obesity.

After the participants fasted for 12 hours, the researchers made baseline assessments. These included height, weight, waist circumference, a fasting blood sample, and vascular testing.

Vascular testing included central and peripheral blood pressure and arterial stiffness measurements. The participants also wore a blood pressure monitor for 24 hours.

The researchers then randomly assigned the participants to one of three groups. Each group would eat one of three diets: a low spice diet, a moderately spiced diet, or a high spice diet. These diets included a daily intake of 0.5 grams (g), 3.3 g, and 6.6 g of herbs and spices, respectively.

The aim was to incorporate herbs and spices into a diet that was representative of the average U.S. diet. The additional herbs and spices included cinnamon, turmeric, and oregano.

The participants followed their respective diets for 4 weeks, with a 2-week break in between. At the end of each diet period, the participants returned for follow-up assessments. A total of 63 individuals completed the study.

The study showed that the high spice diet tended to improve 24-hour blood pressure readings, compared with the medium and low spice diets.

The researchers did not observe any effect of the diets on low-density lipoprotein cholesterol, clinic-measured blood pressure, markers of glycemia, vascular function, or oxidative stress.

However, they say that 24-hour blood pressure readings are a stronger predictor of cardiovascular death than clinic blood pressure measurement.

The authors believe that the study might have been too short for vascular remodeling to occur, which might explain why they did not see any effect on arterial stiffness.

They also note that the dosages of herbs and spices might not be adequate to overturn the metabolic effects of an unhealthy background diet. Therefore, they cannot recommend increasing intake of herbs and spices alone in the context of a poor quality diet to lower the risk of cardiovascular disease.

Moreover, because each day of the menu included different amounts of the 24 herbs and spices, exposure was not consistent. As herbs and spices do not stay in the system for very long, the food consumed during the days closest to testing may have influenced the results more strongly.

Dr. Simon Steenson, a nutrition scientist at the British Nutrition Foundation, told MNT, This study suggests there could be potential benefit in terms of blood pressure reduction for including more herbs and spices within our diet.

However, he continued, the effects seen were small and not significant between all levels of intake. While the authors suggest there may be some benefit to including herbs and spices in a suboptimal diet, clearly, the aim from a public health point of view must be to improve dietary patterns in line with evidence-based guidance on diet and health.

Prof. Kris-Etherton said to MNT, It will be important to evaluate the effects of individual spices on blood pressure and to understand the mechanism[s] by which each lowers blood pressure.

It would also be interesting to assess the effects of herbs and spices on the microbiome and evaluate whether the effects of herbs and spices on [blood pressure] are modulated by any changes in the gut microbiome.

Beyond clinical trial research, studies are needed to evaluate effective education programs that teach use of herbs and spices in a healthy dietary pattern that is lower in sodium, saturated fat, and added sugar on diet quality and clinical endpoints, such as risk factors for chronic diseases.

Dr. Steenson concluded:

It is important to note that while the aim of this study was to look at the average American diet, we need major shifts in average dietary patterns to make our eating habits healthier and more sustainable. While certain foods or ingredients may have a small benefit alone, we need to encourage a shift to healthier eating across the board.

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Hypertension: Could herbs and spices lower blood pressure? - Medical News Today

UFC Vegas 43’s Terrance McKinney Shares How Weight Issue Fast-Tracked Career – Cageside Press

Posted: November 19, 2021 at 1:59 am

Flashback to 2019 and Terrance McKinney was not where he wanted to be in the MMA world. Sure, he had turned his live around in a well-documented story of perseverance that is one of the best told stories of all time. However, he had lost his chance to get to the UFC with a loss on the Contender Series to Sean Woodson. He then followed that up with a loss to Darrick Minner at Midwest CF 18.

Despite running into that tough luck and not being able to find a fight in 2020 largely due to the pandemic the spirits of McKinney were still high. He knew that it might not be long before he turned that corner.

I knew I was close. I got on Contender Series and I saw the guys that I lost to were winning in the UFC. So, you know, it helped me stay in good spirits and let me know Im right there, McKinney explained, noting the changes leading into the incredible run this year. Im just being more humble and giving my opponents the respect.

That change in mentality has been huge for McKinney. In 2021 he rattled off three quick knockouts that put him right back on the UFCs radar. He followed that up with a knockout over Matt Frevola in his debut in just seven seconds.

Although he attributes some of the turnaround to the change in respect for his opponents, he feels that a change in weight was just as vital to his newfound success.

Also, going up a weight [Im] thinking about my health more than how big I was at 145lbs, he shared. I was already kind of growing. I could never get below 146lbs any time I made it. I knew eventually that Im not going to be able to make this weight and then it happened sooner than I expected.

It happened all too quickly before the Darrick Minner fight. Knowing that he was having issues getting down to the contracted featherweight limit, he and Minner agreed on a catchweight. From there, is was lightweight or bust for McKinney.

That all turned out to be a blessing in disguise. The weight miss made him feel like he had to go up a weight class, and McKinney feels like his choice to go up to 155lbs brought him all the power and energy he needs to knockout each of his last four opponents and perhaps the next one as well. Unlike other fighters, though, McKinney did not make this bulk intentionally.

I just got bigger out of literally nowhere, to be honest. I just started lifting this fight camp, McKinney admitted. I went to the PI and they told me all the stuff that I need to do, and I know this is my job now.

Its a scary prospect to know that McKinney is now getting even stronger. With some more muscle behind those devestating hands, theres a chance well see yet another quick finish at UFC Vegas 43 this weekend. His bout with Fares Zaim will air as part of the ESPN+ prelims, which start at 3pm EST.

You can catch the entire audio of this interview at 2:33.

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UFC Vegas 43's Terrance McKinney Shares How Weight Issue Fast-Tracked Career - Cageside Press

Anti-trans sports bills: Protecting women or discrimination? – The Current – The Student-Run Newspaper of Nova Southeastern University.

Posted: November 19, 2021 at 1:59 am

In June, Gov. Ron Desantis signed into lawthe Fairnessin Womens SportsAct, a bill that makesathletesinK-12womenssportsineligible to compete if they were not assignedfemale at birth. Atitssigning, Desantis said,In Florida, girls are going to play girl sports and boys are going toplay boysports, echoing age-old transphobic rhetoric.Texas State Rep. Valoree Swanson, who introduced House Bill 25,which works ina similar wayto the Florida bill and was recently passed by Gov. Greg Abbottsaid,House Bill 25 is one of the greatest victories for equality for girls since Title IX passed 50 years ago.

But do these laws actuallyguaranteesome sort of fairness in sports and is there any biological advantage for trans women to begin with?

Valerie Starrattisa professor in thedepartment ofpsychology andneuroscienceat Nova Southeastern Universityandspecializesin evolutionary psychology and sexual conflict.

The things that people say are the reason why they implement these bills, I dont think always necessarily coincides with the real motivation behind it, and I dont think, always necessarily coincides, Starratt said.

Although thelaws are advertised to be about fairness, thereal issue regarding trans women in sports is all about hormonesand how they affect the human body.

From the biological perspective, the issue is not actually male, female or otherwise. The issue is people who live in bodies that have been affected by testosterone and people who live in bodies that have not been affected by testosterone,saidStarratt.The developmental effects of testosterone cannot just be undone.

There are certainreportedadvantages that fully developed trans women who transition later in life have asopposedto those who transitionprepubescentlyorcisgenderwomen.According tothe academic journalCurrent Sports MedicineReports 2016 article titled Beyond Fairness:The Biology of Inclusion for Transgender and Intersex Athletes.

There are a number of sports where anatomical and biological features, such as size, muscle mass, and even lung capacity would be an obvious advantage,the article states.

However,according toa studyperformedby Louis J G Gooren and Mathijs C M Bunck in 2004,going on hormone replacement therapy for about a year puts testosterone and hemoglobin levels for trans womenat around the same level for cisgender women.A 2019 study from Endocrine Reviews found thatMTF trans people reported a loss of muscle mass, an increase in fat mass, and a decrease in bone mineral density.

Potentially due to datasimilar tothis, in2015the International Olympic Committee allowed transgender athletes to compete in the Olympics afteronlyone year of hormone replacementtherapy.

Even though the dataright nowshows that biological differences in adult trans athletes are minimal,these bills are targeted at trans children and teenagers, who have had little to noeffectsof long-term testosterone.

Ifweretalking about prepubescent athletes,theresno effect of testosterone.Theresno differenceofadvantage or disadvantage, its irrelevant. It only becomes relevant when you see the effects of testosterone or not. said Starratt.

This raises questions about if these bills willfacilitateanti-trans discrimination, something thatZachary Scalzo,adjunct professor of gender studies at NSU,saidhas already begun.

If you start on a gender affirmative path like hormone therapy early or prepubescent then it mitigates a lot of the physiological changes that a lot of these laws are focusing on as the clear biological advantage, said Scalzo, adding that, regarding discrimination, We also have totake into accountthings like school environments have often facilitated lots of anti-trans bullying and behavior and aggression.

The focus on sex assigned at birth instead of gender also encourages a dangerous discourse for public schools.

Researchfromthe University of Oxford in 2018 found thatwhen132 college studentsarepresented withinformationthat either bases gender on sex or social terms, the students who receiveda social view of genderwere more opentoviewing trans women as women but students who received thesex-based information were more likely to see trans women as men, saying that, ultimately, The findings suggest that essentialist claims that ground the male/female binary in biology may lead to more transprejudice.

According to Scalzo, these bills are insisting that in some way trans women are not real women and just shouldnt be able to engage in public forum practices,adding that we are also now expanding this to be an act of aggression on gender variant minors.

According toCurrent Sports Medicine Report, when discussing the concept of gender, a surveys respondentsoverwhelmingly agreed thatan athlete gender wasa suitable replacement for male/female binary sports. For those who disagreedwith the proposal, their main argument was that biological differences between males and females remained even after the transition.

As for now, the bills stand in the states previously mentionedand other, but the debate surrounding transathleticsis far from over.

I think the billsare further confusing what gender actually is,said Scalzo.

Related

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Anti-trans sports bills: Protecting women or discrimination? - The Current - The Student-Run Newspaper of Nova Southeastern University.

Codoxo, Platinum Sponsor, to Present at the NHCAA Institute for Health Care Fraud Prevention’s Annual Training Conference – WFMZ Allentown

Posted: November 19, 2021 at 1:59 am

ATLANTA, Nov. 16, 2021 /PRNewswire-PRWeb/ -- Codoxo, a trusted provider of healthcare artificial intelligence solutions for healthcare payers and agencies, will be presenting at the NHCAA Institute for Health Care Fraud Preventions's Annual Training Conference on Thursday, November 18 at 2:30 p.m. Eastern Time. Codoxo, a Platinum Sponsor for the virtual event, is thrilled to support one of the industry's most important healthcare anti-fraud events, as it serves to provide attendees training, industry trends, emerging schemes, and critical investigative skills.

Codoxo's Derik Ciccarelli, Healthcare Fraud Analyst will present "Detect the Undetected: Using AI & Data Analytics to Identify Previously Unknown FWA Schemes." The session will highlight the journey one non-profit health payer took to AI-based fraud detection and how they leveraged Codoxo's AI platform to identify and investigate previously unknown fraud schemes, including testosterone replacement therapy (TRT). Attendees will learn how this particular FWA scheme significantly impacted patient safety and created a projected risk exposure of over $2.2M over an 18-month period. Ciccarelli will provide practical insights into the data, codes, and analytics that helped to detect this outlier provider behavior and the investigation process that followed for rapid intervention.

"Codoxo is working very closely with its health payer and agency clients each day to execute some of the most innovative AI solutions available to the industry and we are pleased to share that story with NHCAA attendees and spotlight the stellar work of this special investigations unit," stated Musheer Ahmed, Codoxo's Chief Executive Officer.

Codoxo is a member of NHCAA and has a stated mission "To make healthcare more affordable and effective for everyone." Through it's Forensic AI Platform and Healthcare Integrity Suite, it is disrupting the cost containment and payment integrity space by implementing the most innovative AI available to reduce fraud, waste, and abuse for health payers and agencies.

To find out more about Codoxo and its presence at the annual NHCAA Institute for Health Care Fraud Preventions's Annual Training Conference, please visit https://www.codoxo.com.

About Codoxo

Codoxo is the premier provider of artificial intelligence-driven applications that help healthcare companies and agencies identify and act to reduce risks from fraud, waste, and abuse. Codoxo's Healthcare Integrity Suite helps clients reduce risks and costs across network management, clinical care, provider education, payment integrity, and special investigation units. Our software-as-a-service applications are built on our Forensic AI Platform, which uses a patented algorithm to identify problems and suspicious behavior earlier than traditional techniques. Our solutions are HIPAA-compliant and operate in a HITRUST-certified environment. For additional information, visit http://www.codoxo.com.

Media Contact

Ronda Duncan, Codoxo, 8472549782, rduncan@springmarketinggroup.com

SOURCE Codoxo

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Codoxo, Platinum Sponsor, to Present at the NHCAA Institute for Health Care Fraud Prevention's Annual Training Conference - WFMZ Allentown

Kim Jong-kook truly unnatural? What does science say? – The Korea Herald

Posted: November 19, 2021 at 1:59 am

Singer and entertainer Kim Jong-kook has enjoyed over two decades of success in TV and music. But the 45-year-old recently made headlines for something other than his voice: his workout routine.

Controversy broke out one faithful Halloween to spook fans of the beloved TV personality, when a fitness YouTuber named Greg Doucette called him out for likely not being natural when working out to build his body.

Is he natural? Of course not! Doucette said in his video. He added that he thought it was not likely that Kim was using performance-enhancing drugs like anabolic steroids, but rather hormone replacement therapy like Doucette himself. HRT has been found to be effective at reversing the aging effects on muscles.

Doucette, a bodybuilder and powerlifter, appears to know what he is talking about when it comes to workouts with PEDs. In 2014, it was reported that Doucette was fined by the Canada Border Services Agency $50,000 for smuggling and distributing anabolic steroids, and that a 2010 search of his Halifax home found $250,000 worth of steroids and steroid distribution materials, along with 56 envelopes containing raw testosterone powder.

The Canadian bodybuilder admitted on Instagram in 2020 to using steroids in the past and said he was on HRT, both then and now. And now, he is accusing Kim, one year his junior, of doing the same as he is doing to compensate for his aging body -- that he is not natural.

In bodybuilding, being natural generally refers to not having been enhanced by any means other than working out, eating right, getting sufficient rest and protein supplements. A lot of the times it refers to not adding male hormones via artificial means. Obviously, this rules out PEDs and HRT, although the implications of using the two methods are not the same among bodybuilders.

The focal point of the dispute is simple: Is it feasible for a 45-year-old man to have a body like Kims without taking a shortcut?

Kims bodyThere can hardly be any dispute that Kim has a phenomenal body. In 2018, Kim -- one of the main cast members of SBS My Little Old Boy -- took an InBody scan as part of a routine health checkup. He stood 177.4 centimeters tall, weighed 81 kilograms and his body fat was 8.5 percent.

To put that into perspective, the American Council on Exercise says athletes are normally in the 6-13 percent range, fit people are 14-17 percent and 18-24 percent is considered acceptable. It was reported in 2018 that then 33-year-old Cristiano Ronaldo, one of the biggest soccer superstars in the world, had 7 percent body fat.

Kims skeletal muscle mass was measured to be 42.8 kilograms. In short, Kim has an athlete-level body by any standards.

The controversy stems from Doucettes argument that it is highly doubtful Kim is a natural athlete, based on the fact that the body does not keep growing with age and that male hormones decrease over time.

Nobody beats Father Time, but for how long can he be hoodwinked?

Deterioration of body over time

There have been amazing individuals in sports world who seemingly defy the test of time. Tom Brady, arguably the greatest quarterback of all time, was Super Bowl MVP in 2020, six months before he turned 43. Karl Malone, who had become the oldest NBA MVP ever at almost 36, was reported in 2013 to still be retaining his playing weight by working out three hours a day at the age of 50.

Brady and Malone have never been officially accused of PED use -- save a few blind allegations that they could not possibly be that fit at that age -- but even so, one could say they are the exception, not the rule.

Professor Yoon Joon-shik of the rehabilitation department at Korea University explained that among the deteriorating effects that accompanies aging is sarcopenia, defined by the loss of muscle mass and strength with aging. Korean Longitudinal Study on Health and Aging found sarcopenia to be prevalent among 16.7 percent of the male population above 65 in Korea, and 5.7 percent of the same female population.

It usually manifests after 40, and becomes one of the biggest (health) issues around 50 or 60. Its not just the loss of muscles, but also the accompanying changes in hormones and give effects on related organs, Yoon explained, adding that working out is the most common advice he would give patients.

But he stressed that age alone would not be enough in determining a persons physical condition as the age when ones body breaks down differs for everyone. Sarcopenia is likely to manifest later in a body of a person who has taken great care of his or her body. It would help to test ones strength, cardiopulmonary function and to be aware of the hormonal level changes within ones body.

Hormone levels are another issue. The general clinical opinion is that testosterone, the primary sex hormone in males, usually start declining around age 30 at rate of 1 percent per year.

Juiced up athletes

But Kim has a famously high testosterone level. In the aforementioned SBS show, it was revealed that Kims total testosterone was 9.24 nanograms per milliliter, which was considered very high for a man his age -- 42 at the time -- since the average figure for a man was 2.7-10.7 ng per mL, according to Severance Hospital in Seoul.

In a video Kim uploaded to his YouTube channel Friday, a blood test at a local hospital found Kims total testosterone levels to be 8.38, a lower figure than three years ago, but still very high for his age.

While it is clear Kims body is flowing with male hormones, the dispute is over where they came from. One of the most notable smoking guns in doping tests is actually low -- not high -- testosterone levels.

In 2017, one of the top UFC fighters of his generation, Jon Jones was tested to having abnormally low total testosterone levels. The samples collected on Dec. 4 showed results of 0.59 ng per mL and 1.8 ng per mL. But a test on samples collected Dec. 18 tested at 4.9 ng per mL.

He tested positive for Turinabol, an anabolic steroid in an early drug test, although he stated that he did not knowingly take any prohibited substances. He received a 15-month suspension.

Not judging the validity of Jones case, the extended use of anabolic steroids and other PEDs can have long-term deteriorating effects on testosterone levels. In laymans terms, injecting steroids will pump up your testosterone in the short term, but your body will get lazy and stop producing them over time.

In a Q&A session with a local newspaper, endocrinologist Jung Yoon-seok of Ajou University said that consistent exposure to large quantities of steroids can suppress hormone production inside the body. He was further quoted as saying that abusing such substances can affect the bodys capacity to maintain homeostasis -- the state of the internal, physical and chemical condition -- which can be very difficult to repair.

But Kims high testosterone levels are exactly the opposite of this case, although his accusers claim this is also unnatural because of his age.

Kim looks natural, but doubters doubtDoucette has said from the beginning that Kim looks 100 percent natural, but that is unlikely because nobody can grow forever. Kim has claimed that his weight has not varied beyond 1 or 2 kilograms for the last 15 years, showing he hasnt grown forever.

Urologist and YouTuber Lee Yeong-jin, who runs a clinic in Daegu, posted on his channel a video saying that a man in his 40s with a testosterone level of 9.24 is perfectly feasible. If ones hormone (testosterone) levels were to increase because of drugs, the figure would be ridiculously high or low, not within normal range like Kim, he said in his video.

There is no substantial evidence as of now that ties Kim to ever using HRT or steroids, but it would still be a tall order convincing everyone he is natural. This is from the simple fact that it is nearly impossible to prove a lifetime of PED non-use, despite how thorough the testing is.

Upon the accusations, Kim went out and immediately tested his blood to find that he had 99.4 micrograms per deciliter of dehydroepiandrosterone sulfate, the endogenous androstane steroid. The typical male range is 80-560 micrograms per deciliter, which puts Kims figures within the normal range.

This contrasts from the aforementioned Jones, who tested at 2.1 micrograms per deciliter, significantly lower than the male average.

But even this would not be definitive proof, as it is possible to also inject DHEAS for medical purposes.

Another suggestion would be to test his epitestosterone, as the testosterone to epitestosterone ratio is used as an important barometer for screening PED use. But even this can be faked, as athletes sometimes take synthetic epitestosterone to equalize the ratio.

Kim has expressed his willingness to take every drug test available and said he is currently taking necessary steps to do so. And while a great many people believe in what they perceive to be his earnest attitude toward working out, it is highly likely there will always be doubters regardless of the medical proof. No test covers a lifetime, at least not with todays technology.

Kim himself said it best, People are going to believe what they want to believe anyway. The controversy, after all, started without any presentation of scientific proof.

By Yoon Min-sik (minsikyoon@heraldcorp.com)

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Kim Jong-kook truly unnatural? What does science say? - The Korea Herald

Gender-Affirming Care: What It Is and How to Find It – Livestrong

Posted: November 19, 2021 at 1:59 am

Gender-affirming services have evolved quite a bit in the last 50 years, but we still have a long way to go.

Image Credit: LIVESTRONG.com Creative

From "genderqueer" to "gender-affirming care," the newest terminology in the LGBTQ+ community does much more than slap a new label on an old idea. The words we're now using to identify patients and their health care needs show that the goals of care providers are becoming more closely aligned with the needs of transgender and gender-nonconforming people.

The best part? Gender-affirming care isn't just helping a small fraction of the population; it's making health care better for everyone.

What Is Gender-Affirming Care?

Gender-affirming care describes an array of health services that alleviate the suffering associated with gender dysphoria, defined in the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as clinically significant distress or impairment related to a strong desire to be of another gender.

But gender-affirming care is more than hormones and surgery. "At its core, it's about seeing the whole person, affirming them exactly as they are," J. Aleah Nesteby, nurse practitioner, former director of LGBTQ services for Cooley-Dickinson Hospital and a clinician and educator with Transhealth Northampton, tells LIVESTRONG.com.

Gender-affirming care isn't just a new way to say "sex change." And that's important, because how trans and gender-nonconforming people's identities and experiences are named and described reflect our broader cultural values of diversity, equity of access and consent.

While language like "sex reassignment" or "gender-confirmation surgery" used to be accepted, today it is recognized that sex assignments at birth are an unscientific guess at best, and that only the individual can confirm their own gender. We don't know everything there is to know about gender, but we know it is evident in early childhood, and no amount of therapy or conditioning can change a person's innate sense of their gender, according to a landmark article in the March 2006 issue of the OAH Magazine of History.

Gender-affirming care allows a patient to change their sex characteristics, bringing their minds and bodies into greater alignment, while continuing to receive a lifetime of competent care from providers who recognize that the challenges people who are trans and gender-nonconforming or nonbinary (TGNC) face are not just medical, but social. This type of care goes far beyond treating dysphoria to acknowledge the physical differences of postoperative bodies and the stress of living with transphobia.

More than 50 years after the first gender clinic (that is, a center that provides transition-related services) opened its doors, gender-affirming care is no longer experimental. The June 2017 issue of The Journal of Sex and Marital Therapy describes it as the best, most effective treatment for gender dysphoria.

The authors behind a March-April 2021 paper in The International Brazilian Journal of Urology agree, adding that gender-affirming care enjoys a very high rate of patient satisfaction. According to the most recent World Professional Association for Transgender Health (WPATH) Standards of Care (SoC), published in 2012, satisfaction rates range from 87 to 97 percent and regrets are rare, topping out at just 1.5 percent.

Who Needs Gender-Affirming Care?

As we mentioned, gender-affirming care directly benefits people with gender dysphoria. About 44 million people worldwide have a diagnosis of gender dysphoria, according to The International Brazilian Journal of Urology paper mentioned above. But estimates like these likely underreport the true figures, according to WPATH.

In previous editions of the DSM, the desire to be of another gender was described as a disease doctors were meant to cure; but today, we embrace a diversity of gender identities as healthy and normal. Still, gender dysphoria can cause distress or impairment, and a person with the condition may want to change their body's primary and/or secondary sex characteristics through hormones, surgery and other procedures.

In the U.S., there are about 1 million TGNC people, a number that is expected to continue rising, according to the January 2017 issue of the American Journal of Public Health. But not everyone who is TGNC wants or needs gender-affirming services.

That's because a diagnosis of gender dysphoria is completely separate from a person's gender identity or sexual orientation. Transgender people, for example, have a gender identity or expression that's different from the sex they were assigned at birth. But that doesn't automatically mean they want to change their sex characteristics, or that this difference causes them the stress or impairment marked by gender dysphoria.

Similarly, people who do not feel strictly like a man or a woman all the time might identify as nonbinary, gender-nonconforming, genderqueer or with another label to describe their gender. Nonbinary people (also called "enby" or "enbies") are a fast-growing demographic, making up about 35 percent of the trans community, according to the June 2019 issue of Translational Andrology and Urology. Like men and women, enbies can be straight, gay, bisexual, asexual or identify with another sexual orientation. And like other trans people, enbies may seek gender-affirming care, or they may not.

For people who do want gender-affirming services, though, this approach to treating gender dysphoria has been overwhelmingly successful, and has been the standard of care for more than 30 years.

Gender-Affirming Care Is Patient-Centered Care

The first U.S. gender clinics only accepted patients who would complete a social, legal and medical transition that resulted in a perfect binary: a heterosexual man or woman who "passed" as such in society, and who retained no reproductive capacities associated with the sex assigned to them at birth.

Retention of reproductive capacity is a human rights issue. In the past, certain areas of the country and some clinics and private practices had policies that required transgender people be sterilized before they were issued corrected documentation of their sex or access to gender-affirming care. These policies are now recognized as a serious breach of human rights.

But obstacles to getting corrected legal documents still exist in some states, and there are medical providers who still insist on sterilization before performing reconstructive genital surgery. Yet patients are pushing back, and finding surgeons who will work with them to achieve outcomes that treat symptoms without sacrificing fertility.

James, who first sought gender-affirming care in 2001, wanted to keep his options open. (Several of the people LIVESTRONG.com interviewed for this story asked to be identified by their first names only for privacy reasons.) Now married, he and his wife are using reciprocal in-vitro fertilization (IVF) to grow their family. In this process, an egg from James is harvested and fertilized using donor sperm; the resulting zygote is implanted in his wife's uterus. James has already gone through one successful round of egg retrieval. If all goes well, his wife will experience a normal, healthy pregnancy, and both parents will have a biological connection with their child.

IVF technology has been available for more than 40 years; the innovation is in putting a high priority on James' desired outcomes from gender-affirming treatment. Under the model of care most doctors used to be trained in, medical experts would assess James, diagnose him and decide how to treat him, all without asking him what he wants.

In the informed consent model, on the other hand which is the backbone of gender-affirming care communication between patient and physician is intended to allow the patient to make educated choices about their care. This approach isn't just for TGNC patients: Informed consent increases patient satisfaction across the board. "Over time, most of the prescribing world has caught up to the informed consent model, and now it's seen as the standard of care," Nesteby says.

"Fifteen years ago when I entered practice, the bar was so low for providers in terms of who was considered good and trans competent," Nesteby says. "Now, expectations have changed. Patients, especially younger people, expect providers to talk to them about their options, including what's outside the typical standards of care."

Joshua Tenpenny's experience with gender-affirming care illustrates this point. Tenpenny is a massage therapist who lives as a man and identifies as nonbinary. When he sought genital surgery years ago, he wanted a nonbinary outcome neither male nor female so he looked for a surgeon who was open to an experimental approach, he tells LIVESTRONG.com.

The initial procedure was not entirely successful, and the surgeon was reluctant to perform a revision, but Tenpenny says he may try again in the future with another provider to achieve the results he envisioned. All procedures come with risks of complications and failure, and despite the outcome, Tenpenny found that not being confined to a small menu of options for bottom surgery has been an empowering experience.

The History of Gender-Affirming Care in the U.S.

The concept of gender-affirming care first reached most Americans in 1952 when Christine Jorgensen's transition from male to female made headlines. The first gender clinic in the U.S. opened in 1966 at Johns Hopkins. Backed by the most influential professionals in transgender care, the Harry Benjamin International Gender Dysphoria Association today the World Professional Association for Transgender Health (WPATH) became the standard-bearer in the early 1980s.

But through the '80s and early '90s, seeking gender-affirming care continued to be an isolating experience, with cruel barriers like the "real-life test," in which people with gender dysphoria were only allowed to access hormones and surgery after six months, a year or longer living successfully in the target gender. For trans people who did not pass, the dangers of the real-life test ranged from harassment, unemployment and homelessness to violence and death.

Today, trans people are rewriting the standards for their own care. The WPATH Standards of Care, which have been broadly adopted worldwide, are in their seventh edition. Authors of the most recent version and the current board of WPATH include trans professionals: people who have a TGNC identity as well as cultural competency and expertise in the medical care of TGNC people. Even more significantly, stakeholders in gender-affirming care TGNC people, their families and their caregivers are changing health care for the better, making it easier to access and using informed consent to customize treatment to a patient's individual needs.

These changes are allowing people like Ian, who identifies as nonbinary, to receive the care they want. "When I first learned that the Standards of Care had been updated to include nonbinary people back in 2013, I made an appointment at Fenway Health in Boston in the hope of starting HRT [hormone replacement therapy]," Ian recalls. "I'd known that I was genderqueer and wanted to go on T since 2001, but I hadn't been willing to lie about my identity by pretending to be binary trans to obtain it."

Still, past versions of the SoC continue to influence the law, health insurance practices and guidelines developed by health care providers. Levi Diamond, a 43-year-old trans man, was recently told by surgeons that they would not perform top surgery on him (to alter the appearance of his chest) until he had lived a year in the male role. The current SoC criteria for mastectomy and creation of a male chest in transmasculine patients make no mention of a real-life test, but some providers crafted their own guidelines years ago, based on older versions of these standards, and have not updated their policies to reflect advances in care.

Similarly, Katy sought gender-affirming care after learning she was born with Klinefelter syndrome, a chromosomal difference of sexual development. Genetically XXY, people with Klinefelter syndrome are assigned male at birth. The signs of having an XXY karyotype versus the more common XY for boys can be subtle and difficult to discern, and those with Klinefelter syndrome are frequently unaware of their genetic difference from XY men and boys.

After a karyotype test confirmed her doctor's diagnosis, Katy was referred to an endocrinologist. Male hormones are often prescribed to treat symptoms of Klinefelter syndrome, but Katy asked for a prescription for estrogen. Disregarding her request and focusing on her intersex diagnosis, Katy's endocrinologist prescribed her testosterone. By doing so, he exemplified the bias many trans people encounter in seeking care, and the limits of the "pathology" model of care.

After nine months on testosterone, Katy was more certain than ever that male hormones were not for her. Years later, she found a more patient-affirming health care provider and began feminizing hormone therapy, a decision she knew was right within days of beginning treatment. Now 50, Katy has had four gender-affirming surgeries.

Innovations in Gender-Affirming Care

Both acknowledgment by the medical profession that gender-affirming care is medically necessary and laws preventing discrimination against TGNC people have led to an increase in gender-affirming services, according to a February 2018 article in The Washington Post. Coverage by health insurance has created greater access to care, which has also driven demand. The growing market has led more professionals to specialize in gender-affirming services, and more procedures have led to improvements, making treatments safer. Surgical results are also more aesthetic and more functional.

The typical order in which gender-affirming care is applied mental health services before HRT, then chest surgery, and finally, lower surgery has not changed, but protocols have evolved, and the sequence is more flexible in patient-affirming care models that use informed consent and harm reduction.

Usually, someone with gender dysphoria begins gender-affirming care with a mental health professional who diagnoses them and helps them decide on priorities and address concerns related to the next phase of treatment. Patients may be referred for hormone therapy in coordination with mental health treatment, or they may be assessed and prescribed by a physician.

It's a common misconception that gender-affirming care must be handled by a specialist. "A lot of people think you need to see an endocrinologist to be on hormones," Nesteby says. "It's not necessary for every person. A lot of cases can be managed in primary care." She compares HRT to diabetes care, which is typically handled by primary care providers.

About 80 percent of TGNC people will seek HRT, according to Jerrica Kirkley, MD, co-founder and chief medical officer of Plume, which provides gender-affirming care using telemedicine in 33 U.S. states. HRT in TGNC patients usually involves administering estrogen, testosterone and/or hormone blockers to achieve blood levels typical among cisgender people.

In the late 1960s, transgender patients were warned their surgical outcomes from what's collectively called "lower surgery" or "bottom surgery" would not resemble the genitals of cisgender women and men. For trans women, a vagina that could be penetrated by a penis was considered the only functional goal of surgery. By contrast, in the November 2013 issue of Sexual and Relationship Therapy, researchers note that patient satisfaction is now a well-accepted tool for measuring whether a health care service has been successful.

By the late 1980s, surgeons offered vulvoplasty creation of the labia and clitoris and were able to preserve sensation in the new structures. In recent years, the surgical results of transfeminine vaginoplasty closely resemble the cultural ideal, and 80 percent of trans women surveyed were orgasmic following lower surgery, The Journal of Sexual Medicine reported in February 2017. In Plastic and Reconstructive Surgery in June 2018, it was reported that 94 percent of one surgeon's patients, treated over a 15-year period, were pleased with the results overall and would repeat the procedure.

Bottom surgery for trans men has also come a long way. There are two general categories: metoidioplasty and phalloplasty. The former takes advantage of the physical changes caused by testosterone therapy, which include the growth of the clitoris (the analogous organ to the penis). This larger clitoris becomes a penis that retains sexual function and sensitivity but may be too short for penetration. The latter creates a penis using a graft taken from the forearm, thigh or abdomen, which looks and functions like that of a cisgender man but doesn't always retain sensation.

In an article in the May 2021 issue of The Journal of Sexual Medicine on patient satisfaction with transmasculine lower surgery, two-thirds were satisfied with the appearance of their genitals after surgery, but only one-third were satisfied with sexual function. However, 82 percent were happy with the effects of the operation on their masculinity.

Chest or "top surgery," sought by up to a quarter of people with gender dysphoria, has been about twice as common as lower surgery among patients seeking gender-affirming care, according to the Translational Andrology and Urology article. Today, there are methods available to retain greater sensation and result in less scarring for chests of all sizes.

Besides "top" and "bottom" surgeries, other procedures for masculinizing or feminizing the appearance to reduce gender dysphoria include facial feminization surgery (FFS), which is a category of aesthetic procedures including hairline correction, rhinoplasty and jaw reduction. Hair removal, nipple tattoos, vocal training, facial masculinization surgery, liposuction and other cosmetic procedures may also help treat gender dysphoria.

Hair removal has emerged as a critical gap in access to care for people using health insurance to pay for lower surgery. It is medically necessary preoperative treatment, delivered by a licensed professional. In a catch-22, though, hair removal has traditionally been offered in clinics that do not accept health insurance, because their services have not been covered in the past. "No one was credentialed to get covered by insurance," Nesteby explains. "Now you have this necessary service, but people are still having to pay out of pocket. That's been an access issue we only realized after insurance started covering surgery."

How to Access Gender-Affirming Care

The people who responded to interview requests for this article reported starting their search for gender-affirming care with a primary care physician, or through a clinic for underserved sexual minorities. Callen Lorde in New York City, Lyon Martin in San Francisco and Tapestry in Greenfield, Massachusetts, all came up in interviews. "I had an excellent experience with the Equality Health Center in Concord, New Hampshire," Ian says. "EHC offers informed consent as an access protocol for HRT. This fit well with my personal goals and preferences."

A major hurdle in accessing gender-affirming care is that, often, finding one educated and trans-competent provider isn't enough, because TGNC people need a lifetime of treatment.

For example, if a patient has surgery at a center hundreds of miles away, then experiences a complication after returning home, local emergency medical service providers must understand the treatment the patient has received and how his body differs from their expectations in order to properly care for him.

Similarly, trans women who have had vaginoplasty need urological and gynecological services that are different from the care appropriate for a cisgender man or woman. Yet both patients and physicians have reported a lack of provider competence, per an August 2021 paper in the Journal of Gynecologic Surgery.

Using a clinic whose mission is to serve the transgender community does not guarantee competent care either. In fact, one interview subject treated by a big-city provider focusing on the TGNC community routinely felt they mismanaged a common side effect of HRT, causing him distress when his dysphoric symptoms returned. Rather, gender-affirming care can come from small towns, family doctors and providers who don't specialize in TGNC care.

But it takes more than good intentions to provide appropriate care: It requires ongoing medical and cultural competency training. Many patients rely on word of mouth, transgender community message boards and online directories to find competent providers. A directory of transgender-aware care providers is available through the WPATH Global Education Institute, which offers a 50-hour training program to its members. (Patients can search for WPATH members who are care professionals here.)

"Gender-affirming services have evolved quite a bit in the last 50 years, but there's still a great lack of access," Dr. Kirkley says. "Primary care is improving, but there is no standardized curriculum of gender-affirming care in medical schools, nursing schools and public health programs. We still have a long way to go."

More recently, in the age of COVID-19, telemedicine is helping to close another gap in access: geography.

"Virtual care has changed the dynamics of all health care dramatically," Dr. Kirkley says. Insurance began to routinely cover telemedicine during the novel coronavirus pandemic, making trans-aware providers available to patients who would not have otherwise been able to access their services. "Before COVID there was a lot of doubt [that telemedicine is effective], but [the shutdown] has really validated the model. As an innovation in health care delivery, it has enabled Plume and other providers to provide gender-affirming care."

Still, the changes that have come with gender-affirming care benefit more than the TGNC community. People in all walks of life can appreciate the greater access telemedicine brings and the revolution in patient-centered care.

"I think that one of the benefits that cisgender, heterosexual people don't see about gender-affirming care or trans visibility is that it helps everybody," Nesteby says. "It's not only trans people who suffer from rigid boxes we put people in. When we don't force people into binaries, everybody wins."

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Gender-Affirming Care: What It Is and How to Find It - Livestrong

Senior Weight and Ways to Work it Off

Posted: November 8, 2021 at 2:14 am

Image from Pixabay

Seniors experience a host of physical changes that can affect their overall health and well-being. With age, metabolism begins to slow and the body doesn’t burn quite as many calories as it did in previous years. The digestive system may be unable to utilize the nutrients in many common foods. For many seniors, aches and pains may prevent intense physical activities. All of these factors combined contribute significantly to obesity in the 65-plus crowd.

While it may be more difficult, it’s still possible to lose weight despite advancing age. Later, we’ll highlight a few diet and exercise habits that can help seniors shed pounds. But first, Cool Kinetic Beautiful wants you to understand why maintaining a healthy weight is vital regardless of age.

Weight and disease

Obesity is one of the most dominant health crises around the world, with 13% of the adult population tipping the scales with a body mass index of 30 or higher. As Sciencedirect explains, this is problematic. Obesity is a known contributor to diseases such as diabetes, hypertension and pulmonary disease. Furthermore, and especially for seniors, a higher body mass may result in arthritis, a systemic inflammation of the joints that can significantly impede mobility.

Obese individuals have shorter lifespans and a degraded quality of life. In older persons, excessive weight is directly associated with urinary incontinence and visual impairments.

The role of diet and exercise

Diet and exercise are important throughout a person’s life. But these needs change as men and women enter their post-retirement years. Osteoporosis and waning muscle mass can make it more difficult to participate in activities, such as weightlifting and high intensity cardiovascular workouts. However, there remain a number of physical fitness options for seniors.

Swimming, walking and Pilates are among the most viable workouts for seniors. But if you’re not sure where to start, a Silver Sneakers program can be the hot ticket. Available to anyone who has Medicare Advantage or MediGap, this fitness program is typically found in most gyms and even some senior centers. You have access to fitness equipment in addition to a wealth of classes. 

Older people who exercise regularly enjoy greater flexibility, better balance, preserved neurocognitive function, reduced lipids in the blood, better joint health and lower blood pressure. Seniors can look to some technology for some extra fitness motivation. For example, a pair of wireless earphones can help them complete a workout because music can be an excellent motivator. Seniors can also use a fitness tracker to evaluate their progress. 

Exercise and everyday activities require fuel. And for humans, that means food. Unfortunately, we are a society of convenience and tend to gravitate toward fast and processed foods that require less preparation. As previously mentioned, age causes the metabolism to dwindle, making the body less able to properly digest certain types of food. For this reason, as well as to boost overall health, seniors should focus on eating a balanced diet that includes plenty of fruits, vegetables, and whole grains.

At home and on the go

Regardless of age or lifestyle, it is possible to create a healthy routine that includes a balanced diet and exercise without making sacrifices that impede a person’s standard of living. When out at restaurants, for instance, seniors should choose vegetable-based dishes or those that center on fish instead of red meat. Seniors no longer able to transport themselves back and forth to a gym or fitness center may opt for a simple home gym consisting of basic equipment such as yoga mats, resistance bands, dumbbells and other accessories.

A healthy weight looks different on people of different ages and body shapes. A good rule of thumb, however, is that seniors should strive for a body mass index of between 18.5 and 24.9, which is in the normal category. Most otherwise healthy adults will benefit from at least 150 minutes of mild to moderate exercise each week. Dietary needs vary according to age. Seniors should speak with their doctor to determine their unique needs and safest forms of exercise.

Elite HRT Releases Guidance on Lipotropic Injections – StreetInsider.com

Posted: November 6, 2021 at 1:57 am

News and research before you hear about it on CNBC and others. Claim your 1-week free trial to StreetInsider Premium here.

Detailed guide will help you understand if these injections are right for you

LOS ANGELES--(BUSINESS WIRE)--The experts at Elite HRT have published a new guidance on the ingredients and effectiveness of lipotropic injections, which work to break down fat in the body. This free online resource provides information about the various benefits seen from these injections as well as who they may be right for, and who would be unfit to receive them.

The article, reviewed by regulatory affairs specialist Camille Freking, explains that lipotropic injections help to not only induce weight loss, but also improve the health of the integumentary system that supports the skin, hair, and nails. The most commonly known type of these injections is the MIC injection, which stands for methionine, inositol, and choline; these are the primary substances that help to break down the fat. Methionine is an amino acid that acts as an antioxidant to remove free radicals from the body and help the liver to metabolize fat. Inositol is a substance akin to a vitamin that helps break down both cholesterol and fat itself, while Choline is an essential nutrient that helps to produce a hormone that also breaks down fats. Also seen in lipotropic injections are B-12, a vitamin that boosts both energy and metabolism to help both with exercise and healthy eating. There are other essential B vitamins included in these injections as well, including thiamine, riboflavin, niacin, pantothenic acid, pyridoxine, biotin, and folic acid, which all help support weight loss.

Elite HRT notes that lipotropic injections do not cause weight loss, but help facilitate it, meaning that it is still advised to both exercise and diet when working to burn fat from the body. In addition, these procedures can bring side effects such as pain or swelling at the injection site, dry mouth, anxiety, fatigue, allergic reactions, or disruptions to bowel movements. These injections should not be used as a get thin quick method, but instead should be used only with the supervision of a trained medical professional.

About Elite HRT: Elite HRT is a telemedicine firm led by a network of physicians specializing in hormone replacement therapies. With unique approaches to HRT, TRT, HGH, and more, Elite HRT works to tailor solutions uniquely created for specific patients, all at affordable rates. Those wanting to learn more and contact Elite HRT can visit https://www.elitehrt.com/ and submit a contact request form with background information today.

View source version on businesswire.com: https://www.businesswire.com/news/home/20211103005007/en/

Media Contact:Emma LombardiGR0press@gr0.com

Source: Elite HRT

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Elite HRT Releases Guidance on Lipotropic Injections - StreetInsider.com

Will Raiders Crack Under the Weight of Tragedy? Derek Carr Wont Let It Happen – gvwire.com

Posted: November 6, 2021 at 1:57 am

Life has thrown a lot at the Las Vegas Raiders and my younger brother Derek this season.

David Carr

On Football

As the face of the franchise, hes had to answer questions about the forced resignation of coach Jon Gruden. Now hes facing even tougher questions about Henry Ruggs III, who is accused of causing the burning death of a 23-year-old Las Vegas woman by driving his Corvette, while drunk, into her car at 127 mph.

Im confident that Derek is up to the challenge. His strong Christian faith and life experiences have prepared him for these moments. We saw his faith displayed when he said, I love the man, I hate the sin, after Grudens racist, homophobic, sexist emails surfaced.

This week, while acknowledging the tragic death of Tina O. Tinto and the terrible loss to her family, he said of his now-former teammate Ruggs, He needs people to love him right now. If no one else will do it, Ill do it.

I didnt expect him to say anything different.

This situation has hit my brother harder than you can imagine. Thats because he and Ruggs, in his second season with the Raiders, were becoming closer on and off the field. They had been texting Monday evening before the crash and Derek told me that Ruggs said he was having a good time at TopGolf, a Las Vegas sports entertainment venue. He even asked Derek for tips on his golf swing. Nothing appeared to be out of the ordinary.

But, from there, Ruggs made deadly and life-altering decisions that are inexcusable. I think back to my time in NFL locker rooms. The coaches are always warning you about drinking and driving. They almost plead with you to be responsible. And, even if youve had too much to drink, the NFL will get you home safely. All you have to do is text or call.

As compassionate as Derek is, hes also geared for leadership, and that means getting himself and his teammates focused on the Raiders game at the New York Giants on Sunday. Thats how it is in the NFL. You have to compartmentalize because youre constantly switching between real life and your football life.

Im sure people are waiting for the Raiders to crumble under the weight of what theyve already endured seven games into their schedule. I dont see that happening because I know what my brother is made of.

(You can listen to David Carrs podcast with his former New York Giants teammate Mark Herzlich titled The Super Hero Dads at this link.)

Former Las Vegas Raiders wide receiver Henry Ruggs III makes an initial appearance in Las Vegas Justice Court in Las Vegas, Wednesday, Nov. 3, 2021. The team released Ruggs just hours after the crash. (Steve Marcus/Las Vegas Sun via AP, Pool)

Last Sundays results shined a bright light on four clipboard holders who led their teams to victory.

Trevor Siemian, who hadnt started a game in four years and is third on New Orleans depth chart, came in for the injured Jameis Winston and helped the Saints take down Tom Brady and defending Super Super Bowl champion Tampa Bay. Siemian is a cerebral quarterback and he knows exactly what coach Sean Payton wants to do with the football.

Mike White of the New York Jets has been waiting for a chance to show what he can do since Dallas drafted him in 2018. Since joining the Jets, hes been waived and assigned to the practice squad too many times to count.

With first-round pick Zach Wilson injured, White took one look at Cincinnatis vanilla defense and carved it to pieces, completing 37 of 45 passes for 405 yards and three TDs. Coach Robert Saleh instantly made White the starter for the Thursday night game against Indianapolis. That could be a good thing for the Jets and for Wilsons future as he learns by watching White have success by taking what the defense gives him.

You didnt have to be a Dallas fan to love watching Cooper Rush fill in for Dak Prescott and lead the Cowboys past a good Minnesota team. With few people expecting much from him, Rush made some big-time throws with his parents watching in the stands. Rushs performance will raise the Cowboys confidence in him and it might lead to a 10-year career in the league.

Geno Smith has played pretty well for Seattle while filling in for Russell Wilson. Against Jacksonville, he finished 20 of 24 for 195 yards after completing his first 14 passes. The result: a 31-7 victory and a game ball from my NFL Network colleague Nate Burleson, a former Seahawks wide receiver.

Dallas quarterback Cooper Rush (10) was one of four backup QBs leading their teams to victory last Sunday. (AP Photo/Bruce Kluckhohn)

Von Miller isnt as good as he once was, but hes still a guy that can do pretty well against a majority of offensive tackles. For the Los Angeles Rams, the beauty of getting Miller in the trade with Denver, is pairing him up with Aaron Donald and forcing teams to go to great lengths to protect their quarterback.

You put Miller and Donald on the same side in third-and-long and the Rams could drop eight defenders into coverage one of them Jalen Ramsey. Thats a scary prospect for any offense.

Obviously, Millers not the force he once was, but he can still wreck a game.

1. Dallas (6-1) The Cowboys are playing so well they could afford to rest Dak Prescott and still get a win at Minnesota, a tough place to play. This week, they return home to face Denver and figure to make it seven wins in a row. (Last week: No. 4)

2. Green Bay (7-1) The Packers were on cruise control until Aaron Rodgers tested positive for COVID and will miss Sundays game at Kansas City. Now Green Bays front office gets to see if Jordan Love is ready to be a winning quarterback. (Not ranked.)

3. Arizona (7-1) The Cardinals all-in strategy took a hit when they lost J.J. Watt to a shoulder injury. Coming off a 3-point home-field loss to the Packers, theyve got another tough assignment Sunday at San Francisco. (Last week: No. 1)

4. Los Angeles Rams (7-1) Not only did the Rams acquire future Hall of Famer Von Miller, but they host a Tennessee squad that lost running back Derrick Henry to injury. After that, the Rams face SF and Green Bay back-to-back on the road. (Last week: No. 5)

5. Buffalo (5-2) The Bills arent especially sharp right now, but their easy schedule offers them opportunities to clean things up without losing. (Last week: No. 2)

Fell out: Tampa Bay (6-2)

28. New York Jets/Giants (4-11) Thanks to Mike Whites heroics, the Jets actually have a winning record at home (2-1). Question is, can they carry the momentum of their upset win over Cincinnati into the Thursday night matchup against disappointing but talented Indianapolis? The Giants, meanwhile, continue to battle injuries and QB Daniel Jones inability to win games that are there for the taking.(Last week: Jets/Giants No. 28)

29. Jacksonville (1-6) The Jaguars got picked apart last week by Geno Smith. Imagine what Josh Allen will do to them this Sunday. (Last week: No. 29)

30. Miami (1-7) The Dolphins began the season bragging about their defense. After eight games, only the Texans and Lions have surrendered more points. (Last week: 30)

31. Houston (1-7) The Texans have lost seven straight since their opener. But, theres good news heading into their game against Miami. Tyrod Taylor, who completed 71% of his passes before getting hurt, will start at QB. (Last week: No. 31)

32. Detroit (0-8) The 2001 Lions lost their first 12 games under first-year coach Marty Marty Mornhinweg. Could they finish 0-17 under first-year coach Dan Campbell? With this bunch, its possible. (Last week: No. 32)

Escaped the Bottom: None

About the Author

David Carr is a former Fresno State quarterback, NFL No. 1 overall draft pick, and Super Bowl champion. Now hes an analyst for the NFL Network and writing a weekly column in collaboration with GV Wires Bill McEwen. The column is sponsored by Valley Childrens Healthcare.

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Will Raiders Crack Under the Weight of Tragedy? Derek Carr Wont Let It Happen - gvwire.com

3 popular weight loss drinks that don’t really help – Times of India

Posted: November 6, 2021 at 1:56 am

Weight loss is on most people's minds and everyone wants to lose weight quickly. Talking about quick weight loss, many people rely on some popular drinks thinking that it will help them lose extra kilos. But do these drinks really work? Can anything as simple as a drink help you cut fat? Not really. A healthy and sustainable weight loss is the combination of healthy eating and exercising. Simple tricks and tips like detoxifying waters and drinks can only support the process. Here are three very popular weight loss drinks that are not really helping you lose weight.As per a recent post by Dr Siddant Bhargava, When will we stop looking for quick hacks to lose weight? 3 drinks are popularly known for their 'weight loss benefits, which seriously don't work. The only thing that will help you lose weight is being consistent in a calorie deficit".

1. Apple cider vinegarApple cider vinegar has been a popular drink for weight loss. It has various health benefits including taking care of your heart health and reducing your diabetes risk. But talking about weight loss, ACV can not actually help.

ACV can make one feel fuller for longer but it cannot change their body mass index. In fact, its consumption can lead to acidity, digestive issues and oral health problems in many people. It can also react with other medications like laxatives and insulin.

2. Green tea

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3 popular weight loss drinks that don't really help - Times of India


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