Youre one of a kind. Its not just your eyes, smile, and personality. Your health, risk for disease, and the ways you respond to medicines are also unique. Medicines that work well for some people may not help you at all. They might even cause problems. Wouldnt it be nice if treatments and preventive care could be designed just for you?

The careful matching of your biology to your medical care is known as personalized medicine. Its already being used by healthcare providers nationwide.

The story of personalized medicine begins with the unique set of genes you inherited from your parents. Genes are stretches of DNA that serve as a sort of instruction manual telling your body how to make the proteins and perform the other tasks that your body needs. These genetic instructions are written in varying patterns of only 4 different chemical letters, or bases.

The same genes often differ slightly between people. Bases may be switched, missing, or added here and there. Most of these variations have no effect on your health. But some can create unusual proteins that might boost your risk for certain diseases. Some variants can affect how well a medicine works in your body. Or they might cause the medicine to have different side effects in you than in someone else.

The study of how genes affect the way medicines work in your body is called pharmacogenomics.

If doctors know your genes, they can predict drug response and incorporate this information into the medical decisions they make, says Dr. Rochelle Long, a pharmacogenomics expert at NIH.

Its becoming more common for doctors to test for gene variants before prescribing certain drugs. For example, children with leukemia might get theTPMTgene test to help doctors choose the right dosage of medicine to prevent toxic side effects. Some HIV-infected patients are severely allergic to treatment drugs, and genetic tests can help identify who can safely take the medicines.

By screening to know who shouldnt get certain drugs, we can prevent life-threatening side effects, Long says.

Pharmacogenomics is also being used for cancer treatment. Some breast cancer drugs only work in women with particular genetic variations. If testing shows patients with advanced melanoma (skin cancer) have certain variants, two new approved drugs can treat them.

Even one of the oldest and most common drugs, aspirin, can have varying effects based on your genes. Millions of people take a daily aspirin to lower their risk for heart attack and stroke. Aspirin helps by preventing blood clots that could clog arteries. But aspirin doesnt reduce heart disease risk in everyone.

NIH-funded researchers recently identified a set of genes with unique activity patterns that can help assess whether someone will benefit from taking aspirin for heart health. Scientists are now working to develop a standardized test for use in daily practice. If doctors can tell that aspirin wont work in certain patients, they can try different treatments.

One NIH-funded research team studied a different clot-fighting drug known as clopidogrel (Plavix). Its often prescribed for people at risk of heart attack or stroke. Led by Dr. Alan Shuldiner at the University of Maryland School of Medicine, the team examined people in an Amish community. Isolated communities like this have less genetic diversity than the general population, which can make it easier to study the effects of genes. But as in the general population, some Amish people have risk factors, such as eating a high-fat diet, that raise their risk for heart disease.

Many of the Amish people studied had a particular gene variant that made them less responsive to clopidogrel, the scientists found. Further research revealed that up to one-third of the general population may have similar variations in this gene, meaning they too probably need a different medicine to reduce heart disease risks.

The findings prompted the U.S. Food and Drug Administration (FDA) to change the label for this common drug to alert doctors that it may not be appropriate for patients who have certain gene variations. Two alternative drugs have since been developed. If people have these gene variants, they know they have options, says Shuldiner. This is a great example of how study results made it onto a drug label and are beginning to be implemented into patient care.

Getting a genetic test usually isnt difficult. Doctors generally take a sample of body fluid or tissue, such as blood, saliva, or skin, and send it to a lab. Most genetic tests used today analyze just one or a few genes, often to help diagnose disease. Newborns, for example, are routinely screened for several genetic disorders by taking a few drops of blood from their heels. When life-threatening conditions are caught early, infants can be treated right away to prevent problems.

The decision about whether to get a particular genetic test can be complicated. Genetic tests are now available for about 2,500 diseases, and that number keeps growing. Your doctor might advise you to get tested for specific genetic diseases if they tend to run in your family or if you have certain symptoms.

While there are many genetic tests, they vary as to how well they predict risk, says Dr. Lawrence Brody, a genetic testing expert at NIH.

For some diseases, such as sickle cell anemia or cystic fibrosis, inheriting 2 copies of abnormal genes means a person will get that disease. But for other diseases and conditions, the picture is more complex. For Type 2 diabetes, testing positive for some specific gene variants may help predict risk, but no better than other factorssuch as obesity, high blood pressure, and having a close relative with the disease.

The latest approach to personalized medicine is to get your wholegenomesequenced. Thats still expensive, but the cost has dropped dramatically over the past decade and will likely continue to fall. Since your genome essentially stays the same over time, this information might one day become part of your medical record, so doctors could consult it as needed.

You can start to get a sense of your genetic risks by putting together your familys health history. A free online tool calledMy Family Health Portraitfrom the U.S. Surgeon General can help you and your doctor spot early warning signs of conditions that run in your family.

But personalized medicine isnt just about genes. You can learn a lot about your health risks by taking a close look at your current health and habits. Smoking, a poor diet, and lack of exercise can raise your risks for life-threatening health problems, such as heart disease and cancer. Talk to your healthcare provider about the steps you can take to understand and reduce your unique health risks.

Matching Treatments to Your Genes was originally published by the National Institutes of Health.

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A part of the U.S. Department of Health and Human Services, NIH is the largest biomedical research agency in the world.

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"Boundaries are not about telling someone else what they can or cannot do," says Urban. "A boundary is not designed to control someone else. A boundary is designed to let other people know what actions we are going to take to keep ourselves safe and healthy." For example, let's say you'd like to set boundaries with family members around diet culture conversations. "The boundary in this situation is not to tell your family, 'You can't talk about your diets anymore,'" says Urban. Rather, frame the boundary around how you participate in those conversations and offer an actionable solution.

You could say, "Just so you know, it makes me really uncomfortable when we talk about the food that's on our plate while we are eating. Can we not bring that subject of conversation up?" Or perhaps, "I'm not in a great place with my mental health when it comes to my body, so it would really be helpful for me if we chose not to talk about our bodies or our weight when we get together. Is that something you're willing to do?"

If that person is unwilling to respect the boundary after that, then you may need to set stricter boundaries in place. For example, if a family member keeps talking about diet culture, you could say, "It seems like we just can't eat together without this being a subject of conversation. So I'll come by after dinner." As Urban reminds us, "You're always focused on the actions that you are going to take on behalf of yourself (and perhaps your younger children) to keep you safe and healthy."

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3 Tips To Set Healthy Boundaries With Yourself & Others - mindbodygreen

Dieters have long been warned to avoid eating late at night. Some research, like this study from 2019, provides scientific support for that conventional wisdom by associating eating later in the day with a higher risk of obesity and losing less weight after completing weight loss surgery.

However, little research has been conducted on how the timing of eating impacts physiological mechanisms, according to the researchers from Brigham and Womens Hospital who published the results of a new randomized, controlled, crossover trial in the journal Cell Metabolism.

We wanted to test the mechanisms that may explain why late eating increases obesity risk, notes senior author Dr. Frank A. J. L. Scheer, director of the Medical Chronobiology Program in Brighams Division of Sleep and Circadian Disorders.

The current buzz surrounding intermittent fasting, an eating pattern that involves fasting for a period each day, makes this study particularly timely, according to Prof. Kelly C. Allison, a professor of psychology at the Perelman School of Medicine at the University of Pennsylvania, and director of the Center for Weight and Eating Disorders, who was not involved with this study.

This study really does a nice job of targeting [] the impact of the timing of eating, she told Medical News Today, and it did so in a tightly controlled way within a laboratory experiment.

The study featured 16 participants with a body mass index (BMI) in the overweight or obesity range. They ranged in age from 25 to 59, with a mean age of 37. Five women and 11 men participated. The paper notes five participants were Black, three were Asian and one was Hispanic.

To be selected for the study, participants had to be in good health. They also reported habitually eating breakfast, and stable levels of physical activity.

None had worked shift work in the prior 12 months. For 2 weeks before each testing visit, the participants did not drink caffeine or alcohol, use tobacco in any form, or take drugs, either recreational drugs or medicinal, except for birth control and one participant took antihypertensive medication throughout the study.

No women in perimenopause took part in this study. Pre-menopausal women were scheduled to participate during specific times of their menstrual cycles to avoid hormone surges around ovulation.

For the study, participants spent 9 days in laboratory suites at the Brigham and Womens Hospital Center for Clinical Investigation on two separate occasions. They took 3 to 12 weeks off between each laboratory stay.

Additionally, in the 2 to 3 weeks prior to arriving at the laboratory for the first stay, participants prepared for the study by going to sleep and waking up on the same schedule. Researchers monitored that participants spent a fixed, 8-hour period in bed by having them wear a wrist actigraphy.

Participants also kept a sleep diary and called into a time-stamped voicemail prior to going to sleep and after waking up.

Their effort here was to try to get people to conform to a regular sleep-wake cycle before they came into the lab, Prof. Allison explained.

In the 3 days prior to arriving at the laboratory, participants were also instructed to strictly follow identical diets and meal schedules.

At the facility, light levels and temperature were strictly controlled. Participants did not have phones, radios, or access to the internet, and they were not allowed visitors. They did not exercise. A video camera in each room monitored compliance.

During each stint at the laboratory, participants ate controlled nutrient diets on a firm schedule. Participants on the early meal schedule had their first meal 1 hour after waking and ate again every 250 minutes.

For the late meal schedule, every meal was scheduled for 4 hours later. A researcher timed participants as they ate and no meal lasted longer than 30 minutes.

On test days, participants reported their perceived hunger and appetite using a series of computerized visual analog scales 18 times a day.

Researchers looked at the impact of late eating on the hormones ghrelin, which tells the brain that the body needs food, and leptin, which tells the brain that the stomach is full. Researchers tested these hormones hourly over the course of 24 hours on every test day.

Additionally, researchers measured participants energy expenditure using indirect calorimetry 12 times over the 16 hours participants were awake on test days. They also measured the participants core body temperature continuously for each test day to examine energy expenditure.

To measure how the timing of meals affected molecular pathways involved in how the body stores fat, researchers collected a biopsy of subcutaneous white adipose tissue, the fat stored between skin and muscles, from seven participants during both the early eating stage and late eating stage.

Late eating doubled the odds of being hungry compared to early eating. Late eating also significantly increased the odds of a high rating on a scale of how much a participant would like to eat as well as a high rating on a scale measuring desire to eat starchy foods and meat.

Eating late decreased levels of the hormone leptin by 16% during the 16 hours participants were awake. Additionally, eating late increased the ghrelin-to-leptin ratio, which has been correlated with hunger, by 34% during that time.

Participants who ate later also had significantly lower energy expenditure. Late eating also significantly reduced the participants average core body temperature over 24 hours.

The subset of participants who allowed a biopsy to be collected exhibited adipose tissue gene expression towards increased adipogenesis and decreased lipolysis, which promotes fat growth, when on the late-eating schedule.

I think what [the study] basically is telling us is that it probably really is beneficial to stop eating late into the night.

Prof. Kelly C. Allison

Prof. Allison acknowledged that this study had a small sample size.

These laboratory studies are [] just difficult to do, she told MNT. And Im sure this was done during the time of COVID, which made it even more difficult to find participants.

Of particular concern: The study only had five female participants, which Prof. Allison said limits the generalizability of the research.

And theres only certain kinds of people who can stay in an inpatient unit for 6 days, she said. There are definitely limitations for doing a lab study. There are pros and cons, like the pros are that [] you know exactly what theyre doing, what theyre eating [] when theyre sleeping, you can measure them really frequently. But the cons are that they [] dont represent everybody.

DJ Mazzoni, a registered dietitian based in New York and a medical reviewer for Illuminate Labs, said that even after reading this study his main recommendation continues to be that people should eat nutritious diets free of processed foods.

What a person eats, he told MNT, is more important than time of eating.

Reading the study, Mazzoni wondered whether it was highlighting the benefits of intermittent fasting. I wondered whether the issue was simply that late eating extends the eating window which reduces the time that the body can regenerate and heal without actively digesting food, he explained.

Mazzoni provided an example where two people eat breakfast at 10 a.m. One of those two individuals eats their final meal of the day at 6 p.m. while the other eats their final meal at 11 p.m.

The first individual has an eating window thats 5 hours shorter in duration which may have metabolic benefits, he said. I would be curious to see a study where individuals tried intermittent fasting late in the day, as this could potentially disprove some of the supposed health risks of late eating suggested by the study authors.

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Eating time and weight gain: Why might late meals increase risk? - Medical News Today

Sustainable Diet: A sustainable diet must be economical, available, nutrient-dense, and devoid of hazardous substances like food-borne viruses in order to maintain humans in the short term.

Sustainable Diet: It requires eating foods that are not harmful for the environment

You might be wondering about a sustainable diet if you want to reduce your environmental impact or connect to your local ecology via the foods you eat.

Even while the topic of sustainability in relation to food is frequently discussed, its definition is rarely touched upon. Diets that are fully plant-based or organic are frequently thought of as being sustainable, however, sustainability is far more complicated.

Environmental aspects including resource utilisation and greenhouse gas emissions are crucial. A truly sustainable diet, however, considers labour, food availability, and land management.

How does a sustainable diet work?

There are several recommendations on what constitutes a sustainable diet. A sustainable diet, however, typically takes into account the sort of food we eat, how it is cultivated, delivered, and packaged, as well as the impact this has on the environment.

For instance, a sustainable diet would include a wide range of fruits and vegetables, whole grains, legumes, nuts, dairy, eggs, poultry, fish, and modest amounts of red meat can all be included.

Along with this minimises the use of plastics and other derivatives in food packaging minimises the use of antibiotics and hormones in food production minimises food loss and waste.

How to follow a sustainable diet?

Our diets should become more flexitarian, which means we should consume a greater variety of vegetarian meals together with little portions of fish and meat, such as one huge steak per month or one beef burger per week. Concerns about the lack of protein in a diet that is primarily plant-based are common.

Even while you can consume some meat in a sustainable way, it's vital to think about how much you consume, cut back on your red meat intake, and determine whether you can offset the effects of your meat consumption through other aspects of your diet or consumer behaviour.

Plant-based foods should dominate sustainable diets. You do not have to completely avoid meat or dairy, though. Any diet heavy in plant-based foods fruits, vegetables, grains, legumes, nuts, seeds, and anything made from these sources and low in animal foods is linked to greater health for both people and the environment.

What is the impact of a sustainable diet on us?

A sustainable diet must be economical, available, nutrient-dense, and devoid of hazardous substances like food-borne viruses in order to maintain humans in the short term.

In addition, it's critical that those employed in all facets of the food system from farming and packing to transport, retail, and cooking earn a liveable income, have sufficient health benefits, and work in environments that are secure.

A sustainable diet should reduce the risk of diet-related diseases such as type 2 diabetes, heart disease, and cancer in order to maintain people over the long run.

What is the impact of a sustainable diet on the planet?

A sustainable diet should reduce greenhouse gas emissions, water usage, soil erosion, and pollution, promote animal welfare, and encourage biodiversity in order to preserve the environment for both the short and long term, which also benefits people.

On a personal level, this entails adopting adjustments like cutting back on meat consumption and selecting fruit cultivated without poisonous chemicals and fertilisers. It includes spending money on agricultural systems that replenish rather than degrade the ecosystems to which they belong on a bigger scale.

A sustainable diet emphasises consuming more entire plant foods. Though in far smaller amounts, people may still opt to consume animal products. If you areconsidering changing to a more sustainable diet, youshould think about what diet would be most likely easyto follow and start by taking baby steps.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Diet: Here's What A Sustainable Diet Means And How To Follow It - NDTV Doctor

On September 27, the Biden-Harris administration announced its Nutrition, Hunger, and Health Strategy, revealed at the first White House conference to address health and hunger in 50 years. The plan includes initiatives spread across 25 different agencies and commissions, all aimed at ending hunger in America by 2030 and reducing rates of diet-related disease. The five pillars of the new strategy are food access, nutrition, consumer empowerment, physical activity and research.

The plan is massive in scope and has a lot to offer, especially in the area of food access, but ultimately it falls short. The strategy relies heavily on donations from industrial agriculture, but makes scarce mention of the kinds of plant-based dietary interventions that could substantially address food insecurity without the environmental damage caused by the meat and dairy industries.

The new plan relies on a collaborative strategy of working with historically marginalized groups, including Indigenous communities and individuals living in food deserts. The strategy recognizes the importance of sustained dietary change to improve health outcomes, as well as the undeniable reality that many Americans are disadvantaged in terms of health and food access

The initiatives within include boosting physical activity programs, connecting more people to national parks and creating multilingual educational content that covers nutrition.

The White House also wants the FDA to update the requirements for food companies using the term healthy on their labels, a move that would address a longtime concern of public health advocates that the food industrys misleading use of the term is detrimental to public health.

The campaign incorporates a food is medicine approach in seven of their corporate collaborations. Research is beginning to show this to be a highly effective strategy for improving health outcomes.

Yet the plan will undoubtedly face an uphill legislative battle, reports NPR, as much of the strategy will require funding and approval from Congress. The final form of the plan may ultimately end up neutered by compromises made with the Republican Party.

There is barely any mention of plant-based meals or diets in the plan, and just a few proposals focused on fresh fruits and vegetables, despite the many health benefits from boosting consumption of plant-rich meals.

Diets that feature mostly or entirely plant-based whole foods are linked with many positive health outcomes, including lower risk of heart disease, cancer and Type-2 diabetes. Despite these benefits, the vast majority of people in the U.S. do not eat enough fruits and vegetables, according to a 2019 study from the CDC. Getting more people to meet their daily recommendations would improve immune health and decrease disease rates.

Despite these many benefits, the White House is only suggesting a few programs. One proposal seeks to expand SNAP discounts for fruits and vegetables, which would boost access to produce for lower-income individuals. Another would work with the James Beard Foundation to encourage chefs, restaurant owners, and operators to offer at least one plant-based or vegetarian option on their dinner menus. The plan also references a Boston-based program to grow produce and healthy meals for patients too, but doesnt mention expanding this practice nationwide.

Increasing plant-rich diets and decreasing consumption of meat and dairy wouldnt just be a boon for public health, but a clear win for planetary health too, and at a critical time for climate action. Even if the world managed to cut all other emissions to zero, research shows we would still not meet the Paris Accord goals without changing our food systems to reduce red meat consumption.

Meat is also highly inefficient. 77 percent of all agricultural land is used for meat, despite it only providing 17 percent of our food. Calorie-for-calorie, animal products are frighteningly inefficient; for every 1000 calories of feed invested into beef production for example, consumers can only consume 19 calories.

Research suggests that widespread adoption of a vegan diet would allow the U.S. to reduce its agricultural land use 8 times over. This would free up farmland for rewilding efforts and conservation reserves but, when combined with effective distribution channels, would also give the U.S. enough resources to wipe out food insecurity entirely. Despite all of these upsides, the White House strategy doesnt offer much to boost plant-based food production.

What the administrations plan does feature is donations and initiatives from meat and dairy companies, including Tyson, Chobani and Danone. The proposal includes $4 billion in donations from corporations and nonprofits as compared to $2.5 billion for research

The strategy perpetuates the industrys outsize role in crafting federal food policy despite its environmental track record. Over the last 25 years, the U.S. government has given meat and dairy companies subsidies worth 50 billion, not including 160 billion in subsidies for animal feed, a policy that shows no signs of stopping. By comparison, plant-based proteins received less than 20 million in the same period. These subsidies are partly responsible for keeping the price of animal products artificially low and increasing the land use of animal agriculture. Their donations to the White House strategy are modest by comparison.

The agenda mentions climate change once, in the final prong of the final paragraph of the legislation. It doesnt offer much in the way of specifics, simply to research the effects of climate change on food quality and nutrition security.

There is no mention of the consensus on foods impact on climate that already exists: Study after study after study shows that in virtually every area land use, water use, carbon emissions, pollution animal agriculture is significantly more damaging to the Earth than plant-based agriculture.

This is an anathema to the administrations stated climate goals. President Biden campaigned on climate change, while Vice President Kamala Harris is herself a flexitarian and has advocated against the environmental destruction of Big Meat in the past. And while their flagship Inflation Reduction Act is a significant step forward for emissions reduction, possibly the biggest step forward of the century, less than 5 percent of that act goes towards farming, and 0 percent goes towards plant-based solutions.

The Biden-Harris strategy could have done so much more to address hunger and environmental health, in what could have been a food system overhaul to truly address food inequities. This latest proposed federal policy lags behind many local initiatives already working to address food-related emissions, including the New York City School District, which offers Vegan Fridays, and the Washington DC School District, which has mandated plant-based options. The new national strategy could have expanded these initiatives or implemented policies in line with Universal Meals, a plan backed by the Physicians Committee for Responsible Medicine that aims to create whole-foods plant-based options in hospitals, prisons, schools, and other federal facilities. But for now, the Biden-Harris administration appears unwilling, or perhaps unable, to tackle the climate damage caused by our food system..

Read More

What Are the Environmental Impacts of Dairy Farming?

Making Plant-Based More Accessible Through Universal School Meals

Plant-Based Meats Are Better for Your Health and the Environment

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The New White House Nutrition Strategy Barely Mentions Plant-based Diets, and That's a Problem - Sentient Media

By Monica Saumoy, MD

Millions of people across the United States struggle with obesity. This common and serious disease increases the risk for a variety of other health conditions, such as diabetes, high blood pressure, and infertility, and it can negatively impact body image and self-esteem.

Treating obesity, however, has been shown to decrease the risk for many of these conditions and to help people overcome the damaging physical and emotional effects of being overweight.

A Complex Disease

Obesity is a complex disease influenced by a range of factors, including:

In addition, obesity itself can cause hormonal and other chemical changes in your body that contribute to the disease and make it difficult to lose weight solely through diet and exercise.

More than 42% of U.S. adults have obesity, which is defined as having a body mass index (BMI) of 30 or above, according to the Centers for Disease Control and Prevention (CDC).

Diet and Exercise Often Not Enough

Many people who have obesity have struggled for years or even decades to lose weight on their own, trying various diets and or exercise programs that promise rapid results.

Diet and exercise alone are often not enough to treat obesity.

This is in part because when your body notices a calorie deficit it starts to get nervous, afraid it could be starving to death. Your brain and your gut then work together to fight the perceived threat, conserving calories to keep your body alive.

A Minimally Invasive Treatment Approach

Endoscopic sleeve gastrectomy is a minimally invasive procedure for weight loss that reduces the size of the stomach so the patient will eat less and lose weight.

With endoscopic sleeve gastroplasty, doctors insert an endoscope equipped with a suturing device into your throat and down to your stomach. The doctor then sutures the stomach to create a smaller, tube-shaped pouch, which effectively restricts the amount of food you can eat.

The procedure is available through the Center for Digestive Health at Penn Medicine Princeton Medical Center, in consultation with the Center for Bariatric Surgery & Metabolic Medicine at Princeton Medical Center. It takes about an hour to 90 minutes to perform and does not require any incisions. Most patients go home the same day.

Following endoscopic sleeve gastroplasty, a liquid diet is temporarily prescribed in order to allow for healing and to jumpstart the weight-loss process. There generally are no other restrictions beyond diet following the procedure. Patients usually return to work within a few days after the procedure and begin to integrate a diet and exercise routine to help lose weight and keep it off.

Studies show that the endoscopic sleeve gastroplasty can result in rapid weight loss, and the average patient can expect to lose 15-18% of their body weight within one year. For example, if you weigh 250 pounds, you could lose up to 45 pounds over time.

Obesity-related medical problems will likely improve with a modest degree of weight loss following the procedure. With steady weight loss, patients often require lower doses of medications for diabetes and high blood pressure, and in some cases, they may no longer need medication at all.

Candidates for endoscopic sleeve gastroplasty include patients with obesity who have a BMI greater than 30 and have not had success with weight loss through diet and exercise.

One Piece of the Puzzle

Successful weight loss is a process, and a procedure like endoscopic sleeve gastrectomy is just one piece of the puzzle. Patients who undergo endoscopic sleeve gastrectomy are encouraged to follow these eight tips to help ensure long-term weight loss success:

1. Attend each and every follow-up visit with the doctors and support staff.2. Eat smaller portions and listen to your fullness signals.3. Choose healthier foods for better nutrition.4. Exercise regularly doing the physical activities you enjoy most.5. Participate in support groups both in person and online.6. Join a bariatric exercise program for support and motivation.7. Get into the habit of monitoring your weight.8. Celebrate your weight loss success with friends and family.

When it comes to weight loss, there is no such thing as a quick fix. Endoscopic sleeve gastrectomy, however, is an effective treatment for obesity that can help jump start your weight loss and give you the leverage you need to build lifelong healthy habits. Coverage for the procedure varies by insurance plan. Check with your plan to see if it is covered.

To find a gastroenterologist with Penn Medicine Princeton Health or for more information about the Center for Bariatric Surgery & Metabolic Medicine at Princeton Medical Center, call 888-742-7496 or visit http://www.princetonhcs.org.

Monica Saumoy, MD, is board certified in gastroenterology and internal medicine and specializes in obesity medicine. She is a member of the Medical Staff at Penn Medicine Princeton Health.

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Health Matters: A Minimally Invasive Approach to Treating Obesity - centraljersey.com

If youve been diagnosed with multiple sclerosis (MS), you no doubt want to do everything you can to stay as healthy and symptom-free as possible. Youre probably wondering if changing your diet might be a good move.

Is there a best diet for MS? The honest answer is that we dont know, says Ben Thrower, M.D., senior medical advisor for the Multiple Sclerosis Foundation and medical director of the Andrew C. Carlos MS Institute at Shepherd Center in Atlanta, Georgia. Big picture, there are no specific foods that have been shown to be good or bad for MS.

There is lots of research looking into how certain ways of eating may positively impact the course of MS in individual patients, however. A review of studies found that three factors are important when it comes to stopping MS progression: reducing inflammation, protecting against neurodegeneration and repairing the damage MS does to the nervous system. Which foods could help accomplish these goals? Because MS is a disease that has such a specific impact on different people, its important to experiment and explore. Lets take a deeper dive into the evidence, so you can try an eating strategy that might work uniquely to make you feel better.

A quick Google search will show you a number of food plans that are supposed to help reduce MS symptoms like fatigue. The problem is that a lot of these diets are too nutritionally limited.

You can find some very restrictive diets targeted to people with MS, says Lauren Gluck, M.D., assistant professor of neurology at Albert Einstein College of Medicine in Bronx, NY. Overall, these diets are not well validated. Not enough people who used them were studied overall, and specifically not enough people were studied across different ages, sexes and ethnic groups. I tend not to recommend them. If you do decide to follow a restrictive diet, be sure to focus on getting enough nutrients and calories and check if you are feeling well. Plus, be sure to share information about the diet with your MS treatment team.

Heres what the research on some of the most popular diet plans shows:

The Mediterranean Diet

The Mediterranean Diet is well-known for its great effect on heart health. When it comes to MS benefits, there may be some key benefits to giving it a try. Studies have shown that because the diet is high in good fat, low in saturated fats and salt, and high in fruits and vegetables it may have a benefit when it comes to brain health, and that too may make an impact on slowing neurodegeneration for MS patients.

The Wahls Protocol

This Paleolithic-based plan has three levels, is gluten and dairy-free, and involves periods of fasting. Unexpected foods like raw meat, seaweed, and organ meats take the place of grains. Other factors are also added in addition to the diet aspect of this philosophy. This is a combination of diet, exercise, and stress management, explains Dr. Thrower. Research has suggested a decrease in fatigue for those following the protocol. A recent study looked at blood markers of inflammation in people with MS doing intermittent fastingit showed a decrease in these markers. Whether these lab findings would translate into clinical benefits is not known, however.

The Swank Diet

Founded over thirty years ago, the Swank diet is extremely low-fat, to the point where even a hamburger or two ounces of cheese is purported to reverse any benefits from it. That theory is linked to the finding that saturated fat can worsen MS symptoms because it causes inflammation. Obesity is also thought to be a contributing factor to both the cause of MS and the flaring of its symptoms, again due to its link to inflammation in your system.

The McDougall Diet

This plan is also very low-fat, with an emphasis on starchy veggies, and no animal products or oil whatsoever. It has been shown to have some potential positive impact on MS-related fatigue and also helps patients lose weight, but research showing any more specific or proven benefits is still ongoing.

Are there general rules to follow when deciding what to eat when you have MS?

As a rule, with balanced eating, you cant go wrong. People with MS, and many people in general, tend to feel better when eating a diet with more fruits and vegetables, unsaturated fats, lean meats and fish, legumes, beans, and whole grains, with less processed foods, red meat, sodium, and refined sugar, says Dr. Gluck. This can help reduce fatigue, brain fog, and pain, and may benefit long-term brain health. These food patterns are also part of many heart-healthy diets that reduce the risk of heart disease, strokes, and overall inflammation. Since we know that people with MS who have additional cardiovascular disease have worse MS disease, it's possible that some of these recommendations help MS by helping the rest of the body stay healthy.

I recommend eating more nutritious food over taking a ton of nutritional/vitamin supplements unless you are specifically deficient in a vitamin, says Dr. Gluck. I also advise against juicing for meal replacements. Juicing removes the beneficial fiber and many nutrients of fruits and vegetables and just leaves the carbohydrates and sugars.

However, its important to know that having MS wont force you to avoid all the foods you love. It doesn't mean you can't have a piece of cake or a steak once in a while, Dr. Gluck adds. Two simple tips to make healthy daily changes: Add a vegetable to every meal, and cut out sugary beverages like soda and juice, she suggests.

"Its hard to find dietary rules that would apply to everyone with MS," Dr. Thrower sums up. Eat a healthy daily diet then tweak. Introduce new foods into your routine, and see how you feel. If you detect a decrease in your symptoms or feel like you have more energy, you may have found a food thats acting as medicine for you.

Keeping a food diary can be very helpful, noting when you try a new food and how many times you consume it before you notice any change in how you feel. Keep your doctors informed about any changes you notice and look at trying new foods as a handy tool in your self-care kit. You know your body best keep doing what works for you!

Lisa Mulcahy is an internationally established health writer whose credits include Good Housekeeping, Prevention, Oprah Daily, Womans Day, Elle, Cosmopolitan, Glamour, Parade, Health, Self, Family Circle and Seventeen. She is the author of eight best-selling books, including The Essentials of Theater.

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Aramark, which is the largest U.S.-based food service provider, has announced that it will be increasing efforts to offer plant-based dining options at over 250 colleges and universities across the country (via BusinessWire). The company's goal is to have 44% of its offerings be plant-based by 2025.The company's announcement comes after having worked with the Humane Society of the United States for 15 years on efforts to reduce harmful climate change impacts. On Aramark's website, the company previously announced a commitment to reduce its greenhouse gas emissions by 25% by 2030. The food service provider also offers "Cool Food Meals," which have a lower carbon footprint during their creation and are more plant-based than its other offerings.

Currently, Aramark's menus offer 26-30% plant-based options across its offerings. To prepare for the change, Aramark has announced that it will increase training for dining staff, amplify its marketing, release a report on its progress annually, and work to add even more plant-based options to college dining halls in the future through recipes and menu concepts.

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It's About To Get Much Easier To Eat Plant-Based In College Dining Halls - Tasting Table

I think culture is definitely important, but I try to have a more nuanced view of what culture is, said Fuster. I was born and raised in an urban setting. There are so many different layers that influenced me and how I view Puerto Rican [food culture]. For me, it's different from somebody in Puerto Rico right now, or somebody that grew up in New York or Boston, or a different part of the country.

She added, That's something that I try to do in the book: to explain that we're more than just where we're from. We have to look at people at the intersection of what I refer to in the book as structural factors. Our class, race, gender, agethose are things that interact with each other and where we're from. It all shapes our views and practices around food.

Its also common for dietitians to link high rates of diet-related diseases to Hispanic Caribbean cuisine, said Fuster, and to suggest that traditional cooking in these cultures includes fatty meat, starchy roots, and a lot of frying.

When we think about ethnic foods, or immigrant diets, we think of these stereotypes, said Fuster. Like You're Puerto Rican, so you only eat rice and beans... things like that. What I try to do is show that the Caribbean is a melting pot. There are, unfortunately, some erroneous ideas about what we eat.

In her book, Fuster opens up about her own acts of stereotyping, including anecdotes like a conversation she once had with a Puerto Rican woman about the motivations that led to her changed diet.

She mentioned that she had been eating more saladsspecifically ones that went beyond the usual salad that you might see in Puerto Rico, the iceberg lettuce, tomato, and potentially avocado or onions, said Fuster.

My first thought was, Oh, she must have had a chat with a dietician; somebody must have told her she had to change what she was eating, said Fuster. The real reason? It was because she got a pet iguana! added Fuster, with a laugh. She had to research what iguanas ate, realizing that our traditional iceberg lettuce was mostly water, prompting her to switch to more nutritious greens. This experience led her to reflect on the reality of multiple (and unpredictable) drivers for dietary change and her own stereotypes about diets in the community.

As part of her response to these issues she brings to light in her book, Fuster founded TheLatin American Restaurants in Action(LARiA) Project, an initiative that collaborates with Hispanic Caribbean and Latin American restaurants to develop strategies aimed at boosting cultural visibility and improving unity, health, and trust among Latin American communities through the lens of food. Its funded by the National Institutes of Health.

Something we forget is that we need to make a healthy choice a desirable one, said Fuster. I see restaurants as a vehicle for that. I also see that, historically, restaurants and food in general, are a vehicle for new immigrants to enter the economy.

LARiAs goal is to work directly with restaurants (it is already partnering with two) to curate dining options that offer both comfort and education to Latin American patrons.

Something that we did with a Puerto Rican restaurant in New York City was that the chef developed a side dish with cabbage, peppers, squashvegetables that [Puerto Ricans] are familiar with, but we might not eat it this way, said Fuster. But the chef seasoned it with the same flavors were accustomed to. People might go out and say, I won't go to that restaurant because they won't prepare the food like my mom or my grandma or I'm not going to spend money eating out at a place when I can make the food at home, but the idea here is to inspire some creativity in home cooking.

Fusters plan is to grow the network of chefs and restaurants with which LARiA partners and expand the work to address how policies and regulations can help facilitate changes, to help inspire people in Latinx communities to consider healthy and tasty cooking habits, and, above all, to embrace their multifaceted identity.

My aim is to change social and cultural norms about the deliciousness of healthy food, said Fuster.

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The Complex Intersections of Food, Health, and History in Hispanic Caribbean Communities - Tufts Now

When it comes to the health of your heart, your diet plays a primary role. In fact, right from the management of your blood pressure to proving prime protection from a number of heart diseases, your diet can do it all. Healthy eating choices and eating patterns can not only give your heart a necessary health boost, but they can also help you fit into a smaller pair of jeans and keep your skin healthy and young. Studies show the reason behind approximately one-third of the deaths worldwide is because of heart disease alone. Interestingly, just the addition of certain heart healthy food items to add to your daily diet can make all the difference. In fact, there are certain common food items that can impact blood pressure, cholesterol levels, triglycerides, and inflammation.

Understanding Heart Health

Did you know the heart of a healthy adult beats over 2 billion times in an average lifetime? During which it works to push more than millions of gallons of blood to all the parts of the body. The consistent flow of blood transports oxygen, hormones, and several crucial elements to all the parts of the body. In fact, if the heart stops working, all the essential bodily functions simply fail and the body breaks down. Despite the constant workload that never ends, the heart is steadfast and dependable.

However, in the absence of heart-healthy habits, which include lack of heart healthy food, absence of exercise, and unhealthy habits like smoking, and drinking the heart stumbles and in worse cases even breaks down. This absence of heart-healthy habits makes you more prone to several big and small heart diseases including high blood pressure and even heart attack.

Heart attack

One of the major problems that come with bad heart health is atherosclerosis. Atherosclerosis is nothing but the accumulation of cholesterol inside your already thin arteries. This accumulation limits the normal blood flow through the arteries, which can lead to a life-threatening heart attack or stroke.

Although with age the functioning of the heart gradually slows down, however, it is important to understand unhealthy habits can make your heart age faster. With healthy lifestyle changes, you can not only reduce the chances of getting a heart attack you can achieve an overall better immunity. But the question remains on how to incorporate heart-healthy habits.

How to incorporate Heart-Healthy eating habits?

Despite being one of the leading causes of death in the United States, heart attacks are totally avoidable. All you need to do is incorporate a few heart-healthy habits. When it comes to heart-healthy living, you have a chance to make healthy choices at every point of your life. Right from taking the stairs to eating broccoli, every little action plays a very important role.

While there are many factors in how you can minimize the chances of getting heart disease, your diet is the most important. With heart-healthy eating habits, you can consciously add heart healthy food items to add to your daily diet including certain fruits and vegetables and minimize the intake of saturated fats and sugars. Ahead, find a carefully curated list of 15heart healthy food items for the soundness of your heart.

Here is a list of 15heart healthy food items to maximize your heart health:

1. Green leafy vegetables

When it comes to heart healthy food items to add to your daily diet green vegetables definitely top the list. It is well established that green leafy vegetables are an excellent source of vitamins, minerals, and even antioxidants. Whenever you have a chance to incorporate kale, spinach, and collard greens into your diet, please say yes. Not only are they a great source of vitamin K, but they are also one of the best heart healthy foods out there. Research shows, green vegetables promote improved blood flow through your arteries and even a enable healthy blood clotting process which reduces the risk of heart diseases. Moreover, green veggies are also rich in dietary nitrates, which help in the management of blood pressure, arterial stiffness, and overall cell function.

2. Tomatoes

Another vegetable that works as well as green vegetables to protect the heart is a tomato. Tomatoes are one of the best heart healthy foods that are rich in lycopene. Lycopene is a natural plant-based pigment filled with antioxidant properties. These antioxidant-rich properties work to neutralize damaging free radicals that prevent and protect from any oxidative damage or inflammation thereby protecting from heart diseases. Lycopene is also linked to reducing the risk of heart attack and even stroke. Incorporation of tomatoes into your daily diet can help you manage blood pressure, blood lipids, and even endothelial function. Studies reveal tomatoes are known to increase the levels of HDL or good cholesterol. HDL further works to eliminate any excess cholesterol or plaque from arteries which promotes better flow of blood thereby protecting the heart from heart diseases and stroke.

3. Whole grains

Whole grains are another heart healthy food items that you must add to your daily diet to promote a healthy heart. Germ, endosperm, and bran are all nutrient-rich parts of any grain. Top whole grains you must incorporate into your diet include:

whole wheat

While the consumption of refined carbohydrates might increase the risk of heart disease, the consumption of whole grains actually works to protect the heart. Studies claim that incorporating more whole grains into your diet can definitely work to benefit your heart and improve overall heart health while reducing the risk of heart disease. In addition to that, it also works to prevent as well as manage hypertension. So the next time you go grocery shopping, make sure you buy whole grains, you get products with the labels whole grain or whole wheat. When it comes to labels like wheat flour or even multigrain you must read the label to confirm if they are whole grains.

4. Avocados

Avocados are another one of several heart healthy food items out there. Avocados are one of the best sources of monounsaturated fats which are incredibly heart healthy. They are known to effectively reduce the levels of cholesterol hence lowering the risk of heart disease. Studies reveal that avocados reduce the incorporation of LDL or bad cholesterol, which lowers the risk of heart disease. Also, multiple studies also claim that avocados exhibit lipid-lowering and cardioprotective properties. They are rich in potassium which works to benefit the heart. Avocados help in reducing the risk of high blood pressure, high cholesterol, metabolic syndrome, and even stroke.

5. Berries

Berries, including strawberries, blueberries, raspberries, and even blackberries are one of the best categories of heart healthy food items. Filled with the essential nutrients and antioxidants for the body, berries work to nourish as well as protect the body against oxidative stress as well as inflammation. Not just that, studies show berries specifically strawberries help in the improvement of insulin resistance and management of LDL also known as bad cholesterol.

Another study about blueberries reveals that the incorporation of blueberries in your diet can improve the functioning of cells lining the blood vessels. This helps in controlling blood pressure and promotes healthy blood clotting. Almost all kinds of berries work to reduce LDL or bad cholesterol and help in the maintenance of systolic blood pressure, body mass index, and inflammation. When you have a bad sugar craving or simply need a snack, berries cab definitely be that low-calorie but delicious dessert. Another food for healthy heart might include fruits like cherries and oranges for the heart.

6. Fatty fish & fish oil

Studies claim that fatty fish like salmon, sardines, tuna, and mackerel are rich in omega-3 fatty acids that are flooded with heart-health benefits. Omega-3 fatty acids derived from fatty fish play a crucial role in protecting the heart from developing any heart disease. Moreover, it also reduces the risk of arrhythmias and CVD events. Studies claim that the consumption of fish for an extended period of time can reduce cholesterol levels and help in the management of blood triglycerides, blood sugar levels, and blood pressure. Another study proved the positive relationship between the consumption of fish and the risk reduction of cardiovascular diseases and depression. It even works to increase overall longevity. Another way to incorporate the benefits of fish is by incorporating fish oil which ensures the daily dose of omega-3 fatty acids. Apart from fish oils, fish oil supplements are also food healthy for the heart, they also work to deliver benefits like reduction of blood triglycerides, improvement of arterial function, and management of blood pressure. Similar benefits can also be incorporated through omega-3 supplements like krill oil or algal oil.

7. Beans

Beans are one of the best heart healthy food options out there. They are rich in resistant starch, which helps in the digestion process. Resistant starch in beans also works to benefit the gut. Several studies claim that adding beans and legumes to the daily diet can reduce the risk of heart disease by reducing levels of blood triglycerides and LDL or bad cholesterol. Beans also help in the management of blood pressure and inflammation which again reduces the risk of heart disease. Add beans to your daily routine if you want to incorporate a diet for a healthy heart.

8. Dark chocolate

Another exciting food item that actually helps in improving heart health is dark chocolate. When incorporated in moderation, dark chocolates can incorporate a healthy dose of antioxidants including flavonoids, that work to promote better heart health. Studies claim that consuming less than 5-6 servings of unsweetened dark chocolate per week reduces the risk of coronary heart disease, stroke, and even diabetes. However, when eaten in huge amounts chocolates can be harmful because of their sugar and calorie content. Make sure you pick good quality dark chocolate with at least 70 percent cocoa content. Moderate consumption of dark chocolate is also known to reduce the risk of plaque accumulation thereby reducing the risk of heart disease.

9. Green tea

Green tea has always been linked to innumerable health benefits. Right from boosting a fat-burning metabolism to improving insulin sensitivity, green tea is no less than a magic drink. Green tea is flooded with polyphenols and catechins. They serve as antioxidants that prevent all kinds of cell damage while reducing inflammation. Studies prove green tea works to protect the soundness of your heart. Research shows green tea promotes leptin and reduces LDL or bad cholesterol which works to help with obesity. Another study claims, green tea works to reduce blood pressure triglycerides, and even LDLs. Matcha green tea also seems to have multiple benefits for the heart. All kinds of green tea-infused snack or green tea as a beverage works as one of the best heart healthy food options.

10. Almonds

Almonds are another nutrient-rich healthy snack that works to benefit the heart. They are rich in all kinds of vitamins and minerals and work to promote heart-healthy monounsaturated fats and fiber. These work to protect against heart disease. Research claims eating almonds regularly can even work to reduce cholesterol levels. It even reduces belly fat along with the levels of LDL or bad cholesterol thereby reducing the risk of heart disease. In addition to that, studies show almonds increase the levels of HDL or good cholesterol. This in turn reduces any plaque buildup while clearing your arteries to promote better blood flow. Almonds are rich in nutrients and calories as well. However, when consumed in moderation it is known to deliver fiber and monounsaturated fats which reduces cholesterol as well as belly fat.

11. Walnuts

If you have been looking for heart healthy food items, walnuts are another snack you can definitely incorporate into your daily diet. They are flooded with fiber and micronutrients including magnesium, copper, and manganese. Just a few servings of walnuts can help in the protection against several heart diseases. Studies show several tree nuts including walnuts work to prevent cardiovascular diseases when incorporated into the daily diet. Research shows that walnuts also decrease LDL or bad cholesterol in the body and help in the maintenance of blood pressure.

12. Seeds

Another one of the best heart healthy food items that you must consider adding to your diet are certain kinds of seeds including, chia seeds, flaxseeds, and hemp seeds. Not only are they rich in heart-healthy nutrients like omega-3 fatty acids they promote the incorporation of fiber. Studies claim the incorporation of seeds into your diet can effectively minimize risk factors like blood pressure, inflammation, cholesterol, and triglycerides that might lead to a heart attack. Hemp seeds are rich in arginine which is an amino acid that works to promote lower blood pressure levels and reduces inflammatory markers. This reduces the risk of heart disease. Another example of a heart-healthy seed is flaxseed which also helps in blood pressure and cholesterol management. This proves flaxseed minimizes the risk of cardiovascular disease as well as cancer. Also, it also helps in minimizing the risk of diabetes and certain gastrointestinal conditions. When it comes to seeds chia seeds are another health healthy food item that potentially works to lower blood triglyceride levels while boosting the levels of beneficial HDL or good cholesterol.

13. Olive oil

A staple in Mediterranean diets, olive oil is one of the most documented heart healthy food items out there. Packed with antioxidants, olive oil is known to relieve all kinds of inflammation while decreasing the risk of chronic diseases. Studies have shown olive oil is rich in monounsaturated fatty acids that work to improve heart health. Another study shows olive oil works to effectively lower the risk of acquiring heart disease. Moreover, olive oil is rich in oleic acid as well as antioxidants that help in the prevention as well as treatment of hypertension. Olive oil can easily be substituted with your cooking oil and can even be added to salads and sauces.

14. Edamame

Immature soybean popularly known as edamame thats used in several Asian dishes is another one of the most effective heart healthy food items. Just like any other soy product, edamame is filled with soy isoflavones which is a flavonoids. It helps in lowering cholesterol levels and works to improve heart health. Soy protein also reduces the risk of developing cardiovascular diseases. When combined with a better lifestyle and more dietary changes, it can even reduce cholesterol levels which works to reduce the risk of heart ailments. Studies show soy protein works to manage blood lipids, which reduces the risk of cardiovascular disease. Along with that, edamame is rich in dietary fiber and antioxidants as well. Tofu is another soy-rich snack thats good for the heart.

15. Garlic

It is well established that garlic has plenty of health care benefits. In fact, it is one of the best home remedies to treat a number of problems. Research shows garlic is flooded with medicinal properties one of which is the improvement of heart health. Garlic is rich in compounds known as allicin which is one of the most therapeutic compounds. Studies show garlic extract works as well as a standard prescription drug for the reduction of blood pressure. Another study shows that garlic works to reduce cholesterol and LDL which makes it beneficial for patients with high cholesterol. Studies also reveal garlic works to reduce any sort of platelet buildup, which reduces the risk of blood clots and even stroke. When consumed raw garlic is the most beneficial.

When it comes to incorporating a heart-healthy diet there are a number of heart healthy food items out there. Diet is one of the most important factors that significantly affect health. What you consume on a regular basis can impact every aspect of your health including heart health. Also, there are certain diet plans like the DASH diet that help in the management of heart health. However, before you incorporate any major changes in diet, it is important to consult your healthcare professional. If you wouldn't like to incorporate a whole new diet, With a little moderation and healthy food choices you can manage to control your blood pressure, inflammation, cholesterol levels, and even triglycerides. While the above-mentioned food list for a healthy heart or heart-healthy snacks is incredibly healthy when you combine them with healthy habits and better lifestyle changes, the risk of heart disease practically goes away. Not just that, a healthy heart diet, regular exercise, and a little moderation in diet can help naturally improve your overall health which will be visible in the form of better skin, better fitness, and overall better immunity.

Note: If you are medically diagnosed with any heart disease, these dietary recommendations cannot substitute for your medications. In fact, you must consult your healthcare professional before you incorporate any major changes in your diet.

Also read: 9 Easy Diet plans for weight loss and overall health boost

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15 Heart healthy food items to add to your daily diet - PINKVILLA