Trouble swallowing can be a slippery slope to a number of other health issues. Being Patient spoke to two experts in speech, language, eating and swallowing about ways caregivers identify, manage and treat swallowing-related conditions known as dysphagia.

As many as half of people living with Alzheimers maylose the ability to feed themselves as the disease progresses. Declining motor, sensory and cognitive skills may lead to trouble eating, or to difficulty swallowing, due to any of a number of swallowing-related conditions called dysphagia. Trouble swallowing can in turn lead to more serious health issues, from dehydration and malnutrition to pneumonia.

Rinki Varindani Desai, a speech-language pathologist at the University of Mississippi Medical Center, said caregivers of people living with dementia should consult with a doctor as well as aspeech-language pathologist on the best and safest ways to manage dysphagia, nutrition and hydration options, keeping in mind the persons advance directives and wishes.

Caring for a person with dysphagia and dementia presents a set of unique and difficult challenges, Desaiwrote in an article for the National Foundation of Swallowing Disorders.With the right training, knowledge, and support, caregivers can enhance the quality of life of their loved ones with dementia. Regardless of a diagnosis, every individual deserves to dine with dignity.

Being Patient spoke to two speech-language pathologists about treatments and strategies for caregivers that may help manage and treat dysphagia.

Posture can be a major player when it comes to safety and swallowing.Caregivers should ensure that their loved ones with dementia and dysphagia are in a comfortable and upright position during meals, Desai wrote, and keeping them upright for 30 minutes after eating can help with digestion.

Meanwhile, a speech-language pathologist may recommend adjustments to a patients postures.According to Nicole Rogus-Pulia, a speech-language pathologist and an assistant professor of medicineat the University of Wisconsin-Madison, one adjustment includes the chin tuck, which moves the base of tongue further back to the throat and narrows the entrance to the airway to reduce the risk of aspiration. Another is the head rotation, which involves turning the head to the side while swallowing. It can be helpful for people with weakness on one side of the throat, redirecting material to the stronger side.

It really depends on the patient whether or not these postures are effective, Rogus-Pulia told Being Patient. For some patients, it can actually have the opposite effect where it causes more material to go down the wrong way.

Some people conduct these postural adjustments without consulting a speech-language pathologist, and she urges people to see a one before attempting these postural adjustments on their own.

Eating safely requires focus even for people in peak cognitive and physical health. For older adults grappling with dementias impacts on cognitive, motor and sensory skills, its all the more important.

To reduce distractions, Rogus-Pulia said, limiting the number of people eating with the patient can help while ensuring that dining remains a social event.

We use the same mechanism in our throat to breathe, cough, swallow [and talk], Rogus-Pulia said. If were trying to do too many things at once and were not paying close attention, the precise coordination that says its now time to stop breathing, and swallow can be disrupted.

Serving meals in a quiet environment, Desai added, using basic utensils required for a meal and avoiding placing unnecessary items on the table that can be distracting or confusing can also help.

Rogus-Pulia noted that caregivers should encourage loved ones to feed themselves, helping to the extent necessary so they can remain independent while dining. One approach that is effective is known as the hand-under-hand technique, where caregivers place their hands under the hand of the person they are looking after to help guide the hand to their mouths.

Caregivers should encourage their loved ones to eat slowly as people with dementia may require longer to complete their meals, Desai said. Smaller, more frequent meals or snacks throughout the day may help.

To ensure swallowing safety, she reminded caregivers to ensure that all food and liquid are swallowed before feeding the next bite. Frequently checking their mouths to make sure there is no accumulation of food is also important. And maintaining oral hygiene is crucial as it is one of the leading risk factors of aspiration pneumonia for those with dysphagia.

Selecting dish ware that makes it easy to see the food because of its color or lack of patterns is another helpful way to guide a person through a safe meal.

Desai added that verbal prompts can help, too: Depending on the persons language ability, this may mean giving very specific directions such as open your mouth, chew, swallow, offering simple choices such as Do you want soup or a sandwich?, or asking simple yes/no questions rather than open-ended ones.

Making food easier to see may not be quite a big enough change. Changing the food altogether, so that it is easier to manage, could be needed. Desai writes:

For some people with dysphagia, the texture of a normal diet can simply present too many risks, in which case, specific recommendations may be given by the [speech-language pathologist] about making changes to the texture or consistency of food/liquids, to reduce the risk of choking and other dysphagia-related complications Though it will sometimes be necessary to make these changes to food texture or to thicken liquids, it is important to still try to maintain the look of a normal diet, as this can preserve your loved ones enjoyment of food and help people with perceptual or memory difficulties recognize what they are eating.

A feeding tube is a medical device designed to provides nutrition to people who cannot eat or swallow safely, or who need supplemental nutrition. For caregivers to people in advanced stages of dementia, its a complex decision.Some physicians may recommend tube feeding when peoples dementia progresses to advanced stages and dysphagia becomes severe. However, studies have shown that the tube-feeding does not improve the quality of life for people with advanced dementia nor prolong duration of life.

According to Desai, tube-feeding may also increase a patients risk for additional health problems. In advanced stages, we have overwhelming evidence to show that its not going to prevent aspiration pneumonia, she said. Its not going to prolong their survival rate. And its actually another source of infection when you have a feeding tube in the stomach. The burden of having it doesnt outweigh the benefits.

Rogus-Pulia added: Sometimes, a speech-language pathologist isnt included in the end-of-life feeding discussion. And we really should be, because theres so much we can do to recommend safe swallowing that also aligns with the patient and [their familys] goals of care. There are ways that we can modify what youre swallowing that still are enjoyable. She said it is critical for people with a dementia diagnosis and their caregivers to discuss feeding options with their clinicians early, to make an informed decision.

However, both experts noted that tube feeding can help if patients with swallowing problems are admitted to the hospital temporarily due to acute illnesses or choking incidents. According to Desai, patients should work with a speech-language pathologist for rehabilitation.

Some studies have found that certaintongue-strengthening exercises and other rehabilitative therapies for dysphagia have shown promise in helping people improve sensory function, chewing abilities, and their safety and efficiency in swallowing.

Butaccording to Rogus-Pulia, there is still a dearth of research on effective therapies for swallowing for those living with dementia:Traditionally, its just been expected that individuals who have cognitive impairment cant participate in more of a rehabilitative approach, she said. We know from other studies focused on individuals with Alzheimers disease and other dementias that certainly they can participate in rehabilitative interventions.

General exercise has been shown to be really effective and lots of studies [show it can reduce] fall risk, she added. We really need to think about how we can apply that same type of intervention to swallowing.

Rogus-Pulia and colleagues are currently conducting a clinical trial to study the effectiveness of two interventions. One includes placing a small pressure bulb on the tongue which patients can push against the roof of their mouths repeatedly. With the device, clinicians can examine the pressure exerted by the patient and create targets for patients to work toward. Another intervention is a saliva substitute gel, which may increase lubrication in the mouth, reduce the effort needed while swallowing, and potentially improve oral health.

She hopes that such interventions may help slow down the decline of peoples swallowing abilities and build their muscle reserves, thus staving off the potential impacts of dysphagia for as long as possible and improving their quality of life.

Contact Nicholas Chan at nicholas@beingpatient.com

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7 Ways to Help a Loved One with Eating and Swallowing Difficulties - Being Patient

The pain started in Emma Smrekars back, last spring. Then it spread to her side. Next came extreme fatigue.

Eating was the worst; it gave the Stillwater teen a horrible stomachache. A change in diet didnt help, and tests for gastrointestinal issues came back negative. She kept losing weight and getting weaker and weaker.

By the end of August, Emma had lost 30 pounds, could barely take a bite and couldnt sleep through the night without medication.

On the night of Sept. 1, Emmas parents, Scott and Lindsey, raced her to the emergency room at Childrens Hospital in St. Paul. A CT scan showed the cause of her unbearable pain: a tumor the size of a cantaloupe in her abdomen.

Within hours, Emma, 17, was transferred to Childrens Hospital in Minneapolis. Two days later, she was diagnosed with cancer. She spent the next 11 days in the hospital, where she underwent three surgeries, including the placement of a port for chemotherapy.

She has been in and out of the hospital ever since. Next month, she will start five weeks of intensive proton radiation therapy at the Mayo Clinic in Rochester.

Through it all, the residents of Stillwaters Oak Glen neighborhood have rallied to help. Theyve installed teal lights Emmas favorite color outside each house. Theyve brought meals, donated money and stepped up in every way possible, Lindsey Smrekar said.

I cant even talk about it without crying, she said. Its so hard to go through something like this. Everyone is so lovely, and theyve been so supportive. I wasnt expecting anything. Im just trying to figure out how to survive day-to-day and get my daughter through this. Its just this wonderful gift and support and love from everyone.

Emma is a senior at St. Croix Preparatory Academy in Baytown Township. Last year, she served as the school photographer and worked on the yearbook. She has not had the strength to attend school this fall, but she expects to graduate on time. She needs only three credits to graduate.

Emma loves taking pictures, drawing and painting. Her favorite artist is Van Gogh. At the top of her bucket list is seeing The Starry Night at the Museum of Modern Art in New York.

Shes the type of teen who tutors young neighbors in math and volunteers as a dog walker at the Animal Humane Society in Woodbury.

Emma is determined and persistent, Lindsey Smrekar said. If she doesnt get something right away, she just keeps doing it until she gets it.

Emma took her own senior photos. She set up a tripod near Lake McKusick in Stillwater, connected her Canon Rebel T6 camera with her phone and set up the angle and everything how she wanted it, Lindsey Smrekar said. When she told me to hit the button on the phone, I did. It was all her.

Her favorite TV show is The Office. Shes seen every episode at least 14 times thats a guess, but probably not embellishing, Scott Smrekar said. She loves Jim and the pranks that he pulls on Dwight. She has the Office Lego set, an Office pillow case, COVID masks, t shirts, sweatshirts, blankets, even a painted sign in her bedroom.

Many of the Dunder-Mifflin treasures were gifts from friends and family after learning of her diagnosis, he said.

The diagnosis has been hard on Emma, Lindsey Smrekar said. She is such a strong girl. I cant even imagine. I would have been doubled over and crying. Eventually, when she got into the hospital bed, she was puking from the pain.

Emma can still eat, but she receives most of her nourishment through a feeding tube. Her goal is around 1,000 calories a day. At first, she was into a lot of bakery products donuts and a lot of toast, Lindsey Smrekar said. But her taste buds are changing. Even foods she used to love like Dr. Pepper sodas, Twix and Kit Kat chocolate bars she doesnt now.

Emma loves the color teal because it reminds her of the ocean. Her favorite photo is one she took during a family vacation to Key West, Fla., last year. Her Make-A-Wish request is to go to Maui.

Chemotherapy has shrunk her tumor to the size of a baseball. Doctors at Mayo plan to treat her with 33 rounds of proton therapy, which has shown promise in treating several kinds of cancer. It can cause fewer side effects than traditional radiation, because doctors can better control where the proton beams deposit their energy.

They can stop it at a certain point, so it doesnt hurt any of her important organs that they are trying to keep safe, Lindsey Smrekar said. They want to safely get her better so she doesnt have a ton of side effects afterwards or problems later in life.

Hopefully, it just doesnt come back, her mother said. She can go to college and live a normal life.

Emma wants to study neuropathology at Bethel University in Arden Hills and specialize in cancer research because she just wants to make life better for other kiddos with cancer, Lindsey Smrekar said.

The Smrekars moved to their house on Swenson Street in Oak Glen from the citys North Hill neighborhood in 2018.

The first neighbors to introduce themselves were Dan and Amy Stoffer, who live across the street. They brought a pizza and a 2-liter bottle of soda.

After learning of Emmas diagnosis, Dan Stoffer came up with the idea of illuminating the neighborhood with teal lights. Many of the houses still have the original matching globe lamp posts that were installed when Oak Glen was developed. The lights stretch the length of Swenson Street and extend around the corners to Oak Glen Drive and Oak Glen Trail. Every household in the immediate vicinity 23 in all is participating.

No matter what, she can see those lights, Amy Stoffer said. Her neighbors know that shes going through a struggle, and we wanted her to know that we stand by her and her family.

It turns out finding the perfect shade of teal in a LED light bulb isnt easy.

The couple ordered multiple bulbs from different online shopping sites before settling on an 85-watt color-changing LED light bulb with a remote control they found on Amazon.com. They ordered enough for the neighborhood.

The Stoffers, who have lived in Oak Glen since 2005, wheeled around a wagon with brown paper bags, which included the teal light bulb, a flier describing Emmas situation and an ask for an Emma Fun Fund. We were thinking theyd get her a nice Lego set or something, Scott Smrekar said.

Instead, the Stoffers returned with a gift box filled with cash, checks, a robe, cards and messages. The neighbors raised $1,170, enough for Emma to buy the new Canon EOS 90D camera she had been wanting.

Everybody gave money, even during this time, when theres a little bit of uncertainty That says a lot about our neighborhood, Dan Stoffer said.

Jon and Shelly Hill, for example, started a Meal Train online account for neighbors to take the Smrekars meals on Wednesday night. The Hills brought pulled pork and gluten-free apple crisp one week; next-door neighbor Josh Mogren brought over a full rack of very tasty ribs on another.

The Stoffers, who have two sons, Ben, 13 and Henry, 11, signed up to take chicken tortilla soup to the Smrekars.

We just know as parents how terrifying that must be for them and their whole family, and we just want to be there for them, Amy Stoffer said. I was really thankful for the opportunity to show our kids how important it is to care about other people, to take action when they see something that needs doing and to step up for other people.

The teal lights are expected to stay lit for as long as Emma is working to overcome her cancer, Amy Stoffer said. The couple bought extra bulbs in case replacements are needed.

The show of support has lifted the family through this hard year, Scott Smrekar said.

It means so much, he said. There is a lot of division right now in the country. We have Biden supporters and Trump supporters out here. Youll see Black Lives Matter signs, Blue Lives Matter signs. But none of this seemed to factor in whatsoever when the neighborhood learned of Emmas diagnosis. Everyone was so gracious and helpful. All they wanted to know was: How is she doing? What do you need? What can I do to help? We are so grateful.

A GoFundMe has been set up to help offset the cost of Emma Smrekars medical bills. To donate, go to https://www.gofundme.com/f/emmasmrekarstrong.

More:
The lights are on for Emma. Neighborhood glows teal as Stillwater teen battles cancer. - TwinCities.com-Pioneer Press

Marcel Gemme, For the Headlight Published 10:40 a.m. MT Nov. 25, 2020 | Updated 12:14 p.m. MT Nov. 25, 2020

Retro manual typewriter with printing hands and sheet of paper(Photo: vectorikart, Getty Images/iStockphoto)

Now that the holidays are upon us,many of us face a set of decisions wed rather not be forced to make.These revolve mostly around COVID-19, the uninvited guest.

Weve never seriously had to consider canceling Christmas.But this virus has proven to be resilient in large countries where preventative measures arent uniformly used. So, instead of having it under control right now and being able to enjoy our holiday, we just saw a one-week total of over 1 million positive cases of the virus, according to the CDC. This has left many feeling uncertain about how to plan for what is normally a joyous occasion and a time to gather together.

If youre looking for reassurance about what to do, good luck.There are no direct answers provided by health authorities, perhaps to not offend anyone.But this lack of direction seems to leave the subject in question and a matter of ongoing debate. Even the CDC has dodged the issue.

They never state that you should not travel to visit your family this Thanksgiving. Instead, they provide a virtual flowchart of potentially risky situations, which anyone could have easily experienced within the last few days.Then, they say that if you have been exposed to any of these risks, you should probably make other plans for Thanksgiving.Its a subtle way of saying that there are no safe circumstances.

The common language states that its safer to stay inside. It is safer not to go to the store. Its safer never to see anyone.All of these statements are true.But, following that logic, its safest to live in an isolation chamber with IV fluids and a liquid diet forever.

So, what are we to do?Before COVID, the flu was our deadliest threat.And people did not live inside in fear the way that we do now or are supposed to.But we knew that the flu was here to stay, and it came around every year in what we call flu season.

Lets imagine for a second that this was COVID-19.If we knew that it was here for good, wed likely act differently.Suddenly, wed be weighing every decision against the same risk, but from an entirely different viewpoint.Everything would be indefinite.

A senior citizen who was nearing the end of their life would have to decide that they would never see their family again.They may live for years longer this way.Or they could choose to spend what could be their last Christmas with their loved ones, knowing that COVID-19 could quickly bring about their premature end.

As you can see, this changes things.But the only factor that has changed in this scenario is knowing how much longer were in this thing for.

On the other hand, if we knew that it would all be over in a month, we could all easily buckle down and wait it out safely, even if that meant missing a major Holiday.But unfortunately, we just dont know.

If we all acted as if it would be over in a month, we could potentially cause it to dwindle away.But this is where it comes down to one little thing. We each have a choice.

We each also have a life.Not everyone can lock themselves in their house and avoid the world until this all passes.Most people must work, raise children, and go to the grocery store.And many seniors, who are at the highest risk, need someone elses help day-to-day.

So, whats the right decision for you?This will likely depend on your circumstances and viewpoint.But it may mainly hinge on your perception of how long the virus will be around.

Those who believe that it will be around for a long time will likely be the least cautious in the days ahead.This includes people with cynical attitudes since they doubt that things will ever get better.This is a sure route to hypocritically engaging in risky behaviors.

Instead, lets all trust each other for once.Lets pretend that it will be gone by Christmas.If we all act that way, it just might.

Marcel Gemme has dedicated his life to helping others find help. He focuses his attention on helping individuals find long-term senior care, he does this through his journalism, community outreach, and his website,ECDOL.org.

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Your turn: How will you deal with the uninvited guest? - The Deming Headlight

Timsi Bector

We often come across this statement I am on diet or I am dieting these days. Now what does it mean exactly? Do you really know the difference between being on diet and on a diet plan? When you are dieting, you are restricting your diet, starving yourself or skipping meals. Why did you start it? Probably you felt that you were gaining inches or you were getting overweight and did not have the time to hit the gym. So, this was an easy escape. If this is the case, then let me foretell your fitness future.

1. You are slowing down your BMR (Basal Metabolic Rate), instead of boosting it. You are not giving any task to your system but expecting it to work.

2. By dieting, you can see some temporary results but cannot achieve a sustainable fit body. These temporary results do not come alone in life. They come along with problems like low- energy level, headache, mood swings, irritating behaviour and digestion problems.

3. You will also devoid yourself of some very important nutrients by avoiding many food items. So you will end up ageing, being lethargic, untoned and unfit.

4. By dieting you are losing not only fat but muscles also. So, from where will you get your body strength? Looking fit and being fit are two different things.

Path to wellness

You need a complete wellness plan. A wellness plan includes a nutrient rich diet that is planned considering your medical condition, physical data and many other factors. It includes a suitable workout regime and lifestyle modifications. Burning out in the gym is good, however, restricting your diet for a few months is not a sustainable solution.

Things to do

1. Alter your lifestyle by focusing on your breathing pattern, your posture, your daily movements and also your thought process.

2. Include a workout regime suitable for your body and medical conditions.

3. Be disciplined in your approach when it comes to fuel your body. Focus on clean, home-cooked, unprocessed and local food.

This will surely lead to:

1) Change your internal body composition which is the healthiest way of losing weight.

2) Increase your BMR which implies sustainable fitness.

3) Make your system stronger and increase your immunity.

4) Replenish all the required nutrients by improving their absorption and circulation to each and every cell of the body.

This ultimately will help you achieve holistic wellness by achieving a stress-free mind and a fit body. So next time you think of fitness, go for a diet plan and not just dieting.

(Bector is a Ludhiana-based nutritionist and fitness trainer)

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When you think of fitness, think of a diet plan - The Tribune India

A newly published study has found that vegans may be at higher risk of bone fractures than people who incorporate meat into their diet. The risk may also be higher for vegetarians and pescatarians.

Researchers have found that vegans with lower calcium and protein intakes had a 43% higher risk, on average, of experiencing bone fractures than people who ate meat.

The longitudinal study that reached this finding appears in the journal BMC Medicine.

According to the study, among the study participants eating a vegan diet, there were close to 20 more cases of fractures per 1,000 people over a 10-year period. In particular, vegans faced a higher risk of fractures of the hips and legs, as well as other main site fractures, such as the clavicle, ribs, and vertebrae.

This is the first comprehensive study on the risks of both total and site-specific fractures in people of different diet groups, says Tammy Tong, lead author and a nutritional epidemiologist at the Nuffield Department of Population Health at the University of Oxford in the United Kingdom.

The biggest differences were for hip fractures, where the risk in vegans was 2.3 times higher than in people who ate meat equivalent to 15 more cases per 1,000 people over 10 years.

Tammy Tong

Vegetarians and pescatarians individuals who do not eat meat but do eat fish also had a higher risk of sustaining hip fractures than people who ate meat, according to the study.

However, the researchers found that taking body mass index (BMI), dietary calcium, and dietary protein into account partly reduced the risk of fractures in these groups.

The researchers analyzed data from nearly 55,000 men and women living in the U.K. who had agreed to participate in the Oxford component of the European Prospective Investigation into Cancer and Nutrition (EPIC) study to examine how diet affects fracture risk.

Of the participants, nearly 30,000 ate meat, about 8,000 were pescatarians, more than 15,000 were vegetarians, and nearly 2,000 were vegans at the time of their recruitment between 1993 and 2001.

Researchers at the Universities of Oxford and Bristol examined the outcomes of the participants by monitoring their hospital records and death certificates until mid-2016. The team followed the participants for more than 17 years, on average.

Over the course of the study, 3,941 fractures occurred in total, including 566 arm, 889 wrist, 945 hip, 366 leg, and 520 ankle fractures and 467 fractures at other main sites, which the researchers established to mean the clavicle, ribs, or vertebra.

The authors observed no significant differences in risks between diet groups for arm, wrist, or ankle fractures once they took BMI into account.

Earlier studies have linked calcium and protein intake to bone health. Researchers have also shown that a low BMI is associated with a higher risk of hip fractures but a lower risk of ankle fractures.

Regarding specific diet types, previous studies found that vegetarians had lower bone mineral density (BMD) than those who ate meat.

According to other research, people who follow vegan or vegetarian diets have lower intakes of dietary protein, as well as lower BMIs than those who eat meat. Additionally, vegans may have substantially lower intakes of calcium.

The studys authors found that the differences in the risk of total and site-specific fractures became less once they factored in BMI, dietary calcium, and dietary protein.

A 2019 analysis found that combined vitamin D and calcium supplements were effective in fracture prevention.

Well-balanced and predominantly plant-based diets can result in improved nutrient levels and have been linked to lower risks of diseases, including heart disease and diabetes, says Tong. Individuals should take into account the benefits and risks of their diet and ensure that they have adequate levels of calcium and protein and also maintain a healthy BMI that is, neither under nor overweight.

A 2007 study from the Oxford-EPIC cohort that included almost 35,000 participants also found that vegans had a higher risk of total fractures, but not vegetarians.

However, when the study only looked at the participants who reported consuming at least 525 milligrams a day of calcium, the increased risk dissipated.

Researchers caution that this study had a shorter follow-up period of 5 years and relied on the participants self-reporting.

The authors of the new study caution that they were unable to pinpoint the causes of the fractures and did not know whether the participants had used calcium supplements.

They hope to see additional studies looking at non-European populations, as other studies have indicated that there are differences in BMD and fracture risks among ethnic groups.

As three-quarters of the participants in this study were women, the researchers also call for a study with a larger proportion of men to explore differences in risk by sex.

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Vegan diets may be linked to a higher risk of bone fractures - Medical News Today

When everything seems to have a mysterious double-meaning, it probably comes as no surprise that we think our body shape might provide clues to what foods it wants you to it. For instance, if you've been told your body type is endomorph, you've probably wondered if there's a magical diet plan that will bust fat like none other. So is there? We asked nutrition and exercise experts to explain what the endomorph body type is and what the best diet is for an endomorphic person to follow.

Back in the 1940s, a psychologist and physician named William H. Sheldon created a new method of somatotyping, a.k.a. classifying human bodies into three different groups according to the way they look:

The theory is that everyone can be placed, neatly, into one of these generalized categories, but this is not always the case as many people display characteristic traits of multiple body types, says Chris Gagliardi, the Scientific Education Content Manager for the American Council on Exercise (ACE) and an ACE certified health coach and personal trainer. For example, he points out that someone with a "pear-shaped" body has a thin upper body and more fat around the thighs and hips, while someone with an "apple-shaped" body has more fat around the waist, but thin arms and legs. The idea of body types originated to compare body shape to personality and delinquent behaviors, says Gagliardi. More current methods of assessment involve looking at objective measurements such as the amount of fat mass and fat-free mass an individual has.

Since people with this body type are said to have higher levels of body fat, most diets for endomorphs revolve around eating protein and fats while limiting carbohydrates. I typically recommend to my clients a low-carb diet, but not a ketogenic one, as Ive found that most of the women I work with find it challenging to maintain a ketogenic diet for a long period of time, says Rachael Attard, a certified personal trainer and nutritionist and the creator of the 3 Steps to Lean Legs Program. She advises people with an endomorph body to focus on healthy whole-food sources of protein and fat such as fish, lean meat, eggs, beans, avocado, nuts, coconuts, and olive oil.

Endomorphs dont have to and probably shouldnt cut out carbs completely: Attard says vegetables, sweet potatoes, oats, berries, and legumes are all smart carbohydrate options. When it comes to carbs, I recommend eating your carbs after your workout as this is when your body uses them to replenish and build muscles, not store fat, she says. She even created a calculator to help clients figure out how many daily calories they should consume and what portion of them should come from proteins, fats, and carbohydrates according to the persons height, weight, age, body type, and activity level. However, the most important part is finding a regimen that works for you and your goals, that does not feel too restrictive or overwhelming, Attard explains. This is the only way to maintain a healthy body and lifestyle in the long run.

While a low-carb diet may work for some people with an endomorphic body, its not a surefire strategy that will work for everyone with that body type. Generally, the thought process for this kind of dietary pattern has revolved around altering macronutrient intake based on someone's body fat to muscle mass ratio, says Ryan D. Andrews, M.S., M.A., R.D., R.Y.T., C.S.C.S., principal nutritionist and adviser for Precision Nutrition. To say that there's robust scientific evidence supporting this dietary pattern as a way to improve public health would be misleading and inaccurate. Andrews says its possible that following an endomorph dietary pattern may help you reach your weight goals, but it could also distract you from addressing your foundational food-related behaviors. This body-type dieting creates rules and regulations that make day-to-day nutrition choices unnecessarily complicated and restrictive, which may lead to rebound overeating, a preoccupation with certain foods, and can even move someone further away from their goals, Andrews says. The most important nutritional behaviors include emphasizing a variety of minimally processed foods, eating plenty of plants, ensuring enough protein, eliminating nutrient deficiencies, noticing and responding to hunger and fullness cues, eating slowly, and staying hydrated with beverages that don't contain high amounts of added sugars.

It depends on what your goals are! My personal belief is that it is best to exercise, eat, lead a lifestyle, and adopt habits that will support goal attainment rather than trying to do what is best for your body type, says Gagliardi. A primary goal for many endomorphs is centered around weight loss or increasing fitness levels, but when it comes to exercising to reach these goals, it is important to start at a level that allows you to comfortably accomplish what you set out to do. Essentially, if you arent very active right now, its vital to start slowly and then build from there in order to avoid injury or burnout. If youre already active, youll have to intensify or change the exercises youre currently doing if you want to see changes on the scale.

First, keep in mind that the body type someone has is a by-product of many different factors including genetics, food choices and amounts, physical activity, stress, trauma, inequalities, sleep, job, social support, and the list goes on, says Andrews. The good part of that is that you shouldnt feel like the shape of your body is entirely your doing. The bad part of that is that youll likely have to make changes in several aspects of your life if you want to alter your body. But you can change it. You are not stuck with your body type, says Gagliardi. Because body type is based on physical characteristics this means it can be changed. He notes that those changes take time, consistency, hard work, and adjustments in your behavior, habits, and lifestylebut its possible.

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What Is the Endomorph Diet? What Can You Eat on the Endomorph Diet? - GoodHousekeeping.com

An age old saying goes: You are what you eat and so, when it comes to maintaining your health and wellbeing in these unprecedented times, it all depends on your eating habits and lifestyle. Considering that health and fitness is the number one priority today, some simple yet essential steps are important to remain healthy in the long run. While activities like exercising, yoga and meditation are a must to build a strong immunity. Apart from that healthy eating and eating foods that boost immunity as equally essential for a healthy body and mind. This also helps you stick to the path of health and fitness. Thus, one can easily find out what kind of foods and fluids help in achieving those fitness and immunity goals and take small but daily measures to stay at the top of their health game. If you are wondering about boosting your immunity to stay at the peak of your health, read on to find out about five such foods which are the holy grail for building immunity naturally. Pure HoneyUsed in multiple home remedies that are passed on from one generation to another, honey is the most widely used food ingredient. Also known as the liquid gold, many people prefer the taste of honey over sugar as it not only tastes great but also helps in boosting immunity. It is rich in antioxidants, great alternative for sugar and an immunity booster. Honey has various types which are easily available in the market, but the catch is that one must be careful before choosing their brand of honey since there are cases of honey adulteration too. Thus, before choosing a honey brand, always make sure to check for its purity by looking for an NMR tested label as it suggests that the honey is treated with Nuclear Magnetic Resonance technology which guarantees 100% purity since it goes through multiple quality checks along with filtration stages to remove any kind of impurities resulting in 100% pure honey.MoringaWhile Moringa is known as the drumstick tree, it surely classifies itself as an excellent superfood. When the leaves of the Moringa oleifera are dried into a powder, it provides a range of nutritional benefits. From boosting immunity, reducing inflammation to providing antimicrobial effects, moringa is a clear winner. The powder from the Moringa leaves is also help in improving heart health, controlling the levels of blood cholesterol, blood pressure and prevention of formation of plaques in the arteries. If you choose to add daily supplements of Moringa leaves, it can result in the reversal of formation of fatty liver and thus in turn reduce visceral fat. 100 g of Moringa leaves has 314 mg of calcium which is a known ingredient to strengthen bones. One of the best ways to consume Moringa is also through green tea which provides a great amount of nutrition as well as an added flavour to your taste buds.Dry fruitsDry fruits are packed with natural sugars that provides great energy and help elevate moods. Dehydrated fruits like anjeer, dates, apricot, raisins, etc. have various benefits. Figs/anjeer contain high fibre content which helps in maintaining a healthy digestive system by preventing constipation while apricots provide a rich source of potassium which aids nerve signaling, muscle contractions and fluid balance along with preventing high blood pressure and even strokes. Sweet, dry raisins, rich in fibre, help aid the digestion by softening and increasing the weight and size of stools and preventing constipation. Thus, consuming dry fruits can end up in not only boosting your immunity but also aiding digestion, regulating blood pressure and elevating mood!

Cold Pressed Virgin Coconut Oil Virgin coconut oil, just like honey has been a staple in many Indian households and rightly so. It is one of those superfoods that is not only known for aiding weight management and boosting energy but for its immunity boosting properties. The important components present in Coconut Oil like lauric acid, caprylic acid and capric acid along with monolaurin acts as an antiviral agent in the body. Apart from using it for cooking, it can also be used for baking vegan desserts, salad dressings or sauting basic vegetables. It is recommended to consume 2 teaspoons of virgin coconut oil every day for an energetic start to the day.

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Add these 5 foods to your diet to strengthen immunity for winter - Times of India

Chia seeds are small, edible seeds of the Salvia hispanica plant native to central and southern Mexico. They are gray with black and white spots and measure about two millimeters in diameter. However, even though they're small, chia seeds are packed with nutrients and offer several health benefits.

Here are six health benefits of chia seeds and how to incorporate them into your diet.

A serving size of chia seeds one ounce or two tablespoons contains about 11 grams of fiber. That's almost half of the recommended daily amount for women (25 grams) and about a third for men (38 grams), says Amanda Miller, a registered dietitian from Chicago who specializes in weight loss and medical nutrition therapy.

Fiber is an essential part of a healthy diet. Consuming foods high in fiber can:

A 2009 review found high intakes of dietary fiber significantly lowers one's risk of developing a stroke, hypertension, diabetes, and obesity. It also found that increasing intake of fiber improves insulin sensitivity in both non-diabetic and diabetic individuals. The review concluded children and adults should consume 14 grams of fiber for every 1000 calories.

Two tablespoons of chia seeds also contain about four grams of protein. Chia seeds are a complete source of protein, meaning they contain all nine amino acids, which the body is unable to produce on its own.

Most complete sources of protein are animal products like eggs, fish, beef, and dairy. Plant-based sources of protein like nuts, beans, and whole grains contain some but not all of the essential amino acids. This makes chia seeds a good plant-based protein option for vegetarians and vegans, Miller says.

Amino acids in protein are the building blocks for organs, skin, and muscles. Consuming adequate amounts of protein is essential for cell growth and repair, says Karen Kjaerulff, a registered dietitian and nutrition consultant based in Delray Beach, Florida.

Chia seeds are a great source of omega-3 fatty acids, Miller says.

Consuming a diet rich in omega-3 fatty acids can reduce the risk of heart disease and stroke. Omega-3 fatty acids from chia seeds, in particular, have been found to lower levels of low-density lipoprotein (LDL) cholesterol, the "bad" kind of cholesterol that can increase your risk of heart disease.

Among plant-based sources of omega-3 fatty acids, chia seeds contain the highest concentration.

Kjaerulff says chia seeds should be part of a well-balanced diet with other sources of omega-3s like:

Omega-3 fatty acids, like those found in chia seeds, also prevent inflammation in the body during times of disease, stress, and illness, Miller says. Caffeic acid, an antioxidant found in chia seeds, has also been shown to fight inflammation in the body.

"Inflammation is the body's natural and helpful way to deal with harmful foreign substances in the body or an injury," Miller says. "But when inflammation persists, that's when it's cause for concern."

Chronic inflammation may increase a person's likelihood of developing diseases like arthritis, diabetes, and heart disease. But a 2018 review found omega-3 supplementation may reduce symptoms of rheumatoid arthritis a chronic inflammatory disorder that affects the joints.

Chia seeds contain several different types of antioxidants, including:

Antioxidants help fight against the production of "free radicals" in the body, which damage cell molecules.

"Free radicals are constantly being formed in our bodies and a certain amount are necessary for our health, for example, they help fight infections," Kjaerulff says. "When free radicals outnumber antioxidants, oxidative stress occurs which can damage your DNA and lead to cell death and has been linked to diseases such as cancer as well as aging."

Chia seeds contain high amounts of calcium 18% of the recommended daily intake per serving and can improve bone health.

Research on how chia seeds could improve bone health in humans is still emerging, but a 2018 study in rats found that chia seeds improved bone mineral density. The researchers examined 20 rats divided into two groups. One group received a diet containing 10% chia seeds and the other did not. After 13 months, the bone mineral content of the chia-fed rats was significantly higher than the control group.

Chia seeds are usually sold in bulk bags and can be found at many local grocery stores, health food stores, or online. They can be eaten either whole or ground, Kjaerulff says.

Chia seeds are very versatile and you can incorporate them into your diet in many ways, like:

Chia seeds offer many health benefits and contain fiber, protein, and omega-3 fatty acids. Research shows that eating a diet rich in nutrients like these can reduce inflammation and improve heart health. To achieve these health benefits, add chia seeds to yogurt and smoothies or make a chia seed pudding with milk and fruit.

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6 science-backed health benefits of chia seeds and how to incorporate them into your diet - Insider - INSIDER

Numerous studies over the past several decades have found evidence that wine's anti-inflammatory compounds can reduce the risk of cardiovascular problems like high blood pressure, stroke and heart failure. A new study from Harvard University, published in the Journal of American College of Cardiology, followed people's diet habits for more than two decades and found that avoiding pro-inflammatory foods such as red meat and sweet drinks while consuming anti-inflammatory foods such as wine, tea and vegetables, can significantly lower your risk for cardiovascular disease.

To examine long-term dietary habits, lead author Dr. Frank Hu and his team at Harvard's T.H. Chan School of Public Health analyzed data from three different cohorts spanning well over 20 years, including the Nurses' Health Study (NHS) and Nurses' Health Study II (NHSII), which included over 165,000 women, and the Health Professionals Follow-Up Study, which followed 44,000 men. Hu's team examined food frequency questionnaires the large studies collected every four years to monitor diets. They also evaluated the inflammatory potential of each participant's diets using an empirical dietary inflammatory pattern (EDIP) score.

What makes this study unique is that it is the first to employ an empirical food-based dietary inflammatory index in association with cardiovascular disease. The index, or EDIP score, was developed by Harvard and is calculated as the weighted sum of 18 food groups that show the strongest association with inflammation. Participants with higher scores consumed diets with more pro-inflammatory foods, such as red meat, refined carbohydrates and sweetened beverages. Those with lower scores ate more anti-inflammatory foods, such as leafy vegetables, whole grains, coffee and wine. Dr. Jun Li, one of the study's co-authors, told Wine Spectator that wine had the highest statistical association with lower inflammation.

The researchers updated the scores every four years. All participants were free of cardiovascular disease at the start of the study. Over time, doctors reported the development of cardiovascular disease, and researchers analyzed autopsy records to ascertain evidence of fatal heart conditions.

The results showed that higher EDIP scores were significantly associated with a higher risk of cardiovascular disease. "We hypothesized that a higher dietary inflammatory potential may be associated with higher risk of cardiovascular disease incidence before conducting the study, and our findings confirmed our results," said Dr. Li. "The group of individuals that consumed the most pro-inflammatory diet were 46 percent more likely to develop coronary heart disease and 28 percent more likely to develop a stroke, compared to the group that ate the most anti-inflammatory diet."

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What surprised Dr. Li and her team was the robustness of the results. The findings are consistent across the cohorts, between men and women, even after they addressed confounding factors such as health conditions, anti-inflammatory medications and other risk factors.

One of the biggest limitations of the study is that these are correlationsthe research has not measured a direct link between an anti-inflammatory diet and a lower risk of heart disease. Also, the cohorts used in the study included only health professionals who were mostly white.

Dr. Li says the team is conducting follow-up studies to address these factors. "We are replicating our study in other cohorts that include higher proportions of African Americans and American Hispanics/Latinos," she said. "We are also using other technologies, such as metabolomics [the study of metabolites], to examine potential biological mechanisms underlying the associations between dietary inflammatory potential and cardiovascular risk."

So what does this mean for wine lovers? Dr. Li notes that past studies suggest excessive alcohol intake can be detrimental toward cardiovascular and mental health. But she says that moderate wine intake with a healthy and anti-inflammatory diet, such as the Mediterranean diet, could be beneficial.

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Leafy Greens, Whole Grains and a Glass of Wine May Keep the Heart Healthy - Wine Spectator