Cholesterol can be confusing. But understanding it could help you live a longer, healthier life.

So in honor of Cholesterol Education Month, we asked a pair of experts to clear up five common questions.

Do my blood cholesterol numbers matter?The answer is yes, said Dr. Neil J. Stone, Bonow Professor in Medicine-Cardiology at Northwestern Universitys Feinberg School of Medicine in Chicago.

Studies show healthy people with LDL levels of 100 mg/dL or below tend to have lower rates of heart disease and stroke, supporting a lower is better philosophy, according to cholesterol guidelines issued by the American College of Cardiology and American Heart Association in 2018.

Older recommendations emphasized targeting specific cholesterol numbers. But today, doctors use cholesterol tests as part of a personalized assessment of overall cardiovascular risk. Those with the highest risk have the most to gain from cholesterol-lowering, said Stone, who was vice chair of the task force for the guidelines.

But cholesterol doesnt exist in isolation, he said. One has to think about diet and lifestyle and medication to treat the whole risk continuum of blood pressure, cholesterol, blood sugar and weight.

The guidelines recommend getting cholesterol and other traditional risk factors checked every four to six years starting at age 20. If the COVID-19 pandemic has complicated those plans, get up to date when you can do so safely, said Kristina Petersen, an assistant professor in the department of nutritional sciences at Texas Tech University in Lubbock.

Im confused about good cholesterol versus bad. What should I focus on?When you get your blood tested, youll probably see numbers for total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides.

LDL is the so-called bad cholesterol because it increases the risk of heart disease, stroke and other health problems. HDL is dubbed the good cholesterol because having a higher level is associated with lower risk of heart disease and stroke.

Lowering LDL should be the priority, said Petersen, co-author of an AHA science advisory on dietary cholesterol and heart disease published in December in the journal Circulation.

The most important thing is to lower LDL cholesterol, because that is what ultimately increases your risk of heart disease, she said.

Should I worry about cholesterol in food?Many sources of cholesterol in the diet also are sources of saturated fat, Petersen said. We do want to limit dietary saturated fat intake. And if you do that, your intake of dietary cholesterol will be low. Cutting back on saturated fat can improve your LDL number in four to six weeks, she said.

The advisory on dietary cholesterol emphasizes that a healthy diet is more important than focusing on a specific cholesterol target, and such a diet highlights fruits, vegetables, whole grains, low-fat or fat-free dairy products, lean animal protein or plant protein sources, nuts, seeds and liquid vegetable oils.

Selecting the right food may be particularly important for people who are sensitive to dietary cholesterol, which some studies suggest could be the case for roughly 1 in 4 people. A 2019 review published in JAMA of long-term studies suggested that each additional 300 milligrams of dietary cholesterol consumed per day was significantly associated with higher risk of heart disease.

The patient should talk to the doctor about individualizing limits on dietary cholesterol, Stone said.

Is it OK to eat eggs?Egg yolks are known for their cholesterol, with one large scrambled egg containing 169 milligrams of cholesterol.

You can eat eggs, Petersen said. We suggest eating no more than one full egg per day in order to keep your cholesterol intake low, but you can definitely have eggs as part of a healthy dietary pattern.

The research is inconsistent, she said, because eggs often are consumed with foods high in saturated fat, making it hard to parse out potential harm.

And people vary, Stone said. Some patients have two eggs a day, and their cholesterol doesnt budge. Other patients have two eggs a day and their cholesterol goes up 50 points.

Is possible to inherit high cholesterol?High LDL cholesterol is sometimes caused by a genetic abnormality called familial hypercholesterolemia that affects an estimated 1 in 212 U.S. adults. If its picked up early, medication combined with a healthy diet and exercise can be very effective.

The ACC/AHA guidelines say its reasonable to check cholesterol in children as young as 2 who have a family history of early heart disease or high cholesterol.

Everyone needs to stay aware of their cholesterol levels and be mindful of the connection to overall health, even amid the pandemic, Stone said.

This is exactly not the right time to let diet and regular exercise go to develop habits that are not heart-healthy, he said. This is exactly the right time to learn how to eat less, eat smarter, move more daily, and keep from gaining weight.

See the original post here:
The good, the bad and the dietary: Making sense of cholesterol - The Augusta Chronicle

Matthew F. Watto, MD: Welcome back to The Curbsiders. I'm Matthew Watto, here with my greatest friend, Dr Paul Williams. Paul, tell us what we are going to do on this short video.

Paul N. Williams, MD: We're going to highlight some of our favorite clinical pearls and practice-changing knowledge that we gleaned from a recent interview with the amazing Dr Michelle Kittleson, a renowned cardiologist, heart failure expert, and Twitter phenom. We had a long conversation about the inpatient management of acute decompensated heart failure, and we thought we'd spend a little time in this video talking about the things that we liked best from that discussion.

Watto: Pearl number one. She made it pretty easy on the physical exam. What she cares about is elevated jugular venous pressure or pulsations, and she looks for lower-extremity edema. She gave us permission not to listen to the lungs. She doesn't really care about crackles because they are very nonspecific.

When it comes to the labs, you can check the B-type natriuretic peptide (BNP) once if you are making the diagnosis of heart failure, but it shouldn't be trended. The things you should trend are sodium, potassium, and creatinine levels. Those are the important labs that have some prognostic value. With potassium you just have to make sure it's high enough so that the patient doesn't code on you.

Williams: Tremendous advice. I made a half-hearted defense of the lung examination, but I was scared of her so I didn't really lean too hard into it. Another point that came from a nice conversation the two of you had was about precipitants of heart failure exacerbation and whether we should be blaming the patient for the exacerbation, in terms of things like medication or diet nonadherence. I liked her take on this, which was, you really aren't duty-bound to look for precipitants, whether that's an acute ischemic event or medication nonadherence, either because they couldn't afford the medication or any of the other reasons patients might not have access to them.

You need to look and examine for those problems because they are reversible. But she also made the point that if patients are doing everything right and they still have acute decompensated heart failure, that's a pretty bad prognostic indicator.

Watto: I loved that point. It can't be said enough that when you read notes, people are clearly blaming the patient for their exacerbation. Sometimes the patient might have been able to avoid it, but a lot of times, it's just progression of disease. And I really liked what she said about fluid and salt restriction.

Williams: Her point was that there is no point to mercilessly restricting fluid and salt in the inpatient setting. If you can't control someone's volume status when they are on 2 g of sodium and 2 L of fluid daily, it doesn't matter how much more you restrict them at that point. You need to adjust their diuretic to optimize them. There's no point in relentlessly controlling fluid and sodium intake because you aren't going to significantly impact the volume status that way. It has to be done with medications at that point.

Watto: She even implied that the physician ordering the very restrictive diet should be put on the same diet. I like that point.

Williams: She didn't imply it; she outright said it.

Watto: That's right. She was not mincing words.

Finally, there was one other pearl that I thought was really great and very important, because I see this all the time. When a patient comes into the hospital, we should not just automatically pull off the ACE inhibitor or the beta-blocker. The guideline-directed medical therapy should be continued if you can do it if there's room in the blood pressure.

She talked about spending the blood pressure. In her practice (and we're talking about systolic heart failure here), she prioritizes the ACE inhibitor, the ARB, or these new angiotensin receptorneprilysin inhibitor (ARNi) compounds. Those would be her first agents that she would keep the patient on if she could. The next agent she would try to prioritize is the beta-blocker. You really should have a higher threshold to stop those agents because patients will do better, and we speculate that they might not get restarted when the patient is discharged from the hospital. It's really best to leave them on if you can safely do so.

Williams: That's exactly right. Prioritizing the ARNi over the beta-blocker feels like such a paradigm shift in recent years. It was fascinating to have that discussion.

Those are just a few nuggets of goodness from a wide-ranging conversation. If you want to hear the whole podcast (and you should), just click on the link below. You can also subscribe to our show to get our weekly episodes, and you can get a free PDF copy of our show notes and infographics at thecurbsiders.com.

Click to hear the full episode, Kittleson Rules Acute Heart Failure, or find The Curbsiders podcasts on iTunes.

The Curbsiders is a national network of students, residents, and clinician educators from across the country, representing 15 different institutions. They "curbside" experts to deconstruct various topics in the world of medicine to provide listeners with clinical pearls, practice-changing knowledge, and bad puns. Learn more about their contributors and follow them on Twitter.

Follow Medscape on Facebook, Twitter, Instagram, and YouTube

Read more here:
Heart Failure in Primary Care: Do's and Don't's - Medscape

A north-east education boss has thanked parents and carers for their support in recent weeks following the reopening of schools.

Laurence Findlay, Aberdeenshire Councils director of education and childrens services, has issued a letter halfway through the first term of the new school year.

He said the return to school following the Covid-19 peak had generally gone well and they are learning to live alongside the virus.

Mr Findlay said it was important for parents and carers to continue to speak to children about following the safety measures that are in place.

He also urged parents to follow the rules when it comes to drop-off and pick-up arrangements. As is currently stands parents are not allowed inside schools.

Mr Findlay said: The return to school has generally gone well, although the school environment is very different and rightly so given that we are now learning to live alongside Covid-19.

This requires all members of a school community to take responsibility and follow the measures put in place to protect everyone. All Aberdeenshire schools are following the guidance as issued by Scottish Government and all are engaged in an ongoing assessment of risk to keep young people and adults safe.

It is essential that everyone plays their part in this effort. I would encourage you to continue talking to your own child or children about the importance of following the procedures and measures the school has put in place.

Furthermore, I would urge you as parents and carers to follow the instructions the school is giving, particularly with regards to drop-off and pick-up arrangements. This is for everyones safety and wellbeing.

Aberdeenshire Council also issued a frequently asked questions guide which focuses on the Covid-19 restrictions around both primary and secondary schools.

It sets out the guidance schools are following as well as the reasons certain restrictions are in place.

Over the summer months, Scottish Government produced general guidance for local authorities on how to reopen schools safely. The process of publishing more detailed stage and subject-specific guidance is still ongoing, and on receipt of these, schools are required to revisit their working practices and procedures.

Schools undertook extensive risk assessment in the preparation for pupils returning in August. As a result, new rules and routines have had to be and continue to be introduced in all establishments. No two schools are the same, however, so each schools approach must be tailored to fit its own context.

Creating and then implementing all this new guidance has been necessary to ensure the health and safety of young people and school staff. It has been a major challenge and has resulted in a major change to established working patterns.

Significant time is now being spent explaining and reinforcing the guidance and because safety has been prioritised, some of the tasks which were routinely completed by staff before the pandemic are not being done so often or so quickly as before.

From the outside, it may look as if schools are as they always were but they are not. School life has changed significantly. Parents may be aware that queries are not dealt with so promptly, that members of leadership teams are not available to take calls, or that information takes longer to reach home, but we would ask for patience, as delays are often caused by the fact that so much time is now being diverted into supervision and the maintenance of good health and safety, and schools will still get back to parents as soon as they can.

All Aberdeenshire schools are following Scottish Government guidance to ensure the safety of pupils and staff in schools. They are also acutely aware of the need to reduce movement between different groups of people and the need to ensure that every possible measure is in place to try to prevent infection entering schools. Because of this, to protect the safety of pupils and staff, many schools are unable to allow parents to access school buildings.

Where there is need for a parent to engage with the school because, for example, a child has forgotten to take something important into school, or there is some emergency situation at home, the school will do what it can to help. In these cases, parents should telephone the school to explain the problem and the school will then explain how that can be overcome.

The most important thing to remember is that parents should not appear at school unannounced because in such cases, it is likely that they will not be able to access the building.

Although young people are back in school, Covid 19 is still an ever-present threat in our communities, and like everywhere else, schools have had to change and adapt. The certainty which we for so long have taken for granted has now gone and everyone in the country is having to cope with changing rules, and restrictions which differ day to day, week to week.

With this as the backdrop to school life, it is difficult for head teachers to make decisions too far ahead. The focus, for now, will be to try to ensure that young people are supported to learn and achieve in a safe and healthy environment.

At present parents, and other non-essential school personnel, are not allowed to enter school buildings. As a result, therefore, schools are unable to hold parents evenings.

The position as regards parent evenings will be reviewed in November. If the situation around Covid 19 improves significantly, restrictions may be eased and should this happen, individual schools will look at how best they can manage to accommodate parent meetings. These may, however, look different in each school and may differ in Primary and Secondary settings.

Parents should be aware that there may not be a full return to face to face meetings. Schools will, however, be mindful of the need to share information about pupils progress with parents and will look at ways of managing this.

This may mean parents evenings being replaced and we will look at ways of managing this via collegiate dialogue at school level and advise parents accordingly in due course.

We are continuing to cover all aspects of the curriculum in classes as best we can, but there are some activities often practical activities which pose some challenges. Guidance from Scottish Government has suggested that where possible schools should look to use outdoor spaces to deliver some aspects of the curriculum and schools are looking for ways to do this.

Where an activity is heavily dependent on shared specialised equipment, teachers must consider how or if that can be used safely, and risk assess activities accordingly. Everywhere in schools, there is a huge emphasis on cleaning, and regular hand washing or hand sanitising is now part of the routine in all schools.

During normal times at school, homework is an integral part of the school week. Currently, however, homework presents schools with some challenges. Movement of equipment and resources between home and school has to be restricted because of concerns about infection.

Furthermore, when written work is submitted by pupils in jotters, or on paper, the rules say that it must be quarantined for 72 hours before it is marked, a delay which could be counter-productive for many young people. Schools could choose to set homework on-line and ask for work to be submitted in the same way, but this is only feasible where they are certain that all pupils can access such tasks.

We are currently in what the Scottish Government has dubbed the Recovery Phase. In this phase, the focus has been on Health and Wellbeing, Literacy and Numeracy and homework has been less of a priority.

Schools will, however, soon be considering how to resume homework safely and will communicate with parents as necessary to explain how this will be managed.

Many of the subjects pupils study in school involve a significant degree of practical work Art, Music, Drama, Home Economics, PE, Technical subjects, Business subjects and Sciences have very significant practical elements, but there is also practical work built into other courses.

Guidance from Scottish Government, through Education Scotland, and from agencies like Scottish Schools Education Research Centre (SSERC) has been or is being created for schools to use in their planning, but there is no one size fits all approach.

Factors like school rolls, school buildings, staffing levels, timetable design and the availability of resources differ from school to school and all affect what can and cannot be done.

Where a subject is resource and equipment dependent, there are rules about the sharing of equipment and the cleaning protocols that are required to ensure pupil and staff safety.

This may mean that pupils can do less hands-on work and that they must learn from watching demonstrations rather than by doing the activities themselves. Where pupils are getting hands-on experience there are more frequent cleaning protocols to be worked into teaching time and depending on period lengths, this can be prohibitive.

Just as there are restrictions applied to facilities like public gyms and swimming pools, there are restrictions on what can and cannot be done in PE classes. PE classes are mainly, if not wholly, happening out of doors, even in poor weather, and changing facilities are an issue for many schools given that changing rooms are generally quite small and often windowless.

It is because of this that the guidance schools received said that pupils should come to school dressed in PE kit. Some schools have the accommodation to be able to create changing areas which satisfy the safety considerations, but in some schools, pressures on teaching space will not allow this.

Home Economics lessons provide another set of challenges because the design of most school kitchens makes any physical distancing very difficult and some equipment inevitably must be shared.

Pupils are encouraged to observe physical distancing rules, but teaching staff must maintain physical distancing as much as possible. In small kitchens, this is very difficult, and head teachers are mindful that they cannot risk the safety of staff.

There are also additional cleaning routines which add significant time pressures. Solutions to these challenges are being sought but as with everything in our new normal there are no easy answers.

At present, schools are looking for ways to ensure pupils can learn and develop practical skills, but this is not easy. Teachers are working with colleagues within their own school and from other schools locally and nationally to find solutions to these challenges while awaiting the promised national guidance.

Colleges, like schools, had to close their doors to students when lockdown began. Like schools, they have had to do a huge amount of preparation, involving detailed risk assessment, to be able to reopen safely.

The guidance for reopening colleges was only published at the beginning of September and it included the steps that were to be taken to permit school pupils to return to college link courses.

For now, NESCol, SRUC and Dundee and Angus College courses are being delivered to school pupils through on-line platforms and plans are being drawn up to start the process of on-site delivery for some courses. Although the picture varies from college to college, broadly speaking if a course has no significant practical element it may be delivered wholly or mainly on-line this session. For more practical courses, planning is underway to see how pupils might attend college for some lessons. Because of physical distancing rules which have to be imposed in colleges, as they cater largely for adults, pupils are unlikely to be permitted to attend college every week.

This may mean that pupils are unable to complete full courses, but in lieu of the usual qualification, a college certificate could be given.

Schools are doing all they can to ensure appropriate arrangements are in place for pupils with a college course in their timetable, but it may take time for final plans for these courses to be finalised.

Last session, SQA exams did not take place and the submission of coursework was also affected by the closure of schools in late March. This session, Scottish Government and SQA are planning for a full exam diet in 2021.

At the moment, extensive consultation is taking place with local authorities, teaching unions and members of the teaching profession more widely, to try to produce a workable plan for examinations in 2021, with contingencies in place in case there are further spikes in Covid 19 cases.

There are a whole range of factors which will have to be considered:

The uncertainty surrounding SQAs plans is undoubtedly causing anxiety for young people, parents and of course teachers, but we must all wait for final decisions to be made and new guidance on assessment in general, and examinations, in particular, to be produced.

In the meantime, staff in schools are trying to ensure key aspects and skills from each course are covered until revised guidance is made available. Their aim is to try to ensure pupils are encouraged to stay positive and have the best possible chance to achieve.

Which regular school events can I expect to happen during this school year? School life mirrors life in the community and just as many community events have had to be cancelled because of Covid 19, school events are subject to the same rules and regulations.

This means that as things stand, schools cannot plan to hold events like school concerts, fund-raising events and curricular information events. Even occasions like school parties and proms are under threat in their current form.

If restrictions are eased, there may be a possibility of some of the more traditional school calendar events taking place, but as always, schools will keep you fully informed.

This is a time of huge uncertainty for everyone: no one has a guide book to help them chart their way through this pandemic. Our young people will emerge stronger and more resilience from this difficult time if parents and staff work together.

Please continue to support your school in any way you can, within present restrictions, supporting your parent council, or any other parent forums your school has in place, as best you can.

See the article here:
Why can't I go into my child's school, what is happening with SQA Exams? North-east council release FAQ guide to help parents - Aberdeen Evening...

publication date: Sep. 18, 2020

Shelley A. DuBois

Science/health writer,

San Francisco, CA

Raymond N. DuBois, MD, PhD

Dean of Medicine,

Director, Hollings Cancer Center,

Medical University of South Carolina;

Editor in chief, Cancer Prevention Research

This story is part of The Cancer Letters ongoing coverage of COVID-19s impact on oncology. A full list of our coverage is availablehere.

This January, the American Cancer Society reported the sharpest drop in U.S. cancer mortality ever recorded. Between 2016 and 2017, the death rate from cancer fell 2.2%, continuing the trajectory of a 29% decline in cancer mortality since 1991.

Within a month after ACS reported those numbers, the COVID-19 pandemic hit, sending shockwaves through the already fragmented U.S. healthcare system. The pandemic could potentially reverse a decades-long downward trend in cancer mortality. We must not let this happen.

Specifically, we must ensure patients can get indicated screenings they need to detect cancer early, prevent it when possible, and save lives. We must also make sure that cancer patients continue their treatment regimens already underway uninterrupted and initiate new treatment for cancer when needed.

We have our work cut out for uspatients are understandably worried about seeking care during the pandemic, which has caused the death of nearly 200,000 people in the U.S., and continues to claim the lives of around 1,000 people in the country every day. These numbers do not adequately reflect the collective trauma and depth of our loss.

As we continue to mourn the lives lost due to the pandemic and adapt our lives to the measures necessary to keep one another safe, we must recommit to lifesaving preventive measures such as screening for cancer. Every year, cancer kills 600,000 people in the U.S. These lives, too, are invaluable. The risk of a significant reduction in screenings, a proven method to reduce mortality from cancer, is too great to bear.

Any significant drop in screenings could have profound consequences. Routine colonoscopies that led to the removal of noncancerous colorectal polyps reduced mortality from colorectal cancer by 50%, according to a study published in the New England Journal of Medicine.

Screening exams also enable health care providers to detect and treat malignancies early, when they are often more responsive to therapy. A study published in the journal Cancer found that routine mammograms reduced a womans risk of dying from breast cancer within 10 years of her diagnosis by 41%, and also led to a 25% reduction in being diagnosed with advanced breast cancer, which is much more difficult to treat.

According to a 2016 study published in the British Journal of Cancer, screening for cervical cancer has prevented nearly 68% of would-be deaths from the disease.

To gain the lifesaving benefits of routine screening, we must safely resume scheduling patients for these examsor risk a worse outcome in some individuals.

As the pandemic peaked in waves around the country, healthcare organizations and local officials released policies to delay elective procedures. For many, elective procedures included routine screening exams. These measures were necessary for providers to assess the threat of COVID-19, or for hospitals with active COVID-19 wards to redirect staff and resources towards virus-infected patients.

Now, patients continue to delay preventive screenings for many reasons. At first, patients were told to postpone screenings by their healthcare providers, so they did. But even as hospitals have developed protocols to deliver routine care in a much safer environment, screening rates remain too low, and ultimately bad outcomes could result in lives lost.

Again, this is understandable. Even in the best of times, we are not capitalizing on the full potential of prevention measures that we know work. As of 2015, screenings for breast, cervical and colon cancer fell short of targets set by the Office of Disease Prevention and Health Promotion.

These, of course, are not the best of times. The pandemic temporarily brought routine screenings to a halt. That type of inertia is dangerous, especially as the pandemic intensifies factors that make barriers to care worse. Patients tend to seek less care in an economic downturnthey conserve their health care dollars for acute issues and emergencies.

Patients across the world are now suffering from economic hardship. The World Bank predicts the global economy will shrink by 5.2% this year, and that the U.S. economy will contract by 6.1%. Moreover, up to 12 million Americans may have lost their employer-sponsored health insurance during the pandemic, according to the Economic Policy Institute, adding to peoples financial stress.

Besides the economic hardship triggered by the pandemic, patients are sometimes afraid. The background noise of COVID-19 can drown out other health concerns. With a lack of clear direction and/or conflicting messages, some patients have been receiving inconsistent information about how and when to resume health care services.

With state and local healthcare leaders overburdened with the requirements of the pandemic response, it leaves few stakeholders to bang the drum about the importance of screening for cancerand cancer screening is needed to maintain the health and wellbeing of individuals in the U.S., the healthcare system, and the country as a whole.

Already, COVID-19 has halted cancer screenings to a degree that could negatively affect outcomes. Researchers estimate that mammograms, a crucial tool for early detection of breast cancer, have dropped anywhere from 75% to 95% since March 2020. Pandemic-related screening delays could cause an excess of 10,000 deaths over the next 10 years, National Cancer Institute director Ned Sharpless told STAT this past Juneresulting in a 1% increase in expected deaths for the decade.

As of June, cancer screenings had not returned to their pre-COVID-19 levels, according to data from the Epic Health Research Network. Breast, colon and cervical cancer screenings remained 29%, 36%, and 35% lower than expected, respectively.

In short, we risk a significant increase in the number of deaths and poorer outcomes from cancer if we dont successfully address these issues during the pandemic.

Our challenge is to earn patients trust, so that they can safely and cost-effectively resume screening procedures for cancer.

Healthcare leaders need to explain measures they are taking to ensure a low infection risk at clinical facilities that offer screenings.

We must also assure individuals that discovery of a malignancy or a premalignant lesion can be safely treated in the clinic or hospital. Early studies show that cancer patients undergoing chemotherapy or other treatments are not at increased risk of mortality from COVID-19. Although, outcomes data is emerging from large cohort studies that will address this issue much more carefully in the next several months.

We must adhere to social distancing and mask-wearing policies in clinical facilities and communicate those policies clearly to patients and their family members. We must make such small steps as scheduling appointments and negotiating with payers as easy as possible, since every barrier to care takes on added weight during COVID-19.

It can be difficult for people to grasp the harm of not doing a procedure. But forgoing cancer screenings has the potential to derail the countrys decades-long progress in lowering cancer mortality. COVID-19 has been destructive enough. We must not let it stop measures to detect early diseasethe most effective method we have to prevent deaths from cancer.

In order to understand better the impact of COVID-19 on cancer patients, the Hollings Cancer Center here at the Medical University of South Carolina (@muschollings) in Charleston joined the COVID-19 and Cancer consortium (CCC19) and is one of 120 institutions in the country collecting data on adult patients (18 and older) with cancer who have been diagnosed with COVID-19.

This is being done in order to collect and disseminate prospective, granular, uniformly organized information on cancer patients and survivors who are diagnosed with COVID-19at scale and as rapidly as possible to understand, in real time, how this disease is affecting cancer patients.

There are several steps we can all take to reduce our risk of getting cancer:

Dont use tobacco in any form or expose yourself to secondhand smoke. Cancers linked to tobacco use make up to 40% of all cancers, so avoiding this exposure can have a huge benefit.

Eat a healthy diet that includes fruits and vegetables. If you choose to drink alcohol, do so in moderation, and limit intake of processed meats.

Maintain a healthy weight and stay physically active. Any amount of physical activity is helpful, but to maximize benefit, the Mayo Clinic recommends getting at least 150 minutes per week of moderate activity or 75 minutes per week of vigorous aerobic activity.

Protect yourself from exposure to the sun and avoid tanning beds or sun lamps at all costs.

Get vaccinated for hepatitis B and the human papilloma virus (HPV) at the recommended ages. Avoid risky behaviors that can lead to infections known to increase your risk of cancer, like unprotected sex or the sharing of needles used by others.

Seek routine medical care, as noted above, that includes regular self-exams and screenings for various types of cancers, such as cancer of the skin, colon, cervix and breast. These preventive exams increase your chances of discovering cancer early, when treatment is most likely to be successful.

Do not hesitate to ask your doctor about the best cancer screening schedule for you based on your medical and family history.

Remember, if we collectively, as a population, adhere to all of these recommendations, we could reduce cancer globally by as much as 40-50%today, without any further advances in diagnostics or treatment.

Originally posted here:
COVID-19 threatens to increase cancer mortality The Cancer Letter - The Cancer Letter

Lockdown was a time of terror for me. I was a sixty-something granny living alone some 40 miles away from my adult children and my seven-year-old granddaughter, Edie.

I was terrified that actually I might die (something that had not really worried me before) of Covid, or maybe starvation as I struggled to get an elusive supermarket delivery. My home, lovely though it was, had become a kind of prison and I was in solitary confinement. I overdosed on vitamin pills, I talked (a little too much) to the dog and I absolutely lived for my daily face time calls with Edie. In short I discovered what if felt like to be terribly, terribly lonely.

There is, then, just one huge thing I will do the moment that any new lockdown is announced. I will pack the dog, the cat and a suitcase in my car and drive as fast as I can to London.Begging Bryony to please let me into her bubble.

Christine Armstrong, author of The Mother of all Jobs

Given that school has had six months to plan, well be leaving the kids timetabling to them. Which means that instead of wasting time on colour-coded plans of school classes and Joe Wicks that have less basis in reality than the Governments testing plans we can createtimetables for us parents instead. Filled with the things that keep us calm and happy.

Stuff like, times for each of usto exercise every day (hello again Yoga withAdriene). An hour alone to watch rubbish TV, listen to podcasts, call a friend or just hide from the children. And a system to decide whose work video call is more important, which doesnt involve us yelling about it as we dial in.

To help keep the house under control, we will take inspiration from Our Yorkshire Farm, and all jobs will be shared between kids and adults. Cleaning, washing, cooking, food ordering, gardening.

Obviously this will go extremely well and not end up in a squalid shouting match...

Linda Blair, clinical psychologist and author of The Key to Calm

Start by knowing you can face this uncomfortable possibility with confidence. The first time we have to cope with unexpected change is always the most challenging. Youve already done that, which means you can do it again and with the benefit of experience.

Here are three reminders to help you through:

Structure: Nothing is more important to convey a sense of control. Plan each day the night before. Include time to prepare and enjoy wholesome meals at regular intervals. Establish a regular bedtime and rising time, and recreate your favourite bedtime routine. Make sure you take at least 20 minutes of daily aerobic exercise. Set three small goals you know you can achieve each day. Write them down and tick them off at the end of the day.

Micro-breaks: What are your warning signs that stress is building decreased concentration, inability to make decisions, fidgeting, irritability? Whenever you notice them, take a three-minute micro-break. Sit somewhere comfortable, close your eyes, and take 20 slow breaths: in through the nose for four, hold for seven, out through the mouth for eight. For added effect, envelop yourself in your favourite colour or scent at each in-breath.

Compassion: Studies across the US and Europe have repeatedly demonstrated the benefits of kindness, both to yourself and to others better mood, better physical health, increased tolerance of pain and distress, even greater longevity. Contact a friend every day, preferably talking and/or sharing screens rather than by email or text. Ask how theyre coping; listen non-judgmentally and with full attention. If you can, thank or compliment them genuinely. Finally, dont let fear of imposed limitations sabotage your mood. Expect them instead then every day there are none, enjoy the resulting sense of relief.

Read more here:
How to be second wave savvy and what not to repeat from the first lockdown - Telegraph.co.uk

Buy Photo

A bowl of sweet potato black bean chili, a heart healthy recipe prepared by Anna Jones, a local dietician and nutritionist, Friday Feb. 15, 2019. (Photo: Alicia Devine/Democrat)

If you are like so many clients and friends Ive talked with lately, and myself included, your pants may be fitting a little tighter than they were pre-quarantine.

You probably have seen the memes and heard jokes and talk of the quarantine 15. Although the jokes may seem harmless, many people are really stressing about their weight and feeling a lot of shame and guilt around the changes they are noticing in their bodies.

We live in a fatphobic, weight stigmatizing culture that paints weight gain as the worst possible scenario.

I dont know a single individual who has not been impacted by this pandemic, in a mix of both positive and negative ways. Many of us are working from home, learning new technology, and many are trying to parent and manage our kids stress and anxiety at the same time.

For some of us food was comfort and helped us cope over these months of being more isolated and our schedules and routines changing.

While all of this is true it wont change what many people will decide to do next go on a diet.

It probably doesnt come as a shock that these diets and quick fixes dont work for the majority of people in the long run. But did you know that not only do restrictive diets and plans not work to keep the weight off, but that going on a diet is an excellent predictor of weight gain. Here are a just two of the research studies that support this paradoxical result of weight gain from dieting.

The reasons for this weight regain are biological, not based on willpower or perceived human failure as many of us might believe. Our bodies respond with a myriad of biological responses including hormonal adaptations that drive hunger, decreased metabolism, and a stimulation of the brain to increase cravings to eat more.

I can almost hear the thoughts in your head, OK, great, I get it, diets dont work, but Ive got to do something!

If youwant to make strides to incorporate healthier habits and self-care back into your life to feel better and healthier, and realize dieting is not the answer, here are three suggestions for you to consider.

Instead of beating yourself up, take a few deep breaths and give yourself some grace and compassion for everything you and your body have been through over the past several months. Appreciate your amazing body and the fact that you have survived this pandemic and are still thriving, with yes a few more pounds on you and possibly a diminished selection of well fitting clothes to wear.

Self-criticism and being hard on ourselves actually hinders our progress instead of helping us. A significant amount of research supports the concept of self-compassion, that being kinder to ourselves when faced with adversity is the key to resilience and the ability to bounce back leading to a greater feeling of empowerment and inner strength.

One practice for noticing self-critical thoughts is to begin to write them down. Ask if you would say the same words to a friend or someone you loved. If not, how could you change those self-critical thoughts to more compassionate ones?

Two women stretch before a class at Momentum Fitness. Rectangles created with tape designate a space for individuals to workout in while practicing social distancing. (Photo: Alicia Devine/Tallahassee Democrat)

Maybe you were someone who exercised pretty regularly before all this blew up and due to the virus and all its disruptions youhavent been able to get it in. Maybe you, like me, havent yet felt quite safe going to your gym or studio.

When we get in diet mode and reach a point where we feel like we have to do something, we typically approach movement and exercise with an all-or-nothing way of thinking that ultimately keeps us from moving our bodies in consistently joyful ways.

Every bit of movement is beneficial, and finding ways to do that regularly and consistently and finding enjoyment and pleasure in the way you move is the key.

Walking, doing yard work or other outdoor activities, yoga or dance sessions on YouTube, all are great ways to just move your body, which we know to be an important part of physical and mental health.

Although coping with emotions with food can be comforting and even helpful in the moment, becoming aware of how you respond to emotions and boredom and finding other ways to cope is important too.Emotional eating can become an automatic response and a cycle that can be challenging to break.

If you notice that you have been turning to food for comfort or just simply for something to dolately try to acknowledge that without judgment. Three questions to ask yourself when you get in auto-pilot mode and want to reach for food for comfort are:

1. Am I biologically hungry? If so, then you need food. Ignoring your hunger will ultimately only lead to stronger cravings. If no, move on to question #2.

2. What am I feeling sad, lonely, stressed, bored, afraid anxious, frustrated, exhausted? Recognizing what you are actually feeling can be tough, but well worth it.

3. What do I need? Once you acknowledge and recognize how you feel, the next step is to find other ways to cope that will truly fulfill what you need in that moment.

More than likely food has become an easy go-to, but there are many, many ways to cope that dont involve food.

Making sure your basic needs are being met is a great place to start, focusing on things like getting enough sleep, being heard and understood and expressing your feelings, being intellectually and creatively stimulated, moving regularly, eating in a balanced way most of the time, and being socially connected (even if it is virtually) are all things that are really helpful and can bring a sense of comfort and normality in our stressful world.

It is not necessary to go on a diet to feel better and be healthier, or whatever your goal might be. A different approach to consider is Intuitive Eating or the Non-Diet approach. This approach is one based in self-care, instead of an obsessive focus on changing the number on the scale or shrinking our bodies to fit a culturally acceptable ideal.

It is about re-learning to eat outside of the diet mentality, trusting your body and its internal cues like hunger, fullness and satisfaction, and moving away from external cues like food rules and restrictions. It is about coming from a place of abundance, instead of restriction and being flexible in our food choices. Ultimately it is about finding sustainable ways to care for yourself that create mindset shifts that last.

So next time someone mentions the quarantine 15, ignore it and move on.

Anna Jones(Photo: Anna Jones)

Anna Jones is a registered dietitian. Visit her website at annajonesrd.com.

Never miss a story: Subscribe to the Tallahassee Democrat.

Read or Share this story: https://www.tallahassee.com/story/life/wellness/2020/09/21/stop-stressing-over-quarantine-15/5847515002/

Here is the original post:
Rethink dieting and stop stressing over the 'quarantine 15' | Anna Jones - Tallahassee Democrat

Environment September 20, 2020 Johnny Wood Senior Writer at Formative Content

A migrant farm worker from Mexico harvests organic zucchini. While the benefits of going plant-based may be clear, changing the diet of an entire region is not without its challenges.

Photo: John Moore/Getty Images

Share this article

A recent study suggests moving to a plant-based diet is key to help decarbonize Latin America and the Caribbean.

Improved health, reduced greenhouse gas emissions and countless new jobs these are some of the potential benefits of switching to a plant-based diet, highlighted by a new report on the impact of Latin America and the Caribbean transitioning to a net-zero economy.

The joint study by the International Labour Organization and the Inter-American Development Bank sees moving to a plant-based diet as a central pillar of regional efforts to cut CO2 emissions.

While abandoning established diets that include meat, poultry, fish and dairy could lead to an estimated 4.3 million job losses in the region by 2030, adopting plant-based foods grown using sustainable farming methods could generate 19 million new employment opportunities, the report predicts.

While the benefits of going plant-based may be clear, changing the diet of an entire region is not without its challenges particularly when the region in question relies heavily on animal rearing for its livelihood and is one of the worlds biggest exporters of both beef and poultry, with demand for the regions meat growing.

That said, the climate crisis may prevent beef and poultry farmers pursuing a business-as-usual approach in the coming years. Farmed livestock generates 14.5% of all greenhouse gas emissions related to human activity, with cows responsible for the largest share.

As global air temperatures warm, farmers in Latin America, the Caribbean and elsewhere will face increasing pressure to switch to more sustainable practices to curb greenhouse gas emissions.

Rearing plants in place of animals offers a way to reduce the regions dependence on livestock, while creating new opportunities to replace livelihoods dependent on farming.

Jobs Created and Destroyed by Decarbonization in 2030 by Gender

Source: ILO

Decarbonizing farming would potentially create more jobs for males than females, which reflects the current gender bias in the labor market, but both sexes would see an increase in new work opportunities.

Male-dominated occupations look set to gain 18.5 million jobs and lose 6 million by 2030, whereas occupations employing women could gain 4 million and lose 1.5 million, the report finds.

Jobs Created and Destroyed by Decarbonization as of 2030, by Skills Level

Source: ILO

Decarbonizing the regions farming would likely create predominantly medium- and low-skilled jobs, suitable for burgeoning plant-based agriculture and food manufacturing sectors. However, medium- and low-skilled workers would also face the most job losses.

While overall job numbers look positive, the reports authors express doubt whether workers currently involved in animal rearing could transfer easily to plant-based employment. There is also skepticism about the reality of a mass switch to a plant-based diet happening throughout the region.

Its true that in many parts of the world, plant-based foods are more prevalent on grocery store shelves in recent years, which could be the result of health or environmental considerations. In the United States, the plant-based food industry was worth more than $5 billion in 2019, up 11% from around $4.5 billion the previous year. This rapid market expansion compared to just 2% growth in overall retail food sales.

It remains to be seen how quickly, if at all, the world is prepared to break with its meat consumption habits and move to more sustainable options.

A version of this article first appeared on the World Economic Forums Agenda blog.

URL: https://www.brinknews.com/millions-of-jobs-could-be-created-in-latin-america-and-the-caribbean-if-the-region-switches-to-a-plant-based-diet/

Read the original here:
Millions of Jobs Could Be Created in Latin America and the Caribbean If the Region Switches to a Plant-Based Diet - BRINK

A celebrity chef, known around the world for her promotion of a nutrient-rich diet, is launching her newest venture nutrient-dense cuisine from her home in Southwest Missouri.

Robin Jeep, who once worked as a private chef for Paul McCartney, Peter Max, Mikhail Baryshnikov and more, is working with Mark Adams to develop The Farmer and The Chef, and The Kitchen Nutrition Education, both as ways to promote eating choices that are both fast and easy, as well as healthy.

The pair met when Jeep was working for a medical firm in Northwest Arkansas, creating healthy meal plans for patients fixing three meals a day for patients on a three-, six- or nine-month schedule.

At the time, Adams wife, May Belle, sought out nutritional treatment for rheumatoid arthritis. While Adams knew the diet of freshly grown vegetables helped sustain his wifes life, he became sold on the lifestyle after meeting Jeep. Using her plan, Adams dropped 50 pounds and reversed his high blood pressure.

Moving to southwest Missouri in 2016, Jeep and Adams initially worked together to create Vibrant Cuisine LLC, a food formation company, which developed a line of whole-food, plant-based smoothies for Walmart.

Now under their newest venture, Enliven Foods LLC, with former Walmart buyer Chase Worthen, the pair are less than two months away from launching a line of whole food, plant-based, grain-free muffin mixes. The mixes, which Jeep describes as high-end offerings, are slated to hit shelves and to be available online in November.

Behind the muffins

The muffins are just the newest way Jeep is promoting a healthy, whole-food, plant-based food diet.

As a chef, she learned to use powdered or pured dates in her desserts, because dates provide a fiber-rich way to sweeten the treats. Shes followed this lifestyle since the 1970s, saying then it was the hippy thing to do.

As a model and racehorse jockey, Jeep used plant-based eating to help maintain her weight and strength. After a serious horseback riding accident, the nutrient-dense diet helped her as she regained her strength.

It was then she met Dr. Joel Fuhrman, eventually becoming his dietary assistant, recipe developer and patient health coach. Jeep said her work with Fuhrman helped her learn how to reverse multiple health issues, including Type 2 diabetes, migraines and more, using a nutrient rich diet.

Eventually, Jeep ended up first in Northwest Arkansas and now Southwest Missouri because of her love of the area. She grew up traveling to the Ozarks with her family.

Working with Adams, the pair began launching The Farmer and The Chef team, only to be sidelined temporarily by the COVID-19 pandemic.

Together the pair would do demonstrations at George Washington Carver National Monument, Suzannes Natural Foods and other health food locations in the region.

Eating healthy

Adams and Jeeps website, EnlivenFoods.com, is designed to serve as an online education portal for those seeking information about a nutrient-rich diet using foods that allow people to get the most nutrients per calorie.

Most people dont have enough micronutrients in their diets, Jeep said. To do that it takes eating a lot of plant foods, which is hard for people to do when they are not used to that.

Jeep said she focuses on teaching people how to transition to nutrient-rich eating and find food that tastes good along the way.

She said it often takes time for a person to transition to this lifestyle because of past eating habits. For those not wanting to make the complete leap to a whole-food, plant-based diet, she helps them learn to eat a diet with 75% raw vegetables and 25% veggies and meat.

If we eat the way we are designed to eat, we will have a strong immune system, Jeep said. It means we will be unlikely to get COVID, the flu, colds. We just dont get sick.

Jeep is a vegan. But she knows some people arent ready to give up meat or animal products. She teaches people how to eat animal products without increasing their risk for illnesses.

Plant-based, whole-food diet

Jeep said whole foods, many in the raw form, are good because they are rich in fiber, carbs and fat all without processing.

For the muffin mix she and Adams developed, called Manna Muffins, Jeep focused on grain-free products, including coconut flour and almond flour, whole nuts, seeds and more. Every ingredient is minimally processed, which often helps with how it is digested within the human body.

When making desserts, Jeep often uses dates as the sweetener because, as a whole food, dates are rich in micronutrients, including potassium and minerals.

The muffin mixes are complete. Users only need to add water to the mix before baking. There are three flavors to date: cacao cherry, golden chai and sweet potato sunrise.

Its not only healthy, but its also good for you, Jeep said. The cacao cherry tastes like a high-end dessert you would find in a restaurant. We use high quality ingredients, high in protein and fiber.

The mixes, which will be available locally at Suzannes Natural Foods and Natural Grocers, will run at least $14.99, making 12 muffins.

Its a little more expensive, but its because of the ingredients we used, Jeep said. Were starting with this and seeing where it goes from there.

Jeep believes her work is a God-ordained mission with a purpose to help teach people in a healthy way using rock-solid science.

Learning how to prepare food is vital for success, Jeep said. Our culture encourages destructive eating habits. An alcoholic can get away from alcohol, but eating bad food is socially acceptable and socially encouraged.

Continued here:
Not bluffin' with her muffins: Plant-based treats offer nutrition option - Joplin Globe

Researchers from South Korea and Canada reported that paraprobiotic heat-killed lactic acid bacteria (HLAB) combined with grape seed flour (GSF) prebiotic could reduce weight gain and adipose tissue weight in obese mice.

Published in the Nutrients journal, this is the first study assessing the synergistic anti-obesity effect of paraprobiotic and prebiotic. Most studies on anti-obesity have focused on probiotics with live bacteria rather than paraprobiotics.

Paraprobiotics are non-viable microbial cells (intact or broken) or crude cell extracts, which when administered in adequate amounts can confer a benefit on the human or animal consumer. It has advantages over the use of live probiotics, especially in terms of safety for immunocompromised subjects and the ease of preparation.

In this study, the HLAB wasobtained from kefir, a fermented dairy beverage which typically contains natural probiotics (lactic acid bacteria).

Kefirs health benefits have been studied, some of which include cholesterol-lowering, antimicrobial, immuno-modulatory, anti-inflammatory, anti-obesity effects and even inhibiting non-alcoholic liver disease.

The GSF is a by-product of winemaking made from the seeds and skin of grapes and processed into a dry powder. Other studies have shown supplementing the diet with GSF could suppress body weight gain and high cholesterol, attributed to its high flavonoid levels.

For this study, HLAB and GSF were assessed individually and together in a high-fat and high-fructose diet-fed obese mice model.

The mice (n=10 per group) were split by treatment as follows: control diet (high fat high fructose), 2.5% GSF, 2.5% GSF+HLAB and HLAB. The study duration was eight weeks.

Blood samples were collected and measured for cholesterol, glucose, and adipose tissue.

The findings revealed that supplementing the diet with GSF, HLAB, and GSF+HLAB for eight weeks significantly (p<0.05) lowered body weight gain by 29%, 21%, and 52% respectively, compared to the control group.

Compared to the control group, adipose tissue weight of GSF, HLAB and GSF+HLAB groups were also significantly (p<0.05) lowered by 37%, 36% and 61% respectively.

The GSF+HLAB supplementation also significantly reduced plasma triglyceride concentration by 27% compared to the control group (p<0.05).

The combination of wine GSF and paraprobiotic kefir HLAB seemed to work synergistically to prevent the increase of body weight, adipose tissue weight, and plasma triglyceride concentrations in obese mice consuming a high fat high fructose diet.

Researchers wrote: The synergistic effect of GSF and HLAB in the current study could be due to the activation of multifunctional pathways by a combination of bioactive components (cellular components in HLAB and polyphenols in GSF), as well as the alteration of intestinal microbiota.

Further study is required to determine the role of intestinal microbiota in the synergistic anti-obesity action of HLAB and GSF. These studies suggest that kefir HLAB are functional ingredients that can be used to alleviate obesity, especially in combination with GSF.

This study suggest that a combination of prebiotic Chardonnay GSF and paraprobiotic kefir HLAB are potential functional food ingredients that synergistically alleviate obesity, especially for immunocompromised individuals.

Source: Nutrients

https://doi.org/10.3390/nu12082465

Synergistic Effects of Heat-Killed Kefir Paraprobiotics and Flavonoid-Rich Prebiotics on Western Diet-Induced Obesity

Authors: Kun-Ho Seo, et al.

Read the original post:
Kefir and wine by-product: Combination of paraprobiotic and prebiotic may work as potential anti-obesity functional ingredient - BeverageDaily.com

Study Outlines Increase in Unsafe Working Conditions for Agricultural Workers

High heat indexes prove to be increasingly dangerous for farmers while working outside.

The University of Washington and Stanford University released a study that analyzes significant temperature increases in the United States in concentrated areas where crops are grown, according to Science News.

The study details strategies that the over 2 million agricultural workers in America can use to protect their health while working outside in heat. The proposed practices include working less vigorously, taking longer breaks, wearing clothing that is thinner and more breathable and taking breaks in a cool environment. The study determines that the most effective way to lessen heat stress for farmers and agricultural workers would be development of light clothing that is still protective.

The people who are the most vulnerable are asked to take the highest risk so that we, as consumers, can eat a healthy, nutritious diet, said Michell Tigchelaar, a postdoctoral researcher at Stanford.

Those that work in agriculture are vulnerable to conditions that are related to heat stress. There are an estimated 21 days each year that agricultural employees experience in which the heat index exceeds worker safety standards. According to the study, these extreme heat conditions will increase to 39 unsafe days by 2050.

Information on agricultural safety can be found at nifa.usda.gov.

About the Author

Nikki Johnson-Bolden is an Associate Content Editor for Occupational Health & Safety.

The rest is here:
Study Outlines Increase in Unsafe Working Conditions for Agricultural Workers - Occupational Health and Safety