1. Diet alone had nearly identical benefits on insulin sensitivity compared to gastric bypass surgery.

2. The metabolic benefits from diet and gastric bypass surgery were related to weight loss.

Evidence Rating Level: 2 (Good)

Study Rundown: Previous studies have demonstrated that bariatric surgeries are far more effective than medical therapy to treat type 2 diabetes. However, many of these studies have results which are confounded by the difference in weight loss among the participants undergoing these procedures. Because of this, the effects of bypass surgery independent of weight loss on major factors in type 2 diabetes pathogenesis such as beta-cell function and insulin resistance is unclear. As such, this study evaluated whether gastric bypass surgery provided metabolic benefits, independent of weight loss, in participants with obesity and type 2 diabetes. The results of the study demonstrated that both diet and gastric bypass surgery confer metabolic benefits, which were actually related to resulting weight loss from the interventions. This prospective cohort study was limited by the assessment of metabolic outcomes after weight loss between 16 to 24%. Therefore, the study results could not be extrapolated for weight loss above or below that range. Nonetheless, this study was strengthened by matching participants based on weight loss to control for the confounding variable.

Click to read the study in NEJM

Relevant Reading: Effects of moderate and subsequent progressive weight loss on metabolic function and adipose tissue biology in humans with obesity

In-Depth [prospective cohort]: This prospective cohort study followed 33 participants at a single center in the United States. Participants included in the study were diagnosed with type 2 diabetes and obesity. Participants unable to achieve the target weight loss, defined as 16 to 24% of the participants original weight, were excluded from this study. The participants underwent a comprehensive metabolic function assessment before and after weight loss from gastric Roux-en-Y bypass surgery or low-calorie diet therapy. The diet group received weekly education on dietary practices and prepackaged meals. Prior to analysis, the participants were matched between the two intervention groups based on percentage of weight loss. Once the participants achieved the target weight loss, the body weight was maintained for three weeks before conducting the final comprehensive metabolic function assessment. The primary outcome was the change in hepatic insulin sensitivity. The mean weight loss in the diet group was 17.81.2% (range, 16.1 to 20.4) and 18.72.5% (range, 16.0 to 24.4) in the surgery group. Insulin sensitivity in the liver increased after weight loss in the diet group (31.0 mol/kg; 95% confidence interval [CI], 22.5 to 39.6) and the surgery group (25.1 mol/kg; 95% CI, 16.4 to 33.8). There was no significant difference between the two group (-6.5 mol/kg; 95% CI, -15.7 to 2.7). Additionally, beta-cell function increased after weight loss in the diet group (1.83; 95% CI, 1.22 to 2.44) and in the surgery group (1.11; 95% CI, 0.08 to 2.15); however, there was no significant difference between the two groups (-0.71; 95% CI, -1.75 to 0.34). Interestingly, weight loss in both groups resulted in a decrease in plasma bile acids, plasma branched-chain amino acid, and C5 acylcarnitine concentrations. However, the decrease in these plasma components were greater for the surgery group than the diet group. Taken together, weight loss resulting from diet or gastric bypass surgery provided near identical benefits for insulin sensitivity in participants with type 2 diabetes and obesity.

Image: PD

2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

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Diet and gastric bypass have similar metabolic benefits in diabetic patients - 2 Minute Medicine

Among the many celebritiesthat have played a role in inspiring us to go vegan, we have to say the uplifting words of Ariana Grande reverberate in our ears often.

Back in 2014, when The Mirrorasked her why she went vegan, she said, I love animals more than I love most people, not kidding. But I am a firm believer in eating a full plant-based, whole food diet that can expand your life length and make you an all-round happier person.

Though Ariana Grande is of Italian heritage, it doesnt seem like shes big on eating staples from the Mediterranean countrys culinary playbook. In The Mirror interview, Grande conceded that even though shes very proud of her lineage, ...I dont eat a lot of Italian things, because Im vegan. I was raised on meat and cheese, so Ive had enough for anyones normal life span.

According to Grandes trainer, Harley Pasternak, the pop star is all about Japanese eats. "Ariana Grande, she's vegan, and she loves daikon, lotus, adzuki beansalmost like a macrobiotic Japanese [diet]," Pasternak told Glamourin 2015. A macrobiotic diet also focuses on nutrient-dense whole grains like brown rice, barley, millet, and oats, as well as fresh vegetables, sea vegetables, and miso, a fermented soy paste. (Sign us up for this quick and easy vegan pho with creamy miso broth).

Though Pasternak doesnt say whether or not Grande has a sweet tooth for macrobiotic desserts, we hear sweet potatoes and pumpkinsboth go-to's in the macrobiotic realmtaste really, really good in pie form.

Ariana Grande has never met a berry she didnt like, it appears. Whether posting her blueberry haul on Instagramor tweetingthat shes eaten at least five strawberries a day since she can remember (theyre my favorite food!), its clear the star gets some of her sky-high energy and glowing skin from all the fruit she consumes.

"Ariana eats incredibly well and she always had a healthy diet. I think what I've gotten her to do now is to create a more balanced diet and feel OK about indulging and celebrating sometimes, said Pasternak of Grandes eating MO in a 2017 PopSugararticle. She has widened the ingredients she puts into her diet. She makes a lot of my smoothies, so for the body-reset smoothies she'll make the white smoothie, red smoothie, and green smoothie, notes Pasternak, referencing healthy smoothie recipes from his book The Body Reset Diet.

Here at The Beet, we cant ever get enough tantalizing smoothie recipes. Thats why we deliver a healthy Smoothie of the Day recipe to you each day. Sign up here. Want to kick the day off with a smoothie right up Grandes lane? Try this Berry-Fun and Refreshing Smoothie Everyone Will Love.

In addition to talking to the media about how going vegan has helped her health and happiness, Grande also takes a stance when it comes to animal rights issues. This spring, she took to Twitter to disapprove of Tiger Kings Carle Baskin from appearing in her music video Stuck with U, a duet with Justin Bieber.

She shared her dismay of the clip and ensured it didnt appear in the music video, publicly stating, "for the record, I did not allow or approve this clip to be in the actual video. but. nonetheless. it exists and thats ..... unique.

Named one of peta2s sexiest vegetarian celebrities of 2014, were glad to see that Grande is still keeping her plant-based game strong a few years later. Heres to many more happy and healthy years of strawberries, macrobiotic culinary delights, and of course, loving animals more than people (were joking here, kind of).

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Ariana Grande is Vegan: Here's What She Eats in a Day - The Beet

Dietary potassium restriction appears prudent in normokalemic patients with chronic kidney disease (CKD) to keep serum potassium levels in check and reduce mortality risk, but this advice is based on very low-quality evidence, according to the authors of a new review published in the Journal of Renal Nutrition.

Andrew Morris, MRes, of Coventry University in Coventry, United Kingdom, and colleagues performed a systematic review and meta-analysis of 2 randomized trials and 5 observational studies involving 3489 normokalemic patients with CKD stages 3 to 5D. A restricted (1295 mg/d) versus unrestricted (1570 mg/d) potassium diet lowered serum potassium by just 0.22 mEq/L, although the absolute differences in potassium intake between cohorts seemed small.

In further analyses, a relatively low dietary potassium intake of 1670 mg/d was associated with a 40% reduction in mortality compared with a high potassium intake of 4414 mg/d. Low dietary potassium intake did not significantly correlate with slower CKD progression, however.

Our meta-analyses also offer support to the current opinion that dietary potassium intakes should be limited to 2,000-2,500 mg/d (50-65 mmol/d) in those with CKD stage 5 on maintenance hemodialysis to help maintain normokalemia, Morris team wrote.

The reviewers found no studies supporting potassium supplementation to reduce blood pressure in patients with nondialysis CKD.

Morris and colleagues deemed the quality of the evidence very low according to GRADE criteria. They encouraged future high-quality trials in this area that include patients with hyperkalemia.

In a recent paper in Kidney International, the authors reported specific areas for future research based on a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference on the management of dyskalemia. Investigators should:

The authors of the paper observed: Generalized dietary [potassium] restriction in people with CKD may deprive them from other beneficial effects and nutrients of [potassium]-rich diets.

Morris A, Krishnan N, Kimani PK, Lycett D. Effect of dietary potassium restriction on serum potassium, disease progression, and mortality in chronic kidney disease: a systematic review and meta-analysis. J Renal Nutr. 2020; 30(4):276-285. doi:10.1053/j.jrn.2019.09.009

Clase CM, Carrero JJ, Ellison DH, et al. Potassium homeostasis and management of dyskalemia in kidney diseases: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) controversies conference. Kidney Int. 2020;97(1):42-61. doi:10.1016/j.kint.2019.09.018

Read the rest here:
Dietary Potassium Restriction in CKD Challenged - Renal and Urology News

Keith Roach, To Your Health Published 8:47 p.m. ET Aug. 23, 2020

Dear Dr. Roach: Ive never smoked, drank alcohol or used illegal drugs. My doctor says Im in great health. My only vice is drinking diet soda, and I drink three or four cans a day. Id like to know what you think about it. I know its not great for me, but I figure its better than the other vices.

P.V.

Dear P.V.: Im not sure vice is the correct term.

Compared with sugar-sweetened soft drinks, diet sodas are probably less harmful in several ways. Compared with plain water, they probably have some drawbacks. The effects vary by person, and the literature on this subject is mixed and controversial.

For your teeth, less sugar means less cavities. However, diet sodas are acidic and drinking too many can weaken the enamel on your teeth.

The effect of diet sodas on weight is complicated. Paradoxically, many people will gain weight when switching to diet soda. Scientists believe this is due to effects on the bacteria in the intestines (the microbiome). Consuming sweet beverages may also stimulate the desire for other sweets and less-healthy foods.

Some of the sweeteners in diet sodas can cause intestinal problems in susceptible people, especially diarrhea and gas. If you have no symptoms from drinking diet sodas, have no weight issues, get your teeth checked regularly and have good oral hygiene, then the risk from three or four daily cans of diet soda is modest. Its still better to drink plain water.

Dear Dr. Roach: I have read numerous articles regarding the use of marijuana but have not seen a reference to cannabinoid hyperemesis syndrome. This is a condition that was recently identified and is increasing in frequency due to legalization and potency. I would appreciate your thoughts on this syndrome.

D.L.

Dear D.L.: Cannabis use is indeed increasing, and one unusual side effect is the hyperemesis (literally, too much vomiting) syndrome. This most often occurs in daily users of cannabis, usually after years of use. The vomiting tends to occur in cycles: nausea, abdominal pain and vomiting, which can be severe, occur without warning and last 24-48 hours. This is followed by a recovery phase lasting weeks or months, where people feel generally well. The diagnosis can be confused with cyclical vomiting syndrome, and the correct diagnosis is often missed for years.

Physicians sometimes fail to think of the diagnosis or have never learned of it -- it was first described in 2004. Cannabis users are sometimes highly resistant to the idea that the cannabis is causing these symptoms, as they have often been using for years with no problems. Further, cannabinoids are sometimes used to relieve nausea, so the mechanism of cannabinoid hyperemesis syndrome is not understood. The patients I have seen with this syndrome -- including one yesterday, coincidentally -- often have had very extensive evaluations, such as CT scans and endoscopies.

One clue that points toward cannabinoid hyperemesis syndrome is that most people learn that taking a hot shower temporarily relieves symptoms, and they will take several hot showers or baths during the day.

During the acute phase, treatment is supportive care, sometimes including anti-nausea drugs. However, the long-term treatment is cannabis cessation. It may take months before it is clear that the symptoms have resolved with cannabis cessation. Unfortunately the risk of relapse is high if the patient returns to cannabis use.

Readers may email questions to ToYourGoodHealth@med.cornell.edu

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Dr. Roach: Where does diet soda fall on the vice spectrum? - The Detroit News

Kidney health: Diet, medication and psychological tips for a person on dialysis during COVID-19 pandemic  |  Photo Credit: iStock Images

New Delhi: Health experts have warned that people living with certain chronic health conditions such as chronic kidney (CKD) disease, chronic obstructive pulmonary disease (COPD), type 2 diabetes, cancer are at an increased risk of severe illness due to COVID-19, the disease caused by the novel coronavirus or SARS-CoV-2. Current available data suggest that people living with kidney disease, particularly those on dialysis and transplant recipients might be at risk of severe infection and mortality from COVID-19.

As the coronavirus pandemic persists all over the world, doctors, health agencies and governments are engaging in several activities to educate, inform the public with kidney disease and other chronic health issuesto reduce their exposure to this dreaded virus and how to respond to a potential infection. Yet, before we list some COVID-19 guidance for patients with chronic kidney disease, let us try to understand what happens to the body when a person with CKD reaches the end-stage of renal disease.

When a person with chronic kidney disease reaches the end-stage (stage V) of renal disease, the kidneys no longer essay the role or function as healthy kidneys do. The kidneys are unable to remove the toxins, metabolic wastes and excess fluid from the bloodstream effectively. At this point, one of the treatment modality is dialysis, which flushes out unwanted toxins, excess fluid and waste products by filtering the blood.

Dialysis is one of the treatment methods for these patients, apart from preventing the accumulation of excess waste in the body, the purpose of dialysis is also to help control blood pressure and regulate levels of chemical elements in the blood, including sodium and potassium. Without dialysis, salts and other waste products continue to accumulate in the blood which eventually damages other important organs of the body, said Dr A S Mathur, Nephrologist, NephroPlus Dialysis Center.

As we pass through the tough times of a pandemic and have been isolated due to intermittent lockdown restrictions in many parts of the country, dialysis patients need to grapple with certain unique challenges with regards to their diet, medication as well as mental health. Below are a few tips suggested by the nephrologist that will help kidney patients, especially those on dialysis, stay healthy amid the pandemic:

Food and Nutrition

Diet is fundamental and, therefore, dialysis patients must make note of their dietary needs:

Medication

People with chronic kidney disease undergoing dialysis face unique health challenges and, thus, it is important to manage all their medication and take them as prescribed. Here are a few tips for managing medication at home:

Mental Health

Your mental health affects your physical health, it is, therefore, common for chronic kidney disease patients and their caretakers to experience mental health issues caused by lifestyle changes especially when living in isolation nowadays.

As a kidney patient, you may feel overwhelmed making decisions surrounding your treatments in these difficult times. However, its important to realise the fact that you have many rights and options when it comes to your care, helping you live a longer and healthier life.

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Always consult your doctor or a professional healthcare provider if you have any specific questions about any medical matter.

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Kidney health: Diet, medication and psychological tips for a person on dialysis during COVID-19 pandemic - Times Now

Banana apricot smoothie recipe is a must-try.

Highlights

Smoothie is a full package of 'health' and 'taste'. Made with fruits, milk and/or curd, water with the additional goodness of nuts and seeds, smoothie is as refreshing as it is nutritious. Perfect to quench you thirst and hunger at the same time, this drink can be easily made at home with foods of your choice. Here we have an extremely useful recipe of banana apricot smoothie that just doesn't taste great; it may also accelerate weight loss and boost immunity.

Banana apricot smoothie brings together two highly nutritious fruits and creates a magical melange of sweet and tangy flavours. Both banana and apricot boast of high fibre content and are rich in antioxidants like vitamin C, making them perfect for your weight loss and immunity-boosting diet. The mushiness and sweetness of banana and milk, mixed with tanginess and sourness of apricot and curd, creates a wholesome drink that simply tastes superb. Dried apricots are available all year round and can be easily found in grocery stores and fruits and vegetable markets. If you can use fresh apricots, it's even better.

(Also Read: 7 Recipes To Stay Hydrated In Monsoon)

Banana is a fibre-rich fruit.Photo Credit: iStock

(Makes 1 glass)

Ingredients -

1 banana

3 dried apricots

2 tbsp curd

1 cup milk

Half glass cold water

1 tbsp honey

A pinch of cinnamon powder

Method -

Step 1 - Peel and cut banana into small pieces. Chop apricots into small pieces. If you are using fresh apricots, de-seed them.

Step 2 - Toss the fruits in the blender jar. Add water and blend till the fruits are fully mashed.

Step 3 - Add curd, milk, cinnamon powder and honey, and blend again. Pour the smoothie in a glass, top it with ice cubes or refrigerate for some time and serve.

You may add dry fruits, nuts and seeds of your choice and blend them with the fruits, or you may sprinkle nuts and seeds later on the top of the smoothie before serving. If you don't want to add anything else except the fruits, it's okay; this smoothie already comes with the goodness of the two fruits proffering various health benefits.

Make this delicious smoothie for weight loss and strengthen your immunity too.

About Neha GroverLove for reading roused her writing instincts. Neha is guilty of having a deep-set fixation with anything caffeinated. When she is not pouring out her nest of thoughts onto the screen, you can see her reading while sipping on coffee.

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Banana Apricot Smoothie Can Be A Refreshing Part Of Your Weight Loss And Immunity-Boosting Diet - NDTV Food

Good evening, here are the coronavirus updates you need to know tonight.

Top headlines:

In Canada, there have been at least 124,279 cases reported. In the last week 2,621 new cases were announced, 2% fewer than the previous week. There have also been at least 110,600 recoveries and 9,062 deaths. Health officials have administered more than 5,359,807 tests.

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Worldwide, there have been at least 22,678,483 cases confirmed and 793,698 deaths reported.

Sources: Canada data is compiled from government websites, Johns Hopkins and COVID-19 Canada Open Data Working Group; international data is from Johns Hopkins University.

Coronavirus explainers: Updates and essential resources Coronavirus in maps and charts Lockdown rules and reopening plans in each province Global rules on mask-wearing

People wearing protective masks carry an idol of the Hindu god Ganesh, the deity of prosperity, for immersion off the coast of the Arabian sea during the Ganesh Chaturthi festival in Mumbai, India, on Sunday. REUTERS/Francis Mascarenhas

FRANCIS MASCARENHAS/Reuters

The number of coronavirus infections in India crossed the 3 million mark, with 69,239 new cases reported on Sunday. Federal health ministry data showed the countrys case total, 3.04 million, was behind only the United States and Brazil.

India on Sunday issued guidelines to open up its media production industry with norms for social distancing, crowd management and sanitization. Film production and theatres had been shut nationwide after Prime Minister Narendra Modi imposed a more than two-month-long lockdown in March to curb spread of the virus.

Deaths in India from COVID-19 rose by 912 to 56,706.

In Ottawa

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Foreign Affairs Minister Francois-Philippe Champagne is heading to Lebanon this week to get a firsthand look at the devastation caused by this months deadly explosions in Beirut.

The trip will mark Champagnes first overseas travel since March, when countries around the world, including Canada, closed their borders to slow the spread of COVID-19.

Conservative race: A record number of votes for the Conservative leadership race and malfunctioning mail-opening machines delayed the party from revealing the winner of the race on Sunday night. Results were initially scheduled to be revealed around 6 p.m. ET.

Even if an election doesnt come soon, the next Conservative leader will take over during a rocky time in Ottawa. As the governing Liberals turn their attention to economic recovery from the COVID-19 pandemic, the Conservatives will seek to assert themselves as the countrys voice of fiscal discipline.

Canadas largest banks are expected to report improved third-quarter earnings thanks in part to deferred payments on troubled loans and easing pressure to build reserves against losses. But with persistent challenges still to come, the rebound could amount to a head fake, as one banking analyst put it.

The banks capital levels could also stabilize or even improve slightly after taking a second-quarter dip. And surging trading activity, as well as demand to issue new debt, could help capital markets divisions deliver generous returns for the second consecutive quarter.

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Yet some of the scars the pandemic is carving into banks balance sheets may be harder to erase.

Also today:

Distractions

For the bookworm : Margaret Atwoods September book club pick is Obsidian by Thomas King

Join The Globe and Mail on Thursday, September 24, for a livestream conversation between Margaret Atwood and Thomas King.

Margaret Atwood is returning to host the next Globe and Mail Book Club and has selected as her author-guest Thomas King, whose work she has championed since the early days of his career. Atwood first reviewed King long before he was named to the Order of Canada and won the Governor-Generals Award, the RBC Taylor Prize for his 2012 book The Inconvenient Indian.

What are we missing? Email us: audience@globeandmail.com. Do you know someone who needs this newsletter? Send them to our Newsletters page.

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Coronavirus Update: B.C. toughens its tone on COVID-19 warnings as cases resurge - The Globe and Mail

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The Notorious Lehigh Valley Serial Vegan has struck.

Memphis Taproom owner Ken Correll came up with the name for the sender of a letter that arrived at his bar last week one he had to read three times before finally setting it aside with a head shake and a chuckle.

The typed note begs, beseeches and nearly demands the Kensington tavern bring back a discontinued item, referred to as the spaghetti and meatball hoagie.

Said sandwich, which is actually vegan (those meatballs are lentils) is semi-famous among Memphis many plant-based-diet customers, according to numerous complimentary social media posts. But it was taken off the menu at least two years ago, Correll confirmed.

Why did someone make the effort to send a notice about it now? Hes not sure.

Mailed anonymously, the letter offers few clues. It was stamped with a postmark from Lehigh Valley, Pa., where theres a big USPS processing and distribution center, and addressed simply to Owner on a printed address block taped to the envelope.

We get a lot of requests from local parishes and organizations that need fundraising help, so I thought it was one of those, Correll said. Then I open it and its this kidnapper-style letter.

One part of the message especially gave him pause. As part of the argument for bringing back the dish, the analog troller uses a racist Trumpism to refer to the pandemic. If anything is going to get us through this Chinese Virus, the note reads, it will be the Carbs on top of Carbs Hoagie.

Memphis Taproom recently received some backlash for posting in support of the Black Lives Matter movement, Correll said, which the hoagie-focused missive does not mention.

Either way, when he shared a pic of the note on his personal page, fans of the spaghetti sandwich immediately showed up in the comments, agreeing that it was a favorite. Good news if youre in that camp: you can still order it as an off-menu special.

We still make spaghetti and vegan meatballs, served [as an entree] with garlic bread, Correll explained, so its easy to turn that into the hoagie version, which comes with vegan mozzarella melted on top.

The bar, located at the corner of Memphis and Cumberland between Fishtown and Port Richmond, is currently serving lunch and dinner Thursdays through Sundays.

A spacious backyard beer garden considered one of the first in the city when it opened back in 2008 has made the pandemic business model tenable, according to Correll. About 80% to 85% of staff has been hired back, he said, with additional positions opening up now. The outdoor dining area, outfitted with some plexiglass barriers, will safely seat 50 or so guests.

Memphis may try indoor dining after Sept. 8, assuming the city maintains its date for allowing the expanded service, but they plan to take things slow. Were unsurewell dip our toes in.

As for the carbs-on-carbs monster, if theres high enough demand, it could also make a comeback. Its popularity doesnt approach another sandwich that has stayed firmly on the menu: a veganized BLT with smoked coconut shavings taking the place of bacon.

If we took off the coconut club, Correll said. I can only imagine the kind of letters wed receive.

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Philly bar trolled with ransom note over spaghetti sandwich - On top of Philly news - Billy Penn

Alas, two long-known protective factors early childbearing (in the teens and 20s) and prolonged breastfeeding run headlong into the life goals of many modern women who seek graduate degrees and professional advancement, as well as young women financially unable to support a family.

Many older women run into another confusing and controversial decision: whether and for how long to take hormone therapy to counter life-disrupting symptoms of menopause. Barring an earlier history of breast cancer, current advice for women who have not had a hysterectomy is to take combination hormone therapy (that is, estrogen and a progestin) for as short a time as needed to control symptoms but no longer than a few years.

A recent study, published July 28 in JAMA, described the long-term effects on breast cancer risk among 27,347 postmenopausal women randomly assigned to take hormone replacement or not. The authors, led by Dr. Rowan T. Chlebowski at UCLA Medical Center, reviewed the health status of the participating women more than two decades later.

Among the 10,739 women who had no uterus and could safely take estrogen alone (progestin is typically added to prevent uterine cancer), menopausal hormone therapy significantly reduced their risk of developing and dying from breast cancer. However, among the 16,608 women with a uterus who took the combination hormone therapy, breast cancer incidence was significantly higher, although there was no increased risk of death from the disease.

In commenting on these results, Dr. Christina A. Minami, a breast cancer surgeon at Brigham and Womens Hospital, and Dr. Rachel A. Freedman, an oncologist at Dana-Farber Cancer Center, wrote that the new findings are unlikely to lead to the use of hormone therapy for the sole purpose of breast cancer risk reduction.

But Dr. Freedman said in an interview, If Im counseling a patient whos really miserable with menopausal symptoms and is a candidate for estrogen only, these findings are reassuring that her breast cancer risk will not be any higher over time.

Then theres the possibility of taking a daily drug to suppress a potential breast cancer in high-risk women who have not yet had the disease. Dr. Jeffrey A. Tice, an internist at the University of California, San Francisco, suggested that womens doctors use one of the several risk assessment calculators to determine how likely the patient might be to develop breast cancer within the next five or 10 years.

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Medication and Lifestyle May Lower Breast Cancer Risk - The New York Times

While keyboard warriors have long debated whether or not electric bicycles provide a good workout, the science is conclusive: e-bikes can provide just as effective of a workout as pedal bicycles, and sometimes more.

But you dont have to tell Jon Treffert, a medical devices software developer from Knoxville, Tennessee. He already knows it.

Jon had enjoyed cycling as a grad student 30 years ago but gave it up after school. Fast forward three decades later, and Jon was diagnosed with type 2 diabetes.

Weighing 270 lb (122 kg) at the time, that diagnosis was the wake-up call he needed to change his lifestyle. Along with focusing on a healthier diet, Jon decided to get back into cycling. But hilly Knoxville was a tall order for someone who hadnt cycled in three decades. So Jon opted for an accessible, comfortable e-bike from the company Day6 Bikes and began putting on the miles. As time went on, he began increasing his rides and pushing harder.

As Jon explained to Selene Yeager in Bicycling:

Five months into my journey I reached a milestone of 1,000 miles [1,600 km]. I was riding primarily from home with a typical distance of 30 miles [48 km] and an elevation gain of 2,000 feet [600 m] at a brisker pace of 15.6 mph [25 km/h].

Just over a year into his e-biking journey, Jon had covered over 3,300 miles (5,310 km). But Jon didnt stop there. He kept riding, and now three years later, he is back to his high school weight of 165 lb (75 kg).

Of course Jons e-bike wasnt the only part of his impressive weight loss journey. Rather, it was part of an overall lifestyle shift that included becoming more active and eating healthier.

As Jon explained:

Cycling is so great for your mood, joints, and health. Its such a tonic every time Im out on the road. I want to motivate people by showing them an enjoyable sustainable pathway to change for which the e-bike is a catalyst and remains a key component. If we can replicate my experiment of one, we can, person by person, make a real change in our obesity and diabetes epidemic.

One of the reasons an e-bike was so useful in helping Jon change his lifestyle was because it lowered the barrier of entry.

Electric bicycles still allow the rider to pedal as hard as they want, offering an effective workout, yet they also provide a safety net to help returning riders cycle more safely when further from home. E-bikes are also helpful for taking the edge of off hills, which are one of the biggest obstacles preventing people from picking up biking a fear of cycling up hills.

Ive worked in the e-bike industry for over a decade, and I recently created a list of my top five tips for anyone who wants to get fit and lose weight with the help fo an e-bike. Check them out below:

Choosing the right e-bike is important, and weve previously discussed how to choose your first e-bike.

But dont let decision paralysis stop you. There are hundreds of interesting e-bikes out there. You dont necessarily need to drop $4,000 on a Specialized fitness e-bike (even though its a totally awesome e-bike).

My brother-in-law rocks the pedal assist function on his $1,199 RadRunner utility bike from Rad Power Bikes. Thats definitely not the first bike youd think of for fitness, but it works for him and gets him riding. He doesnt even touch the throttle, opting instead for a low pedal assist level so that he does most of the pedaling work.

Even an $899 Lectric XP would make an awesome e-bike for trail riding, and the pedal assist function would allow you to put in a decent afternoons effort while the bike simply assists you as much (or as little) as necessary.

So dont let yourself get sucked too far down the rabbit hole of comparing every single nut and bolt on every e-bike. Find something that fits you and your budget and get out there and ride!

Pedal-assist, or the ability for the e-bike to multiply your pedaling force, is what makes e-bikes such potent exercise tools for riders that are returning to cycling. And most e-bikes have between four to eight levels of pedal assist, allowing you to fine-tune the amount of extra power provided by the motor.

But I always advise new e-bike riders to avoid using the very lowest or very highest pedal assist setting.

Some riders mistakenly opt for the very lowest level with the goal of getting the best workout, but this can often leave new riders exhausted and in over their heads. The last thing you want is to find yourself totally spent while youre still many miles from home.

On the other hand, the highest pedal assist is often nearly the equivalent of full throttle and usually doesnt result in much of a workout at all. The highest pedal assist level is best for when climbing steep hills and usually isnt appropriate for casual riding on flat ground.

So like most things in life, moderation is key when it comes to pedal-assist. Try starting in the middle, then working down to a lower pedal assist level as your fitness level improves.

It might sound difficult to use your e-bike every day.

But the best way to achieve it is to incorporate your e-bike into your life as a form of transportation, not just as a piece of exercise equipment.

Try to replace as many car trips as you can with your e-bike. If you just need a couple of things from the store, toss on a backpack (or add a pair of panniers) and ride there instead of taking the car.

If youre visiting your friends at the coffee shop, consider riding instead of taking an Uber.

Find any way you can to fit the e-bike into your daily schedule. The more you ride, the more it becomes integrated into your lifestyle.

If you have the option of riding off-road, I highly recommend including it at least occasionally in your rides.

Bike lanes are great for transportation and roads are certainly easier for efficient pedaling, but theres nothing more enjoyable than pedaling down a nature trail with the sights, sounds, and smells of the earth around you.

You dont have to find a crazy, super technical single-track course; in fact, its better if you can ride on a relaxed, easy-going, and flat trail in the beginning. The point isnt to make the ride harder, but rather just to mix it up with a more pleasant atmosphere.

Whether youve got a local beach path, a forest trail, dirt roads, or any other piece of land that hasnt been paved, youll be surprised how big of a difference it can make if youre used to riding on the road.

And anything you can do to make the e-biking experience more relaxed and fun will go a long way towards ensuring that e-biking becomes integrated into your lifestyle and not relegated to the side as just some task that you know you should complete.

Lastly, try and find at least one other person to ride with. It could be a riding group or even just a friend that you convinced to get an e-bike after you discovered how much fun they are.

Riding with others can be another great way to ensure that youre getting out there more often. Both of you will keep each other honest since its harder to blow off a ride when you already told someone youd meet them.

You dont even need to find another e-bike companion.

A good friend of mine is a performance cyclist and we go on rides together all the time. I could never keep up with his fancy (non-electric) gravel bike on my own, but my e-bike helps me pace him and we enjoy rides together on the same trails, even though hes a much stronger cyclist than I am.

My e-bike helps level the playing field and allows us to ride together.

Ultimately, e-biking for exercise and fitness is all about putting in the time so that you can reap the rewards.

For some people, the reward is a lower number on the scale or a few holes down on the belt.

For others, those are just side benefits that accompany the main reward of finding a fun new hobby that brightens their day.

For me, e-biking has become a mixture of fitness, recreation, and transportation. I can do it all on just one e-bike, and I wouldnt have it any other way!

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Original post:
E-bikes and weight loss: How this man lost over 100 pounds (and how you could be next!) - Electrek.co