One in five 17-year-olds consume high levels of alcohol, are daily or occasional smokers and have poor diets, new research on clusters of health behaviour in adolescents shows.

A new report from the Economic and Social Research Institute (ESRI), the States independent think tank, published on Tuesday, found three distinct health clusters among young adults.

A group comprising 21 per cent of 17-year-olds - described as unhealthy smokers and drinkers - were found to have the highest level of alcohol consumption, were daily or occasional smokers, had moderate to low levels of physical activity and poor to moderate dietary quality.

Another group described as the unhealthy diet and physical activity group made up 36 per cent of this age group and did not smoke or drank alcohol rarely, once a month or less, but had the worst levels of physical activity and had the poorest diets.

A healthy group representing 43 per cent of 17-year-olds were non-smokers, drank rarely, engaged in exercise in six or more occasions in the previous fortnight and had the best diet.

The research, drawing on data from the Growing Up in Ireland 98 Cohort and funded by HSE Health and Wellbeing, found that young women are more likely to fall into the unhealthy smoker and drinker group and especially the unhealthy diet and activity groups.

Young people from working-class backgrounds were more likely to be a smoker and drink and those whose mothers had lower levels of education - Leaving Certificate or lower - were more likely to have poor diet and physical activity levels.

There were higher rates of drinking and smoking among young people whose parents are occasional or regular smokes, reflecting the impact of parental health behaviour on children.

The socioeconomic background of students and the school climate had a more significant effect than school policy on the membership of the various groups.

Negative interaction with teachers and disaffection from school was found to lead to greater levels of smoking and drinking.

The research findings show that measures to promote both school engagement and a more positive school climate, while important for educational outcomes, are likely to have positive spillovers for other aspects of young peoples lives, including health behaviours, said Anne Nolan, one of the authors of the report.

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One in five 17-year-olds are unhealthy smokers and drinkers - ESRI report - The Irish Times

There's no question that modern, processed diets are bad for the gut. Due to the vast majority of farming subsidies going to producers of corn, wheat, and soy, prices for the foods containing these crops (many of which are high in sugar and refined carbohydrates and low in meaningful vitamins, minerals, micronutrients, and fiber) have droppedmaking them cheap and readily accessible for consumers.

Fiberfound in vegetables, fruits, and a variety of whole grainspromotes microbial biodiversity and feeds beneficial gut bacteria, which these "good" bugs then use to produce gut-healing, anti-inflammatory compounds called short-chain fatty acids (SCFAs). But the average American gets just 15 grams of fiber per day, when we should be getting at least 25 to 30 grams. "Part of the problem we're seeing today could be due to three to four generations of progressively diminished fiber consumption," says gastroenterologist Will Bulsiewicz, M.D., referencing a groundbreaking 2016 study inNatureby Stanford University microbiome researcher Justin Sonnenburg, Ph.D.

For the study, researchers fed mice a low-fiber diet over multiple generations. After one generation, there was a decline in microbial biodiversity in the gut, which was reversible when fiber-rich foods were returned to the diet. But with each subsequent generation, there was a progressive loss of biodiversity that was harder to reverse (and impossible tocompletelyreverse).

"Compared to the Hadza of Tanzania, some of the last remaining communities of hunter-gatherers, people in the U.S. have about 40% less microbial diversity in the gut," says Bulsiewicz. "This leads us to believe that we've essentially lost 40% of what we're supposed to have as humans. To an extent it's reversible, but this study shows that we might be in a place where we're impaired from the get-go."

Excessive consumption of animal products (particularly in the absence of fiber-rich foods) may also have a negative impact on the gut microbiome. This was illustrated in a 2014 study by Harvard researchers in which they put the same group of people on two drastically different dietsan animal-based diet of foods like bacon, eggs, salami, and pork rinds; and a vegan diet of foods like rice, tomatoes, lentils, squash, and fruitand measured the effects of each. What they found: On the animal-based diet, there were significant increases in the bile-tolerant gut microbes, which are necessary for breaking down fat but also associated with inflammation.

Additionally, excessive refined carbohydrate and sugar intake has been shown to reduce the microbial biodiversity and feed bad microbes. "Someone who's eating way too much sugar is going to become a fertile ground for yeast to grow in their gut, and they can get candida overgrowth," says Vincent Pedre, M.D., integrative physician and author ofHappy Gut.

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5 Things That Are Seriously Messing With Your Gut And What You Can Do - mindbodygreen.com

Have you ever felt cramps in your stomach right before you enter an exam hall or meet an interviewer? Well, this is one of the simplest signs that indicate a connection between your brain and your gut. But what you might not know is that some diseases or microbes related to your gut could result in neurological diseases such as Parkinsons disease, Alzheimers and dementia.

Can gut microbes result in brain diseases?

Many studies in the past have suggested that the microorganisms in the gut can affect the brain. A study published in the Journal of Parkinsons Disease stated that Parkinsons disease (a chronic illness affecting the nerve cells in the brain) can also begin from your gut and can affect the entire brain function. The scientists found Lewy bodies in the gut and the nose which are abnormal protein bodies that form inside nerve cells and are responsible for Parkinsons disease. These Lewy bodies were seen to affect the peripheral nervous system (the nervous system outside the brain and spinal cord) first and then the brain.

Inflammatory bowel disease can lead to dementia

A new study, published in the journal Gut on 23 June 2020, stated that people with Inflammatory Bowel Disease (IBD) may have an increased risk of developing dementia in later stages of life. IBD is the chronic inflammation of the digestive tract. The study included data of around three million people from the Taiwan National Health Insurance programme, out of which 3,744 patients above the age of 45 years were reported to have IBD and 17,420 people were included in the control group.

After 3 to 5 years, scientists found that out of all those subjects 1,742 people with IBD developed dementia. With this study, the scientists concluded that people with IBD have significantly higher lifetime dementia risk than those included in the control group.

How to keep your gut healthy?

You can keep your gut healthy by following ways:

1. Probiotics and prebiotics: Include probiotic foods such as curd, cheese and kimchi and prebiotic foods such as asparagus, bananas, garlic, onions and whole grains in your diet as they promote the growth of good bacteria in the gut.

2. Reduce stress: Psychological stress can disturb the colony of good microorganisms in the intestines. Keep stress at bay by practising deep breathing exercises, meditation and listening to soothing music.

3. Exercise daily: Studies reveal that exercising 15 minutes a day or 90 minutes a week can help in improving the gut microbes and also add on three years to your life.

4. Maintain your oral health: Various inflammation-causing bacteria can travel from down from your mouth to your gut. Maintain oral hygiene by brushing your teeth and cleaning your tongue regularly.

5. Cut down sugar: Studies reveal that sugar and artificial sweeteners can result in dysbiosis, which is the medical term for an imbalance in the gut microbiomes.

6. Sleep well: According to various animal studies, irregular sleeping patterns can damage gut microflora, thus leading to inflammatory diseases. Sleep for at least 7 to 8 hours a day.

7. High fibre diet:Food rich in fibre such as legumes, beans, peas, oats, bananas and asparagus help in improving gut health.

8. Quit smoking: Chronic smoking can damage the good microbes present in the gut and also gives rise to the harmful microorganisms which can lead to intestinal conditions such as inflammatory bowel disease and Crohn's disease.

9. Add polyphenols in your diet: Foods like dark chocolate and black tea contain polyphenols which are plant-based molecules known to enhance the growth of good bacteria in the gut.

For more information, read our article on Irritable Bowel Syndrome.

Health articles in Firstpost are written by myUpchar.com, Indias first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

Updated Date: Jun 24, 2020 16:13:06 IST

Tags : Alzheimer's Disease, Brain, Dementia, Health, Inflammatory Bowel Disease, Lewy Bodies, Myupchar, Nervous System, NewsTracker, Parkinson's Disease, Reuters, Spinal Cord

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Gut microbes are connected to brain diseases; probiotic foods, high fibre, low sugar diet key in keeping... - Firstpost

Fatty foods, dairy, and sweetened treats can raise the risk of acne in adults.

A study by French researchers found that foods such as milk chocolate or sugary drinks could trigger acne in adults.

The results of our study appear to support the hypothesis that the Western diet (rich in animal products and fatty and sugary foods) is associated with the presence of acne in adulthood, the authors wrote.

More than 24,000 adults in France took part in the study. They were asked to keep a 24-hour dietary record over a 2-week period.

The participants were asked to note everything they ate and drank as well as the amounts consumed.

The researchers concluded that fatty, dairy-based, and sugary foods can trigger an acne outbreak.

Drinking five glasses a day of either milk or a sugary drink increased risk of acne by more than 50 percent.

One portion of fatty foods such as french fries or a sugary food like a doughnut increased the risk of acne by 54 percent, the researchers reported.

Dr. Joseph Zahn, an assistant professor of dermatology at George Washington University in Washington, D.C., says the study results arent surprising.

The fact that fatty foods, sugary foods (those foods that are high glycemic), as well as dairy foods (particularly low fat dairy) cause acne doesnt surprise me in the least, Zahn told Healthline.

There have been a number of studies in the recent past which have suggested this particular link, and many of my patients have personally noted acne flares when eating such foods, he said.

Though the exact reasons arent clear at this time, the current school of thought regarding why these particular foods may cause acne to flare is that they may play a role in regulating certain hormones, such as insulin or androgens, which we already know cause acne to flare, Zahn explained.

The researchers suggest a diet high in sugar as well as the consumption of milk causes a rise in levels of circulating insulin.

This, in turn, stimulates cell production while also inhibiting cell death, promoting inflammation and the development of acne.

In addition, an increase in insulin levels also encourages the production of hormones that produce sebum, which can cause acne.

Insulin is a hormone secreted by our pancreas to address glucose levels in our blood. It would make sense that having a high sugar diet or one that is processed would affect insulin levels and other hormones within our bodies as well, some of which also apparently regulate acne, said Dana Hunnes, PhD, a senior dietitian at the University of California Los Angeles Medical Center.

Dairy has its own innate hormones, estrogens, progesterones, likely even some testosterone (as even human females produce some testosterone) that is likely exacerbating our own endogenous hormones and increasing the likelihood of a breakout, Hunnes told Healthline.

Study participants who reported having current acne consumed significantly more milk, sugary beverages, milk chocolate, and fast foods than the participants who reported never having acne.

The group with current acne also ate significantly less meat, vegetables, and dark chocolate.

Lauri Wright, PhD, an assistant professor in public health at the University of South Florida, says if dairy foods trigger an individuals acne, they can find their calcium elsewhere.

Dairy is an important source of calcium and protein, and generally can be a part of a healthy diet. If individuals with acne find dairy to be a trigger food, they can substitute nut milks instead, Wright told Healthline.

She argues that more research needs to be done to determine a diet that could help prevent acne, but she says cutting back on sugar is a good place to start.

​A diet low in sugar and saturated/trans fats is protective against many diseases. For health, limiting sugar and saturated/trans fats while incorporating healthy fats, lean meats, whole grains with a foundation of fruits and vegetables is optimal, she said.

Milk chocolate increased the risk of an acne outbreak by 28 percent, while dark chocolate was linked to a 10 percent reduction in the risk.

Experts say theres some truth to the claim that chocolate can cause breakouts.

Milk chocolate contains whey, a milk-derived protein. Intake of whey protein has been associated with increased levels of acne. Some individuals will be more sensitive to whey, dairy, and sugar (no matter the amount) than others. When we look at the composition of chocolate, it also contains sugar, Kristin Kirkpatrick, a registered dietitian and manager of wellness nutrition services at the Cleveland Clinic Wellness Institute in Ohio, told Healthline.

Zahn agrees that people can respond differently to foods like chocolate, and not everyone will experience acne if they eat it.

Acne can be flared by many different foods, and each person has their own unique triggers. Im not surprised that some people flare in response to milk chocolate or any kind of chocolate, he said.

We just arent sure yet what part of the food causes the outbreak, if its the food itself or a secondary effect of the food, such as increasing levels of certain hormones, Zahn added.

Zahn says acne in adults appears to be on the rise, although the reasons why are yet to be determined.

Its possibly related to rising amounts of stress, fluctuating hormone levels, or new medications, or even other reasons we dont fully understand yet, he said. Its a common problem, and many adults aged 30 to 50 still have acne.

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Adult Acne Is Real: Here Are the Foods That Can Cause It - Healthline

WWE wrestlers are well-known for their imposing physiques, and one ex-wrestler is coming good on a vow to return to his prime physical condition.

The Great Khali - real name Dalip Singh Rana - became the first-ever Indian WWE world champion in 2007 after winning a 20-man battle royal.

Khali rose to prominence in WWE in 2006 when he fought The Undertaker in a last man standing match, with his huge 7ft 1in frame making him a unique threat in the world of wrestling.

He retired from WWE in 2014, but returned briefly in 2017 to help Jinder Mahal beat Randy Orton to retain the WWE world title.

The longer he spent in the sport, however, the less toned the Indian wrestler became - though Khali is determined to return to his previous shape.

Over a decade after he first took on The Undertaker, Khali has been working hard to bring his physique back to the same level as his early days as a pro wrestler.

Now, the 47-year-old looks better than ever thanks to a gruelling workout regime and strict diet.

The so-called Punjabi Playboy consumes an enormous amount of food every day, which is packed with protein to help him maintain and build his muscle mass.

According to Sportskeeda, Khali starts his day with fruit juices, two glasses of milk, eight eggs and 100 grams of dried fruit.

Before he even begins his workout plan, the Indian ex-wrestler also goes for a morning walk before taking down a breakfast of chicken and bread.

For lunch, he reportedly eats curry, pulses, vegetables, wheat bread, eggs, more dried fruit and, if that isnt enough, another kilogram of chicken.

For dinner, Khali consumes another mountain of food, including even more chicken, brown rice, six eggs, wheat bread and two litres of milk and ice.

He also has a sweet tooth and a need for a caffeine fix, meaning his diet also includes ice cream, sweets, coffee and curd - a product similar to yoghurt that is popular in India.

His huge diet seems excessive, but his need for so many calories becomes clear with a look at his workout plan.

Khali starts his week with bicep and tricep training on a Monday, which includes barbell and dumbbell curls, tricep dips and sit-ups.

Tuesdays are for cardio work, centred on treadmill and cycling sessions.

On Wednesdays, Khali works on his shoulders and traps, before moving on to his back and abs on a Thursday.

Fridays are for his legs and abs, with sets of leg extensions, leg press and squats, as well as ab crunches and squats.

On Saturdays, Khali takes a rest day, though, even that includes 30 minutes on the treadmill. On Sundays, he returns to his full schedule, focusing on building his chest.

Khali regularly shares his progress on Instagram, allowing his 436,000 followers to keep track of his body transformation since his retirement from the sport.

Rana's diet and workout plan certainly arent for the faint-hearted, but they have clearly had results for this WWE icon.

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WWE news: The Great Khali has undergone an impressive body transformation - GIVEMESPORT

Right now companies have these pretty deeply embedded structures that are geared toward diversity, says Lieberman, who studies race-based discrimination and policy. If a diversity program is to become an instrument of racial equity, rather than an instrument of creating and sustaining diversity, theyre going to have to do something different.

So why not consider the coercive powers of quotas? In perhaps the most successful diversity push in recent years, California passed a law in 2018 requiring all public companies based in the state to have at least one female director by the end of 2019. At the close of 2021, boards with five directors must have at least two women, and those with six or more have at least three. Failure to comply costs $US100,000 ($145,000) the first year and three times as much after that. The move was unpopular, even with women, because it suggested hiring committees would have to lower their standards. A year after compliance began, thats not what happened. Instead, opportunities opened for overlooked executives.

There was a perception when the law passed that there was a limited pool of qualified candidates, says Annalisa Barrett, a governance expert at KPMGs Board Leadership Centre. It doesnt seem to have been the case. Women accounted for almost half of new board seats in the state in 2019, outpacing female hires for similar positions in the rest of the country.

Even without quotas, people assume you were hired because you were Black.

Kimberly Reyes, a Black copywriter

There are judicial roadblocks, of course. Since the Supreme Court weighed in on its first affirmative-action case in 1978, its limited government use of numerical targets. In the ruling, a university admissions case, the court said an institution could use race as a factor in its decisions, but that quotas went too far.

Meanwhile, Californias law has faced multiple legal challenges. Judicial Watch, a conservative activist group, called the requirement unconstitutional in a lawsuit filed on behalf of taxpayers, and a shareholder of a California-based company with an all-male board argued in a federal complaint that its discriminatory. The first case is ongoing; the second was dismissed in April. While lawyers duke it out, California companies are moving ahead with meeting their quotas. Even if the law is struck down, the gains women have made will be in place.

Despite programs to improve diversity, there are even fewer Black coaches in the NFL than there were five years ago.AP

Boards are just about as White as they are male as of 2019, 37 per cent didnt have a single Black director. Still, a law similar to Californias that would address racial inequities is highly unlikely and would face much stronger opposition than the gender quota law, says Michael Hyter, chief diversity officer at Korn Ferry. There is an apprehension among companies that if they are perceived as setting a target for hiring for people of colour, that the focus will mean hiring less qualified candidates, Hyter says. Its a familiar yet unfounded fear that is hilarious on so many levels, says Kimberly Reyes, who spent years working as one of a few Black copywriters at various companies. Even without quotas, people assume you were hired because you were Black.

If legislators wont act, shareholders could. State Street, BlackRock and activist investors already pressure companies to disclose the gender diversity of their boards. Those campaigns have resulted largely in gains for White women. They could shift their focus to Black representation, says Natasha Lamb, a managing partner at Arjuna Capital, which pushes banks and tech companies to disclose gender and racial pay gaps. People bristle at the idea of racial quotas, Lamb says, but they work. There need to be interventions, she says. The protests are an intervention. Shareholders exercising their voice is an intervention. Without intervention, nothing is going to change.

Vanguard says it had already planned a 2020 emphasis on getting boards to disclose their racial and ethnic data. BlackRock says it continues to be committed to pushing for board diversity. State Street says its committed to being part of the solution and continuously evaluating the issue of racial diversity.

Our goal is to inspire people versus shame them.

Pam Jeffords, diversity and inclusion consultant at PwC

The boardroom is just one of many White corners of the business world. Up and down the corporate ladder, strictly enforced targets could legally be used to fix racial imbalances, says David Oppenheimer, director of the Berkeley Centre on Comparative Equality & Anti-Discrimination Law. Quotas cant be used in perpetuity, he says, but they can be put in place for a short period to correct a manifest imbalance in workforce make-up.

Its sort of like dieting, says Oppenheimer. Sometimes you have to go on a severe diet to lose some weight, and then hopefully you can go on a maintenance diet where you can eat a little bit more. Thats the theory. One hopes it works better than dieting.

Why arent more companies wielding the powers of this blunt but useful tool in their commitment to diversity? Quotas are always a bit of an issue, says Pam Jeffords, a diversity and inclusion consultant with PwC. Our goal is to inspire people versus shame them. The consulting firm prefers to look at hiring rates instead. The idea, she says, is to make sure companies arent hiring any specific demographic at a greater rate than another. Jeffords concedes that alone wont change overall representation over time: What are we really looking for? We dont want the numbers to go down. Theres been some decreasing in hiring rates for Black employees.

Half-measures rarely move anyone forward. Take the Rooney Rule named for Dan Rooney, former chairman of the diversity committee of the NFL, which pioneered it. The 2003 rule, widely adopted by corporate America, requires hiring managers to include a diverse slate of candidates for a given role. Since 2003, non-Whites have been considered for open slots in head coaching positions at professional football teams. There are just as few Black coaches now as there were then. In May, the leagues owners all but admitted the failure of the program when they met to consider additional incentives for teams that hire non-White coaches.

To be sure, quotas are limited in what they can achieve. In Norway, where public companies must set aside 40 per cent of board seats for women, they hold 42 per cent of those positions. But even with all those women in charge, men still hold most of the executive power. Only 7.7 per cent of those companies have female chief executives. In Malaysia, government policies giving preferential treatment to the ethnic Malay majority have helped them move up the social and economic ladder, at the expense, critics say, of ethnic Chinese and Indians.

The way to stop discrimination on the basis of race is to stop discriminating on the basis of race.

US Supreme Court Justice John Roberts in a 2007 ruling

Quotas wont solve racism. As US Supreme Court Justice John Roberts said in a 2007 ruling, the way to stop discrimination on the basis of race is to stop discriminating on the basis of race. Sending Black people into a hostile environment isnt much better than not hiring them at all. If you hire a lot of Black people and the culture is such that their jobs are at risk, they will be undermined, says Nadia Owusu, who does diversity and inclusion work at Living Cities and earlier this year wrote a column for the online magazine Catapult called "Hiring a Chief Diversity Officer Wont Fix Your Racist Company Culture. Indeed, the internal dynamics of corporations often end up undermining the executives in charge of diversity, many of whom are women of colour, Owusu says.

Quotas also invite lawsuits as they have in California. Harvards use of race as a factor in deciding on admissions has been called an evil of private prejudice and discriminatory by Edward Blum, a legal activist whos brought multiple suits against universities, including Harvard, for what he sees as biased admissions policies. The Supreme Court has allowed institutions to consider race in hiring and admissions, as long as its in an organisations interest.

Diversity as the reason for affirmative action is incredibly ahistorical.

Kimberly Reyes

Affirmative action was originally meant to counteract deeply ingrained prejudices. It has travelled somewhat of a distance from that idea, says Johns Hopkins Lieberman. It used to be a form of reparations and compensatory justice a form of payback for inequalities that exist because of the US history of slavery. It also counteracts programs like legacy admissions that work as affirmative action for White people.

Through the decades, however, its become part of a mushier push for diversity. Racial justice has been dropped in favour of a business case for diversity of thought and experiences, says Lieberman. Indeed, while research has confirmed the financial benefits of diverse teams, the profit motive hasnt changed the face of corporate America. Many companies still look for credentials Ivy League, Fortune 500 internships, for example that perpetuate the status quo.

A debate about quotas may just force corporate diversity programs to shape up. Maybe thinking about the issue as a matter of justice not just money will make a difference. Diversity as the reason for affirmative action is incredibly ahistorical, says Reyes, a Fulbright scholar whos written about affirmative action for the Atlantic. It was initially supposed to be about righting wrongs, or trying to balance something lopsided. Without quotas, how exactly do you change that?

Bloomberg Businessweek

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Quotas can help fix the glaring whiteness of America's C-suites - The Australian Financial Review

BARTOW, Fla., June 24, 2020 /PRNewswire/ --A new population based study1 published in Frontiers in Nutrition reports that the consumption of 100% orange juice was associated with multiple dietary and health benefits for children and adults. Orange juice consumers had higher quality diets, higher intakes of key nutrients, including bioactive flavonoids, and lower intake of added sugars. There were no negative effects on body weight.

Dietary data for almost 16,000 children and adults (>2 years of age) came from the nationally representative 2013-2016 National Health and Nutrition Examination Survey (NHANES). The study was conducted by researchers at the University of Washington and Albert Einstein College of Medicine and was funded by the Florida Department of Citrus.

Orange juice consumers had diets with significantly higher amounts of vitamin C, potassium, calcium, and vitamin D (adults), when compared to non-consumers. No difference in dietary fiber intakes was observed, suggesting that 100% orange juice did not displace any fiber from the diet. Notably, orange juice consumers had diets with significantly less added sugars when compared to non-consumers.

Focusing on the intakes of bioactive compounds from plants, the study found that orange juice consumers had significantly higher intakes of flavanones and total flavonoids (children), as compared to non-consumers. The flavanone, hesperidin, is provided in the diet almost exclusively by oranges and orange juice. Hesperidin may have antioxidant properties and help promote cardiovascular and brain health.2,3,4 For children, 100% orange juice may be especially important as a key source of healthful bioactives since their diets do not typically include fermented black tea, the principal source of flavonoids in the American diet.

Orange juice provides key nutrients, contributes to total fruit intake and may also serve as a marker of a healthier diet overall. For both children and adults, 100% orange juice consumers had higher-quality diets, measured using the USDA Healthy Eating Index 2015, which also tracks the consumption of grains, fruit, and vegetables, and the Nutrient Rich Food Index..

Importantly, there were no differences in BMI z-scores or waist circumference between children who consumed 100% orange juice and those who did not. For adults, orange juice consumers had significantly lower BMI and waist circumference. These results are consistent with the preponderance of research showing no negative effects of 100% fruit juice or orange juice consumption on body weight.5,6,7

"National data support the inclusion of 100% orange juice as part of an overall healthy diet for both children and adults. We show that orange juice consumption was associated with better diets, less added sugar, and did not affect body weight" said Dr. Adam Drewnowski, Professor of Epidemiology at the University of Washington and principal investigator on this study.

Just one-in-ten Americans meet their daily fruit intake as recommended by the Dietary Guidelines, missing out on important nutrients.8,9 A glass of 100% orange juice can help close that gap in a convenient, quick, and satisfying way without contributing to overweight or obesity when consumed as part of a healthy and calorie-appropriate diet. This study is cross-sectional in nature and, therefore, can only show associations and not cause and effect.

About the Florida Department of Citrus

The Florida Department of Citrus is an executive agency of Florida government charged with the marketing, research and regulation of the Florida citrus industry. Its activities are funded by a tax paid by growers on each box of citrus that moves through commercial channels. The industry employs more than 37,000 people, provides an annual economic impact of $6.5 billion to the state, and contributes hundreds of millions of dollars in tax revenues that help support Florida's schools, roads and health care services. For more information about the Florida Department of Citrus, please visit FloridaCitrus.org.

1Maillot et al. Front Nutr. 2020; published online May 13. 2Rangel-Huerta et al. J Nutr. 2015;145(8):1808-1816.3Morand et al. Am J Clin Nutr. 2011;93:7380. 4Kean et al. Am J Clin Nutr. 2015;101(3):506-514.5 Auerbach et al. Pediatrics. 2017;139(4): e20162454.6 Crowe-White et al. Crit Rev Food Sci Nutr. 2016;56(5):871-884.7Sakaki et al. Nutrients. 2019;11(11):2687.8USDA/DHHS. 2015-2020 Dietary Guidelines for Americans. 9CDC. Disparities in State-Specific Adult Fruit and Vegetable Consumption. 2015.

SOURCE Florida Department of Citrus

https://www.floridacitrus.org/

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In this video, Vladimir Maletic, MD, MS, discusses diet and nutrition challenges that patients with major depressive disorder may be experiencing during the COVID-19 pandemic.Dr. Maletic is a member of the Psych Congress Steering Committee andClinical Professor of Psychiatry and Behavioral Science, University of South Carolina, Greenville.

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Hello. My name is Vladimir Maletic. I am Clinical Professor of Psychiatry and Behavioral Science at University of South Carolina in Greenville, South Carolina. The topic of our conversation this morning will be the influence of COVID19 on dietary requirements in major depressive disorder.

One might ask, "Is this a topic that deserves some special attention at this point? Is there anything that would be specific to COVID19 and nutrition in depressed patients?" I would say definitely so.

COVID19 pandemic may have had direct and indirect impact on the risk of depressive relapse. When it comes to indirect impact, there's a lot of stress in lives of patients suffering from major depressive disorder during these times related to compromised social supports, changes in circadian rhythm. People are going to sleep at odd times, napping during the day. Very often, there is increased substance use. There is also, unfortunately, in part due to change in daily schedule, possibly in part because some of the reminders are lacking, decreased treatment adherence.

In addition to that, many patients who have major depressive disorder receive psychosocial treatments. Many of the outpatient clinics either have limited hours or have closed. I've had several depressed patients report to me that they can no longer see their therapists with regularity.

Unfortunately, due to a lack of support from other mental health professionals and limited access to general health clinics, unless one is in an urgent situation, there are problems. All of these factors influence risk of major depressive disorder.

In addition to that, patients suffering from major depressive disorder are not exercising as much, which is quite understandable. Many of the gyms are closed. Due to the change in routine, they are not exercising as regularly as previously and are frankly making some poor dietary choices.

Instead of adhering to their usual diet, very often they're up in the middle of the night, and they're making trips to fast food restaurants in the middle of the night. All of that has resulted in increased risk of destabilizing mood and precipitating depressive episodes.

Having increased stress due to some of the reasons that have been mentioned, we can add to that distance from friends and family members and financial stress related to COVID19. Many times, it's unemployment situation.

There is typical stress response. Hypothalamicpituitaryadrenal axis tends to be overly active. Increased cortisol and other hormones, which obviously have an impact on metabolism. In addition to that, there is a disbalance in autonomic activity, more sympathetic activity, less parasympathetic activity, as well as increased inflammatory signaling.

Whenever one is under distress, food choices change. I don't think you have heard people saying, "Oh, I'm stressed out. I can hardly wait to get home and get into my celery sticks and carrots." It's usually cream pies and ice creams. When one is under duress, one tends to seek out socalled comforting foods, or comfort food, which tend to be caloriedense foods.

What would be direct impact of COVID19? COVID19 has been associated with socalled cytokine storm. Cytokine storm is increased peripheral inflammatory signaling. These inflammatory signals do reach the brain. Once they reach the brain, they cause perturbations of neurotransmission, so monoamine signaling is off. Norepinephrine, dopamine, and serotonin, as well as changes in GABA and glutamate transmission.

Increased peripheral inflammatory signaling also translates into diminished neuroplasticity. All of these events compromise appropriate activity of circuitry that is involved in regulating mood, and therefore carry increased risk of major depressive disorder relapse.

What are some of the nutritional adaptations that one can make? They have to do both with quantity and quality of food. Speaking about quantity of food, we know that there is genetic link between major depressive disorder and risk for obesity. These 2 conditions, based on large, genomewide association studies, share anywhere between 15 to 20 common risk genes. There is a genetic setup, and some individualsnot all individuals suffering from depression, but some individuals suffering from depressionactually have different response to food than typical individuals.

How is this different? Based on imaging studies, it has been demonstrated that their reward circuitry has overly intense response to calorierich foods. It is sometimes almost irresistible temptation.

It tends to be present more in individuals who suffer from socalled atypical depression, where it is also associated with, in addition to increased appetite and food intake, it is associated with decreased energy and psychomotor retardation.

These individuals tend to have altered signaling between adipose tissue and the brain. If we have accumulated too much adipose tissue, it will start releasing typically leptin and adiponectin.

Individuals who have atypical depression have been demonstrated to have elevated levels of leptin, but decreased leptin receptor sensitivity. Meaning that their brain is not receiving the message that they have overabundance of calories stored.

On the other hand, adiponectin is an intermediary compound involved in regulation between adiposityso accumulation of fat tissueinflammatory signaling and sensitivity of insulin receptors.

In other words, patients who have depression on average will have decreased levels of adiponectin, meaning that they are at a greater risk of developing metabolic disorders. Presence of adiposity does not signal to their brain and does not make adjustment in sensitivity of insulin receptors.

All of this can be problematic as increase in appetite and adiposity increase the risk of having depressive episode. Viceversa, having depression increases the risk of obesity.

What can we do in terms of our dietary recommendations? A couple of things. One is limit the amount of dietary intake to balance out caloric requirements and exercise levels. The concern is if the BMI continues to grow, increased BMI has also been associated with decreased response to antidepressants. It becomes a vicious cycle.

Are there some specific diets that can be helpful in these circumstances? Definitely so. Studies have shown that modified Mediterranean diet, socalled antiinflammatory diet, may be of benefit in individuals who suffer from major depressive disorder.

What are some of the main points of this modified Mediterranean diet? The emphasis is on fresh vegetables, especially green leafy vegetables and legume, as well as fresh fruit, especially berries, which seem to have greater antioxidant content.

Furthermore, ingesting more nuts, seeds, and wholegrain cereal seems to be beneficial. In terms of protein, fish is definitely preferred. It appears that poultry and white meats may be relatively neutral. Moderate consumption of coffee and tea; alcohol no more than one glass of wine a day.

It is suggested that cooking with olive oil would be preferential. What do these individuals need to avoid? They need to avoid red, processed meat, fast food, fried food, sweetened beverages, simple sugars, and excessive alcohol intake.

What might be some of the payoff, some of the benefits from this modified Mediterranean diet? Modified Mediterranean diet is associated with decreased risk, not only of variety of chronic mental health problems, but also medical problems.

This is a huge bonus, because having chronic medical illness, along with stress, is one of the major precipitants of future depressive episodes. If one adheres to Mediterranean diet, one will have reduction in obesity. One will have reduction in inflammatory signaling. There will be improvement in cognition. In addition to that, imaging studies have found that there is an increase in total brain volume. This applies both to gray and white matter, as well as improved brain connectivity.

In other words, circuitry that is involved in regulation of stress response and mood is likely to function better if one has proper diet. Are there any indicators in the studies that support this? Indeed, patients who adhere more to this modified Mediterranean diet have reported greater life satisfaction, have higher wellness scores and happiness scores.

Indeed, what we eat does influence our mood to a significant degree. There is a specific scenario related to major depressive disorder when it comes to gutbrain signaling. Namely, a number of patients who suffer from major depressive disorder also has something that is termed gut dysbiosis.

This refers to altered composition of gut flora. Altered composition of gut flora has significant ramifications. Not only is the gut the greatest immune organ and endocrineso about 70 to 80 percent of immune cells reside in the gutit is a major source of serotonin, dopamine.

Anywhere between 80 and 90 percent of serotonin is synthesized in the gut. About 50 percent of dopamine is synthesized in the gut. Gut also has a significant role in producing glutamate and GABA.

If gutbrain axis is not functioning very well, it may very well have impact on neurotransmission in the brain. You have probably heard reference to leaky gut. Leaky gut allows exposure to various antigens and increased inflammatory signaling.

This increased inflammatory signaling does come to the brain. We have already mentioned that there is relatively constant relationship between peripheral and central inflammation, whereby central inflammation may cause perturbation in neurotransmission, in neuroplasticity, and the function of the brain circuitry involved in mood regulation.

Can anything be done to correct this? Yes, there is evidence that probiotic usewhen I say probiotic, these are live microorganisms that are ingestedthey can help with mood. What are some of these bacteria that can be obtained in health food stores in various probiotic preparations?

Typically, they include lactobacillus and bifidobacter. A typical amount would be two billion cultureforming units per gram. Use of these probiotics in controlled studies has been associated with reduction in depression scores compared to controls and placebotreated individuals.

A more recent development, I'm talking about research conducted in the last couple of years, indicates that symbiotics may be even better. What are symbiotics? Those are pro[biotics] and prebiotics combined. A combination of pro[biotics] and prebiotics may have been even more effective in improving depressive symptomatology as well as decreasing inflammatory signaling and promoting neuroplasticity.

What are some of these prebiotics, and what is the relevance of prebiotics? Again, probiotics are live cultures. Prebiotic is nutrition for these live cultures. They include nondigestible carbohydrates. They can be found in various sources of dietary fiber, such as onion, garlic, apple, bananas, artichokes, asparagus. All of this will support healthy gut flora.

In addition to pre[biotic] and probiotic, are there any other kind of nutrition supplements that can be helpful in depression? I must preface this by saying that data and evidence is uneven when it comes to use of some of these micronutrients.

Be it as it may, there's pretty solid proof that vitamin B complex, including folate and Lmethylfolate, may be helpful in depressed individuals, especially in situations where there is higher bodymass index, higher inflammation, or higher oxidative stress.

SadenosylLmethionine, or SAM, also has some evidence supporting its efficacy, as does Nacetylcysteine, often referred to as NAC. AcetylLcarnitine has some interesting research that has been conducted recently indicating that it may help with metabolic status and mood in individuals who have propensity towards depression. There are also control studies supporting the use of saffron and curcumin in individuals suffering from major depressive disorder.

Especially in COVID19 pandemic times, individuals don't leave their home a whole lot, and therefore have less exposure to sun. There is some indication that decreased vitamin D levels may be supportive of developing depressive symptomatology. Unfortunately, there is much less evidence suggesting that correction of vitamin D is helpful with depression. Nevertheless, it's a good idea to at least have normal, healthy levels.

In addition to that, there is some evidence that some of the microminerals may be helpful. I'm speaking about calcium, zinc, magnesium, and selenium.

Particularly, if the levels of these microelements are decreased, supplementation may be useful. Finally, there is some limited support that DHEA (dehydroepiandrosterone) may also be supportive of good mood.

In summary, COVID times have created great disturbance and distress in our patients' lives. Indirect impact of stress leads to disturbance in HPA axis, autonomic regulation, and inflammatory tone, which can act as precipitant to depressive episodes.

Having correct nutrition, adhering to modified Mediterranean diet, having greater intake of pre[biotics] and probiotics, as well as some of these nutraceuticals may help ward off the risk of major depressive episodes in these circumstances.

With that, I would like to thank you on your kind participation in this program. I hope that some of this information will be of use to you and your patients, and I wish you to stay healthy and well. Thank you.

Read more:
Dr. Vladimir Maletic on Diet and Nutrition in Patients With MDD During the Pandemic - Psych Congress Network

My patients occasionally ask me about, and I frequently recommend moving to, a plant-based diet. During the stay-home order, many people have been experimenting for the first time with plant-based proteins rather than meat. If youve read my column, you know I encourage regular consumption of a wide variety of fruits and vegetables. The health benefits are enormous.

Im a proponent of plant-based diets. In fact, as I write this column, I am eating a bowl of brown and wild rice, pinto beans and olive oil. Research shows that plant-based diets lower the risk for heart disease, many cancers and other health problems such as obesity, diabetes and high blood pressure.

There are a number of different plant-based diets that are popular. The most studied related to heart health and brain health include the Mediterranean diet, the DASH diet and the MIND diet. These diets feature foods like whole grains, fruits, vegetables, legumes, nuts and healthy oils like olive oil.

They have plenty of fiber, vitamins and minerals that help lower blood pressure and LDL (bad) cholesterol, reduce the risk of diabetes and help maintain a healthy weight. In other words, these diets are great for people with or at risk for heart disease. You can find the diets online along with their daily recommended allowances.

If you go completely off animal foods, you might need to take vitamin B12 and D supplements. The fiber found in beans, whole grains and fruits and vegetables helps most peoples guts to work better, lowers blood sugars and promotes a healthy gut microbiome.

Its important to know that not all plant-based foods are alike, so your plant choices are important. For example, white rice is highly processed and depleted of many heart-healthy nutrients found in brown rice.

Fruit juice is not as nutritious as eating fruit since it often contains sugar and is stripped of the fiber and some of the vitamins found in fruit. On occasion, Ive had patients who dropped meat but replaced them with chips and cookies and didnt increase the beans and grains, and that doesnt promote health.

Frozen fruits and vegetables are often cheaper than fresh and are more nutritious than canned ones. We are fortunate to live in a region that is rich with local fruits and vegetables for most of the year. Take advantage!

Consider talking to your health care provider about any major change youre thinking about making for your diet, especially if you suffer from chronic diseases. Your provider will want to be in the loop to monitor how youre doing and support you. For a few people, a pure plant-based diet doesnt work for their body.

I have a patient who is very thin and has had a difficult time her entire life maintaining her weight. She tried a vegetarian diet because she felt strongly about wanting to stop eating meat. But she felt hungry all the time, had very little energy and lost significant weight. Thats not usually the case, but she felt better when she added meat and dairy protein back into her diet.

I also know that for all its benefits, not all of my patients will be completely satisfied with a plant-only diet. You dont need to go completely vegetarian in order to get the health benefits of a plant-based diet. You can mix it up maybe start by having 2-3 fewer servings of meat per week, having some meat free days and building from there. Your body will thank you.

Bob Riggs is a family medicine physician at Kaiser Permanentes Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.

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House Call: Considering moving to a plant-based diet? Heres what you need to know - The Spokesman-Review

Keto Diet Vs. Paleo Diet: Keto and Paleo diet are two of the most popular diets in the world. Read on to know the differences and benefits of these diets.

To maintain a healthy weight and keep health diseases at bay, we often resort to diets. There is no shortage of diets out there and it is difficult to keep track. While eating a healthy diet is an essential part of being fit, but you should be careful with what kind of diet you should incorporate in your life. Keto diet and Paleo diet are two of the most popular diets today.

Many people follow these diets to lose weight and improve overall health. But how healthy are they? They might seem similar but they are extremely different. The main difference is that the calories in paleocome from proteins, whereas in Keto, they come from fat. Today, we look at how the two diets are different from each other.

Ketogenic or Keto diet is one of the most popular dietsamong those trying tolose weight. Keto diet is about eating healthy fats, protein and minimal carbohydrates. The body uses carbohydrates as a fuel for energy and when it doesnt get enough carbs, it starts using up the fat for energy. This is the purpose of the keto diet.

Paleo Diet is based on the idea of what our ancestors would have consumed in the Paleolithic age. It focuses on the elimination of foods that requires a lot of farming like legumes, grains, dairy products and processed sugar. Basically, a strong emphasis on meat, fruits and vegetables rich in protein and fibre.

1. While following the paleo diet, you need to indulge in some exercise and mindfulness. Keto, on the other hand, doesnt require lifestyle changes other than includingcarbs, protein and fat in your diet.

2. Paleo does not eliminate foods in carbs, while keto does. Paleo allows for whole-food sources of carbs, given it falls within the parameters of the diet. Keto, on the contrary, restricts all sources of carbohydrates.

3. With paleo, you are not allowed to eat any dairy products or soy. However, keto encourages eating high-fat dairy foods and soy.

4. A paleo diet might include grilled chicken, vegetables, avocado or some form of carbs. Keto, on the other hand, limits all carbs and allow you to eat less number of fruits and vegetables. Basically, there is more flexibility of food choices with paleo diet.

5. Paleo diet is rich in protein and fibre but lacking in calcium, and vitamin D. Keto is extremely low in carbs, which often leads to Keto flu, which causes nausea, fatigue and muscle cramping. Each diet has certain side effects.

6. When it comes to weight loss, keto diet is designed to help you to lose weight. But the results may not last long. Wherss.eas, there is not enough evidence that paleo helps with weight loss.

Paleo and keto diets, both are healthy depending on how they are incorporated. However, the paleo diet is easier to follow than the keto diet as you have more food options with the former. Paleo also encourages exercise and mindfulness, which makes it more of a lifestyle than a diet.

However, research is still going on regarding the safety and effectiveness of these diets.

ALSO READ | Intermittent Fasting vs Ketogenic Diet: Which one is best for weight loss?

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Keto Diet Vs. Paleo Diet: Which one is a healthier option? - PINKVILLA