Leading dietitian Dr Carrie Ruxton says Scots add risk upon risk upon risk amid calls for obesity levels to be tackled.

One of Scotlands most prominent dietitians says the coronavirus pandemic has exposed the health risks Scots face through poor diet, heavy drinking and inactivity.

Mortality rates from the coronavirus in the UK have been among the highest in the world.

The government has been accused of not implementing lockdown fast enough and of failing to protect care home residents who account for a large proportion of the fatalities. But there is also evidence to suggest high levels of obesity and related conditions in Scotland and the rest of the UK could have played a role.

Dietitian Dr Carrie Ruxton believes poor diet and unhealthy lifestyles put us at an increased risk from coronavirus. She said: Im seeing a lot of people blaming the government, saying they should have shut down the country earlier, organised more PPE [protective equipment] and I do sympathise and agree, but I also think, What about all of us?.

If you look at countries where they havent had so many deaths, were looking at healthier populations, lower rates of obesity. Look at Greece, a poorer country compared with us, but they do better because they have a better diet, more sun, more outdoor and less sedentary work, so theyre less overweight. We have to have a real look at our weight and our diets and ask, What changes could I make to protect myself from health threats in the future?

A study of 99 countries by the US Centers for Disease Control and Prevention found obesity is the biggest risk factor for death from coronavirus among under-50s and those aged between 50 and 64.

Covid-19 patients in England with type 2 diabetes, which is often linked to being overweight or inactive as well as family history, account for around 31%. In Scotland, figures suggest almost of fifth of deaths were linked to diabetes, though there isnt a breakdown between types 1 (which is not preventable) and type 2, linked to lifestyle.

Last week the charity Obesity Action Scotland said tackling the nations weight problem must be central to the Scottish Governments recovery plans when it comes to the pandemic. Epidemiologist Professor Tim Spector, of Kings College London, also said recently: Obesity and poor diet is emerging as one of the biggest risks factors for a severe response to Covid-19 infection that can no longer be ignored. Dr Ruxton agrees.

She said: Scotland has the biggest obesity problem in the world after America. We have a culture where people dont tend to do a lot of exercise at all so theres a huge amount of inactivity, a huge amount of obesity which causes type 2 diabetes, we have a drinking culture we go to the pub and neck it back theres so much going on there.

Ill health is multi-factorial and [unhealthy lifestyle] adds layer upon layer upon layer of risk. You dont eat fibre, fruit and veg, you dont exercise, you smoke, youre adding risk upon risk upon risk. Theres a solution there. Try and scrape off some of those layers of risks dont smoke, drink moderately, eat more fruit, veg and wholegrains, be more active it will help.

Its about having a healthy weight not skinny malinky, but in a healthy range and staying active. You can still be quite big and healthy. People shouldnt think, Im a size 16, Ill never be a size 8 so Ill give up. If you are a size 16 and youre active and eating better and you drop down to a size 14 thats going to make a difference.

Dr Ruxton, who is a dietitian with the Health and Food Supplements Information Service, says the best starting point when it comes to what we eat is to move towards a diet high in fibre and rich in vitamins and minerals.

There are two key areas. Theres the fibre, the non-digestible carbohydrates like inulin [a type of dietary fibre found naturally in plants], that feed the good, positive bacteria in the large intestine.

Then there are polyphenols, plant compounds found in foods including red wine, dark chocolates, orange juice, tea and they arent absorbed in the small intestine, they go to the large intestine and get broken down by the bacteria there and absorbed into the blood. Polyphenols are linked with protecting against cancer and heart disease and even the effects of aging.

Other important aspects of the diet are the vitamins and minerals, and they often get forgotten about. In rich Western society we talk about over nutrition and we say, Eat less of this and avoid that, but we dont say anything about vitamins and minerals. If you look at the Scottish diet theres considerable numbers of people who arent getting enough vitamins and minerals.

Take vitamin D; the Government advice has always been to consider a supplement from autumn to spring but people arent doing it. People in care homes should be given routine vitamin D supplements and that isnt happening. People should be saying to their grandparents to take vitamin D and this [pandemic] has raised awareness like never before.

Studies show that 54% of people in Scotland on average do not have sufficient vitamin D levels by the end of winter, a figure that is significantly higher among those in deprived areas.

Dr Ruxton added: Obesity makes a lot of vitamin D in your body unavailable. Your fat cells trap it, so it doesnt go into your blood to be used. Overweight and obese people can increase levels simply by losing weight. These things need to be highlighted more.

She also points to common low levels of important minerals such as zinc (thought to help regulate immune function) and selenium (which has antioxidant properties with multiple health benefits) in the general population.

Eating frequently, smoking, high-fat diets, these increase free radicals in the body, and our body deals with them by having antioxidants in its back pocket so when we have illnesses or inflammation our body can re-balance it again. If youre not eating those things, if you dont have fish or brazil nuts [good sources of selenium] much, then you will have a lack of antioxidants and your cells get damaged.

With vitamin D [derived mainly from sunlight] natural food sources are oily fish, eggs and some mushrooms, but supplements are highly effective and if you take the recommended amount of 10mg a day you will increase your vitamin D levels. We want people to get outside too, so its about having a look at your overall lifestyle.

If you dont eat oily fish things like mackerel, herring, trout then think about an omega 3 supplement. Theyre an anti-inflammatory and from an immune function perspective they have an important role in keeping the balance right in your body. If I caught an influenza or another bug, my immune system reacts and in reacting it creates a burst of inflammation in our bodies which can be damaging in itself.

The aches and pains are caused by inflammation a by-product of the virus and omega 3s calm that down. Theyre a very helpful nutrient so I think thats important. If youre looking for a vitamin D and Omega-3 supplement, ask your pharmacist because you could get a combined supplement. Cod liver oil is very inexpensive and has vitamins D, A and Omega-3 all together so you might not have to take another supplement on top.

If you know your diet is rubbish then something like a multivitamin and mineral is good and thats a good idea for teenagers who can be very resistant to healthy eating for a period of time.

Should you take vitamin D during the pandemic? And what are the best food sources? Your questions answered

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Coronavirus: Why the pandemic has to be a wake-up call for Scots when it comes to diet - The Courier

"You would be very focused on what you ate," Phillips says.

She advises cooking almost all your meals from home; eating until you're 80 per cent full; reducing alcohol intake to one or two days a week, and limiting it to spirits in zero-calorie soda and carefully managing your protein levels (eating around 1-1.5g per kg bodyweight) to preserve and build muscle.

"Say goodbye to calorie-dense, nutrient-poor food such as fried food, pasta, pizza, desserts, and say hello to buddha bowls, veggies, legumes, lean meats, eggs and rice," she says.

Follow those two simple steps to a six-pack. Thanks for reading!

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But of course, "simple" isn't the same thing as "easy" despite what Instagram's led you to believe, a six-pack is a devilishly hard thing to earn and maintain.

I've battled to get a six-pack, and can tell you that the extreme calorie restriction makes you obsessed with the foods you're not allowed to eat. And you can't even turn to your friends for relief from your punishing ab quest.

"Often your social life may suffer because it's no fun eating out when you can't have what you really want!" says Phillips.

While rippling abs are taken as a sign of peak fitness, the ultra-low body fat it takes to get them can have seriously unhealthy side effects: Phillips says they include fatigue, a compromised immune system, vitamin deficiencies, muscle wastage, and organ shrinkage in severe cases.

Women, who naturally carry more body fat than men, may experience added consequences when it falls too low.

"Loss of period aka amenorrhea is one telltale sign that body fat has dropped below healthy levels and obviously leads to fertility issues," Phillips warns.

"Think of it as the body saying it is not capable of supporting the demanding nutrient needs of a growing baby," she says. "Chronic amenorrhea can lead to bone diseases such as osteoporosis, high cholesterol and premature aging."

And they're just the physical side effects.

"There are also psychological risks such as body dysmorphia, disordered eating patterns, orthorexia, and anorexia nervosa," warns Phillips, who hosts the podcast Healthy Her.

Amelia Phillips, who hosts the podcast Healthy Her.

Precision Nutrition's internet-famous infographic The Cost of Getting Lean breaks down how incredibly high that cost actually is.

And take it from someone who has put in the hard work to get a six-pack (my lowest ever body fat checked in at 4 per cent): it's not really worth it, and it won't make you happy.

Phillips agrees.

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"I don't think it's worth all the effort, focus and deprivation. I would rather someone put that energy towards getting healthy," she says where healthy means staying within a normal body fat range; eating a diet that's low in processed foods, high in fruits, veggies and legumes; and cooking more from home.

She shares Boot Camp's philosophy of training and eating to feel better, not just look better.

"Set physical challenges such as a fun run, learning a new sport or skill, and do some mindful work on loving and respecting your body warts and all," she says. "Your body will respond way better, and you'll feel amazing."

A version of this story first appeared on Executive Style.

According to Sam Downing, the secret to good health and wellbeing is pretty simple: keep it simple. Sam is a qualified personal trainer, fitness instructor and nutrition coach.

Read the original:
How to get six-pack abs and a solid reason why you might not want them - Sydney Morning Herald

Chile is facing one of the most prolonged droughts in its history. The amount of rainfall in the country has been in decline, which has made the water crisis a major problem for the agricultural industry.

The Chilean Ministry of Agriculture, Antonio Walker, has emphasized the importance of tackling this problem and has assured that "without water, there is no country", as this precious resource is essential for food production.

Experts say that once the country has overcome the Covid-19 pandemic, the water crisis will be the next major challenge.

In that regard, the Israeli Ambassador to Chile, Marina Rosenberg, has highlighted the importance of individuals working together to make a difference in order to overcome the challenge,stressing that "water is vital for agriculture and forms the basis of our diet".

The following interview has been translated from Spanish.

What are the geographical and climatic conditions in Israel that create water shortage problems in the country?

Israel is a country with very low rainfall, with almost none in the far south of the country where the Negev Desert is, and in the north there is around 250 milliliters annually. In addition, we have one single source of freshwater - the Kinneret Lake, or the Sea of Galilea. In summary, we're talking about an area that is 60% desert and with limited aquifers.

Broadly speaking, how has the country been able to develop its agricultural industry and overcome the water shortage over the years?

Since the birth of the State of Israel in 1948, one of the main challenges has been self-sufficiency, as the geopolitical situation has made trade with nearby countries very difficult. Therefore, the plans for agricultural development and water management have also formed part of public policies. Water is vital for agriculture and forms the basis of our diet.

What are the main techniques or solutions that have been used to meet the demand for water?

Israel's strategy to face the water challenges can be resumed as "centralized and multi-focused". In other words, we have a national authority in charge of water that coordinates all the actors and areas of focus, including production, prices, demand, incentives, technologies, legislation, etcetera. And on the ground, we can say that Israel's success in this regard has been based on concepts like water saving, reuse, and new sources of production.

Does the Water Authority also have a role in finding new sources of water?

The Water Authority has a very important role in the long-term strategic planning of the country's future needs in terms of human consumption, agricultural production, emerging industrialization, and other needs that could arise.

With this estimate, it can identify the sources of water - where the water comes from - and also the destinations - where it will go. There is an important link between origin and destination. For example, reused water is generally used for agriculture and irrigation.

In Israel, desalinated water is provided for human consumption and specific industrial processes. This planning allows costs to be managed for treated and quality water for consumption and energy use, and also to precisely plan the future tenders in plant materials and treatment technologies so that neither human consumption nor agriculture is affected.

Could these solutions you mentioned be implemented in Chile?

Of course. In terms of saving water, Israel was a pioneer in the development and use of drip irrigation, which is now widely used around the world and present on many Chilean farms.

As for the reuse of water, Israel, through its treatment plants, treats and reuses almost 90% of the municipal water, and in Chile undoubtedly this experience can be duplicated, reusing water that is already treated in the different regions.

Lastly, on the subject of production of new sources of water, in Israel this has been done using desalination, generating more than 60% of the country's potable water, which without doubt demonstrates that Chile could find an answer to its problems with this technique.

In any case, as well as the technified irrigation, desalination and reuse, there are other technologies that reduce the amount of water lost in transportation - amongst other areas -, satellite technology for leak management, which has helped Israel to have less than 10% loss - a very low figure in comparison to other countries, but one that can still be improved upon.

How well do you think Chile is facing the water shortage?

We have seen that the authorities have a great interest in tackling this topic in-depth, which has translated into numerous invitations to Israeli experts and consultants in the development of private projects between the countries, in academic cooperation, and in the creation of memorandums of understanding to tackle this challenge.

How important is it for a country to be conscious about the management of water, its use and reuse?

It is vital to be able to support decisions that will involve public policies and finances. And, on the other side, the sum of individual actions can make a difference. In Israel, for example, it is unthinkable for a child to brush their teeth with the water running, or for someone to wash their car with a hose in the street. And this is because of the education on the saving of water is very strong for all citizens and companies too.

In what way could people be made more conscious about the use of water in Chile, taking into account examples from Israel?

I believe that during this 10-year drought, a new consciousness has been created. And obviously it's important to invest in education and public campaigns. In fact, through bilateral cooperation, a few months ago Israel handed over to Chile a campaign called "Israel is drying up", which was adapted and implemented locally for television by the Ministry of Public Works. Additionally, we are promoting cooperation in this area with different national and regional institutions.

Do you plan to become involved with the water problems in Chile, providing advice based on your experience?

We like the idea of cooperating and sharing, more than giving advice. While Israel resolved the issue of water some time ago - due to the fact that it always had a shortage - Chile is working very well, and the coordination of efforts between the government, lawmakers, universities, and private entities will surely provide positive results in the short-term.

Rosenberg will participate in the upcoming Agricultural Water Summit, the first event that will tackle the water crisis that the agricultural industry is facing in Chile and the rest world today. The event will take place in San Francisco de Mostazal on Sept. 22, 2020.

During the day, numerous leading experts from around the will analyze the current situation with water and will provide solutions, drawing on successful experiences in other countries and highlighting the role of innovation and technology for the management and preservation of water in agriculture.

Rosenberg said that the space that the Agricultural Water Summit creates will facilitate essential discussions between different actors related to water regarding the impact that the drought is having on the industry.

"This event also serves the important purpose of bringing the different water resource management technologies into the Chilean ecosystem, linking together the different challenges that the country is currently facing, and sharing the experience that has been gathering in countries like Israel," she said.

For more information about the Agricultural Water Summit, click here.

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Q&A with the Israeli Ambassador to Chile on water - Fresh Fruit Portal

Ash Naeck and Avery Warner ended this season of 90 Day Fianc: Before the 90 Days with plans to see each other again after Naeck obtained an Australian passport. During part one of the tell-all reunion, fans found out that the two had parted ways. During the reunion, Warner revealed the reason for their split, and fans dont exactly understand where she is coming from.

By the time the 90 Day Fianc cameras started filming, Naeck and Warner had already broken up and gotten back together a number of times. Most of the breakups occurred because Warner was unsure if she could trust Naeck. He had even deleted all of the pictures of Warner off of his social media at one point. Despite their past issues, Warner decided to go to Australia to visit Naeck anyway.

The trip was full of ups and downs. During one of Naecks relationship seminars, Warner realized that Naecks views on gender roles were different than her own. She also discovered that Naeck had lied about his divorce, telling her that he had been divorced for 10 years when he really had only been divorced for one. He also told her that his ex-wife was fine with them taking his son Taj to America when that was not the case.

Despite all of these issues, the two still ended Warners trip on good terms and planned to continue dating long distance.

RELATED: 90 Day Fianc: Babygirl Lisa Hamme Confirms That She and Usman Umar Split in Shady Instagram Post

Naeck and Warner rehashed their breakup on the tell-all. Warner said that after filming wrapped, she wanted to take a break to think about things and Naeck ended the relationship.

If that person is really committed, we will work things out without taking a break, Naeck said. How many breaks do you need to take to decide what you want to do?

Warner said that Naeck lied to her face and Naeck admitted that he wasnt 100% real with her.

I wasnt authentic with you because youve run away 10 times, he said.

But the real kicker was when Warner revealed that the last straw was when Naeck lied about continuing a diet that they were both supposed to be on.

The other 90 Day cast members had a hard time making sense of Warner ending a relationship over a diet. Even Babygirl Lisa Hamme called Warner out.

Fans could not get on board with Warners reason for ending things with Naeck.

I feel like Avery is just a miserable person in general, regardless of what Ash did or didnt do, one person tweeted.

They broke up over a diet? A diet though? another person wrote.

Some didnt think the diet was the real reason behind the split.

RELATED:90 Day Fiance: Big Ed Is Trying to Shut Online Trolls Up by Donating to Charity

I like Avery, but I feel like she checked out of that relationship when she watched ol dude mansplain to women at his seminar,' one fan said. Since that episode I saw her energy completely change.

She was over him long before that diet, another person chimed in. This was just the excuse she was using.

Though the reasoning behind the breakup may have been petty at best, Warner has not completely ruled out a reconciliation with Naeck. When asked if she would get back together with him, she said it was too soon to tell.

Read the original post:
'90 Day Fianc': Avery Warner Revealed the Real Reason She Broke Up with Ash Naeck and Fans Think It's Dumb - Showbiz Cheat Sheet

Is there any distinction between positive screen time and negative screen time? Thinking about the shift to online learning, does it contribute to the harm of kids being online too much?

Yes, but this is tricky because the most important thing to notice about screen time is the amount of it. Data from research on representative samples of Americans by Common Sense Media (research available at commonsensemedia.org) suggest that a typical young adult will die having spent roughly one third of her or his life with the mass media in general, most of it on screens. One estimate, by Michael Bugeja at Iowa State University (see, Interpersonal Divide in the Digital Age), suggests that on average roughly 70% of our time waking time is spent staring at a screen. Digital life is a reallocation of attention for most people. Screen attention already was a powerful commodity in the television age, and it had won eyes and ears with little or no resistance. If the pandemic works like previous shifts in media history, we likely will not see a return to whatever was normal screen media time before the COVID-19 sequester time. Though I dislike the phrase right now, there likely will be a new normal whenever the pandemic is said to be over. So for my money, any fruitful conversation about positive and negative screen time must begin with the simple but often overlooked fact that no human population has ever spent this much time with this much screen media.

We are the living participants in this new media experiment. Even though data are colonizing modern life (see, The Cost of Connection, by Nick Couldry and Ulises Mejias) the data that can speak to its positive and negative influence will take much more time to gather and interpret. We dont know what adaptation looks like yet, or how to tell the difference between adaptation and accommodation. Think about the evolution of using a cell-phone while driving, for example, when trying to imagine adaptation and accommodation. And that might be the easier of the challenges to spot and mitigate, and we have failed pretty miserably at the easier of them (see, A Deadly Wandering, by Matt Ritchel for a great history of this story). Both prudence and patience are warranted until we know more about the effects of digital living, not unlike how we wait for a vaccine for COVID-19.

With all that in mind, I like to think of media as the delivery systems we use for consuming information, and then to think about information as food. Its not merely a metaphor. Increasingly, and especially during a pandemic, information guides survival. Like food, empirical research reveals that media use can also threaten survival. Although it is less common to think of information as unhealthy for the body, the way we do food, more people are starting to see parallels between them. Here are three research examples on which to chew. One line of research shows that writing affectionately reduces total cholesterol, even just for a few weeks, compared to writing without expressing affection. Conversely, a fascinating epidemiological study coded the affect (or emotion) in Twitter postings from regions of the Northeast to predict heart disease mortality in that same area. Remarkably, the authors found that negative Twitter posting was the largest and most robust predictor of death from heart disease, county by county. The effect was stronger even than diet and exercise variables also measured - combined. Finally, more than a decade ago researchers used a case-control design to test the relationship between television consumption and Alzheimers disease. Using those already diagnosed with Alzheimers Disease and a matched group of study participants without Alzheimers Disease, they found that television consumption in midlife was a significant predictor of the disease diagnosis. These are just a few studies pointing to the potential for information to alter not just on how we think and feel, but also to erode health. Information consumption and production both impact the body not the same as food, of course, but there is impact nonetheless.

Now having said all that, here are two distinctions that help. The first is between active and passive consumption, and the second is between ritualistic and instrumental media use. The brain burns glucose when it processes information, so it is useful to think about media consumption this way. Active consumption burns more glucose, requires more thinking, to put it simply. Not all screen-based media is the same in terms of its glucose production, and sadly there are not great data mapping it all out. Right now, Im staring at a screen. But Im creating something, effortfully. Its more effortful than, say, when I watch The Office on Netflix. But there is also a difference between watching Jeopardy on TV and The Office, especially if you are trying to guess the answers before the contestant does. Video games tend to be more active than television, in terms of cognitive processing, but reading is the probably the most active. Sadly, reading also tends to be the form of media that kids today spend the least time with, and by a lot, especially for pleasure. People also read on a screen now, though not as well and for sure differently (see, The Shallows, by Nicholas Carr). Still, one question to ask and/or to monitor among your children is to take stock of how active is the media time. Shy away from thinking about screen time as a lump thing. To be the most healthful, push toward reading, even on screens if it has to be, and to forms of engagement which invite participation from the consumer. Its important to note a sobering statistic from Common Sense Media, who has great data tracking media use among representative samples of U.S. children. Although web 2.0 promised all this great new capacity for creating and disseminating content, only about 4% of a childs time with media is dedicated to creating. Most of it, by far, for most kids, by far, is just consumption, and most of it, by far, still comes from traditional television. YouTube time seems to be increasing fast, which from a sensory standpoint is just a different delivery mechanism for televisual content.

The second distinction is between ritualistic and instrumental use. Instrumental use of media has an offline application, or in other words, is engaged in for some delayed gratification. Say you watch a cooking show on PBS so you can try it for dinner. Thats one type of instrumental use. Or, maybe you learn to play a song on the piano by watching an instructional video on YouTube. That too, is instrumental. Ritualistic media use is the opposite. The end is itself engagement for engagements sake, or, entertainment for entertainments sake. Research suggests it is healthful to encourage instrumental media use. This has been a significant problem for people to negotiate since television became popular, however. Many people today feel digital life encourages ritualistic use even when it starts out as instrumental. This is why a web page on social media lacks a bottom. It never was actually a page, of course, but we fit it into that existing schema and then features of it are disappeared. One can scroll continuously in many applications now. That feature, or some would call it an affordance encourages ritualistic use. Some researchers now refer to this feature as a lack of a stopping cue and developers know it is a powerful way that instrumental use can become ritualistic even in the midst of an instrumental session. In many ways the disappearance of stopping cues is the sine qua non of the digital age (see Adam Alters Irresistible). An instrumental media user tends to say things like, From 1 2 pm Im going to play Minecraft, and then Im going to do something else. The game starts at a mindful time and ends at a given time, even if its purely for entertainment. That too is a form of instrumental media use, less healthful perhaps, but still instrumental. On the other hand, ritualistic users of media tend to start media consumption indiscriminately and with no plan for stopping. More and more, screen media lacks stopping cues and encourages ritualistic use, again, even when it starts as something else. Who among us hasnt felt this? If youve ever opened up a browser and spent 20 minutes online and then forgotten what you went online to do, youve been snared by this property of the web today.

What is a recommended amount of screen time for elementary-aged kids? High schoolers?

The American Academy of Pediatrics (AAP) probably has been the strongest voice on this issue, but recommendations have shifted for reasons which I fail to understand, nor do they seem to be guided by empirical research. For instance, the organization used to sponsor a public health campaign about how ages zero to three are critical years to get right from a developmental perspective. Around that time, they recommended no screen time for children zero to 2 years old. Already, those ages dont line up, but there was at least a clear call for no screen time at certain ages. Now, the AAP has dialed that back to less than 2 hours per day for the youngest kids. But this seems to be a capitulation to cultural norms and the pervasiveness of digital life more than anything else. In fact, they have stated as much when revising them. Certain key cognitive skills critical for digital literacy dont emerge in full until ages 8 or even 10 years old, but nobody I know recommends that amount of limiting. Relaxing the guidelines on time spent is not to my knowledge based on research that suggests limiting screen exposure at those ages is somehow not warranted. Indeed, it is. Tweens (ages 8 12) and teens (13 -18) are the heaviest periods of screen media use in childhood. Common Sense Media shows consistently finds that kids at these ages consume about 8 10 hours of media content per day, overall, NOT INCLUDING for work or for school. Thats just the average child. Roughly 2 in 10 children experience at least twice that amount on average per day. Even the average is far greater than the AAP recommends. Research has not yet led to official or even smart, in my view, guidelines for screen time. If your child is 13 and spends four hours a day with screen-based media for pleasure, he or she is probably less than the average. Is that good? I doubt it. Thats almost a full-time jobs worth of screen-based media in a week. So, while I cannot cite or even necessarily have a recommendation, for all but the most austere among us, less is more. A lot less.

What's happening to kids' mental health when they're exposed to too much screen time?

This is an expansive question, too large to handle here. As with any complex causal association, especially in the media effects realm, data can be found to pick and choose what answer you like. Still, as the research mounts, there looks to be a (statistically) small, negative effect overall, which for some can be very powerful, even deadly. We have all seen those stories on the news about social media and bullying and suicide. While those cases deserve all the attention they get and more, I tend to focus more on general well-being and the displacement of interpersonal interaction from screen time, which seems to affect human functioning negatively, again, the way a poor diet affects energy and health. Again, going back three decades now, the Kaiser Family Foundation and more recently Common Sense Media find in survey research that kids with the heaviest media exposure tend to be the least happy and well-adjusted in school. Newer longitudinal research corroborates those claims.

Do you have any tips for parents trying to cut back on the amount of time their kids are on electronic devices?

I specialize in one tip. Its an axiom: access = use. I strongly encourage it. Over time, however, I have noticed how difficult it is to follow. I say this from experience both as a researcher and a parent of two teenagers (ages 17 and 16): The best way to curb screen media time is to limit access. Take an ecological approach and inventory your childs home environment. How many devices are there? If there is one for each person, and if they are mobile, I say, good luck. Access is already problematic. But that is pretty normal these days, if a cell phone counts as a screen which of course it should. Limiting the number and mobility of screens is the best way to control time. In our house, we have one full bathroom, and it limits shower use like a champ, though at times three people are frustrated. We live with it. Have one computer, put it in a well-travelled room, make it a desktop that you cant move. Have one TV, put it in a common room where other things happen. Put the game player on it if you have one, and share. At times, people will be frustrated. But thats when other activities start to emerge. If you do this when the children are younger, cognitive and physical habits will emerge that will become more robust as they age. A word of caution to those who figure they can add devices and set rules and control them. Seldom does that work. Its almost comical, but tragic, how powerless to media temptations people really are, especially families. The force is strong. I cant tell you how many parents I run into who have tried this, thinking its reasonable to have some media things, and then theyll just limit by setting and keeping rules. The rules are very hard to establish and the conflict between parent and child rises. In my house that conflict has happened, and we delayed devices for a pretty long time. Remember, access = use. If you dont want to use, dont have access. Its just that simple. Would that it were also just that easy.

What else would you like people to know?

Researchers Kubey and Csikszentmihalyi wrote an article on television addiction published in Scientific American magazine some years ago. In it they have this marvelous quote: Perhaps the most ironic aspect of the struggle for survival is how easily organisms can be harmed by that which they desire. The trout is caught by the fishermans lure, the mouse by cheese. But at least those creatures have the excuse that bait and cheese look like sustenance. Humans seldom have that consolation. The temptations that can disrupt their lives are often pure indulgences. Already this great quote is stale, though, isnt it? We all live in a confounding world in 2020 where digital life is enmeshed increasingly with the struggle for survival in a way that Kubey and Csikszentmihalyi didnt even imagine in 2002. One thing that has changed is that the temptations that disrupt our lives are far more closely connected to and often do resemble the pure indulgences of digital life. I think we DO have that consolation now, but its a hollow one, because it just means that our new normal will be more media time and it will be harder to tell the bait and the cheese from sustenance. We should all stay on alert about how to make this distinction. Its a long game, a steady struggle, one worth fighting, just like diet and exercise. Again, no human population in the history of the planet has ever had to negotiate this much bait... in a media ecology that has lured us more completely into a digital way of life.

See the article here:
Expert Alert: Screen Time and Kids - UMM News, Sports & Events

Supplements: To take them or not?

It seems like every corner of the internet is overstuffed with ads for vitamins, herbal remedies, fat-loss supplements, muscle-building shakes and sleeping pills.

As someone who's worked in the health fitness industry for years, I know that much, if not most, of it is just clutter. It's charlatans and hustlers trying to make a quick buck off of your pain points. It's great marketers who know that phrases like "lightning fast weight loss" and "banish cellulite forever" sell products that may or may not be straight-up flimflam.

In the largely unregulated supplement industry, many products are ineffective, full of fillers or undisclosed ingredients. Some are downright dangerous. Who can you trust? How do you know which supplements are best for you? What products are actually effective -- and safe to take?

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I want to preface the rest of this article with two very important disclaimers:

First, it's impossible to cover everything you need to know about choosing safe and effective supplements in one article. If you want to learn more, you should read official information from the Food and Drug Administration (FDA), the Office of Dietary Supplements (ODS) and the US National Library of Medicine. While I cite many primary studies in this article, you can browse the PubMed database for more information on specific supplements., their uses, benefits and risks.

Second, although I have training in nutrition, anatomy and physiology, I am not a registered dietitian nor a doctor of any sort. If you are interested in taking supplements for a particular symptom or medical condition, please, please, please consult a registered dietitian or your doctor before doing so.

Now onto what you should know about supplements before you waste your money.

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Currently, the supplement industry is largely unregulated, especially compared to the food and drug industries. The FDA still uses an act passed nearly 20 years ago -- the Dietary Supplement Health and Education Act of 1994 (DSHEA) -- that only has one real stipulation: "Manufacturers and distributors of dietary supplements and dietary ingredients are prohibited from marketing products that are adulterated or misbranded."

This means the manufacturers themselves are responsible for testing the safety and efficacy of their products, as well as for labeling their own products. The FDA can crack down on a supplement after it hits the market if it's incorrectly labeled or unsafe, but by that time, damage may already be done.

You can learn more about what's required of supplement manufacturers by reading the FDA's FAQ on dietary supplements. However, FDA Commissioner Scott Gottlieb did announce in a February 2019 statement that he plans to implement stricter regulations, so things are definitely looking up for the supplement industry.

Nonetheless, here are a few examples of what has happened in the past because of the low-level regulation:

Personalized vitamins are better than taking whatever you find on the shelf, but you should still consult a doctor or dietitian about supplements for particular concerns.

If your diet, lifestyle, fitness routine, sleep habits and health status aren't the same as anyone else's, why would it make sense to take the same supplements as everyone else?

For some supplements, this is obvious: You probably wouldn't feel inclined to take a calorie-dense, high-protein and high-carb post-workout shake if you weren't trying to build muscle. You also probably wouldn't reach for sleep aids if you don't have trouble sleeping at night.

For other supplements, the disconnect isn't so conspicuous. Everyone needs vitamins, right?

Yes, everyone does need vitamins and minerals and other certain nutrients (here's a very helpful PDF chart from the FDA on the main nutrients, their functions and RDAs), but not everyone needs the same amount of the same nutrient.

Take vitamin B12 as an example: People who eat a vegan or vegetarian diet may benefit from supplementing with B12 because this vitamin is found primarily in animal products or fortified products. If you eat eggs, dairy products, chicken, seafood or steak, you likely don't need additional vitamin B12.

If you're interested in learning more about which vitamins you actually need, I highly recommend reading The Vitamin Solution by Dr. Romy Block and Dr. Arielle Levitan, two doctors who founded Vous Vitamin, a personalized multivitamin company.

I found this book to lay out all of the essential knowledge on vitamins, minerals and other supplements in a way that's easy to understand and can help you determine which supplements are best suited to you -- or at least open up a helpful discussion with your doctor.

Supplements will never be as good as eating whole, nutrient-dense foods like fruits and vegetables.

It's unfortunately a myth that taking vitamins and supplements can replicate a healthy diet. Just like you can't "out-exercise" a poor diet, you can't "out-supplement" one either. Vitamins can certainly help bridge the gap between what you get from your diet and what you don't, but using supplements as a way to "fix" your diet won't work.

There are so many nuances at play here. For example:

That list is far from comprehensive, but you can see that vitamins and supplements don't just magically undo poor eating habits. Scientific conclusions vary greatly -- from "we don't need vitamins at all" to "the benefits outweigh the risks" -- but the general consensus seems to be that vitamins and supplements can help prevent nutrient deficiencies in certain populations and when taken correctly and support health in conjunction with a nutritious diet.

Taking too many vitamins can result in dangerous side effects, so be careful to check the Recommended Daily Allowance (RDA) for each vitamin you take.

One common vitamin myth is this: "If I take too many vitamins, it's fine, because my body will only keep what it needs and get rid of the rest as waste."

This is a pervasive mindset but a dangerous one. You can, in fact, overdose on vitamins. The term is "vitamin toxicity" and it can happen with any vitamin. For almost every vitamin, there is an established Recommended Daily Allowance (RDA) or Adequate Intake (AI), as well as a Tolerable Upper Intake Level (UL).

The RDA or AI signifies an ideal daily intake while the UL indicates the high end of what's safe to consume. RDAs, AIs and ULs are all values under Dietary Reference Intakes (DRIs), the set of reference values assigned to foods and supplements for consumption.

Recently, experts have seen an increase in vitamin D toxicity, likely related to the touting of vitamin D's benefits on immune function, bone health and mood.

It's not just vitamins that can be toxic either: Minerals taken in high doses can be toxic, as can electrolytes, herbs and sports supplements. Zinc, for example, a mineral known and loved for its immune-boosting properties, can actually cause immunosuppression in extremely high doses.

Pre-workout supplements high in caffeine can cause abnormal heart rhythms and severe overdoses can be fatal. Potassium, a well-known electrolyte found in foods such as bananas and spinach and in sports drinks, can also cause toxicity. Called hyperkalemia, this condition can lead to muscle weakness, fatigue, nausea and, in severe cases, life-threatening heart arrhythmias.

Surpassing the UL of any vitamin, mineral, electrolyte or other supplement can cause harm, so be careful to do your research on any supplements you intend to take.

Some supplements can reduce the effectiveness of certain medications or result in side effects -- talk to your doctor about supplements if you take medications.

If you currently take prescription or over-the-counter medications regularly, you should talk with your doctor about drug-nutrient interactions.

A drug-nutrient interaction is any reaction that occurs between a vitamin, mineral, antioxidant, electrolyte or other nutrient and a medication. A drug-supplement interaction is any reaction that occurs between a supplement and a medication.

Good intentions to supplement your diet with vitamins, minerals and herbs can backfire and cause complications. Take these examples:

Supplementing smartly can optimize your health and fitness, but supplementing poorly can potentially be dangerous.

If you're generally healthy and want to take supplements for overall health, I think the best bet is to use a personalized multivitamin service, such as Vous Vitamin, Baze or Persona Nutrition. This isn't as good as going to a doctor or dietitian, but it's far better than just swiping the first multivitamin bottle you see into your cart at the grocery store.

Some of these companies have more thorough personalization processes than others, but in general, with a personalized multivitamin, you can feel confident that you're not getting too much of a specific vitamin or consuming a vitamin that may be necessary or actually harmful to you.

If you don't go that route (and even if you do), you should always (always!) look for signs that a supplement is legitimate. By legitimate, I mean it's undergone third-party testing and/or evaluation, and it is certified not to include any ingredients other than what's on the label (aka it doesn't have any shady fillers). Those signs are:

Even better yet, look for a nutrition facts label versus a supplement facts label. A nutrition facts label means the product is sold as a food product, not a supplement, which means it has been evaluated and approved by the FDA for human consumption. A whole-food supplement with a nutrition facts label, an NSF certification, a USP Verified Mark and GMP certification is the best of the best.

To avoid vitamin toxicity, check the labels of every supplement you take. If you take multiple supplements every day and also get vitamins from food, you can put yourself at risk for vitamin toxicity -- for instance, if your protein shake is fortified with vitamin B12 and your multivitamin contains 250% of the DRI for vitamin B12, you may want to alternate them or choose a different protein shake that isn't fortified.

Finally, I'll end with the same sentiments I opened with: Please consult your doctor or a registered dietitian if you're interested in taking vitamins or supplements for a specific symptom or medical condition.

Not only can supplements dangerously interact with medications you may be taking already, it's important to rule out any medical conditions that may need to be treated with prescription medication.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

Read the rest here:
Do you really need to take a vitamin? 5 things to know before you buy - CNET

The novel coronavirus can cause gastrointestinal symptoms such as nausea, vomiting and diarrhea.

Patient: Doc, I get heartburn every time I eat birthday cake.

Gastroenterologist: Next time, remove the candles.

In a medical specialty about the gut, bloating and pooping, jokes pretty much write themselves. But for many people struggling with gastrointestinal (GI) symptoms and Covid-19 infection, life is far less funny. And right now, the coronavirus pandemic shows no signs of slowing down. Amid nationwide protests following the murder of Mr. George Floyd, Covid-19 cases and deaths in the U.S. are rising steadily, now at 1.98 million and 112,000, respectively.

As coronavirus unnervingly looms, we continue to learn more about this novel SARS-CoV-2 pathogen. For instance, stomach ache and diarrhea may be the first signs of the infection, as Robert Glattner, MD discussed in March. Since that time, weve gained additional information about the COVID Gut both in adults and in children, as well as its mechanism of action and treatment options.

Diarrhea is a common symptom in children who test positive for Covid-19.

A recent case report from China reported that digestive issues were the first symptoms observed in five Covid-19-positive children. Another study from the U.K. described eight children presenting with atypical appendicitis. Abdominal pain, diarrhea and vomiting were observed in children presenting with the Kawasaki-like illness now referred to as multisystem inflammatory syndrome in children.

We also know that adults infected with Covid-19 are also presenting with GI issues. In fact, the CDC tacked on GI complaints to their symptom watch list.

The main GI symptom in adults is diarrhea, occurring in up to 30% of patients, states Mark Pochapin, MD, Director of the Division of Gastroenterology and Hepatology at NYU Langone Health. However, patients also can have lack of appetite (anorexia), nausea and vomiting. Dr. Pochapin also cited a Stanford study demonstrating that Covid-19-infected patients with GI symptoms were five times more likely to be hospitalized than those without GI symptoms (8 times more likely if experiencing diarrhea).

Endoscopic procedures such as EGDs and colonoscopies are routinely used screen for benign and ... [+] cancerous polyps.

In addition to digestive symptoms, clinicians need to be mindful of abnormal tests.

The common GI manifestations of Covid are diarrhea, nausea and vomiting, observes Shifali Arora, MD, Assistant Professor of Medicine,Division of Gastroenterology and Hepatology, UNC Chapel Hill. But the other issue to watch out for are elevated liver enzymes which we see typically as well. Namely, AST and ALT are enzymes that are usually elevated during liver injury. In addition, a recent meta-analysis revealed that 48% of patients with Covid-19 and GI symptoms had viral RNA detected in their stool.

The pandemic put a halt on all elective procedures including esophagogastroduodenoscopies (EGDs) and colonoscopies. How these endoscopy procedure units open and ramp up will differ nationwide, according to Dr. Arora who is assisting with reopening efforts at her institution. She adds: Clinicians and staff have been working hard to create new workflows and work spaces that allow for socially distanced waiting rooms, providing masks for patients and staff, and extensively cleaning between cases.

SARS-CoV-2 coronavirus binds to the ACE2 receptor which is found in many organs including the lungs, ... [+] colon, pancreas, liver and gallbladder.

So, whats the connection between this presumed respiratory virus and the gut? Well, it involves the ACE2 receptor which is found in multiple organs, including the lungs and the GI system (e.g. esophagus, gallbladder, pancreas, liver and colon).

In terms of the mechanism, it's thought that the ACE2 receptor plays a role in the pathogenesis of Covid-19, explains Supriya Rao, MD, gastroenterologist and managing partner at Integrated Gastroenterology Consultants in Chelmsford, MA. This receptor is present in very high amounts in the GI tract. The virus adheres to the receptor via its spike protein and can then cause symptoms.

Moreover, according to Dr. Wenbin Li, author of the Wuhan study, the presence of the ACE2 receptor in two different organ systems suggests that Covid-19 can infect patients through the respiratory tract in the form of air droplets as well as through the digestive tract by fecal-oral transmission.

Speaking of transmission, we still dont know how much a toilet plume can transmit Covid-19, reminds Dr. Pochapin: People should pay particular attention to hand washing after using the toilet, close the toilet lid and wear a mask in public bathrooms.

Current treatment for Covid-19 patients with GI symptoms includes medications such as Imodium and ... [+] Pepto-Bismol.

We still do not have a treatment, cure or vaccine for Covid-19, so doctors are managing symptoms.

Treatment relies on supportive care antiemetics, PPI (proton-pump inhibitors), antidiarrheals and adequate hydration, advises Dr. Rao.

Loperamide (Imodium) and bismuth (Pepto-Bismol) are common over-the-counter medications used to treat diarrhea. Omeprazole (Prilosec) is a PPI that can reduce heartburn and gastritis. Promethazine (Phenergan), odansetron (Zofran) and metoclopramide (Reglan) minimize nausea and vomiting.

A recent study reports that the coronavirus pandemic has caused seismic shifts in the management of patients with liver transplants, cirrhosis and hepatocellular carcinoma, a.k.a. liver cancer, and other forms of advanced liver disease. Decreased access to routine care including procedures such as EGDs to screen for esophageal varices has prompted hepatologists and other GI professionals to adjust quickly.

Gut health. Follow a meal plan that's high in fiber, whole grains, fruits and vegetables; and low in ... [+] processed foods and animal products.

The gut microbiome is key to maintaining overall health and immunity, according to Dr. Rao, who recommends following a plant-based diet thats high in diverse fruits and vegetables, fiber, whole grains, and minimal animal products and processed foods. She adds that adequate water intake and sleep, smoking cessation and daily exercise are also critical.

Stress and anxiety can also manifest as GI symptoms, points out Dr. Arora. In the midst of a pandemic, record unemployment and nationwide racial tensions, who isnt tense as an overstretched elastic band?! Someone with irritable bowel syndrome may experience a flare-up of symptoms during this stressful period, indicates Dr. Arora.

Other key GI health tips:

Digestive health sometimes takes a back seat to cardiac or neurologic issues. Until something goes wrong. Sharp abdominal pain, unrelenting vomiting and severe diarrhea are some of the most debilitating and concerning symptoms experienced by humans. As coronavirus continues to spread, we need to be mindful of GI issues, report them to our doctors and treat them accordingly. Were still learning about this novel virus, and like a trainee gastroenterologist, we have to work our way up from the bottom. [I clearly have too many GI doc friends]

Read the original:
Coronavirus In The Gut: GI Manifestations, Mechanism And Medications - Forbes