By Nneka Jonas Apr 1, 2020

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Hand sanitizers expire as the alcohol concentration dissolves with time. Once it drops below 60 percent alcohol, it will not be as effective in destroying germs.

The manufacturer estimates how long it would take for the percentage of the current active ingredient to drop below 90 percent of the percentage indicated on the label. That time estimated becomes the expiration date.

However, expired hand sanitizer can still be very useful, especially if it has not yet been opened. Take a look at your hand sanitizer packaging.

You will see a date of expiration which is usually written on top or back. Since the Food and Drug Administration (FDA) controls hand sanitizer it is legally required to have an expiry date and lot number.

This expiry date indicates the period of time that research has verified that the active ingredients of the sanitizer are safe and reliable. Normally the standard is typically two or three years beforehand sanitizer expires.

Sanitizer can still have some effectiveness past its expiration date because it still contains alcohol (the active ingredient). Even if its concentration has dropped below its original percentage, the product is not unsafe to use, but it is less effective, or even ineffective.

In most hand sanitizers gel and foam the active sterilizing ingredients are ethyl alcohol and isopropyl alcohol.

The Centers for Disease Control and Prevention (CDC) advises the use of hand sanitizers that contain at least 60 percent alcohol Reliable Source.

The active component of the hand sanitizer, alcohol, is a volatile liquid that quickly evaporates when exposed to air. Although common hand sanitizer containers protect the alcohol from the air, they are not airtight, so evaporation can occur.

As the alcohol evaporates over time, the percentage of the active ingredient of your hand sanitizer decreases which makes it less effective. although hand sanitizer may still work after it has expired, the best option is to replace it after the expiration date has been reached, because it will be less effective.

Read more here:
Can you safely use expired hand sanitizer? - IOL

This joint note aims to consolidate the current recommendations on Infant and Young Child Feeding in the context of the COVID-19 pandemic in Eastern, Central and Southern Africa. This guidance is not intended to replace national guidance, rather to serve as a resource that is based on the latest evidence. The contents are adapted to the African region from Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected, Interim Guidance, 13 March 2020 WHO [1]

1. Caring for infants and mothers in the context of COVID-19: Infection prevention and control (IPC) and Breastfeeding

Published research [1]based on nine Chinese mothers, found no evidence of vertical transmission of COVID19 during pregnancy. Further, all breastmilk samples taken from the mothers after the first lactation were also found to be negative for the COVID-19 virus.

Remarks: Breastfeeding protects against morbidity and death in the post-neonatal period and throughout infancy and childhood. The protective effect is particularly strong against infectious diseases that are prevented through both direct transfer of antibodies, other anti-infective factors and long-lasting transfer of immunological competence and memory [2]. In settings where diarrhea, respiratory infections and infectious morbidity are common in infants, any possible risk of transmission of COVID-19 through breastfeeding (not reported to date) is outweighed by the known risks associated with replacement feeding. Therefore, standard infant feeding guidelines should be followed with appropriate respiratory hygiene during feeding. i.e.

Always wash hands with soap and water before and after contact with the infant.

Routinely clean surfaces, which the mother has been in contact with, using soap and water.

If the mother has respiratory symptoms, use of a face mask when caring for the infant is recommended, if available.

Maintain physical distancing with other people and avoid touching eyes, nose and mouth.

2. Infants born to mothers with suspected, probable, or confirmed COVID-19 should be fed according to standard infant feeding guidelines , while applying the necessary hygiene precautions listed above.

Remarks: Breastfeeding should be initiated within 1 hour of birth. Exclusive breastfeeding should continue for 6 months with timely introduction of adequate, safe and properly fed complementary foods at age 6 months, while continuing breastfeeding up to 2 years of age or beyond. Because the health and survival benefits of breastfeeding are dose-response and because neonatal mortality is reduced by early initiation of breastfeeding, mothers who are not able to initiate breastfeeding during the first hour after delivery should be actively supported to breastfeed as soon as they are able5.

3. As with all probable, confirmed or suspected COVID-19 cases, symptomatic mothers who are breastfeeding or practicing skin-to-skin contact or Kangaroo Mother Care (KMC) should practice respiratory hygiene, including during feeding (for example, if the mother has respiratory symptoms it recommended to use of a face mask when near a child, if possible), perform hand hygiene before and after contact with the child, and routinely clean and disinfect surfaces with which the symptomatic mother has been in contact.

4. Breastfeeding counselling, basic psychosocial support, and practical feeding support should be provided to all pregnant women and mothers with infants and young children, whether they or their infants and young children have suspected, probable or confirmed COVID-19 .

5. In situations when severe illness in a mother with COVID-19 or other health complications, prevents her from caring for her infant or prevents her from continuing direct breastfeeding, mothers should be encouraged and supported to express milk , and safely provide breastmilk to the infant, while applying appropriate hygiene measures.

Remarks: If the mother is able to express breastmilk, the milk can be given to the infant using a cup with a wide mouth, or a cup and spoon. Using a bottle is not advised as it requires sterilization prior to each use and makes it more difficult for the baby to return to the mothers breast when she becomes well again. Expressed breastmilk (EBM) can be stored in a closed container or covered with a cloth or plate at room temperature for up to 8 hours. If stored in a sterile container, expressed breastmilk can be kept for 24 hours at 18o20oC in a shady place, for about 72 hours in a refrigerator (at 4o5oC) and for about four months in a freezer (at -18o to -20oC). [6]

If the mother is too unwell to breastfeed or express breastmilk, an appropriate breastmilk substitutes [7], informed by cultural context, acceptability to the mother, and service availability should be provided. There should be no promotion of breastmilk substitutes, donation of feeding bottles and teats, pacifiers or dummies or donations of breastmilk substitutes in any part of facilities providing maternity and newborn services, or by any of the staff. Health facilities and their staff should teach mothers/caregivers how to safely prepare milk and how to give milk using a cup with a wide mouth or a cup and spoon. Health facilities and staff should not give feeding bottles and teats or other products within the scope of the International Code of Marketing of Breast-milk Substitutes and its subsequent related WHA resolutions, to breastfeeding infants.10 Please note wet nursing is not recommended in contexts of high HIV prevalence and donor milk should only be considered if appropriate screening and pasteurization services are included.

6. Mothers and infants should be enabled to practice skin-to-skin contact, kangaroo mother care and to remain together and to practice rooming-in throughout the day and night, especially immediately after birth during establishment of breastfeeding, whether they or their infants have suspected, probable, or confirmed COVID-19.

Remarks: Mothers should not be separated from their newborns, unless medically indicated. Minimizing disruption to breastfeeding during the stay in the facilities providing maternity and newborn services will require health care practices that enable a mother to breastfeed for as much, as frequently, and as long as she wishes [8].

7. Parents and caregivers who may need to be separated from their children, and children who may need to be separated from their primary caregivers, should have access to appropriately trained health or non-health workers for mental health and psychosocial support.

Remarks: Given the high prevalence of common mental disorders among women in the antenatal and postpartum period, and the acceptability of programmes aimed at them, interventions targeted to these women need to be more widely implemented. Prevention services should be available in addition to services that treat mental health difficulties [9].

8. Mothers and health workers should be counselled/ advised to continue breastfeeding should the infant or young child become sick with suspected, probable, or confirmed COVID-19 or any other illness

Remarks: During an illness, breastfeeding infants need to breastfeed more often. After an illness, babies need to be offered more food than usual, such as more frequent meals, to replenish the energy and nourishment lost due to the illness. Withholding breastmilk during an illness increases the possibility that baby will get sick and deprives the baby of the superior nutrition from breastmilk including the immunological benefits. Caregivers should increase childrens fluid intake during illness (including by frequent breastfeeding) and encourage the child to eat (for example, by offering soft, appetizing or favorite foods). After illness, caregivers should provide meals more frequently than usual and encourage the child to eat more.

9. Caregivers and health workers should be counselled/ advised on the importance of healthy diets during complementary feeding and safe food preparation/ handling to reduce risk of transmission of COVID-19.

Remarks: Parents should be supported to ensure that children 6-23 months of age are fed the minimum number of meals per day to ensure dietary adequacy and from at least 5 out of the 8 food groups to ensure dietary diversity. Young children need to consume a variety of foods to meet their nutrient needs and expose them to various tastes and textures. A diverse diet includes meals consisting of foods from a variety of food groups each day: (1) breastmilk; (2) grains, roots and tubers; (3) legumes, nuts and seeds; (4) dairy (milk, yoghurt, cheese); (5) flesh foods (meat, fish, poultry, and liver or organ meats); (6) eggs; (7) vitamin A-rich fruits and vegetables (carrots, mangoes, dark green leafy vegetables, pumpkins, orange sweet potato); and (8) other fruits and vegetables. To promote a healthy diet, caregivers should avoid providing drinks or foods with low nutritional value, such as sugar-sweetened beverages, candy, chips and other foods high in sugar, salt and trans fats.

Before preparing or eating food, caregivers should ensure they implement the recommended hygiene practices such as handwashing with soap and regular cleaning and disinfecting of food preparation areas.

Those engaged in the COVID-19 response, therefore, need to be aware of and sensitized as to the importance of Infant and Young Child Feeding (IYCF) and the continued protection and promotion of breastfeeding.

Chen H et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. The Lancet published online February 12, 2020. https://doi.org/10.1016/S0140-6736(20)30360-3

WHO Essential newborn care and breastfeeding (https://apps.who.int/iris/bitstream/handle/10665/107481/e79227.pdf).

WHO Essential newborn care and breastfeeding (https://apps.who.int/iris/bitstream/handle/10665/107481/e79227.pdf). 5 https://apps.who.int/iris/bitstream/handle/10665/42590/9241562218.pdf), as endorsed by the Fifty-fifth World Health Assembly, in resolution WHA54.2 in 2002

Ensuring all health workers practice recommended precautionary measures e.g. wearing masks, social distancing, when providing counselling and other support

Ensuring recommended precautionary hygiene measures are applied while handling breastmilk

Where breastmilk is not accessible, appropriate breastmilk substitutes include: Ready to Use Infant Formula if the infant is 10 This recommendation is consistent with the WHO guidance Acceptable medical reasons for use of breast-milk substitutes (https://apps.who.int/iris/bitstream/handle/10665/69938/WHO_FCH_CAH_09.01_eng.pdf;jsessionid=709AE28402D49263C8D F6D50048A0E58?sequence=1).

WHO Guideline: protection, promoting and supporting breastfeeding in facilities providing maternity and newborn services (https://apps.who.int/iris/bitstream/handle/10665/259386/9789241550086-eng.pdf).

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Infant and Young Child Feeding in the Context of the COVID-19 Pandemic - Eastern, Central and Southern Africa - Africanews English

As soon as it became clear that the only way to mitigate the impact of the novel coronavirus was to isolate and stay indoors, talk of the quarantine 15, a horrifyingly timely update to the freshman 15, was inevitable. Stuck inside our homes with only Netflix and snacks as comfort in the middle of what is arguably the most uncertain time in modern history, many of us were more worried about getting fat than contracting an illness that makes it so difficult to breathe that you might die.

It manifested, of course, in memes. One meme depicted a woman rolling her floured belly onto a cutting board like yeasted bread dough. So after this quarantine, will the producers of My 600 Pound Life just find me, another meme wondered. Self-described fitness experts shared at-home workouts, with posts detailing how to use ones own body weight and the canned goods weve all stockpiled to stave off isolation-related weight gain. Some fitfluencers suggested putting on actual pants, the kind that button, every couple of days to make sure that youre not gaining weight, because your comfy pants will make you believe that all is well in the kingdom. All together, it adds up to a neverending trickle of body-shaming.

It almost makes sense. In the middle of a global health crisis, why shouldnt people try to stay as healthy as possible? But, of course, there is nothing healthy about diet culture, which encourages everything from orthorexia, or an obsession with clean eating, to other forms of disordered eating in its pursuit of thinness above all else. These memes function as a shroud for the obvious harm that diet culture does to all of us. More than that, these jokes hide diet cultures insidious connections to classism, body shame, and a multibillion-dollar industry that stands to profit from all of us deeply hating ourselves.

First, jokes about the horrors of getting fat are a direct and painful jab at people who are actually fat in the present tense. All of us that exist in before-picture bodies are keenly aware that many people would rather be dead than fat. Theres nothing like seeing your thin friends react with disgust to photos of bodies that look just like yours. Every time you share one of those memes, you let the fat people in your life know exactly what you think of them that their bodies are disgusting, and youll do just about anything, including periods of literal starvation, to avoid looking like them.

And diet culture doesnt just harm fat people. It reminds all of us that we are not good enough, that being just a little bit thinner and more toned is the key to happiness. Quarantine-themed workouts targeting problem areas like chubby arms, bellies, and thighs remind us that the things we are told to be self-conscious about are, in fact, not good enough. Weight Watchers and NutriSystem literally would not exist without stoking fears that the couple of extra pounds that come with disrupting normal life will transform everyone into fat, shapeless monsters.

Whats so frustrating about all of this self-torture is that science has told us, over and over, that it is extremely unlikely to work. Somewhere around 95 percent of all dieters will eventually gain back all of the weight that they lost. Often it will be more, because dieting trains our bodies to hold on to every single calorie like its the last one well ever eat. Diet culture isnt successful because dieting works, its because its designed to set you up to fail. If it were, in fact, possible to lose all the weight and keep it off, we wouldnt all be dieting all the damn time.

And dont think that the industry doesnt see this moment as an opportunity. Multilevel marketing shillers and snake oil salesmen immediately realized that this is their time to shine, hawking everything from quarantine-friendly diet plans to vitamins that will allegedly prepare the immune system to fight off the novel coronavirus. As a journalist, Ive been pitched everything from bone broths to protein powders that will allegedly boost my immune system while warding off weight gain.

Most crucially, many of us arent sitting indoors just watching Netflix and relaxing. For the millions of people who have lost their jobs in the service industry and beyond, these are not times of abundance and leisure. People are having a hard enough time figuring out where their next meal is coming from, and shaming them because that meal is a package of ramen noodles or a fast-food burger is at best a dick move, and at worst a classist punch-down at people who are doing their best to survive. Admonishing working parents feeding their kids what theyve got instead of veggie-packed bento boxes they cant afford is as cruel as it is pointless.

Being stuck indoors, socially isolated and inundated with diet culture bullshit, is particularly fraught for people who are struggling with disordered eating habits. These unhealthy eating patterns are much more common than we think, and arent limited to the clinical diagnosis of illnesses like anorexia and bulimia. The leap from dieting to disordered eating is often not that dramatic, and because being stuck indoors can limit access to mental health treatment, its a good idea to err on the side of not being a complete asshole to those who are stuck at home, suffering in silence, enduring countless jokes about the weight that people are terrified to gain.

What we should really be doing right now is figuring out how to stop fighting with our bodies every single day. That is a productive use of this time, especially considering that no amount of starvation or exercise is going to make this pandemic feel any less scary, and no amount of thinness can protect any of us from contracting COVID-19. What is possible, though, is using this time to be a little bit nicer to both our own bodies, and the bodies that we are told are not good enough.

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Quarantine Diets Reveal the Absolute Worst of Diet Culture - Eater

Photo-Illustration: Megan Paetzhold. Photos: Getty Images

Last week, New York and Grub Street asked some of our favorite past Grub Street Diet subjects to keep one-day diaries of what they eat while self-quarantining, which well be running over the next few days. Here, author and restaurateur J. Kenji Lpez-Alt walks us through Monday, March 23.

The first thing my daughter usually does when she wakes up is use up her daily allotment of screen time on Tumble Leaf. After 25 minutes, she says, Papa, its breakfast time, and we head to the kitchen. This mornings project: strata with bacon, onions, peppers, mushrooms, and Colby-Jack. She always wants pancakes. We eat a lot of pancakes, but not today.

I put Alicia to work tearing up bread heels. We have lots and lots of Japanese shokupan heels that came from the 16 loaves of bread I made sandwiches out of yesterday. The heels of all those loaves of bread ended up in a plastic bag in my kitchen.

Like most restaurants, mine, Wursthall, is facing some tough times. Part of our revitalization plan is to work with a couple of fundraising organizations (as well as our fundraising initiative) to raise some money and put our team to work making free meals for folks in need first responders, emergency room and other hospital staff, folks out of a job, people with kids home from school, etc. Everyones having a hard time, but some more than others. Were building the plane as were flying into new territory here, and this has been occupying nearly all my free time since the pandemic started in earnest.

The day before, Alicia helped me drop off deviled-egg-salad sandwiches and roasted broccoli with pumpkin-seed vinaigrette to San Francisco General and the Oakland Fire Department, a trip I almost had to postpone because, in all my planning, I didnt think about how I would fit 75 individually packed meals and a toddler into my car. (I finally found a couple big boxes in the shed.)

Incidentally, that amazing shokupan came from Andersen Bakery, and its likely the last Andersen shokupan heels Ill ever see, as I just got an email announcing that this Fridays delivery will be their last ever. They are closing the business for good. Damn, this one really stings.

We whisked the custard together, layered everything in a buttered casserole (she loves buttering things), and popped it in the toaster oven to bake. It was pretty darn delicious, and I decided then and there that breakfast strata is gonna be the first recipe if and when I ever start doing the Food Lab Jr. column Ive been dreaming of.

My wife, Adri, woke up and we all sat down to eat. I used a hot sauce that my buddy Greg Kuzia-Carmel made at his (excellent) restaurant Camper in Menlo Park. He calls it NAPALM. I think he needs to up his spice tolerance (I love you, Greg). Adri used a hot sauce we picked up in Colombia (the brand is Codi) made with uchuva (gooseberries) and habaneros. Im sorry we sound like hot-sauce snobs. We arent, I swear. Id be lost without my Franks.

Alicia went au naturel.

Ive lost 30 pounds in the last year or so, finally hitting my ideal weight, with a combination of exercise and portion control. Since social distancing began, Ive gained back ten of those, because we cant go to the gym, and eating just seems like a good way to pass the time. I hope Im not going to gain back the full COVID-19. Gotta find another way to exercise.

Lunch was chili that Adri made from one of those Sun Basket kits. Up until a few months ago, I did 100 percent of the cooking in the house. Adri wanted a chance to cook for us, and meal kits seemed like a good way to ease into it. Its fun for her, I love when other people cook for me, and the chili is pretty darn delicious with a dollop of Greek yogurt and a dash of Tapato.

Adri is still working full-time from home, so I hang out with Alicia all day on most days, taking a precious hour or two during her naps for Zoom conferences and work-related phone calls. Currently, those phone calls are with virologists and food-safety experts Ive been consulting with to write a comprehensive food-safety guide for Serious Eats, that I intend to keep updated as new information on the virus continues to roll in.

Taking my daughter during the daytime is a fine arrangement for me, as hanging out with my daughter is my favorite thing to do (Ive missed her since she started going to preschool a few days a week), and keeping happy is one of the best things we can do. Happy people have stronger immune systems, and we should all be taking whatever steps necessary to make sure that we dont get sick, whether its COVID-19 or anything else thatll put a strain on our medical system.

But it does mean that Im left to nights for the restaurant and writing. Ever since the restaurant closed for dine-in service, Ive been spending a few nights a week there, prepping and cooking for the free-meal deliveries. I was going to head in at six, then thought twice. Nobody has ever said on their death bed, I wish I had spent less time with my children, and fuck it, Im the chef I can just work extra late tonight.

Dinner was another meal kit Adri was going to make, but she was busy playing with Alicia, so I took over. I crisped up the prepacked pork carnitas in a cast-iron skillet while I heated the tortillas on a Baking Steel griddle (easily top-five most used things in my kitchen). Alexa played Beethoven and Beatles, my usual cooking mix. The tacos were legitimately delicious. (Though, I admit, I did not follow the directions that came with the kit.) This time, on the table was El Yucateco XXXtra Hot Kutbil-Ik, possibly my favorite widely available hot sauce.

Afterdinner, I gave a good-night hug and kiss to Adri and Alicia and finally headed into Wursthall. These days, were closed on Mondays and Tuesdays (so my incredible and tireless sous-chefs, Erik and Orlando, can have a full two-day weekend), which means I had the whole place to myself. The night before, I braised a few pork shoulders, sauerbraten style, in wine and vinegar. Today, I pulled, seasoned, and shredded them, cooked ten pounds of chickpeas I had soaking overnight (in salted water it helps prevent the skins from blowing out during cooking), and shredded 20 pounds of cabbage.

This particular batch of pork sandwiches should feed 48, and was destined for the San Mateo Samaritan House, where Ill deliver it bright and early.

My last meal of the night was a test-fire of the pork sandwich Ill pack into cook-at-home meal kits later this week. Half of them will go to the Samaritan House, and the rest will go to currently furloughed employees, especially those with kids out of school and families to take care of. Its heartbreaking whats happening, especially the feeling of helplessness that comes with it. A good sandwich can help a little. I crisp up the pulled pork, glaze it with a vinegary pork jus, and pile it on a buttered brioche bun with a red-cabbage slaw and pickled Fresno chiles (which I could eat by the fistful theyre so good). The kits will also contain a marinated chickpea and carrot salad.

But before I started cooking, I strapped a GoPro to my forehead. For some reason, people seem to enjoy watching first-person cooking videos on my YouTube channel. Im fine with that, I guess, as silly as it is. These days, I relish any opportunity to be silly.

*A version of this article appears in the March 30, 2020, issue of New York Magazine. Subscribe Now!

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J. Kenji Lpez-Alt Quarantines With Carnitas and Breakfast Strata - Grub Street

Adopting a healthier lifestyle can be challenging, especially if youre trying to lose weight.

With most weight loss diets focusing on consuming smaller portions and fewer calories, many people struggle to stick to these diets due to feelings of frustration when they dont experience results even if they follow the plan perfectly (1).

That said, many people are reporting success by adding a refeed day into their weekly eating routine.

Simply put, a refeed day is a planned increase in calories for one day on a weekly or biweekly basis. Its intended to give your body a temporary respite from calorie restriction.

This article tells you all you need to know about refeed days, how to do them properly, and whether theyre right for you.

A refeed day is a day on which you intentionally overconsume calories after a period of being in a calorie deficit whether it arose from eating fewer calories or increasing physical activity, or both (2, 3).

The idea behind a refeed day is to counteract the negative effects of being in a calorie deficit, such as lower hormone levels, increased hunger, lethargy, tiredness, and hitting a weight loss plateau (2, 3).

Although this sounds similar to a cheat day, the two should not be confused.

Cheat days involve uncontrolled and unplanned eating for one day. On most cheat days, any type of food is allowed in unlimited quantities (4).

In contrast, a refeed day involves thoughtful planning and controlled food intake. Unlike cheat days, only a moderate increase in calories is permitted, and the type of food matters, as most refeed days emphasize calories from carbs over fats and protein (2, 3).

While refeed days can vary from person to person, the main goal is to eat in a calorie surplus in a controlled manner.

A refeed day is a temporary break from calorie restriction that involves a controlled day of overeating with a focus on carbs. It aims to counteract the negative effects of calorie restriction and aid weight loss.

You may wonder why a temporary calorie surplus would lead to weight loss, but the reasoning behind it addresses one of the main problems most people have when losing weight a weight loss plateau or slowdown.

As you decrease your calorie intake and begin to lose body fat, a change in hormones occurs, which tells your body that youre experiencing a calorie deficit. At this time, your body will begin to look for ways to reduce it as much as possible to limit weight loss (2, 3).

In particular, a hormone known as leptin begins to decline. Leptin is produced by fat cells and tells your body that it has adequate fat stores, helping regulate appetite and encouraging calorie burning (2, 3, 5, 6).

However, low levels of this hormone signal your brain that youre entering an unknown period of calorie deprivation. As a result, your body receives signals to eat more food and burn fewer calories. This process is known as adaptive thermogenesis (2, 3, 5).

Adaptive thermogenesis is a protective process that alters your bodys metabolism to increase energy intake and decrease energy output to slow weight loss.

During this process, your body releases various hormones and increases food cravings to push you to consume more calories (2, 3, 7).

Additionally, the rate at which you burn calories can change. For example, you may experience a decrease in exercise activity thermogenesis (EAT) and non-exercise activity thermogenesis (NEAT).

EAT involves deliberate physical activity while NEAT includes any energy used for daily tasks, such as walking, fidgeting, and general movement. Other components of your energy expenditure include your basal metabolic rate (BMR) and the thermic effect of food (TEF) (2, 3).

Due to the changes that occur as you lose weight, you may feel less energetic about exercise, opt for the elevator instead of taking the stairs, and move less in general.

Combined, the reduction in the number of calories you burn and increase in calorie intake lowers the likelihood of continued weight loss (2, 3, 7).

Though this may be viewed as a problem, its an evolutionary process that helped people survive during times of famine or starvation (7).

When youre trying to lose weight, you may be in a calorie deficit most days, therefore progressively forcing your leptin levels to drop (7, 8).

By introducing a refeed day every week or so, you might temporarily increase your leptin levels through increased calorie intake, which may help keep your bodys fat-burning process working more efficiently (3).

Carbs are the main focus of refeed days due to their superior ability to increase leptin levels, compared with fats or proteins. Therefore, by eating carb-rich foods on your refeed day, youre likely giving your body the best chance to balance its leptin levels (3).

Refeed days may elevate hormone levels, such as leptin, reducing the effects of adaptive thermogenesis, a survival process that has been shown to slow weight loss.

Refeed days may provide certain benefits.

The main reason for refeed days is to prevent a weight loss plateau.

When people are trying to lose weight, they may see immediate results initially, but this is usually followed by a period during which no weight loss occurs. This is partially due to a survival process called adaptive thermogenesis (9).

By feeding your body excess calories mostly in the form of carbs, your leptin levels temporarily increase, which may prevent adaptive thermogenesis from interfering with your weight loss (10).

However, more research is needed to better understand the effects of temporary refeeding and leptin levels (3).

Most research has found that food restriction ultimately leads to overeating or binging, which is why cheat days have become popular in the fitness community (4).

However, cheat days are designed as a way to binge on an unlimited amount of food, which may lead to a distorted relationship with food and limit your progress. In contrast, refeed days are designed to gently and purposefully increase calories, which may reduce binging (4, 11).

Introducing a refeed day may help limit binging by permitting foods typically discouraged on many diet plans, especially carb-rich ones. Furthermore, it may help satisfy cravings and decrease feelings of deprivation (12).

However, a refeed day coupled with an overly restrictive diet wont likely resolve this. Therefore, opt for an eating pattern that welcomes a wide-range of foods that you enjoy (12).

Refeed days may help improve physical performance.

During periods of calorie restriction, your bodys ability to store glycogen is limited. Glycogen is a long-chain carbohydrate thats stored in your muscles and liver and used as a quick energy source during physical activity (3, 13, 14, 15).

Since refeed days emphasize carb intake, this may help replenish glycogen stores, potentially improving your performance in the gym, on the race track, or on the field.

Though more research is needed, refeed days may help you overcome a weight loss plateau, avoid binging, and improve athletic performance.

Despite the possible benefits, some potential downsides need to be considered before introducing a refeed day.

Though the theory of refeed days makes sense, there isnt much research on the topic. Moreover, adaptive thermogenesis is still a contested topic among researchers, further calling into question the effectiveness of refeed days (16).

Moreover, the human body is incredibly sophisticated and can easily adapt to changes in food intake. Your metabolism does not experience lasting changes from one day of being in a calorie surplus or deficit and is largely dependent on genetics and age (17).

Just as it takes many days to weeks of calorie restriction for leptin levels to decline and adaptive thermogenesis to take place, it likely takes more than a single day to adequately elevate leptin levels enough to support weight loss (17).

Even though you may have a thoughtfully planned refeed day, you may have a hard time controlling your intake once you start. Depending on the intensity of your calorie restriction during the week, you may experience intense cravings that override your good intentions.

Therefore, when trying to lose weight, it may be best to limit yourself to no more than a 500 calorie deficit per day through both increased exercise and a modest decrease in calorie intake (18).

Though this balanced approach may make weight take longer, you may be less likely to regain it in the long run (9).

Although refeed days encourage a temporary respite from calorie restriction, they still emphasize diets as a way to lose weight.

Considering most diets fail to produce long-term weight loss, following a healthy lifestyle that does not eliminate entire food groups or encourage an intense calorie restriction may be most sustainable (19).

Most guidelines recommend a conservative approach to weight loss for long-term success. It involves a modest calorie deficit through increased physical activity and the consumption of whole, minimally processed foods (20, 21).

Through this approach, weight loss may be achieved without the need for a refeed day.

Any diet comes with the risk of negatively affecting your relationship with food.

Though refeed days encourage carb-rich foods for one day, theyre usually paired with diets that vilify carbs or other food groups, creating an unhealthy good versus bad mentality (19).

Moreover, only allowing one day free of calorie restriction every week or two may create a heightened sense of stress and fear surrounding food and calories. This may ultimately lead to disordered eating thoughts and behaviors (22).

If you have a history of disordered eating or eating disorders, it may be best to avoid refeed days and diets altogether, or to consult a qualified health professional.

Although refeed days are popular, theres limited research on their efficacy. Moreover, theyre usually paired with extreme diets that may promote a negative relationship with food and disordered eating thoughts and behaviors.

If youre interested in incorporating refeed days into your eating routine, its best to spend time planning them out to ensure youre not going overboard. Moreover, you may need to adjust the rules to meet your bodys needs.

Generally speaking, most people in a calorie deficit should consider including a refeed day once every 2 weeks, although this will depend on your body fat percentage and goals. Those with lower body fat percentages may need to increase their number of refeed days (2, 3).

Use the following chart as a reference:

*Note: Most women should aim to have a body fat percentage above 15% to support reproductive and overall health.

Although there are no official guidelines, most refeed days should aim to increase daily calories by 2030%. For example, if you need around 2,000 calories per day to maintain your weight, you should aim to have 400600 additional calories per day.

Aim to consume most of your additional calories from carb-rich foods, such as whole grains, pasta, rice, potatoes, and bananas, as carbs have been shown to increase leptin levels more than protein or fat (2, 10).

You can continue to eat protein and fat at each meal. However, prioritize carbs first, then protein, and limit fats.

Most refeed diets recommend limiting fats to around 2040 grams per day and suggest consuming around 0.680.9 grams of protein per pound (1.52.0 grams per kg) of body weight.

To ensure youre meeting your bodys needs, it may be best to speak to a healthcare professional before implementing a refeed day into your eating regime.

On refeed days, aim to increase your total daily calories by 2030%, with most of the increase coming from carbs.

If youre wondering what a refeed day would look like, here is an example. Keep in mind that the portions of each food will vary depending on your weight and other needs.

Conversely, follow an eating pattern similar to that of your regular diet and add additional servings of carbs to each meal.

Meals on refeed days should emphasize carb-rich foods with moderate amounts of protein and limited fats.

Refeed days are designed to give a temporary break from calorie restriction.

The theory behind refeed days is to improve your hormone levels, namely leptin, to prevent weight loss plateaus caused by a process known as adaptive thermogenesis. They may also decrease your risk of binging and improve athletic performance.

However, more research is needed to better understand the purpose and role of refeed days in weight loss. Moreover, they may not be suitable for those with a history of disordered eating.

If youve reached a weight loss plateau, you may want to consider incorporating a refeed day into your routine.

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Refeed Day: What It Is and How to Do It - Healthline

Many Americans may find their bodies flabbier and less healthy when they finally emerge from the Great Quarantine of 2020.

And is it any surprise? Hello, pantry full of snacks and comfort foods. Heres looking at you, refrigerator packed with meat, cheese and milk.

Its all so tempting during the coronavirus crisis as people stay at home bored, anxious and stressed and seek relief by eating all day.

By the middle of this month, popcorn sales rose almost 48%, pretzel sales were up 47% and potato chip sales rose 30% compared to the same period last year, Bloomberg reported.

Theres also surging demand for cookies, crackers, soup, macaroni and cheese, breakfast food, potatoes, and canned, dried and fresh meat.

It didnt surprise Lisa Young, a registered dietitian in New York and author of Finally Full, Finally Slim.

When people are stressed, they tend to fall back on lazy patterns, letting the vigilance with the food go. And its comfort food its feel-good food, it keeps them full, Young told TODAY.

I think that in these times, its not a time to diet and to make yourself crazy but (social distancing) has now become a way of life and its so important that we make our way of life healthy.

Its also not surprising that people are buying shelf-stable foods that dont require a lot of time to prepare, said Dr. Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy at Tufts University in Boston.

Still, food prepared outside the home is generally less healthy than home-cooked meals, so he was optimistic the break from restaurant eating could be positive when it came to nutrition.

We dont know, well have to see, but Im hopeful that people will actually be healthier than they were before. Theyre not eating at (restaurants), Mozaffarian said.

Here are expert tips on how to stay on the nutritional track during this time:

Trending stories,celebrity news and all the best of TODAY.

People may be disoriented by their new reality of staying at home all the time, so the No. 1 most important thing is to set up a plan for the day, Young said.

You dont just want to nibble on seven mini-meals. You want to set structured meals for yourself, she advised.

Set a time for eating breakfast, lunch and dinner. Limit any mindless snacking in between. Stick to a routine.

Take the time when youd normally commute and do an online exercise class or take a walk. Any kind of morning exercise sets you up for good structure for the rest of the day, Young said.

This is a time when people truly should be supporting their immune systems, Mozaffarian noted.

Theres good evidence that healthy diets improve the immune system and so if you want to fight COVID-19, eating foods that are rich in vitamins and nutrients especially many red and yellow and other colored fruits and vegetables can help the immune system, he said.

We have to try to make ourselves healthier COVID-19 is a reminder that healthy eating remains important.

Young advised buying healthy staples including:

Make your own comfort food by having whole -wheat pasta, red sauce and frozen vegetables, for example.

If you really want to have cookies in your pantry, stick to one type. Dont buy seven varieties of cookies because youll end up eating more of each of them, Young cautioned.

Eating snacks straight out of the packaging is a recipe for overeating. You dont want to spend unlimited time with that giant open box of crackers from Costco.

Instead, try portion control to limit how much youre eating. Its easy to do at home where theres usually access to a food scale or measuring cups.

Take the food out of the bag and figure out exactly how much you want to eat. Then you put it on a plate and you sit down and you enjoy it. You dont eat it standing while watching the latest news reports, stressed out, Young noted.

Young is a fan of what she calls the 80/20 rule, or eating well 80% of the time, and allowing yourself treats 20% of the time.

Its good to have something to look forward to, like air-popped popcorn, whole-grain pretzels or whole-grain crackers. Shes even OK with the occasional small portion of ice cream or macaroni and cheese. Just focus on nutritious food the vast majority of the time and sprinkle in any less-healthy favorites.

This is a stressful time dont make things worse by sitting on the couch and eating all day.

You think youll feel better after you eat, but then after you eat, you feel worse. It ends up being a totally vicious cycle, Young said.

You want to say: I want to be healthy, thats my goal right now. I dont want to get this thing and I want to stay healthy.

A. Pawlowski is a TODAY contributing editor focusing on health news and features. Previously, she was a writer, producer and editor at CNN.

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Coronavirus: How to stop overeating and avoid weight gain in self-quarantine - TODAY

Let's face it when life hits a few bumps in the road, so, too, do our diets and food habits. As more people transition to a work from home lifestyle, the new normal of spending an inordinate amount of time confined to their homes and home offices takes some getting used to. There are shifts in work production, alterations of one's sleep and exercise habits, and drastic changes to what, when, and how food is consumed.

For many people, this change leads to eating habits and schedules that are less healthy than they're typically accustomed to, making it challenging to stay focused on their health and fitness goals.Thankfully, there are plenty of excellent resources a mere smartphone app away designed to help us stay on track no matter how difficult it might seem.

Both Apple's App Store and the Google Play Store are filled with apps offering the promise of losing weight and eating healthier. But wading through the choices can be both difficult and time-consuming, as even the best apps may not be right for everyone.

To help sort through the choices, we turned to Samantha Cassetty, an MS, RD, and national nutrition and wellness expert with a private practice based in New York City, for a bit of advice and her thoughts were especially insightful.

"There are many free and paid apps to help you learn how to eat more healthfully," Cassetty told Business Insider. "The most important thing is to find one that supports a variety of healthful foods in balanced amounts that are right for your needs."

Using a smartphone to track your diet isn't a new idea. In fact, some of the earliest apps on the App Store were aimed at helping iPhone users eat healthier. After all, we carry our mobile devices with us everywhere, making them ideal for providing insights and advice on what we should be buying at the grocery store or ordering at a restaurant.

Some of the apps that are available even create extensive meal plans, provide diet and exercise routines, or offer consultations from dietitians and nutritionists. Others simply track what we're eating in order to raise awareness of the calories we're taking in. Cassetty says there are benefits to both and that even basic food trackers are valuable.

"Free tools allow you to track your food intake, which is a form of self-monitoring that's been found helpful for reaching or maintaining a comfortable weight," she said. "They can also expose when you might be grazing or over-snacking, which happens when you're spending more time working at home with a stocked kitchen."

While Cassetty does find plenty of value in the use of smartphone apps to track dietary intake, she also urges caution, saying that "unless you're getting the tools and information you need to make lasting changes, it's unlikely that you'll be able to maintain any weight you've lost."

She recommends working on developing an understanding of how to balance meals so they fill you up while tasting great at the same time. She also stresses the importance of developing healthier coping strategies rather than turning to food when we're bored, stressed, anxious, depressed, or even happy.

"Rather than focus on a goal weight, I think a better way to go is to focus on small steps you can take to create healthier habits," Cassetty said. "Examples include, limiting soda, upping your veggie intake at lunch and dinner, cooking an extra meal or two, drinking more water, and aiming for 7-9 hours of sleep each night."

Those are words of wisdom, no doubt, but Cassetty also expressed the importance of cutting ourselves some slack when things get especially stressful and difficult.

"I think it's important to be flexible and compassionate with yourself during these challenging times," she added. "You may not be able to eat as well as you'd like or maintain your healthy routines, and that's alright. As long as you're putting in some effort versus none at all it's a step in the right direction."

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How to choose a diet and weight loss app that's right for you, according to a nutritionist - Business Insider - Business Insider

After years of taking a cholesterol-lowering drug with side effects that are worse than death itself, I made the decision to stop the drug to see if I would either be free of painful side effects, or have my arteries plug up like a bus station toilet.

Oh no, youre not, the wife said when she heard of my plan. You need to stay on your meds so I can keep you around for at least five more years, or until I lose a little weight. I am not ready to date at my current, um, density.

But I cant tolerate these side effects, constant muscle aches and pains to the point that cartwheels are totally out of the question.

Whats a few muscle aches? Hey, at least your side effects dont include dizziness, vomiting and anal leakage.

Excellent point, I said. But Im still quitting those meds.

Well, the wife said, Let me do a little research and see what I can find out about how to lower cholesterol without medication. And with that, she went to the computer to do some research.

Thank you, dear. And I better not see you working on your Tinder profile.

Fine. Youre no fun.

After an hour or so the wife came to me with a new plan. Sitting next to me on the sofa with the laptop on her, well, lap (so thats why they call it that), she said, It looks like a Mediterranean diet would be perfect for lowering your cholesterol.

Perfect, Ill book a 60-day Mediterranean cruise, I said.

Not going to happen. We are both going to consume healthy foods like legumes, avocados, nuts, fish, whole grains and fruits.

Hey, Im a hunter, not a gatherer. Wheres the beef?

There is no beef, she said. No red meat, only fish and poultry.

I pondered. I pondered long and hard. And then I thought about the days of care-free cartwheeling and I said, Alright, lets do this.

Oh honey, the wife said all a-titter. I cant believe youre agreeing to do this. I promise Ill delete my Tinder profile. We are going to lower your cholesterol for sure and maybe even decrease our densities too. Who knows? Maybe youll last another 10 years.

Since the first of the year the wife has made amazing Mediterranean meals that are absolutely delicious. We have cut out all red meat and sugar. Its not an easy diet in terms of preparation. But fortunately the wife loves to research new recipes, and enlists my help in the kitchen to prepare meals. Im an excellent chopper, if I do say so myself.

The jury is still out on whether my cholesterol has gone down, but at least I know Im eating a much healthier diet. But the biggest plus is no more muscle aches, dizziness, vomiting or anal leakage.

Raul Ascunce is a freelance columnist for the Sentinel-Tribune. He may be contacted at RaulAscunce@gmail.com.

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Pirates of the Mediterranean diet | Community | sent-trib.com - Sentinel-Tribune

Many of our routines are changed because of the restrictions caused by the Coronavirus and those changes can threaten our health. Yesterday we told you about replacing yoga and other fitness classes virtually to help with anxiety. Today, We hear the concerns of a dietitian who says what you eat can have serious health impacts.

I feel like it too a pandemic for people to start thinking about their health.

Kelly Springer is a registered dietitian and shes worried that the way many people eat is actually an additional threat at this time when were all concerned about the spread of COVID 19.

We have a high number of people on ventilators (statewide) and are not recovering well because of obesity and comorbidities that are directly realted to their food intake.

CNY Dietitian Kelly Springer shares thoughts about how a thoughtful diet can help reduce anxiety during Coronavirus isolation, and avoid bad habits amid disrupted meal routines.

There are several issues here that she unpacks. All of the restrictions were living under might lead to bad eating habits. And there are also real medical consequences of what we eat. To start off, the disruption in our schedules and being at home primarily, can blur the lines of regular mealtimes.

The problem is, I think its the lack of routine that is the hardest thing. We have access to food 24/7 now where before we were (busy) with a job or getting kids to school or something ese. And now that refrigerator is calling our name all day long.

So if youre home a lot more, plus add in extra stress, you have cravings for foods that are usually carb-heavy. Springer says she falls victim too. And not everything that comes out of the microwave is healthy. At work, theres probably a vending machine, with chips? Candy? Well you know. And its not just lack of will power. Springer notes hormones and other receptors actually change under stress.

and that actually controls our hunger. So its interesting, its not that youre just having low will power. Its truly hormones are messed up during this time. So, by having those set meal times it can actually help to not think about your own hunger and fullness cues.

With meals, Make sure youre including a protein, vegetables and good grains in those meals not just carbohydrates. You can also control what goes into your mouth to work on anxiety, starting with drinking a lot more water than most of us do.

I know that sounds like the simplest thing in the world but your body is made up of 70% water. And if you become dehydrated, it actually puts a stress on your body in general. So by making sure youre getting hydration throughout the day, it actually helps to lower your stress levels.

She adds fiber-rich foods, such as whole grains, fruits and vegetables help the good bacteria in our digestive tracks, and both reduce anxiety and boost serotonin levels, which help with good moods. Springer says up to 90% of serotonin is developed in the digestive system.

Healthy eating can also relate directly to keeping you from getting sick.

80% of your immunity cells are actually in your digestive tract, so making sure were getting foods that are feeding that good bacteria.

She explains pre- and pro-biotic foods can help your gut-health, especially foods that have active bacterial cultures.

That could be foods like kefir, kimchee, sauerkraut, fermented pickles; anything that has been fermented is going to have live bacteria. Those live bacteria help to spur more good bacteria production in your digestive tract, which can actually boost and support your immunity.

So, there are a number of issues here related to what youre eating at this time of worry, of disruption at home and at work, and perhaps of stress because of income or health problems. Whether its avoiding bad snacking habits, eating in a way that can reduce your anxiety, or a diet that can actually keep you from getting sick or sicker, Springer wants you to know, food is pretty important.

Weve been really good at having people stop smoking or get moving, but I feel like weve missed, the central core of wellness is what we eat. So youve heard the term, youve heard it forever, we are what we eat but it really is true. So if youre eating tons of sugar, rich foods and fried foods, that will kill the gut bacteria and you can actually decrease your serotonin levels, decrease your immunity. So if you put in good fruits and vegetables, whole grains, youre going to be a healthier, happier person.

Springers practice, under the name Kellys Choice has been able to do a lot of work virtually. Her staff have met with individuals and business clients through video, where they can see materials and interact. She and other experts are offering a free series starting April 6th to help people with food choices, exercise and their health as a way to give back at this time.

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How Nutrition Can Reduce Corona Anxiety and Severity of a COVID 19 Case: CNY Dietitian - WAER

Samantha Irbys new essay collection, Wow, No Thank You (Vintage Books), is an irreverent, hilarious, and vulnerable dive into the authors brain. Irby skewers herself and her daily life, whether it is her work-from-home malaise, the dangling of luxuries she cant afford, the difficulties of making friends as an adult, or her comfortable but often unsexy marriage.

The book is filled with the follies of turning 40, hauntings by dead pet cats, lunch meetings with Abbi Jacobson, going clubbing with bowel issues, and the trials and tribulations of being married to another woman in the rural Midwest. For all of Irbys wit, depression over debts, and social awkwardness, there is a deep resounding warmth in her essays, too. A hard-won empathy, a stubborn acceptance of self that invites us to join her and revel in the chaos.

We spoke with Irby about various topics, random and not-so-random, from smelling good in tax jail to Love Is Blind.

I got a D.S. & Durga candle, and you wanna talk about smelling rich? It was like $65, but it smells incredible. I think its called Big Sur After the Rain. Its the kind of thing I get and think, Im a stupid fucking person. Theyre sending actual rich people this shit for free. But it makes me feel very luxurious. This year, Im pivoting to sweatshirts. The one Im currently wearing is from Rachel Antonoff, but even my raggedy sweatshirts, I will spray some Jo Malone on them and think, this is luxury. It makes me feel like Im actually a person worthy of things. Im like, put me in Coming to America, because I am a queen. Dont tell the IRS Im on a payment plan. When they finally take me to tax jail, theyre gonna be like, You know what bitch? You smell amazing.

I came of age in the super sweet spot where you could still be homely at the club. You could not wear heels but also get in. Now, if you try to get in the club with New Balance, which is what I like to do, they are like, no bitch, get out. I spent so much of my twenties in nightclubsI wouldnt take it back. But now, Im just like, where are the chairs? Take me to the cordoned off senior section where I can just watch other people. After like five drinks, I can feel my body dying. Its a race to get home, like Cinderella. At midnight, my body goes from keeping me alive to shutting down all my organs unless I get somewhere with a bed and air conditioning. I wanna go out, but I also want to not die in a club. One of my worst nightmares is an ambulance coming to get me at the club. The lights come on and everyone looks like shit. I dont want that to be the last thing I see.

Truly the greatest invention of all time. People who are anti-phone, I dont get it. I refuse to believe there is a person who is so fulfilled by their life that they dont need any of the distractions or joys of phones.

I crossed the threshold. Facebook creates a false intimacy between yourself and people you only know on the internet, which is extremely seductive. But its not real and Facebook was the place where I felt I had to be careful. Then I created a book group and every day there was a new issue monitoring the group. I would rather walk into a lake and never stop walking or die from whatever Chlamydia is in the lake over and over like Groundhog Day, than to keep moderating a group where everyone is fighting about Young Adult fiction.

I had no other way to tell people I had crushes on them. I couldnt use my words and be rejected. It only takes one time of watching someones face crumple in horror as you reveal your crush on them. Ever since the seventh grade, I was like, okay Im never doing that again. I will only prove my slavish devotion to them by spending hours recording CDs to tapes for them. The feeling when someone made you a tape? Launch a thousand love boats right into my heart. And when youre young, it was also so cool to see what your friends were into. I would always pull out my most obscure, cool sounding songs even if I didnt like them that much. Id really be crying to Ani DiFranco, but Id be like, let me put this punk song on here.

I wanted to write an actual twenty-two-minute porn teleplay called Two Old Nuns Having Amazing Sex. But I just didnt have time, so I made fun of the trope that old broads dont have sex, but then wrote about the stuff we do. Like, I dont have to have an orgasm if I get to cancel on a lot of parties. It truly is the same rush. I want to get over this cultural myth. Everyone thinks everyone else is having more and better sex than they are. I just want to be like, no, none of us are, and its fine. Like, maybe there are people somewhere fucking all day and thats great, but over here, we read books and dont talk to each other.

You cant have gone to as much church as I had to go to as a kid and not have some residual belief. I did aura readings twice and I had an orb that the photographer said was a spirit. I am not smart enough to deny the existence of anything. I want there to be a little mystery, a little inexplicable crop circle. I feel like that makes life better and more fun.

I havent watched it because I cannot watch attractive people falling in love. I dont believe in it. Wake me up when love is ugly, or fat, or fucked up. Its very easy to be in a pod, get out of it and fall in love with someone who is conventionally beautiful. I want someone to talk to me for seven months, be ready to give me a kidney, then come out the pod and be like, oh look how swollen her ankles are, Im done, get me off this show.

I love to see a regular looking lady. I love Bernard. Regular people 2020.

Im drinking a little sip can right now. Diet Coke is the best when its crackling cold and those tiny cans stay cold for the whole can. My wife started getting them because she is for real an everyday doomsday prepper. I was like honey, you can keep getting these.

I dont ever have any on hand. Its tragic its now sold out. I am truly a hand washer. Nobody wants my sensitive doughy, writers hands to get cracked and bloody from sanitizer. It smells like a hospital that I dont mind in the hospital, but in my real life I want everything to smell like butter and Jo Malone. Put that on my tombstone when I die from Corona: I dont use hand sanitizer, Im a washer.

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Samantha Irby on 'Love Is Blind' and Doomsday Prepping with Diet Coke - Interview