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  2. Is it safe to go vegan in older age? The diet takes vegetarianism to the extreme and poses a risk for nutrient deficiency. But it does offer health benefits. If tofu turkey and meatless meatloaf are on your holiday menu this year, you may have made the switch to a vegetarian diet, eliminating at least some animal protein. But how much animal protein can you safely cut out of your diet? Vegetarian diet benefits Among the many types of vegetarian diets, three are particularly common: a pescatarian diet allows seafood; a lacto-ovo diet allows dairy products and eggs; finally, a vegan diet allows no seafood, dairy, or other animal products. All of these approaches typically include lots of fruits, vegetables, legumes, whole grains, nuts, seeds, and healthy oils. These plant-based foods contain several healthy components: a wide variety of antioxidants, which have anti-inflammatory properties that are linked to better health lots of fibre, which helps prevent constipation, lowers LDL (bad) cholesterol, and controls blood sugar and weight low saturated fat compared with a non-vegetarian diet. Compared with meat-containing diets, the health benefits of all vegetarian diets are well documented: lower rates of heart disease, high blood pressure, diabetes, obesity, and cancer. The picture isn't completely straightforward: a study published Sept. 4, 2019, by The BMJ found that along with lower rates of heart attacks, vegetarians had higher rates of haemorrhagic (bleeding) stroke, compared with meat eaters. The increase equalled about three more cases of haemorrhagic stroke per 1,000 people over 10 years. Most other studies have not identified such a risk. Vegan diet benefits and challenges If plant-based foods are generally healthier than animal-based foods, should you consider a vegan diet, banishing all animal products? It seems like something to consider, with the increasing amount of vegan foods now sold in grocery stores and restaurants. Whether a vegan diet has even greater benefits than a less restrictive vegetarian diet is unclear. "Because the vegan diet is restrictive, it can be a challenge to maintain over the long term," says Kathy McManus, director of the Department of Nutrition at Harvard-affiliated Brigham and Women's Hospital. A study published in April 2019 in The Journal of Nutrition found that a vegan diet slightly outperformed a pescatarian diet and a lacto-ovo diet when it came to the amount of antioxidants and omega-3 fatty acids in the blood, and that a vegan diet significantly outperformed diets with meat. However, this is just one study. "Most studies don't separate vegan and vegetarian diets, so we don't have a lot of evidence comparing one vegetarian diet to the other," says McManus. A vegan diet also comes with health risks, especially for older adults, although you can take action to counteract those risks. In particular, McManus notes, when you cut out animal products, you may come up short on certain nutrients: Calcium. Calcium is important to many functions, especially bone, dental, heart, nerve, and blood health. Protein. We need protein to build strong muscles, bones, and skin — particularly as we age and lose muscle and bone mass and have a harder time healing from wounds. Vitamin B12. This vitamin comes only from animal-based foods. B12 is crucial to our DNA, red blood cell formation, new cell growth, glucose metabolism, and maintaining our nervous system and thinking skills. In addition, you may have trouble getting enough calories on a highly restricted diet. If you don't give your body enough fuel, you may become tired or malnourished. Avoiding deficiencies "You have to be selective when choosing a plant-based diet to ensure that you get enough calories and nutrients," McManus says. Here's how to avoid the potential pitfalls of a vegan diet — or, for that matter, any other type of vegetarian diet: Avoid calcium deficiency. Eat plant-based foods that are rich in calcium: almonds, dark leafy greens (kale, spinach), figs, tofu, and oranges. A medium-sized orange has about 50 milligrams (mg) of calcium; a cup of cooked collard greens has 268 mg of calcium. Aim for 1,000 to 1,200 mg of calcium per day. Get enough protein. Eat protein-rich plant foods: soy products (tofu, tempeh, and edamame), legumes (beans, lentils), nuts (walnuts, almonds), chia seeds, and spirulina (blue or green algae). For example, a cup of canned navy beans has 20 grams of protein. Chia seeds have about 4.5 grams of protein per ounce, and sunflower seeds have about 6 grams per ounce. You need about 7 grams of protein daily for every 20 pounds of body weight. Avoid vitamin B12 deficiency. Try B12-enriched vegan foods such as fortified plant milks (like almond or soy milk) or fortified cereals. McManus says you may need to take a B12 supplement while on a vegan diet. We also advise that your doctor check your blood level of vitamin B12 regularly. How should you start? Get the okay from your doctor before starting a vegan diet, and then seek advice from a registered dietitian, who can tailor an eating plan to your nutritional needs. Combine plant food sources for the maximum amount of vitamins and nutrients. Soups, salads, and smoothies with lots of different kinds of foods will help you maximize calories and nutrients. And by all means, take it slowly. "Get rid of red meat, and then poultry, and then dairy products and fish," McManus says, "But don't feel that you have to eliminate all of them at once." https://www.health.harvard.edu/ kalip
  3. Healthy habits 'deliver extra disease-free decade' Women can gain 10 and men seven years of life free of cancer, heart problems and type-2 diabetes from a healthy lifestyle, a study in the BMJ suggests. They must exercise regularly, drink in moderation only, have a healthy weight and good diet and not smoke. The US research is based on 111,000 people tracked for more than 20 years. Lead author Dr Frank Hu, of Harvard School of Public Health, in Boston, said the study had "a positive message for the public". "They gain not just more years of life but good years through improved lifestyle choices." What is a healthy lifestyle? At the age of 50, study participants were asked if they met at least four of these five criteria: never smoking a healthy, balanced diet 30 minutes of moderate or vigorous activity every day a body mass index (BMI) between 18.5 and 24.9 no more alcohol than a small glass of wine a day for women and a pint of beer for men Women who said they met four out of five lived an average of another 34 years free of cancer, cardiovascular disease (such as heart attack and stroke) and type-2 diabetes - more than 10 years longer than those who did not. For healthy men, it meant another 31 years of disease-free life - more than seven years extra than unhealthy men could expect. Why the difference between women and men? It may be linkMen who smoked more than 15 cigarettes a day and obese men and women (with a BMI of more than 30) had the lowest disease-free life expectancy, the study found. But some things were true for both sexes - not only did a healthy lifestyle reduce the risk of cancer, cardiovascular disease and type-2 diabetes, it also improved survival if men and women were diagnosed with any of the diseases. "The benefits add up for men and women," Dr Hu said. Why focus on these diseases? Cancer, cardiovascular disease and type-2 diabetes are three of the most common diseases in old age. They are also closely linked to people's lifestyles. Being obese or overweight, for example, is thought to be linked to 13 different types of cancers, including breast, bowel, kidney, liver and oesophagus. ed to the fact women live longer than men on average. Cancer Research UK has calculated that four in 10 cancers can be prevented by people changing aspects of their lifestyle, such as cutting down on processed meat, eating more fibre in their diet and protecting their skin in the sun. Could other factors play a role? This was a large, observational study, so it can't conclude these lifestyle factors were directly responsible for extending life free of disease. It did try to account for other factors, however, such as family medical history, ethnic background and age, which could have had an impact on the results. The research team also had to rely on people giving them information on their food intake, their exercise habits and even their height and weight, which is not always accurate. Most of the participants in the study, involving more than 73,000 women and 38,000 men, were white health professionals. https://www.bbc.com/news/health kalip
  4. Running your first marathon ‘makes you four years younger’ in heart health Running a marathon for the first time can reverse key markers of ageing by four years, a British study has found. The research on novice runners who tackled the London Marathon found they experienced a significant reduction in artery stiffness and blood pressure – cutting their chance of heart attacks and strokes. Scientists said the changes were equivalent to a four year reduction in vascular age. The greatest benefits were seen among those who were older, male and slower runners. Researchers from University College London and Barts Health NHS Trust tracked 138 healthy people who ran the London Marathon for the first time in 2016 or 2017, Participants had been running for less than two hours a week before they began training, mostly following a beginner’s plan consisting of around three runs a week. After six months of training, scans found major improvements in their blood pressure and arterial stiffness. On average systolic and diastolic blood pressure dropped by 4mmHg and 3mmHg respectively. Stiffness of the arteries indicates damage to the blood vessels, and is a key predictor of heart and circulatory problems in later life. Arteries normally stiffen with age, but experts said exercise could reverse or limit the damage. Among participants, some measures of arterial flexibility increased by nine per cent. The study, published in the Journal of the American College of Cardiology, only included healthy participants. Experts said even more benefit might be seen in those with higher blood pressure and stiffer arteries. Lead researcher Dr Charlotte Manisty said:“Our study shows it is possible to reverse the consequences of aging on our blood vessels with real-world exercise in just six months. “These benefits were observed in overall healthy individuals across a broad age range and their marathon times are suggestive of achievable exercise training in novice participants.” The average running time for those in the group was 5.4 hours for women and 4.5 hours for men. Expert said this suggested a training schedule of six to 13 miles per week. Dr Manisty said signing up for a major health challenge could be a good way to make significant changes in health. “Making a goal-oriented exercise training recommendation – such as signing up for a marathon or fun-run – may be a good motivator for our patients to keep active. “Our study highlights the importance of lifestyle modifications to slow the risks associated with aging, especially as it appears to never be too late as evidenced by our older, slower runners.” NHS guidance says all adults should get 150 minutes of exercise each week – such as a 30 minute brisk walk five times a week. Commenting on the British Heart Foundation-funded study, its Associate Medical Director Professor Metin Avkiran said: “The benefits of exercise are undeniable. Keeping active reduces your risk of having a heart attack or stroke and cuts your chances of an early death. “As the old mantra goes, if exercise were a pill it would be hailed as a wonder drug. “Setting yourself a goal – such as training for a marathon – is a great way to stay motivated and follow through on your New Year health resolutions. “But you don’t need to train for a marathon to reap the benefits. More is usually better, but every bit counts.” https://www.telegraph.co.uk/health/ kalip
  5. AI 'outperforms' doctors diagnosing breast cancer Artificial intelligence is more accurate than doctors in diagnosing breast cancer from mammograms, a study in the journal Nature suggests. An international team, including researchers from Google Health and Imperial College London, designed and trained a computer model on X-ray images from nearly 29,000 women. The algorithm outperformed six radiologists in reading mammograms. AI was still as good as two doctors working together. Unlike humans, AI is tireless. Experts say it could improve detection. How good is it? The current system in the NHS uses two radiologists to analyse each woman's X-rays. In rare cases where they disagree, a third doctor assesses the images. In the research study, an AI model was given anonymised images, so that the women could not be identified. Unlike the human experts, who had access to the patient's history, AI had only the mammograms to go on. The results showed that the AI model was as good as the current double-reading system of two doctors. And it was actually superior at spotting cancer than a single doctor. Compared to one radiologist, there was a reduction of 1.2% in false positives, when a mammogram is incorrectly diagnosed as abnormal. There was also a reduction of 2.7% in false negatives, where a cancer is missed. Dominic King from Google Health said: "Our team is really proud of these research findings, which suggest that we are on our way to developing a tool that can help clinicians spot breast cancer with greater accuracy." Most of the mammograms came from Cancer Research UK's OPTIMAM dataset collected from St George's Hospital London, the Jarvis Breast Centre in Guildford and Addenbrooke's Hospital, Cambridge. It takes over a decade of training as a doctor and specialist to become a radiologist, capable of interpreting mammograms. Reading X-rays is vital but time-consuming work, and there is an estimated shortage of more than 1,000 radiologists across the UK. Will AI take over from humans? No. It took humans to design and train the artificial intelligence model. This was a research study, and as yet the AI system has not been let loose in the clinic. Even when it is, at least one radiologist would remain in charge of diagnosis. But AI could largely do away with the need for dual reading of mammograms by two doctors, easing pressure on their workload, say researchers. Prof Ara Darzi, report co-author and director of the Cancer Research UK (CRUK) Imperial Centre, told the BBC: "This went far beyond my expectations. It will have a significant impact on improving the quality of reporting, and also free up radiologists to do even more important things." Women aged between 50 and 70 are invited for NHS breast screening every three years - those who are older can ask to be screened. The use of AI could eventually speed up diagnosis, as images can be analysed within seconds by the computer algorithm. Sara Hiom, director of cancer intelligence and early diagnosis at CRUK, told the BBC: "This is promising early research which suggests that in future it may be possible to make screening more accurate and efficient, which means less waiting and worrying for patients, and better outcomes." Helen Edwards, from Surrey, was diagnosed with breast cancer at the age of 44, before she was eligible for screening. She required surgery, chemotherapy and radiotherapy, but has been cancer-free for more than a decade. She was a patient representative on the CRUK panel which had to decide whether to grant Google Health permission to use the anonymised breast cancer data. Helen told the BBC: "Initially I was a bit concerned about what Google might do with the data, but it is stripped of all identifiers. "In the long term this can only benefit women. "Artificial intelligence machines don't get tired... they can work 24/7 whereas a human being can't do that, so to combine the two is a great idea." https://www.bbc.com/news/health kalip
  6. 'Intermittent Fasting' Diet Could Boost Your Health Here comes the new year, and with it hordes of folks looking for ways to fulfill resolutions to eat healthy. Intermittent fasting is a legitimate option they might want to consider, claims a new review in the Dec. 26 issue of the New England Journal of Medicine. "The state of the science on intermittent fasting has evolved to the point that it now can be considered as one approach, with exercise and healthy food, to improving and maintaining health as a lifestyle approach," said senior author Mark Mattson, a neuroscientist with Johns Hopkins Medicine in Baltimore. There are two main ways to adopt intermittent fasting into your life, Mattson said: Daily time-restricted feeding gives you a narrow window during which you can eat, usually 6 to 8 hours each day. 5:2 intermittent fasting requires that people only eat one moderate-sized meal on two days each week. When people are fasting, they are slowly burning through the glucose stored in their liver, Mattson explained. The liver holds about 700 calories of glucose. "It takes 10 to 12 hours to use the liver's energy stores," Mattson said. "Then what happens is, fats are used for energy." This process is called "metabolic switching," and the three-meals-a-day eating pattern favored by Americans doesn't allow their bodies to run through their liver's energy stores and make the switch to fat-burning, Mattson said. In the new paper, Mattson and colleagues summarised the current scientific evidence. Studies show that intermittent fasting can: Stabilise blood sugar levels, increase resistance to stress, and suppress inflammation. Decrease blood pressure and cholesterol levels, and improve resting heart rate. Improve brain health and memory. "If you're thinking of intermittent fasting as a fad diet, I think it's actually a pretty legitimate option," said Hannah Kittrell, a registered dietitian and manager of the Mount Sinai PhysioLab in New York City, a nutrition and exercise physiology clinic. "The reason for that is it's not completely cutting out any food groups," said Kittrell, who wasn't part of the study. "It's not telling you don't eat carbs, don't eat fat. It's just modulating when you're eating food." Kittrell said her lab evaluates different diets by looking at the evolutionary, historical and biological basis for them, and intermittent fasting passes all three tests. "There's an evolutionary basis in the sense that hunter-gatherers essentially followed an intermittent fasting diet because food was scarce. They wouldn't necessarily know the next time they'd eat," she said. The metabolic switch described by Mattson reflects the biological basis of intermittent fasting, and history is full of examples of humans engaging in fasting, Kittrell said. "It's been used a lot for medical and religious reasons," Kittrell said. "Ramadan is a great example of prolonged intermittent fasting." In the paper, Mattson lays out a couple of sample prescriptions for incorporating fasting into your daily life. People who want to try time-restricted feeding could limit themselves to a 10-hour feeding period five days a week for the first month, then bring the period down to 8 and then 6 hours in subsequent months. The goal would be to achieve a 6-hour feeding period seven days a week, the researchers wrote. Or people could start out by fasting one day a week, with one meal on that day of 1,000 calories, and extend that to two days a week by the second month. The goal would be a single 500-calorie meal on two days each week. Mattson and Kittrell warn that you'll likely be uncomfortable as your body adapts to your new eating pattern. "This is very similar to exercise programs where someone who is sedentary, they take a month or two to get in shape while their organ systems adapt to the exercise," Mattson said. It can take between a few weeks to a couple of months for someone to get comfortable with intermittent fasting, Mattson and Kittrell said. "If someone typically eats breakfast and tomorrow they don't eat breakfast, they're going to be hungry and irritable as it gets towards lunchtime," Mattson said. "That will be gone after two weeks to a month, if they stick with it. That's a very important practical aspect." Don't expect immediate results, either -- it can take a few weeks before your body adapts to the point where you'll start dropping pounds and experiencing improved health indicators, Mattson said. Participants also must keep in mind that fasting doesn't give them free license to eat whatever they want, Kittrell added. "Obviously, you're still going to want to follow a healthy diet," Kittrell said. "It's not like you can eat only fast food but because you're doing intermittent fasting you'll be healthy." Although Kittrell considers intermittent fasting a reasonable diet option, she said there's still a lot to learn about it. For example, studies show that some people respond better to fasting than others, though the reasons why aren't yet understood, she said. "I think it shows promise, but there's still a lot of work to be done before you can say that intermittent fasting is 100% safe and effective for everybody to follow," Kittrell said. Mattson, who's been fasting for 20 years himself, said there are certain types of people for whom he wouldn't recommend the practice -- children, the elderly and people who already have very low body weight. He agrees with Kittrell that more research needs to be done regarding the health potential of fasting. For one thing, there's a strong argument to be made that intermittent fasting might improve cancer treatment, Mattson said. "It turns out cancer cells typically only use glucose as a food source. They cannot use fats," Mattson said. "If you hit them with chemotherapeutic drugs or radiation when the person is fasting, then their cancer cells are more easily killed." There are multiple trials ongoing to see if fasting could help treat cancer, Mattson noted. https://consumer.healthday.com/ kalip
  7. Carbohydrates and Cholesterol Levels Not all carbohydrates are equal -- especially when it comes to their effect on cholesterol. Some carbohydrates raise cholesterol, while others lower it. You find carbohydrates in breads, cereals, grains, milk, yogurt, fruits, vegetables, and foods that contain added sugars. All carbs are converted into glucose -- which is also known as blood sugar -- in the body and carbs can be used immediately for energy or stored for later use. Research suggests that the quantity and type of carbohydrates consumed can affect cholesterol. Cholesterol and Triglycerides Cholesterol is in the fats in your blood. High cholesterol is the build-up of these fats, which can lead to heart disease or stroke. Two types of cholesterol exist: LDL, which is also known as low-density lipoprotein and HDL, which is also known as high-density lipoprotein. LDL is the "bad" cholesterol, because it causes a build-up of plaque in the arteries. HDL is the "good" cholesterol, because it helps the body get rid of excess LDL in the blood by carrying it away from the organs to the liver, so that it can be removed. Triglycerides are another type of fat found in the blood, and high triglyceride levels also increase the risk for heart disease. Research on Carbs and Cholesterol Carbohydrate consumption from refined carbohydrates that are high in sugar and low in fibre such as cookies and cakes, is associated with lower levels of HDL and higher levels of LDL and triglycerides, which is associated with an increased risk for heart disease. Very high carbohydrate intakes of more than 60 percent of total calories -- along with excess sugar consumption -- are associated with an increase in triglycerides, according to the National Heart, Lung and Blood Institute. A 2005 OmniHeart study by Johns Hopkins Medical Institutions compared three diets that emphasised either protein, monounsaturated fat or carbohydrate and found that the protein and monounsaturated fat diets were more effective in reducing the risk factors for heart disease than the high-carbohydrate diet. Breaking Down the Carbohydrates A food's glycaemic index -- which is how fast it increases blood sugar -- may affect your cholesterol. The glycaemic index of a food depends upon a handful of factors, including the type of starch, fibre content and fat content of that food. For example, a refined or processed food such as white bread, has a higher glycaemic index than whole-wheat bread. Additionally, ripe foods tend to have more sugar, while lower fat foods digest faster and cause blood sugar to rise more rapidly, causing them to have a higher glycaemic index. In general, whole grains, beans, fruits and vegetables are not only healthy but also have a low glycaemic index. Women who eat a high-glycaemic index diet are more than twice as likely to develop heart disease, according to a 2010 study published in the "Archives of Internal Medicine." Soluble fibre Plays a Role Although refined carbohydrates may raise your cholesterol, healthier carbohydrates with whole grains and fibre can help lower your cholesterol. The beneficial effects of a low-glycaemic diet that contains whole grains may because of its high-fibre content. In particular, soluble fibre has been shown to block cholesterol and fats from absorption, thus lowering the LDL cholesterol. Foods high in soluble fibre include kidney beans, oatmeal, barley, pears, apples and prunes. Aim for five to 10 grams of soluble fibre each day to lower your total cholesterol and your LDL cholesterol. For example, it is possible to meet this goal if you have half a cup of oatmeal for breakfast, half a cup of kidney beans for lunch, one apple for a snack and one medium artichoke with dinner. The Takeaway To improve your cholesterol, eat only a moderate amount of carbohydrates. Everyone has individual requirements, but it can be helpful to have less than 60 percent of your calories come from carbohydrates. Choose carbohydrates that have whole grains, are high in fibre and low in sugar, and include fruits and vegetables. Try replacing unhealthy, high-glycaemic carbohydrates -- such as chips or cookies -- with either whole grains or healthy fats, such as nuts or guacamole. https://www.livestrong.com/ kalip
  8. Cholesterol levels in young adults can predict heart disease risk A recent study investigates the relationship between cholesterol levels in young adulthood and cardiovascular risk in later life — with interesting recommendations for further research. Research has already well documented that high cholesterol levels can lead to heart disease, the leading cause of death in the United States, and stroke, the fifth leading cause of death. Cholesterol is a fatty substance that the liver and foods we eat, such as eggs, cheese, and certain meat products produce. Cholesterol is necessary for the body to function. However, too much "bad" cholesterol, which is also called low-density lipoprotein (LDL), can clog the arteries with a fatty build-up, increasing the risk of heart attack, stroke, or peripheral artery disease. Scientists have also linked high total cholesterol to overweight, lack of exercise, smoking, and alcohol consumption. More than 12% of adults in the U.S. aged 20 years and over have total cholesterol levels above 240 milligrams per decilitre (mg/dl), which doctors consider high. Of children and adolescents aged 6–19 years, some 7% have high total cholesterol. High-density lipoprotein (HDL) is "good" cholesterol and helps to sweep LDL from the arteries back to the liver, which removes it from the body. A long look at lipids A new, comprehensive study, appearing in The Lancet, follows almost 400,000 people in 19 countries for up to 43.5 years (1970–2013). The findings shine a spotlight on the link between bad cholesterol (non-HDL) levels in people under 45 years of age and the long-term risk of heart disease and stroke. Set apart from previous studies, this observational and modelling study, which looked at individual level data, suggests that elevated non-HDL cholesterol levels at a younger age can predict cardiovascular risk at 75 years of age. The study used data from 38 studies carried out in the U.S., Europe, and Australia. Of the nearly 400,000 individuals that the study followed, none had cardiovascular disease at the start. The scientists tracked the participants over decades and took details of any heart disease event, fatal or otherwise, or stroke. In total, there were 54,542 incidents of heart disease, fatal or non-fatal, and stroke. When researchers analysed the data for all age groups and both sexes, they saw that the risk of heart disease or stroke dropped continuously as non-HDL levels dropped. In fact, those with the lowest non-HDL levels, — which the scientists defined as 2.6 millimoles (mmol) non-HDL cholesterol per litre — had the least risk. The highest long-term risks of heart and artery disease were in those younger than 45 years old. "This increased risk in younger people could be due to the longer exposure to harmful lipids in the blood," says Prof. Barbara Thorand, of the German Research Centre for Environmental Health in Neuherberg. Study suggests early intervention vital The study confirmed that the level of non-HDL and HDL cholesterol in the blood played a significant part in predicting the risk of cardiovascular disease over time. Researchers used data to create a model for people aged 35–70 years that could estimate the chances of a heart event by age 75 years. It factored in @@@, age, non-HDL levels, and cardiovascular risk factors, such as blood pressure, BMI, diabetes, and smoking status. It also examined how much one could lower risk if non-HDL cholesterol levels were a hypothetical 50% lower. Using this approach, the researchers saw the most significant reduction in risk in the youngest age group. As an example, a male under 45 years of age has starting levels of non-HDL cholesterol of between 3.7–4.8 mmol per litre and at least two risk factors for cardiovascular disease; if the individual was to halve their levels of non-HDL cholesterol, they could reduce the risk from 16% to 4%. A female with the same factors could reduce their risk from around 29% to 6%. Using the same levels of non-HDL cholesterol in individuals of 60 years or more, males could reduce risk from 21% to 10%, and females from 12% to 6%. The researchers suggest that intensive efforts to lower non-HDL cholesterol levels could reverse early signs of blocked arteries, which is known as atherosclerosis. However, there was no clarity on how much slightly increased or seemingly normal cholesterol levels affected cardiovascular risk over a person's lifetime or at what level treatment recommendations should occur, especially in younger adults. "Our estimates suggest that halving non-HDL cholesterol levels may be associated with reduced risk of cardiovascular events by the age of 75 years and that this reduction in risk is larger the sooner cholesterol levels are reduced." Co-author Prof. Stefan Blankenberg "The risk scores currently used in the clinic to decide whether a person should have lipid-lowering treatment only assess the risk of cardiovascular disease over 10 years, and so may underestimate lifetime risk, particularly in young people," notes the study's co-author, Prof. Stefan Blankenberg. The authors say future research is needed to understand whether early intervention in younger people with low 10-year risk but high lifetime risk would have more benefits than later intervention. A limitation of the study is that it may not apply to all regions or ethnic groups because its focus was on high income countries. High cholesterol has no symptoms, and many people are unaware that they have high levels; however, doctors can check levels with a simple blood test. https://www.medicalnewstoday.com/ kalip
  9. Fatty Diets Tied to Leading Cause of Vision Loss in Seniors - Diets heavy in red meat and fatty foods could help spur a leading cause of vision loss in older Americans, new research suggests. The study found that people who ate more typical Western diets were three times more likely to develop an eye condition that robs you of your central vision -- late-stage age-related macular degeneration. "What you eat seems to be important to your vision, and to whether or not you have vision loss later in life," said study lead author Amy Millen. She's an associate professor in the department of epidemiology and environmental health at the University at Buffalo's School of Public Health and Health Professions, in Buffalo, N.Y. "People know that diet influences cardiovascular risk and the risk of obesity, but the public may not know that diet can affect vision loss," Millen said. Age-related macular degeneration occurs when a part of the eye called the macula is damaged. Sometimes this happens when deposits called drusen grow on the macula. Or it can occur when new blood vessels keep forming and leak blood, scarring the macula, according to the American Academy of Ophthalmology. Genetics and smoking are known risk factors for age-related macular degeneration. The study included almost 1,300 people from a nationally representative sample. Most did not have macular degeneration. There were 117 who had early AMD, and 27 had late. All of the study participants completed surveys about their diets twice during the 18-year study. The researchers sorted the foods into 29 categories to measure the quality of the diet. They found that people who ate a more Western diet were much more likely to develop late-stage AMD. Foods linked to a higher risk included: Red and processed meats Fats, such as margarine and butter High-fat dairy Fried foods. "Diet is one way you might be able to modify your risk of vision loss from age-related macular degeneration," Millen said, especially if you have a family history of the disease. She noted that since the study was observational, it couldn't prove that eating healthy foods would reduce the risk of AMD, but she said it did show the foods you probably don't want to eat often. Dr. Avnish Deobhakta, an ophthalmologist at the New York Eye and Ear Infirmary of Mount Sinai in New York City, wasn't involved with the study, but said he wasn't surprised by the findings. "This study shows what we've suspected. A diet high in fatty foods, processed meats and refined grains makes the more severe form of macular degeneration more likely," Deobhakta said. Both Millen and Deobhakta said inflammation caused by a less healthy diet and stress on the cells in the eyes (oxidative stress) are likely behind the increased risk. "The eyes are a sentinel for the rest of the body. In the tiny blood vessels of the eyes, even small changes that you would not otherwise notice in other organs, you will notice in the eyes," Deobhakta said. So can you make up for a lifetime of eating poorly? That's not known. But both experts said that a healthy diet -- full of vegetables (especially dark, leafy greens) and fruits and fatty fish -- contains important nutrients for eye health, including lutein and zeaxanthin. "It's difficult to switch the way you eat overnight, but this is almost certainly a decades-long process, so try to slowly move toward more virtuous behaviour with food. Try to supplement your current diet with more leafy vegetables and increase your consumption of fish," Deobhakta said. And both experts strongly advised no smoking. The study was published in the December issue of the British Journal of Ophthalmology. More information Learn more about macular degeneration from the American Academy of Ophthalmology. healthday kalip
  10. Eggs and cholesterol: Is industry funded research misleading? Whether dietary cholesterol increases levels of cholesterol in the blood is a controversial topic. Although many researchers have investigated this question, a recent review asks whether industry funding has slanted the overall results. Cholesterol is a waxy substance that is essential for good health as it is an important structural component of cell walls. Our liver can produce all of the cholesterol that we need, but we also consume it in animal products. As cholesterol circulates the body, it can cause problems. Low-density lipoprotein (LDL) cholesterol, which people often refer to as "bad" cholesterol, increases the risk of atherosclerosis, which is the accumulation of fatty plaques on the walls of blood vessels. Atherosclerosis increases the risk of stroke, heart attack, and peripheral artery disease. As eggs are high in cholesterol, scientists have raised concerns that they might lead to elevated cholesterol levels in the blood if a person eats them in excess. To investigate this, scientists have carried out many studies over more than 50 years. To date, however, the findings have fallen short of conclusive. The egg industry's role Some experts are concerned that industry funded research is muddying the waters and skewing result As the authors of the recent review explain, "In recent years, the egg industry, working especially through [United States] federally administered programs, has funded studies investigating the effects of eggs on blood cholesterol concentrations." They continue: "[T]he potential for industry funding for research to influence nutrition policy decisions has become an important concern." The primary purpose of the current review was to understand whether the proportion of industry funded studies is growing. The researchers also wanted to see "whether study conclusions reflected their objective findings." In total, the researchers found 211 papers that met their criteria for review, and they published their results in the American Journal of Lifestyle Medicine. The authors note that industry funding has increased significantly. In the 1950s and 1960s, there were no industry funded studies, but from 2010 to 2019, 60% of studies had industry backing. Misrepresenting findings Overall, more than 85% of the studies reported that eggs increased blood cholesterol. However, the findings showed that the authors of industry funded papers were more likely to downplay the significance of these results. In fact, 49% of industry funded papers reported conclusions that did not match their results, compared with 13% of the papers that had not received industry funding. As an example, in one study, the researchers asked college students to eat two eggs with breakfast for 5 days each week for 14 weeks. At the end of the study, the participants' average LDL cholesterol had increased by 15 milligrams per decilitre (mg/dl). To put this into perspective, LDL cholesterol should be under 100 mg/dl for a healthy adult. So, an increase from 100 mg/dl to 115 mg/dl is a 15% rise in LDL cholesterol. Although this seems to be a substantial rise, in this study, it did not reach statistical significance. In other words, there was more than a 5% chance that the increase could have occurred by chance. As a result, the authors of the study concluded that an "additional 400 mg/day of dietary cholesterol did not negatively impact blood lipids." Study author Dr. Neal Barnard explains that "t would have been appropriate for the investigators to report that the cholesterol increases associated with eggs could have been due to chance. Instead, they wrote that the increases did not happen at all. Similar conclusions were reported in more than half of industry funded studies." The authors write, "It is important to differentiate between the absence of a statistically significant difference and the absence of a difference." Influencing policy The findings of this review are particularly worrying because this line of research has the power to influence policy. In 2015, for instance, the U.S. Dietary Guidelines Advisory Committee wrote that "available evidence shows no appreciable relationship between consumption of dietary cholesterol and serum cholesterol." However, after reviewing the available evidence, in the final guidelines, they called for eating "as little dietary cholesterol as possible." According to the Centres for Disease Control and Prevention (CDC), about 95 million adults over the age of 20 years have high cholesterol. Giving the public the right advice is of paramount importance. "In decades past, the egg industry played little or no role in cholesterol research, and the studies' conclusions clearly showed that eggs raise cholesterol," explains Dr. Barnard. "In recent years, the egg industry has sought to neutralise eggs' unhealthy image as a cholesterol-raising product by funding more studies and skewing the interpretation of the results." In particular, the authors identify the American Egg Board, which is a federally authorised, industry funded body. Their mission is "to increase demand for all U.S. eggs and egg products." Over the years, scientists have carried out a number of meta-analyses to assess the effect of egg consumption on levels of LDL cholesterol in the blood. As one example, a recent analysis that collated results from 28 studies concluded that eating eggs significantly increases both total cholesterol and LDL cholesterol concentrations. "The egg industry has mounted an intense effort to try to show that eggs do not adversely affect blood cholesterol levels. For years, faulty studies on the effects of eggs on cholesterol have duped the press, public, and policymakers to serve industry interests." Study author Dr. Neal Barnard https://www.medicalnewstoday.com/ kalip
  11. Ultra-processed foods may raise the risk of type 2 diabetes Sugary drinks, packaged snacks, and ready-made meals all count as ultra-processed foods — that is, foods that contain a higher number of additives and last longer because of the added preservatives. New research suggests that these foods also raise the risk of type 2 diabetes. Sugary drinks, packaged snacks, and ready-made meals all count as ultra-processed foods — that is, foods that contain a higher number of additives and last longer because of the added preservatives. New research suggests that these foods also raise the risk of type 2 diabetes. Share on Pinterest Some packaged foods may be ultra-processed and raise the risk of type 2 diabetes, according to new research. Research has linked ultra-processed foods with conditions such as cancer, obesity, and cardiovascular disease, as well as with a higher risk of premature mortality. These foods are prevalent in Western diets, and the Western world has also seen a surge in the incidence of diabetes in recent decades. Are ultra-processed foods and type 2 diabetes linked? And if so, how? Bernard Srour, Ph.D., of the Epidemiology and Statistics Research Centre–University of Paris in France, and his team of researchers set out to answer this question. They did so by examining the dietary habits of more than 100,000 people. The results of their analysis appear in the journal JAMA Internal Medicine. Ultra-processed foods and diabetes Srour and team carried out a population-based prospective cohort study in which they included 104,707 adult participants who had participated in the French NutriNet-Santé study. Of these participants, 21,800 were men, and 82,907 were women. The NutriNet-Santé study spanned a decade, running from 2009 to 2019. The researchers collected data on the dietary intake of the participants using repeated 24 hour dietary records that asked them about their consumption of about 3,500 different foods. Using the NOVA classification system, the researchers classified the 3,500 food items according to their degree of processing. There were four categories: unprocessed/minimally processed foods, culinary ingredients, processed foods, and ultra-processed foods. The researchers used multivariable Cox proportional hazard models, which they adjusted for the known risk factors for type 2 diabetes, such as sociodemographic background, lifestyle, and medical history. Ultra-processed foods may raise risk Srour and colleagues found a consistent association between the absolute amount of ultra-processed food consumption, which they measured in grams per day, and the risk of type 2 diabetes. "In this large observational prospective study, a higher proportion of [ultra-processed foods] in the diet was associated with a higher risk of [type 2 diabetes]," conclude the authors. Srour and colleagues add: "Even though these results need to be confirmed in other populations and settings, they provide evidence to support efforts by public health authorities to recommend limiting [ultra-processed food] consumption." The researchers say that ultra-processed foods are a modifiable risk factor for type 2 diabetes. They also point to countries such as France and Brazil, whose public health authorities have already started encouraging the population to eat minimally processed foods and avoid ultra-processed ones as a precautionary measure. What might explain the link? The researchers did not single out one type of food or ingredient but instead looked at the cumulative effect of ultra-processed foods on type 2 diabetes risk. The authors recommend caution in interpreting the associations that they found. Most of the additives in ultra-processed foods "are likely to be neutral for long-term health, and some may even be beneficial," they write, giving antioxidants as an example. However, there are other compounds that recent studies in mice and in vitro have suggested may be harmful. For instance, "carrageenan, a thickening and stabilizing agent, [...] might contribute to the development of diabetes by impairing glucose tolerance, increasing insulin resistance, and inhibiting insulin signalling," write the authors. Nonetheless, they caution that more research in humans is necessary before drawing conclusions about the harms of such compounds. Chemicals such as phthalates and bisphenol A (BPA), which are often present in plastic packaging, may contaminate many ultra-processed foods. BPA and phthalates may disrupt endocrine function, and the authors note that some recent meta-analyses have shown that high concentrations of these compounds are associated with a higher risk of type 2 diabetes. Furthermore, research has associated metabolites that form as a result of high-temperature cooking — such as acrylamide and acrolein metabolites — with insulin resistance. "Finally, industrial partial oil hydrogenation may lead to the creation of trans unsaturated fatty acids in products containing hydrogenated oils," mention the authors. "Although still debated, trans fats were linked to increased risks of heart disease and [type 2 diabetes]," they note. Nevertheless, Srour and team conclude: "Additional research is needed to understand the biological mechanisms underlying the present observations." https://www.medicalnewstoday.com/ kalip
  12. Black Patients May Not Gain Heart Benefit From Low-Dose Aspirin The daily use of low-dose aspirin against heart disease may have taken another knock. New research shows that the practice may not provide black Americans with any lowering of their heart attack risk. Researchers analysed 11 years of data from more than 65,000 people, ages 40-79, living in the American Southeast. More than two-thirds of the participants were black, and about two-thirds were at high risk for heart attack or stroke at the start of the study period. Taking low-dose aspirin was associated with a reduced risk of a fatal heart attack in whites, particularly in white women, but it did not appear to lower the risk among blacks, even among those with the highest risk of heart disease, the research found. The reasons for the "race gap" in aspirin effectiveness are unclear, but "we think the reason aspirin use did not have a beneficial effect for African Americans could involve a different genetic response to aspirin therapy and poor control of other risk factors," said study lead author Dr. Rodrigo Fernandez-Jimenez. He's a cardiologist and researcher at National Centre for Cardiovascular Research in Madrid, Spain. The researchers stressed that the study wasn't designed to prove cause and effect, only showing associations between aspirin use and heart health. The findings were published Dec. 11 in the Journal of the American Heart Association. While millions of aging Americans take a daily low-dose (81 milligrams) aspirin in hopes of reducing their odds for heart attack and cancer, new data has emerged casting the practice in doubt. In fact, earlier this year, the American Heart Association and the American College of Cardiology issued a joint statement that -- at least in older people at low risk for heart disease -- daily aspirin use was probably not worth it, given the added risk for bleeding tied to the drug. Dr. Benjamin Hirsh directs preventive cardiology at Northwell Health's Sandra Atlas Bass Heart Hospital in Manhasset, N.Y. He reviewed the study and agreed that "physicians are accustomed to prescribing aspirin to patients with lower risk of heart disease, but the findings of this study and others are changing this practice." Also, most of the previous research on aspirin's usefulness against heart trouble was based on data from white patients, Fernandez-Jimenez noted. "Most available data shows that African Americans have a higher risk of having a heart attack, stroke or other heart diseases compared to whites; however, previous studies didn't include enough black participants to determine if taking a low-dose aspirin for primary prevention of heart disease was useful for this group of people," he said in a journal news release. Dr. Satjit Bhusri is a cardiologist at Lenox Hill Hospital in New York City. He stressed that aspirin is still being recommended for people at high risk of a heart attack, such as those who've already had an attack. So why didn't that benefit seem to extend to black patients? "There may be an underlying genetic, compliance or socioeconomic play here," said Bhusri, who wasn't involved in the new study. In the meantime, informed decisions as to who is "high-risk," regardless of race, are easily made, Hirsh said. "We now have multiple tools including imaging scans, such as coronary calcium scores, which help identify individual risk to guide the recommendation for aspirin," Hirsh explained. "We need to individualise our patients' risk of heart disease in order to determine who will be most likely to benefit from aspirin." That's in keeping with American Heart Association guidelines, which now advise that decisions about aspirin use must be based on a patient's specific health status, in consultation with their physician. More information The U.S. Centers for Disease Control and Prevention has more on heart disease prevention. https://consumer.healthday.com/ kalip
  13. Stroke: Excessive sleep may raise risk by 85% Stroke is one of the leading causes of death and disability worldwide and in the United States, specifically. New research finds that excessive sleep considerably raises the risk of this cardiovascular problem. Share on Pinterest New research suggests that people who take long naps in the day may be at a higher risk of stroke. Globally, 15 million Trusted Source people experience a stroke each year. Almost 6 million of these people die as a result, and 5 million go on to live with a disability. In the U.S., over 795,000 Trusted Source people have a stroke each year. The list of traditional risk factors Trusted Source for stroke is long, ranging from elements of lifestyle, including smoking, to pre-existing conditions, such as diabetes. More recently, researchers have started exploring sleep duration as another potential risk factor. Some studies Trusted Source have found that either too much or too little sleep can increase the risk of cardiovascular events, including stroke. According to these findings, regular sleep deprivation and sleep for more than 7 hours per night are each associated with a higher risk of stroke. Now, a study appearing in the journal Neurology finds an association between daytime naps, excessive sleep, and stroke risk. Dr. Xiaomin Zhang, from Huazhong University of Science and Technology, in Wuhan, China, is the corresponding author of the paper that details this study. 85% higher risk in long sleepers, nappers Dr. Zhang and the team collected information from 31,750 people in China. None of the participants — who were 62 years old, on average — had a history of stroke or any other serious health condition at the start of the study. The participants answered questions about their sleeping patterns and napping habits, and the researchers clinically followed the group for an average of 6 years.The team found that 8% of the participants were in the habit of taking naps that lasted longer than 90 minutes, and 24% reported sleeping for at least 9 hours each night. Over the study period, there were 1,557 strokes among the participants. Those who slept for 9 or more hours per night were 23% more likely to experience a stroke than those who regularly slept only 7–8 hours each night. People who got less than 7 hours of shuteye or 8–9 hours had no higher risk of stroke than those who slept 7–8 hours. Importantly, people who both slept for longer than 9 hours and napped for more than 90 minutes per day had an 85% higher risk of stroke than those who slept and napped moderately. Finally, sleep quality seemed to play a role — people who reported poor sleep quality were 29% more likely to have a stroke than those whose sleep quality was reportedly good.These results continued to be significant after adjusting for potential confounders, such as hypertension, diabetes, and smoking. "These results highlight the importance of moderate napping and sleeping duration and maintaining good sleep quality, especially in middle-age and older adults." Dr. Xiaomin Zhang Study limitations and potential mechanisms The researchers acknowledge some limitations to their work, as well as the fact that more research is necessary. First, because the study was observational, it cannot prove causality. Second, the research did not account for sleep apnoea or other sleep disorders that may have influenced the results.Third, self-reported data is not as reliable as data recorded by researchers who observe participants' sleep. Finally, the results may only apply to older, healthy Chinese adults and not to other populations. "More research is needed to understand how taking long naps and sleeping longer hours at night may be tied to an increased risk of stroke, but previous studies have shown that long nappers and sleepers have unfavourable changes in their cholesterol levels and increased waist circumferences, both of which are risk factors for stroke," explains Dr. Zhang."In addition, long napping and sleeping may suggest an overall inactive lifestyle, which is also related to increased risk of stroke." https://www.medicalnewstoday.com/ kalip
  14. What to know about CoQ10 and its dosage? Coenzyme Q10, or CoQ10, is a naturally occurring chemical that exists in almost every cell of the human body. CoQ10 carries out several vital roles, including promoting energy production and neutralising harmful particles called free radicals. A deficiency in CoQ10 can adversely affect a person's health. People can get CoQ10 through foods and supplements. In this article, we discuss the benefits, side effects, and recommended dosages of CoQ10. What is CoQ10? Coenzyme Q10, or CoQ10, is a naturally occurring chemical that exists in almost every cell of the human body. CoQ10 carries out several vital roles, including promoting energy production and neutralising harmful particles called free radicals. A deficiency in CoQ10 can adversely affect a person's health. People can get CoQ10 through foods and supplements. In this article, we discuss the benefits, side effects, and recommended dosages of CoQ10. What is the correct dosage? The exact recommended dose of CoQ10 will vary according to the following factors: • a person's age • a person's health • the condition receiving treatment Standard daily doses of CoQ10 Trusted Source range from 60 milligrams (mg) to 500 mg. The highest recommended dose is 1,200 mg. However, clinical trials have used dosages as high as 3,000 mg per day. Different types of CoQ10 supplements may also require different dosages. Most supplements contain the inactive form of CoQ10, ubiquinone, which is harder to absorb than ubiquinol. A 2018 randomised trial compared the effects of 200 mg daily doses of ubiquinone and ubiquinol supplements on CoQ10 levels in older men. Ubiquinol supplementation led to a 1.5-fold increase in the amount of CoQ10 in the blood. Supplements containing ubiquinone did not have a significant effect on CoQ10 levels. Benefits of CoQ10 CoQ10 protects cells against oxidative damage. It also plays a vital role in producing the body's primary source of energy, ATP. CoQ10 could, therefore, provide a range of health benefits. Some examples include: Improving heart health The heart contains some of the highest concentrations of CoQ10 in the body. The vast majority of people with heart disease also have low CoQ10 levels. Researchers Trusted Source now consider low CoQ10 levels to be an indicator of the severity and long-term outcome of various heart diseases. In one 2018 pilot study Trusted Source, ten children with cardiac muscle dysfunction received 110–700 mg of liquid ubiquinol per day. At weeks 12 and 24 of treatment, the children had significantly higher CoQ10 plasma levels and improved heart function. Reducing muscle pain from statin use Cardiovascular disease (CVD) is an umbrella term for conditions that affect the heart or blood vessels. Doctors often prescribe statins to treat CVD. These drugs work by reducing the cholesterol production that can contribute to the disease. Although statins reduce cholesterol production, they also lower CoQ10 levels. Reduced CoQ10 levels can lead to mitochondrial dysfunction, which can cause muscle pain Trusted Source, or myopathy. CoQ10 supplements may help relieve muscle pain related to statin use. A 2019 randomised controlled trial Trusted Source investigated the effect of CoQ10 on statin-related muscle pain. The study involved 60 participants who had previously reported muscle pain while taking statins. Over 3 months, each participant received daily doses of either 100mg of CoQ10 supplement or a placebo. The participants who took the CoQ10 supplements had significantly reduced statin-related muscle pain. Those who received the placebo reported no change in muscle pain. However, the authors of a 2015 meta-analysis evaluated the efficacy of CoQ10 supplementation for treating statin-related muscle pain. The meta-analysis included six studies with a combined total of 302 patients. The authors found no evidence that CoQ10 significantly improves statin-related muscle pain. Further large-scale RCTs are necessary to determine whether CoQ10 is a viable treatment for people experiencing statin-related muscle pain. Treating migraines Chronic migraines may be due to inflammation of neurons and cells in a part of the brain called the trigeminovascular system. A 2018 clinical trial investigated whether coQ10 supplements could reduce inflammation in 45 women with episodic migraines. The women took 400 mg daily doses of either a CoQ10 supplement or a placebo. The women who took the CoQ10 supplements had fewer and less intense migraines when compared to the placebo group. Women who took the CoQ10 supplements also showed lower levels of certain inflammatory biomarkers. Inflammatory biomarkers are substances in the blood that indicate the presence of inflammation somewhere in the body. A 2018 meta-analysis re-examined five studies investigating the use of CoQ10 supplements for migraines. The meta-analysis concluded that CoQ10 is more effective than a placebo at reducing the duration of migraines. However, CoQ10 did not appear to affect migraine severity or frequency. Protecting against age-related diseases Mitochondrial function decreases as the body's CoQ10 levels naturally deplete with age. Research Trusted Source suggests that mitochondrial dysfunction can contribute to age-related neurodegenerative diseases, including Alzheimer's disease and Parkinson's disease. These diseases are associated with free radical damage. A 2015 study investigated the effect of a Mediterranean diet combined with CoQ10 supplementation on metabolism in elderly adults. This combination led to an increase in antioxidant biomarkers in the urine. The authors concluded that taking CoQ10 and eating a diet low in saturated fat may help protect against diseases caused by free radical damage. In another 2015 study Trusted Source, older adults received CoQ10 and selenium supplements for 48 months. The participants reported improvements in vitality, physical performance, and overall quality of life. Risks of too much CoQ10 CoQ10 supplements appear to be safe, and most people tolerate them even at high doses. However, CoQ10 supplements can cause the following side effects: • nausea • stomach pain • heartburn • headache • dizziness • fatigue • light sensitivity • insomnia • skin rash CoQ10 supplements may interfere with certain medications, including: • blood-thinners, such as warfarin • insulin • some types of chemotherapy medication People should consult a doctor before taking any new medications or dietary supplements, including CoQ10. Summary CoQ10 is an antioxidant that exists in almost every cell of the human body. CoQ10 deficiency is associated with various medical conditions, such as heart disease, cancer, and Alzheimer's disease. Although the body naturally produces CoQ10, some people may benefit from taking supplements. Overall, CoQ10 supplements appear relatively safe and cause few side effects. Supplements are not regulated by the Food and Drug Administration (FDA) for purity or verified for labeling accuracy, so purchase only those products that have been tested by an independent lab. People who are interested in trying CoQ10 supplements may want to consult a healthcare professional first. Experts do not recommend CoQ10 for people taking blood-thinning medications, insulin, or certain chemotherapy drugs. CoQ10 is available in some drug stores, pharmacies, and online. https://www.medicalnewstoday.com/ kalip
  15. Low-Dose Aspirin Might Cut Cancer Risk Daily low-dose aspirin might reduce your risk of dying from cancer, particularly if you've packed on a few extra pounds, researchers say. Taking aspirin three or more times a week is associated with a lower risk of cancer death as well as death for any reason, a new study report. Aspirin's protective effect appears particularly pronounced among people who are overweight -- those with a body mass index of 25 to 29.9, the results show. Low-dose aspirin reduced overall cancer death risk by 15% and all-cause death by 19% among more than 146,000 people who participated in a cancer screening trial conducted between 1993 and 2008, the study authors said. Overweight folks also experienced a marked decline in their risk of death from gastrointestinal cancer (28%) and colon cancer (34%). "Our primary focus was really on colorectal cancer deaths, since there's a lot of evidence to suggest that aspirin use may lower risk of gastrointestinal deaths," said lead researcher Holli Loomans-Kropp, a cancer prevention fellow with the U.S. National Cancer Institute. The study results support the standing recommendation of the U.S. Preventive Services Task Force (USPSTF), which says people 50 to 59 should take low-dose aspirin to prevent colon cancer if they're not at increased risk for bleeding. Daily aspirin use as a preventive health measure has become controversial over the past few years, however. In March, the American College of Cardiology and the American Heart Association changed their guidelines to restrict low-dose aspirin use to people at high risk for heart disease or stroke. The two groups argued that the bleeding risk from aspirin outweighed the heart benefits for healthy people. The USPSTF continues to recommend low-dose aspirin for middle-aged people for heart health, if they have a 10% or greater chance of developing heart disease within the next decade. The new study involved a re-analysis of data gathered during the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial, which was sponsored by the National Cancer Institute. No one knows why aspirin might have this protective effect, but Loomans-Kropp said evidence points toward its anti-inflammatory action. "Gastrointestinal cancers are highly inflammation-associated cancers, and where the strongest effect has been is with the gastrointestinal cancers," Loomans-Kropp said. It's also possible that aspirin's blood-thinning effect might play a role, said Eric Jacobs, senior scientific director of epidemiology research at the American Cancer Society. "Aspirin may help prevent cancer the same way that it helps prevent heart attacks, which is by blocking the activation of blood platelet cells," Jacobs said. "We know that activated platelets can release factors that help tumours grow, and activated platelets may also help cancers spread throughout the body." People worried about colon cancer should talk with their doctor about getting screened for the disease, since a colonoscopy can remove polyps before they can develop into cancer, Jacobs said. "Aspirin use is not the only way or the best way to lower risk of colorectal cancer," Jacobs said, adding that maintaining a healthy weight, being physically active, quitting smoking and eating less red meat also can help reduce your risk. Anyone thinking about taking daily aspirin should discuss it with their doctor first, said Dr. Merry Jennifer Markham, a spokesperson for the American Society of Clinical Oncology and a cancer doctor with the University of Florida. "It's important to have a discussion with the physician about whether the benefits of regular aspirin use outweigh the harms," Markham said. "I don't believe this is a one-size-fits-all approach, and must be individualized based on the individual person's other health issues and bleeding risks." The new study was published online Dec. 4 in JAMA Network Open. https://consumer.healthday.com/ kalip
  16. Ingredients 2 tablespoons olive oil 1 medium onion (chopped) 2 large stalks celery(chopped) 4 cloves garlic (pressed) 1 red medium bell pepper (chopped) 1 cup carrot (chopped or chopped pumpkin if available) 1 heaping tablespoon sweet paprika 3 teaspoons turmeric 1/2 teaspoon cinnamon 1 bay leaf 1 tablespoon hot sauce 450 grams can tomatoes (chopped) 5 cups vegetable stock 280 grams green beans (frozen or fresh) 1 large leaf chard (cut into thin strips, or spinach or kale) Preparation In a large soup pot, simmer oil, onion, and celery. Cook over low heat for 5 to 10 minutes to develop more sweetness in the onion. Add garlic and cook for 1 to 2 minutes. Turn up the heat to medium and add the peppers and carrots. Cook another 1 to 2 minutes and add the spices. Stir and cook until fragrant—another minute or so. Add tomatoes and stock, and simmer for 15 minutes. Add beans and chard and simmer for another 5 minutes or until the beans are cooked. (If using cooked cubed meat such as chicken or turkey, add at this time.) Adjust seasonings with salt and pepper as needed. https://www.verywellfit.com/ kalip
  17. Religion vs. Spirituality: What Is the Difference? You may have heard—or even used—the terms religion and spirituality interchangeably. But while they aren’t diametric opposites, neither are they the same. Learn how to tell the difference between religion and spirituality. For thousands of years, humanity has passionately pursued the Truth with a capital T—the ultimate answers to life and the universe. This perennial knowledge constitutes the answers to what are often called the soul questions: Who am I? What do I want? What is my purpose? What is the meaning of life? Historically, from the perspective of the soul, there have been two foundational routes to discover these truths: religion and spirituality. Although they have many similarities and there is a relationship between the two, there are differences between religion and spirituality. Religion: By definition, religion is a personal set or institutionalised system of religious attitudes, beliefs, and practices; the service and worship of God or the supernatural. Spirituality: Spirituality, on the other hand, connotes an experience of connection to something larger than you; living everyday life in a reverent and sacred manner. Or as Christina Puchalski, MD (leader in trying to incorporate spirituality into healthcare), puts it, “Spirituality is the aspect of humanity that refers to the way individuals seek and express meaning and purpose and the way they experience their connectedness to the moment, to self, to others, to nature, and to the significant or sacred." Origins of Religions and Spirituality Religion: Religions are most often based upon the lives, teachings, and beliefs of a historical or archetypal figure (e.g., Christ, Buddha, Moses, Krishna, Muhammad). The details of their lives as holy or highly evolved beings have been carried to us across the mists of time through oral tradition and written scriptures. These figures are the subject of worship and devotion and form the foundation of religious practices and rituals in a community. Spirituality: By contrast, spirituality is more often based upon the practical application of the founder’s teachings. Spiritual aspirants heed the advice of Japanese poet Matsuo Basho, “Do not seek to follow in the footsteps of the wise. Seek what they sought.” The Lines Blur If you feel these definitions get blurry and cross into each other’s territory, you’re not alone. For example, you may know people who consider themselves spiritual, but not religious. Conversely, there can be individuals who are devoutly religious but are not what most would consider deeply spiritual. Let’s try to clear things up by taking a closer look at the most defining differences between religious and spiritual paths. Bear in mind that there are no absolutes in these distinctions. They are merely general markers meant to better explore the qualities between two equally valid approaches to seeking the truth. Objective vs. Subjective Experience Religion: On the whole, a formal religion is often an objective experience. In other words, there is usually a greater focus on the externals: Houses of worship (e.g., a church) Books of scripture Eternal rituals Observances This is the equivalent of object-referral in which your attention is placed upon the objects in your experience. Spirituality: Spirituality, however, leans more toward self-referral or the internalisation of your awareness of your soul. Spirituality is an inward journey that involves a shift in awareness rather than some form of external activity. As such, spirituality is much more about inner understanding than outer worship. This is not to say that worship is not a part of spirituality; it’s a matter of where the devotion and worship are directed: To an external practice, object, or figurehead To your soul, higher self, or divinity within Organised vs. Formless Religion: One of the hallmarks of religion is its organisation. It is a structured, frequently rule-based construct that to some degree governs the behaviour of its members. Moral rules, laws, and doctrines, as well as specific codes and criteria, create the organised structure that contains the religion’s specific belief system. This isn’t necessarily a bad thing. In previous, more uncertain times, the rules and dogma of organised religion helped to give society a sense of certainty and helped to guide and comfort those whose faith was lacking. Spirituality: Spirituality though, breaks free from the restrictions and rigid structure sometimes associated with traditional religion. The spiritual aspirant recognises that he or she is on a “pathless path” of self-discovery. They are following not a set of external rules, but their own inner call to spirit. In this way, spirituality can sometimes feel like a rebellious act of going solo and leaving the tribe, very much in the spirit of American philosopher and poet Ralph Waldo Emerson when he said, “To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment.” Traditional vs. Evolutionary Approach Religion: Due to their centuries- to millennia-old histories, religions are by nature often deeply rooted in tradition, ritual, creed, and doctrine. Religious institutions conservatively guard their practices and values, holding rigidly to the past and the original interpretations of the founder’s teachings. This is understandable in that all religions wish to preserve the essence of their teachings so they may be accurately transmitted through history. Spirituality: By comparison, spirituality is often less focused on the rigidly traditional approach and often favour an evolutionary mentality. This refers to both a more flexible and adaptive mindset toward core teachings of the great wisdom traditions but also reflects the understanding that, as the name implies, spiritual growth is an evolutionary process. Spirituality embraces change and the evolution of consciousness. With spiritual practice, ideas and interpretations change as individuals, societies, and the world move forward. Exclusive vs. Inclusive Religion: Traditional religious beliefs, sometimes based upon rigid interpretations of key teachings, can create an exclusive worldview that isolates those who may not share their views or interpretations. Sadly, this religious “in-group” mentality can be used to justify the exclusion of minorities or those deemed unworthy of God’s favour. Spirituality: Spirituality makes no such distinctions. Instead, it favours an inclusive approach. In the recognition that pure spirit is a unifying force, no one is left out. You are part of the universal hologram, all gods and goddesses in disguise. As Krishna explains in the Bhagavad Gita, Chapter 4, verse 11: “As men approach me, so I receive them. All paths Arjuna, lead to me.” In other words, from a spiritual perspective, no one has a monopoly on the truth. All are welcome in God’s eyes. Belief vs. Spiritual Experience Religion: At its core, religion is about faith. That is to say, belief in something based upon unconditional acceptance of the religion’s teachings. Unlike the scientific worldview, religions don’t require evidence to validate their claims. Through religion, you are taught to have faith in God or the scriptures as being the infallible and ultimate truth of reality. Acceptance and surrender to the divine are taught as the path that leads to ultimate salvation. Spirituality: Spirituality doesn’t dismiss faith; however, it often leans more heavily on direct experience of the soul or divinity. Spiritual practices such as meditation, yoga, silence, and contemplation allow you to make conscious contact with more expanded states of consciousness, thus helping to experientially validate the teachings rather than accepting them on faith alone. You know something because you have tasted the experience yourself and have allowed it to resonate, as opposed to taking the word of another. Fear vs. Love Religion: Despite the best of intentions, religions can sometimes contain a subtle (or not so subtle) undercurrent of fear woven into their teachings. The concepts of original sin, divine judgement, God’s wrath, or eternal punishment can create a mental environment burdened in worry and anxiety over your worthiness and whether your actions will result in divine retribution or karmic punishment. Your fate in the afterlife can loom like a spectre in the back of your mind, subtly influencing your thoughts and behaviour. Spirituality: By contrast, spirituality typically discards the vestiges of fear and worry in favour of a more loving, compassionate approach to life—and death. Spirituality embraces a consciousness-based worldview that supports all human beings on their path to awakening in unconditional love and kindness. Your choices and behaviour are guided not by fear of punishment, but rather by a desire to end suffering and create a peaceful and loving world for all. As you can see, there are noticeable distinctions between spirituality vs. religion; however, these comparisons aren’t meant to be absolutes or an attempt to polarise one against the other. Religious beliefs and spiritual beliefs differ in the ways in which they are practiced. However, each practice serves as a vehicle to lead you closer to the truth you seek. Whichever path or combination of the two you follow is the personal and subjective expression of your journey of awakening. https://chopra.com/articles/ kalip
  18. Surgeons withdraw support for heart disease advice European clinical guidelines on how to treat a major form of heart disease are under review following a BBC Newsnight investigation. Europe's professional body for heart surgeons has withdrawn support for the guidelines, saying it was "a matter of serious concern" that some patients may have had the wrong advice. Guidelines recommended both stents and heart surgery for low-risk patients. But trial data leaked to Newsnight raises doubts about this conclusion. Thousands of people in the UK and hundreds of thousands worldwide will be treated for left main coronary artery disease each year. This is a narrowing of one of the main arteries in the heart. The guidelines on how to treat it were largely based on a three-year trial to compare whether heart surgery or stents - a tiny tube inserted into a blocked blood vessel to keep it open - was more effective. The trial called Excel started in 2010 and was sponsored by big US stent maker, Abbott. It was led by eminent US doctor Gregg Stone and aimed to recruit 2,000 patients. Half were given stents and the other half open heart surgery. Success of the treatments was measured by adding together the number of patients that had heart attacks, strokes, or had died. The research team used an unusual definition of a heart attack, but had said that they would also publish data for the more common "Universal" definition of a heart attack alongside it. There is debate around which is a better measure and the investigators stand by their choice. In 2016, the results of the trial for patients three years after their treatments were published in the prestigious New England Journal of Medicine. The article concluded stents and heart surgery were equally effective for people with left main coronary artery disease. But researchers had failed to publish data for the common, "Universal" definition of a heart attack. Newsnight has seen that unpublished data and it shows that under the universal definition, patients in the trial that had received stents had 80% more heart attacks than those who had open heart surgery. The lead researchers on the trial have told Newsnight that this is "fake information". But Newsnight has spoken to experts who say they believe the data is credible. Prof Rod Stables, clinical lead for research at the British Heart Foundation, said this information should have been published and knowing it would have made a "substantial contribution to our ability to appreciate the nuances of the results". Shortly after Excel was published, the professional bodies for heart surgeons and cardiologists got together to write a new set of guidelines. But they had not seen the unpublished Universal definition data. Currently, European guidelines recommend either a stent or open heart surgery for people who have less severe forms of this disease. The European Association for Cardio-thoracic Surgery (EACTS), which helped draw up the guidelines, told Newsnight if the information on the trial is proven to be correct, "the recommendation is unsafe". "It is a matter of serious concern to us that some results in the Excel trial appear to have been concealed and that some patients may therefore have received the wrong clinical advice," Prof Domenico Pagano, EACTS secretary general, said. Newsnight has also learned that as the guidelines were being drawn up, the trial's Data Safety Monitoring Board - an independent body that looks after the interests of patients - was raising concerns. Newsnight has seen emails where they raised concerns about the higher mortality rate amongst those patients who were receiving stents. The board thought this information should be made public, as they were aware new guidelines were being drawn up that would recommend stents or surgery. However, the main investigators chose not to do so at the time. They point out that the board allowed the trial to continue unchanged. Prof Nick Freemantle worked on the guidelines. He told Newsnight he would "never" have agreed the treatments were interchangeable if he had seen the leaked data. He said that the result of making the "wrong recommendation" is that "patients who have received stents [for left main coronary artery disease] will have died who otherwise would have lived for longer, survived for longer, if they'd had open heart surgery". The European Society of Cardiology, the other professional body involved in writing the guidelines, rejected the claim that the guidelines may have caused harm to patients. They stand by the guidelines, which they say were based on more than the Excel trial. 'Dangerous for patients' This year the trial published a further set of its results, showing what had happened to the patients five years after their treatment. This found for every 100 who died after having open heart surgery, 135 people with stents died. Overall, 10% of people who had surgery died in the trial compared with 13% who had stents. Prof David Taggart, a surgeon at Oxford University, resigned from the trial. He says he "had no choice" as he believed the academic paper describing the five-year results did not give enough prominence to the mortality data in the trial. The NEJM had recommended that the researchers should give it greater prominence too. Prof Taggart said he believed the paper's final paragraph, which concluded that there was "no significant difference" between stents and open heart surgery was "dangerous for patients". When challenged by Newsnight, the trial's principal investigator, Dr Gregg Stone, said he believed that it had been given sufficient prominence and had been considered to meet NEJM's standards. Sponsors of trials like this are also responsible for making sure all results are published. When Newsnight contacted Abbott, the sponsors of the trial, they directed the BBC towards the trial's main researchers. The EACTS has now urged their members to "disregard the guidelines relating to left main disease for the time being". "We recommend that patients seek the advice of the multidisciplinary heart team at their hospital before deciding which treatment option is most appropriate for them," said Prof Domenico Pagano. Conflicts of interest In the course of the investigation, Newsnight found a larger debate within the medical community about the way that conflicts of interest are handled. There is one school of thought that says they raise questions and need to be carefully managed because of potential bias - conscious or unconscious. Others say that interactions between research and business are vital and there is a real public good to be gained by them. In the Excel trial, the four main investigators all declared conflicts of interest. Lead investigator Prof Gregg Stone declared he had received personal fees or held equity in 20 private medical companies, several of which made tools that helped with putting in stents. He's also the course director for TCT, an annual medical conference where the results were presented. TCT makes money from exhibitors including some of the biggest stent makers - Abbott, who sponsored the trial, Boston Scientific and Medtronic. Prof Pieter Kappetein, who worked on the trial and on the body that worked on the guidelines, declared that he had left the guidelines body to go and work for Medtronic, a medical device manufacturer that makes stents. Newsnight found that he'd become chief medical officer of Medtronic Structural Heart. By Newsnight's count, around half of the investigators on the trial had declared personal fees from companies that made stents, and around a third of those on the taskforce writing the guidelines. These relationships are all within the rules. https://www.bbc.com/news/health kalip
  19. How to Fit Meditation into Your Day Sometimes the biggest challenge in learning a new skill or practice like meditation is learning how to fit it into your routine. Most everyone has those days when it is a feat to even have showered, let alone setting time aside to sit quietly and meditate. Here you will learn how to fit your meditation practice into your busy day—perhaps when you need it the most. Give the skills outlined below a try for one week. Consider it a one-week experiment in learning how to take what you've learned into the "real world." Make a commitment to follow these simple steps every day of the week. What You’ll Do A good meditation practice does not end when the timer goes off. Too often, once a meditation session stops, it may only take moments before you get caught up in the stresses and routines of the day and many of the benefits of having had meditated are erased. Meditation should not be seen as a temporary break, but rather a transformative process that enriches your life and the lives around you. This week, we’ll work on bringing meditation “off the cushion” and into the rest of your life. How It Works By adding brief “reminder” or "mini" practices into your day, you can maintain some of the benefits of meditation all day long. By using a few simple techniques to achieve a brief meditative state, you’ll be able to work your meditation practice into your daily activities to achieve lasting calm and focus. Get Motivated for Week 4 With these practices, you’ll be able to evoke a meditative state—however brief—whenever you need some calm or creativity in your life. Doing meditations in a variety of environments will help you stay focused and in control of your mind. You won’t be as influenced by impulsive emotions and will be able to focus more on what you would like to do. The Steps to Meditate Every Day Below are six techniques for working meditation and the mindfulness that comes with it into your daily life. Try at least one of these each day this week to find what works best for you: Chore Meditation: Any repetitive chore can be turned into a meditation simply by adding a focusing element. You can count your breaths while cleaning counters, folding laundry, or washing windows, for example. Any chore that is automatic in nature and does not require decision-making while you are doing it works well. Take a moment for mindfulness. Walking Meditation: While taking a walk, link your breathing with your steps. A traditional walking meditation practice (made popular by Vietnamese monk Thich Nhat Hanh) is to take a step with each breath. This slow walking meditation practice can be very powerful. If you don’t have the time or place for slow walking, then just take a breath with every two or three steps while walking down the hall, across a parking lot, or in a store. Exercise Meditation: Turn exercise into meditation by focusing your mental energy on your body. Picture the push and pull of your muscles. Feel how your body gracefully adjusts to your movements. Be amazed at your balance. Even better, try out an exercise program that is rooted in breath and mindfulness like tai chi or yoga. Two Breaths: Taking two simple, mindful breaths can engage your meditative state at any point in the day. Take two breaths before making a phone call, answering an e-mail, or starting your car. This is a great way to bring meditation into your day dozens of times, particularly in the midst of a busy or stressful day when you need it the most. Sound Cue: Choose a particular sound, and take two breaths every time you hear it. Traditionally, monks would do this when they heard the wind chimes and bells of the temple. Choose a sound that occurs frequently in your setting. You could take a five-second pause in your thinking whenever you hear someone else’s cell phone, for example. Transitions: Transitions are times when you move from one setting to another. Coming home from work, for example, is a transition from your professional self to your private self. Going into some meetings, you may transition into a different personal style in order to get something done. Lunchtime may be a transition for you as well. Traditionally, monks would pause every time they crossed a threshold and transitioned from one room to another. Pick a few transitions in your daily life (like getting into your car, walking into your workplace, and opening your front door), and take a five-second meditative pause before entering the new setting. Perhaps you will even make opening a certain computer program or checking your e-mail a transition. Your Meditation Commitment This Week: "This week I will try at least one of these brief meditation practices every day." Tips Don’t be tempted to substitute these practices for your daily meditation. You must maintain your daily habit of sitting and focusing. That habit will allow you to use these practices effectively. You develop your “meditation muscles” by sitting and focusing. These new applications are about using that new strength in your daily life for an extra boost. In the beginning, try to pick practices that you can do when you are alone. It is difficult to take two mindful breaths while talking to someone, or even when you are in a situation where other people can watch you. Your car is a great place for a bit of privacy. While you are working on your computer or doing laundry are also good times for these meditation moments. Look at an anatomy book and marvel at the human body. As you go through your day, you can do an “exercise meditation” that focuses on whatever your body is doing. You could simply be walking, typing, or going up the stairs. Picture how the muscles and nerves work. Be awed by your own body. Ready for More? If you want to do more, try developing a mindfulness practice. In mindfulness, the idea is to be aware of whatever you are doing. The opposite of mindfulness is an automatic action. Pick something you do often during the day, like opening a door. Can you be aware of yourself opening the door each time? Are you really present as you open the door? Are you aware of your hand on the door, the door opening, your body crossing through and the door closing behind you? Or is it an automatic process without awareness? Develop your mindfulness skills by picking something that you do often and trying to be aware of yourself doing it each time. It is a lot harder than it sounds, and it takes practice. https://www.verywellmind.com/ kalip
  20. The Risks of Having an Exercise Addiction While it may not necessarily sound like a bad thing to everyone, exercise addiction can lead to real problems, so you may be wondering, what is exercise addiction? After all, numerous studies have demonstrated the physical and emotional health benefits of regular exercise — it is essential to our well-being. Unlike many other addictive behaviours, we are encouraged to exercise more. However, there is such a thing as exercise addiction — and it can have harmful consequences. Characteristics of Exercise Addiction Several characteristics distinguish healthy regular exercise from exercise addiction. Firstly, exercise addiction is maladaptive, so instead of improving a person’s life, it causes more problems. Exercise addiction can threaten health, causing injuries, physical damage due to inadequate rest, and in some instances (particularly when co-occurring with an eating disorder), malnutrition and other problems. Secondly, it is persistent, so an exercise addict exercises too much and for too long without giving the body a chance to recover. We all overexert ourselves on occasion and usually rest afterward. But people with exercise addiction exercise for hours every day, regardless of fatigue or illness. As the individual’s principle way of coping with stress, they experience anxiety, frustration, or emotional discomfort if they are unable to do so. The Confusion and Controversy About Exercise Addiction Exercise addiction is probably the most contradictory of all the addictions. As well as being a widely promoted health behaviour, important for the prevention and treatment for a range of ailments, exercise can be an effective part of treatment for other mental health problems. Exercise is even promoted as part of a complete program of recovery from other addictions. It forms part of new and effective approaches to treating mental health problems which commonly co-occur with or underlie addictions such as depression and borderline personality disorder (BPD). It's understandable how some are confused by how exercise could be an addiction itself. Like other behavioural addictions, exercise addiction is a controversial idea. Many experts balk at the idea that excessive exercise can constitute an addiction, believing that there has to be a psychoactive substance that produces symptoms — such as withdrawal — for an activity to be a true addiction. Although there is considerable research showing that exercise releases endorphins (opioids produced within the body), and excessive exercise causes tolerance to the hormones and neurotransmitters released, these physiological processes are often not considered comparable to other substance addictions. Exercise addiction is not currently included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the gold standard for the diagnosis of mental disorders, although several authors have suggested diagnostic criteria. Excessive exercise is included in the DSM-5 as one of the criteria for the eating disorder bulimia nervosa, along with other “compensatory behaviours” used to prevent weight gain, such as self-induced vomiting, fasting, and misuse of laxatives. How Is Exercise Addiction Like Other Addictions? There are several similarities between exercise addiction and drug addiction, including effects on mood, tolerance, and withdrawal. Neurotransmitters and the brain's reward system have been implicated in exercise and other addictions. For example, dopamine has been found to play an important role in overall reward systems, and regular, excessive exercise has been shown to influence parts of the brain involving dopamine. Like other addictive substances and behaviours, exercise is associated with pleasure and social, cultural or sub-cultural desirability. People who develop exercise addiction tend to be inflexible in their thinking, similar to people with other addictions, and this can reinforce the pattern of addiction by helping them to exercise regularly. In addition, research shows that even people at high risk of developing exercise addiction are supported in exercising by family and friends. Healthy Fitness vs. Exercise Addiction Only 8% of gym users meet the criteria for exercise addiction. In the classic pattern of addiction, exercise addicts increase their amount of exercise to re-experience feelings of escapism or the natural high they had previously experienced with shorter periods of exercise. They report withdrawal symptoms when they are unable to exercise, and tend to go back to high levels of exercise after a period of abstinence or control. Three percent of gym users feel they cannot stop exercising. While many reasons for exercising are shared among exercisers whether or not they are addicted — health, fitness, weight management, body image, and stress relief — exercisers who are not addicted cite other reasons that exercise addicts do not share, such as social enjoyment, relaxation, and time alone. People at risk for exercise addiction have difficulties in other areas in their lives that drive them to exercise to dangerous levels. They feel strongly that exercise is the most important thing in their life, and they use exercise as a way to express emotions including anger, anxiety, and grief, and to deal with work and relationship stress. Some know that their excessive exercising has caused conflicts with their family members. A central function of exercise addiction is the sense of control — over mood, the body, the environment — that exercise provides. It also provides a sense of structure. Ironically, as with other addictions, the attempt to exert control eventually leads to a loss of control over the ability to balance the activity with other priorities in life. What to Do If You Think You May Be Addicted to Exercise Exercise is a great way to manage stress and to address negative feelings. If your need for exercise is greater than your ability to manage your relationships and feelings, you may need more help, both to overcome your addiction and to find healthier ways of coping. Speak with your doctor about the best way to treat your addiction. https://www.verywellmind.com/ kalip
  21. 7 Blue Zone Foods to Include in Your Diet For a long life and better health, try boosting your intake of foods that people living in Blue Zones have in their diet. A concept developed by National Geographic Fellow and author Dan Buettner, Blue Zones are areas across the globe where people tend to live the longest and have remarkably low rates of heart disease, cancer, diabetes, and obesity. With their strikingly high concentrations of individuals who live to be over 100-years-old, Blue Zones include the following regions: Ikaria, Greece; Okinawa, Japan; the province of Ogliastra in Sardinia, Italy; the community of Seventh-Day Adventists in Loma Linda, California; and Costa Rica’s Nicoya Peninsula. Although food choices vary from region to region, Blue Zone diets are primarily plant-based, with as much as 95 percent of daily food intake coming from vegetables, fruits, grains, and legumes. People in Blue Zones typically avoid meat and dairy, as well as sugary foods and beverages. They also steer clear of processed foods. A wholesome diet isn’t the only factor thought to lead to longevity for those living in Blue Zones, however. Such individuals also have high levels of physical activity, low stress levels, robust social connections, and a strong sense of purpose. Still, sticking to a vibrant, nutrient-rich eating plan appears to play a key role in the exceptional health of Blue Zone dwellers. Here’s a look at seven foods to include in your own Blue Zone-inspired diet. Legumes From chickpeas to lentils, legumes are a vital component of all Blue Zone diets. Loaded with fibre and known for their heart-healthy effects, legumes also serve as a top source of protein, complex carbohydrates, and a variety of vitamins and minerals. Whether you prefer pinto beans or black-eyed peas, aim for at least a half-cup of legumes each day. Ideal for any meal, legumes make a great addition to salads, soups and stews, and many veggie-based recipes. "If you want to make a three-bean chili for dinner, use dry beans and soak them, cooking them with your own spices and fresh veggies," recommends registered dietician Maya Feller, owner of Maya Feller Nutrition. Dark Leafy Greens While vegetables of all kinds abound in each Blue Zone diet, dark leafy greens like kale, spinach, and Swiss chard are especially prized. One of the most nutrient-dense types of veggies, dark leafy greens contain several vitamins with powerful antioxidant properties, including vitamin A and vitamin C. When shopping for any kind of veggie, remember that people in Blue Zones generally consume locally grown, organically farmed vegetables. Nuts Like legumes, nuts are packed with protein, vitamins, and minerals. They also supply heart-healthy unsaturated fats, with some research suggesting that including nuts in your diet may help reduce your cholesterol levels (and, in turn, stave off cardiovascular disease). "Nuts are a high-fibre food," says Feller. "Almonds, for instance, provide about 3.5 grams of fibre in a one-ounce serving." For healthier snacking, borrow a habit from Blue Zone residents and try a handful of almonds, walnuts, pistachios, cashews, or Brazil nuts. Olive Oil A staple of Blue Zone diets, olive oil offers a wealth of health-enhancing fatty acids, antioxidants, and compounds such as oleuropein (a chemical found to curb inflammation). Many studies have shown that olive oil may improve heart health in a number of ways, such as by keeping cholesterol and blood pressure in check. What’s more, emerging research indicates that olive oil could help protect against conditions like Alzheimer’s disease and diabetes. Select the extra-virgin variety of olive oil as often as possible, and use your oil for cooking and in salads and vegetable dishes. Olive oil is sensitive to light and heat, so be sure to store it in a cool, dark area like a kitchen cabinet. Steel-Cut Oatmeal When it comes to whole grains, those in Blue Zones often choose oats. One of the least processed forms of oats, steel-cut oats make for a high-fibre and incredibly filling breakfast option. Although they’re perhaps best known for their cholesterol-lowering power, oats may also provide plenty of other health benefits. For instance, recent research has determined that oats may thwart weight gain, fight diabetes, and prevent hardening of the arteries. "Oats are known for their fibre content, but they also provide plant-based protein," says Feller. "Oatmeal made with 1/4 cup of steel-cut oats provides 7 grams of protein." Blueberries Fresh fruit is the go-to sweet treat for many people living in Blue Zones. While most any type of fruit can make for a healthy dessert or snack, foods such as blueberries may offer bonus benefits. For example, recent studies have demonstrated that blueberries may help shield your brain health as you age, and fend off heart disease by improving blood pressure control. For other Blue Zone-friendly but sweet-tooth-satisfying eats, look to such fruits as papayas, pineapples, bananas, and strawberries. Barley Another whole grain favoured in Blue Zones, barley may possess cholesterol-lowering properties similar to those of oats, according to a study recently published in the European Journal of Clinical Nutrition. Barley also delivers essential amino acids, as well as compounds that may help stimulate digestion. To get your fill of barley, try adding this whole grain to soups or consuming it as a hot cereal. https://www.verywellhealth.com/ kalip
  22. The sweet danger of sugar Too much added sugar can be one of the greatest threats to cardiovascular disease. Here's how to curb your sweet habit. Sugar has a bittersweet reputation when it comes to health. Sugar occurs naturally in all foods that contain carbohydrates, such as fruits and vegetables, grains, and dairy. Consuming whole foods that contain natural sugar is okay. Plant foods also have high amounts of fibre, essential minerals, and antioxidants, and dairy foods contain protein and calcium. Since your body digests these foods slowly, the sugar in them offers a steady supply of energy to your cells. A high intake of fruits, vegetables, and whole grains also has been shown to reduce the risk of chronic diseases, such as diabetes, heart disease, and some cancers. Consuming too much sugar However, problems occur when you consume too much added sugar — that is, sugar that food manufacturers add to products to increase flavour or extend shelf life. In the American diet, the top sources are soft drinks, fruit drinks, flavoured yogurts, cereals, cookies, cakes, candy, and most processed foods. But added sugar is also present in items that you may not think of as sweetened, like soups, bread, cured meats, and ketchup. The result: we consume way too much added sugar. Adult men take in an average of 24 teaspoons of added sugar per day, according to the National Cancer Institute. That's equal to 384 calories. "Excess sugar's impact on obesity and diabetes is well documented, but one area that may surprise many men is how their taste for sugar can have a serious impact on their heart health," says Dr. Frank Hu, professor of nutrition at the Harvard T.H. Chan School of Public Health. Impact on your heart In a study published in 2014 in JAMA Internal Medicine, Dr. Hu and his colleagues found an association between a high-sugar diet and a greater risk of dying from heart disease. Over the course of the 15-year study, people who got 17% to 21% of their calories from added sugar had a 38% higher risk of dying from cardiovascular disease compared with those who consumed 8% of their calories as added sugar. "Basically, the higher the intake of added sugar, the higher the risk for heart disease," says Dr. Hu. How sugar actually affects heart health is not completely understood, but it appears to have several indirect connections. For instance, high amounts of sugar overload the liver. "Your liver metabolizes sugar the same way as alcohol, and converts dietary carbohydrates to fat," says Dr. Hu. Over time, this can lead to a greater accumulation of fat, which may turn into fatty liver disease, a contributor to diabetes, which raises your risk for heart disease. Consuming too much added sugar can raise blood pressure and increase chronic inflammation, both of which are pathological pathways to heart disease. Excess consumption of sugar, especially in sugary beverages, also contributes to weight gain by tricking your body into turning off its appetite-control system because liquid calories are not as satisfying as calories from solid foods. This is why it is easier for people to add more calories to their regular diet when consuming sugary beverages. "The effects of added sugar intake — higher blood pressure, inflammation, weight gain, diabetes, and fatty liver disease — are all linked to an increased risk for heart attack and stroke," says Dr. Hu. How much is okay? If 24 teaspoons of added sugar per day is too much, then what is the right amount? It's hard to say, since sugar is not a required nutrient in your diet. The Institute of Medicine, which sets Recommended Dietary Allowances, or RDAs, has not issued a formal number for sugar. However, the American Heart Association suggests that men consume no more than 150 calories (about 9 teaspoons or 36 grams) of added sugar per day. That is close to the amount in a 12-ounce can of soda. Subtracting added sugar Reading food labels is one of the best ways to monitor your intake of added sugar. Look for the following names for added sugar and try to either avoid, or cut back on the amount or frequency of the foods where they are found: • brown sugar • corn sweetener • corn syrup • fruit juice concentrates • high-fructose corn syrup • honey • invert sugar • malt sugar • molasses • syrup sugar molecules ending in "ose" (dextrose, fructose, glucose, lactose, maltose, sucrose). Total sugar, which includes added sugar, is often listed in grams. Note the number of grams of sugar per serving as well as the total number of servings. "It might only say 5 grams of sugar per serving, but if the normal amount is three or four servings, you can easily consume 20 grams of sugar and thus a lot of added sugar," says Dr. Hu. Also, keep track of sugar you add to your food or beverages. About half of added sugar comes from beverages, including coffee and tea. A study in the May 2017 Public Health found that about two-thirds of coffee drinkers and one-third of tea drinkers put sugar or sugary flavourings in their drinks. The researchers also noted that more than 60% of the calories in their beverages came from added sugar. Yet, Dr. Hu warns against being overzealous in your attempts to cut back on added sugar, as this can backfire. "You may find yourself reaching for other foods to satisfy your sweet cravings, like refined starches, such as white bread and white rice, which can increase glucose levels, and comfort foods high in saturated fat and sodium, which also cause problems with heart health," he says. Where does your added sugar come from? Rank Food group Proportion of average intake 1 Soda/energy/sports drinks 42.2% 2 Grain-based desserts 11.9% 3 Fruit drinks 8.5% 4 Dairy desserts 5.5% 5 Candy 5.0% 6 Ready-to-eat cereals 2.9% 7 Sugars/honey 4.1% 8 Tea 3.8% 9 Yeast breads 2.3% 10 Syrups/toppings 1.4% Source: CDC, National Health and Nutrition Examination Survey, 2005–06. https://www.health.harvard.edu/ kalip
  23. Low-dose aspirin 1. About low-dose aspirin Daily low-dose aspirin is a blood thinning medicine. Aspirin is also known as acetylsalicylic acid. Low-dose aspirin helps to prevent heart attacks and strokes in people at high risk of them. Your doctor may suggest that you take a daily low dose if you have had a stroke or a heart attack to help stop you having another one. Or, if you're at high risk of heart attack - for example, if you have had heart surgery or if you have chest pain caused by heart disease (angina). Only take daily low-dose aspirin if your doctor recommends it. Low-dose aspirin comes as tablets. It's available on prescription. You can also buy it from pharmacies, shops and supermarkets. Children are sometimes treated with low-dose aspirin after heart surgery or to treat a rare illness called Kawasaki disease. Children should only take low-dose aspirin if their doctor prescribes it. Taking low-dose aspirin to prevent heart attacks and strokes is not the same as taking aspirin as a painkiller. Read our information on aspirin for pain relief. 2. Key facts • Daily low-dose aspirin makes the blood less sticky and helps to prevent heart attacks and stroke. • It's usual to take a dose of 75 mg once a day. Sometimes doses may be higher. • It's best to take low-dose aspirin with food so it doesn't upset your stomach. • Taking low-dose aspirin isn't safe for everyone. Only take low-dose aspirin if your doctor recommends it. • Low-dose aspirin is also called by the brand names Caprin, Danamep, Micropirin and Nu-seals. 3. Who can and can't take low-dose aspirin Most people aged 16 or over can safely take low-dose aspirin if their doctor recommends it. Low-dose aspirin isn't suitable for certain people. It's sometimes called baby aspirin because of the small dose, but it's not safe for children. Never give aspirin to a child younger than 16, unless their doctor prescribes it. There's a possible link between aspirin and Reye's syndrome in children. Reye's syndrome is a very rare illness that can cause serious liver and brain damage. To make sure low-dose aspirin is safe for you, tell your doctor if you have: • an allergy to aspirin or similar painkillers such as ibuprofen • ever had a stomach ulcer • high blood pressure • indigestion • heavy periods - taking daily aspirin can make them heavier • recently had a stroke (low-dose aspirin isn't suitable for some types of stroke) • asthma or lung disease • ever had a blood clotting problem • liver or kidney problems • gout - it can get worse if you take daily aspirin • Check with your doctor that it's safe for you to take low-dose aspirin if you're pregnant, trying to get pregnant, or if you want to breastfeed. 4. How and when to take it Take low-dose aspirin once a day. Don't take it on an empty stomach. It's best to take it with or just after food. This will make it less likely to upset your stomach. How much should I take? Your doctor will discuss what dose is right for you. It's important to take low-dose aspirin exactly as recommended by your doctor. The usual dose to prevent a heart attack or stroke is 75 mg once a day (a regular strength tablet for pain relief is 300mg). The daily dose may be higher - up to 300 mg once a day - especially if you have just had a stroke, heart attack or heart bypass surgery. Different types of low-dose aspirin tablets Low-dose aspirin comes as several different types of tablet: • standard tablets - that you swallow whole with water • soluble tablets - that you dissolve in a glass of water • enteric coated tablets - that you swallow whole with water. These tablets have a special coating that means they may be gentler on your stomach. Do not chew or crush them because it'll stop the coating working. If you also take indigestion remedies, take them at least 2 hours before or after you take your aspirin. The antacid in the indigestion remedy affects the way the coating on these tablets works. You can buy low-dose enteric coated aspirin and low-dose soluble aspirin from pharmacies, shops and supermarkets. What if I forget to take it? If you forget to take a dose of aspirin, take it as soon as you remember. If you don't remember until the following day, skip the missed dose. Do not take a double dose to make up for a forgotten dose. If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember to take your medicine. What if I take too much? Taking 1 or 2 extra tablets by accident is unlikely to be harmful. The amount of aspirin that can lead to overdose varies from person to person. 5. Side effects Like all medicines, aspirin can cause side effects, although not everyone gets them. Common side effects Common side effects of aspirin happen in more than 1 in 100 people. Talk to your doctor or pharmacist if the side effects bother you or don't go away: • mild indigestion • bleeding more easily than normal - because aspirin thins your blood, it can sometimes make you bleed more easily. For example, you may get nosebleeds and bruise more easily, and if you cut yourself, the bleeding may take longer than normal to stop. Serious side effects It happens rarely, but some people have serious side effects after taking low-dose aspirin. Call a doctor straight away if you get: • red, blistered and peeling skin • coughing up blood or blood in your pee, poo or vomit • yellow skin or the whites of your eyes turn yellow - this can be a sign of liver problems • painful joints in the hands and feet - this can be a sign of high levels of uric acid in the blood • swollen hands or feet - this can be a sign of water retention Serious allergic reaction In rare cases, it's possible to have a serious allergic reaction to aspirin. 6. How to cope with side effects What to do about: • mild indigestion - take your aspirin with food. If the indigestion still doesn't go away, it could be a sign that the aspirin has caused a stomach ulcer. Talk to your doctor - they may prescribe something to protect your stomach or switch you to a different medicine. • bleeding more easily than normal - be careful when doing activities that might cause an injury or a cut. Always wear a helmet when cycling. Wear gloves when you use sharp objects like scissors, knives, and gardening tools. Use an electric razor instead of wet shaving, and use a soft toothbrush and waxed dental floss to clean your teeth. See a doctor if you're worried about any bleeding. 7. Pregnancy and breastfeeding Pregnancy and low-dose aspirin It's generally safe to take low-dose aspirin during pregnancy, as long as your doctor has said it's OK. Your doctor may advise you to take low-dose aspirin during pregnancy: • to help prevent heart attack and stroke • to help prevent pre-eclampsia (pregnancy-related high blood pressure) • if you're having fertility treatment • if you have had several previous miscarriages For more information about how low-dose aspirin can affect you and your baby during pregnancy, read this leaflet on the Best Use of Medicines in Pregnancy (BUMPS) website. Breastfeeding and low-dose aspirin Aspirin is not generally recommended while you're breastfeeding. But your doctor may suggest that you take low-dose aspirin while you're breastfeeding if they think the benefits of the medicine outweigh the possible harm. 8. Cautions with other medicines Some medicines interfere with the way aspirin works. Tell your doctor if you're taking these medicines before you start taking aspirin: • medicines to thin blood or prevent blood clots, such as clopidogrel and warfarin - taking them with aspirin might cause bleeding problems • medicines for pain and inflammation, such as ibuprofen and prednisolone • medicines to prevent organ rejection after a transplant, such as ciclosporin and tacrolimus • medicines to treat high blood pressure, such as furosemide and ramipril • digoxin, a medicine for heart problems • lithium, a medicine for mental health problems • acetazolamide, for an eye problem called glaucoma • methotrexate, a medicine used to stop the immune system overreacting and sometimes to treat some types of cancer • diabetes medicines, such as insulin and gliclazide Mixing low-dose aspirin with painkillers It's safe to take paracetamol with low-dose aspirin. But don't take ibuprofen at the same time as low-dose aspirin without talking to your doctor. Aspirin and ibuprofen both belong to the same group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). If you take them together, it can increase your chances of side effects like stomach irritation. Mixing low-dose aspirin with herbal remedies or supplements Aspirin may not mix well with quite a lot of complementary and herbal medicines. Aspirin could change the way they work and increase your chances of side effects. For safety, speak to your pharmacist or doctor before taking any herbal or alternative remedies with aspirin. https://www.nhs.uk/ kalip
  24. Life Expectancy Shrinks for America's Working-Age Adults Despair, as evidenced in rising rates of drug abuse and suicide, may be eroding the average life expectancy of Americans, a new study finds. Deaths among working-age adults, especially, have been increasing in the United States for decades, particularly in economically struggling parts of the nation such as the "Rust Belt" and Appalachia, the researchers reported. These early deaths are causing average life expectancy to decline in the United States. U.S. life expectancy dropped between 2014 and 2017, even while citizens in more than a dozen other industrialised nations continue to enjoy ever-longer lives. The U.S. trend is being driven not just by the widely publicised "deaths of despair" -- drug overdoses, alcoholism and suicide -- but also by a diverse list of diseases affecting organs throughout the body, said lead researcher Dr. Steven Woolf. He's director emeritus of the Virginia Commonwealth University School of Medicine's Centre on Society and Health. The root cause of all this illness and death could be economic stress. Woolf and his colleagues suspect that the decline of the middle class in America is contributing to an average shorter lifespan across the country. "It might turn out that investment in the middle class, and helping to bring jobs and economic development to those communities, might do more to save lives than adding another wing onto the hospital," Woolf said. Average U.S. life expectancy stood at 78.6 years in 2017, down from a peak of 78.9 in 2014, the researchers said in background notes. The increase in working-age death rates has tracked closely with major shifts in the U.S. economy dating back to the 1970s and 1980s, when the country began to lose manufacturing jobs and the middle class started shrinking, Woolf said. The largest relative increases in midlife mortality rates have occurred in the Ohio Valley (West Virginia, Ohio, Indiana, Kentucky) and in northern New England (New Hampshire, Maine, Vermont), according to the researchers' analysis of federal data. "In our analysis, we estimated how many excess deaths occurred in the United States due to this problem between 2010 and 2017," Woolf said. "One-third of those deaths occurred in those four states in the Ohio Valley." Life expectancy in the United States rose at a steady rate in the 1960s and 1970s, but began to lose pace in the 1980s, Woolf said. "By 1998, we had fallen below the average increase of the other industrialised countries. We plateaued in 2011, and now we're falling," Woolf said. "That it's decreasing at all speaks volumes, because it continues to climb at a healthy rate in other industrialised countries." Declining life expectancy has been fuelled by a "sharp increase in deaths among the working-age population," Woolf said. There's been a 6% increase in death rates among people 25 to 64, and in young adults 25 to 44 it's more like a 25% increase, Woolf said. "It's noteworthy that the Rust Belt is where we're seeing the largest number of excess deaths in this pattern," Woolf said. "You have people and communities that have gone through a long period of economic stress. If you're a family that's been struggling for many years with these kinds of stresses, that might lead on a set of consequences that could affect your health in multiple ways." It's not just that economic stress makes one more likely to turn to drink, drugs or suicide, Woolf said. People struggling financially might not be able to pay for health care or prescriptions, afford healthy food, or be able to effectively manage chronic conditions like diabetes or high blood pressure. This falls in with a school of thought called the "social determinants of health," said Dr. Howard Koh, a professor at the Harvard T.H. Chan School of Public Health, in Boston. "I like to say health starts where people live, labour, learn, play and pray," said Koh, co-author of an editorial accompanying the new study. "You can't be healthy if you're living in poverty. You can't really be healthy if you don't have stable housing. It's difficult to be healthy without stable employment. Spirituality and social engagement are critical to well-being," Koh explained. "We are really in an important point in our public health history where medical experts are realising that health is much more than what happens to you in the doctor's office," he continued. Woolf pointed out that this decline has occurred even though the United States spends more than any other nation on health care. That could mean this nation needs to consider a solution outside medicine for its poor health. "Policies we don't typically think of as health policies -- like living wages and affordable housing and broadening access to a good education -- actually may be more effective in improving our health than investments in medical care," Woolf said. Koh noted that without a broader view of health, people in the United States are likely to continue to die at younger and younger ages on average. "It has long been assumed that rising life expectancy would always be the norm. The nation now risks life expectancy going downward as a troubling new norm. That's something we desperately need to avoid," Koh said. The findings were published Nov. 26 in the Journal of the American Medical Association. More information The U.S. Centres for Disease Control and Prevention has more about U.S. life expectancy. healthday. kalip
  25. Roasted Cauliflower and Lentil Tacos with Creamy Chipotle Sauce INGREDIENTS Cauliflower 1 large head of cauliflower, sliced into bite-sized florets 2 to 3 tablespoons olive oil Salt and freshly ground black pepper Seasoned lentils 1 tablespoon olive oil 1 cup chopped yellow or white onion 2 large garlic cloves, pressed or minced 2 tablespoons tomato paste 1/2 teaspoon ground cumin 1/2 teaspoon chili powder 3/4 cup brown lentils, picked over for debris and rinsed 2 cups vegetable broth or water Chipotle sauce 1/3 cup mayonnaise (vegan) 2 tablespoons lime juice 2 to 3 tablespoons adobo sauce (from a can of chipotle peppers) or chipotle hot sauce to taste Salt and freshly ground black pepper, to taste Everything else 8 small, round corn tortillas 1/2 cup packed fresh cilantro leaves (cilantro haters, substitute some fresh spring greens instead) INSTRUCTIONS To roast the cauliflower: Preheat oven to 220°C . Toss cauliflower florets with enough olive oil to cover them in a light, even layer of oil. Season with salt and pepper and arrange the florets in a single layer on a large, rimmed baking sheet. Roast for 30 to 35 minutes, tossing halfway, until the florets are deeply golden on the edges. Warm the olive oil in a medium-sized pot over medium heat. Sauté the onion and garlic with a dash of salt for about 5 minutes, until the onions are softened and turning translucent. Add the tomato paste, cumin and chili powder and sauté for another minute, stirring constantly. Add the lentils and the vegetable broth or water. Raise heat and bring the mixture to a gentle simmer. Cook, uncovered, for 20 minutes to 45 minutes, until the lentils are tender and cooked through. Reduce heat as necessary to maintain a gentle simmer, and add more broth or water if the liquid evaporates before the lentils are done. Once the lentils are done cooking, drain off any excess liquid, then cover and set aside. To prepare the chipotle sauce, just whisk together the ingredients and set aside (if you have no choice but to use whole chipotle peppers from the can, use a blender to purée it all). Warm tortillas individually in a pan over medium heat. Stack the warm tortillas and cover them with a tea towel if you won’t be serving the tacos immediately. Once all of your components are ready, you can assemble your tacos! Top each tortilla with the lentil mixture, cauliflower, a drizzle of chipotle sauce and a generous sprinkle of chopped cilantro https://cookieandkate.com/ kalip
  26. Study Casts Doubt on Angioplasty, Bypass for Many Heart Patients Bypass operations, angioplasty and the placement of artery-opening stents: For decades, millions of Americans have undergone these expensive, invasive procedures to help treat clogged vessels. However, the results of a large and long-awaited clinical trial suggest that, in most cases, these procedures may not have provided any benefit over medications and lifestyle changes. In fact, people treated with meds and healthy changes in lifestyle wound up about as healthy as those who underwent an invasive procedure to open their hardened arteries, researchers reported Saturday at the American Heart Association (AHA) annual meeting in Philadelphia. Only a subgroup of patients who suffered from frequent angina appeared to receive any benefit from an invasive procedure, and that benefit was in their quality of life, not in lowering their odds of death or future heart problems. "Based on the trial results to date, I as a clinician would feel comfortable advising my patient not to undergo the invasive strategy if their angina was absent or controlled or it was tolerated," said Dr. Alice Jacobs, director of the Cardiac Catheterisation Laboratory and Interventional Cardiology at Boston Medical Centre. She wasn't involved in the new research. Still, doctors are often uncomfortable limiting their treatment of clogged arteries to drugs, diet and exercise alone because they're worried the patient will wind up suffering a heart attack or other heart-related illness, according to past AHA president Dr. Elliot Antman. The new findings are expected to give physicians more confidence in saying no to invasive treatments, the experts said. The study did not focus on people who are admitted to a hospital with a heart attack -- these patients often receive bypass, angioplasty or stenting to quickly open a blocked artery. Instead, the trial focused on patients with stable but severe heart disease. A typical patient in this group might be a 71-year-old grandmother who has noticed during the past two months some chest heaviness walking from the parking lot to her grandkids' soccer game, the AHA presenters said. Stress testing and imaging scans could reveal some moderately c logged arteries leading to her heart. The new trial was very comprehensive, involving nearly 5,200 patients across 37 countries. Half were randomly assigned to undergo an invasive procedure: About three-quarters underwent angioplasty (most receiving a stent as well), while the others had a bypass operation. The other half of patients were treated with medications and lifestyle changes alone. Researchers mainly focused on whether the invasive procedure would reduce a patient's risk of heart-related death, heart attack, hospitalisation with unstable angina, heart failure or cardiac arrest. Overall, an invasive strategy "did not demonstrate a reduced risk over a median 3.3 years" compared with the more conservative, drugs/lifestyle therapy, said trial co-chair Dr. Judith Hochman, a cardiologist and senior associate dean of clinical sciences at NYU Langone Health, in New York City. However, invasive procedures did have a positive impact on one patient subgroup: People who regularly suffer the chest pain and shortness of breath associated with angina, said co-researcher Dr. John Spertus. He directs health outcomes research at Saint Luke's Mid-America Heart Institute in Kansas City. "For a patient who has weekly angina, there would be 15% of them who would be expected to be angina-free with the conservative approach, while 45% would be expected to be angina-free with the invasive approach," Spertus said. "This is such a large difference that you would only have to treat about three patients with weekly angina for one to be angina-free at three months." On the other hand, patients who did not regularly have angina received only minimal quality-of-life or symptom benefits after undergoing an invasive procedure, Spertus added. A smaller set of trials -- this time focused on patients with chronic kidney disease -- revealed even less promising results, researchers said. Patients didn't ain any health benefits and didn't have any improvement in their quality of life after getting an invasive treatment. Angioplasty might even help put them on dialysis earlier or increase their risk of stroke, the study found. Dr. Glenn Levine, a professor of cardiology with Baylor College of Medicine in Houston, said that when it comes to kidney patients with clogged arteries, he "will treat them with medical [drug] therapy alone" unless they have marked or uncontrolled angina. Experts said the main message from these studies is that doctors shouldn't feel pressured to immediately send patients with clogged arteries into a catheterisation lab, especially if they aren't suffering any symptoms. That could free up physicians to focus on getting patients to take their medications, Jacobs said. If drug therapy helps relieve their occasional angina or other symptoms, then angioplasty might be avoided in two out of every three patients, she estimated. The trials were funded by the U.S. National Heart, Lung, and Blood Institute. For more information: There's more on common heart procedures at the American Heart Association. healthday kalip https://www.youtube.com/watch?v=LOMesWPenSU
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