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The CDC should recommend agricultural reforms to reduce pandemic risks caused by factory farms.

The U.S. public has many lovescar ownership, large sports events, and Fourth of July fireworks. But no love affair burns quite as hot as the publics love for cheap, plentiful meat.

But could consuming large amounts of meat affect more than just your cholesterol levels?

Some scientists and activists have already warned that factory farming, which is the rearing of livestock under extreme confinement, emits dangerous amounts of greenhouse gases, abuses animals, and worsens nutritional diets and health. Despite these reasons for consumers to cut back on eating meat, the threat of another global pandemic could finally persuade U.S. consumers to reduce their meat consumption.

Changing meat-eating habits and encouraging stronger animal advocacy is difficult, but COVID-19 has forced more disruptive changessuch as altering work schedules, social habits, schooling, masking requirements, and more. To amass public support and spur agricultural change, the Centers for Disease Control and Prevention (CDC) should propose non-binding recommendations that encourage factory farms to limit extreme animal confinement, improve facility hygiene, cease antibiotic overuse, and reduce selective breeding practices.

Researchers have linked concentrated animal feeding operations (CAFOs) with increased viral and bacterial transmissions. Environmental stressors on CAFOssuch as animal overcrowding, enclosed facilities, illness-inducing grain feed, and unsanitary conditionsfacilitate the spread of disease. These conditions also take a substantial toll on farm animals bodies and their ability to fight off infections.

In addition, CAFO operators administer large quantities of antibiotics to farm animals, increasing bacterias likelihood to mutate, develop antibiotic resistance, and pass to humans. Moreover, operators rear animals for profitable physical characteristics, such as breeding chickens to have large breasts. Breeding practices that produce genetically similar animals permit easier spread of infections because the animals lack the genetic variation needed to combat new viruses or bacteria.

Globalized markets add another layer of risk. International trade of farm animals and human travel redistributes pathogens and viral hosts, facilitating the exchange of genetic material between strains that otherwise would not have encountered each other.

Despite the global pandemic risk created by factory farming, the U.S. Department of Agriculture only has congressional authorization to regulate animal slaughtering, animal transportation, and animal product inspection, which all occurs after handlers have already removed animals from the CAFO facility.

Some agencies have attempted to reduce on-farm infection risks even without a specific law authorizing regulation of CAFO conditions. The U.S. Food and Drug Administration (FDA), for example, released nonbinding guidance to reduce animal ingestion of antibiotics that are critical to human health. Yet, factory farms have not drastically decreased antibiotics use and still pose a global pandemic risk.

Just as FDA attempted to redress factory farming pandemic risks through guidance, the CDC should release guidance recommending the elimination of extreme animal confinement and cleaner living and waste disposal standards. The CDC should also recommend ceasing antibiotics overuse and limiting selective breeding that produces genetically homogeneous animal populations. These recommendations would decrease the probability that novel viral or bacterial strains would survive and spread in factory farms, which decreases the probability that a human would become infected and spread illness to others in turn.

Although CAFO operators and managers would likely refuse to comply with such CDC guidance, the agency should not limit the guidances ambition because of anticipated noncompliance. Instead, the guidance should serve as a publicity tool to inform the public about the substantial and unjustifiable pandemic risks that factory farms impose on the United States and the entire globe.

And because the CDC has become a household name during the COVID-19 pandemic, it currently has the publics attention and is in the best possible position to issue non-binding guidance about factory farms extraordinary pandemic risks.

Theoretically, the CDC could go a step further and issue binding regulations on factory farms to reduce pandemic risks. Under the Public Health Service Act, the CDC can issue regulations that are necessary to prevent the introduction, transmission, or spread of communicable diseases, that manifest in CAFOs.

But even if the CDC were to issue binding regulations, a court might invalidate them.

The U.S. Supreme Court has demonstrated that it will disregard an agencys action if based on a legal interpretation that implicates major political or economic issues, even though courts in the past have usually deferred to agencies interpretations of ambiguous laws.

For example, the Supreme Court rejected the U.S. Environmental Protection Agencys ability to regulate an energy transition from polluting plants toward less carbon-intensive energy generation under a certain section of the Clean Air Act. The Court determined that the Acts section did not give the agency clear authority to regulate a fundamental sector of the economy and force a nationwide transition toward green energy.

Similarly, the Court would likely invalidate a CDC attempt to regulate the meat industryfor which the CDC lacks institutional expertisebecause of the meat industrys scale and profitability. The CDC might be able to regulate some less-consequential on-farm activities, such as requiring protective respirators for workers, but it is unlikely to dismantle the abusive practices that concern animal activists.

Furthermore, the Supreme Court and various district courts have clawed back the CDCs regulatory power during the COVID-19 pandemic. The Supreme Court, for instance, held that the CDCs second authorization of an eviction moratorium exceeded its legal authority, noting that the Public Health Service Act only explicitly authorizes inspections, fumigations, and other sanitary measures. Given the current trend, a CDC attempt to regulate factory farms as a pandemic threat would likely not survive judicial review.

But when binding legal approaches fail, rule makers can still facilitate change through nonbinding guidance. Despite no clear congressional authorization to regulate factory farm conditions, the CDC should issue guidance to illuminate the industrys catastrophic pandemic risks. Then, consumers can determine whether they would rather uphold the meat industry as it currently exists or advocate agricultural changes to reduce risks of another life-altering global pandemic.

Link:
How Factory Farming Could Cause the Next COVID-19 - The Regulatory Review

New funding will advance research on the role of diet and race in knee arthritis pain and pain sensitivity, respectively, in transgender community.

Burel Goodin, Ph.D., and Robert Sorge, Ph.D.Two University of Alabama at Birmingham faculty members in the College of Arts and Sciences Department of Psychology have received R01 grants from the National Institute for Nursing Research to further their research projects.

Professor Burel Goodin, Ph.D., and Associate Professor Robert Sorge, Ph.D., received $472,384 in funding for their project titled Sex, Hormones and Identity affect Nociceptive Expression, or SHINE, and $525,800 in funding for the project Diet Interventions, by Race, Evaluated as Complementary Treatments for Pain, or DIRECTPain.

These grants will allow Dr. Sorge and me to continue our work focused on improved pain management options, as well as better understand the pain experiences of people historically under-represented in research, Goodin said.

SHINE will focus on the understudied transgender community and aims to determine the impact of gender identity, sex assigned at birth and hormone status on pain sensitivity. The goal is to examine social and psychological factors that contribute to pain sensitivity in these groups, and it is the first study to examine evoked pain sensitivity and immune cell responsivity between cisgender and transgender individuals.

DIRECTPain is the first study to examine the efficacy of diets to reduce knee osteoarthritis pain with an emphasis on race, sex and interactions. The overall aim of this study is to examine the efficacy of diets to reduce evoked pain and to determine the contribution of race and sex to these effects, with an emphasis on psychosocial variables.

Both of these grants are the natural extension of our work examining ways in which biopsychosocial variables can affect chronic pain in populations that are historically undertreated for pain, Sorge said. Providing a non-drug alternative for chronic pain through DIRECTPain and partnering with local community groups through SHINE will allow us to directly impact those shouldering the greatest burdens and at the highest risk for poor health outcomes.

See original here:
Nearly $1 million in R01 grants to support UAB psychology research - University of Alabama at Birmingham

By Chayil Champion September 28, 2022

When a client tells me they want to go on a diet, I say, OK, lets look at this diet and see what you have to sacrifice to make it work, said Deviny Mo, manager of UCLA Health Sports Performance powered by Exos. Are you sacrificing taste? Are you sacrificing how you shop? When you go out with friends, do you get to eat what you want? You need to ask these questions, because if youre making all of these sacrifices to follow a diet plan, then clearly it is unsustainable.

Mo is referring to short-term goal-oriented dieting, which often culminates with a return to poor habits once the goal has been reached.

A better approach, she said, is to aim toward developing healthy eating habits that are sustainable over the long term.

Some people do succeed with restrictive diets. But diets are not one-size-fits-all. One person can find success with intermittent fasting while another has better results with a Mediterranean or paleo diet.

Too often, however, dieting becomes unsustainable because people do not take into account their bodys nutritional needs and what may be lacking when they cut out certain foods on a restrictive diet.

You have to ask yourself, Can I eat like this day in and day out? said Mo. Once the diet is over, what am I going back to?

Changing short-term diet goals to longstanding healthy eating habits is key. What can you do to change the composition of your meals and snacks? Mo asks. Also, can you change the frequency of your meals and snacks? Then you have to look at consistency to make sure you can maintain this on a daily basis.

Such changes should be done progressively and with the help of a dietitian or a certified nutritionist. Some useful tips include adding more vegetables to one corner of your plate each day; replace a bag of chips with healthy nuts; or grab a piece of fresh fruit instead of a sugary sweet to curb cravings.

Nobody says it will be easy. Changing our eating habits to achieve a healthier lifestyle is challenging. Our brains and bodies have been trained to enjoy the sweet and savory foods we consume, and exchanging those foods for healthier, albeit perhaps not as tasty, choices can mess with our psyches. When a craving hits, we may find ourselves spooning down a pint of our favorite ice cream.

The result, alas, often is shame and remorse as we are wiping the evidence of that binge off our lips. But Mo said we shouldnt feel that way.

How do you feel after you finish eating something? Mo asked. You dont have to feel guilty because you splurge on something. Its OK.

Instead, take the 80/20 approach to create a positive relationship with food and still sometimes eat the foods you really enjoy.

Eighty percent of the time you want to try to eat healthy and eat well, Mo said. This is good during the weekdays. You can time your meals and snacks around your work hours; that way, the nutrition stays consistent with your lifestyle. On the weekends, when youre out with friends, you can treat yourself."

If you truly want a healthy lifestyle, you have to invest in your nutrition, said Mo. That investment, in the long run, is going to improve your quality of life.

Learn more about nutrition.

Tags: diet, eating healthy, Fitness & Nutrition, fruits and vegetables, intermittent fasting, keto diet, Mediterranean diet, paleo diet, Top Stories, vegan diet, Wellness

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Obesity can seriously compromise a persons physical and mental health. It is defined as abnormal or excessive fat accumulation that may impair health and is a known risk factor for heart disease, type 2 diabetes, and certain cancersall of which are leading causes of preventable, premature death.

Rates of obesity have tripled since 1975, over 41% of adults and almost 20% of children in the U.S. are classed as obese. People are considered obese if they have an excess of body fat and a Body Mass Index (BMI) over 30.

BMI is a simple but rather controversial measurement, defined as a persons weight in kilograms divided by the square of their height in meters (kg/m2).

Recently, researchers at Baylor College of Medicine suggested that obesity risk in humans may be determined by environmental and genetic factors during early development and argue that obesity should be considered a neurodevelopmental disease.

Study lead Dr. Robert A. Waterland, professor at Baylor College of Medicine, told Medical News Today:

[] genetic variation certainly contributes to individual differences in body weight, early environmental influences on the development of body weight regulatory mechanisms (developmental programming) may, in general, play a bigger role in determining individual propensity to obesity.

The work published in the journal Science Advances uses epigenetics to show that obesity is linked to nutrition during certain phases of development.

A number of things such as poor diet, lack of physical exercise, and a lack of good sleep, are known to increase the risk of obesity.

The type and amount of food eaten are also directly linked to obesity risk, consuming an excess of calories and burning very few will create a calorie surplus leading to weight gain. That said, the public health message to eat less and exercise more hasnt stemmed the tide of obesity.

Once seen as a result of a lack of will and self-restraint, the biological nature of obesity has been shown to be much more complex. Indeed, prenatal and early life studies have linked undernutrition to obesity in rats.

The effect of nutrition during early development in human studies has shown famine during the first trimester of pregnancy resulted in higher obesity rates, but famine during the last trimester and the first months of life was linked with lower levels of obesity.

It is widely accepted that body weight is also influenced by genetics. The CDC reports over 50 different genes that have been associated with obesity. Genes determine the signals that are transmitted by hormones to the brain, where they direct the body to eat or move.

Large-scale human genome studies have found changes in genes linked to BMI are expressed in the developing brain.

Epigenetics studies the way genes work, allowing scientists to study how behavior and environment can alter how genes work. Epigenetic changes dont change the sequence of the DNA, they change how the body reads the DNA sequence.

For this study, mice ages 2 to 4 months were monitored through pregnancy and their pups were studied through post-natal development.

Whole genome analysis and RNA sequencing were completed on neuron and glia cells and studied for epigenetic markers and gene expression. Specifically, the researchers used tissue from the arcuate nucleus of the hypothalamus of the brain, the area that controls hunger and satiety.

The researchers noted the post-natal period in mice is critical for epigenetic changes linked to obesity and energy balance regulation, suggesting obesity could be a consequence of dysregulated epigenetic maturation, according to Dr. Harry MacKay, the studys first author.

Interestingly, when comparing the epigenetic data with data from human genome studies the investigators found a strong correlation between regions of the human genome linked to BMI and the areas of epigenetic changes in mice, leading to the suggestion that adult obesity may be determined in part by epigenetic development in the arcuate nucleus.

The authors propose this new understanding may create effective interventions to prevent obesity this work provides the argument that prenatal and early postnatal development can at least in part determine human obesity risk.

[E]vidence from the last several decades indicates that once an individual is obese, it is extremely difficult to achieve a normal body weight. And, when obese adults do succeed in losing substantial weight, it is extremely difficult to maintain the weight loss in the long term. It is our hope that an improved understanding of the developmental neuroepigenetic mechanisms underlying the establishment of body weight regulation will enable effective approaches to prevent obesity. Dr. Robert A. Waterland

When asked if the work could lead to new nutritional recommendations for pregnancy, Dr. Waterland commented that the current research, which was conducted in mice, does not provide a basis for making nutritional recommendations for humans. Although we dont yet have the data, it is a reasonable guess that the postnatal epigenetic maturation we cataloged in this mouse study occurs during late fetal development in humans.

[] such data would bolster existing recommendations that women try to achieve a healthy body weight prior to becoming pregnant, as maternal obesity during pregnancy not only raises the risk of pregnancy complications like preterm birth and gestational diabetes but also appears to promote lifelong positive energy balance in her developing child, he added.

The study is not without limitations.

The nature of the ever-changing cell population during early development makes interpreting the data complicated, it is possible that changes in the cell population between the time points may affect the results.

The authors plan to overcome this in future studies by using more time points and using computational modeling.

The next step for the research is to extend it into human studies.

[] an obvious next step is to determine when this BMI-associated epigenetic maturation occurs in humans. Because many neurodevelopmental processes occur earlier in humans than in mice, it is likely that this hypothalamic epigenetic maturation occurs during late fetal development in humans, said Dr. Waterland.

[A]n obvious next step would be to try to determine if maternal obesity during pregnancy somehow impairs these developmental changes, resulting in persistently impaired regulation of energy balance in her child. Dr. Robert A. Waterland

See the rest here:
Does obesity have more to do with the brain than we initially thought? - Medical News Today

Heart disease is a major public health concern in the United States. Besides taking medicines a doctor prescribes, a person can take a range of actions to improve their heart health. This includes eating a healthy diet, keeping active, and avoiding behaviors such as smoking.

According to the Centers for Disease Control and Prevention (CDC), there are several ways a person can reduce their risk for heart disease and heart attack.

Keeping blood pressure, blood sugar, and cholesterol levels in healthy ranges can help.

In this article, we will explain how to improve heart health.

Many of the recommendations for improving heart health focus on diet.

The American Heart Association (AHA) recommends that people consume:

There are a few specific diets that have these characteristics, including:

The Mediterranean diet focuses on vegetables, grains, lean proteins, and the regular consumption of olive oil. It advocates that people eat dairy and red meat infrequently and foods with added sugar rarely.

A 2019 review in Circulation Research found strong and consistent evidence supporting the benefits of the Mediterranean diet for heart health. The more a person sticks to this dietary pattern, the lower their risk for developing heart disease.

The DASH diet includes more protein from low-fat dairy, meat, and poultry.

A 2019 review of previous research found that the DASH diet has links to a lower chance of developing cardiovascular disease and improved blood pressure, as well as other heart health benefits.

Physical activity plays an important supporting role in heart health. It can also help a person maintain a healthy weight, especially in combination with a diet.

A 2019 study in Frontiers in Cardiovascular Medicine found that moderate and vigorous intensity exercise improves cardiovascular function in people who have had heart failure.

Different types and intensities of exercise offer benefits to heart health:

Cardio, or aerobic exercise, is any physical movement intense enough to raise the heart rate and cause sweating.

Moderate-intensity physical activity can lower a persons risk of heart disease by improving blood pressure and cholesterol levels. A person should aim to get at least 150 minutes of aerobic exercise per week, if possible.

Examples of moderate-intensity cardio activities include:

Examples of vigorous-intensity cardio activities include:

A person can mix moderate-intensity and vigorous-intensity physical activity. Doing this can allow people to spend less time exercising because 1 minute of vigorous-intensity activity is equivalent to 2 minutes of moderate-intensity activity.

Aerobic exercise is not the only type of exercise that benefits heart health.

A 2021 systematic review in Frontiers in Cardiovascular Medicine concluded that resistance training combined with aerobic training is more beneficial for people with coronary heart disease than aerobic training alone.

The authors reported that resistance training improves a persons capacity for exercise and quality of life.

The CDC also recommend doing strength training on top of aerobic exercise. A person should aim to do strengthening activities at least 2 days per week.

They can train using their own body weight, such as by doing pushups, or using resistance machines or free weights in the gym. A person should aim to work all the major muscle groups, including the:

A study in the Journal of Strength and Conditioning Researchsuggests that stretching could be a useful therapy for improving the regulatory effect of the nervous system on the heart. Additionally, without flexibility, the body may struggle to do some aerobic or strength exercises.

The American College of Sports Medicine recommends stretching to the point of feeling slight tightness or discomfort at least two or three times a week, or daily for best results.

Besides nutrition and exercise, a number of lifestyle changes can also help to improve heart health. The AHA recommends:

A person should also make sleep a priority because it supports overall health and wellbeing, including heart health.

Some people take supplements to try to improve their heart health. However, research supporting the use of many popular heart health supplements is mixed. In some cases, there is no strong evidence they work.

Supplements for heart health include:

Co-enzyme Q10 (Co-Q10) supplementation may be beneficial to people with cardiovascular disease.

The authors of a 2017 review looked at data from a mixture of human and animal studies to assess the benefits of this nutrient and found some evidence that Co-Q10 may reduce disease and death in people with heart and metabolic conditions.

However, the authors pointed out controversies in the available data and urged future researchers to carry out randomized trials that assess the impact on survival.

Low vitamin D levels have links with some of the risk factors for cardiovascular disease, such as high blood pressure and inflammation. For people with a vitamin D deficiency, taking this supplement or getting more from sunlight may be beneficial.

A 2018 review of 81 studies concluded that vitamin D supplementation may have a protective effect on cardiovascular health. However, other studies have found different results.

For example, in a 2019 review, scientists analyzed data from 21 randomized clinical trials involving 83,000 participants. They found no link between vitamin D supplementation and a reduction in major adverse cardiovascular events, heart attack, stroke, or death from any cause.

More research is necessary to confirm that vitamin D supplementation is beneficial for heart health.

A 2017 review investigated whether niacin may benefit heart health. Although niacin has links with lower cholesterol and triglyceride levels in the blood, the authors did not find evidence that taking it as a supplement lowered the number of deaths, heart attacks, or strokes.

Additionally, 18% of people experienced side effects and had to stop taking the supplement.

How soon measures such as diet and exercise work to improve heart health depends on a persons situation and what their goals are.

For example, a person who quits smoking will start to gain benefits from this in as little as 2 weeks. At this point, circulation and lung function begin to improve. After 1 year, their risk of coronary heart disease is 50% lower.

Lowering cholesterol can be more variable. For people using diet and lifestyle changes alone, doctors may allow up to 3 months to see if it works. For people who take statins, cholesterol may reduce significantly after 68 weeks.

Other changes can be harder to predict or measure. If a person would like to track markers of heart health as they change their diet or lifestyle, they may be able to ask a doctor to assist with this.

Heart disease is the leading cause of death in the U.S., but people can do a lot to reduce their risk. This includes eating a nutritious and balanced diet that is low in added sugar and salt.

Getting regular exercise and making lifestyle changes such as quitting smoking also support heart health.

Read the original post:
How to improve heart health: Diet, exercise, and more - Medical News Today

AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts inmedicineon COVID-19, monkeypox, medical education, advocacy issues, burnout, vaccines and more.

Featured topic and speakers

In todays AMA Update, what physicians need to know about nutrition education both for patient care and self-care with Stephen Devries, MD, executive director of the nonprofit Gaples Institute and an adjunct associate professor of nutrition at the Harvard T.H. Chan School of Public Health. AMA Chief Experience Officer Todd Unger hosts.

Access "2022 Update: Nutrition Science for Health and Longevity: What Every Physician Needs to Know" via AMA Ed Hub.

Learn more about the Gaples Institute Nutrition and Lifestyle Education.

Unger: Hello and welcome to the AMA Update video and podcast, an ongoing series covering a range of health care topics affecting the lives of physicians and patients. Today, we're talking about one of my favorite topics, what physicians need to know about nutrition education for both patient care and self-care. I'm joined by Dr. Stephen Devries, executive director of the nonprofit Gaples Institute and adjunct associate professor of nutrition at the Harvard TH Chan School of Public Health. He's calling in from Deerfield, Illinois. I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Devries, it's such a pleasure to have you today.

Dr. Devries: Oh, great to be with you, Todd.

Unger: Well, you were a preventive cardiologist. Is that a big part of what drove you to become focused on educating physicians about nutrition?

Dr. Devries: Absolutely. Early on in my career in cardiology, I used to see patients coming in for an acute cardiac problem and we would patch them up, send them out, and very often, they would come back again. In the old days, there were hard films of cardiac catheterizations, of tests that were done and some patients had 8, 10, 12 of these films lined up from prior hospitalizations. So I figured there had to be a better way. We had to stop this from recurring, rather than just trying to patch people up when they came in sick.

Unger: Well, I'm curious, I think I know the answer to this but I bet people don't immediately link nutrition to that particular problem. And you've said that nutrition education doesn't receive nearly enough attention in physician training. What accounts for this kind of gap? It seems straightforward and simple.

Dr. Devries: It does, but you're absolutely right, nutrition just hasn't been recognized as a priority in medical education, despite the fact that dietary changes are well recognized to be the leading risk factor for premature death and disability in the United States. But still, medical educators often report that they just don't have enough time in the curriculum. And my response is, what deserves more attention than the leading risks for premature death and disability? We just don't have a greater priority.

Unger: I know there's a long list of things that people want to be taught in medical school but I was pretty surprised. I can't remember what the figure is but I think it's a matter of minutes that get spent on nutrition education for physicians. Should that be a required course in medical school, in your book?

Dr. Devries: Oh, absolutely. Absolutely. Nutrition is covered to a small degree. On average, medical students spend about 19 hours over the course of four years in medical school on nutrition. But much of that is related to biochemistry and topics that are important but not directly clinically relevant for patients. So in the absence of meaningful nutrition education, what are medical students to think when they graduate, other than the fact that nutrition must not be very important in their training because they only learned about drugs and procedures?

So we have to change that paradigm because we know, sadly, it's not working, that even with all the new technology ... cardiology that we have, and new drugs and procedures, what is very clear is that what used to be a very rapid decline in mortality rates from cardiovascular disease over the recent decades has now begun to plateau, despite all the new technology. And what is the reason? It's the growing prevalence of overweight and obesity, and with that, type 2 diabetes that comes with it. We just can't out-high-tech poor lifestyle.

Unger: And the numbers on that particular front are pretty discouraging, in terms of obesity rates, overweight percentages. It seems like a lot of what we're doing right now is not necessarily working because the problems continue to get worse.

Dr. Devries: Absolutely.

Unger: You've outlined, on one hand, lack of training. I imagine, on the other hand, that physicians run into a lot of challenges, in terms of educating patients on diet and lifestyle. What do you think there?

Dr. Devries: It's, well, lack of education is one major one but there are others, as you say. One is insufficient reimbursement for prevention services in general, including dietary counseling. And the other one that goes with it is lack of time. And obviously, clinicians are really submerged with work. They've got lots to do and not enough time to do it. So time spent in counseling is a problem.

But what is very possible, imminently doable for clinicians is to at least emphasize to patients that, although taking their medications is a critical part of their health care, that they will never achieve optimal health without, in addition, more attention to nutrition and lifestyle. And making that priority clear by clinicians doesn't take a whole lot of time. And then what physicians who are knowledgeable about nutrition, what they can do is begin to even recognize opportunities to make very empowered referrals to nutrition and diet professionals. And unfortunately now, without adequate education, physicians don't even necessarily recognize great opportunities for making such referrals. And it's very clear that nutrition and diet professionals are vastly underutilized.

Unger: And I'll tell you, from my experience, I think if you're not getting that information from your physician or from an expert like that, there are plenty of other people out there willing to give you information. And a lot of that is not good information. I think my social feeds are filled with products and the latest fad diet, whatever it is. Is this getting worse, or am I just imagining that?

Dr. Devries: No, you're not imagining. It is worse. The threshold for entry into the health advice sphere is very low. So there are some hallmarks of suspicious content to look out for. Of course, when there are claims of miraculous, this is the only diet that has been proven for this or that, those are obviously red flags.

But another one that it's much more common and a little bit more subtle is that there's a tendency for the results of the latest study to be seen as the new truth, which in some people's minds may supersede everything else that they knew before. And that is certainly not necessarily the case. So that's why it requires some background to really get a context to know does this new study, is it a better study than all the ones that came before it or is this surprising result maybe suspect and one that we shouldn't take as the new truth?

Unger: I know exactly what you mean. I mean, we've got kind of a news machine that's working out there. And one day, it's this particular food or ingredient that's identified as either good or bad. And I imagine a lot of people out there are just kind of likethey can't keep up or just kind of give up and throw their hands up. Is that what you find with patients?

Dr. Devries: Oh, absolutely. There's a seesaw. You know, butter is good one day, bad the other. And people feel like no one knows anything about nutrition. But the fact is, if you can get past the media blur, there actually is quite a bit of well established principles of nutrition science. And they can be a little bit more difficult for the public to ferret out but my goal is that physicians and other health care professionals, that they at least be grounded in those well-established principles so they can help teach their patients.

Unger: Well, one thing that you've done and that we at the AMA have been working with you on getting the word out is you've developed a course to help educate physicians and address a lot of these challenges through the Gaples Institute. Why don't you tell us a little bit more about what is the mission of the Gaples Institute and what have you developed, in terms of that course? What are you trying to teach?

Dr. Devries: Yeah, thanks. Well, the mission of the nonprofit Gaples Institute is to advance the role of nutrition and lifestyle in medicine. And we are guided in that mission by national leaders who are on our board, who are leaders in nutrition research and education. And we are, importantly, supported completely through philanthropy. We don't accept corporate support of any type.

So in furtherance of the mission of the Gaples Institute, we have developed a condensed online nutrition course for health professionals. And I'm pleased to say that this course has been evaluated by the AMA and featured on the AMA website since 2017. We update and reaccredit the course every single year, so it always includes the most up-to-date information.

And very importantly, the aim of the course is not to steer physicians or patients toward any one specific type of diet. Our goal is to teach solid, evidence-based principles. And the principles are those of healthy eating. And then we encourage the physician and patient to take that solid evidence base of principles, and then to apply them individually as is appropriate for each patient based on their cultural history and preferences and so forth. So the goal of the Gaples course is to provide the essentials of nutrition clinically.

And the course is used in medical schools, residency programs and used by practicing physicians in all specialties. It includes topics of special relevance that physicians really need to know about, especially now including screening for food insecurity. It talks about the information that helps clinicians understand popular diets. And very importantly, it includes information about self-care for physicians because physicians, obviously, are in the service of caring for their patients but often neglect themselves. And their own diet is one way that can really help to take good care.

So I'm pleased to say the Gaples Institute's course, the one that we're referring to, is the nutrition course that is now required in six medical schools. And it's been taken by over 3,000 medical students and clinicians to date, 97% of whom report that it will change their practice. So we're really proud of the work that we're doing in this nonprofit, proud to have the work that the AMA is doing to help feature the course. And we feel that it's kind of like the missing manual that should have been included in medical education, but up until now has not been.

Unger: And I really encourage everybody out there to check out that course on the AMA Ed Hub, where you can find that. Just such great information. One thing, too, that I want to point out, I think we've learned time and time again, and nothing like the last two and a half years to say it's not just about the information but it is really about communication. And I know your course goes beyond, then, the science part to help physicians communicate. What are physicians going to learn on that front? Why is it so important?

Dr. Devries: It's such a great point, Todd, because in addition to having a background in the science of nutrition, it's really important to be able to make use of that information to help a patient. And that's hard to do. It's a challenge, right, in a busy clinical environment. So one very important topic that we talk about in this single course that it gives four hours of credit for those who need it but many people can do it in two hours or thereabouts, so we include topics in how to do a rapid dietary assessment. And we provide resource tools to help people do just that.

And also, how to use motivational interviewing. Once a goal has been established through the rapid dietary assessment, how can you help patients work with them, not to tell them what to do but to work with them to understand their priorities and to make use of their own internal motivation and to help enhance that through some strategies that we do with clinical scenarios with motivational interviewing? So that's all part and parcel because having the knowledge is not going to be impactful unless you can apply it, and apply it in a very busy clinical setting. And that's what we set out to help clinicians do.

Unger: Couldn't be more important, that combination. You also mentioned earlier this issue around self-care. And I want to dig into that a little bit. We work in a very peculiar environment right now, where burnout was already at a very high level and then induced by the pandemic, we now see physician burnout at an all-time high. I don't think that folks may necessarily make the instant connection between what we're talking about here, which is nutrition education and burnout and self-care. How do those connect?

Dr. Devries: Hm. It's a terrific question. Well, I wouldn't want to say that nutrition and diet are the bulk of the issue relating to burnout but it is a very important part of what we can do to sustain ourselves. And there's a substantial body of knowledge that connects what we eat with cognitive function, with mood and with just a sense of well-being. So if physicians could themselves work toward a healthy diet, they would at least be able to stack that part of the deck way in their favor.

And in fact, residency and fellowship requirements talk about a recommendation that physicians should be eating a healthy diet for self-care. But without detailed knowledge that physicians currently are not receiving about nutrition education, how are physicians in training in a better place to understand what a healthy diet means than any of the general public? So we need to do better with that. So nutrition education for clinicians is not only great for patient care, it's really important for physician self-care.

Unger: Well, an excellent discussion. Such important work that you're doing. And again, you can find the Gaples Institute course on nutrition education on the AMA Ed Hub. Go search it on the AMA site and you'll find that information. Dr. Devries, thank you so much for being here today and your continued work on nutrition education.

That's it for today's episode. We'll be back soon with another AMA Update. You can find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.

Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

Here is the original post:
Nutrition education for patient care and physician self-care with Stephen Devries, MD - American Medical Association

Sometimes, it can be hard to follow dietary recommendations despite new dieting ideas and trends.

Everyones dietary needs are different, which means that diets often need to be diverse and tailored based on individual needs and health risks.

A recent study published in Gastroenterology looked at diets high in fermentable fiber in mice and their associated risk for developing liver cancer.

The researchers found that the risk for developing liver cancer among mice with a specific congenital defect was substantial when they ate a diet enriched with fermentable fiber. The blood of these mice also had a high bile acid content.

Based on this and additional data from people, the researchers suggest that screening for bile acid levels may help to predict liver cancer risk. People with higher bile acid levels may need to exercise caution regarding the amount of fiber-enriched processed foods they eat.

Fiber is a carbohydrate that provides certain health benefits to the body but doesnt provide many calories.

However, whole food sources of dietary fiber are an important component of a healthy diet and can be beneficial in disease prevention.

Fiber occurs naturally in many foods, including fruits and vegetables. There are a few different types of fiber, including soluble and insoluble, which provide specific health benefits.

Fermentable fiber, on the other hand, refers to types of fiber that the gut bacteria can ferment and break down. Food manufacturers will sometimes add highly refined, fermentable fiber to processed foods.

Brian Power, RD, nutrition expert and registered dietician not involved in the study, explained to Medical News Today:

Food processing techniques can make fiber fermentable, which means it can be broken down by gut bacteria and produce many byproducts that are good for your health.

Examples of processed foods containing highly refined, fermentable fiber include convenience foods like snacks and cereals fortified with fiber.

But foods containing highly refined, fermentable fiber may not a healthy choice for everyone. Some people in specific subgroups, such as those at risk for liver cancer, may need to be cautious about diets high in fermentable fiber, as indicated by the new research.

According to the American Cancer Society, liver cancer accounts for over 700,000 deaths worldwide each year.

Liver cancer is increasingly serious in the U.S. and is projected to be the third deadliest cancer within this decade, Dr. Yiing Lin, Ph.D., a liver surgeon with Siteman Cancer Center at Washington University in St. Louis, not involved in the study, told MNT.

For the study, the authors researched how a few different components may be related to liver cancer risk.

Researchers examined mice that had a specific congenital defect called a portosystemic shunt, which impacts blood flow and exchange between the liver and the rest of the body. These mice had a higher risk for liver cancer.

When the at-risk mice ate fermentable fiber-enriched diets, their risk of developing liver cancer increased. Researchers theorized that this could be because the fermentable fiber diet contributed to a suppressed immune system.

Whats more, the mice had high levels of bile acids related to the portosystemic shunts. The liver makes bile acids out of cholesterol. Bile acids help the body digest and absorb fat.

While it was difficult to thoroughly study portosystemic shunts in humans, researchers could examine bile acid levels. They looked at the bile acid levels in men who developed liver cancer and matched these participants with controls that did not develop liver cancer.

They found that bile acid levels were about double for the men who developed liver cancer later in life. This indicates that screening for this could be helpful in the prediction of liver cancer.

Next, researchers looked at overall fiber intake and associated liver cancer risk in humans. Among men with high bile acid levels, high fiber intake was associated with an increased risk of developing liver cancer.

Overall, the study notes a potential screening method for liver cancer and the potentially cautious use of fermentable fiber in certain at-risk groups. Dr. Lin noted the following:

The findings are that in the setting of congenital portosystemic shunts in mice, fermented fiber-rich diets increase the chance of developing liver cancer. In humans, congenital portosystemic shunts are not common, but shunts develop in patients with cirrhosis. The findings in the study could help patients with liver disease and decrease their chances of developing liver cancer by diet modifications or other interventions.

The study had several limitations, and further research is needed before experts can genuinely understand how diets high in processed fiber influence liver cancer risk. First, the initial data is from mice studies, which can only provide so much information.

Power noted the following:

The greater our understanding of the biochemistry involved in the breakdown of dietary fiber and its impact on health such as liver cancer, the closer we get to developing new, effective treatments. In the current study, the work puts our finger on the molecular basis for the link between fiber and liver cancer risk. But it does need care in interpretation. Especially when trying to apply evidence from mice to humans.

The data from people was only from men, indicating further diverse follow-up is needed.

Researchers could not distinguish between fiber types in their data from human subjects. This means that further research is needed to understand if it is actually fermentable fiber that contributes to liver cancer risk.

Researchers also note that further research is needed on the prevalence of congenital liver shunts and how they impact liver disease and liver cancer.

Dr. Lin noted the following areas for research:

The effects of a modified diet in humans with liver disease will need to be confirmed. These are challenging studies since liver cancer develops in subsets of people with liver disease, and the effects of diet modifications have to be tracked over long periods of time and can be a challenge to control. However, these are important questions to address since metabolic syndrome and its association with liver cancer are significant problems in the U.S.

See the article here:
Diets high in processed fiber may increase risk of liver cancer in some people - Medical News Today

A plant-based diet can protect you against a variety of cancers affecting the digestive system, according to a study published in the medical journal Frontiers of Public Health. According to the study authors, common digestive system cancers such as liver, esophageal, gastric, and colorectal tumors are among the 10 most significant healthcare issues worldwide.

Researchers at the Shandong University of Traditional Chinese Medicine searched five English databasesincluding PubMed, Medline, Embase, Web of Science databases, and Scopusfor studies linking diets to cancers of the digestive system. The studies that the researchers analyzed included a total of 3,059,009 subjects which, according to the researchers, provided the power to detect a statistically significant relationship between plant-based diets and digestive cancers.

The study defined plant-based diets as a diet that excludes any meat, meat products, seafood, or food of animal origin; and a diet characterized by a higher consumption of fruits, vegetables, legumes, and nuts rather than animal products.

The results of the studies were meta-analyzed for effect sizes and confidence intervals, and the conclusions suggested that a plant-based diet pattern played a protective factor for the risk of digestive system cancer in the cohort studies and case-control studies.

Plant-based diets were statistically significant for pancreas cancer, colorectal cancer, colon cancer, rectal cancer, gastric cancer, liver cancer, and esophageal cancer in the cohort studies, and equivalent connections were found in case-control studies for pancreatic cancer, colorectal cancer, gastric cancer, pharyngolaryngeal cancer, and liver cancer.

No statistically significant relationship was found between plant-based diets and colon cancer or rectal cancer.

In summary, it is important to understand and reveal eating habits that make our lives healthier and the important role these habits play in the management and prevention of oncological diseases, the study notes. Our study proposes that a plant-based diet is promising to prevent the development of cancer.

Conversely, the study noted that diets containing red or processed meat are associated with a growing risk of digestive system cancers. According to the World Health Organization, processed meats such as bacon, ham, and sausage are a Group 1 carcinogenic and red meat such as beef and pork is linked to colorectal, pancreatic, and prostate cancers.

Ella Olsson

A study published earlier this year in the medical journal The BMJ found that a high consumption of ultra-processed foods comes with a 29 percent increased risk of colorectal cancer in men. The research from Tufts University and Harvard University noted the strongest association between colorectal cancer and ultra-processed foods came from meat, poultry, and fish products.

We started out thinking that colorectal cancer could be the cancer most impacted by diet compared to other cancer types, Lu Wang, the studys lead author and a postdoctoral fellow at the Friedman School of Nutrition Science and Policy at Tufts, said in a statement.

Similarly, another study published last year in the journal Cancer Discovery identified a DNA mutation that could account for this relationship between eating meat and colorectal cancer. The research, conducted by the Dana-Farber Cancer Institute in Boston, sequenced the DNA from 900 colorectal cancer patients and found a common mutationor alkylationsignificantly associated with patients who consumed both processed and unprocessed red meat prior to their cancer diagnosis. The chemical compounds found in red meat such as nitroso and heme are believed to cause this alkylation.

While not all cells with this mutation damage turned cancerous, Giannakis found that patients with the highest levels of this mutation had a 47 percent greater risk of colorectal cancer death in comparison to patients with a lower level of damage. Researchers are hopeful that these findings can be used to help individuals prevent colorectal cancer, or at least catch it at an earlier stage.

When it comes to colon cancer, another study conducted by a team of international researchers and scientists at the University of Leeds found that women who consume meat increase their chances of contracting distal colon cancer.

Our research is one of the few studies looking at this relationship, and while further analysis in a larger study is needed, lead author Diego Rada Fernandez de Jauregui said, it could provide valuable information for those with family history of colorectal cancer and those working on prevention.

Nicole Axworthy is the News Editor at VegNews and author of the cookbook DIY Vegan.

Original post:
Want the Best Protection From Digestive Cancers? New Study Says Try a Plant-Based Diet. - VegNews

From competitive weightlifters and other professional athletes to those who simply enjoy hitting the dumbbells at the gym, cultivating stronger muscles and increasing muscle mass is a health goal many can relate to. No matter where you might start on your own muscle-building journey, it's important to stick to your routine, which means remaining committed to not only your workouts but also the quality of your diet. What you eat plays just as much of a significant role as how you train, and striking the right balance is what will help you achieve your goal.

But when deciding on what to include in your daily meal plans, how do you know what eating habits will best position you to make the greatest strides in your pursuit of stronger muscles? Jen Bruning, MS, RDN, LDN, and spokesperson for The Academy of Nutrition and Dietetics, believes that the most crucial eating habit for building stronger muscles is to consume a balance of nutrients.

"A combination of foods containing lean protein, complex carbs, and healthy fats should do a similarly good job of supporting and maintaining muscle mass," Bruning says. "Give your body carbs to work your muscles more rigorously, protein to build them, and healthy fats to support body movements and recovery."

"Proteins are one of the most important nutrients for muscle building, as muscles are built from the same amino acids that we get from eating protein-rich foods," says Bruning. "When we eat foods containing protein, we digest the protein into amino acids."

Amino acids are what Cleveland Clinic calls "the building blocks of protein." According to Bruning, our body absorbs amino acids and then puts them to work for your body in a variety of ways, including building and maintaining muscles. She also notes that protein even helps your body recover post-workout when eaten within two hours of your exercise session.

"Day by day, using our muscles and eating plenty of protein-rich foods can build muscle," Bruning says.

If muscle gains are your aim, certain high-protein foods may help with muscle synthesis and cultivating mass. If muscle gains are your aim, some high-protein foods that may help with muscle synthesis. But this doesn't mean you can go ahead and eat bacon all day, every day, under the assumption that it's providing you with the quality protein intake you need to increase your strength and maintain a healthy lifestyle.

"Animal and plant-based high protein foods can both facilitate the building of lean muscle," Bruning advises. "There may be a slight benefit to using animal sources, but plant-based sources will also help muscles to build. Lean animal-based protein has the most protein per [ounce] of food, generally."

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She also notes that it's important that you eat lean proteins low in saturated fat when trying to build up your muscle strength. Examples of quality lean proteins include fish, poultry, and plant-based proteins like tofu and tempeh. You can also have some lean cuts of pork and beef, as wellbut always, of course, in moderation.

Lean proteins may seem like the star of the show when it comes to building muscle and strength training. , But a common misconception is that this nutrient is all you need to eat to gain muscle mass and increase strength. To support the whole body while building muscle, Bruning claims that balanced diets need just enough protein rather than excessive amounts of this nutrient.

"It's important to keep in mind that while protein is essential to build muscle, other nutrients are important for supporting the body, as it does the work that helps build muscle," Bruning explains.

Depending on protein alone could potentially set you up for a dead end, but a well-balanced diet can provide your body with all the nutrients it needs to function effectively. So when trying to build muscle, don't forget to also include carbs and healthy fats.

As much as we may spite carbs with the mentality that they are all bad for you, it's essential to eat them for proper muscle development and add them to a balanced diet.

"While protein should be consumed as part of a balanced diet, allow nutrients like carbohydrates to help provide fuel during a workout," Bruning says.

Carbs are among the quickest sources of fuel for strength development and weight training. According to the Mayo Clinic, "During a workout, carbohydrates fuel your brain and muscles. [] If you are in good shape and want to fuel a daily, light-intensity workout, eat about 3 to 5 grams of carbohydrates for every kilogram of body weight."

But before you start eating ziti by the box full for your workouts, make sure you're consuming the right kind of carbs. Bruning suggests that whole grains are ideal for increasing muscle strength.

"Whole grains contain some protein as well as B vitamins and iron," she says. "B vitamins help build muscle, and iron carries oxygen in the bloodstream to the muscle, so having enough iron helps muscles work more efficiently."

Whole grains can even emphasize protein in the body. In a study published in Current Developments in Nutrition, researchers found that consuming 50 grams of whole grains per day helped to promote higher protein turnover and enhance net protein balance in adults. Some nutritious whole grain carbs include whole wheat bread, brown rice, oatmeal, millet, and barley.

Antioxidants are substances that can help shield your cells against free radicals. Too many free radicals can be difficult for your body to regulate, which can have several side effects, including altering proteins.6254a4d1642c605c54bf1cab17d50f1e

Similar to the negative stigma around carbs, fats as a whole are often snubbed and looked down upon when it comes to improving your health. In actuality, not all fats are bad for your body. Although "healthy fat" may seem like an oxymoron, they are a good resource for muscle strength. Some evidence even suggests that consuming omega-fatty acids could potentially amplify skeletal muscle anabolismwhich is when the body naturally builds and repairs muscle tissuedepending on factors like how much protein you eat per day.

"Healthy fats and antioxidants can assist with recovery," Bruning says."Omega-3s are a type of healthy fat that may play a role in muscle cell efficiency and muscle recovery," Bruning says.

For some good sources of antioxidants, Bruning suggests consuming plant foods such as colorful fruits and veggies, whole grains, seeds, nuts, and even coffee. And for healthy fats, try salmon or other fatty fish, flax seeds, chia seeds, and walnuts.

Excerpt from:
The Most Crucial Eating Habits for Stronger Muscles, According to a Dietitian - Eat This, Not That

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The ancient Greeks were on to something when they referred to olive oil as an "elixir of youth and health." Centuries later, research offers evidence about the benefits of olive oil in our daily diets.

Consuming more than half a tablespoon of olive oil a day may lower heart disease risk, a 2020 study found. And earlier this year, researchers reported in the Journal of the American College of Cardiology that people who ate more than half a tablespoon per day had lower rates of premature death from cardiovascular disease, Alzheimer's disease and other causes compared to people who never or rarely consumed olive oil.

"Olive oil is the hallmark of the Mediterranean diet, and its link to lower mortality is well established in southern European countries. But this is the first long-term study to show such a health benefit here in the U.S.," said Dr. Frank Hu, the study's senior author and a professor of nutrition and epidemiology at Harvard T.H. Chan School of Public Health in Boston.

Among all edible plant oils, olive oil has the highest percentage of monounsaturated fat, which lowers "bad" LDL cholesterol and increases "good" HDL. It's been shown to lower blood pressure and contains plant-based compounds that offer anti-inflammatory and antioxidant properties known to reduce the disease process, including heart disease.

Olive oil is derived from the fruit of the olive tree, cultivated mainly in the Mediterranean for over 5,000 years. Spain is by far the largest producer of olive oils in the world, followed by Italy and Greece. In the 18th century, Spanish missionaries brought olives to California and planted them along the coast. Today, over 40,000 acres of olive trees grow exclusively for oil in California, Arizona, Georgia, Florida, Oregon and Hawaii. Just 5% of the 90 million gallons of olive oil consumed annually in the U.S. are produced here, according to the American Olive Oil Producers Association.

Several grades of olive oil are found on store shelves in the U.S., from regular to extra virgin olive oil commonly known as EVOO. EVOO is the staple fat source for the Mediterranean diet, considered one of the healthiest dietary patterns and a diet emphasized by the American Heart Association for preventing cardiovascular disease.

EVOO is the fatty fraction of olive juice extracted only by mechanical and physical processes without any refinement. It's the lack of refinement that maintains both its sensory and health properties. "First-pressed" and "cold-pressed" are terms that emphasize the EVOO is an unrefined, natural product that has undergone a single, simple milling process without any processing to alter its quality.

Regular olive oil, on the other hand, has been refined, bleached, deodorized and then blended with 5% to 15% EVOO. "Pure" or "light" are marketing terms used for olive oil that has been refined and mixed with a small amount of EVOO to yield a product that's lighter in flavor, aroma or color.

Hu's recent study did not differentiate between grades of olive oil, but he said European studies have shown better health results with EVOO which has a higher amount of plant compounds and antioxidants than other edible oils. Hu said future research may compare the different grades of olive oils for beneficial effects.

When cooking, olive oil can be a healthy substitute for butter, margarine and other types of fat. In Hu's study, for example, replacing unhealthy fats with olive oil was associated with a lower risk of dying. "Olive oil is a much healthier replacement for dietary fats, especially animal fats," Hu said.

Other liquid vegetable oils make good substitutes, too. Strong evidence demonstrates the heart-healthy benefits of soybean, canola, corn, safflower, sunflower and other plant oils.

According to Christopher Gardner, director of nutrition research studies at Stanford Prevention Research Center in California, no single food or nutrient has as much health impact as the whole dietary pattern.

"A moderate amount of plant-based fat and reduced intake of refined grains and sugars are important goals for any healthy dietary pattern," said Gardner.

EVOO can be more expensive than other vegetable oils, so it works well to keep several healthy plant oils on hand for different uses.

Since EVOO has a fragrant aroma and strong flavor, its best uses may be to dress salads or vegetables, in place of butter on whole-grain bread, or in Thanksgiving's mashed potatoes. Canola oil is virtually flavorless, so it tends to work well in baked goods. Other plant oils can be used for sauteing, marinades and more.

If you have questions or comments about this American Heart Association News story, please email [emailprotected].

Link:
The benefits of adding a drizzle of olive oil to your diet - American Heart Association News

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