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Chattanooga, TN Long-term work disability claims for musculoskeletal issues have climbed 40% overall and 62% among men since 2010, and are especially prevalent among workers in occupations that require heavy lifting, repetitive motion or prolonged sitting, a recent analysis from insurance company Unum shows.

Unum tracks and publishes data associated with worker disability claims each May as part of Disability Insurance Awareness Month. Although cancer remains the most common cause of long-term disability, according to the organization, the next leading causes are injury, back disorders, cardiovascular issues and musculoskeletal conditions.

In a May 12 press release, Marcy Ledford, director of health and productivity at Unum, said various physical and biological attributes of workers including aging, obesity and lower activity levels also can influence musculoskeletal issues.

To help prevent long-term disability claims associated with musculoskeletal issues, Ledford encourages employers to:

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Long-term disability claims related to MSDs rose over past decade: report - Safety+Health magazine

FROM THE ACADEMY OF CONSULTATION-LIAISON PSYCHIATRY

CASE REPORT

Ms Zorn was a 45-year-old woman with no previous psychiatric history who presented with a 2-month period of feeling like I am losing myself and seeing visually distorted faces. Faces of people she was looking at would appear to be hideously elongated, with the facial components distorted, as if it was melting. Cars would also appear to be more round than usual.

She was admitted to an inpatient psychiatry unit for unspecified psychosis, but after 2 days she was transferred to a general medical unit for additional medical evaluation. She was started on 25-mg quetiapine bid, which was titrated to 200 mg bid. Lumbar puncture was completed to rule out central nervous system infection or autoimmune encephalopathy, with results pending at the time of transfer to an academic medical center for higher level of multispecialty care.

On interview, she said that she felt like she was losing herself and reported visual distortions of faces melting. Ms Zorn was able to recognize faces and colors. She reported photophobia. She had headaches, which were relieved with ketorolac. Her husband reported that she had new onset of episodes of shaking her arms in a circular motion. She would also walk around the room in circular patterns while saying to herself that she was lost.

Ms Zorn had decreased appetite, weight loss, and decreased sleep. She denied depressed mood, decreased energy, mania, trauma, or previous problems with memory. She denied auditory hallucinations and suicidal/homicidal ideation. She denied a family history of suicide and psychiatric illness. Developmental history was unremarkable. She had no history of substance abuse.

On mental status examination, she was awake, alert, oriented to person, time, place, and situation. She continued to experience visual distortions of faces melting. Ms Zorns thought process was linear and coherent. Affect was mildly anxiously perplexed, non-labile, and non-tearful. Speech was normal. Insight and judgment were marginal. Her Montreal Cognitive Assessment (MoCA) score was 10/30. Her decisional capacity was impaired, and the screening neurological examination was non-focal.

Due to the atypical presentation of psychotic disorder, the full workup included a neurology consultation; brain MRI and lumbar puncture results were normal, except for autoimmune encephalitis results that were pending. Serum HIV, syphilis, vitamin B12, lead, rapid plasma regain (RPR), anti-nuclear antibody ammonia, and thyroid stimulating hormone (TSH) levels were normal; EEG was unremarkable. Pelvic ultrasound and CT were ordered to rule out ovarian teratoma. Quetiapine regimen was changed to 100 mg in the morning and 300 mg in the evening.

Ms Zorn was seen in follow-up on hospital day 2. Neurology had started her on 1-g methylprednisolone daily for a 5-day course for presumed autoimmune encephalitis. She was placed on a continuous EEG. On exam, she reported feeling better compared with the previous day. She no longer reported any distortions of faces or objects in the room, although she did report some blue dots in her field of view. She had 3 hours of sleep the previous night. Her husband noted that the she had decreased episodes of her aimless pattern of waving her arms in a circular motion. Her MoCA score was 14/30. Due to the significant improvement in her hallucinations following the first dose of methylprednisolone, the scheduled quetiapine was held.

When seen on hospital day 3, Ms Zorn said that she could fall asleep, but had trouble staying asleep. She had an episode where she got up and walked around the room purposelessly. Her MoCA score was 13/30 and decisional capacity was impaired. Quetiapine 50 mg post merdien (PM) was started to address poor sleep. On hospital day 4, she reported that her visual phenomena had returned, with her seeing pixels (flashing punctate lights) and faces melting. She had had difficulty sleeping. MoCA was 12/30 with continued limited insight, judgment, and decisional capacity. Quetiapine was increased to 100 mg pm and mirtazapine 7.5 mg pm was started to improve sleep.

On hospital day 5, her husband reported that she had had continued visual phenomena of pixels and faces melting. Ms Zorn was only able to sleep for 1.5 hours after receiving quetiapine and mirtazapine. On exam, she reported the visual hallucinations and had a MoCA score of 12/30. Continuous EEG was reported as normal and abdomen CT was negative for ovarian teratoma. To address continued psychosis and poor sleep, quetiapine was increased to 100 mg am and 300 mg pm. Mirtazapine was increased to 15 mg pm.

Ms Zorn was seen again on hospital day 6. She reported that she had been able to sleep for 8 hours. She denied any visual melting of faces but stated that the world looked pixelated at times. MoCA score was 14/30. Subsequently, when seen on hospital day 8, she stated that she was still seeing pixels in the periphery of her visual field. MoCA score improved to 17/30. Quetiapine was consolidated to 400 mg pm.

She was next seen on hospital day 10. The cerebrospinal (CSF) encephalopathy panel came back positive for anti-NMDA receptor antibody R1, confirming a diagnosis of anti-NMDA (N-methyl-D-aspartate)-receptor encephalopathy (ANMDARE). Neurology started plasmapheresis for 7 treatments, every other day. She had no hallucinations. She reported that she was getting deep sleep. MoCA score was 16/30. A quetiapine 50 mg am dose was added.

Plasmapheresis started on hospital day 11. The patient denied any visual distortions. She said that she felt significantly better than the previous week; MoCA score was 16/30. When next seen on hospital day 15, Ms Zorn reported sleeping from 11:00 pm to 5:30 am. She denied visual distortions. MoCA score had improved to 21/30; however, decisional capacity continued to be impaired. On hospital day 18, she was doing well. She had declined her scheduled quetiapine the previous day to give it a try. She no longer saw distorted faces. She had no gait disturbance. MoCA score improved further to 25/30. Given her improved mental status, the psychiatry team decided that she had recovered her decision-making capacity. Mirtaza-pine was decreased to 7.5 mg pm and quetiapine held.

Ms Zorn was seen for the last time on day 22 of hospital admission. After her final plasmapheresis treatment, she continued to be free of psychotic symptoms. She stated that she was doing better than last week, and that she was 80% back to normal. She was sleeping well and was increasingly physically active during the day. She was excited to return home; MoCA score was 22/30. Decisional capacity continued to be intact. Mirtazapine 7.5 mg bedtime was continued.

As she was medically stable for discharge, she was referred for psychiatric follow-up near her home. She was advised that any future recurrence of psychosis should first be addressed as if it was a recurrence of delirium and/or ANMDARE.

Discussion

ANMDARE is a relatively recently described illness that may present with psychiatric symptoms, neurologic symptoms, or both (either simultaneously or sequentially).1-5 While the exact mechanism remains obscure, antibodies to the NMDA receptor (on CSF and/or serum assay) is confirmatory.2 Management includes empiric treatment of manifest symptoms and immunomodulation systemic therapies.4,5

ANMDARE is important to the consultation-liaison psychiatrist for a number of reasons. First, its presentation lies in the neuropsychiatric borderland involving collaboration between psychiatry and neurology (as in other neuropsychiatric illnesses like Parkinson disease, Huntington disease, and multiple sclerosis). Second is its importance in the often hard-to-define syndrome of atypical psychotic disorder. In comparison to the classic presentation of schizophrenia, ANMDARE features a later age of onset, female predominance, visual hallucinations, relative lack of cognitive disorganization, and a lack of an extended prodromal period.

This case illustrates the atypical presentation of psychotic illness rather well. Ms Zorn was in her mid-40s, of high academic and professional achievement, adaptive social function; without a clear prodrome, she relatively promptly developed a psychotic picture with striking and disturbing visual hallucinatory phenomena. Clinical suspicion for ANMDARE was confirmed with reference laboratory (Mayo Clinic) results of + R1 antibody to NMDA receptor on CSF analysis. This was accomplished in the context of a thorough laboratory evaluation for other esoteric causes of atypical psychotic illness.

Empiric treatment of the psychiatric symptoms with mirtazapine and quetiapine, concurrent with 2 rounds of immunomodulation therapy, led to amelioration of symptoms and near complete cognitive recovery in a period of 2.5 weeks. Her cognitive status based on objective measure with the Montreal Cognitive Assessment (MoCA) was initially in the moderate to severely impaired range.6 With comprehensive treatment, Ms Zorns cognitive status improved to a level of only mild impairment. Correspondingly, her decisional capacity improved from significantly impaired to largely intact over the same period.

Psychiatrists assessing and treating patients with atypical presentation of psychotic illness should actively consider a diagnosis of ANMDARE as explanatory.3,4 In female patients with suspicion of ANMDARE, pelvic ultrasonography and/or CT scan should be ordered to rule out commonly co-occurring ovarian teratoma.1 Patients with ANMDARE who are treated with high-dose intravenous corticosteroids should be monitored (and treated for) any corticosteroid-associated psychiatric adverse effects, which can overlap with the atypical psychotic symptoms at illness onset. Empiric treatment with psychopharmacology for psychotic and/or depressive symptoms should be pursued, although such medications may not be necessary indefinitely once definitive immunomodulation therapy is completed.4

ANMDARE should be on the differential for atypical psychosis, with an expectation of a thorough search for laboratory and systemic clinical (especially neurologic) findings, empiric treatment of psychiatric symptoms, and reassessment of the patient as immunomodulation therapy is completed. Prospective study of ANMDARE illness cohorts are needed to quantify recurrence risk, need for ongoing intervention, and ultimate prognosis.

Consultation-liaison psychiatrists working in academic medical centers may be in a position to assist multispecialty teams in the identification, diagnosis, management, and ongoing follow-up of these patients. As with any illness that affects cognitive function, attention to and serial assessment of decisional capacity is a critical part of C-L psychiatry care, especially as pertains to patient consent for major immunomodulation therapies.

Dr Bourgeois is chair, Department of Psychiatry, Baylor Scott & White Health, Central Texas Division, and clinical professor for medical education, Texas A&M University Health Science Center, Temple, TX. Mr Li is a medical student, Texas A&M University Health Science Center, Temple, TX. The authors report no conflicts of interest concerning the subject matter of this article.

References

1. Tuzun E, Zhou L, Baehring JM, et al. Evidence for antibody-mediated pathogenesis in anti-NMDAR encephalitis associated with ovarian teratoma. Acta Neuropathol. 2009;118:737-743.

2. Gresa-Arribas N, Titulaer MJ, Torrents A, et al. Antibody titres at diagnosis and during follow-up of anti-NMDA receptor encephalitis: a retrospective study. Lancet Neurol. 2014;13:167-177.

3. Kayser MS, Titulaer MJ, Gresa-Arribas N, Dalmau J. Frequency and characteristics of isolated psychiatric episodes in anti-N-methyl-d-aspartate receptor encephalitis. JAMA Neurol. 2013;70:1133-1139.

4. Warren N, OGorman C, McKeon G, et al. Psychiatric management of anti-NMDAR encephalitis: a cohort analysis. Psychol Med. November 19, 2019; Epub ahead of print.

5. Titulaer MJ, McCracken L, Gabilondo I, et al. Treatment and prognostic factors for long-term outcome in patients with anti-NMDA receptor encephalitis: an observational cohort study. Lancet Neurol. 2013;12:157-165.

6. Nasreddine Z. Montreal Cognitive Assessment (MoCA) Administration and Scoring Instructions. Montreal Cognitive Assessment. Accessed July 9, 2020. http://www.mocatest.org/wp-content/uploads/2015/tests-instructions/MoCA-Instructions-English_2010.pdf .

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Anti-NMDA Receptor Encephalitis With Visual Hallucinations and Cognitive Impairment - Psychiatric Times

There's new evidence that the high-fat, low carb keto diet might have benefits for reproductive health.

In new case reports, two men with obesity who lost weight on a very low calorie keto diet saw significant improvements in both sperm count and quality, according to research from the Universidade de SoPaulo, Brazil, presented at the 2020 European and International Obesity Congress,

In the first case, the patient lost nearly 60 pounds in the three-month dieting period, dropping his body fat percentage from 42% to 34%. Subsequently, his sperm quality improved by nearly 100%, based on the percentage of motile sperm in a test sample. His testosterone levels also more than doubled.

The second case report was of a patient who lost less weight, 20 pounds in three months, dropping from 26% to 21% body fat. His sperm quality also improved, but he saw even more significant benefits to sperm count, with over 100 million more sperm tested in the final sample, an increase of nearly 30%. Interestingly, his testosterone levels decreased slightly.

These results were based on the dieting plan called Pronokal, a highly-studied commercial weight loss method launched in Spain in 2004, which differs from traditional keto in that it's both low-carb (fewer than 50 grams a day) but also limited to 800 calories a day.

Two patients is hardly a large enough sample size to draw broader conclusions about keto and sperm count. But existing evidence supports the notion that low-carb diets could have benefits for sexual health, as increasing fat consumption appears to support healthy sperm levels.

Previous research has also linked higher levels of dietary fat intake to increased testosterone.

One caveat to these findings is that extremely restrictive diets can have side effects, particularly in the long term, and very low calorie diets in particular should only be done with medical supervision.

It's also not only the keto diet specifically that's linked to better sperm count, quality, and other measures of fertility.There's evidence healthy dietary changes of any sort can boost sexual health.

The Mediterranean diet, for instance, has been linked to improvements in erectile dysfunction. In a 2004 study, a healthy diet and exercise program helped improve erectile dysfunction in obese men.

A 2019 study found eating processed foods was linked to poor sperm count, while eating more fish and veggies was linked to better sperm count, which is also related to sex drive and overall sexual function.

The DASH diet, which limits red meat and full-fat dairy in favor of fruits, veggies and whole grains, is also linked to higher sperm count, according to research.

That suggests that the benefits may be less related to any one dietary pattern, such as keto, and more about improvements to overall health that affect every area of the body.

Read more:

There's now evidence that junk food like pizza and chips could reduce your sperm count, but eating fish and veggies may improve it

A vegan diet can boost erections, according to a new Netflix documentary. Here's the reality.

Going on a low-carb diet could be more effective for weight loss than cutting calories, especially for people with insulin resistance

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The keto weight loss diet could help boost sperm count and quality, according to 2 case reports - Insider - INSIDER

Kate Middleton green juice

Another favourite breakfast of Kate Middleton's is porridge.

Porridge has been found to help with slimming.

Numerous studies have shown porridge is one of the best choices to start the day for stable and steady weight loss.

Porridge is full of fibre, which keeps you fuller for longer. One US study found of 22,000 adults, those who ate porridge had lower body weights and smaller waists than those who didnt eat it.

David Wiener, Training Specialist at Al-based fitness and lifestyle coaching app Freeletics told Express.co.uk how consuming turmeric can help aid weight loss.

David says: Turmeric contains a natural anti-inflammatory compound called curcumin, which helps your body to fight foreign bacteria and also helps to repair damage.

While acute inflammation is beneficial for your body and allows for effective fighting bacteria, long term internal inflammation has recently been linked to a number of chronic illnesses, such as heart disease and some cancers.

Thus, including turmeric in your diet can help control inflammation for long term health benefits.

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Kate Middleton has certain breakfast everyday to maintain size six figure and flat stomach - Express

New data presented at the recent European and International Congress on Obesity suggests testosterone therapy may be a helpful treatment for some men suffering from obesity. The research finds long-term testosterone therapy can, in some cases, be as effective as bariatric surgery in morbidly obese subjects.

Low testosterone levels have consistently been detected in severely obese men, and obesity has also been noted as a common symptom of hypogonadism, a clinically diagnosed condition where men cannot produce average levels of testosterone. This complicated bidirectional relationship between obesity and low testosterone has been referred to as a vicious cycle by some researchers.

Farid Saad, from the UAEs Gulf Medical University School of Medicine, has been investigating the relationship between testosterone and obesity for over a decade. His latest research examines 15 years of data from a German registry tracking men with hypogonadism.

Saad and his colleagues looked at data from 471 obese men with hypogonadism, 276 of whom received long-term testosterone therapy, while 195 chose not to undergo hormone treatments, thus serving as a functional control group.

Across a follow-up period of about eight years, the data shows the testosterone group dropping 23 kg (50 lb) in weight, on average. The men in the control group not receiving testosterone therapy showed an average increase in weight of 6 kg (13 lb).

Waist circumference, body mass index, and visceral fat measurements all improved in the testosterone group compared to the control. Even more strikingly, the overall mortality rate of the testosterone group was significantly lower than the control by the end of the follow-up period: 7.6 percent vs 32.3 percent. Plus, over 20 percent of men in the control group developed type 2 diabetes across the study period, whereas no men in the testosterone group developed the metabolic disorder over the same timeframe.

"Long-term testosterone therapy in hypogonadal men resulted in profound and sustained weight loss which may have contributed to reductions in mortality and cardiovascular events, says Saad. Untreated men with hypogonadism gained weight."

Zooming in on those most obese subjects, the researchers found 76 men could be classified in the highest risk class 3 category of obesity. This category is occasionally referred to as morbid obesity, and bariatric surgery is often recommended as an effective treatment.

Of the 76 men in this category, 59 received testosterone therapy, and the remaining 17 served as controls. In this sub-group, the testosterone cohort lost an average of 30 kg (66 lb), while the control group gained an average of 5 kg (11 lb). Saad notes the weight loss and general metabolic improvements seen in this morbidly obese cohort following long-term testosterone therapy resemble benefits seen with bariatric surgery, suggesting this may be a useful alternative treatment option.

"Long-term testosterone therapy in men with hypogonadism and the most severe level of obesity resulted in profound and sustained weight loss in a magnitude comparable to that achieved with metabolic (obesity) surgery, says Saad. Side effects and complications may be in favor of testosterone therapy.

These results of course need broader validation before testosterone therapy can be widely recommended as a treatment for obesity in men. The data gathered in this new research is limited to a very specific cohort of older men with clinically diagnosed hypogonadism.

The new research was recently presented at the European and International Congress on Obesity.

Source: European Association for the Study of Obesity via Eurekalert

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New evidence testosterone therapy is effective obesity treatment in men - New Atlas

When you're starting a new weight loss journey, it's easy for your mind to zero in on one thing: how quickly you can reach your goal weight. It's not uncommon to start doing calculations in your head, like, Can I lose this weight before that wedding that's coming up? or, How much weight can I realistically lose in three months?

But achieving any amount of weight loss in a short time span like three months requires lots of small decisions along the way, like conscious choices about what you're eating, how much exercise you want to incorporate into your week, and what you can do to effectively manage your stress, which can also affect your weight.

If you're trying to shed a few pounds in the next three months specifically (which is realistically how much time you'll need to see a big difference in your weight), here's what a registered dietitian and certified personal trainer have to say about the processand how to figure out what your goal weight should be on that timeline.

In order to experience weight loss that's sustainable, it's important to do it gradually, says Stephanie Carter, RDN. "According to the National Heart, Lung and Blood Institute (NHLBI) and the Centers for Disease Control (CDC), as well as many other leading experts, individuals who lose weight gradually and steadily, one to two pounds per week, will be more successful at achieving lifelong weight maintenance," she says.

That one- to two-pound weight loss per week translates to about 12 to 24 pounds over the span of three months. "This means youre aiming for four to eight pounds per month," says Dannah Eve Bollig, a trainer and creator of The DE Method. But Bollig also warns that if you're trying to shed a lot of weight, say, 50 pounds or more, it's not uncommon to lose weight at a faster pace than one to two pounds a week in the beginning of your journey, before your weight loss slows down or even plateaus for a bit. "This can be extremely frustrating and is mainly caused by a metabolism decline resulting in your body burning fewer calories than it did at its heavier weight."

The reason you lose weight more quickly in the beginning is because you're shedding a lot of water weight. "When you consume foods in excess of your metabolic needs, your body stores this energy as glycogen, the storage form of glucose, or sugar, in the liver and muscles," says Carter. So when the body isn't getting enough energy from calories, it'll start using up the stored glycogen. "Because glycogen is bound to water, any glycogen broken down for energy will also release water. This accounts for the initial significant changes in body composition when people begin to diet," adds Carter.

In order to drop about one pound of fat, you'd need to burn about 3,500 calories. That means that, in a week, you'd need to consume 3,500 to 7,000 less calories than normal (or burn those calories) to drop one to two pounds.

There are several ways to safely achieve this calorie deficit, but how you should do it depends on a lot of lifestyle factors. "The best thing to do is take into account a person's age, weight, height, and goal, and decide on a proper and realistic plan for that individual. There is no magical solution that will work for everyone," says Bollig, who adds that losing weight is all about balance, not cutting out all less-nutritious food. But, mathematically speaking, if you were to cut out about 500 to 1,000 calories per day, youd likely lose about one to two pounds per week, she notes.

Carter says she's helped her own clients lose weight by moving them towards redefining their relationship with food, instead of encouraging calorie counting. "While it does take an energy deficit of 3,500 calories per week to lose one pound, I counsel clients to look at the composition of their meals rather than the calories they provide," she explains. "Restricting foods you love because youve labeled them as 'bad' will only lead to unhealthy behaviors such as binge eating or overeating. If you listen to your bodys natural hunger and fullness cues you very well may create an energy deficit."

But if you prefer a more structured diet plan and that works for you mentally, there are tons of options. One of the most popular options people turn to is a low-carb diet, or even the keto diet, which aims to get your body to use fat as a form of energy by minimizing your intake of carbs.

For others, a preferred method of weight management is intermittent fasting (IF). There are a variety of ways to try IF, but all of them require windows of eating and fasting periods. For example, the 16:8 diet recommends you eat all your meals within an eight-hour window. "Time restricted eating or intermittent fasting depletes your glycogen stores, which supports metabolic flexibility and insulin sensitivity," says Carter. "High insulin sensitivity allows the cells of the body to use blood glucose more effectively, reducing blood sugar and promoting weight management."

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You can also try to meet a calorie deficit by keeping detailed logs of what you're eating, using something like a food diary app, and focusing on portion control. A nutrition app can also help you see eating patterns, so that you can make better-informed choices about what you decide to eat, and count calories.

Whichever way(s) you decide to lose weight, it's best to first consult a doctor to make sure that the diet or lifestyle change you want to make is appropriate for you.

Adding an exercise program to your routine can not only help you lose weight, but it can also reduce the risk of conditions like heart disease and diabetes. The U.S. Department of Health and Human Services actually recommends adults get at least 150 minutes to 300 minutes a week of moderate-intensity exercise, or 75 minutes to 150 minutes a week of vigorous-intensity exercise.

Bollig says that cardio can definitely assist in weight loss, but that it isn't necessary if you're not into it. "Its important to keep in mind that you do not need to do cardio to lose fat. You can lose fat by restricting caloric intake, and by doing other types of training like resistance training, weight training, HIIT, or a combination of all the above," she says. "The key to losing body fat is to consume fewer calories than you expend."

Strength training can also serve as a great way to aid weight loss, since the more muscle mass you have, the more calories you burn day to day. Bollig recommends incorporating strength training about two to three times per week to help build lean muscle mass, decrease body fat, and strengthen muscles, joints, and bones.

If you need help deciding on a fitness plan, first consult your doctor to make sure you're cleared to get active, and get familiar with these calorie-burning exercises.

Losing weight isn't just about what you're eating or how much you're exercising. Other factors like hormones and sleep can also have an impact on your metabolism.

Not getting enough sleep can throw your body out of whack. Carter recommends getting at least seven hours or more a night to make sure your diet and exercise habits have the best shot at working. "Inadequate sleep has been shown to alter glucose metabolism, decrease insulin sensitivity, and disrupt the hormones involved in regulating metabolism," says Carter. So, make sure you're getting enough Zs!

Not managing your stress levels (a.k.a. how much stress hormone, or cortisol, is flowing through your body) can also make it harder to lose weight. In fact, cortisol can cause the body to metabolize calories slower, according to a study published in the Journal of Biological Psychiatry. Keeping your stress in check by nixing the things that trigger it, or by managing your daily stress with self-care techniques, is super important for weight loss efforts to work.

Some tough exercise can up cortisol too, Carter adds, "so it's important to vary high-intensity exercise with restorative workouts such as yoga, stretching and meditation."

It's best to look at the whole picture when you're trying to lose weight, not just your diet. "Implementing sleep, meditation, and exercise with a balanced diet is the best recipe for sustainable, long-term results," says Bollig.

And don't become discouraged if you hit a plateau, which is pretty normal for anyone on a weight loss journey. It's also easy to stray away from the healthy habits you've built once you experience your initial weight loss, which you usually have to keep up in some capacity to maintain your results.

"If your weight loss does slow down, the best thing to do is stay on track, believe in yourself, work hard and talk to your doctor, nutritionist, or personal trainer about what youre feeling and reevaluate your current plan," Bollig says. "There are plenty of solutions including cutting more calories daily, increasing physical activity, changing the type of physical activity or a combination of all three." By changing up your routine a bit, you're bound to lose weightand hit that goal come three months.

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How Much Weight Loss Can You Achieve In Three Months? - Women's Health

NEW LONDON Lawrence + Memorial Hospital will host free webinars on bariatric weight-loss surgery. Patients 60 or more pounds overweight and concerned about developing obesity-related conditions such as diabetes, high blood pressure, sleep apnea or gastric reflux may be candidates for weight-loss surgery.

The webinars will be hosted by the hospitals qualified bariatric surgeons on Sept. 17, 21 and 30; Oct. 6, 15, 19 and 28; Nov. 4, 10, 18 and 23; and Dec. 3 and 16. The webinar will be available in Spanish on Sept. 8 and Dec. 8. The Sept. 17, Oct. 19 and Dec. 3 sessions will be hosted by Dr. Geoffrey Nadzam, chief of surgery at L+M.

Attendees will learn about the two surgical options available: a gastric bypass, which bypasses a portion of the stomach and re-routes food to the intestines, and a sleeve gastrectomy, in which nearly 80 percent of the stomach is removed leaving a long sleeve to restrict food intake. The minimally invasive procedures offer an opportunity for those who have struggled with morbid obesity to make behavior and lifestyle changes that can result in significant weight loss and health improvement.

A board-certified bariatric surgeon will discuss the criteria to qualify for surgery, the pros and cons of each procedure, the long-term health benefits, and the counseling and support services available to patients afterward. The surgeon will also answer questions about the team of experts in medicine, nursing, nutrition, psychology and surgery who lead the program, as well as the national accreditation that recognizes the bariatric surgery program for its safety, efficiency and commitment to quality care for the bariatric patient.

To register for the seminar, call 203-789-6237 or visit ynhh.org/services/bariatric-surgery/info-request-form.aspx.

Sun staff

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L+ M Hospital to host free webinars on weight-loss surgery - The Westerly Sun

Many people struggle to keep their weight in check as they age. Now brand-new research at Karolinska Institutet in Sweden has revealed why that is: Lipid turnover in the fat tissue reduces throughout ageing and makes it much easier to gain weight, even if we dont eat more or workout less than in the past. The research study is released in the journal Nature Medicine.

The scientists studied the fat cells in 54 males and females over a typical duration of 13 years. In that time, all subjects, despite whether they got or slimmed down, showed decreases in lipid turnover in the fat tissue, that is the rate at which lipid (or fat) in the fat cells is eliminated and kept. Those who didnt compensate for that by consuming less calories gained weight by approximately 20 percent, according to the study which was carried out in partnership with researchers at Uppsala University in Sweden and University of Lyon in France.

The scientists likewise took a look at lipid turnover in 41 ladies who underwent bariatric surgery and how the lipid turnover rate affected their capability to keep the weight off four to seven years after surgical treatment. The outcome revealed that only those who had a low rate prior to the surgery managed to increase their lipid turnover and keep their weight loss. The scientists believe these individuals might have had more space to increase their lipid turnover than those who already had a top-level pre-surgery.

The results indicate for the first time that processes in our fat tissue regulate changes in body weight during ageing in a way that is independent of other factors, says Peter Arner, professor at the Department of Medicine in Huddinge at Karolinska Institutet and one of the studys main authors. This could open up new ways to treat obesity.

Prior research studies have actually revealed that one way to accelerate the lipid turnover in the fat tissue is to work out more. This new research study supports that concept and further suggests that the long-term result of weight-loss surgery would enhance if combined with increased physical activity.

Obesity and obesity-related diseases have become a global problem, says Kirsty Spalding, senior researcher at the Department of Cell and Molecular Biology at Karolinska Institutet and another of the studys main authors. Understanding lipid dynamics and what regulates the size of the fat mass in humans has never been more relevant.

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Why individuals put on weight as they age - Drew Reports News

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Hedonic adaptation describes the human phenomenon of putting a check on happiness even after the best news, from weight loss to lottery wins. Put another way, in terms of investing: What have you done for me lately? Perhaps then its no surprise that Wall Street always has one eye to the future, no matter how well a company has done in the past and is performing in the present.

Big-box retailers fit that scenario, as investors wonder how long the good times can last. For Costco and Target, the answer is: at least through last month.

After the close of regular trading Wednesday, Costco Wholesale (ticker: COST) reported another month of double-digit comparable-sales growth. Comps climbed 14.5% in August, excluding fluctuations in gasoline and foreign exchange, while e-commerce sales soared more than 100%.

That is par for the course for the discount retailer, which put up similarly strong same-store sales in June and again in July. While the company got a boost from panic-buying in March, flat April sales had some investors worried that demand had simply been pulled forward, and wouldnt rebound. Strong May results showed that wasnt the case. And the fact that Costcos comps have held steady above the 14% mark for three consecutive months shows that the trend has legs.

While some investors may have been concerned to see August levels dip from Julys robust 15.8% rate, the results were still strong, and included e-commerce sales that accelerated from the previous two months, even as more physical locations reopened.

Costcos August report echoes similarly upbeat news from Target (TGT). The company reported strong second-quarter results on Aug. 19, and at the time management said that month-to-date same-store sales were up by percentages in the low double digits.

That helped Targets stock pop, especially because the results contrasted with Walmarts (WMT) just a day before. Walmart said July same-store sales were up just 4%, a deceleration from more than 9% in the quarter as a whole, which it blamed on the fact that most consumers had already spent their government stimulus checks, with no second round in sight.

Of course, it isnt an apples-to-apples comparison, because Walmart didnt provide August data. Still, both Costco and Target saw double-digit same-store sales growth for their most recent quarter as well. Targets comps jumped 24.3%, while Costcos were up 14.1%. Although Costco doesnt report until later this month, it provided preliminary top-line results on Wednesday.

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A morning briefing on what you need to knowin the day ahead, including exclusive commentary fromBarron's and MarketWatch writers.

So although the sustainability of sales growth will remain a major question in retailevery great comp figure becomes a hurdle to pass the next yearcontinued strength in August should provide investors with some level of reassurance that, while consumers may be in a tight spot, the big essential retailers will likely continue to win. It is also reassuring that both saw broad-based gains, demonstrating that shoppers arent just buying low-margin food and sundries.

That isnt to say investors should count Walmart out. The companys sheer size means it cant grow as quickly as its smaller peers, and with the shares up 21% in 2020, it is the best-performing stock, helped by optimism about its bid for TikTok and other initiatives including its Walmart+ subscription service.

Ultimately, there is room for more than one winner. Margaret Reid, senior portfolio manager with the Private Bank at Union Bank, says that all three will continue to succeed, although she thinks that because of Walmarts size, Target and Costco will capture greater market share post-pandemic.

Target is absolutely one of those brands that consumers can look to for value and convenience, she notes, highlighting its strength in areas such as apparel for children, which Barrons also noted it in s back-to-school coverage.

For all its success, Costco still has low market share in the U.S. and globally Reid notes, meaning that it has much more white space than Walmart, and potentially Amazon.com (AMZN). She also likes its value proposition, convenience, and the strength of its supply chain. Its one of those companies that can continue to have a long-term, sustainable growth rate higher than a lot of other[s] in food and apparel retail.

As weve noted before, the stocks might not look cheap, but growth is a rare commodity among traditional retailers these days, one that investors have been willing to pay up forespecially when there is evidence it can continue. And if history is a guide, that premium has been rewarded. All three stocksled by far and away by Costcohave easily outperformed the S&P 500 over the past 20 years.

Write to Teresa Rivas at teresa.rivas@barrons.com

More here:
Growth Is a Rare Commodity in Retail. Costco and Target Are Cashing In. - Barron's

Sleeping well is important if you want to lose weight

Weight loss tips: Having a good diet not only favours your nutrition, it also helps to sleep well. What you eat effects your sleep. Many people find it difficult to sleep at night. One of the important reasons people wake up at mid-night is the blood sugar crash. Most of us snack on cookies, brownies at evening which results in blood sugar crash at midnight and wakes you up. Getting good sleep is very important for your overall health as it reduces the risk of certain chronic diseases and boost immunity. You might be on the least calorie diet however if you are sleep deprived, it can lead to weight gain leaving you puzzled and grumpy.

It's generally advised to get between 7 to 9 hours of uninterrupted sleep each night, though many people struggle to get enough. A lack of sleep in the long term can cause changes in the hormones that regulate appetite and hunger. There are two important hormones - Ghrelin that triggers the feeling of hunger and Leptin which supresses hunger and signals the brain to stop eating once full. Sleep deprivation reduces the level of leptin and ghrelin shoots up. This increases your hunger constantly and causes you to eat more than needed. It also fails to give you a signal when the stomach is full.

To induce sleep, avoiding caffeine or caffeinated drinks 5 hours before sleep time can be the first step you can take. There are mainly four vitamins and minerals which are found in foods and can promote better sleep: calcium, B6, tryptophan and magnesium. These nutrients help the body produce melatonin, the hormone that is responsible for regulating your circadian (sleep/wakeup pattern). The good news is there are certain foods and drinks which naturally have these nutrients that you can consume and get a peaceful, stress free sleep as a reward.

Also read:Weight Loss: 4 Changes You Need To Make To Your Night-Time Routine For Better Digestion And Good Sleep

1. Almonds: are a great source of magnesium and has potential sleep-promoting effects.

Almonds have sleep-promoting effects on the bodyPhoto Credit: iStock

2. Chamomile Tea: known for its content of antioxidants especially apigenin, it promotes sleepiness.

3. Milk or Yogurt: dairy products contain tryptophan, vitamin D and calcium thus can be a relaxing nightly ritual.

4.Tart cherries juice: are a great source of fibre, vitamin C, vitamin E, potassium, polyphenols, tryptophan making it great source of peaceful sleep.

5. Fatty fish:May help improve sleep because they are a great source of omega3 fatty acids, potassium, magnesium, folate and calcium.

Also read:5 Nuts And Seeds Loaded With Omega-3 Fatty Acids You Must Add To Your Plant-Based Diet

6. Kiwi: Kiwi is a great fruit for inducing sleep as being rich in melatonin, flavonoids, potassium, folate and calcium.

7.Oatmeal: being the natural source of melatonin, oats are a perfect meal for having great sleep.

8.Bananas: bananas are nature's sedative, as they contain potassium, magnesium and tryptophan which are great for inducing sleep.

It is not just foods, there are many drinks contain essential nutrients that help aid with sleep. These are almond milk, peppermint tea, chamomile tea, passion fruit tea, valerian tea, etc. It is always advised to avoid consuming high caffeine, high fat, high salt or high water foods before going to bed. Thus, the bottom line is getting enough sleep is very important for your health and eating well can really help you reward with great sleep.

Also read:Try These 7 Foods That Have More Potassium Than A Banana To Control High Blood Pressure

(Monisha Ashokan is a nutritionist at Nourish Me)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

Read the rest here:
Weight Loss: Nutritionist Explains Why A Good Night's Sleep Is Important For Shedding Calories - NDTV

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