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Have you given someone advice lately? Turns out, it might help you as much as it helps them.

Whartons Behavior Change for Good Initiative, which is working to learn how behavioral science can teach people to be healthier, better educated, and more responsible with their finances, recently published research that made our Wharton Global Youth Program team do a double-take. Its not every day that researchers here at the Wharton School of the University of Pennsylvania in this case postdoctoral student Lauren Eskreis-Winkler and professors Katherine Milkman and Angela Duckworth conduct a large-scale field study involving high school students. Our favorite demographic!

The study, titled Advice-giving with CLRN (Character Lab Research Network) gathered data from the experiences of nearly 2,000 high school students attending seven diverse high schools in the U.S. The investigation examined the benefits of asking individuals, specifically teenagers, to give advice to others (like telling a younger student how to stop procrastinating), and then measured the impact that this giving had on the advisors grades. Advice givers earned higher report card grades in math and a self-selected target class over an academic quarter, the study concludes. This psychologically wise advice-giving nudge, which has relevance for policy and practice, suggests a valuable approach to improving achievement: one that puts people in a position to give. In other words, giving advice helps you do better in life.

This Knowledge@Wharton interview with Eskreis-Winkler takes a closer look at the study, which was published in Proceedings of the National Academy of Sciences (check out the Related Links in the side toolbar to read the research in more detail). Not much previous research has looked at the benefits of giving advice and sharing information, but instead at the results of receiving advice. Turns out, it might be better to give than to receive.

Knowledge@Wharton: Does this research start from the point that we are all experts about ourselves?

Lauren Eskreis-Winkler: Exactly. I think people do know in many ways what works best for them. It remains an open question as to why advice-giving works, but one of our primary hypotheses and weve gathered some evidence for this is that it really builds your confidence.

If you imagine you are constantly trying to lose weight and repeatedly failing to achieve that goal, it saps you of your confidence. The notion that suddenly youre put in a position where someone asks if you have useful information and presumes that you do, that could raise your confidence. The act of giving advice forces you to focus on the things that you already know how to do versus things you dont, the things that are in your control versus the things that arent. For all of these reasons, we think that advice-giving probably is a confidence booster that raises peoples motivation, giving them what they need to achieve their goals and to realize whats holding them back.

Knowledge@Wharton:Maybe its something thats often been a source of shame or embarrassment, whether its losing weight or stopping smoking. Then youre taking that problem that is a source of bad feelings and making it into a source of good feelings because youre being looked to as an expert. Is that correct?

Eskreis-Winkler: Exactly. We also studied this in kids in school, even the kids who arent necessarily feeling bad about themselves. I think its a totally novel experience in todays educational world that youd go up to a 15-year-old in school and say, Hey, we think you have really useful knowledge. Could you share it with someone else? The whole structure of education is that these kids are the recipients. Theyre sitting in class taking notes, receiving knowledge. In general, it was just a very novel experience for a kid, regardless of the degree to which theyre failing or not failing, to be suddenly appointed as an adviser to just make them feel that, Wow, I have something to give to somebody else.

Knowledge@Wharton:How did you design this experiment with high school students, and what were the results?

Eskreis-Winkler:This was a large-scale, randomized controlled trial that was run with close to 2,000 high school students. The scale of this was only made possible by partnering with the Behavior Change for Good Initiative and the Character Lab, both at the University of Pennsylvania. They really made this research frictionless and facilitated these partnerships. Typically, I think its very hard for researchers to test questions like this at scale.

We recruited about 2,000 students and randomized them to one of two conditions. Either theyre in the treatment, which is that they give advice to younger students, or theyre in the control condition, which is practice as usual and they didnt receive anything in particular. The program was online, so teachers took their students to the computer lab and students signed in. There was this very aesthetically pleasing, graphically designed program that students walked themselves through. They were asked to be coaches. We said, Help us help other students. Then the treatment they went through a series of exercises that tried to elicit their advice.

There were some multiple-choice questions that asked them to advise on optimal study locations. There were some open-ended questions where they were writing notes of advice to younger students. The whole experience was short, but it was meant to make them feel like bona fide advisers. They had information to give, and we were getting it, and we were actually going to give it to younger students.

The hypothesis was that this act of stepping into the adviser role would raise the students confidence, increase their motivation. It was a pretty high bar, but we were hoping and expecting that it would, in turn, raise the students achievement levels. We collected the students grades over the academic quarter to see whether this intervention, which was delivered to students at the beginning of the third quarter, would increase their grades. And it did. We specifically pre-registered and predicted in advance that it would raise their grades in a target class. This is a class in which students self-report that theyre most motivated to improve. Math is a subject thats notoriously difficult to change student achievement and a subject in which many students lack confidence. We thought this advice-giving intervention would be effective in math, and we did find that the students target grades and their math grades improved relative to students in the control condition.

The student who has two pages of math problems and really doesnt want to do them tells me that he will put a candy at the end of the page. Each time he goes through the problems, he eats a candy. Lauren Eskreis-Winkler, Wharton Postdoctoral Researcher

Knowledge@Wharton:How much did their grades improve?

Eskreis-Winkler:It was a couple of points. The grading scale was between 50 and 100, so students who are at 50 are failing out of their classes, and 100 is the best you can do. On average, students improved one or two grade points, so its not like a huge effect. But I think its really noteworthy given the cost of the intervention. Its a marginal cost of zero. Any school district could implement this. Unlike many very intensive, costly programs like tutoring that often have very small, if any, effects, this program is costless not only in money but also in time.

Students had a very brief interaction with the program. I think one interesting direction moving forward would be to look at whether booster sessions help. If youre an advice-giver not just once, but many times, or if you interact not just with a computer module, but with an actual younger student, could all these things increase the efficacy of the program and lead to much stronger effects?

Knowledge@Wharton:Its kind of like a mentoring program in that the older students shared what theyve learned with the younger students.

Eskreis-Winkler:Yes, and all of the advice really focused them on motivation: What do you do to stop procrastinating? What would you tell a student whos really not so motivated in school? It was really focusing students on what do you do when you get home and dont want to do your homework? How do you get yourself to do it? Students have these ingenious strategies that, I think, sometimes they lack the motivation to put into action, but they have really great ideas about what they should be doing.

Knowledge@Wharton:Was there one from the student study that really stood out to you?

Eskreis-Winkler: Ive come across a host of different things students say. Theyre very effective at rewarding themselves. The student who has two pages of math problems and really doesnt want to do them tells me that he will put a candy at the end of the page. Each time he goes through the problems, he eats a candy. I think theyre very in tune to rewards and incentives. There are also very creative strategies. One kid who I often quote, a seventh grader, told me very dramatically that he imagines his house is burning down, and if he doesnt finish his homework in time, the fire is going to consume him. Just really imaginative.

I think psychologists have known for a long time that very young children engage in imaginative play, and theyre incredibly creative. Talking to students about how they motivate themselves just reinforced that that never goes away. I think maybe we channel that imaginative and creative play in specific ways, and this is definitely one of those ways.

Knowledge@Wharton:What are the implications here, not just for high school students or educators but also in different settings? If Im a business manager, could I use this? If Im an individual employee and my company is not going to do this, could I try it?

Eskreis-Winkler:Yes, absolutely. We expanded because we were interested in that exact question. We wanted to know not just with regard to academic achievement, but a host of self-regulatory goals like people struggling to lose weight, to control their tempers, to save money, to motivate themselves in the job market. We explored all four of those domains.

We recruited people who self-identified that they really struggle to save money, that they really struggle to lose weight, they struggle to control their tempers, and unemployed individuals who are struggling to get a job. In all of these domains, we tested whether people were more motivated by giving advice or receiving advice from an expert source.

For example, the people who were trying to lose weight either gave advice or received advice from nutritionists at the Mayo Clinic. [People] overwhelmingly said that they were more motivated by giving advice than by receiving advice.

What was especially interesting is that afterwards, we recruited people who didnt go through the two activities but who were predictors. They were yoked to somebody who had given advice and received advice. They had to predict which would be more motivating. Overwhelmingly, the effect flips. People say, Well, of course, somebody who cant save money is going to be more motivated by getting advice from someone at America Saves than by giving advice. So, people completely mis-predicted the phenomenon. We find that its really not confined to kids in school. Generally, when youre struggling with motivation, when the problem is not knowledge, you really do seem to benefit more from giving advice than from receiving it.

Knowledge@Wharton:Instead of looking outward, you need to look inward.

Eskreis-Winkler:I think thats absolutely right. People think that theyre not achieving because theyre lacking something, and often that something is information. Its like, I dont have it within me. I have to go to a teacher or an expert or somebody else who can give me what I lack. To the degree to which youre lacking confidence, it seems like just being repositioned into the role of a giver versus a receiver can give you everything you need.

Do you mentor other students -- not as a tutor, but simply providing advice? What are the benefits of doing this? Do you feel more confident?

Are you more motivated by giving advice, rather than receiving advice? Why or why not?

Using the toolbar accompanying this article, research the Wharton Behavior Change for Good Initiative. What is it and how does it help inform policy and decision-making? What is behavioral science?

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Providing Guidance to Others Could Boost Your Own Success - Knowledge Wharton Highschool

What health questions did people ask Google most often in 2019? (Photo by Ali Balikci/Anadolu ... [+] Agency/Getty Images)

What is keto may not have been the most Googled what is question of 2019. No, that honor belonged what is area 51, followed by what is a VSCO girl, what is momo, what is a boomer, and what is quid pro quo. But what is keto did rank number two among all health questions asked of the popular Internet search engine since January 1, 2019.

Looking at what a person searches for on the Internet doesnt necessarily tell you everything about that person and what he or she does. For example, who knows what I may have Googled before writing stories for Forbes on coffee enemas and boofing? Nevertheless, Google searches can offer a sense of what many people may be curious about or have on their minds. For example, the popularity of what is a boomer could imply that many people are hearing the phrase, ok, boomer, and the popularity of what is quid pro quo could mean that many people happen to be learning Latin.

Therefore, taking a peek at the following 10 most Googled health-related questions of 2019 can give us a window into the health questions of interest over this past year. So without further ado, here are each of these questions and some answers:

1. How to lower blood pressure?

Answer: Not measuring your blood pressure or altering the blood pressure machine is not an option here. What you dont know can kill you. Of course, your blood pressure can fluctuate throughout the day. For example, it may go up monetarily if you see Justin Bieber. Or go down, depending on your situation and point of view. However, having elevated blood pressure over longer periods of time puts you at higher risk for all kinds of badness including heart attacks and stroke. Your first option should never be medications, unless it is an emergency situation. Lifestyle modification should come first such as reducing your sodium intake, losing weight, getting more exercise, limiting alcohol intake, reducing stress, meditating, and listening to Michael Bubl. Dont try to manage your blood pressure on your own. Get help from a physician who really knows what he or she is doing. Be wary of any physician who want to slap you on medications before really getting to know you and trying other non-pharmaceutical options. High blood pressure is quite common, affecting around one in three adults in the U.S. Yet, only 54% have their high blood pressure under control, according to the Centers for Disease Control and Prevention (CDC).

Here is a Cleveland Clinic video on natural ways to lower blood pressure:

2. What is keto?

Answer: In Greek mythology, Keto was the goddess of sea monsters, whales, and large sharks (sorry, small sharks). It also is short for ketoconazole, an anti-fungal medication. KETO-LP is the name of a radio station in Aurora, Colorado, as well. Then, there is Keto Shimizu, a television writer, producer, and comic book writer known for her work for the SyFy channels Being Human and CWs Arrowverse superhero shows. Is there anything else?

When people are Googling "what is keto," they may be searching for Keto Shimizu (L), seen here with ... [+] Jes Macallan and Matt Ryan onstage at Comic-Con International 2018. (Photo by Mike Coppola/Getty Images)

Oh, yes, theres the "Keto" Diet, which is short for ketogenic because genic takes too long to say. The ketogenic diet is a low-carbohydrate, higher fat diet with fat consisting of as much as 90% of the caloric intake. Yes, you heard that correctly, after years of people recommending low fat diets, a high-fat diet is now being pushed. Holy bacon, Batman, whats the theory behind this? Well, depriving your body of carbohydrates is supposed to switch your body from relying on sugar from carbs for fuel to relying on ketone bodies that result when your liver burns fat that is stored in your body. Burning fat in theory sounds good. The relative simplicity of this explanation and the observation that people can lose weight in the short term from this diet has led to a business boom, with many pushing keto products like books, seminars, and foods.

But is keto just a fad or is there some meat (and bacon and cheese) to it? Well, the jury is still out on the keto diet as not enough longer-term scientific studies have been done to determine if it is an effective and healthy way of losing weight and maintaining weight loss. The diet certainly has some potential risks such as not getting enough of the nutrients that you would normally get from fruits, vegetables, and grains, overtaxing your liver and kidneys, constipation, and your constantly telling other people that you are on the keto diet. Plus, some may find the diet tough to maintain. Again, this is a case of the science needing to catch up to the hype.

3. How to get rid of hiccups?

Answer: A vocal hiccup is a singing technique used by Buddy Holly and Michael Jackson, which sounds a little like gulping for air or gasping. So the answer to this question could be just stop listening to Thriller. If you are referring to those involuntary contractions of your diaphragm, the muscular structure below your lungs that help you breathe, then the answer is a bit more complicated. There arent scientific proven ways to stop hiccups because such studies are a bit hard to do. Typically, you can never expect hiccups to occur. You dont say, next Thursday at 3 pm Eastern Time, I will begin hiccuping uncontrollably. Therefore, it is a bit difficult to run scientific experiments, unless you constantly live in a laboratory. Nonetheless, anecdotal evidence suggests the following possible remedies:

Anecdotal evidence suggests that breathing into a paper bag may help stop hiccups. However, there ... [+] have been no studies to prove its effectiveness. (Photo: Getty Images)

4. How long does the flu last?

Answer: If you are wondering about flu symptoms, then the answer is forever if you die from it (which occurs to tens of thousands of people each year in the U.S. alone) and three to seven days if you dont have any complications. If you are wondering about how long you are contagious, you actually start becoming contagious one day before you even have symptoms. In fact, one third of people infected with the flu virus dont ever develop symptoms. But they can still shed flu viruses like some people bedazzle. So that person whom you stood so close to for so long may have given you more than his or her number. This makes it very tough to completely avoid flu viruses. Thats why getting vaccinated is the only way to really protect yourself and others.

5. What causes hiccups?

Pictured here is the diaphragm. (Illustration: Getty Images)

Answer: Looks like lots of people are getting hiccups or at least laughing at people who are getting the hiccups. This is the second appearance on this 2019 list of the diaphragm-spasming-causing-your-vocal-cords-to-snap-shut phenomenon. Its not completely clear what may cause temporary hiccups. It may be having too much stuff in your stomach such as food, air, or bacon. It may be sudden changes in temperature. It may be stress or excitement such as seeing Justin Bieber. In most cases, you just dont know what started them. Chronic or frequently repeated episodes of hiccups are a different story, This can be a sign that something like a mass or inflammation is irritating your diaphragm or the nerves that control and extend to your diaphragm. Certain medication or serious medical conditions such as diabetes, kidney failure, and encephalitis can lead to hiccups as well. Therefore, if hiccups continue to be an issue, call you doctor.

6. What causes kidney stones?

Answer: Being told that you have stones may be good as long as the stones are metaphorical, meaning guts or a backbone. Being told that you have kidney stones, not so good. Kidney stones, otherwise known as renal lithiasis or nephrolithiasis if you want words harder to pronounce, form when some type of mineral or salt clusters together inside your kidneys. Stones can form when you have too much of certain mineral or salt or if you are not hydrated enough. Calcium oxalate or calcium phosphate stones can form when you get high doses of vitamin D, undergo bypass surgery, or have metabolic issues. Uric acid stones can result when you eat too much protein or have gout. Certain types of urinary tract infection can lead to struvite stones.

Here is a video from the University of California-Irvine Health entitled Leave No Stone Unturned, which, of course, is a punny name:

7. What is HPV?

Answer: Well, if you look at the website abbreviations.com, HPV can stand for high production volume, human powered vehicle, high-pressure vent, having purple vomit, high pressure valve, high pitch voice, high point vent, or the Princeville Airport in Kauai, Hawaii. Assuming that 2019 did not see a surge of visitors to Kauai or people eating purple crayons, most searching for HPV probably were interested in human papilloma virus. This type of HPV is the most common sexually transmitted infection in the world. I have already written for Forbes about what this HPV is, after President Donald Trump apparently asked Bill Gates the difference between HPV and HIV, which is a bit like asking the difference between the CIA and a CPA.

This video from the University of Massachusetts Medical School covers details about HPV:

8. How to lower cholesterol?

Answer: If you are asking this for yourself, you may not want to try the keto diet. Cutting your intake of saturated fats and trans-fats is an important step. So is increasing your intake of omega-3 fatty acids and fiber. Getting more physical activity and losing weight may help. If you are smoking, stop. Also, limit your alcohol consumption. High cholesterol can increase your risk of stroke and various types of cardiovascular diseases.

The American Heart Association put together this video on ways to control your cholesterol level:

9. How many calories should I eat a day?

Answer: The answer is more than one per day on average. You need calories to survive. However, people probably are wondering how many calories they should eat based on whether they want to gain weight, lose weight, or do neither. The frequently cited threshold is 2,000 calories for women and 2,500 calories for men per day to maintain the same body weight. However, this greatly oversimplifies the complexities of your body. The calories that you need depend heavily, no pun intended, on many factors, including your body size, your age, and your activity level.If you are Michael Phelps, for example, you probably can consume a whole lot more calories than the Michael Scott character of the television show The Office. The Mifflin-St. Jeor equation, which has nothing to do with Dunder Mifflin, the company in The Office, does take into account differences in sex, age, weight, height, and activity level and serves as the basis for some for some online calorie recommendation calculators such as one offered by Healthline. But even these are just approximations and do not account for every factor that may affect your weight. Plus, all calories are not equal. Getting 2,000 calories from just eating sticks of butter or drinking soda is very different from getting the same number from a more balanced diet. Highly-processed foods may have different effects on your metabolism compared to natural foods. The best thing to do is to see your doctor or a real registered dietitian, who can then personalize their recommendations for you.

Your physical activity and muscle mass can significantly affect your metabolism and how much ... [+] calories you should consume each day. For example, elite athletes such as Jackie Groenen of Netherlands (L) and Alex Morgan of United States (R) may have different energy requirements from others. (Photo by Marcio Machado/Getty Images)

10. How long does alcohol stay in your system?

Answer: This is another tough question that doesnt have a single set answer for everyone. On average, you are probably able to metabolize about half-a-drink per hour. But the speed at which you break down alcohol depends on a whole lot of things. First of all, how big are you? What is your age? What is your metabolism and general health like? How much food did you have in your stomach to soak up the alcohol so that it didnt get absorbed into your bloodstream? What kinds of drinks did you have and what was their alcohol content? Did your drinks have little umbrellas in them (not that this matters for alcohol metabolism, but I am curious)?

Keep in mind that even if your body can clear alcohol from your bloodstream at an average rate of 0.015 per hour, a breathalyzer or blood test can still detect alcohol for up to 12 hours, a urine test for up to 3 to 5 days, and a hair test for up to 90 days. If you are going to drive, operate a combine harvester, or do anything that requires good concentration and coordination, the best thing to do is not drink at all. Even if it means, heaven forbid, revealing your real sober personality at a party or on a date, it is not worth the risk to try to time your personal alcohol clearance exactly.

Trying to guess how long alcohol will remain in your system can be difficult when you have alcohol ... [+] in your system. (Photo: Getty Images)

So there you have it, the most Googled health questions of 2019 and some answers. Remember, just because a Google search returns a website doesnt mean that the website provides trustworthy and science-backed information. The Internet is packed with people with agendas trying the sell things and ideas to you. Google can help find various websites if you know what you are looking for but can at times be misleading. You cant tell a police officer, but Google told me that I would be sober by now. Google cannot replace a doctor or any such real, properly-trained and qualified health professionals. After all, if you were caught in a life-or-death court case, wouldnt you want a real lawyer and legal team? Would you instead tell the judge, your honor, in lieu of a lawyer, I have decided to just bring a laptop for legal representation. And oh by the way, could you slowly and clearly spell out everything that you say so that I can Google every term?

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Here Are The Top 10 Most Googled Health Questions Of 2019 - Forbes

Lets start with what to eat and the foods to avoid eating. What follows will likely sound familiar to aficionados of a Mediterranean-style diet: a plant-based diet focused on fruits and vegetables, whole grains, and cold-water fish and plants like soybeans and flax seeds that contain omega-3 fatty acids.

A Mediterranean-style diet is rich in micronutrients like magnesium, vitamin E and selenium that have anti-inflammatory effects, and its high-fiber content fosters lower levels of two potent inflammatory substances, IL-6 and TNF-alpha.

Dr. Frank Hu, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health, strongly recommends limiting or eliminating consumption of foods known to have a pro-inflammatory effect. These include all refined carbohydrates like white bread, white rice and pastries; sugar-sweetened beverages; deep-fried foods; and red meat and processed meats. They are the very same foods with well-established links to obesity (itself a risk factor for inflammation), heart disease and Type 2 diabetes.

In their stead, Dr. Hu recommends frequent consumption of foods known to have an anti-inflammatory effect. They include green leafy vegetables like spinach, kale and collards; fatty fish like salmon, mackerel, tuna and sardines; fruits like strawberries, blueberries, apples, grapes, oranges and cherries; nuts like almonds and walnuts; and olive oil. The recommended plant foods contain natural antioxidants and polyphenols, and the fish are rich in omega-3 fatty acids, all of which counter inflammation.

Coffee and tea also contain protective polyphenols, among other anti-inflammatory compounds.

The bottom line: the less processed your diet, the better.

At the same time, dont neglect regular exercise, which Dr. James Gray, cardiologist at the Scripps Center for Integrative Medicine, calls an excellent way to prevent inflammation. He recommends 30 to 45 minutes of aerobic exercise and 10 to 25 minutes of weight or resistance training at least four to five times a week.

Although exercise is pro-inflammatory while youre doing it, during the rest of the time it leaves you better off by reducing inflammation, and after all you live most of your life not exercising, Stephen Kritchevsky, professor of gerontology and geriatric medicine at Wake Forest School of Medicine, told me. Independent of any effect on weight, exercise has been shown to lower multiple pro-inflammatory molecules and cytokines.

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Tackling Inflammation to Fight Age-Related Ailments - The New York Times

Opinion over the Joker movie and its message for society may be hotly debated, but everyone agrees that Joaquin Phoenix was brilliant in the titular role, thanks not only to his acting but also his emaciated appearance in the film, suggestive of a deeply unhealthy life filled with deprivation. According to director Todd Phillips though, Phoenix refused to consult a nutritionist for his weight loss regimen, instead choosing to make do with eating only a single apple a day to lose 52 pounds in record time.

For the actor, such a dramatic loss in physical weight also affected his psychology while playing the role, causing him to feel like he was going mad from the lack of food. And in a recent interview, Phillips delved deeper into the effort it took to have Phoenix transform physically into Arthur Fleck, with the director saying:

We talked a lot about, How skinny should Arthur be? How far do we want to go? And I kept saying to him, When are you gonna start losing weight? At what point do you start this? Because it was already like June, and he hadnt started, and we started shooting in September. And hes like 180 pounds. He wasnt fat, but were talking getting to 125 pounds.

And he goes, I got it, I got it. I go, We can hire a guy, Ive got this woman whos a nutritionist, you might want to [talk to her]. No no, thats not how I do it. I go, How do you do it? He goes, I just stop eating and I starve myself. He just ate an apple a day for the whole summer.

Aside from working on the look of the character, Phillips and Phoenix also held intensive discussions about what went on inside the head of the down-on-his-luck clown turned vengeful criminal, with Phillips saying:

We talked a lot about who would he be, and why is he like this, and what is his thing, and where does that laugh come from, and why does he wear makeup or not, [and so on]. And we really just started reading a lot about narcissism, and ego, and things that we think that are kind of baked into our version of Joker.

The ego is Arthur, the ego is the thing thats trying to control this wild force that is Joker. But Joker is pure id. So we just thought, What happens when you go through your life wearing a mask? Which a lot of people do, youre wearing a mask and youre pretending to be a certain way. And Arthur is very kind of controlled, but there are these glimpses of who he is underneath. And what happens when you take the mask off, which is kind of a weird flip, because actually Joker wears a mask or makeup but the idea is, What happens when you stop living that life, and live as the shadow? Then you just make the movie and you forget all that, and you just make the film, and you hope it makes sense on some level.

All those preparations and thought exercises combined to create a stellar film and a performance that will go down in cinema history as one of the finest studies of neglect and mental illness that an actor has ever portrayed. In fact, so successful was Phoenix in making Fleck an empathetic and realistic character that its difficult to imagine the man someday becoming known as the Clown Prince of Crime, engaging in spirited battle atop Gotham buildings against someone dressed in tights and sporting a bat-like mask.

With the unprecedented success of Joker, Phillips and Phoenix now have an open invitation from Warner Bros. to return to the world they created for multiple sequels, although both maintain they would only do so if they can develop a story for a follow-up thats as compelling as the original. Lets just hope such a film doesnt necessitate Phoenix having to once again dangerously subsist on a single apple a day.

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Joaquin Phoenix Only Ate An Apple A Day To Lose Weight For Joker - We Got This Covered

While many patients want to discuss concerns about their weight with their doctors, patients often feel that doctors approach the conversation in a negative way, which leaves patients feeling neglected, stigmatized, and sometimes even insulted, according to a systematic review published earlier this month in the journal Clinical Obesity.

5 myths physicians believe about patient experience

About 40% of the worldwide adult population is overweight or obese, and while doctors are encouraged to intervene when they examine a patient with obesity, it's unclear whether they're going about it the right way, the researchers wrote.

To determine how doctors address weight-related concerns with patients, the researchers analyzed 21 studies that interviewed 466 overweight or obese patients about their primary care visits. Eleven of the studies were conducted in the United States or Canada.

The "overwhelming theme" among the results was that primary care doctors rarely talk to patients who are overweight or obese about weight concerns, the researchers wrote.

In cases in which doctors did not discuss a patient's weight, the patients were left feeling stigmatized and assumed they were being judged, the researchers said. Other patients reported feeling that doctors who didn't discuss their weight likely didn't view it as a serious health risk or felt that the patients were "unworthy of medical time."

In other cases, patients said doctors sometimes attributed all of their medical symptoms to their weight, causing patients to feel "dismissed" or "anxious that a more serious cause for their symptoms might go undetected," the researchers said in the review.

When doctors do address weight with patients, patients who are overweight or obese usually viewed the experience as negative, the researchers found. "A recurrent theme across studies was that doctors often assumed a person who was overweight must have an unhealthy diet," the researchers said in the report. In other cases, patients thought their doctors offered "banal" advice such as "eat less," and "move more," while other patients said their doctors did not believe them when they reported making a sincere effort to lose weight using these methods.

And while most doctors didn't discuss weight with their patients, many patients said they would like to discuss their weight with their clinicians, the researchers noted. Overall, patients were likely to respond positively to supportive advice and active monitoring surrounding weight loss. Some patients said having a doctor recommend small changes for weight loss made them feel motivated.

Paul Aveyard from the University of Oxford and senior author of the study said, "As a doctor myself, 'listening' to these patients' stories was, in many cases, uncomfortable." He continued, "Many patients recounted tales where they had been patronized, marginalized unintentionally, or occasionally insulted."

Aveyard said the results are disappointing because doctors know that "obesity is caused by genetic make-up and a food environment that makes appetite control really hard." Aveyard explained, "You would imagine that doctors and nurses would know this, and this might be uppermost in their mind when they consulted patients." However, he added that the "general view, that obesity is due to a failure of willpower, is so ingrained" in society that even "doctors and nurses sometimes say unhelpful things that undermine the motivation of their patients to lose weight."

At the same time, the results also show that "[i]t doesn't take a lot for the conversation to be a big positive for patients," Aveyard said. For instance, simply pointing out even "modest" changes in weight and regularly weighing patients could yield a positive experience for patients, according to Aveyard.

Kristen Glenister, of the University of Melbourne who was not involved in the study, said, "Discussions regarding overweight and obesity need to be undertaken with the appropriate language and tone, permissive approach, with trusted clinicians, adequate time and tailored advice" (Crist, Reuters, 12/17; Ananthakumar et al., Journal of Clinical Obesity, 12/2; Harrison, Medscape, 12/9).

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Why patients hate talking about their weight (and how to help them open up) - The Daily Briefing

Writing helps declutter your mind and also helps you keep your life in track. In fact it can be a very useful tool is tracking your life. Maintaining a journal does not only mean keeping a record of what you are eating but make it a daily journal. Include your daily steps, your diet, your cheat meals, your workout, your health updates, emotional updates, all in your journal. This will help you to review your day in a holistic manner. On days when you have walked less, and had more of a sedentary day, use your journal as a way to keep a check on your day. Choose a diary that you can carry with you everywhere and add details as much real time as possible. On busy days, you can also add it before bedtime as that will be the best time to reflect upon the day and accordingly plan the next day. Apart from adding simple daily notes, add additional thoughts to it. If you indulged in a cheat meal someday, add additional notes on why you feel you strayed from your health goals. Furthermore, you can set your goals and then monitor their progress with your entries.To ensure you feel encouraged and it does not feel like a busy chore, buy interesting coloured pens, and designate a specific colour to each day. For example, use purple for a day when you worked out, ate well and felt happy. Use Red for the day you were not happy with your diet. You do not have to follow a set pattern or structure for your journal. Make it as personal as possible. A lot of people also use journaling as a de stressing activity; you can also doodle in your physical journal. It is also extremely important to be truthful - be as truthful as possible when you are making your entries.

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Weight loss: Maintain a food and workout journal (Day 6) - Times of India

Kirstie Allsopp, 48, is a property expert who has a passion for renovation inside homes. The presenter revealed she has lost an impressive two stones at the end of last year and revealed what had motivated her to lose the weight.

Kirstie also revealed the reason for her new lease on a healthier life.

She revealed the heartbreaking reason was due to her fear of developing breast cancer.

Kirstie had lost her mother to the deadly disease when she was aged only 66.

This prompted Kirstie to take control of her life and gave her the push to slim down.

READ MORE: Vinne Jones health: Footballer and wife both battled same disease - what is it?

The devastating loss had prompted Kirstie to take a real look at her own life.

Kirstie spoke to The Daily Mail and said: Being overweight on your 50th birthday is the number one risk factor for breast cancer, which my mother got when she was 41; she died in 2014 when she was 66.

"I put on two stone between 40 and 44 and decided that I was being irresponsible as a parent and a partner and it had to go.

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Kirstie sought the advice of celebrity nutritionist Amelia Freer who helped Kirstie to clean up her diet.

Kirstie said: I have stopped eating bread and potatoes and I dont drink wine. I eat three meals a day - I do not leave the house without having breakfast.

"What is key is having five hours between meals and not having anything except water doing those five hours.

Breast cancer is the most common type of cancer in the UK. Most women diagnosed with breast cancer are over 50, but younger women can also get breast cancer.

About one in eight women are diagnosed with the deadly disease during their lifetime.

The NHS said: Breast cancer can have several symptoms, but the first noticeable symptoms is usually a lump or area of thickened breast tissue.

A person can significantly reduce their risk of developing breast cancer by limiting their alcohol consumption, quitting smoking, being physically active and controlling their weight.

Talking about her fitness regime, Kirstie spoke to The Sun and discussed her new healthy lifestyle and workout routine, which helps her to keep the pounds off after her big weight loss.

Kirstie revealed that she gets up early, to prioritise her workout for the day. Kirstie said: On a working day, I get up at 6:15am and Im straight into my exercise kit for a workout.

"I run uphills and then walk down them. I also do the school run on my scooter. Its brilliant.

"Ive lost more than two stone and gone from squeezing into a size 16 to squeezing into a size 12.

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Kirstie Allsopp health: Stars health fear which motivated her to lose weight - Express.co.uk

We can never imagine something as healthy as fruits to be bad for us in any way. In fact, fruits are our go-to-snacks when we are planning to eat something healthy. We also know that many diets criticise fruits for the natural sugar they have. Does that make fruits bad for weight loss?The simple and straight answer is NO!Sugar is the simplest form of carbohydrate and occurs naturally in many foods including milk, honey, vegetables and fruits. Talking about fruits, they contain several kinds of sugar and almost half of it comes from fructose. If you know, fructose makes up about half the carbohydrates in table sugar and high fructose corn syrup. And as fructose filled sweets have been linked with weight gain, many diets say that fructose from fruits can be problematic for weight loss. But thats rarely the case.

Researchers have found that people who eat fruits tend to be slimmer than those who dont eat fruits. In a study published in the journal Metabolism, 107 obese and overweight people volunteered. People were divided into two groups and both were fed with equal calorie plans. One group was fed with 20 grams of fructose from fruits while the other was fed with 50 70 grams of fructose from fruits.

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Are fruits bad for weight loss? We tell you - Times of India

Blake Lewis, 33, used to weigh 23 stone. [Photo: SWNS]

Blake Lewis, 33, used to weigh 23 stone.

He was shamed into losing almost half of hisbody weightafter he was told he was too fat to go on an Alton Towers ride when he visited the theme park with his young daughter.

In May last year he visited Alton Towers with his family. He went to get on the Go Jetters Vroomster Zoom but found that the CBeebies Land ride safety bar wouldnt fit over his stomach.

This kick-started something in Blake, which led to him shedding almost half of his body weight by himself with regularexerciseand healthy eating.

He lost 10 stone after feeling embarrassed about not being able to go on the ride, a situation which left his daughter in tears.

Inspiringly, he managed to do it without any help of weight loss groups. He stuck to a regime of healthy eating and regular exercise, no doubt spurred on by his experience at Alton Towers.

I had always wanted to lose weight ever since having children but never had the will power. Blake, who is a care assistant from Church Gresley, Derbyshire, said.

Id take my children to the park and play with them and thought I could probably run better than a lot of slim people.

READ MORE: Gentle exercise lowers risk of prostate cancer

When some of his overweight friends were diagnosed with heart disease and type 2 diabetes, he started to feel concerned.

He believes it was the ride that did it for him, though.

My daughter Sophie didnt understand why we couldnt go on the ride because we had sat down alright.

I knew I was big but when I couldnt get the belt over my stomach I thought: This doesnt happen to people every day. Something is not right.

READ MORE: Man loses 20 stone and enjoys new lease of life

Blake said there was no nastiness from the staff members who asked him to get off of the ride, but that something clicked in his head.

That's when I thought enough was enough and I needed to do something about my size.

He had an addiction to junk food - which included takeaways, crisps and chips.

Often, hed reach 5,000 calories in one day.

Story continues

When he lost the weight, he dropped his calorie intake dramatically from 5,000 to 1,000 calories per day, choosing to batch-cook his meals so he always had something available.

READ MORE: Four in five young people arent exercising enough

He decided not to join a gym and instead opted to create a gym in his garage. He paired this with walking the one and a half miles to his work each day.

Stick at it hard for the first few weeks then youll be encouraged when the pounds start coming off. Is the advice he offers people trying to lose weight.

Some were concerned that the weight dropped off so quickly that Id make myself poorly. In fact, Ive never been healthier.

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Dad loses almost half of body weight after being told he was too fat for Alton Towers ride - Yahoo News

"Women over 50 should lose weight to cut breast cancer risk," reports The Daily Telegraph.

Previous research has shown that the chances of getting breast cancer are higher for women who are overweight or obese. This may be because overweight women produce more oestrogen. Oestrogen can cause breast cells to grow, which could lead to cancer if the cells grow uncontrollably. However, there is not much evidence about whether losing weight, especially in later life, can lower this increased chance of getting breast cancer.

This study looked at more than 180,000 women aged 50 and over. It found that women who lost weight and kept it off for a period of about 10 years were less likely to be diagnosed with breast cancer, compared to women whose weight remained stable. Women who were overweight or obese before they lost weight saw their chances fall most. Greater weight loss was also linked to a bigger reduction in the chances of getting breast cancer.

The results only applied to women not taking hormone replacement therapy (HRT) to treat the symptoms of menopause.

The results suggest that women over 50 who are overweight or obese could reduce their chance of getting breast cancer by losing weight and keeping it off.

Weight is not the only thing that can increase the chance of getting breast cancer. Other things you can do to that may help prevent breast cancer include:

Read more advice about preventing breast cancer

The researchers who carried out the study were from 18 universities or research centres across the US, Australia and Japan. The study was funded by the Breast Cancer Research Foundation and the National Cancer Institute in the US. It was published in the peer-reviewed Journal of the National Cancer Institute.

The Daily Telegraph and The Times both covered the study, with headlines suggesting that most or all women over 50 should lose weight. Neither made it clear that women of a healthy weight do not need to lose weight. What kind of research was this?

This study was an observational study that combined findings from 10 cohort studies in the US, Australia and Japan. Cohort studies are good ways to spot links between things that can increase the chance of getting breast cancer (called risk factors), such as weight gain or loss, and outcomes, such as breast cancer diagnosis. But they cannot tell us for definite whether a risk factor causes an outcome. Other things could be involved.

Researchers combined information from 10 big studies of women and their chance of getting breast cancer, which included women aged 50 and over. The researchers used studies that had recorded women's weight and height at least 3 times and gave information about breast cancer diagnosis in the years following the weight and height recordings.

Women were excluded if they had not reported their weight or height, or if the reported weight or height measurements were extremely unlikely. The final sample included 180,885 women. The researchers tracked any breast cancer diagnoses for these women from medical records or cancer registries.

Researchers looked at weight change between the first and second recording (an average 5 years apart). They categorised weight loss as:

They then looked at weight change between the second and third recording (again, an average 5 years apart). They categorised weight loss as:

Researchers compared the chance of women with sustained, partly sustained or not sustained weight loss getting breast cancer with the chance of women who had not changed weight by at least 2kg over the 3 recording periods getting breast cancer. They adjusted the results to take account of a range of other things known to be linked to an increased chance of getting breast cancer, including:

The average BMI of women at study start was 25, which is the top end of the healthy BMI category. This increased to an average of 25.6 after 5 years, so just going into the overweight category. The researchers used the 20% of women who maintained a stable weight over the study period as the comparison group.

During the study follow-up period, 6,930 breast cancers were diagnosed. This represents 3.8% of the women in the study.

Women who lost weight and kept it off had a reduced chance of breast cancer compared to women of stable weight:

Women who gained weight, and women who regained all the weight they had lost, had the same chance of getting breast cancer as women of stable weight. However, women who lost 9kg or more and regained some but not all of it still had a 23% lower chance of getting breast cancer, compared to women of stable weight (HR 0.77, 95% CI 0.62 to 0.97).

When the researchers looked more closely at the figures, they found the results were strongest for women who were overweight or obese at the start of the study. Unsurprisingly, few women who were a healthy weight at the start of the study lost more than 4.5kg. Those who did lose more than 4.5kg did not show a change in their chance of getting breast cancer.

The researchers said: "We found that losing weight and keeping it off was associated with lower breast cancer risk for women aged 50 years and over." They added: "It is not too late to lower your risk of breast cancer if you have gained weight after age 50."

Many things affect a woman's chance of getting breast cancer. These include family history and genetics, hormone use, when or if she has children, alcohol use and being overweight or obese. This study supports current understanding and suggests that losing weight may help to reduce your chance of getting breast cancer (as well as many other types of cancer) if you are overweight or obese. However, losing weight does not affect the other risk factors for breast cancer, so it will not totally remove your chance.

Because this was an observational study, it is not possible to fully remove the influence of all these other health and lifestyle factors that may differ between women who lost weight or not. This means it still cannot tell us for definite whether weight loss caused the reduction in the chance of getting breast cancer, or why there was a lower chance. Other factors affecting both weight and the chance of getting breast cancer could be involved.

There are some other limitations. Although the numbers of women in the study are quite high, results for some of the individual groups are small. For example, only 19 women lost 2kg to 4.5kg and regained some of the lost weight. That's too small to assess these women's chance of getting breast cancer.

8 of the 10 studies providing data used women's self-reported weight and height measurements, rather than independently measured results. This could possibly introduce some inaccuracy, which might have affected the results.

Nevertheless, the study is overall a reminder that being overweight or obese raises the risk of breast cancer, along with other illnesses such as diabetes and cardiovascular disease. Find out more about how to lose weight if you need to do so.

Analysis by BazianEdited by NHS Website

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Weight loss linked to lower chance of getting breast cancer for women over 50 - NHS Website

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