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The walking rates were roughly the same among men and women, but men were three times more likely to cycle.

Those discouraging findings underscore that much more needs to be done to make active forms of transportation safer and more convenient, say the studys authors.

Federal funding for policies, programs and infrastructure that encouraging walking and bicycling more than tripled between 2000 and 2018, from $297 million to $916 million. Yet that higher amount still represents only about 2 percent of the U.S. governments transportation budget, points out Ralph Buehler, the studys lead author and chair of the urban affairs and planning program at Virginia Tech School of Public and International Affairs, in a released statement.

Thats not nearly enough to make a significant difference in helping people make walking and cycling part of their daily routine, he adds.

And we should be encouraging people to walk and cycle more. Plenty of research has shown that integrating active travel into our daily lives can help improve our physical and psychological health. Its also a cheaper and more practical way than joining a gym or fitness center of meeting recommended levels of physical activity.

The new study, published online this week in the Journal of Transport and Health, was conducted to see whether the past two decades of research and government investments in active transportation has had any effect on how often and frequently Americans walk or cycle.

For the study, Buehler and his colleagues compared responses from the National Household Travel Survey from the years 2001 and 2017. About 200,000 Americans aged 5 to 65-plus took part in the two surveys. The questions included ones about the frequency, duration and distance the participants walked or cycled. (Parents provided answers for their young children.)

The researchers found a slight increase in the daily walking rates over the 16-year period of the study. The share of Americans who reported walking an average of 30 minutes a day, for example, increased from 7.2 percent to 7.9 percent. There was essentially no change, however, in the cycling rates. The percentage of Americans who said they averaged 30 minutes of cycling a day was 0.9 percent in both years, and the proportion who said they averaged at least 10 minutes a day fell from 1.5 percent in 2001 to 1.3 percent in 2017.

Walking increased the most among middle-aged adults aged 25 to 64, among people in both the highest and lowest household income quartiles, and among people without a car.

In fact, there was an inverse relationship between car ownership and walking. The more cars in a household, the less walking its residents did.

It is not at all surprising that the small increase in walking was in dense, urban cities like Boston, New York City, Philadelphia, and Washington, D.C., where measures have been taken to improve infrastructure and programs and policies have been adopted to make walking and cycling easier and safer, says Buehler.

The walking rates were roughly the same among men and women, but men were three times more likely to cycle.

In general, women will only cycle if they think the entire ride will be safe, says Buehler. If they perceive that there will be any danger at all along the way they will resist.

Cycling rates increased the fastest among highly educated, employed, high-income, white men between the ages 16 and 44. Heres one statistic from the study that underscores that trend: In 2001, there was no difference in cycling rates between university graduates and people without a high school diploma. In 2017, cycling was roughly two times more common among college grads than among those who didnt graduate from high school.

Some of those increases may have resulted from higher-income groups moving to denser, mixed-use, inner-city neighborhoods with short trip distances, the researchers write.

Yet, that doesnt entirely explain the trend.

Recent research has criticized American cities for providing better walking and cycling facilities in higher-income neighborhoods while often ignoring the needs of marginalized communities of low income and color, the researchers explain. Walking and cycling conditions in low-income neighborhoods are often dangerous, inconvenient, or stressful.

Equity should be an important aspect of transportation policy, they stress.

Another troubling trend uncovered in the study is the significant decrease in walking and cycling rates among children and young teens aged 5 to 15. For example, 2.4 percent of young people cycled for an average of 30 minutes a day in 2001. Sixteen years later, that figure had fallen to 0.9 percent.

Sadly, these declines are not new. Theyre a continuation of a trend that started back in the 1970s one that has reduced an important source of childrens regular physical activity and might be a contributor to rising childhood obesity rates in the United States, Buehler and his co-authors point out.

The researchers say any new measures to increase active travel should focus on children, teens and older adults, whose rates of walking and cycling are either lower than average or on the decline.

Many studies indicate that separate, protected cycling facilities and traffic-calmed neighborhood streets would help encourage more cycling among women, children, and seniors, as well as by vulnerable or risk-averse individuals, they write. Special efforts must also be made to ensure safe and convenient walking and cycling conditions for low-income and other disadvantaged communities, which have been inadequately served in many American cities.

Such efforts would benefit not just individuals, but the broader society.

Physical activity through walking and cycling has the potential of greatly improving the physical, mental, and social health of both men and women, all ages, and all income levels, they add. Unlike formal exercise programs, walking and cycling can be integrated into daily routines and are affordable for virtually everyone.

FMI: You can read the study online in the March issue of the Journal of Transport and Health.

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Little change seen in walking and cycling in the US since 2000 - MinnPost

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WASHINGTON Many Americans understand that alcoholism is detrimental to overall health, but it still can be considered a 'hidden addiction'. In fact, according to the National Institute of Alcohol Abuse and Alcoholism (NIAAA), about 14 million adults in the U.S. have alcohol abuse disorder, and only 10% are getting treatment.

Dr. George Koob, Director of NIAAA says, "We have a problem with alcohol in the United States, I call it the 'hidden addiction'. Everybody knows about it but nobody wants to talk about it."

(Related from USA Today: Here's how many years alcohol takes off your life)

"Dry January is a great opportunity to re-evaluate your relationship with alcohol. It also provides choices, so when you go to a party and socializing and you want to be one of the Dry Januaries it's kind of a choice you can make with being stigmatized for not drinking or not ridiculed for not drinking," adds Dr. Koob.

After taking the month off you may find yourself in a better overall healthy state.

"If you're sleeping better, if you're digestive system's better, if you're back with your exercise program, you've got a lot of vim and vigor for work, then your body's telling you something."

This may be surprising to some, but it seems that millennials are active in providing more activities and programs for those who want to have fun without alcohol. They include dry bars, sober curious, silent dance parties, and of course dry January.

Dr. Koob notes, "I think we're in the beginning of a cultural change in relation to alcohol."

"There's another group that seems to be more interested in being more alert and functioning on Monday morning rather than hung over," adds Dr. Koob.

The NIAAA treatment navigator is one of several tools that people can use if they fear that they or a loved one is dealing with an alcohol addiction, and this can be lifesaving.

Dr. George Koob, Director of the National Institute of Alcohol Abuse and Alcoholism.

wusa9

Dr. Koob urges families to take a look at the treatment navigator which provides information, facts, treatment options, and facilities, "It's really a useful tool for learning about alcohol use disorders, helping families interact in this domain, and finding a place for treatment."

(Related from WUSA9: Police say Alcohol a possible factor in fatal BW Parkway crash)

For more information on NIH's National Institute of Alcohol Abuse and Alcoholism visit http://www.niaaa.nih.gov.

Watch Great Day Washington Monday-Friday at 9 am on WUSA9 & follow us onFacebook,TwitterandInstagramfor more features like this!

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Take a break from alcohol this month and feel the positive health effects - WUSA9.com

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By Zara Ingilizian, Head of Future of Consumption, World Economic Forum

Do you follow a personalized diet?

Non-communicable diseases (NCDs), driven by a combination of genetic, physiological, environmental and behaviour factors, account for 71% of all deaths globally, killing 41 million people each year. One in four people globally have a familial inheritance of metabolic imbalances that increase their risk for these diseases.

Precision technologies, the powerful combination of personal data, AI and IoT, offer new ways to address these risks.

To achieve a high quality of life, consumers have long desired to improve their personal consumption and lifestyle habits, including those related to sleep, food, exercise and mood management, to positively impact their overall health and well-being. The technologies of the Fourth Industrial Revolution offer new opportunities to deliver holistic (physical and mental) well-being outcomes for consumers in ways previously unimagined. Furthermore, since precision consumption is inherently preventative, it has the potential to mitigate rising health care costs in the long run.

The recent Precision Consumption 2030 report, produced by the World Economic Forums Future of Consumption Platform in collaboration with Sparks & Honey, a technology-led cultural consultancy, outlines the opportunities and challenges of precision consumption for consumers, business leaders, and society at large. Here are some of the key findings:

Precision technologies will transform industries

The total venture capital funding for precision technologies over the last three years was $1.1 Trillion. At the same time, wellness is a rapidly growing business. Wellness tech that enables people to adapt and manipulate their environments is a budding industry, valued at $333 million.

These trends show that personalization is critical for businesses. People are willing to pay up to a 20% premium on certain DNA-based products and services, a move that puts market pressure on all products and services to become deeply personalized.

Longer lives will also transform business strategies. By 2030, longevity gains from precision nutrition will push healthy life expectancy into the hundreds for those with access to the technology. Corporate strategy will need to adapt to longer lives across talent management, R&D, CSR, and marketing.

Precision data is key to unlocking long-term health and well-being

The pairing of biodata with precision technologies has the power to generate a new set of health and well-being outcomes for consumers. From DNA to voice tech, image recognition to the microbiome, digital biometrics to retinal scanning consumers are now starting to understand the value of their personal, biological data and the implications that the availability of this data has on their potential future well-being. Furthermore, there is increasing awareness that a healthy diet is essential for a healthy brain function.

While still a long way from implementation at scale, according to experts, a good diet must be individualized. As Eric Topol, Executive Vice President of Scripps Research, explains, the idea of a universal diet is overly simplistic. It contradicts the remarkable heterogeneity of human metabolism, microbiome, and environment, to name just a few of the dimensions that make each of us unique.

When consumer products and services are designed based on the data of an individuals, the likelihood of behaviour change increases. Personalization and advancements in technology also offer consumers significant potential to greatly improve their overall wellness through near real-time feedback on their individual information and precision recommendations tailored specifically to them.

For the first time, these precise recommendations can offer consumers the opportunity to improve their day-to-day consumption decisions. As Dr. Ali Mostashari, CEO and Co-founder, LifeNome, explains:

When people do a personalized diet program, we have noticed that the adherence to that program over an eight-week period is around 60% - higher than when people get generic programs.

A world where an individual can continuously monitor his or her blood-glucose to gain personalized health advice every 60 seconds and hack their food intake based on personal chemistry is already a reality. For example, GenoVive uses an individuals unique DNA to develop customized meal and exercise programs to empower consumers to make lasting healthy lifestyle choices. New miniature sensors developed at Tufts University can be mounted directly on the surface of a tooth to directly monitor the effects of food intake on the bodies of human being in real time relaying data on glucose, salt, and alcohol consumption.

The continuous measurement of human biodata is at the core of precision consumption it can empower consumers to make better decisions about their own health and well-being. Within ten years, we will have unlocked enough secrets of the microbiome to accurately personalize nutrition as the first line of defense against any type of diseases: whether you have eye problems, heart problems, or youre at risk of stroke, explains Robin Farmanfarmaian, CEO and Co-founder of ArO.

A public-private ecosystem can enable trust and innovation

Achieving the full potential of precision consumption is fraught with challenges. Trust remains an unresolved issue. There are a growing number of data-rich entities who are leveraging consumer health data in ways that are not transparent. In most cases, these approaches are closed systems. The net result is stifled competition and ultimately, reductions in business dynamism and value for consumers.

According to the report, over 60% of consumer are willing to share data to advance scientific research. This includes their medical data; lifestyle, behavioral and family history data; and genetic info and wearable data. However, 36% of people were not willing to share their data with a private company, if asked. To bring precision consumption to mainstream consumers based on their unique digital biology, the need for consumer protections will only escalate.

What if key stakeholders can join forces to harness the power of technology as a force for societal good grounded in trust and transparency?

The Future of Consumption Platform is working to build a new system called the Precision Data Collaborative that aims to identify the guardrails to ensure the privacy and transparency needs of consumers are being met while enabling data-driven knowledge and innovation to thrive. The collaborative has an ambitious goal of onboarding over 1 million consumers over the next three years to create the most trusted and integrated wellness data set in the world featuring biological, physiological, and behavioral data. As a pilot, this public-private ecosystem will include businesses, members of academia, civil society and government.

Through the power of intentional consent, consumers will know how their data is being used, stored, and shared in ways that are consistent with their interests and the context under which it was collected (e.g. health and well-being). The collaborative will allow consumers to provide a holistic view of their current state of well-being to a select group of organizations who will then make product and service recommendations based on personalized inputs, AI and insights. With healthy competition, consumers will stand to benefit: derive benefits from higher quality and efficacy of precision-driven products and services.

Precision consumption can not only improve the quality of data used in public research and consumer health interventions, longer-term, it can also reduce the ever-increasing burden of healthcare costs on the private and public sectors. The journey starts now.

This article is related to the World Economic Forums Annual Meeting in Davos-Klosters, Switzerland, 21-24 January 2020.

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How Precision Consumption Can Improve Consumer Health And Well-Being - Forbes

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Contributed, Special to the Piscataquis Observer January 14, 2020

Its always exciting to change the calendar from December to January. A new year is filled with potential and the chance to start fresh. And after the busy holidays filled with celebrations and tables of delicious treats, its not surprising that, according to a 2019 survey, 65 percent of people resolved to exercise more with the New Year

DOVER-FOXCROFT Its always exciting to change the calendar from December to January. A new year is filled with potential and the chance to start fresh. And after the busy holidays filled with celebrations and tables of delicious treats, its not surprising that, according to a 2019 survey, 65 percent of people resolved to exercise more with the New Year. While there is no right way to keep a resolution, the Piscataquis Regional YMCA, is excited to offer new programs and popular returning programs to help our community members reach their health and fitness goals in the New Year.

Changing behaviors is a tough task even for the most dedicated and motivated people, said Allison Phillips, fitness manager. The new year is a great time to make changes, but its important to remember that any change takes time, and the type of resolution you make plays is a huge factor in your success. At the Y, our goal is to provide the resources and opportunities that people need to reach their full potential.

With dozens of group exercise classes per week, swimming, indoor racquetball courts and a fully equipped fitness center, there is something for everyone at the PRYMCA. Members can also take advantage of our popular KickStart Program, a comprehensive 8-week program that goes beyond personal training. This unique program offers an individualized approach to building healthy habits or reaching new fitness goals, and includes eight personal training sessions, comprehensive meal plans, personalized workouts, coaching and much more.

Beginning in January we are also excited to announce the return of Women on Weights, a 6-week strength training program for beginners to intermediates designed to build strength and confidence in the weight room; and Power Waves, a moderate intensity shallow and deep water aerobics class.

We are also excited to announce the return of our child watch program which provides on-site child care while parents enjoy the various programs in our facility. Child watch is designed for ages 1-10 years and offers interesting and inviting age-appropriate activities implemented by our caring and fun staff.

As our friends and neighbors look to make themselves healthier in the New Year, we want them to remember that when they join the Piscataquis Regional YMCA, theyre not simply joining a gymtheyre joining a community, said Janna Wasel, development director. The Y brings together people from different backgrounds, perspectives and generations and ensures that we all have access to the opportunities, relationships and resources necessary to learn, grow and thrive.

To learn more about joining the PRYMCA or our programs, contact 207-564-7111 or visit PRYMCA.org.

Thank you for reading your 4 free articles this month. To continue reading, and support local, rural journalism, please subscribe.

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PRYMCA launches new programs to welcome in the new year - observer-me.com

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The notion of fake news has entered our vocabulary as a pejorative term for dissemination of bogus information, usually by social media, sometimes by traditional print and electronic channels which happen to hold positions contradicting the tenets of our conventional wisdom, i.e., liberal democracy. The term has been applied to Russian state owned media such as RT to justify denying such outlets normal journalistic credentials and privileges.

In this essay, I will employ the more traditional term propaganda, which I take to mean the manipulation of information which may or may not be factually true in order to achieve objectives of denigrating rivals for influence and power in the world, and in particular for denigrating Russia and the Putin regime.

The working tools of such propaganda are

Demonstrations of the arguments I present here could easily fill a book if not a library shelf. However, I think for purposes of this essay, it suffices to adduce several examples of the three violations of professional journalism giving us a constant stream of propaganda about Russia and its political leadership by offering a few reports drawn from the very cream of our print and electronic media. In particular, I have chosen as markers the Financial Times and the BBC. The use of propaganda methods in their coverage of Russia is all the more telling and damaging, given that in a great many domains these channels otherwise represent some of the highest quality standards to be found in reporting anywhere today and consequently enjoy the respect of their subscribers and visitors, who little suspect they could be so prejudicial in their coverage of select domains like Russia.

As 2019 drew to a close, many of our media outlets drew attention to two Russia-related anniversaries: the just celebrated thirtieth anniversary of the fall of the Berlin Wall with the retreat of Soviet armed forces from Eastern Europe that it touched off; and the soon to be celebrated twentieth year of Vladimir Putins hold on power in the Kremlin. Both subjects may be fairly called news worthy and so fully correspond to traditional journalistic values. What has been exceptional and unacceptable has come in the second category of violations listed above lack of context.

Starting in October 2019, the BBCs Moscow correspondent Steve Rosenberg did several programs dedicated to the fall of the Berlin Wall. During the Christmas to New Years period, the BBC aired one program which consisted of two parts. In the first half, Rosenberg considered the impact of the withdrawal of Russian forces from East Germany on the Russians themselves and interviewed the former chief of those forces, who explained at length how they came home to shocking living conditions in the provinces, how they were abandoned to their fate by their own government. The tone of the reporting was sympathetic to Russians hardships and it was good that their side of the story from the ground up was given the microphone. What implied criticism there was of the powers that be came from a patriotic source. However, the second half of the program was turned over to a certain Lydia Shevtsova, a very outspoken Putin-hater, formerly with the Carnegie Center Moscow, till she was finally booted out and moved to a more congenial and supportive think tank, Chatham House, in London, where her anti-Russian vitriol is encouraged and disseminated by her co-author, ex-British ambassador to Moscow Sir Andrew Wood. Among the gem quotations which Shevtsova delivered was the claim that Russia under Putin is a declining power which is capable only of disrupting the world order, a spoiler not capable of any creative or productive contribution. Of course, Shevtsova has a right to her opinions, however the BBC had an obligation to its audience to explain exactly who the lady is and, if they wanted to practice fair play, to offer an alternative interpretation of what Vladimir Putins Russia stands for on the global stage today. They did not do either. The result was pure propaganda not news and analysis.

As for violations in the categories one and two above, a very good example arose following the recent publication of a study performed by the Levada Center public opinion polling organization in Moscow during October which showed that 53 per cent of 18-to-24 year-olds wanted to leave the country. This was written about by many of our news peddlers, including FT. The decision to feature this factoid and use it to support claims that the Putin regime is a failure fits well with tendentiousness of our news coverage. Meanwhile, nearly all coverage of that study, including in the Financial Times, offered no contextual information whatsoever, when the context was begging to be told.

The article in FT which carried the Levada Center findings was published on 9 January as Generation Putin: how young Russians view the only leader theyve ever known. The remarks on Levada followed directly on another statement begging for context: Youth unemployment in Russia is more than three times the rate of the total population, according to 2018 data, compared with just twice the rate in 2000.

First, as regards those 53% would-be leavers, one might ask: and so, why dont they just leave? Russia today is truly a free country: anyone other than convicted felons who wants a passport can get it, and get it rather quickly. And thanks to the efforts of their remarkably hardworking Ministry of Foreign Affairs, most of the world welcomes Russian travelers without a visa requirement. But for that matter, getting a Schengen visa for the EU is not so complicated either.

However, those 53% are, in fact, not going anywhere. They are just sounding off about their youthful disgruntlement with a world created and run by their parents.

At the same time, as the Financial Times editorial board knows full well, young, middle-aged and even old have been leaving the Baltic States, Bulgaria, Romania and other former Soviet Bloc countries in droves, for the past thirty years up to the present day. That was the subject of an article published in the FT on the next day, 10 January 2020 under a title which speaks for itself: Shrinking Europe. The states I mentioned here have seen 25 and 30% loss of their population to citizens voting with their feet and departing the shrinking economies and personal prospects which result directly from deindustrialization and economic colonization by Germany and other founding Member States of the EU since 1991. The issue appears in the news now because, as the FT explains, Andrej Plenkovic, the Croatian prime minister, has decided to elevate population decline to the top of his agenda as Zagreb assumes the EUs rotating presidency. Good for him! Now that the skeleton has finally come out of the EU closet, all the stories about Russias demographic crisis can be put in context by those few who wish to do so.

Second, as regards unemployment in Russia today, I believe that similar ratios of youth unemployment to the general population unemployment can be found most everywhere in Western Europe if not in the world at large. The fact that this ratio has worsened comparatively in Russia since 2000 may be explained by the anomalous situation in Russia prevailing throughout the 1990s in step with the economic collapse that accompanied the transition to a market economy. Precisely the older generations, those over 40, were thrown into the street and their children or grandchildren were the first to be hired by the newly emerging industrial conglomerates, not to mention by Western multinationals settling in. What has happened since 2000 is merely a reversion to more normal distribution of employment and unemployment in the population as the Russian economy stabilizes.

Moreover, it would have been helpful had the author named the current level of youth and general unemployment in Russia. In fact, the general unemployment in Russia stands at something like 5%, so youth unemployment would be 15% by his reckoning. I assure you that there are many EU Member States that would be delighted to have similarly low unemployment rates. Here in Brussels the general rate has been over 20% for ten years or more, while youth unemployment has always been considerably higher.

Dear Reader!

For those who find my examples above too subtle to support my argument for egregious propagandistic treatment of Russia in our media, allow me to introduce violation number three, silence, in a way that should sweep away all objections to my thesis.

I draw your attention to an event that occurred in the past week about which you probably know nothing, or perhaps a wee bit from the odd man out reporting in the Wall Street Journal and a few other outlets. I am talking about the visit of Vladimir Putin to Damascus on Tuesday, 7 January. To their credit, the WSJ carried a short article in their 8 January edition, but went no further than to note this was the second visit by Putin since the Russians joined the fight in support of President Bashar Assad back in September 2015, turning the tide in the civil war his way. That is true, but only represents a tiny slice of what all our journalists, including the WSJs could have and possibly did learn from watching Russian state television on the 7th. What our media chose not to report was passed over in silence because it shows the complexity of Russias policy in the Middle East that includes but goes well outside the domain of pure geopolitics. This is so not least because of the date chosen for the visit, which happens to be Orthodox Christmas.

On the evening of the 6th, that is to say on Christmas eve, by the Russian Orthodox calendar, Russian state television broadcast live coverage of the Christmas service in the Christ the Savior cathedral in Moscow officiated by Patriarch Kirill, with prime minister Medvedev present on behalf of the Government. Then it cut to the service in St. Petersburg, where Vladimir Putin sat in the congregation, as is his custom. The commentator mentioned in passing that the Patriarchs father, a parish priest, just happened to be the one who baptized Vladimir Putin as a child where they all lived, in the Northern Capital.

The next coverage of Putin on state television was from Damascus on the 7th, where he obviously arrived on a night flight from Petersburg. I did not see video coverage, perhaps because the journalist pool was very limited for security reasons. But still photos and reports on state television informed us that Putin had not merely held talks with President Assad on the Russian military base outside the capital, but had strolled together with him down the streets of Damascus, had visited the main church in the (still existing) Christian quarter of the city, had presented to the Patriarch of Antioch an icon of the Virgin and had also gone on to visit the citys oldest and largest mosque.

What you have here is precisely the second line of justification for Russian presence in Syria alongside military/geopolitical reasons: resuming Russias 19th century role as protector of the Orthodox population in the Holy Land and the broader Middle East. A similar role was exercised back then by France on behalf of the Catholic populations, but that since has been totally negated by rampant secularism and multiculturalism in Western Europe.

It also has to be said that Putins visit to Damascus was back-to-back with other very high visibility political statements: his visit to Istanbul on the 8th for the official opening of the TurkSteam gas pipeline and for lengthy talks with President Erdogan that ended in a joint statement calling for a truce in the Libyan civil war for which Russia and Turkey support opposing sides; and his visit on the 9th to Russian naval exercises in the Eastern Mediterranean that included the launch of Russias latest hypersonic missiles, the reality of which U.S. and other Western experts have yet to acknowledge.

With this I rest my case on the unfortunate propagandistic behavior of our media which deprive the broad Western public of any chance to make sense of the most dangerous military and political standoff of our age.

Gilbert Doctorow is a Brussels-based political analyst. His latest book Does Russia Have a Future? was published in August 2017. Reprinted with permission from his blog.

Gilbert Doctorow, 2020

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Western Media Coverage of Russia as an Exercise in Propaganda - Antiwar.com

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How can America best work with imperfect partners to achieve pressing security objectives? This question bedevils American foreign policy. Case in point: Over the past decade, Americas most essential military partner in Africa has become one of its most problematic. Uganda has played a key role in two major U.S. priorities on the continent the African Union Mission in Somalia and the multinational campaign against Joseph Konys Lords Resistance Army. Even while Ugandas involvement in these initiatives has led the United States to make it one of the largest recipients of American aid on the continent, its military has been accused of corruption, political interference, and serious human rights violations. The United States has sought to use diplomatic tools to redirect Ugandan behavior, including suspending some aid and canceling a military exercise in 2014, with little evidence of success.

Security sector assistance is the range of activities including training, advising, equipping, exercising, hosting educational exchanges, and institutional capacity building used by the U.S. government to enable foreign partners to effectively, transparently, and accountably govern their own security sectors. The United States implements security sector assistance primarily through the Departments of State and Defense, though the Departments of Justice, Homeland Security, the Treasury, and others contribute programs, personnel, and resources as well. The State Department provides security sector assistance to foreign militaries, law enforcement organizations, non-military security agencies such as border patrols and port security, and judicial systems; the Pentagon primarily provides assistance to foreign militaries, though it has authorities to assist non-military security forces in some cases.

Clear data on the scope of security sector assistance is difficult to come by. The Congressional Research Service estimates that the State Department spends roughly $7.5 billion annually on security assistance, the portion of security sector assistance directed to foreign militaries (though this estimate excludes non-military security sector assistance), and that the Pentagon executes about $9.5 billion each year (though Overseas Contingency Operations funds for Afghanistan and Iraq make up a substantial majority of this number, while several Pentagon programs avoid reporting expenditures). Accounting challenges aside, security sector assistance has been relied upon around the world to achieve a wide range of security objectives, especially since the Sept. 11, 2001, terrorist attacks: From drawing down and ending U.S.-led campaigns (e.g., Iraq and Afghanistan) to tilting the battlefield in regional conflicts (e.g., Ukraine and Syria) to deterring future conflicts (e.g., South China Sea and Northern and Eastern Europe), security sector assistance has taken center stage.

But it hasnt worked out as Washington hoped. Instead of reducing risks and bringing America closer to its goals, weve seen suboptimal results, undermining U.S. strategies and heightening risk to U.S. interests.

As policymakers continually search for new approaches to increase the return on U.S. investments in security sector assistance, attention often turns to the idea of political conditionality. Political conditionality is generally understood as the application of incentives and disincentives tied to identifiable actions by a recipient of assistance to influence the behavior of that recipient. Thus far, the United States has not developed a framework for how to apply conditions systematically to achieve concrete outcomes. Americas historical experience with conditionality indicates that the use of positive conditions, in particular, could improve results in shaping partner behavior. A concrete model for applying positive conditionality to undergird security sector assistance and incentivize desired partner actions can help planners and policymakers realize the potential of security sector assistance to achieve strategic objectives.

A History of Conditions

The United States has adopted forms of political conditionality since at least 1974, when the U.S. Congress passed legislation stating that no security assistance may be provided to any country the government of which engages in a consistent pattern of gross violations of internationally recognized human rights. Since then, the United States has adopted conditionality in a number of cases, including banning security sector assistance to Indonesia from 1992 through 2005 due to human rights concerns, conditioning security sector assistance to Egypt based on concerns about human rights and democratic governance beginning in 2017, and limiting assistance to Pakistan from 1990 to 2001 and again beginning in 2017 due to concerns about its nuclear proliferation and support for terrorism.

Conditionality is a rich and complex concept, without consensus definitions among scholars. Svea Koch argues that conditionality thus describes an incentive instrument in the relationship between two actors, in which one actor aims at changing the behavior of the other by setting up conditions for the relationship and by manipulating its cost-benefit calculation by using material incentives. She proposes a useful four-part typology, in which conditionality can be characterized by whether it is ex ante (that is, whether conditions need to be met before an assistance relationship is initiated) or ex post (in which conditions are agreed or imposed during the course of an existing assistance relationship), as well as by whether it is positive (rewarding and incentivizing) or negative (punitive and restrictive).

In the realm of security sector assistance, experience has been disproportionately focused on negative approaches, almost always negative and ex post. In addition to Egypt, Indonesia, and Pakistan, the United States has sought to limit or cut off security sector assistance in El Salvador in the 1980s, Rwanda in 2012, Bahrain in 2011, and Burundi in 2015. All these efforts followed the ex post/negative pattern in which the United States has taken essentially punitive measures to reframe an existing security sector assistance relationship. One might view the application of the Leahy Law, which restricts assistance in cases of human rights abuse, or post-coup legal restrictions as cases of ex ante/negative conditionality, given that partners are expected to be aware of these condition-triggering laws prior to the acceptance of assistance or the commission of violations.

By contrast, examples of positive conditionality in the security sector assistance arena have been few and far between, even though the idea is not particularly new. Incentive-based conditions might tie additional and/or more sophisticated levels of security sector assistance, including new military capabilities or specific weapons platforms, to reform milestones to incentivize behavioral changes. In addition, rather than authorizing aid and then withholding it, on the basis of shared interests, the United States might identify positive actions that a recipient is considering taking and then incentivize them. More recently, the U.S. Institute for Peace Task Force on Extremism in Fragile States argued for graduated security sector assistance, in which the United States calibrates its engagement with fragile states according to a jointly agreed plan that enables partners in those countries to achieve escalating levels and types of U.S. security sector assistance as partners achieve reform milestones leading to more inclusive governance. These recommendations build on recent experiments in new government approaches to security sector assistance, such as the Security Governance Initiative, which have sought to establish joint bilateral planning on the basis of overlapping interests as the foundation of assistance programs, though these initiatives have not ultimately meaningfully conditioned assistance. The challenge has been that, while positive conditionality has been posited as a potentially viable and beneficial approach to improving security sector assistance outcomes, it has neither been sufficiently attempted in practice nor sufficiently elaborated in literature.

Toward a Framework for Positive Conditionality

What if the United States had approached its relationship with Uganda differently in pursuit of shared objectives? Its possible that if the United States had structured its assistance in a way that incentivized Ugandas politicians and security officials to take specific steps toward clearly and mutually identified milestones, that could have led to the development of stronger capabilities for and commitment to civilian protection and governance by Ugandas military over time. Instead, a reactive posture to human rights and corruption transgressions has had limited effects, and punitive measures may only strain the relationship and undermine possibilities for cooperation.

The United States should develop a framework for positive conditionality in security sector assistance to better shape political and security outcomes with partner countries. On balance an affirmative framework will offer the United States the widest latitude in shaping outcomes in a broad range of circumstances. This approach also does not rule out the sequencing of punitive steps or a pause to assess partner performance.

First, this framework assumes an ex ante/positive approach to conditionality, at least in some manner. With the U.S. government providing security sector assistance to nearly 200 countries around the world, it is unlikely that the United States will be initiating a security sector assistance relationship wholly from scratch. An ex ante approach would focus on developing concrete plans, including triggers for clearly identified conditions, at the inception of an initiative or set of programs. It should involve a plan covering at least five years, identifying ultimate objectives and intermediate milestones, a theory of change for how objectives will be achieved, and metrics to provide a basis for assessing progress. Policymakers and planners can then link conditions to milestones and metrics. Moreover, such an approach builds on recognized best practices for capacity-building initiatives.

Second, the framework must include a partner governments mutual participation in the creation of the assistance plan, the identification of objectives, and the agreement on conditions. The partner will be more incentivized to progress toward objectives when it understands and commits to such objectives based on its own identified interests. A memorandum of understanding, bilateral compact, or some other formal written instrument can commit both parties to its terms.

Third, the framework should structure conditions as positive inducements for the recipient to take steps toward milestones or objectives. Milestones could include completion of defense institutional reforms, starting with development of a process to align budget to strategy, progressing to completion of a first budget cycle with the new process, and culminating in institutionalization of the process through policy and/or law. They might also include progress toward capability or interoperability milestones (e.g., ability to conduct nighttime counter-terrorism operations in accordance with the laws of armed conflict or command and control and intelligence integration across platforms and systems). In addition, milestones could include transparency and accountability activities (e.g., publication of public budget, completion of audit, investigation of specific incidents of resource waste and abuse or diversion, establishment and activity of an independent third-party investigative unit for accountability).

Partners will likely respond to inducements that are material in nature, including access to an expanded variety of types of assistance and an expanded quantity of assistance. However, partners may also value incentives such as eligibility for key agreements to facilitate access and information and/or technology sharing (e.g., acquisition and cross-servicing, general security of military information, etc.) or eligibility for expanded partnership opportunities (e.g., National Guard State Partnership Program or the Military Personnel Exchange Program). Moreover, incentives may also be political, such as access to membership in certain organizations or eligibility for certain agreements.

Such inducements are consistent with the Task Force on Extremism in Fragile States concept of graduated assistance: As a partner achieves key milestones, it is able to graduate into a new status that allows it to access increasing quantities and types of assistance, as well as other benefits. Policymakers should tailor the potential tiers of access and associated benefits, as well as the milestones triggering graduation to a higher tier, to the individual recipient, and accordingly integrate them into bilateral development plans or compacts, as discussed above. A possible tiering of graduated assistance could include:

Yet, for fragile states with weak security institutions, the task force rightly notes that assistance should initially focus on institutional reforms, with increasingly sophisticated and lethal capabilities and equipment contingent on sustained improvements in security sector governance. The reforms should also institutionalize inclusivity. In practice, such an approach may prove difficult if partner governments or their security forces are vested in a corrupt status quo, such that institutional reform poses an existential threat or compromise to their personal gains. In such partnerships, identifying geographic areas or bureaucratic processes that may be more receptive to change first should be the focus of investment, and may be most successful if there are third parties, such as other allies and partners, media, or civil society that are calling for similar changes. For a potential coalition partner with comparatively good governance, on the other hand, milestones and incentives may be built around coalition interoperability and the capability to perform certain roles within the coalition context. In collaboration with the partner, U.S. policymakers should design a program of graduated or tiered assistance, structuring incentives and milestones across the full portfolio of security sector assistance. The total program of assistance could grow in both scope and sophistication as the partner progresses through milestones.

In addition, within each broad category of security sector assistance provided by the United States, policymakers and planners may find opportunities to moderate U.S. investments based on a partners progress (in other words, in relation to specific security sector assistance lines of effort). The table below outlines engagement at low, moderate, and high levels across several broad assistance categories as they could be applied within the U.S. Indo-Pacific Command area of responsibility. As planners construct graduated assistance programs, they thus have options to moderate assistance both within a specific type of support and across the full portfolio of security sector assistance. In practice, the categories and degrees of security sector assistance options would be tailored to meet the objectives of the specific partner relationship.

Figure 1: Potential Categories and Degrees of Security Sector Assistance via Indo-Pacific Command

Importantly, conditions should be based on realistic assumptions about what partners would be willing to do (in terms of both what steps can be realistically expected given the recipients unique political and institutional context as well as what leverage relatively small sums of U.S. assistance can be expected to produce). Also, conditions should be accompanied by concrete U.S. commitments. Positive conditionality will quickly cease to be attractive to partners when the United States fails to follow through on a promised inducement.

Of course, following through in this manner requires sustained availability of funding. Many security sector assistance programs have significant flexibility in the availability of appropriated funds over time. More importantly, in our experience, programs with more rigor in strategy and long-term planning are likely to win the sustained support of congressional appropriators.

This proposed model of positive conditionality offers new possibilities not only for incenting partners to take steps toward shared objectives but also for improving planning and management of security sector assistance resources. Assistance programs are structured such that the achievement of each milestone triggers an expansion of the assistance relationship. Each step also provides an opportunity for an assessment of goals and progress. It enables planners to incorporate natural mechanisms to provide exit ramps, through which the U.S. or partner government can determine to terminate the initiative, or to restructure efforts to achieve a defined milestone. To be effective, it is critical that overarching objectives, as well as milestones leading toward those objectives, are specific, measurable, and time bound.

Deciding When to Use Positive Conditionality

Given competing political pressures and security obligations, positive conditionality will not be the best approach for every security sector assistance relationship. So, when should it be applied? Until implementers of security sector assistance can experiment with positive conditionality in diverse contexts in the field, it will be difficult to provide detailed answers, but we can offer a few hypotheses. The first is that the effectiveness of positive conditionality in the security sector will depend on the degree of recipient country ownership. According to the World Bank, country ownership means that there is sufficient political support within a country to implement its developmental strategy, including the projects, programs, and policies for which external partners provide assistance. Recipients will be more likely to take desired actions to the extent they share an initiatives objectives. Perhaps more importantly, though, as research in the development community has demonstrated, conditionality can undermine the effectiveness and legitimacy of governing institutions if conditions are imposed in ways that supplant domestic decision-making processes or force domestic actions without the recipient governments buy-in. To be effective, positive conditionality should reinforce domestic political institutions, not undermine them.

A second hypothesis is that positive conditionality will be most effective when structured around a recipients concrete priority. In many cases, partners have goals and aspirations that the United States can substantially influence; for example, accession to or interoperability with NATO, participation in military or peacekeeping coalitions, access to certain sophisticated military systems, or certain political agreements. To be effective, positive conditionality should structure milestones and incentives around such concrete priorities determined by the partner, rather than ambiguously defined partnership or capability goals or objectives imposed by the United States. Positive conditionality will work best when the United States is uniquely positioned, in relation to other security exporters, to help a partner obtain its goals.

Third, positive conditionality will work best when the donor avoids interest asymmetry. If positive conditionality is to succeed, the United States cannot afford to need a security relationship more than the recipient. In Uganda, as well as in some other notable cases in recent years, the United States has become so reliant upon single partners (e.g., the security forces of Iraq and Afghanistan; Saudi Arabia in Yemen) that its policy options were sharply constrained by the negative consequences of terminating or redirecting assistance, meaning that Washington was unable to enforce the consequences of noncompliance. Such conditions are incompatible with the model we propose.

Finally, we should acknowledge that any attempt to implement positive conditionality will not take place on a green field; it should be crafted within the context of existing U.S. assistance and arrangements that will limit options and complicate negotiations. In addition, the policy and resourcing process within the executive branch, tensions and different priorities between and among regional and functional offices, as well as interactions and priorities of Congress will add further complexity to implementing a conditionality framework. Simply put, the United States has already committed to assistance and agreements around the world without seeking concomitant commitments from partners. Elements of the U.S. government have different viewpoints on how assistance should be leveraged and applied. This legacy does not foreclose opportunities for positive conditionality but does require a creative and flexible application of the model. Agreements in place can be renegotiated; existing assistance can be phased out over time to make way for new priorities and new approaches. Baseline assessments can help identify a partners most pressing needs and those priorities that may be most appealing for future work.

Some will object that this approach and the obligations it implies for both U.S. planners and foreign counterparts are unrealistic, and that such obligations attached to U.S. assistance could drive partners to alternative security providers. In our experience, many U.S. partners not only want to work with the United States as their security partner of choice but are also motivated by a desire to improve the effectiveness and governability of their own security sectors. Yet, it is also important to acknowledge that this approach will unquestionably require more diplomatic engagement by senior policymakers to achieve and sustain partner buy-in. That is both necessary and appropriate. Security sector assistance is a fundamentally political activity. It should be buttressed by engagement between political stakeholders on both sides to identify political objectives, requirements, and obstacles in relation to an assistance program. Indeed, the lack of this type of persistent political dialogue is a prominent cause of many security sector assistance failures.

Looking Ahead

Incentivizing security partners progress toward common outcomes and objectives will enable the United States to get more out of its security sector assistance investments. Such an approach will be vital to building strong, accountable, and interoperable partnerships globally. It may be particularly important in fragile states, where security sector assistance may otherwise inadvertently fuel predatory behavior by security actors. While political realities will inevitably disrupt routine plans, and policymakers will demand instant or tangible deliverables, such as lethal assistance, the only remedy to mitigate against unintended consequences is to institutionalize a smart, incentives-based planning framework with continuous opportunities for adaptation and adjustment. The United States will need to pilot this approach to experiment and fine-tune a viable framework. This in turn will require bipartisan support in the U.S. Congress for the security sector assistance enterprise to fail forward on a pathway to success.

Several indicators suggest that Congress is ready to move in this direction. In recent years, it has passed several bills most notably the Fiscal Year 2017 National Defense Authorization Act and the Foreign Aid Transparency and Accountability Act of 2016 that have established important foundations for positive conditionality, including mandates for assessment, monitoring, and evaluation of foreign military assistance, more flexible planning horizons for Defense Department assistance, and tighter collaboration between the Defense and State Departments in planning and implementing military aid.

A new legislative initiative, the pending Department of State Authorization Act of 2019, would take several additional steps forward. Recently passed by the House Foreign Affairs Committee with strong bipartisan support, the bill would create several new tools supporting positive conditionality, including strengthening assessment, monitoring, and evaluation of military assistance, authorizing Security Assistance Compacts similar to the bilateral compacts discussed above, and bolstering planning processes to achieve greater strategic focus and prioritization in U.S. assistance. Passage of this legislation would represent a watershed moment for U.S. security sector assistance, particularly aid provided by the Department of State.

The urgency of adopting a new, more strategic approach to security assistance is growing by the day. American partnerships are under increasing pressure from declining resources, domestic isolationist trends, and strategic competition. Meanwhile, the range of global security challenges for which the United States turns to partners to contribute grows in diversity and complexity. Positive conditionality offers policymakers, diplomats, and operators a tool to shape partners behaviors in a manner that offers an opportunity to produce greater return on American investments, simultaneously strengthening partnerships and growing global capacity to deter, prevent, and respond to crises and conflict.

Tommy Ross is a non-resident senior associate at the Center for Strategic and International Studies. He served as Deputy Assistant Secretary of Defense for Security Cooperation at the Pentagon and was the senior defense and intelligence adviser to Senate Majority Leader Harry Reid. He has also held other senior positions in the House and Senate.

Melissa Dalton directs the Cooperative Defense Project and is a senior fellow and deputy director of the International Security Program at the Center for Strategic and International Studies. Prior to CSIS, she served in the U.S. Department of Defense for 10 years.

Image: U.S. Marine Corps (Photo by Staff Sgt. Mark E Morrow Jr.)

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Published: February, 2020

It's February, and many people are still clinging to their New Year's resolutions, which for many includes some sort of weight-loss goal. However, while extra pounds often come off, evidence shows they rarely stay off. Among overweight or obese people who are able to lose 10% of their body weight, just one in six is able to maintain the weight loss for at least a year.

Experts say it's not surprising that weight loss rarely sticks, considering what they now know about how the body works. "Most people believe that obesity is caused by overeating, while we now recognize that the main driver of obesity is one or more disruptions in the body's normal regulation of the amount of fat we maintain," says Dr. Lee Kaplan, an associate professor of medicine at Harvard Medical School and director of the Obesity, Metabolism, and Nutrition Institute at Massachusetts General Hospital.

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A CALCR cell found in mice may stop feeding without subsequential nauseating effects as well as influence the long term intake of food.

Ever eaten something, gotten sick and then didnt want to eat that food again because of how it made you feel? Thats because a signal from the gut to the brain produced that sickness, creating a taste aversion.

Conventional wisdom renders theres one circuit in the brain that suppresses eating it comes from the stomach and makes you feel sick if you activate it too hard. Eating a portioned meal makes your body happy, though, even while stimulating a signal to the brain to stop eating, according to Michigan Diabetes Research Centers director, Martin Myers Jr., M.D. Ph.D.

Therefore, there must be a circuit that stops normal feeding without the adverse effects, right? says Myers.

Now, a Cell Metabolism study may have discovered this second circuit in mice. Myers, Randy Seeley, Ph.D, the director of the Michigan Nutrition Obesity Research Center, and a team of researchers sought to better understand which part of the brain curbs appetite and which neurons play a role in making mice want to eat or not eat.

The gut-brain signal that suppresses appetite is triggered by a type of neuron, containing calcitonin receptor (CALCR), which lives in a structure of the hindbrain called the medulla. Interestingly enough, these neurons didnt need to be active in the brain for gut sickness to cause an aversive response.

This suggested we might be able to dissociate the brainstem systems that stop feeding from those that cause nausea, says Myers, whose group found they could genetically activate those CALCR neurons to do just that.

Since there are neurons that can suppress eating but also cause aversive effects, that must mean there are different types of neurons, or circuits, in the brain that can terminate feeding with differing emotional responses.

When the researchers inactivated the CALCR neurons, they were surprised to make another discovery, which contradicted the idea that the brain only controls short term meal sizes and consumption.

Turning these neurons off didnt only interfere with the suppression of feeding by gut signals, but it also caused an ongoing increase in food intake. The mice became obese, suggesting that the brainstem systems dont only control meal size, but the amount of food consumed long term. This created a predisposition to obesity because of the energy imbalance in the mice (more input than output).

Similarly, activating CALCR neurons decreased the mices food intake and body weight without any aversive gut effects. In the study, Myers and his team found another neuron, CCK, also decreased food intake and body weight but created an aversive internal response, unlike the CALCR neurons. The difference between the two neurons were found in their circuits.

CCK activates what we would call a yucky circuit, says Myers. The neurons activate a certain cell, CGRP cells, which create that sick feeling. Unlike CCK, activated CALCR neurons follow a yummy circuit, activating non-CGRP cells.

Obesity affects more than one-third of the adult population in developed countries, which can lead to diabetes or other serious, long-term health conditions like heart disease, explains Myers, who is also the director of MDiabetes.

Unfortunately, many diet drugs work, but they make people feel nauseous after they take them. Obesity remains a condition difficult to pharmaceutically manage, since the treatment options have limited therapeutic utility. A drug that turns on CALCR and turns off CGRP could greatly benefit patients with obesity by suppressing feeding and creating a long term control of food intake and body weight.

If we could figure out a drug for individuals with obesity that suppresses food intake to produce long term weight loss without the negative side effects, it could absolutely change someones life, says Myers.

Reference: Calcitonin Receptor Neurons in the Mouse Nucleus Tractus Solitarius Control Energy Balance via the Non-aversive Suppression of Feeding by Wenwen Cheng, Ian Gonzalez, Warren Pan, Anthony H. Tsang, Jessica Adams, Ermelinda Ndoka, Desiree Gordian, Basma Khoury, Karen Roelofs, Simon S. Evers, Andrew MacKinnon, Shuangcheng Wu, Henriette Frikke-Schmidt, Jonathan N. Flak, James L. Trevaskis, Christopher J. Rhodes, So-ichiro Fukada, Randy J. Seeley, Darleen A. Sandoval, David P.Olson, Clemence Blouet and Martin G. Myers Jr., 16 January 2020, Cell Metabolism.DOI: 10.1016/j.cmet.2019.12.012

Disclosures: This study was funded by National Institutes of Health and AstraZeneca. Martin Myers Jr., M.D., Ph.D., has been linked to Ionis Pharmaceuticals and Novo Nordisk.

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Celebrities like Kourtney Kardashian, Halle Berry, and Vanessa Hudgens have all touted a high-fat diet as their secret to losing weight and staying fit, all without feeling hungry or deprived. In fact, many of the most popular diets of the past decade included high amounts of fat: the ketogenic diet, Paleo, the Mediterannean diet, the carnivore diet, and the Bulletproof diet.

But it wasnt too long ago that fat had a bad rap. During the low-fat craze of the '80s and '90s, people looking to lose weight and improve their health opted for a low-fat diet. Then, the pendulum swung the other way. Now, low-carb, high-fat diets are trending for weight loss and better overall health.

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Thats probably partially because weve learned a lot about fat since the days of low-fat-everything. Back then, many thought eating fat equaled more body fat, explains Amanda Baker Lemein, R.D. Now, we understand that simply is not true. Instead, we know that if you eat more calories than you burn, you gain weight. And this can happen from overeating any macronutrient protein, carbs, or fat not just one alone.

But even if fat isnt bad for you, does it deserve its current super nutrient status? And is it even healthy to eat a high-fat diet long-term? Here, nutrition pros share everything you need to know.

Fat is the most energy-dense nutrient, containing 9 calories per gram compared to the 4 calories per gram found in carbohydrates or protein, explains Gabrielle Fundaro, Ph.D., a consultant for Renaissance Periodization. Fat is an essential nutrient, Fundaro says, meaning your body cant make it so you have to eat some of it.

While a low-fat diet can be healthy, not getting enough fat in your diet can cause health issues. Consuming too little fat can result in dry skin, decreased energy or satiety levels in between meals, decreased vitamin absorption for vitamins A, D, E and K, increased risk for depression and other mental or cognitive issues, and hormonal imbalances, Lindsay says.

So how much fat should you be eating? Healthy adults should aim to consume between 20 to 35% of their calories from dietary fats, says Victoria Lindsay, R.D. (So if youre eating 1,800 calories per day, that would mean eating between 40 and 70 grams of fat.) Of course, those are just general recommendations. How much fat you should eat is really an individual thing, Linsday emphasizes. And if youre on a true ketogenic diet, your fat intake could be at upwards of 70 percent of your total calories.

RELATED: Whats the Keto Diet? Everything You Need to Know

In a lot of ways, nutrition experts are enthusiastic about fats rise from its previous nutrient non grata status. I think it is a great thing that we are no longer afraid of fat, Lemein says. Fat is incredibly satiating, and because it delays gastric emptying (aka food leaving the stomach), it helps us stay fuller for longer. Plus, some of the most-nutrient rich foods are high in fat, like avocado, nuts, seeds, and fatty fish like salmon.

With fat bombs, Bulletproof coffee, and other high-fat snacks all over social media, its understandable that people get the impression that fat is better than other nutrients, or that certain types of fats are superfoods.

The truth? There are no superfoods, though there are some foods that are more nutrient-dense than others, Dr. Fundaro says. Theres some emerging research showing that certain, very specific types of fat might be beneficial (think: MCT oil). But Dr. Fundaro emphasizes that just because something shows potential benefits in a research setting doesnt mean its worth trying as an expensive supplement.

I find this to be unfortunate, because people may spend time, money, and energy on these biohacks that only add extra (and perhaps unneeded) energy to the diet by way of adding fat to their daily intake, Dr. Fundaro notes. In other words: Eating naturally-occurring fats in whole foods that you enjoy? Great. Adding fat to your diet in the form of supplements or eating high-fat foods you wouldnt normally eat? Totally unnecessary. Especially if you just end up eating unnecessary calories youre not enjoying in the name of health.

Plus, the pendulum effect is real. While Im glad that fat is no longer being vilified, its a tradeoff, as carbs are now the trendy nutrient to avoid, Lindsay points out. But eating carbs is actually better for your health long-term than not eating them.

It seems as though the pendulum has swung a bit too far in the opposite direction, Lindsay adds. While keto can be a healthy way to eat, it does carry some worrying side-effects just like any extreme diet.

Whats more, we dont know much about the long-term effects of a super high-fat diet. While diets like keto can result in weight loss, its usually due to an overall calorie restriction rather than abstinence from or addition of certain foods. But people dont see that: all they see is results, Linsday says. What they dont see is one or two years down the road when the person experiencing the dramatic weight loss has gained all if not more of it back. Nor do they see some of the long-term effects of eating in such a restrictive way, mainly because we often dont know what those are yet. For some diets and eating patterns, only time will tell.

Whether you eat high-fat, low-fat, or somewhere in between, its important to know that the types of fat you eat matter. Some types are associated with better health, while others are not.

Saturated fat isnt inherently unhealthy, but high intakes are associated with increased risk of cardiovascular disease, Dr. Fundaro says. Animal fats (with the exception of fish oils) are common sources of saturated fats. Coconut oil is high in saturated fat, as well. Replacing saturated fat with polyunsaturated fat may reduce the risk of cardiovascular disease. Theres some debate over whether saturated fat really is detrimental to health or not, but for now, its recommended that saturated fat make up no more than 10% of your daily calories.

Monounsaturated is a beneficial fat that is associated with improved cardiovascular health, says Allison Knott, MS, RDN, CSSD. Its found in vegetable oils (like olive and canola oil) and other common foods like peanuts, avocado, and various nuts and seeds.

These are generally found in plant foods and fish, and there are several different types. The most notable are:

You probably know that these are the fats you want to stay away from, as even small amounts can increase your risk of cardiovascular disease, Linsday says. Thankfully, artificial trans fats are being phased out by food manufacturers. They usually come in the form of partially hydrogenated oils in fast food or pre-packaged snack and convenience foods. Trans fats are also naturally found in beef fat and dairy fat in very small amounts.

When figuring out how much fat you should include in your diet, it can be helpful to know that based on the latest research, low-carb and low-fat diets perform equally in terms of weight loss and improving metabolic health. So how do you choose a fat intake that makes sense for you?

The most healthful diets include a variety of foods that an individual enjoys in amounts that promote health and well-being, Dr. Fundaro says. The Mediterranean Diet, DASH Diet, and Flexitarian diets are all often rated as the best diets by U.S. News and World Report, she points out. None of them are particularly low in carbohydrates or fat, nor do they recommend cutting out any food groups. They are simply easy to follow, nutrient-dense, appropriate to use for weight loss (within a caloric deficit), and generally cardioprotective, she adds.

On the other hand, low-fat and low-carb diets can be really hard to follow, which means lasting weight loss is not likely if thats your goal. For that reason, its best to choose a diet that you can envision yourself continuing with long-term. Even if youre not concerned with your weight, Dr. Fundaro says getting a healthy variety in your diet is key. That means eating a wide array of plants (veggies, fruits, and whole grains) while limiting processed foods, saturated fats, trans fats, added sugars, and sodium.

Despite the popularity of high-fat diets, low-fat foods are still widely available in grocery stores. Whether or not you should choose them, Lindsay says, is mostly up to personal preference. I know plenty of people who, for example, prefer 2% or skim milk in their cereal versus whole milk, and Id never disapprove of that choice if thats what they like. Some people are also advised by their doctor to use low-fat products because of a health condition, such as heart disease.

The issue for me is when people choose low-fat foods because theyre too afraid to choose the full-fat counterpart for fear of eating too many calories or eating something they feel might be too unhealthy, Lindsay explains. This may indicate an issue like orthorexia, or another non-sustainable eating pattern.

Lindsay also recommends avoiding processed low-fat snack foods like crackers, chips, and cookies. The problem with these products is that as a substitute for fat, manufacturers will usually compensate with added salt and/or sugar, not to mention that the taste is usually inferior to the full-fat version anyway. If you want to have one of these foods, in most cases, you might as well go for the real thing.

At the end of the day, its about finding balance in your day-to-day food choices and in your overall approach to eating.

For example, if someone is consuming a breakfast that includes nuts (aka another fat source), maybe a low-fat yogurt is the right choice for them to balance out their overall intake, Lemein says. But, if they are just eating fruit and yogurt, the extra fat might add some staying power to the meal and help keep them fuller for longer, she adds.

As a dietitian, what Id love to see is this: balance, Lindsay says. The most nutritious diets are diverse. Have your carbs, have your protein, and yes, have your fat, but keep it balanced by eating a variety of foods.

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The keto diet. You've probably heard of it by now.

It's the low-carb, high-fat diet that caught on and spread quickly, leading some to label it as a fad, while others praised its effectiveness.

The new year brings in anannual flood of personalhealth goals, and for those trying to lose weight, the keto diet might have come into consideration. Is it effective? More importantly, is ithealthy?

Before making any commitments to keto, it's important to understand what you're getting yourself into.In addition to whatthe health professionals below have to say about keto, it's important to consult your doctor before embarking on any high-fat diets.

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Though there are slightly different versions of the ketogenic diet, it's primarily based on a low intake of carbohydrates coupled with a high intake of fat and protein.

Generally, this means people on the diet get70% to 80% of their daily calories from fat, about 20%from protein and about 5%from carbs.

The decreased intake of carbs forces the body into the state of ketosis,in which fat becomes the main provider of fuel for the body.

Though similar, keto is not the same as the Paleo and Atkins diets, which also feature low-carb routines.

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The diet has been associated with effective weight loss, but it doesn't necessarily get the approval from doctors.

"I wouldn't recommend the keto diet to anybody," Jeffrey Mechanick, medical director at Mount Sinai Heart's Marie-Jose and Henry R. Kravis Center for ClinicalCardiovascular Health,told USA TODAY.

When it comes to dissecting popular diets such as keto, doctors stress the importanceof knowing the difference between weight loss and genuine overall health.

Reducing your intake of carbs, as the keto diet does, goes hand-in-hand with reducing intake of whole grains, fruits and some vegetables, which raises red flags for health professionals.

"That's where Iget a little concerned about the keto diet," Vasanti Malik, adjunct assistant professor of Nutrition at the Harvard T.H. Chan School of Public Health, told USA TODAY.

"You want to be mindful, because these foods whole grains, fruits and vegetables carry a number of beneficial nutrients vitamins, polyphenols, fiber that have been shown time and time again to be beneficial for cardiometabolic health."

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As the keto diet essentially nixes the body's intake of carbs, the bodysearches for an alternative source of fuel. Before long, the body breaksdown fat,muscle and tissues to sustain itself, Mechanick said.

"In theory, the keto diet basically mimics starvation," Mechanick said."If you don't eat carbohydrates but you eat an excessive amount of fat and protein, you're still going to waste tissue. Tissue is still going to burn off."

Yes, you might experience weight loss on the keto diet,but that might not actually be good for you, considering what you giveup.

"I don't feel particularly comfortable telling people to reduce intake of things that we know offer benefits for health," Malik said.

Diet-driven peoplemight find this part hard to digest.

Doctors are moving away from what we traditionally think of as a "diet," one with specific restrictions or calorie goals. Instead, theypromotea healthier overall lifestyle.

"The vernacular is changing," Mechanick said. "We try not to even use the word 'diet.' We try to use the phrase 'eating pattern.'"

There's a "rebound" issue with many fad diets such as keto, Malik said. You go on the diet, lose weight, but what happens after that? Most people struggle to stick with it.

"Without a realistic lifestyle change, the individual is going to regain the weight," she said.

The answer might not be a traditional "diet" at all,but there are changes you can make to shed weight while leading a healthy and sustainable lifestyle.

The importance comes in the quality of the foods you eat, not necessarily the number of calories you consume, Malik said. She favors of eating patterns that don't abide by a restrictive calorie count, because they generally help people stick with the pattern longer.

Mechanick recommends minimizing your intake of two types of carbs sugars and starches while boosting another: fiber. High-fiber foods,including vegetables, low-glycemic index fruits, beans and nuts, are instrumental to a healthy eating pattern, he said.

"If you can get it up to seven to 10 servings a day, that's great," he said."You can't do that with the keto diet."

Malik urges people trying to lose weightto target foodssuch as whole grains, fruits, vegetables andnuts, while limiting saturated fat, added sugar and added sodium. Balance those practices with daily physical exercise, and you've established a solid base for weight loss and a healthy lifestyle.Althoughshe argues against daily calorie counting, Malik urges caution about portion sizes there's no use in overeating. Avoid appetizers andsnacks in front of screens, and limit meals to one plate of food, the American Heart Association advises.

Losing weight has its benefits, both in a physical and mental sense. But when striving to eat well and hit the treadmill, don't lose sight of what it means to be healthy.

"People have to be content,"Mechanick said."They have to be fulfilled. That's what being healthy and productiveis, and that's really the endpoint."

Follow USA TODAY's Jay Cannon on Twitter: @JayTCannon

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