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Exercise can be a potent therapy for patients with rheumatologic diseases and can result in improvements in inflammation, disease activity score, pain, stiffness, and fatigue. However, exercise needs to be modified for these patients to address the unique barriers they may have compared with the general population, said panelists during a session at the American College of Rheumatologys annual meeting.

Rikke Helene Moe, PT, MSc, PhD, chair of health professional in rheumatology in the European League Against Rheumatism and a researcher of the national advisory unit on rehabilitation in rheumatology in the Department of Rheumatology at the Diakonhjemmet Hospital in Oslo, Norway, explained that in the past, there was a fear that exercise would increase symptoms and decrease response, and she admitted to being part of that shady past.

We advised people to rest, which resulted in them lying in hospital beds day in and day out, she said.

People with rheumatic and musculoskeletal diseases (RMDs) are less activate than the general population, which is already fairly inactive30% of people globally are insufficiently physically active, and more than 50% of people with RMDs are less active than the recommended 30 minutes per day, Moe said.

Intensity of exercise also matters, and positive effects are greater at higher intensities, but the exercises have to be individually tailored. Its easy to put everyone in the same box and have them do the same exercise, but the likely result is that most people wont follow through, she said. For instance, clinicians have to be patient when working with someone who has fibromyalgia. It will take these patients more time to reach adequate levels of exercise and activity.

In addition to exercise helping with symptoms of RMDs, it also benefits cardiovascular health. RMDs increase the risk of cardiovascular disease because of the inactivity that comes with pain associated with RMDs, being overweight, and the side effects of drugs. Exercise clearly helps with reducing the risk of cardiovascular disease in these patients.

Knowing these things is not enough, Moe admitted. We are working on implementation, working on barriers.

Modifying exercise is incredibly important for patients with chronic pain, said Kim Jones, PhD, RN, FNP, FAAN, professor and dean at Linfield College School of Nursing and research professor at the Oregon Health & Science University School of Medicine.

She noted that chronic pain has to be viewed as a disease like rheumatoid arthritis (RA) or diabetes, not just a symptom, so patients will stop chasing something elusive that will get rid of the pain entirely. The goals of exercise for these patients should be to improve body composition, muscular strength, power, endurance, and flexibility.

What we see in rheumatology, as we increase [exercise] intensity, unless we really know how to do it in a controlled manner, the tradeoff may be that people have more pain, they may even trip into an overtraining syndrome, where they feel depressed and more fatigued, Jones noted. So, there seems to be a tradeoff, and were figuring out where exactly that line is. And as you might guess, its going to be different for different people.

A Cochrane Review analyzed studies on exercise in patients with pain, and while the studies all varied (with lengths anywhere from 1 to 30 months and with exercises ranging from daily to weekly with varied durations and types of exercises), the review did find small to moderate improvements in physical function all studies. There were also small to moderate effects on pain severity. The impact on psychological function and quality of life varied more. Some of the studies showed a huge difference, while other barely moved the needle, Jones said.

For patients with RA, a lack of knowledge about the benefits of exercise on arthritis may be one barrier to physical activity, said Yvonne M. Golightly, PhD, MS, PT, assistant professor in the Department of Epidemiology and adjunct in the Division of Physical Therapy at the University of North Carolina at Chapel Hill. The truth is, the general population has plenty of barriers to physical activity, including lack of time, not finding exercise enjoyable, concerns about injury, uncertainty of where to start, and a lack of motivation or support.

Patients with RA face all the same barriers that the general population faces, plus the additional barriers of pain, stiffness, fatigue, challenges with mobility/function, and fear of aggravating the disease or damaging their joints. In addition, Golightly noted, these patients may have a lack of advice from healthcare providers regarding physical activity because the providers themselves may feel like they have a lack of knowledge regarding programs that are appropriate.

She has studied high-intensity interval training (HIIT) in patients with arthritis, which is not high impact, so its good for the joints. In addition, HIIT may appeal to these patients because bouts of exercise can be as short 60 seconds, and in as little as 2 weeks, patients may start seeing the benefits of the exercise regimen.

Its important to emphasize the benefits of exercise by increasing knowledge for patients and providing support, Golightly said. Teaching coping strategies to overcome perceived barriers is key, as well. Patients with arthritis who are physically active and those who are physically inactive face the same barriers; the only different is that the physically inactive patients perceive those barriers to be a bigger challenge.

Teaching coping strategies is critical for overcoming perceived barriers, Golighty said. And its important to engage in conversations with patients that help them find internal motivation and change their behavior.

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The Many Benefits of, and Barriers to, Exercise in Patients With Rheumatologic Diseases - AJMC.com Managed Markets Network

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When one is new to fitness training, or returning after a significantperiod of time, then considering possible programs, meeting with personaltrainers, or even Googling various training protocols can seem daunting especially when one is trying to keep track of some of the key terminology. Its not that the fundamental ideas behindfitness training are particularly challenging, but an early barrier to comfortwith these programs can be as simple as understanding the basic terms and lingoused regularly within this world.

So today, a little primer on a few key training terms particularlyfocused on the action and movement of muscles while doing functional strengthtraining. By the way, functional strength training, the type of trainingat the core of 45 & Thrive, involves the performing of exercises againstresistance (weights, machines, body weight) in such a manner that theimprovements in strength and fitness are directly related to the movementsand activities of an individuals daily life. Put another way, we train inthe gym to make the tasks, chores, work, fun, play, and life outside the gymeasier.

Okay, lets get started. An initial concept important to the understanding of human movement is that of Anatomical Position This is the reference position for all body parts in relation to each other as standardized in the fields or medicine, anatomy, kinesiology, and personal training. In short, it is a map, or layout for the human body; standing upright, face and palms forward, feet approximately a shoulder-width apart, and arms hanging naturally at the side. From this standardized posture, body movements and indeed many of the names of body parts, are derived.

Flexion Movement at a joint, or involving multiple joints where the joint angle decreases and the body part moves away from anatomical position. Example: When we perform a bicep curl with a dumbbell, the action from start of the exercise to the point where we have curled it as far as possible, is a flexion.

Extension Movement at a joint, or involvingmultiple joints where the joint angle increases and the body partreturns to anatomical position. Example: When we perform a bicep curl with adumbbell, the action from the end of the curl portion, back to the starting(anatomical) position, is an extension.

Hyperextension Movement at a joint, or involvingmultiple joints, where the body part moves from extension beyond anatomicalposition. Example: Tilting the head/neck back beyond anatomical position likewhen we look up at the stars, or when we arch our backs beyond anatomicalposition. Hyper, meaning beyond or excessive, may also used with theterms flexion and extension to describe a movement which goes beyond anatomicalposition to an unstable or injury prone position. We try to avoid that.

Concentric Muscle Contraction The muscle(s) shortenas body segment moves through flexion. Example: When we perform a bicep curlwith a dumbbell, during the flexion phase (first half of the overallexercise) the biceps muscle undergoes concentric contraction; the musclefibres shorten as they add force to the resistance and movement occurs.

Eccentric Muscle Contraction The muscle lengthens,under tension, as it returns to anatomical position. The muscle lengthens dueto the resistance being greater than the force the muscle is producing. Thishappens as we either consciously turn off some of our muscle fibres to allowthe return motion to take place, or, when we are fatigued to the point where wecan no longer produce enough force to hold the concentrically contractedposition. Example: The controlled lowering phase of the bicep dumbbell curlresults in this type of contraction of the biceps muscle. So, the biceps muscledoes not only work as we curl the dumbbell upwards, but is also engaged as welower the weight to the starting position. During this second phase of theexercise, this additional and complementary contraction occurs, which furtherworks the muscle, and does so in a way different than a concentric flexion.

Isotonic Contractions A collective termwhich refers to the action of a muscle undergoing both concentric andeccentric contractions during exercise. Example: A complete bicep curlexercise, single repetition, from start to finish would be considered isotonic, as its fibres changed length while contracting throughout the exercise.

Isometric Contractions A muscular contraction where the length of the muscle does not change. The muscle fires or activateswith force/tension, but there is no movement at the joint. The joint remainsstatic. This might sound counter-intuitive, but we have all contracted muscles,yet no movement has occurred. Simply standing upright and holding that posturerequires muscles to contract and help hold that position, from our core,through to our legs and feet. In the gym, when we do plank exercises, or holda steady position performing a wall sit, we are doing isometric exercise.

So, there you have it. Some key terms related to strength trainingand, in particular, how we both describe and understand body movements centredaround muscle contraction through joints. Hopefully when these terms arise,either in discussion with a personal trainer, watching YouTube videos on newexercises or technique, or while reading about new training programs, an increasedfamiliarity with these terms enhances understanding, focus, and performance ofyour training routines.

Next time, I look forward to discussing how, through 45 & Thrive, we apply an understanding of the mechanics and physiology of the various types of muscle contractions to our method of functional training in order to optimize gains, minimize time spent in the gym, and be prepared to enjoy life to its fullest through robust longevity.

Until next time

Michael Patterson, M.Ed.Lift long and Prosper

Michael Patterson M.Ed, has spent 30+ years as a fitness and health professional. He holds degrees in Physical and Health Education, Psychology, and Education. Find out more about Michael and follow him on his website at http://www.45andthrive.com, and on Instagram @45andthrive. Questions and comments can be sent to mpatterson@kos.net.

*Disclaimer: The information provided and discussed in this column is based on my personal experience, studies of physical and health education and my expertise as a lifelong fitness and health professional. Any recommendations made about fitness, training, nutrition, supplements or lifestyle, or information provided through this column, should be discussed with your physician or other health-care professional.

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45 & Thrive: Contraction action Key movement terms at the core of strength training programs - Kingstonist

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If you are looking pale and feeling tired all the time, if your skin (especially the knuckles) is darkening, if you have severe joint pains, pins-and-needles sensation or feel a numbness while walking, you could be suffering from vitamin B12 deficiency. There could be other symptoms too, such as mouth ulcer (glossitis), blurred vision, a tendency to fall, dizziness or short breath.

But most of the times, we tend to google a remedy or pop a vitamin pill, hoping that the symptoms will go away. Well, they won't, until you visit a doctor and get proper medication. Worse still, a severe deficiency can lead to deep depression, paranoia, delusion, memory loss, loss of taste and smell, and more, according to an article in Harvard Health Publishing. Why is this vitamin so vital for our health? Well, vitamin B12 is essential for the proper functioning and development of the nervous system, red blood cells and even our DNA. But just like most other vitamins, the human body cannot make it. You will find it in dairy products like milk and all sorts of animal proteins such as seafood, meat, poultry and eggs.

An average adult only requires 2.4 micrograms a day, but there lies the problem. Either our intake is not adequate or many of us cannot absorb it. According to medical practitioners, vitamin B12 deficiency cases are on the rise, mainly due to poor dietary habits and lack of awareness.

"However, more and more people are testing now for B12 deficiency (it is a blood test) as they become aware of this condition. A decade ago, there was hardly any testing," says Dr Manoj Chadha, Consultant Endocrinologist at P.D. Hinduja Hospital and Medical Research Centre in Mumbai. Even then, addressing the condition is not easy. For one, the symptoms may take years to show up, and when they do, they can be easily mistaken for folic acid (vitamin B9) deficiency or other related ailments.

"I have seen a doubling of these cases over the past decade and it is a problem that we cannot ignore," says Dr Jeevan H.R., Consultant Medical Gastroenterologist and Hepatologist at HCG Hospital in Bengaluru.

Eating the right food is essential, he says, and a vegetarian diet does not help here as most plants do not grow vitamin B12. You need not be a meat-eater, though, as milk and other dairy products contain this vitamin. Those who consume too many pills to fight gas and acidity are also open to risk. Prolonged intake of these drugs often reduces gastric acid secretion and hinders vitamin B12 absorption. Long-term and heavy use of alcohol is another big risk. Stomach conditions such as atrophic gastritis (inflammation of the gastric mucosa) and pancreas problems also lead to malabsorption of vitamin B12.

Can veggies absorb B12?: Based on several independent studies conducted in different states and regions (Northern India, for instance) and also drawing from their personal experience, doctors say that vitamin B-12 deficiency is quite rampant in the country and becoming a growing health risk. But it is difficult to arrive at a few direct linkages with clearly correlated cause and effect.

Globally, research is on to understand how vitamin B12 deficiency is linked to ailments other than red blood cells or nerve-related diseases. For instance, could it lead to heart conditions, osteoporosis, depression and some cancers? Does the prolonged use of certain drugs trigger lower vitamin B12 absorption? Besides, efforts are on to develop new solutions to help vegetarians and vegans. For example, could plant structures be tweaked to help them absorb vitamin B-12. Last year, scientists at the University of Kent reportedly discovered that certain plants have the potential to absorb this vitamin. This could go a long way in making plant-based foods which will be rich in vitamin B12.

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More than Nerve-Racking - Business Today

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Within minutes this week, two articles crossed my Twitter feed, both telling me how difficult it is to study some very important things.

One was on diet (Why Diet Research Is So Spectacularly Thin, by David S. Ludwig and Steven B. Heymsfield) and the other was on teaching writing (Scientific Evidence on How to Teach Writing Is Slim, by Jill Barshay).

The similarities beyond the headlines ("Thin"/"Slim") are striking. Both articles focus on the lack of high-quality research in their respective areas.

Conducting research on the effectiveness of diets is apparently quite difficult. While we may think that theres an easy metric against which were measuring (weight loss), the confounding variables make it very difficult to attribute any single outcome to a change. As the authors say, High quality trials are hard to do because diets, and the behavior of humans who consume them, are so complicated.

Diet interventions that may work in the short term may do long-term harm. Contestants on the reality show The Biggest Loser lost hundreds of pounds in a matter of months, but many of them quickly gained the weight back, sometimes surpassing their previous levels.

The extreme amounts of exercise and highly restricted diets are not sustainable. Theyre probably not healthy, either. Conflating weight loss with increasing health is probably a category-error mistake to begin with.

The authors close with a call for a Manhattan Project to find definitive answers to epidemics of diet-related disease. They want the research to have the same quality and rigor as pharmaceutical research that is meant to treat disease, rather than prevent it, as good diet can.

Im not in medicine, but I am a researcher. I wonder about that last bit, but lets table it while we look at the article on the research on teaching writing.

Jill Barshay quotes Robert Slavin of the Center for Research and Reform of Education at the Johns Hopkins School of Education, saying, Theres remarkably very little high-quality evidence of what works in writing.

The research problems in measuring writing are similar to dieting. It is difficult to find a true control group. And unlike diets, where we at least have weight loss (as problematic as that may be as our criteria), evaluating writing is inherently subjective.

Tested methodologies for writing show mixed and/or inconclusive results. What works in one group may not in another.

The commonality that Slavin did find is that Motivation seems to be the key: If students love to write, because their peers as well as their teachers are eager to see what they have to say, then they will write with energy and pleasure.

The research shows that the atmosphere in which students are learning makes a difference. What they are doing and who they are doing it for goes a long way to helping students write better because theyre more engaged to write more.

As to the lack of high-quality research, Im wondering if this is truly the problem we should be tackling or rather if we should expand our notion of what high-quality research looks like in these sorts of complicated human endeavors.

Isnt it possible, even likely, that in realms where human variability is at play, we are unlikely to find a single common approach that works best for all, or even most? As anyone who has tried diet and/or exercise has experienced, the chief problem is not necessarily whether or not the diet works -- the principle of taking in fewer calories than your body burns is pretty rock solid -- but whether or not the person can maintain the program itself.

The limiting factor on the success of a diet is not the quality of the diet, but the attitudes and experiences of the person.

The same is true, in my view, of writing. The key to improving as a writer is persistence. Good writers simply keep writing, and anything that keeps one writing is good. Trying to design experiments around these complicated things that meet these "high-quality" standards often involves moving the participants further and further away from the genuine, organic behaviors that attach to these activities in the real world. The diet or writing method that seems to work in the controlled lab experiment may not translate to the wider world. This is the exact problem with the highly prescriptive practice surrounding the use of the five-paragraph essay. Training students to pass the assessment that has become privileged has made them less capable as writers in general, while killing their spirits to boot.

Now that my own approach to teaching writing is out in the world, as embodied in Why They Cant Write and The Writers Practice, I am confronted with questions about how I know if my approach works.

I mean, I know it works. Ive refined it over years of working with students through a continuous process of qualitative research. Because it is not generalizable, qualitative research is not considered high quality, but this does not mean it is inherently low quality. When were looking at these complicated things where solutions are unlikely to be wholly generalizable, it is, in fact, invaluable.

One of the ways I measure the effectiveness of my approach is to ask students whether or not they think theyre learning. I find this to be meaningful data.

Another method I use is to ask students how they would approach an unfamiliar writing task. Here I am assessing the development of the writing practices, the skills, attitudes, knowledge and habits of mind of writers. If they can articulate an approach to a new writing problem, I know that eventually, through practice, the written artifact itself will become better and better.

I want to know how students feel about their writing abilities, whether or not they perceive an increase in their writing power. If I were a nutritionist, I would also want to know how my patients feel when on my program of diet and exercise. If they feel like crap and the experience is miserable, how could I ever expect them to persist?

A generalizable, quantifiable measurement simply doesnt apply here. It is a mismatch between desired information and methodology. The problem were studying is too complex, and what happens when it comes to writing and developing as a writer is a little different inside everyone.

I suspect this is why the available research finds that the writing atmosphere is important seem to be the most promising. Inside a good atmosphere, different students can travel different paths toward similar (yet still different in important ways) destinations.

As to the evidence I look for to see if The Writers Practice is working as I hoped, Im feeling pretty good about this.

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When "High-Quality" Evidence Maybe Shouldn't Be the Goal | Just Visiting - Inside Higher Ed

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Share on PinterestKendrick James Farris at the weightlifting event at the Rio 2016 Olympic Games. Getty Images

Packed with record-setting athletes displaying cut physiques and explosive power, The Game Changers, a new documentary on Netflix, has a clear message: Vegan is best.

The film aims to make the case that a vegan diet isnt only the most advantageous diet for long-term health, but for an athletic edge as well.

From Olympic weightlifter Kendrick Farris and cycling champion Dotsie Bausch to top distance runner Scott Jurek and Arnold Schwarzenegger (a producer of the film), the documentary chronicles several professional athletes who attribute getting faster and stronger, and recovering from injury more quickly, to adopting a plant-based diet specifically vegan.

Vegans dont eat meat or products derived from animals, like eggs or milk.

While theres not much data to back a trend of professional athletes going vegan or vegetarian, Barbara Lewin, RDN, CSSD, LDN, a sports nutritionist who works with professional athletes, including Olympic athletes and members of the NHL and NBA, certainly sees her pro-athlete clients embracing a plant-based diet.

My clients see so many benefits to eating a plant-based diet that postseason, they dont go back to eating as an omnivore or a carnivore, Lewin noted.

Healthline asked that question to David C. Nieman, DrPH, FACSM, a professor of health and exercise science and director of the Human Performance Laboratory at Appalachian State University in North Carolina, where he studies athletes and diet.

Nieman is a vegetarian and marathon runner who sees many reasons someone would want to become vegan. Still, he had a clear answer: No.

The only possible way it [a vegan diet] may help some people is if theyre involved in a sport that takes more than an hour, Nieman stated.

And thats only if they were on a low carb, high fat diet and switched to a vegan diet, which would mean theyd be taking in more carbs. Those people would see improvement in endurance not sports skill, he said.

Studies on the correlation between performance and vegan, vegetarian, and meat-eating diets are rather limited.

One recent study published in the Journal of the International Society of Sports Nutrition tracked the maximum exercise capacity of 76 recreational runners, 18 to 35 years old, for 6 months. Of the group, 26 followed a diet that included meat and plants, 26 ate a vegetarian diet, and 24 ate a vegan diet.

The results suggest that there are no differences in exercise capacity between vegan, lacto-ovo-vegetarians and omnivorous recreational runners, the studys authors wrote.

The bottom line: All kinds of diets are compatible with performance, Nieman said.

Thats if you make healthy choices compatible with whatever diet you want to follow.

Lewin agrees that any diet needs to include wise choices if youre eating for health or performance.

If youre living on crackers, vegan cheese, and other processed foods, its not a good choice. For a vegan diet to be healthy and to work for the elite athlete, it has to have a strong foundation in vegetables and fruits, legumes, whole grains, nuts, and seeds, she told Healthline.

The Game Changers shares stories of both long-term health on a vegan diet and immediate improvements in performance. Bouncing back quickly between workouts is also important for professional athletes and many more casual athletes too.

According to Nieman, youve got to look at nutritions effect on three areas to get an overall sense of how diets affect athletes: long-term, acute, and post-workout recovery.

Long-term health is important for athletes. Plant-based dietary choices are at the heart of all healthy eating patterns, Nieman explained, whether your diet of choice be vegetarian, Mediterranean, or DASH, for example.

The 3-day period before a sports event matters a lot. Athletes should eat a high carb diet, with most carbs coming from grains and dried fruit.

What you eat every day counts towards your health and overall performance. However, the pre-workout or prerace meal is extremely important, Lewin said.

A high fat meal can leave you feeling sluggish and is not a good fuel for the muscles, whereas a meal with the right balance of carbohydrate and protein will digest efficiently and provide good energy, she said.

Finally, Nieman points to an area of study called metabolic recovery, or bouncing back to normal after a race or workout.

This area of study has discovered what you eat can improve your return to homeostasis. The simplest snack? Fruit. Niemans research has found bananas, pears, and blueberries all support your bodys recovery after exercise.

Fans of the vegan diet claim that if you eat vegan, its easier to bounce back between workouts with plant protein since its less inflammatory.

Nieman, whos currently studying athletic recovery after 90 minutes of hard exercise when someone eats pea vs. whey (dairy) protein post-workout, strongly disagrees.

Its nonsense that plant protein will help you recover any differently, he said.

But Lewin believes the anti-inflammatory effect of plant foods help with recovery.

With higher levels of exercise intensity you produce more free radicals and byproducts that can cause inflammation in the body. A vegan, plant-based diet rich in antioxidants can have an enormous impact on reducing inflammation, she said.

Lewin and Nieman agree on one point, though: Its not at all necessary to consume animal products to excel in pro sports.

Whether youre biking or training for a Tough Mudder, weekend warriors can experiment with vegan meals thatll fuel your body.

The prerace meal needs to be high in carbohydrate, low in fat and fiber (which both slow down the digestive process), and can contain moderate amounts of protein, according to Lewin.

Try:

A game-changing takeaway from the film? Its not at all necessary to consume animal products to excel in pro sports.

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Elite Athletes Are Going Vegan. Will It Help You? - Healthline

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What if you stopped obeying a list of rules about what and how much you eat? Intuitive eating aims to help people do just that, working to heal their relationship with food after a lifetime of off- and on-again dieting.

There are 10 different principles that characterize this practice, which was defined by registered dietitian nutritionists Evelyn Tribole and Elyse Resch in 1995. The basic idea is that it is possible to let go of the belief system that dieting is beneficial and necessary for a healthy lifestyle. It encourages the honoring of hunger and cravings and challenges beliefs about good and bad foods. Food is meant to become neutral for those practicing intuitive eating, explains Devrie Pettit, the RD behind Happily Fed. This can give you more freedom while making decisions about food, allowing you to eat what sounds satisfying and what makes your body feel good.

Related: Intuitive Eating Is the Anti-Diet to End All Diets

It sounds pretty great, right? The idea of never dieting again is incredible, but it could also make you feel nervous, too. Surely unconditional permission to eat doesnt apply to everyone, right? If you feel skeptical that intuitive eating is a good fit for individuals with a chronic illness like diabetes, you are definitely not alone.

Intuitive eating is for everyone.

Its a big myth that intuitive eating isnt appropriate for everyone, says Cara Harbstreet, RD, of Street Smart Nutrition. It was created by two dietitians for the very purpose of supporting health and well-being, so its a natural complement to the interventions or management plans for chronic diseases.

Removing food rules may feel risky for someone with a chronic disease. It may seem that doing so could contribute to out of control eating behaviors or worsened symptoms. While some may initially experience intensified cravings and feel they are eating more than normal, this is a pretty normal first step toward a healthier relationship with food, according to Harbstreet.

Unconditional permission to eat is often misconstrued as free and open access to eat whatever you want, whenever you want, says Harbstreet. And perhaps on the surface, yes, this is a process one must go to in order to rebound from years of dieting and restriction.

She adds that, with time, practicing intuitive eating can take on the form of learning to honor when you are hungry and when youve had enough. Youll feel OK eating a snack even though it was unplanned, allowing yourself to eat foods because they bring enjoyment, and eating during times previously seen as off limits, like right before bed.

Try the fur cure. Simply petting an animal can decrease the level of the stress hormone cortisol and boost release of the neurotransmitter serotonin, lowering blood pressure and heart rate and, possibly, elevating your mood.

Additionally, this evolving relationship with food is a chance to see it for what it really is.

When you neutralize all food, you dont see it as good or bad, and you come to realize that all food serves a purpose, says Pettit. Food can provide nutrients, energy, or just taste good. Some foods encompass all three purposes.

This means that, once you allow yourself to consider all foods, you can choose what sounds good to you, what you have available and time to prepare, and what feels good in your body.

Intuitive eating isnt just an OK choice for individuals with diabetes, it can be incredibly helpful in managing the chronic illness for the long term. As an example, the principle of Making Peace with Food is important to individuals with diabetes, says Harbstreet.

So often, foods with carbohydrates are vilified or avoided, she explains. Which creates a cycle of deprivation and intense cravings or binge eating for many people.

Related: How You Can Reverse Type 2 Diabetes, According to Experts

This is just one example. It is possible to see how other principles like, Exercise Feel the Difference, could be a good fit for someone coping with diabetes. Additionally, there is a big mindset shift that comes with adopting intuitive eating as a lifestyle, as Harbstreet points out.

Rather than use scare tactics or fear to motivate someone, IE offers support, encouragement and non-judgment to allow room for learning and mistakes, she says. Ultimately, its a more compassionate way to help people with diabetes feel empowered and confident in their ability to do whats best for them and their bodies.

Another aspect of this mindset shift is letting go of the expectation that weight loss is the goal for someone with diabetes. Pettit is quick to explain that becoming smaller isnt necessary, that it isnt possible to make accurate assumptions about how a person eats or moves based on their size or appearance. It is also true that it is completely possible to improve blood cholesterol, glucose, and blood pressure levels because of new, health-promoting behaviors without seeing the number on the scale change.

The biggest misconception is that weight loss automatically equals better health, Harbstreet adds. I find that although this may be the case for some people, its usually a temporary fix and it removes attention from the other healthful behaviors that are also important.

So, how exactly should someone with diabetes get started with intuitive eating? The first step is to find an IE coach who is also a registered dietitian to visit with about first steps. This person will help you as you face the challenges of completely changing how you think about food and health and they can keep your medical providers looped in so you dont get conflicting advice, according to Harbstreet.

Additionally, Pettit offers a few specific tips for the process. She encourages individuals in these circumstances to make sure they are including foods they love to eat and choosing meals, snacks, and exercise routines that are sustainable because they work well with your existing lifestyle. Intuitive eating embraces gentle nutrition, so it is OK to keep in mind basic principles as you build a meal. For example, pairing protein, fats and carbohydrates together is encouraged by Pettit.

Lastly, although this is a practice that is for anyone, it might not be the very first step for specific people. If you are critically ill or in recovery for an eating disorder, there may be additional healing that needs to happen on the road towards an intuitive eating lifestyle. This is why reaching out for professional support is so important as you work on embracing a less judgmental approach to food and exercise, whether youre chronically ill or trying to break free from years of cyclical dieting.

Find out what celebs are saying about diet cultureand why it can be toxic.

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Intuitive Eating: Can This Anti-Diet Work for Diabetes? - Parade

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Fitness for many is a difficult journey especially when trying to focus on one particular area - such as belly fat- and getting little result.

Exercise and diet both play a crucial role in ensuring you get the results you want.

For so many of us, there are two major factors that prevent us from getting a workout in: time and space,Grincerisaid.

Scheduling time to work out is one thing that takes a lot of organisation and dedication, but finding the physical space to work out should be a no-brainer.

For most, finding the time to go to the gym, especially once winter is in full swing, can be extremely difficult.

Withblastsof cold weather, motivationcandrop and gym membershipsgoto waste, butGrinceriexplained you can do a simple belly fat burning exercise from the comfort of ones home.

DON'T MISS

He said: Working outdoesnt require a huge studio, a spacious backyard, or even the need to move your furniture around, he said.

According to Grinceri, there are four essential moves that use gliders and light ankle weights that each target the core and can be doneina teeny tiny apartment.

These are the top four moves recommended bythefitness specialist.

1. Torso Twist

Angelo Grinceri said: With light ankle weights on, tap right toe in front and put hands behind your head.

Pull belly button in towards the spine as you lift leg up to a soccer kick and rotate torso before bringing to starting position.

Lean body back after restarting each repetition. Repeat 8times on both sides.

2. Rotation Lift

Take one arm straight out at a diagonal and opposite leg out to the side. Lift knee as you squeeze abs, bringing arm to knee and twisting.

Lift and reach back to starting position. Repeateighttimes on both sides, he explained.

3. V-Up

Angelo recommended a V-up as one of the moves a slimmer should do to ensure natural belly fat burning to occur.

He said: Starting on your butt with legs out in a V-position. Lean back and lift knees up slowly as you squeeze core tight before bringing legs back down. Repeateighttimes.

4. Plank Hover

Start in a plank position with both feet on one glider, keeping abs tight and elbows in line with shoulders.

Shift chest forward, bringing it in front of elbows before returning to starting position. Repeateighttimes.

Angelo trained at theGreys Institute of Physiotherapy alongside doctors; armed with the knowledge of how each tiny muscle connects to the bone and how each joint moves. He trained here with his childhood friendStephen Pasterino and founder of the method.

Hisapproach to health and wellness is all about longevity and preparation. He believes we should participate in exercise that prepares the body for all of lifes daily requirements, mainly ones that improve how well we get from place to place (such as walking!)Angelo uses his background in human performance and pilates to stimulate and tone every muscle in the body while challenging balance and coordination.

Angelo regularly treats fans to workout videos and fitness images on his personal Instagram.

As a teenager, he became obsessed with bodybuilding. He lifted heavy weights with basic movement patterns, never stretched, and subsequently felt terrible, with back pain. So he then reviewed his fitness lifestyle and started to replace every piece of it with a more holistic option.

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Star fitness specialist gives his top tips on burning belly fat without going to the gym - Express

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Diet plays an essential role in lowering blood pressure and a growing body of evidence recommends certain foods for their blood pressure-lowering properties.

One study, published in the Journal of the American Heart Association, makes a strong case for supplementing a diet low in saturated fats with walnuts to help lower blood pressure.

In a randomised, controlled trial, researchers examined the effects of replacing some of the saturated fats in participants' diets with walnuts.

Saturated fat is the kind of fat found in butter, lard, ghee, fatty meats and cheese. Eating a diet high in saturated fat is associated with raised levels of non-HDL (bad) cholesterol, a waxy substance found in your blood that is tied to cardiovascular complications, explains the British Heart Foundation.

They found that when participants ate whole walnuts daily in combination with lower overall amounts of saturated fat, they had lower central blood pressure.

READ MORE:High blood pressure: The surprising food that could lower your reading

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High blood pressure: Include this snack in your diet to lower your reading - Express

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By Elizabeth PennisiNov. 14, 2019 , 2:00 PM

Nancy Moran has found clues to evolution in some unlikely places. Some 20 years ago, living in Arizona, she would frequent a Mexican restaurant in Tucson for more than its food. She regularly climbed the fire escape behind it to visit the upper branches of a hackberry treealong with all the insects lurking there. One night, she reached into the foliage and scooped up a nondescript bug that helped change the way she and other biologists think about the evolution of complex life.

The sesame seedsize bug she nabbeda psyllid, which causes the plant stems or leaves it feeds on to form hard nodules called galls around the insectharbored symbiotic bacteria that appear to capture a key stage in the evolution of the cell. Their genomes are so shrunken, Moran found when she returned to her lab and analyzed the bug's microbial cargo, that they seem to be losing their ability to live on their own. They may be on their way to turning into organelles, like mitochondria and chloroplasts, which originated as symbiotic microbes early in the history of life but ultimately became dependent wards of the cell.

Moran, an evolutionary biologist now at the University of Texas (UT) in Austin, has built a career from groundbreaking findings made in plant-dwelling insects. Her work on psyllids, aphids, and other sap-sucking insects has uncovered intricate, intertwined relationships with internal bacteria, which help them survive on a meager diet of plant juices. Moran is "one of the people who pioneered symbiosis as a field and did so with rigorous work and creativity," says John McCutcheon, a former postdoc and now an evolutionary biologist at the University of Montana in Missoula.

Today, such symbioses are widely recognized for creating life as we know it. Energy-producing mitochondria power all complex cells; chloroplasts, where photosynthesis takes place, make plant life possible. The cementing of other host-microbial alliances enabled animals to expand what they could eat, diversify into new species, and conquer almost all parts of the planet. We humans are increasingly aware that communities of microbes in our guts, on our skin, and elsewhereour microbiomeshape our physical and perhaps even mental well-being.

Moran, who received a MacArthur "genius grant" early in her career and was elected to the National Academy of Sciences in 2004, has developed her own vital partnership. She has teamed up with Howard Ochman, another UT biologist, for more than 20 years, both personallythey married in 1998and professionally. She has dedicated her career to symbiosis; he has ranged more widely but has contributed fundamental principles about how microbes evolve. "This is quite the power couple," says biotechnologist Andrew Ellington, a UT colleague.

After decades uncovering the evolutionary roots of symbiosis, Moran now looks to microbial communities for ways to address today's challenges. She's studying the gut bacteria in bees, which depend on microbial guests to thrive. That new system, she hopes, will suggest ways to stop the decline of the bees and other pollinators and perhaps yield a simple model for exploring the roles of gut microbes in people.

Honey bees need their gut bacteria to thrive and keep their hives healthy.

While playing outsidewith her seven siblings or hanging out at the Dallas, Texas, drive-in theater her father ran, the young Moran would collect bugs, leaves, and flowers wherever she could. "I was known as the kid who liked plants and insects," she recalls. Her favorites were the tarantulas. (Yes, the entomology Ph.D. knows they are spiders, not insects.) She kept them in jars and fed them crickets. Her family accepted her hobbies, fretting only when, at age 9, she convinced a friend they should test whether the poison ivy next to the school playground really could cause a rash. "That was a horrible disaster," Moran recalls.

Yet she was slow to realize that she could make a career of biology. At UT, she majored first in art and then in philosophy. But an introductory biology class, a university requirement, had an enduring impact. "Once I learned about evolution and natural selection, I decided this was the most interesting thing to spend time on," Moran says.

As a graduate student at the University of Michigan in Ann Arbor, Moran trained with the famous 20th century theoretical evolutionary biologist W. D. Hamilton, and they became close friends. "We talked about everything big ideas and what kinds of science make a difference in understanding the evolution of life," Moran says. Entomology remained her first love, however. Every free moment she wriggled into bushes, looked under leaves, and peered into flowers to see what new insect species she could find.

After she took a faculty job at the University of Arizona in Tucson in 1986, a phone call from Paul Baumann, a microbiologist at the University of California (UC), Davis, helped her link her two scientific passions. Baumann was studyingBuchnera, a once free-living bacterium now found solely inside aphids. In the 1960s, a German biologist named Paul Buchner had cataloged these endosymbionts and written a tome with intricate illustrations of where they lived in the aphids, as well as in lice, beetles, and other insects. Buchner suggested those symbioses were essential, life-long relationships that had existed for millions of years.

If so, the microbes and the insects must have evolved togetherand their DNA should tell the tale. To test the idea, Baumann needed Moran's aphid expertise. By sequencing the genomes of various aphid species and theirBuchnera, Baumann and Moran built family trees for both organisms, and found that the microbes had diversified in step with the insects. Using various aphid fossils to date the trees, they found that the partnership began some 200 million years ago. Since then,Buchnerahas passed from one aphid generation to the next, coevolving with its host.

Aphids dine on sap they suck from a plants phloem, or circulatory system, but that diet lacks key nutrients. The insects rely on internal bacteria called Buchnera to convert amino acids in sap, such as glutamate, into ones they are missing. The bacteria, in turn, benefit from other nutrients and shelter provided by the aphid.

C. BICKEL/SCIENCE

For the next 15 years, Baumann, Moran, and their colleagues used similar DNA analyses to document equally long-term relationships between bacteria and white flies, spittlebugs, cicadas, leafhoppers, and psyllids. Some partnerships dated as far back as 270 million years, they concluded. The work "established that symbiosis is a central part of evolution that goes way back," Moran says. She and other biologists propose the microbes helped the insects exploit new food sources and habitats, resulting in a rapid diversification that paralleled the diversification of flowering plants.

"Having her as an organismal biologist and him as a microbiologist was really helpful for the field," McCutcheon says.

The sequencing also suggested why such partnerships have persisted for so long.Buchnera, for example, has genes that enable it to make amino acids not available from sap or from the aphid's own metabolism, compensating for the insect's poor diet. Meanwhile, living in the protected environment of the aphid's specialized bacteria-carrying cells,Buchnerahas lost essential genes, so it has to rely on the aphid to make up for those losses. In the late 1990s, this interdependence seemed remarkable, and it helped reshape how symbiosis was viewed.

Moran's genomic approaches to symbiosis have since inspired many researchers, says Angela Douglas, who studies insect-microbe interactions at Cornell University. Twenty-five years ago, "We were the crazy people" for thinking symbiosis was so important, she recalls. Today, such close connections have proved to be the rule for many host-microbe partnerships.

Moran's later work in insects confirmed the power of symbiosis. She, McCutcheon, and others found that some insects can't survive without multiple symbionts. In the glassy-winged sharpshooter and the cicadaboth also sap-sucking insectsone symbiont supplies eight of the 10 essential amino acids missing in their diet, and another symbiont supplies the other two. In other sap-sucking insects, symbionts serve additional functions, Moran and her colleagues discovered. In aphids, a symbiont makes the insect less susceptible to parasitic wasps by carrying a virus that's toxic to the wasp's young. Other symbionts improve the aphid host's tolerance for high temperatures, enabling it to thrive in new environments. That work illustrated the complexity of microbial partnerships and hinted at the spectrum of advantages that microbial guests confer, a theme increasingly evident in studies of the human microbiome.

A room full of plants teeming with aphids keeps Nancy Moran and her team well-supplied for experiments.

Moran also unexpectedly discovered that deleterious mutations are often common in the hosted microbes, suggesting symbiosis isn't always a win-win for both partners. The microbial genomes were naturally decaying through time for two reasons: The bacteria lacked a sexual phase of reproduction, which could recombine DNA and replace bad genes, and only a few of the bacteria trapped inside an aphid pass along to the next generation, a winnowing that further restricts recombination between microbes. The buildup of mutations steadily erodes the number of working genes in the bacteriaBuchnerahas just 600 genes compared with the 5000 or so poweringEscherichia coliand make those that remain less functional. "The insect is basically relying on a symbiont that's falling apart," Moran says.

She and Japanese colleagues later identified one way aphid endosymbionts cope with the decay: by making a lot of heat shock proteins, which can help stabilize faulty proteins produced from the mutated genes. Another bulwark against decay, Moran suggests, is what's known as horizontal gene transfer, in which essential genes from the partner microbe or outside microbes migrate to the host genomeas genes from mitochondria did. That way they can benefit from the host's sexual reproduction, which enables intact copies to replace mutated ones.

Moran's groundbreaking paper on gene decay came out in 1996. Her lab in Arizona was thriving, but her associate professor's salary barely covered her bills. "I was broke," she recalls, and nearly overwhelmed being a single mom. Divorced for the second time in early 1997, with a 5-year-old daughter and a 14-year-old stepdaughter, she struggled to balance work and family life. "If you have kids, you are not allowed to fall apart," she says. Yet she couldn't travel to scientific meetingskey to any young professor's career.

The MacArthur grant she received in 1997, which paid more than $50,000 annually for the next 5 years, lifted those burdens. She immediately hired a housekeeper and reduced her teaching load.

At the time, Ochman was studying bacterial genomes. Curious to meet this newcomer to microbial evolution, he prodded organizers of one of the exclusive Gordon Research Conferences to invite Moran. So few women were present that Ochman knew exactly who she was. With characteristic directness, he walked up and asked what she was doing with the MacArthur money. Moran, who tends to be reserved, was charmed. They married 14 months later, and he followed her to the University of Arizona. In 2010, Yale University recruited them to set up a center on microbial diversity. In 2013, the couple moved back to Moran's home state.

She says their shared passion for evolutionary biology and Ochman's encyclopedic knowledge of the field have aided her immeasurably. He "has had a huge positive impact on my science."

Nancy Moran met her husband Howard Ochman, who studies microbial evolution, at a scientific conference and their professional and personal lives have become deeply intertwined.

Early on, Ochman had been puzzling over two microbial mysteries: why genomes ofE. colistrains can vary in size by as much as 50%, and how other bacteria abruptly change from benign to pathogenic. By scrutinizing the microbes' genomes, he found that they readily gain and lose genes by swapping them with other bacteria or with their hosts. Such horizontal gene transfer could help explain the genome size variation, how bacteria pick up genes for toxins or other weaponsand also how a symbiont such as the ones Moran studies might shift essential genes to its host.

Moran and Ochman have offices less than 100 meters from each other. He often pops in on her, whether to discuss a possible grant proposal, go over the latest data, or just have lunch. "We spend 18 hours a day together," Ochman says. Yet their personalities are a world apart. Boisterous and impulsive, Ochman jumps quickly into new topics (ape microbiomes recently). Steadfastly loyal, Moran picks a questionor a partnershipand works on it thoroughly. "She is more logical and takes a more long-term view," Ochman says.

Moran's continued insect collecting led her to examples of bacterial symbionts with such tiny genomes that they are inextricably tied to host cells. One wasCarsonella ruddii, from that psyllid from the Mexican restaurant, which proved to have just 160,000 bases compared withE. coli's 5 million bases andBuchnera's 640,000. Other genomes were even smaller. The findings have convinced her that no clear dividing line separates organelles and endosymbionts. "My view is that these words are just labels," she says.

Honey bees have become one of Moran's enduring interests, prompted by her hypothesis that gut bacteria might play a role in the well-documented decline in the bee population. Her team's early work showed the honey bee gut contains eight species of bacteriaa manageable number compared with the hundreds typical of the mammalian gutand that every honey bee around the world has the same set. A student in her lab at Yale figured out how to grow each of the eight kinds in the lab; in contrast,Buchneracontinues to be unculturable.

Nancy Morans molecular and microscopy studies of aphids (in dish) have uncovered key principles of symbiosis.

By isolating pupae before they emerge, Moran's team can keep worker bees from inoculating the young bees with the bacteria. The resulting "microbiome-free" bees, the group found, vividly demonstrate the importance of these microbial guests. Lacking their usual microbiomes, the bees gain less weight, are more susceptible to pathogens, and die sooner. Hives decline.

Recently, Moran's graduate student Erick Motta showed that bees with an intact microbiome become more susceptible to pathogens when exposed to glyphosate, the herbicide marketed as Roundup. Glyphosate has been considered harmless to insects and other animals because it affects an enzyme that only plants and microbes use. But through its effects on microbial guests, the compound may harm insects as well, the work suggested. (When this work was published last year, Roundup's maker issued a statement saying: "No large-scale study has ever found a link between glyphosate and honey bee health issues.")

To Moran, the honey bee microbiome is complex enough to stand in for the human microbiome but simple enough to be dissected in a way the human counterpart cannot be. Moran's work on bees "has been some of the most reliable, clearly articulated work" on gut microbes, says Jon Sanders of UC San Diego, who studies human microbiomes. He expects the honey bee studies will yield insights into how gut microbial communities in general function.

The bee work led to other payoffs after Moran started to work with the Defense Advanced Research Projects Agency (DARPA). which sought proposals to harness microbial systems. At first she hesitated: "The purpose was to engineer something, rather than simply to understand something, as had been true for all my work up until then," she explains. But she, UT bioengineer Jeffrey Barrick, and Ellington got DARPA funding to devise methods to alter the bee microbiome in ways that would change the insect's traits. Such tinkering might make bees more resistant to stresses, for example, which could help preserve the vital pollinators. To show a proof of principle, UT graduate student Sean Leonard recently engineered a bacterium from the bee gut to produce RNA that increases production of dopamine, a key neurotransmitter. Preliminary results suggest those bees are better learners as a result.

Colleagues are curious to see what Moran learns next from honey bees or any of the insects whose inner lives she probes. "She's not just a one-hit wonder," says Ute Hentschel, a marine biologist at GEOMAR-Helmholtz Centre for Ocean Research Kiel in Germany who studies sponge-microbe symbioses. "She has an amazing capacity to focus things so that [new insights] precipitate out."

Moran believes that, like most complex partnerships, the unions between insects and microbes will take a lifetime to unravel. "The host and the symbiont communicate in ways we don't understand," she says. "We're working to figure that out."

Originally posted here:
A love of insects and their microbial partners helped this biologist reveal secrets of symbiosis - Science Magazine

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A new study has revealed that millions of Brits dont know what they should be eating to have a healthy, balanced diet

When it comes to food, many Brits are left scratching their heads. Balanced diets and portion sizes could have millions of Brits left confused, a new study has revealed. Looking at the responses of 2,000 British adults, researchers revealed that almost half of us have no idea how much protein, fat, carbohydrates, sugar, dairy, fruit and veg we are supposed to be eating.

A further 49% said they dont understand what a correct portion size would look like, leading to an overwhelming nine out of 10 admitting their diet probably lacks balance. Its no wonder, with a third of adults not eating fruit each week and nearly half (46%) consuming no vegetables at all on a weekly basis. Just a fifth of us are cooking our meals from scratch - and even then, we do it twice a week or less due to the time it takes out of our already busy schedules.

The study went on to reveal that many of us are favouring foods with little-to-no nutritional value. On average, British adults are eating sugary foods four times a week, and resorting to foods high in saturated fats three times a week. Current expert advice suggests we shouldnt be having more than 11% saturated fat from our total daily calorie intake, while sugar should be 5% or less.

Its not all bad news; research revealed that we are consuming plenty of milk, yoghurt and cheese, all of which can be great sources of protein - an essential component in supporting muscle mass - as well as calcium - an important part in maintaining our bones and teeth.

To help us better understand food and nutrition throughout our lives, a group of nutritionists, researchers and health professionals have joined together to form the Food Advisory Board.

Dr Emma Derbyshire, a nutritionist who carried out the study, spoke on behalf of the board: People are being continuously bombarded with nutritional and dietary information. This is leaving them confused as to what they should and shouldnt eat, and ill-informed about the impact dietary restrictions, or fad diets, can have on their health. To ensure you get the key minerals and nutrients needed for maintaining good health, it is recommended you eat a healthy, balanced diet.

This should contain at least five portions of a variety of fruit and vegetables every day, as well as starchy carbohydrates, choosing higher fibre or wholegrain varieties and potatoes in their skins. It should also include dairy products, such as milk or yoghurt, protein, such as lean red meat, beans, pulses, fish, eggs, and small amounts of unsaturated oils or spreads, like rapeseed or olive oil. There is no need to cut out food groups to be healthy.

While vegan, vegetarian and flexitarian diets are hitting the headlines more than ever, research suggests that few of us are keen to give up on meat entirely. This is despite the health benefits these plant-based diets can offer, ranging from decreasing high cholesterol, lowering the risk of type 2 diabetes and heart disease - not to mention the environmental benefits.

Eating a balanced, healthy diet isnt just vital for our physical health it can have a significant impact on our mental health too. Our diets can have a huge impact, from helping reduce symptoms of seasonal affective disorder (SAD) to boosting fertility, reducing high blood pressure to combatting tiredness and improving our skin.

According to professionals from Nutritionist Resource, the three most important things to keep in mind when trying to eat healthily are to:

By focusing on these three areas, you can feel more energised, achieve a better balance, and feel healthier. Through focusing on all-round good health and benefits over short term changes, you can achieve a more sustainable lifestyle that puts your wellbeing first and starts framing food choices in a more positive way.

If you struggle with making healthy food choices and creating a balanced diet, working with a nutrition professional can help. Providing insights into the impact that food and nutrients have on health and wellbeing, speaking with a nutritionist can help you to improve your mood and overall health, and maintain a healthy lifestyle. Working with a professional will also help ensure that you are making safe lifestyle changes that are right for you.

A nutritionist can help you to assess your current eating habits and identify any areas which may be negatively impacting your health. They can help you to develop the confidence in making healthier food choices, by helping you to learn more about what your body needs. Tailoring your food to help manage any diet-related or long-term illness, a nutritionist can help take the hard work out of planning healthy meals, as well as helping you to navigate the multitude of conflicting information available on what you should (and shouldnt) be doing and eating.

To learn more about what makes a balanced diet, and to discover how a nutrition professional can help you, visit Nutritionist Resource.

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Do You Know What You Should Be Eating? - Happiful Magazine

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