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Janet Chrzans work falls at the intersection of nutrition and anthropology. Im interested in how our social worlds channel food choices that contribute to health outcomes, says Chrzan, an adjunct assistant professor in Penns School of Nursing and in the Department of Anthropology in the School of Arts & Sciences.

In the past, shes studied and written about subjects including organic farming and alcohol consumption. Recently, she published a book about fad diets with colleague and psychology professor Kima Cargill from the University of Washington, Tacoma. These diets arent really about the food, Chrzan says. Theyre about identity, status, control, and transformation. They have power because we believe they will fulfill our desires for self-improvement.

Following is an excerpt from that book, Anxious Eaters: Why We Fall for Fad Diets, published in August 2022 by Columbia University Press.

Youve heard of them and may have one or more friends on them; maybe youre on one yourself. With these diets, you sharply limit certain foods because you want to lose weight, avoid illness, reset your body, eat a biologically ideal diet for our species, or live your best life. They come and go, gaining and losing popularity in a somewhat predictable social cycle and changing namesif not practicesas new advocates rediscover and capitalize on their re-creation of the new-old craze. One decade might abjure fats, the next lives in fear of carbohydrates.

Cookbooks pop up in quick and easy abundance to offer simple, family-friendly recipes that supposedly eliminate the forbidden food category (these same cookbooks will populate the shelves of charity thrift stores in a few years). Celebrities and health gurus endorse the diet, and it becomes the only way to demonstrate how much you value health and well-being to your friends, family, and Instagram followers.

These are the diets that define fad diets: they promise easy solutions and rapid fat loss only if you remove an entire category of food from your diet. Why is this particular type of fad diet so appealing?

Food removal diets are often branded and ask the dieter to spend money on special foods, membership in an organization, or the services of a professional nutritionist, personal trainer, or coach. Paradoxically, these food removal diets often wind up adding foods, albeit special ones intended to replace the foods that are supposed to be removed.

These diets appeal to a uniquely American practice of shopping to solve problems, following a widely held belief that consumption solves, rather than creates, problems. It is the commodification of inadequacythe ways in which brands and the consumer marketplace remind you of all the ways you could be better. We suspect that buying things to solve problems creates a sense of agency among dieters: Purchasing special foods makes them feel more efficacious than if they just ate a little bit less all the time.

Shopping, spending, and eating are all part of a faith in consumption that influences our culture, but our attempts to solve the problem of being overweight through more consumption mistakes the disease for its cure, perpetuating a confusing pursuit of good health in a world of consumer goods. Even one of the oldest and most successful diets, Weight Watchers, relied on membership subscriptions well before its branded foods and online services developed.

In the 1960s a woman named Jean Nidetch, after losing significant weight herself, had the idea to create a support group with attendance fees for people who wanted to lose weight (what became Weight Watchers). Scoffers said, Oh please. No ones going to pay money to lose weight. Weight Watchers proved them wrong.

Chrzan has enjoyed hundreds of conversations with people on fad diets, and most of those diets eliminate one or more foods rather than decrease the amount of food eaten. People say they adopt the diets to decrease caloric intake, reset metabolism, restore health, or simply lose weight quickly. These diets are so popular that eliminating a food type may be the archetypal diet in the minds of Americans, rather than, for instance, eating less or less frequently or replacing high-calorie foods like fatty snacks with low-calorie options like fresh fruit.

It is even possible that the concept of food reduction has come to mean reduction of a food group (or macronutrient) rather than reduction of the overall amount of food. Two examples stand out as typical and interesting because the people involved were self-aware and conflicted about the dietsAtkins and Whole30and their efficacy. The former diet eliminates most carbohydrates, and the latter eliminates most carbs and many fats, gluten, all sugars, and alcohol, promising a fast health reset. Both tout their capacity to cause rapid weight loss.

Once when Chrzan was at a pet store, the clerk recommended an all-protein, no-carbohydrate food as the best option for cats: This food has no carbs, which is good. We shouldnt be eating any carbs, and neither should our cats. They are very bad for us. Janet responded that while cats were obligate carnivores and didnt require large amounts of carbohydrates, humans were omnivores and absolutely needed to eat a balanced diet with differing forms of carbohydrates. The clerk asked why everyone knows that carbs are bad if they arent, and then asked what Chrzan meant by different kinds of carbs.

A few minutes later, after discussing simple and complex carbohydrate biochemistry, the clerk said his girlfriend was often on a diet and that most required cutting out carbs. She did Atkins for a while, and now shes on and off Whole30. He admitted that it made dinner much less enjoyable: You know, I do like my pasta and the occasional pizza, and if she cant share with me, its not a real meal. And then he said that she never seemed to lose weight on the diets, that shed take it off, and then as soon as she stopped the dietor went to a new onethe weight would all come back, plus more. Shed look for the next diet, one that was even more restrictive, something that was sure to work because it made sure she couldnt eat all the bad foods.

Chrzan then talked about how the body physically compensates with weight gain after experiencing a starvation episode and why and how avoiding carbs causes rapid weight lossand rapid weight gain after. The clerk eventually agreed that what works for a carnivore probably doesnt work for a species that evolved from fruit-eating primates.

The second example is from a conversation with friends who were anticipating doing the Whole30 as part of a sober January, to clean the body and lose the holiday weight. They explained that they always went on Whole30 in January, to get rid of the toxins from the holiday excess. But, they said, Its really hard, because we get together with friends every week for dinner and so its difficult to have a shared meal. Sometimes were all on Whole30 and so we can agree on the food, but we really enjoy having a glass of wine; we dont get drunk or anything, just its nice to have a relaxing evening. And the food, well, that gets boring too, doesnt it? I mean, there are lots of recipes out there for Whole30 meals, but its just missing something after a while, isnt it?

Chrzan asked why they adopted Whole30 if it wasnt pleasant, and the response was Well, its the best way to lose it, isnt it? You just avoid all the bad foods, and it gets rid of the inflammation and the toxins from the body. But the food is really hard to keep doing; you really start to miss having a pasta dinner or some good sourdough bread. But the diets really good for you, so we do it for a month to get rid of the Christmas weight.

She asked if they lost weight on the diet, and they told her they werent sure they did, but thats not all its about; its about resetting the body, getting a good clean start to the year, getting rid of all the toxinsoh, but then in February we sometimes eat and drink enough to make up for January! Planning a month of sobriety and conscientious eating is a good ideamany cultures embrace fasting to encourage health, reflection, and renewalbut this example demonstrates that embracing a diet that makes socializing difficult could be counterproductive.

Several themes stand out from these conversations.

One is that the diets might not work and may also cause compensatory behavioral overindulgence leading to weight gain. Two, they are difficult because people miss certain foods. Three, they are difficult because they disrupt valued personal and social habits. Four, they make socializing difficult or more complicated because people cant share food easily. And five, they are perceived to be difficult by their users and are unpleasant as an everyday food regime.

They disrupt commensality and food habits enough that maintaining the diet becomes complicated and difficult. Furthermore, people justify their use with a variety of reasons that might not be accurate, because removal of toxins or a perceived decrease in inflammation isnt necessarily something the diets accomplish.

We are left with the question of why people do them if they are difficult and unpleasant, and after many conversations, Chrzan suspects that people justify their adoption because they are unpleasant and difficult. Indeed, she has come to suspect that the difficulty is linked to a mental perception of efficacy and that sacrifices might equate with a magical thinking that such great unpleasantness will produce correspondingly profound wished-for outcomes. Like Benjamin Rushs adoption of heroic medicine, because the cure is so extreme, shocking, and painful, it has to result in a similarly robust positive outcome.

These diets arent really about the food. Theyre about identity, status, control, and transformation.Penn nutritional anthropologist Janet Chrzan

Kima once worked with a couple who fell on and off the diet and exercise wagon with regularity. When they were on, the regimen teetered on masochism. They drank no alcohol and ate only poached chicken breasts, steamed broccoli, and other bland foods that they perceived as healthy. They paid hundreds of dollars per month to a boutique gym with a personal trainer and took boot camp classes whose routines sounded byzantine. They described running through tires, climbing a rope to ring a bell, coming down a zip line, and then doing a lot of jumping jacks and crunches. Because they werent used to eating or exercising this way, the diet resulted in boredom and noncompliance within a couple of weeks, and the exercise program resulted in injuries, soreness, and exhaustion within a month.

Once they fell off the wagon, they ate most of their food from fast food chains, drank both cocktails and wine nightly, and stopped exercising completely. Of course, the weight came back quickly, along with a crushing sense of defeat. What was striking was the difficulty they had achieving something in between these two polarities. Kima could never convince them to go on a daily walk in their neighborhood or enjoy a simple, tasty dinner of chili and one or two beers. They dismissed this middle ground because it wouldnt be efficacious enough, and instead repeatedly opted for episodes of an extreme but unsustainable lifestyle that mirrored what they saw on blogs and social media feeds.

We have heard, again and again, that people simply cant continue on fad diets, that they fail because they are abandoned. Something just doesnt seem right with their meals, and theyre hard to maintain for a long time. That might be why so many of the carb-reduction diets tout a 14- or 30-day plan and then allow users to gradually increase carbohydrates.

But we also suspect that they fail because they interfere with the concept of the meal and with commensality, two deeply embedded cultural practices that define eating for many people. After all, people eat meals (not single foods) even though they often write and think about food as some type of nutrient package, or with some other individualized classification system that separates food from the everyday lived practice of eating. Leaving out a macronutrient may become difficult over time because our brains, cultures, and dining expectations tell us that our meal must include carbohydrates or fat to be conceptually complete.

Our cultures train us to eat a certain way, and if we do not, we feel that something is vaguely wrong. Similarly, most of us also value eating together, and our preferred mental image of how to eat involves food sharing. After all, we valorize the family meal, and people treasure eating out with friends. Many of our cultural rituals require celebrating together over a table groaning with special foods.

The idea of eating together is baked into our understanding of how to feed ourselves, and so adopting a diet that makes it difficult to enjoy a meal with the people we care about makes that diet much less attractive over time. We suspect that these two cultural constructsthe structure of the meal and eating togethermake the practice of these diets difficult and likely to be abandoned.

Janet Chrzan is an adjunct assistant professor in Penns School of Nursing and in the Department of Anthropology in the School of Arts & Sciences. Kima Cargill is a professor in the Social, Behavioral, and Human Sciences division of the School of Interdisciplinary Arts and Sciences at the University of Washington, Tacoma. The text above was excerpted from their book Anxious Eaters: Why We Fall for Fad Diets 2022 Columbia University Press. Used by arrangement with the publisher. All rights reserved.

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In addition to their role in providing energy, carbs also help regulate blood sugar, insulin metabolism and support cholesterol and triglyceride metabolism. When there is an overabundance of carbohydrates in the diet, these bodily functions can be thrown out of whack.

Dietary carbs can be divided into the following categories:

Dietary guidelines recommend individuals fill 45-65% of their diet with carbohydrates, with a focus on having an optimal fiber intake and limiting simple carbs.

Low-carb diets typically provide around 20 to 130 grams of carbs per day and anywhere from less than 10% to 44% of calories from carbs. Some of the more popular low-carb diets include the following:

Keto diets typically include 20 to 50 grams of carbs per day. [This] diet gained attention in the early 20th century when physicians discovered the beneficial effects of carb restriction on the symptoms of epilepsy in children, therefore, these diets were used for the treatment of epilepsy, says Alma Simmons, a registered dietitian nutritionist and maternal fetal medicine dietitian and diabetes educator at Ohio Health Hospital. However, when people started realizing that low- carb diets could also help with weight loss, the popularity increased drastically, she adds.

The goal of the keto diet is to induce ketosis. Typically, the body prefers carbs as its main fuel source, but when there arent enough carbs available, the body is forced to burn stored fat for energy. Ketosis is the name of this fat-burning process.

Its important to note that a keto diet designed for an individual living with epilepsy is quite different from one designed for someone who does not have the condition. Most notably, individuals with epilepsy are routinely advised to go on a more restrictive, very high fat diet so their body goes into ketosis quickly.

Established in 1972 alongside Dr. Robert Atkins book Dr. Atkins Diet Revolution, this diet is based on the idea that a low carb intakeas opposed to the conventional low calorie dietis superior for weight loss. Today, there are variations of the Atkins diet, ranging from 20 to 100 grams of carbs per day. Typically, the Atkins diet is less restrictive when it comes to fruits and vegetables, which may make it a good choice for increased consumption of vitamins and minerals.

Proponents of the paleo diet claim that the foods eaten by hunter-gatherer groups from the Paleolithic era are best for human health. The diet contains about 25% carbs and excludes all grains, legumes, dairy, sugar and processed foods.

Different people may respond differently to low carb diets; just because a certain low carb diet works for one person really well (i.e quicker weight loss), doesnt mean it will work the same way for another persona distinction often due to genetics. Additionally, individuals living with extra weight and obesity may find that it takes them longer to reach ketosis than individuals who are not living with those conditions.

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Are Low-Carb Diets Effective? Here's What You Need To Know - Forbes

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Soon after Sharon Oakley gave birth in 2018, acquaintances were quick to congratulate her on her appearance. "Oh, you look really good you've really bounced back!" she says people told her within months of having her baby.

She may have looked like she'd 'snapped back'. But the reality was different. While she had lost most of the weight shed put on during pregnancy, physically, she was suffering. An avid runner, Oakley, a Canadian who lives in Yorkshire, UK, loved jogging with her son in the stroller, a routine she took up six months after giving birth. But she'd leak urine the whole way. Back at work, she started experiencing bladder leaks in the office, too.

After a complicated diagnosis journey that included a six-month wait for a physiotherapist referral, Oakley was diagnosed with bladder, rectocele and uterine prolapses where the pelvic organs, not adequately held in place by a weakened pelvic floor, slip out of their normal position.

Four years later, her condition has improved. But she still has occasional leaks. She carries spare knickers with her everywhere. She worries when she runs. For a while, she thought she might have to quit her job.

"It is a very strange part of our culture where we gauge a woman's postpartum period in terms of how they look, rather than how they're feeling," says Oakley. "I look fine but I have these birth injuries that I'm still navigating every day."

Stories like Oakley's are far more common than they are talked about publicly. While not always symptomatic, pelvic organ prolapse alone affects up to 90% of women postpartum. Urinary incontinence, which can also be caused by a too-tight pelvic floor, scar tissue or nerve damage, is experienced by about a third. Diastasis recti, where the abdominal muscles that separate to make room for a growing belly haven't yet knitted back together something which can make the belly look like it bulges and cause pain, constipation and urine leaks, as well as make walking or lifting difficult affects 60%.

And even in the absence of specific pregnancy or birth injuries, the drastic physiological changes that happen during pregnancy, labour and postpartum from the hormones that tell the body to hold onto fat stores, to pressure on the pelvic floor, to the nutrients being siphoned out of the mother's diet to feed a foetus or breastfeeding infant mean that it takes time to recover and heal.

But many women find that, once the baby is born, the messaging they're getting isn't to rest and recover. It's to 'snap back' into the bodies and behaviours they had before getting pregnant.

In the media, postpartum celebrities' bodies are dissected based on whether they have or haven't lost weight, with little or no knowledge of what other conditions the person might be dealing with. Diet and fitness programmes aimed at mothers abound, relatively few of them led by experts on postpartum health. Friends, family and even colleagues often make comments about a mother's physical appearance. And while 'dad bod' referring to a man with an 'average' physique is having a celebratory moment, the people who actually give birth rarely enjoy the same latitude.

For some mothers, the pressure to lose weight quickly, combined with inadequate medical support and care postpartum, can be a toxic, even dangerous mix one that can make birth injuries worse and healing harder. It can also take a toll on both mental and physical health in one of the most vulnerable, sleep-deprived, emotionally turbulent periods of life.

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6 HIIT Weight Loss Exercises That Are Better than Cardio

Modified Oct 19, 2022 11:24 PM IST

Have you tried high-intensity interval training for weight loss, toning, and fitness? This type of exercise involves short bursts of intense physical activity, followed by periods of rest. HIIT is an effective way to lose weight and tone up; it is also a good form of exercise for people who want to boost their overall fitness. If you are trying to find the best workout for your goals, then consider trying out HIIT!

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HIIT stands for high-intensity interval training, which is a method of exercise where you alternate between periods of (almost) all-out intensity and low-intensity recovery.

The idea is simple: during your high-intensity bouts, youre pushing yourself almost as hard as you can, and during your low-intensity periods, youre trying to catch your breath in preparation for the next sprint.

High-intensity interval training (HIIT) is a great way to burn calories and get fit. HIIT workouts are time-efficient because you can burn a lot of calories in a short period of time.

For example, a 20-minute HIIT workout can burn about 230 calories. Thats as many calories as youd burn in 30 to 60 minutes of walking, which makes HIIT significantly more time-efficient.

Aside from burning a lot of calories for weight loss in a short amount of time, though, HIIT doesnt have any special fat-burning benefits.

Here are six HIIT exercises that will burn more calories than regular cardio.

Cycling is one of the most popular forms of high-intensity interval training (HIIT) for weight loss because it's low-impact and gentle on your joints. In fact, research shows that when combined with a proper strength training program, cycling can even boost muscle growth.

Cycling outside is also a great way to enjoy nature, but you should always wear a helmet and avoid doing HIIT on busy streets or without proper safety gear. Hill sprints are an excellent choice for HIIT because they allow you to work hard while moving at a slower pace.

Running can be a quick and convenient form of HIIT exercise, because it doesn't require any special equipment. If you don't want to run outside, most gyms have treadmills which allow you to get your heart rate up regardless of the weather.

Despite this, running is one of the best forms of cardio for effective weight loss and increasing cardiovascular strength and endurance. Running can be used in conjunction with strength training to create a well-balanced exercise regimen.

Elliptical machines, rowing machines, and other cardio equipment can help you get a good HIIT workout. Ellipticals are low-impact, so theyre easy on your joints. They also use both your lower body and upper body thanks to the handles.

Rowing machines are excellent for high-intensity interval training, as they involve your entire body and are low-impact. They also make it easy to change your pace, which isnt the case with some machines, like stair climbers. However, keep in mind that many cardio machines overestimate how many calories you burn.

Battle ropes are a good way to get a full-body workout for weight loss, and they're fun and new! You can do many different exercises with battle ropestry alternating waves, jumping slams, or outside circles.

The resistance is up to you: You can make it easier by using more slack or harder by kneeling down while you exercise or using thicker ropes.

Kettlebells are a great choice for high-intensity interval training (HIIT) because they allow you to improve strength and cardiovascular fitness at the same time. To make your HIIT workouts even more effective, try increasing the weight of your kettlebells.

The main disadvantage of using kettlebells for HIIT workouts is that they can be difficult or even dangerous to move quickly when they're heavy, and they take up a lot of space.

Jumping rope is an inexpensive way to burn extra calories for weight loss and improve your cardiovascular health. It only requires a jump rope, and there are many different ways you can make your workouts more challenging as you get better.

For example, you can do double-jumps and crossovers. If you've never jumped rope before, make sure to take a few weeks to get your form down and practice the skill before using it for your HIIT workouts.

HIIT workouts will accelerate your weight loss, even if they are only done a few times a week. But remember, the more intense your HIIT workouts are, and the more frequently you do HIIT workouts, the more fat youll burn

Remember, HIIT may not burn as many calories as hours and hours of hiking, but it can give you a much better return for the time investedand a much better body for your effort, too.

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Is there anything cozier than curling up on the couch with a warm bowl of soup? Didn't think so. As the temperature begins to drop, you may find yourself craving more of this nourishing comfort food. Instead of stocking up on bland canned versions from the grocery store, why not make a batch (or two) at home?

To help you make the tastiest homemade soup this season, we tapped chefs, nutritionists, and other food experts for some tips. From adding in unexpected ingredients, such as a parmesan rind, to making sure you have the right kitchen appliances on hand, read ahead for easy expert-approved ways you can help elevate your soup this fall. Plus, don't miss16 Quick & Healthy Soup Recipes That Could Help You Lose Weight.

Chef Mareya Ibrahim shares that the best soup comes from stock, and there's truly nothing better than making, and storing, your own. "I pour chicken, veggie and beef stock into an old-school ice cube tray and freeze them," says Ibrahim. "Then when I need the stock, I pop out the number of cubes I need and they're perfectly portionedversus pouring it into a big container and having to thaw everything out or waste bags."

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Make your life easier, and soup taste better, with a stick blender that especially comes in handy when making pureed soups and broths. "A stick blender is an absolute necessity for purees, so you can do everything in one pan and not have to transfer hot soup to a blender, which can be quite dangerous," Ibrahim says.

Yankel Polak, Head Chef at ButcherBox, recommends to never boil your soup during the cooking process. "Never more than a gentle simmer," Polak advises, "This allows you to create a clear broth, while keeping some texture in the vegetables."

The way you store soup is just as important as the way you prepare itthis is why you should leave your soup uncovered until it's cooled. "Trapping the hot steam can lead to bacteria growth," Polak shares, "I always chill my soup in an ice bath if I am in a hurry, or just open at room temperature for 30 mins before refrigerating."

RELATED:7 Canned Soups With the Highest Quality Ingredients

Help inject some depth into your soups by adding in canned beans with liquid. "Canned beans, with their liquid, add body and viscosity to a soup broth," says Lisa Lotts, recipe developer, food writer, and owner and publisher of Garlic and Zest. "Don't drain beans before adding them," she advises.

Lotts recommends incorporating hefty greens to brothy soup recipes for an extra nutritional boost. "Avoid spinach as it wilts too quickly," she says, "Kale and escarole are the best choices as they stay bright and add a toothsome chew."

If you are looking to add a bit of an umami kick to your soup, Lotts suggests placing a parmesan rind into the broth as it simmers. "It flavors the soup adding a salty, umami bite without overpowering," Lotts shares. Make sure to remove the parmesan rind before serving.

RELATED:25 Cozy Soup Recipes That Are Perfect For Weight Loss This Fall

The next time you make homemade soup and feel like something is "missing", add in a touch of citrus or vinegar to it to elevate its taste. "We often forget or omit acidic additions in soup recipes, but the brightness makes a world of difference," shares Chef Ellie Golemb of Culinarie Kit. "A nice hit of citrus, vinegar, or wine will act as both a magnifier and a unifier for all your flavors." Golemb recommends adding a squeeze of lemon to lentil soup, a bit of lime to tortilla soup, and a drop (or two) of balsamic vinegar to French onion soup to help brighten.6254a4d1642c605c54bf1cab17d50f1e

"The timing is important, too," says Golemb, "Stir in an acidic ingredient a tiny bit at a time towards the end of cooking your soup, then allow it to simmer off for a few minutes before tasting and adjusting."

Husband and wife chefs, Aaron Israel and Sawako Okochi, of Shalom Japan in Brooklyn have a tip that will help elevate any soup: add in a square of kombu. The kombu will help bring out the umami flavors while also providing a bit of body and textural mouthfeel to any soup. They recommend adding in a two-inch square for every quart of broth.

Although it's tempting to want to finish as quickly as possible, it's important to take your time when cooking homemade soup. Mark Ian, Chef at Mealfan, points out that soups are best when cooked for extended periods at a low temperature. "Slow cooking at a low temperature allows the food's flavors to mix thoroughly, giving it an even better taste," Ian says.

Make the most out of leftover soup by storing it smartly. "To extend the freshness of your soup leftovers, fill the container three-quarters of the way," Ian says. "It will allow air to flow and prevent the growth of mold."

RELATED:Chefs Never Order These Foods From Italian Restaurants, and Neither Should You

Boosting immunity is importantespecially during soup season when colds and flus are seemingly everywhere. You can easily do this by adding mushrooms into your soup recipes. "Mushrooms contain beta-D-glucan, a compound that boosts IgA levels," explains Gigi Carter, food blogger, licensed nutritionist, and co-founder of Healthy for My Purpose Academy. "IgA is an antibodyin our nose, mouth, and throatthat helps fight off illnesses," Carter adds.

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12 Chefs' Secrets for Making the Perfect Soup Eat This Not That - Eat This, Not That

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UAB Nutrition researchers are investigating whether calorie restriction or intermittent fasting can slow the aging process.

Researchers at the University of Alabama at Birmingham are recruiting participants for a new study that investigates whether intermittent fasting or calorie restriction, i.e., losing weight, can slow the aging process and make people younger.

Courtney Peterson, Ph.D., associate professor in the Department of Nutrition Sciences and site lead investigator, says this is the largest study on record investigating the effects of intermittent fasting on aging.

With this study, we want to accomplish several goals find out how easy it is to stick to these two diets long term, how much we can slow aging and improve overall health, and finally whether we can on a molecular level, such as regenerate stem cells, which would be very exciting, Peterson said.

Along with the Pennington Biomedical Research Center, UAB is recruiting 50 participants for the six-month study. Participants are randomly assigned either a calorie restrictive diet, intermittent fasting or to continue their usual diet. Those who are selected for calorie restriction will lose weight by eating less, while those who fast intermittently will fast for 16 hours per day and eat dinner by 6 p.m. about six days per week, with one break day per week. The study provides intensive coaching and support to help participants successfully lose weight or practice intermittent fasting.

Eligible participants should be ages 25-45, take no medications, be healthy, and have a BMI between 22 and 30 kg/m2.

To learn more or apply to participate, call 205-934-1457 or visit pbrc.edudialhealthuab.

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Dean said: "Now youve got your workout routine sorted, dont feel like youre stuck with it forever. Whilst repetition can be positive during workouts, it can also grow tiresome when youre doing the same exercises over and over."

The fitness expert pointed out that if people are repeating the same workouts over and over, not only will their muscles not respond in the desired way but he urged them "not to be afraid to switch things up".

"Identify the exercises that are proving unexciting and replace them with new ones that you enjoy," he said.

"Finding exercises boring may also be a sign that theyre too easy for you, which in itself is a sign that your fitness levels are improving.

"Heres where working with a trainer can help, providing other options to always keep your training fresh, fun and challenging."

Joining a fitness class can be beneficial in many ways and can inject fun and socialisation into people's weight loss journeys.

READ MORE:Michael Mosley weight loss: Remove three foods to stay slim

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Exercise guru shares four effective ways to burn belly fat - crucial for weight loss - Express

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Dwayne 'The Rock' Johnson was ordered to lose weight, drop his stage name and stop talking about wrestling if he wanted to make it in Hollywood.

The 'Fast and the Furious' star shot to fame back in the mid-1990s as a regular performer with the World Wrestling Federation (WWF) - adopting the name The Rock and becoming one of the franchise's most recognisable wrestlers before making a crossover to movies with a role as the Scorpion King in 2001's 'The Mummy Returns'.

However, Johnson has now revealed he was asked to make some serious changes if he wanted to be taken seriously as an actor. Speaking on 'CBS Sunday Morning' on October 9, he explained: "They said, 'Okay, great. But now here's what you have to do: You have to stop working out as much. You have to lose weight. You can't call yourself The Rock. You can't talk about wrestling. Let's stay away from all that.'"

Host Tracy Smith then asked him: "These are all the things they told you? 'Don't be this anymore'?" and the star replied: "That's right. So, I tried that, Tracy, I tried getting smaller, losing weight. It all felt wrong."

Tracy then asked: "And once you started being yourself?" and he explained: "That was it. When that happened, a funny thing happened: Hollywood conformed around me. And years later, I'm sitting here with you."

Johnson went on to land his first leading role, reprising his Scorpion King character for a self-titled 2002 spin-off and his Hollywood career took off. He eventually scored a lucrative recurring role in the 'Fast and The Furious' franchise as well as leading the cast of action movies such as 'San Andreas' and 'Skyscraper'.

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Wellness & FitnessMonday October 10 2022

A session at Corporate Health Gym, Vision Plaza in Nairobi on October 8, 2022. PHOTO | JEFF ANGOTE | NMG

Aerobic exercises come in different forms and shapes from running, walking, jogging, swimming, and biking. Then there is step aerobics.

Step aerobics, however, is not your ordinary aerobics. It is a classic high-intensity cardio workout that involves stepping on and off cardio equipment.

Step aerobics trainer Philip Luchebeleli says steps aerobics is an intense entire-body cardiovascular workout involving using steps during training.

He explains that the workout comes in different forms and though intense, combines effectiveness and fun in the process.

If you want to shed fat fast, take up step aerobic exercises for weight loss. Step aerobics make it more effective and fun as it boosts mood and energy levels, he says.

Just like aerobic exercises, step aerobics is a great way to lose weight through burning calories, improving lung capacity, and increasing heart rate while also boosting metabolism and kick-starting the bodys normal rhythm and functioning.

This as the moves involved work on the legs, upper body, and core, building strength and flexibility in the process as well as improving a persons balance, coordination, and agility leading to improved overall fitness and individual's cardiovascular health.

One needs to be patient as there are moves and terms that one needs to master. If you are overweight, you have to gradually increase the duration of the sessions as you build your fitness, advises the trainer.

He says that step aerobics is becoming popular with fitness enthusiasts with beginner, intermediate and advanced classes made available to cater to all types of individuals.

A few years ago I used to have a few step classes but now I am being called to many gyms. I dont even have free days, says the trainer.

However, to maximise results, one has to be consistent because skipping any session will mean that an individual will have to start from zero on resumption.

The trainer adds that one therefore also has to be patient, focused and consistent to learn the moves and avoid getting injured.

Depending on an individuals objective, if you just want to keep fit then three times a week is fine but for losing weight five days in a week is recommended, says Luchebeleli.

Workout is only 30 percent of the work but food intake accounts for the rest. An individual should observe a clean diet and give him or herself between three and four months to start seeing results, he adds.

This involves standing in front of a step box and marching along with the music beats as one places the right foot on the step and then the left one.

V-Step For this, place a step box in front of you then place the right foot on the step box in a diagonal direction. Place the left foot on the step box in the left diagonal direction with the feet wider than shoulder-width apart. Place the right foot on the ground in its initial position and then the left foot.

Charleston Place the left foot on the step box in front of the right leg then lift the right foot off the floor, lean back a little, and kick the right leg. Place the right leg back on the floor and then place the left foot on the floor and repeat from step one.

Repeater This involves standing with your feet close together and then placing the left leg on the step box diagonally to the right. After, lift the right leg off the floor, bend the knees, and kick up but do not crunch. Place the right foot back on the floor. Then, place the left leg on the floor. Place the right leg on the step diagonally to the left before lifting the left leg off the floor, bend the knees, and kick it up.

Place a step box on your right then step on the step box from the right and get down on the left. Step on the box from the left and get down on the right 20 times.

Begin standing sideways to the step, step up with the right foot and then turn as you bring the left foot up onto the step. Step down with the right foot and bring the left foot down to meet the right.

While performing the moves, Mr Luchebeleli advises that a person should maintain good posture and alignment by gently engaging the abdominals and gluteal muscles.

One should also not use slippery step surfaces, adjust the height of the steps depending on the level of fitness and skills, step softly and take small steps not more than one shoe length away from the platform.

He further recommends that one should get the right sports shoes as there are specific shoes for step aerobics where the soles have to be very soft so that when stepping they can bounce up and down.

The trainer says that the way one steps is key, advising that while stepping up, only the ankles and not the waist should bend and the entire foot should be placed on the step without any part hanging over the edge.

The tempo of the music you are using should not be very fast as one can run the risk of missing the steps and falling hence injuries. In class, do not depend on your neighbor by copying what they are doing. Focus on the trainer and do what the trainer is doing.

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Simple fun ways to shed that stubborn weight fast - Business Daily

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Medical condition

Chronic myelogenous leukemia (CML), also known as chronic myeloid leukemia, is a cancer of the white blood cells. It is a form of leukemia characterized by the increased and unregulated growth of myeloid cells in the bone marrow and the accumulation of these cells in the blood. CML is a clonal bone marrow stem cell disorder in which a proliferation of mature granulocytes (neutrophils, eosinophils and basophils) and their precursors is found. It is a type of myeloproliferative neoplasm associated with a characteristic chromosomal translocation called the Philadelphia chromosome.

CML is largely treated with targeted drugs called tyrosine-kinase inhibitors (TKIs) which have led to dramatically improved long-term survival rates since 2001. These drugs have revolutionized treatment of this disease and allow most patients to have a good quality of life when compared to the former chemotherapy drugs. In Western countries, CML accounts for 1525% of all adult leukemias and 14% of leukemias overall (including the pediatric population, where CML is less common).[3]

The way CML presents depends on the stage of the disease at diagnosis as it has been known to skip stages in some cases.[4]

Most patients (~90%) are diagnosed during the chronic stage which is most often asymptomatic. In these cases, it may be diagnosed incidentally with an elevated white blood cell count on a routine laboratory test. It can also present with symptoms indicative of hepatosplenomegaly and the resulting left upper quadrant pain this causes. The enlarged spleen may put pressure on the stomach causing a loss of appetite and resulting weight loss. It may also present with mild fever and night sweats due to an elevated basal level of metabolism.[4]

Some (<10%) are diagnosed during the accelerated stage which most often presents bleeding, petechiae and ecchymosis.[4] In these patients fevers are most commonly the result of opportunistic infections.[4]

Some patients are initially diagnosed in the blast phase in which the symptoms are most likely fever, bone pain and an increase in bone marrow fibrosis.[4]

In most cases, no obvious cause for CML can be isolated.[5]

CML is more common in males than in females (male to female ratio of 1.4:1) and appears more commonly in the elderly with a median age at diagnosis of 65 years.[5] Exposure to ionising radiation appears to be a risk factor, based on a 50 fold higher incidence of CML in Hiroshima and Nagasaki nuclear bombing survivors.[5] The rate of CML in these individuals seems to peak about 10 years after the exposure.[5]

CML was the first cancer to be linked to a clear genetic abnormality, the chromosomal translocation known as the Philadelphia chromosome. This chromosomal abnormality is so named because it was first discovered and described in 1960 by two scientists from Philadelphia, Pennsylvania, USA: Peter Nowell of the University of Pennsylvania and David Hungerford of Fox Chase Cancer Center.[6]

In this translocation, parts of two chromosomes (the 9th and 22nd) switch places. As a result, part of the BCR ("breakpoint cluster region") gene from chromosome 22 is fused with the ABL gene on chromosome 9. This abnormal "fusion" gene generates a protein of p210 or sometimes p185 weight (p210 is short for 210 kDa protein, a shorthand used for characterizing proteins based solely on size). Because abl carries a domain that can add phosphate groups to tyrosine residues (a tyrosine kinase), the bcr-abl fusion gene product is also a tyrosine kinase.[7][8]

The fused BCR-ABL protein interacts with the interleukin 3beta(c) receptor subunit. The BCR-ABL transcript is continuously active and does not require activation by other cellular messaging proteins. In turn, BCR-ABL activates a cascade of proteins that control the cell cycle, speeding up cell division. Moreover, the BCR-ABL protein inhibits DNA repair, causing genomic instability and making the cell more susceptible to developing further genetic abnormalities. The action of the BCR-ABL protein is the pathophysiologic cause of chronic myelogenous leukemia. With improved understanding of the nature of the BCR-ABL protein and its action as a tyrosine kinase, targeted therapies (the first of which was imatinib) that specifically inhibit the activity of the BCR-ABL protein have been developed. These tyrosine kinase inhibitors can induce complete remissions in CML, confirming the central importance of bcr-abl as the cause of CML.[8]

CML is often suspected on the basis of a complete blood count, which shows increased granulocytes of all types, typically including mature myeloid cells. Basophils and eosinophils are almost universally increased; this feature may help differentiate CML from a leukemoid reaction. A bone marrow biopsy is often performed as part of the evaluation for CML, and CML is diagnosed by cytogenetics that detects the translocation t(9;22)(q34;q11.2) which involves the ABL1 gene in chromosome 9 and the BCR gene in chromosome 22.[9] As a result of this translocation, the chromosome looks smaller than its homologue chromosome, and this appearance is known as the Philadelphia chromosome chromosomal abnormality. Thus, this abnormality can be detected by routine cytogenetics, and the involved genes BCR-ABL1 can be detected by fluorescent in situ hybridization, as well as by PCR.[10]

Controversy exists over so-called Ph-negative CML, or cases of suspected CML in which the Philadelphia chromosome cannot be detected. Many such patients in fact have complex chromosomal abnormalities that mask the (9;22) translocation, or have evidence of the translocation by FISH or RT-PCR in spite of normal routine karyotyping.[11] The small subset of patients without detectable molecular evidence of BCR-ABL1 fusion may be better classified as having an undifferentiated myelodysplastic/myeloproliferative disorder, as their clinical course tends to be different from patients with CML.[12]

CML must be distinguished from a leukemoid reaction, which can have a similar appearance on a blood smear.[10]

CML is often divided into three phases based on clinical characteristics and laboratory findings. In the absence of intervention, CML typically begins in the chronic phase, and over the course of several years progresses to an accelerated phase and ultimately to a blast crisis. Blast crisis is the terminal phase of CML and clinically behaves like an acute leukemia. Drug treatment will usually stop this progression if started early. One of the drivers of the progression from chronic phase through acceleration and blast crisis is the acquisition of new chromosomal abnormalities (in addition to the Philadelphia chromosome).[7] Some patients may already be in the accelerated phase or blast crisis by the time they are diagnosed.[10]

Approximately 85% of patients with CML are in the chronic phase at the time of diagnosis. During this phase, patients are usually asymptomatic or have only mild symptoms of fatigue, left side pain, joint and/or hip pain, or abdominal fullness. The duration of chronic phase is variable and depends on how early the disease was diagnosed as well as the therapies used. In the absence of treatment, the disease progresses to an accelerated phase.[10] Precise patient staging based on clinical markers and personal genomic profile will likely prove beneficial in the assessment of disease history with respect to progression risk.[13]

Criteria for diagnosing transition into the accelerated phase are somewhat variable; the most widely used criteria are those put forward by investigators at M.D. Anderson Cancer Center,[14] by Sokal et al.,[15] and the World Health Organization.[12][16] The WHO criteria[17] are perhaps most widely used, and define the accelerated phase by the presence of 1 of the following haematological/cytogenetic criteria or provisional criteria concerning response to tyrosine kinase inhibitor (TKI) therapy

The patient is considered to be in the accelerated phase if any of the above are present. The accelerated phase is significant because it signals that the disease is progressing and transformation to blast crisis is imminent. Drug treatment often becomes less effective in the advanced stages.[12]

Blast crisis is the final phase in the evolution of CML, and behaves like an acute leukemia, with rapid progression and short survival.[10] Blast crisis is diagnosed if any of the following are present in a patient with CML:[18]

The only curative treatment for CML is a bone marrow transplant or an allogeneic stem cell transplant.[19] Other than this there are four major mainstays of treatment in CML: treatment with tyrosine kinase inhibitors, myelosuppressive or leukopheresis therapy (to counteract the leukocytosis during early treatment), splenectomy and interferon alfa-2b treatment.[19] Due to the high median age of patients with CML it is relatively rare for CML to be seen in pregnant women, despite this, however, chronic myelogenous leukemia can be treated with relative safety at any time during pregnancy with the cytokine Interferon-alpha.[20]

In the past, antimetabolites (e.g., cytarabine, hydroxyurea), alkylating agents, interferon alfa 2b, and steroids were used as treatments of CML in the chronic phase, but since the 2000s have been replaced by Bcr-Abl tyrosine-kinase inhibitors[21] drugs that specifically target BCR-ABL, the constitutively activated tyrosine kinase fusion protein caused by the Philadelphia chromosome translocation. Despite the move to replacing cytotoxic antineoplastics (standard anticancer drugs) with tyrosine kinase inhibitors sometimes hydroxyurea is still used to counteract the high leukocyte counts encountered during treatment with tyrosine kinase inhibitors like imatinib; in these situations it may be the preferred myelosuppressive agent due to its relative lack of leukemogenic effects and hence the relative lack of potential for secondary haematologic malignancies to result from treatment.[22] IRIS, an international study that compared interferon/cytarabine combination and the first of these new drugs imatinib, with long-term follow up, demonstrated the clear superiority of tyrosine-kinase-targeted inhibition over existing treatments.[23]

The first of this new class of drugs was imatinib mesylate (marketed as Gleevec or Glivec), approved by the US Food and Drug Administration (FDA) in 2001. Imatinib was found to inhibit the progression of CML in the majority of patients (6575%) sufficiently to achieve regrowth of their normal bone marrow stem cell population (a cytogenetic response) with stable proportions of maturing white blood cells. Because some leukemic cells (as evaluated by RT-PCR) persist in nearly all patients, the treatment has to be continued indefinitely. Since the advent of imatinib, CML has become the first cancer in which a standard medical treatment may give to the patient a normal life expectancy.[24]

To overcome imatinib resistance and to increase responsiveness to TK inhibitors, four novel agents were later developed. The first, dasatinib, blocks several further oncogenic proteins, in addition to more potent inhibition of the BCR-ABL protein, and was approved in 2007, by the U.S. Food and Drug Administration (FDA) to treat CML in people who were either resistant to or intolerant of imatinib. A second TK inhibitor, nilotinib, was approved by the FDA for the same indication. In 2010, nilotinib and dasatinib were also approved for first-line therapy, making three drugs in this class available for treatment of newly diagnosed CML. In 2012, radotinib joined the class of novel agents in the inhibition of the BCR-ABL protein and was approved in South Korea for people resistant to or intolerant of imatinib. Bosutinib received US FDA and EU European Medicines Agency approval on 4 September 2012, and 27 March 2013, respectively for the treatment of adults with Philadelphia chromosome-positive (Ph+) chronic myelogenous leukemia (CML) with resistance, or intolerance to prior therapy.[citation needed]

Asciminib (Scemblix) was approved for medical use in the United States in October 2021.[25]

While capable of producing significantly improved responses compared with the action of imatinib, neither dasatinib nor nilotinib could overcome drug resistance caused by one particular mutation found to occur in the structure of BCR-ABL1 known as the T315I mutation (in other words, where the 315th amino acid is mutated from a threonine residue to an isoleucine residue).[citation needed] Two approaches were developed to the treatment of CML as a result:

In 2007, Chemgenex released results of an open-label Phase 2/3 study (CGX-635-CML-202) that investigated the use of a non BCR-ABL targeted agent omacetaxine, administered subcutaneously (under the skin) in patients who had failed with imatinib and exhibited T315I kinase domain mutation.[26][27] This is a study which is ongoing through 2014.[28] In September 2012, the FDA approved omacetaxine for the treatment of CML in the case of resistance to other chemotherapeutic agents.[29][30]

Independently, ARIAD pharmaceuticals, adapting the chemical structures from first and second-generation TK inhibitors, arrived at a new pan-BCR-ABL1 inhibitor which showed (for the first time) efficacy against T315I, as well as all other known mutations of the oncoprotein. The drug, ponatinib, gained FDA approval in December 2012 for treatment of patients with resistant or intolerant CML. Just as with second-generation TK inhibitors, early approval is being sought to extend the use of ponatinib to newly diagnosed CML also.[citation needed]

In 2005, encouraging but mixed results of vaccination were reported with the BCR/ABL1 p210 fusion protein in patients with stable disease, with GM-CSF as an adjuvant.[31]

Before the advent of tyrosine kinase inhibitors, the median survival time for CML patients had been about 35 years from time of diagnosis.[3]

With the use of tyrosine kinase inhibitors, survival rates have improved dramatically. A 2006 follow-up of 553 patients using imatinib (Gleevec) found an overall survival rate of 89% after five years.[32]

A 2011 followup of 832 patients using imatinib who achieved a stable cytogenetic response found an overall survival rate of 95.2% after 8 years, which is similar to the rate in the general population. Fewer than 1% of patients died because of leukemia progression.[24]

CML accounts for 8% of all leukaemias in the UK, and around 680 people were diagnosed with the disease in 2011.[33]

The American Cancer Society estimates that in 2014, about 5,980 new cases of chronic myeloid leukemia were diagnosed, and about 810 people died of the disease. This means that a little over 10% of all newly diagnosed leukemia cases will be chronic myeloid leukemia. The average risk of a person getting this disease is 1 in 588. The disease is more common in men than women, and more common in whites than African-Americans. The average age at diagnosis is 64 years, and this disease is rarely seen in children.[34]

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