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LOS ANGELES Andy Ruiz Jr. aims to weigh between 260 to 265 pounds when he steps on the scales to fight Luis Ortiz on Sept. 4 at the Crypto.com Arena in Los Angeles on FOX pay-per-view.

Nothing crazy, Ruiz told a group of reporters that included BoxingScene.com.

I'm not here to lose so much weight. I'm trying to be fit and gain a little bit of muscle and not be too skinny. It's not a body contest. The main thing is to stay focused, stay prepared, and stay ready.

The rotund Ruiz (34-2, 22 KOs) has always had to answer questions about his weight ever since his career kicked off at 297 pounds in 2009. Ruiz has weighed as low as 246 for a fight.

When he shocked and stopped Anthony Joshua in their first fight in June 2019, Ruiz was 268 pounds. But by the December rematch later that year, Ruiz ballooned to 283 pounds and dropped the heavyweight titles to Joshua. Ruiz blamed his lack of conditioning as the main reason for the loss.

Ruiz will have his third head trainer in three fights as he prepares for Ortiz.

Coach Anthony Osuna has replaced Eddy Reynoso, who replaced Manny Robles.

I'm trying to do better than in my last fight [against Chris Areola in May 2021], said Ruiz. I wasn't really impressed by my performance. I need to work on more technique and boxing. I focused more on losing weight, and I think that affected me in the gym. I just have to do better.

For Ortiz, I have to be big. I have to be strong. Most importantly, I have to be conditioned and explosive. I can't underestimate him. He's big. He's strong. He moves around well.

Ruiz said he got a head start on training this time around by hitting the gym beginning in May. Hes looking to avoid ring rust after fighting once in 33 months.

Things could happen, you know. I've been fighting since 6 years old. This is the only job I've ever had in my life. That's why we had a long training camp so we can get ready for the fight. Muscle memory is going to kick in, said Ruiz. I have two trainers that are on me 100% all the time. All of the time is for me. It's kind of harder on me, but this is exactly what I need.

Being the type of fighter that I am, I love to do mitts. Without doing mitts, I feel off. I like to throw combinations and be explosive. We've been doing mitts almost every single day. It's a blessing to have When I was with Eddy, [Osuna] was still there helping us out. He has a good relationship with Eddy as well. Osuna is helping my other fighters as well I told him that I was going to bring him to help me do the mitts. This is what I need to do all the tools that I didn't do in my last camp.

Ruiz is also not closing the door on a reunion with Reynoso.

Me and Eddy have a great relationship with Canelo Alvarez as well. But they understand. Canelo has a tough fight under his belt as well [against Gennadiy Golovkin on Sept. 17]. We both needed our fair time. There's nothing bad going on between us.

Ruiz said having his own gym in San Diego has allowed him to train better under his own preferred terms and schedule.

I learned discipline and me having to work hard, especially, said Ruiz. "I feel once you do that, you become more disciplined. It becomes more of a habit. It's more motivating.

Manouk Akopyan is a sports journalist, writer and broadcast reporter. Hes also a member of the Boxing Writers Association of America and MMA Journalists Association. He can be reached on Twitter, Instagram, LinkedIn and YouTube at @ManoukAkopyan, via email at manouk[dot]akopyan[at]gmail.com or on http://www.ManoukAkopyan.com.

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Andy Ruiz: I'm Not Here To Lose Weight & Be Skinny It's Not A Body Contest - BoxingScene.com

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Various epidemiological studies have shown that the prevalence of gastroesophageal reflux disease (GERD) is increasing worldwide, and the major contributing factor to this trend is the rising prevalence of obesity. The worldwide estimated prevalence of GERD ranges from 15% to 25%. Western countries, including the United State of America, haveaGERD prevalence higher than in Asia, ranging from 10% to 30% [1,2]. Other than obesity,several environmental and lifestyle factors also contribute to this increasing trend, such as being overweight, smoking, and consumption of alcohol, caffeine, fat, and chocolate (these factors indirectly lead to obesity and overweight) [3].In addition, estrogen also has an important role in the development of GERD; one study suggested that pre-menopausal and women on hormone replacement therapy are noticed to have a higher incidence of GERD symptoms [4].Lifestyle modifications, including weight loss, elevation of the head ofbed, smoking cessation, and avoiding late evening meals, lead to the resolution of GERD symptoms[5].One ofthe previous cohortstudies concluded that, in obese individuals, having a low-carbohydrate diet results in the improvement of reflux symptoms[6].

Most of the studies have found a positive correlation between obesity and GERD. Obesity has been defined as having BMI >30 kg/m2 in most of these studies. Four previous cross-sectional studies confirmed a positive association between overweight or obesity and GERD symptoms in the US, UK, Norwegian, and Spanish populations. Two studies have shown a dose-response relationship[7]. The primary mechanism by which obesity promotes GERD isunclear;recent data suggests that obesity increases the intragastric pressure causing relaxation of the lower esophagealsphincter (LES)and reflux of gastroduodenalcontents causing the symptoms of heartburn,acid regurgitation, and eventually causing erosive esophagitis[8].Erosive esophagitis eventually causes Barrett's esophagus, thus increasing the risk of esophageal adenocarcinoma.Treatment of GERD includesconservative and medical therapies. Recent studies suggested that the long-term use of and proton pump inhibitors (PPIs) can cause several adverse effects.

A retrospective cohort study conducted by Bang and Park in 2018 concluded a positive association between a higher BMI and the development of GERD and erosive esophagitis. Conversely, this study also suggested that a decrease in the BMI can lead to the resolution of erosive esophagitis, and weight loss is a potentially effective treatment of GERD [3].Furthermore, it is noticed that in obese individuals, asymptomatic GERD is more common than symptomatic reflux disease[9].

Although many studies have shown that GERD is associated with obesity, not all studies have shown a positive association. For example, two extensive population-based studies from Sweden and Denmark found no association. Researchers assumed that the disparity in results might be due to the non-adjustment of confounding variables[7]. In addition, weight loss had an independent effect on reflux symptoms in an obese individual. Still,wecouldn't find sufficient data to suggest the positive impact of weight loss achieved through different methods, either with lifestyle modification or with surgical procedures (Roux-en-Y gastric bypass or vertical band gastroplasty), on GERD symptoms[10].Thissystematicreview aims to assess non-pharmacological interventions for GERD treatment and the impact of weight loss on GERD in obese patients.

Study Design andSearch Strategy

This systematic review was designed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to improve reporting of this review [11]. We thoroughly searched through the following databases: PubMed, PubMed Central (PMC), Science Direct, and Google Scholar, using suitable keywords and Medical Subject Headings (MeSH) terms to extract all the relevant articles. Weused the Boolean scheme and MeSH strategy to form keywords. The MeSH strategy used was (Obesity/diet therapy"[Mesh] OR Obesity/drug therapy"[Mesh] OR Obesity/prevention and control"[Mesh]) AND (Gastroesophageal Reflux/diet therapy"[Majr] OR Gastroesophageal Reflux/drug therapy"[Majr] OR Gastroesophageal Reflux/prevention and control"[Majr] OR Gastroesophageal Reflux/therapy"[Majr]). For other databases, we used the following keywords: Obesity, Obesity AND GERD, Weight loss AND GERD, Obesity AND weight loss AND GERD. We removed duplicates by carefully scrutinizing the titles, and subsequently, we excluded irrelevant articles by screening the titles and abstract.

Inclusion and Exclusion Criteria

In this review, we included articles published in the English language, focusing on the adult population (18-65 years) and papers relevant to the research question. We excluded papers focusing on pediatric and geriatric populations and unpublished and grey literature.

Data Extraction

After we did the quality assessment, data extraction from the eligible papers included in the study was done. Two researchers did data selection and extraction (first and second authors). We reviewed the study design, relevance to our inclusion and exclusion criteria, intervention used, and outcomes measured in the selected paper.

Quality Assessment of the Studies

We used the Joanna Briggs Institute(JBI) critical appraisal checklist for cross-sectional studies and the Newcastle-Ottawa assessment tool for other observational studies (case-control, cohort). In addition, weused the assessment of multiple systematic reviews(AMSTAR) tool for the quality appraisal of the systematic reviews.

A total of 5922 papers were found after the database search. After removing 3379 duplicates,2543 articles remained. Then screening was done through titles, and we removed 2477 articles because of irrelevance, leaving 66 articles. Next, we checked the availability of full-text articles and pulled 43 out of 66 because of the unavailability of full-text articles, and a total of 23 articles remained. Then critical appraisal was done using different quality assessment tools, and a total of eight articles were found eligible to be included in our study after quality assessment.Out of eight papers, five were cross-sectional studies, three cohort studies, and one was a systematic review. The complete PRISMA flow diagram is well explained in Figure 1 [11].

We set the cut-off for bias at 20% or less to be included in this study (Table 1).

Out of five cross-sectional studies, four concluded that obese and overweight individuals have an increased risk of GERD. Obesity causes disintegration of LES and reflux of acidic gastric content in the esophagus, increasing the risk of erosive esophagitis. One cross-sectional study investigated the benefits of weight loss on GERD symptoms. All three cohort studies reported that weight loss could lead to the resolution of GERD and erosive esophagitis in obese patients. One systematic review investigated the impact of lifestyle intervention on GERD symptoms. That review also reported several adverse effects of the long-term use of proton pump inhibitors. The study concluded that because of some complications and the high costof PPIs, lifestyle interventions, especially weight loss, should be used as first-line management for GERD in obese individuals.

The reflux of gastroduodenal contents from the stomach into the esophagus due to any anatomical defect at the gastroesophageal junction (GEJ) is defined as gastroesophageal reflux disease[12]. Over the last few decades, the prevalence of GERD has been increasing worldwide. Most of studies have found that this increase is due to the increase in the prevalence of obesity worldwide [10]. Obesity is an independent risk factor for developing GERD symptoms, and several studies have been conducted to find a positive association between BMI and GERD.Jacobsonet al. conducted a case-control study in 2006 and found that BMI is directly associated with GERD irrespective of whether the individual is with normal weight or overweight[16].Obesity has been associated with various comorbidities including diabetes mellitus and cardiovascular diseases; however, gastrointestinal disorders including GERD, gall stones and non-alcoholic fatty liver disease (NAFLD) are more frequent in obese individuals [17,18]. Miliet al. conducted a study in 2014 and concluded that NAFLD is associated with obesityand the main treatment option for NAFLD would be weight reduction and life style modification[19].

Pathophysiology

The intra-abdominal pressure theory states that obesity in general and abdominal obesity increase intragastric pressure that causes mechanical stress on the gastroesophageal junction, causing transient lower esophageal sphincter relaxation (TLOSR) and predisposition of the hiatus hernia, which further facilitates reflux. The dietary habit theory suggests that some nutritional habits may be the main reason for increasing the risk of obesity and eventually increasing GERD risk. Both approaches are based on assumptions [13]. Hiatus hernia in obese individuals causes disturbances in the integrity of GEJ, thus aggravating reflux [20]. Obesity may cause humoral changes such as changes in leptin and insulin levels and hormonal changes such as changes in estrogen levels, which indirectly cause GERD [7]. Not enough evidence supports these mechanisms, so further studies are required to explore them.

A study conducted by Wuet al. in 2007 concluded that abnormal relaxation of the lower esophageal sphincter (LOS) might cause obesity-related GERD [14]. In this study, patients were divided into three groups: obese (BMI >30 kg/m2), overweight (BMI 25-30), and average weight (BMI <25), according to the World Health Organization (WHO). During the postprandial period, esophageal manometry and pH monitoring were done using the standard method. It was noted that TLOSRrates were higher in obese and overweight subjects. It was speculated that obese patients tend to overeat, causing an increase in intragastric pressure and gastric distention, disrupting the integrity of the LOS and causing acid reflux. Esophageal manometry was done in obese individuals before bariatric surgery and most of the people were noted to have motility disorder; this could be another reason for GERD in overweight individuals [21].

Non-pharmacological Interventions

Although obesity is a significant independent risk factor for GERD, several other factors are also noted to play an essential role in GERD development. In a recent retrospective cohort study conducted by Bang and Park, it was stated that GERD is associated with some dietary habits, for example, late-night meals, consumption of alcohol, caffeine, chocolate, fat, and smoking [3]. The intake of citrus fruit is also noted toaggravatethe GERD symptoms [22]. Non-pharmacological interventions, including smoking cessation, avoiding late-night meals, reducing the consumption of alcohol and caffeine, and behavioral changes such as weight loss, can lead to the resolution of GERD symptoms [3,5]. Another study suggested that elevating the head of the bed in the supine position and lying on the left side helps to improve reflux symptoms [23]. Furthermore, regular physical activity was noted to have a positive effect on GERD symptoms [24,25].

Smoking Cessation

Most studies have shown a positive association between smoking and GERD symptoms. In a recent systematic review conducted by Ness-Jensen et al., it was revealed that smoking reduces the LOS pressure facilitating reflux [5]. Also, it causes decreased secretion of salivary bicarbonate, eventually decreasing acid buffering. Another study concluded that smoking cessation was associated with decreased reflux symptoms in normal weight individuals. However, in obese individuals, obesity was the leading cause of GERD, so smoking cessation didn't help much in that group [5].

Lifestyle Modification

Some studies showed a positive association between some dietary habits, lifestyle factors, and the development of GERD symptoms, but previous data supporting these facts are scarce. For example, a randomized controlled trial (RCT) conducted with a small sample size (only 15 patients) showed that the elevation of the head of the bed decreased the time for which lower esophageal pH was <4 [5]. Another RCT demonstrated that an increased dietary fat intake causes more time without heartburn symptoms. A systematic review has shown that a high fiber intake and moderate physical activity can reduce GERD symptoms [5]. Arecent cohort study suggested that adjusting meal size and timing, i.e., avoiding late-night meals, is reported to be helpful for the management of GERD [3]. Although physical activity helps to improve the symptoms, but vigorous exercise after a meal can worsenthe condition. Post-dinner walking is recommended to relieve the reflux and heartburn, but eating before exercise should be avoided [26].

Weight Loss as a Management of GERD

Many observational and experimental studies confirmed the association between a high BMI and GERD. A retrospective cohort study was conducted in 2018 to investigate whether a decreased BMI can resolve erosive esophagitis (EE) [3]. All the participants underwent upper GI endoscopyand EE was classified according to Los Angeles (LA) classification; the baseline BMI wasnoted and all patients were instructed to lose weight. During five-year follow-up periods, the EE resolution rate was higher in subjects who had a decrease in BMI >2 kg/m2;the researchers concluded that a significant weight loss is required for EE resolution because some of the patients who had a reduction in BMI <1 kg/m2 did not show any positive effects [3]. Weight loss reduces intragastric pressure and pressure on the gastroesophageal junction, thus reducing the reflux episodes [10]. An RCT of 17 patients reported normalization of the esophageal pH with weight loss in a follow-up period of four months.

A cross-sectional study conducted in 2006 suggested that weight loss is an effective treatment for GERD. Still, two other studies showed contradictory results, stating that a reduction in the BMI does not cause improvement in healing rates after proton pump inhibitor use [15]. Other than heartburn and acid regurgitation, some extraesophageal manifestations of GERD include cough, hoarseness, asthma, sore throat, sinusitis, and globus sensation. There is a significant and nonlinear relationship between a higher BMI and GERD with extraesophageal manifestations reported in a previous study conducted by Aslam et al. The study concluded that an increased BMI is significantly associated with esophageal acid exposure and these findings suggest the benefit of weight loss in the treatment of GERD [13].Fraser-Moodie et al. conducted a prospective cohort study in 2014 to assess an independent effect of weight loss on the improvement of GERD symptoms [12]. This study found that weight loss is the first line of management in treating GERD in overweight patients. Weight loss either achieved through lifestyle interventions or through bariatric surgery was noticed to have improvement in symptoms of GERD [27].

Individuals can use different strategies to lose weight, including physical activity, dietary modifications, and behavioral changes. Physical activity can include walking or some other exercises. In a prospective cohort study, overweight patients were followed for six months for weight loss. Weight loss was achieved through different conservative measures, such as increasing physical activity, some dietary modifications that reduced the daily calorie intake to 1200-1500 cal/day, and some behavioral changes, including goal-setting, self-monitoring, feedback, reinforcement, and social support. Most patients lost weight, and with a structured weight loss program, GERD symptoms were entirely resolved. In addition, a dose-response relationship was reported between weight loss and the resolution of GERD symptoms [10]. But not all obese patients in this study had a reduction in GERD symptoms after losing weight [5].

Why Is Weight Loss More Effective Than PPIs for GERD SymptomResolution in Obese Patients?

Treatment options for gastroesophageal reflux disease include conservative measures and medical treatment. Conservative measures, as already mentioned, include weight loss, if the patient is obese and overweight, the elevation of the bed head, avoiding late-night meals, and reducing the consumption of alcohol, fat, caffeine, and chocolate intake [3,5]. Medical treatment is commonly achieved through antacids, H2 receptor antagonists (H2RAs), and proton pump inhibitorsfor heartburn and acid regurgitation [28]. PPIs work by inhibiting the acid secretion from parietal cells. Additionally, if symptoms are non-responsive to medical treatment or complications havedeveloped, then surgical treatment is also recommended especially in the presence of hiatal hernia [29].

Initially, PPIs were mainly used for treating GERD symptoms, but recently, some studies suggested that the long-term use of proton pump inhibitors can cause some adverse effects. Now that awareness about the side effects of PPIs has increased, lifestyle modification is preferred. For example, withdrawal of PPIs induces reflux symptoms. Other adverse effects include hypergastrinemia and rebound acid secretion. In addition, due to increased gastric pH, the risk of enteric infection and community-acquired pneumonia is increased. There is also an increased risk of hip fractures because of malabsorption of calcium [5].

Another study suggested that obese individuals require a long-term use of H2RAs and antacids for heartburn and reflux symptoms, concluding that obese individual are not as responsive to medications for GERD. Lifestyle interventions, including weight loss and smoking cessation, having a low economic cost and no harmful side effects, should be preferred for GERD treatment. Although proton pump inhibitors positively impact the resolution of GERD symptoms and extensive data supports these positive results, very few RCTs and observational studies are available investigating the positive effects of lifestyle interventions on GERD.

Weight loss should be used as the first-line treatment for GERD in obese and overweight patients because of its low-cost effects, preventing complications of GERD, and improving the quality of life. It was estimated in a recent study that around 10 billion US dollars a year are spent on medical treatment of GERD, and that is considered a burden on the healthcare system [10]. However, there are a few limitations of our study. Extensive data is available reporting the positive association between obesity and GERD development, but studies suggesting the impact of weight loss on GERD are scarce. We could not find sufficient RCTs and observational studies suggesting that weight loss is an effective treatment for GERD.

Further studies, including clinical trials for evaluating the effect of weight loss on symptoms of reflux, are required. Two extensive studies reporting the impact of weight loss on GERD produced contradictory conclusions [15]. Another limitation is that our research does not apply to the pediatric and geriatric population; it is only limited to the adult population (18-65 years).

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Living with diabetes can increase the risk of various complications, including nonalcoholic fatty liver disease (NAFLD).

In this condition, excess fat builds up in the liver. Around 24% of people in the United States have NAFLD. But for adults who live with both obesity and type 2 diabetes, the estimates are greater than 70%.

This article will investigate the association between fatty liver disease and diabetes, whether one condition impacts the other, and how they can be managed effectively.

NAFLD is sometimes called fatty liver disease or hepatic steatosis. Its defined as the buildup of excess fat in the liver. As its name implies, heavy alcohol use does not cause this form of liver disease.

NAFLD is becoming more common in Western countries, especially in the United States. NAFLD is one of the most common forms of liver disease in the country.

Up to two-thirds of people with type 2 diabetes have NAFLD, according to the National Institute of Diabetes and Digestive and Kidney Diseases. With type 1 diabetes on the rise nationally, the rate of NAFLD is also expected to increase. Thats tied to the growing T1D incidence and the related risk factors for the following:

Some people who have NAFLD may develop nonalcoholic steatohepatitis (NASH). Its an aggressive form of NAFLD marked by inflammation as well as fat buildup in the liver.

NASH may progress to liver scarring and damage (cirrhosis) and liver failure, which can be life threatening.

The main cause of NAFLD in people with diabetes is overweight or obesity. Weight loss is one way to slow the progression or reverse the development of NAFLD.

Studies show that losing just 7% to 10% of your body weight is the best way to achieve sustained weight loss. You can do this through regular physical exercise and calorie restriction.

High fructose consumption is also associated with the development of NAFLD. Limiting or avoiding high-sugar foods and drinks, like processed foods and sodas, can also be helpful in preventing or slowing the progression of NAFLD.

NAFLD is also common in people with high blood pressure and cholesterol. If you have NAFLD and it has progressed to NASH, some studies have linked taking statins to improved liver function and reduced cardiovascular events. Research notes that those statin-related benefits are specific to people without any liver issues after 3 years.

Oftentimes, NAFLD has no symptoms until it has progressed to advanced stages (cirrhosis or liver failure).

Symptoms of advanced liver disease include:

If youre experiencing any of these symptoms and have risk factors for NAFLD, contact your doctor for further testing.

Risk factors for NAFLD include:

Having NAFLD may not affect your day-to-day at the beginning, but it can worsen over time. One contributing factor is having elevated blood glucose levels, like if you live with diabetes.

One 2021 study found that the average 3-month blood glucose levels of people with NAFLD determined their likelihood of having more severe cirrhosis, which can lead to liver failure.

A 2019 study found that NAFLD can lead to the overproduction of glucose, leading to insulin resistance and abnormal blood sugar levels. Over time, this can develop into prediabetes and type 2 diabetes.

In short, while NAFLD and diabetes dont cause each other, they can exacerbate each other and make both conditions harder to manage.

Theres no particular diet for managing both diabetes and NAFLD. Rather, one goal is to lose and manage weight to help slow the progression of both conditions.

One way you can manage your weight is by eating a balanced, nutritious diet. Whole foods are one way to do this. Consider adding more of these foods to your diet:

If you smoke or drink alcohol, its important to quit. Quitting smoking and drinking can be difficult, but you dont have to do it alone. Your doctor can help you create a quit plan that works for you and your needs.

Doctors also advise limiting or avoiding foods high in saturated fats and sugar, like:

There are no medications that can reverse NAFLD. But you can help slow its progression and, in some cases, reverse its damage with certain lifestyle strategies. These include:

Most healthcare professionals recommend losing 3% to 5% of your body weight to see results in the liver. However, its important to lose weight sustainably. Rapid weight loss may actually make NAFLD worse, so aim to lose no more than 1 to 2 pounds per week.

Your doctor can help you plan the healthiest and most sustainable weight loss options for you.

One 2014 pilot study out of Japan suggests taking a glucagon-like peptide-1 (GLP-1) analog can help weight loss if you have diabetes and NAFLD.

Researchers in a 2013 study pointed out that taking thiazolidinediones, a drug for type 2 diabetes, may be beneficial for people who also have NAFLD. These medications help reduce insulin resistance and may lead to weight loss.

According to a 2014 study, dipeptidyl peptidase-4 (DPP-4) inhibitors may be beneficial if you have NAFLD and type 2 diabetes because they can lead to:

Taking these steps in the beginning stages of NAFLD can prevent permanent damage to your liver.

NAFLD affects up to two-thirds of people with type 2 diabetes. NAFLD often does not have any symptoms in its beginning stages but can lead to liver failure when not treated.

Higher blood sugars can also make NAFLD more difficult to treat, and having NAFLD can increase blood sugars.

The best treatment for NAFLD is weight loss. Eating a balanced diet and getting more exercise into your daily routine can help you manage your weight.

You may also want to talk with your doctor about taking certain medications, such as GLP-1 analogs, thiazolidinediones, or dipeptidyl peptidase-4 (DPP-4) inhibitors, to help you lose weight and improve insulin sensitivity.

When not treated, NAFLD can lead to nonalcoholic steatohepatitis (NASH), an aggressive form of NAFLD. It may also progress to cirrhosis and liver failure, which can be life threatening.

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Low-Carbs Diet Eating it helps to control body weight, type 2 diabetes, and improve overall health. In such a situation, low-carb diets have gained tremendous popularity in the last few years. It is a weight loss diet that encourages people to limit their carb intake. However, with the rise in popularity, myths and concerns about low-carb diets persist. Particularly on the topics of getting enough nutrients and psychological well-being. Some believe that it is good for human health, while for others it is permanent and harmful. Let us know what is the truth.Low-carb diets are bad for your heart

According to a research, it is a widespread belief that a long-term low-carb diet can be bad for your heart health as it is high in cholesterol and fat. Following this diet for a long time may increase the level of cholesterol in your blood, which increases your risk of developing heart problems.

Low-carb diet is also known as no-carb diet. It is believed that people following a low-carb diet tend to reduce plant-based food, which leads to a lack of nutrients in the body. But this is not true, you can have lots of vegetables, berries, nuts and seeds without exceeding the limit of 50 grams of carbs per day. Eating 100-150 grams of carbs every day is still considered low-carb.

Athletes primarily eat high-carb diets, so its obvious to think that carb intake is important for physical performance. Low carb intake can hurt physical performance. However, these symptoms are temporary and over time the body learns to burn fat instead of carbs. Some studies also suggest that a low-carb diet is good for physical performance.

There are different types of low-carb diets, and not all low-carb diets need to be high in protein. A very low carb diet mostly consists of fat but if a person is following a low carb diet for weight loss, the protein intake should be moderate.

A fad diet refers to weight-loss diet trends that promise exaggerated results. But being quite unhealthy, it cannot be followed for a long time. However, over 20 scientific studies have shown low-carb diets to be quite effective in reducing unwanted fat from the body. In addition, it has been followed by people for decades and is quite effective when trying to lose weight.

Click here to read this article in English.

Disclaimer: This article is for general information only. It cannot in any way be a substitute for any medicine or treatment. Always contact your doctor for more details.

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Liquid diets don't scream fun. If you've ever been on one, you know that it's often bland, boring, and texture-less. And while sticking to a diet of non-solid foods is pretty miserable for most people, they are used for many reasons. Some have even followed a liquid diet for weight loss.

Doctors sometimes prescribe a liquid diet to patients for different medical reasons. "A liquid diet is a specific type of diet that provides all or most of your daily calories from a liquid source," explains Erin Rossi, RD, LD, with Cleveland Clinic's Center for Human Nutrition. "Any liquid that can be poured at room temperature or a soft solid that can melt in your mouth and has a smooth texture could be included on this type of diet."

She adds that liquid diets may be prescribed prior to gastrointestinal surgeries to help prep the body for the procedure or after surgeries of the mouth, throat, or stomach, where liquids can lessen the pain of eating or rubbing against the surgical site.

Post-surgery they can help and allow for healing. "This provides an opportunity for the body to heal, improve hydration, and assess toleration of the liquids before advancing to liquids or foods that are more difficult to digest," says Melissa Majumdar, RD, CSOWM, LDN, a spokesperson for the Academy of Nutrition and Dietetics.

Liquid diets may also be prescribed in other health situations. "Some doctors use liquid diets when patients are unable or unwilling to eat solid food due to mental health concerns," adds Rossi.

Meet the experts: Erin Rossi, RD, LD, is a nutritionist with Cleveland Clinic, and she specializes in adult chronic disease management, bariatric nutrition, and weight management.

Melissa Majumdar, RD, CSOWM, is a bariatric coordinator at Emory University Hospital Midtown, and focuses on the care of bariatric surgery patients. She is the chair of the integrated health planning committee for the American Society for Metabolic and Bariatric Surgery.

On the other hand, liquid diets are also utilized to lose weightand quickly. (Liquid diets are also known as fad diets.)

"Liquid diets for weight loss are not recommended, as they are not sustainable or healthy. They lack essential nutrients such as fiber and protein, which are crucial for overall health and well-being," says Rossi.

A medically controlled liquid diet is often short-term and closely supervised by a doctor or dietitian to ensure the person following the diet does not become malnourished, she explains.

And FYI: Liquid diets for weight loss generally do not provide long-term results. "Often, patients are discouraged that they have gone through the trouble of following a liquid diet and then lose very little weight or gain any lost weight back as soon as they begin eating food again," Rossi adds.

You can definitely lose weight on a liquid dietup to three to four pounds per week, but the number of pounds you drop will vary depending on your height, weight, nutritional status, and the timeframe of the diet.

"These types of diets typically come with pre-determined structured routines, which can be helpful when reducing calories," says Rossi. "Long-term, liquid-only diets do not provide sustainable weight loss because when a person drastically reduces their calories, it tends to also slow down their metabolism."

So, when you stop the liquid diet, weight gain typically happens. You have slowed your metabolism down so much that you then have rebound weight gain. "Those that use a combination of liquid meals and solid meals tend to have more long-lasting weight loss," Rossi adds.

A medically supervised liquid diet can offer some benefits.

"Many surgeons request liquid diets after surgeries to help ease the pain of eating and to relieve some GI discomfort following surgery," says Rossi. "However, recent research is looking at the effects of lessening liquid-only diets surrounding surgeries with promising outcomes."

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A liquid diet can also be helpful for those with mental health concerns or physical disabilities who cannot or will not consume solid foods by removing the stressor of eating and improving quality of life.

If the medical team is concerned about a person being able to meet their nutritional needs while on a liquid diet, they will prescribe supplements or nutritional support. "This means they may use a tube for feeding or an IV or central line to get closer to the vitamin, mineral, carbohydrate, fat, and protein needs of that person," says Majumdar.

The downsides of liquid diets are almost all related to missing essential nutrients like vitamin and minerals. "Physical side effects of missing out on these nutrients include hair loss, muscle wasting, dizziness, heart damage, kidney stones or gall stones, fatigue, and constipation," says Rossi.

One of the worst things about liquid diets is the lack of protein. "Protein is required for healing and repair, so even in a medically supervised liquid diet, a person would be encouraged to meet the bodys protein requirements (typically at least 60 grams protein per day, higher during times of healing) and choose a variety of liquids to meet the bodys macro- and micronutrient requirements," says Majumdar.

Overall, there are many people who should not go on a liquid diet, including pregnant or breastfeeding individuals and those who take insulin, according to Rossi. And you should always check with a doctor before starting a liquid diet.

There are different types of medical liquid diets: clear and full liquid.

However, weight loss liquid diet foods can vary depending on the program you follow.

"Many commercial programs allow specific protein shakes, smoothies, teas, and drink mixes," says Rossi. "However, they also typically allow for the above-mentioned clear liquids as well."

The bottom line: A liquid diet is not a sustainable way to lose weight and you may develop nutritional deficiencies if you follow this eating plan. If you're still curious, check with your doc before starting one.

Emily Shiffer is a former digital web producer for Mens Health and Prevention, and is currently a freelancer writer specializing in health, weight loss, and fitness. She is currently based in Pennsylvania and loves all things antiques, cilantro, and American history.

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Liquid Diet For Weight Loss: Do They Work And Are They Safe? - Women's Health

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Whether you're trying to lose weight, build muscle, or simply develop healthier eating habits to improve overall wellness, dieting can be a tricky game to play. Although adjusting your lifestyle down to your fitness routine and what you consume throughout the day can help you reach your goals, the pressure to stay the course over an extended period of time can sometimes prove challenging, especially if you aren't seeing your desired results fast enough or notice your initial progress suddenly begin to plateau.

The rigidness of one's routine can actually become an obstacle unto itself, and ineffective dieting practices, in particular, can become an impediment to reaching your health and wellness goals. If you're deep into your diet but have had marginal success and still do not feel your absolute best, it might be a sign to stop what you're doing and regroup with a new approach.

We spoke with Amy Goodson, MS, RD, CSSD, LD, and author of The Sports Nutrition Playbook, to get her advice on when it's the right time to stop dieting. Read on to better understand and recognize the signs for when it's time to change gears with your ongoing diet and how to best take action in response.

Perhaps the most glaring red flag that it might be time to stop dieting is when your eating routine starts to negatively impact other aspects of your health.

For instance, Goodson explains that some challenges often associated with low-carb, high-fat, and high-protein diets stem from how they sometimes limitif not completely eliminatefruit and whole grains, consequently cutting out lots of dietary fiber in the process. However, your body needs soluble fiber because this helps to keep your cholesterol in checkwithout it, you're at greater risk of developing high cholesterol.

"If you are eating a keto diet or similar, and head to the doctor to get your lab work done and find your cholesterol is trending upit might be time to cut out some of the saturated fat and increase your fiber intake," says Goodson.

So, if you've noticed an uptick in your cholesterol amid your current diet, consult with your doctor on the best strategies to help regulate this. Ask if pivoting your existing diet to opt for a more high-fiber one would be the best move to optimize your health, given the circumstances.

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Having an insatiable appetite despite eating healthy-sized food portions throughout the day can be a sign that it's time to tweak your current dieting tactics. According to Goodson, no one should have to tolerate feeling hungry all the time.6254a4d1642c605c54bf1cab17d50f1e

"If you truly feel hungry all day long, you may not be eating enough," she explains. "While weight loss does require a reduction in calories, eating too little can make you feel miserable."

Instead, Goodson suggests logging everything you eat in an app. Use your log to determine what could be missing from your diet by comparing it to what you should take in each day. If your current diet involves eating significantly fewer calories, you might consider incorporating an extra nutrient-rich snack or some additional protein during the day to help curb your hunger.

RELATED: I Kept a Food Journal for a Monthand the Results Surprised Me

If you're inexplicably exhausted even after getting a full night of sleep, your diet may be the culprit. Making adjustments to your eating routine could be the key to solving this mystery.

"Many people don't realize that the fatigue they often feel might be from not eating the right foods or enough," Goodson says. "Many restrictive diets call for a drastic reduction in calories, leaving you feeling tired and [lacking in] energy."

If you're constantly feeling tired and think your existing diet could be the cause, Goodson suggests assessing the frequency at which you're eating because your lethargy could mean you're not eating often enough. You should also make sure you're eating carbohydrates and protein with each mealand if not, adjust your diet accordingly to better sustain your desired energy levels.

When it comes to having a productive health and wellness journey, diet and exercise often come hand in hand. No matter what the reason is for your diet, if your lifestyle changes are driven by a strong desire to improve your overall health, exercise is a vital aspect of this equation. However, basing your eating habits on a diet that isn't appropriate for your unique body chemistry could counter your workout efforts by causing you to feel sluggish.

"If you feel like you are climbing a mountain at the gym and really have no energy to complete your workouts, you may not be providing your body with enough nutritionspecifically carbohydrates," says Goodson. "Carbohydrates help fuel activity; without them, an intense workout can seem like climbing Mount Everest."

In addition to eating an adequate amount of complex carbohydrates, Goodson recommends making sure you have enough high-quality proteins in your diet, especially if you find yourself dragging through your workout, you're not recovering quickly enough, and you're struggling to see the results of your overall efforts manifest in the mirror or on the scale. These foods will help fuel and refuel your body to carry you through your workouts and beyond.

Kayla Garritano

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4 Signs It's Time To Stop Dieting Eat This Not That - Eat This, Not That

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Urban garden in Tapada da Ajuda, Lisbon

From playful elements in street architecture in Cork, Ireland, to teaching children how to grow vegetables in Lisbon, Portugal, cities across Europe are using urban design and health interventions to promote the well-being of their populations.

Europe has a unique opportunity to make city life healthier since it has relatively few mega cities; more than 70% of Europeans live in cities with less than half a million inhabitants.

These are some of the World Health Organizations findings in a new report, Urban design for health: inspiration for the use of urban design to promote physical activity and healthy diets in the WHO European Region, published Wednesday and launched at the 11th Conference of HEPA Europe on health-enhancing physical activity in Nice, France.

The report, prepared by the WHO European Office for the Prevention and Control of Noncommunicable Diseases, looks at ways to promote physical activity and healthy diets in urban settings.

Rather than simply telling people about the right food choices and benefits of physical activity, cities can use better strategies to help people choose more wisely, the report suggests. Research has shown that design also plays a role in the health of communities around the world.

If we want to make cities a better environment that helps people to live healthier lives, first we need to understand the peoples needs, said Dr Kremlin Wickramasinghe, head of the WHO European Office for the Prevention and Control of Noncommunicable Diseases.

This will give us insights to integrate healthier habits into everyday lives effectively.

The report says urban design and planning influence public health and human behaviour by limiting or providing access to healthy foods and active lifestyles, which have profound effects on peoples physical and mental health.

For instance, in the WHO European Region, environmental risk factors are estimated to cause at least 1.4 million deaths per year, approximately half of which are linked to air pollution, a major contributor to the rise in noncommunicable diseases (NCDs). One in four cases of ischaemic heart disease and strokes, and one in five cancers are estimated to result from environmental exposure.

These risk factors can be the result of inequalities in environment and health from different aspects of home and work life, including housing conditions and access to basic services and transport.

Traffic tends to be greater in cities less affluent neighbourhoods, posing a greater risk of road-related injuries and exposure to air and noise pollution, which has implications for poor health and a higher incidence of NCDs.

That is why it is crucial, the report emphasizes, to find the best approaches to address these risk factors in urban settings: Cities are places where it all comes together.

Wickramasinghe emphasizes that gathering data and building connections with local communities is essential for healthier urban planning.

WHOs report presents several tools to facilitate this:

One such tool, called the healthy streets approach, uses an index for large-scale, long-term strategic planning to make improvements across ten indicators.

The index has indicators for things such as how much clean air there is, whether the streets are easy to cross, and the degree to which everyone feels welcome.

The intent, the report says, is to make it easier for citizens to promote a healthy, safe neighborhood through simple language that everyone can understand and relate to.

Many cities are trying to improve urban transport and mobility, as well as access to urban nature and green spaces. The new report highlights some of the positive examples.

Cork, Ireland

As Cork is dominated by cars but lacking in green spaces, air quality was found to be a problem, in addition to limited outdoor spaces for physical activity.

This city decided to introduce more playful elements into its street architecture by developing ten new parklets with entertainment equipment and seating. It also included a playful culture trail in July 2021 to encourage active, playful movement between and within the locations.

Tbilisi, Georgia

Tblisi has a transport system that is not pedestrian-friendly and lacks buses and cycling infrastructure. Its car-dependent nature results in traffic congestion and air pollution.

Additionally, pedestrian areas are considered possible only in tourist areas and are, therefore, not found in resident neighborhoods

To solve this problem, the city is transforming its streets to make them pedestrian-oriented. The new street design is meant to address the main challenges of Tbilisi: air quality, physical inactivity, and mental health.

Adam Mitskevichi Street, a pilot area, was closed down for a few days, to familiarize citizens with a different perception of how the street could be used. From the first hours of the streets dedication to the public, children arrived with music and started dancing, and some people enjoyed cycling and skateboarding.

Lisbon, Portugal

Tapada da Ajuda, a green space in Lisbon, is located on hilly terrain, and its steep topography makes it difficult to ensure easy access for children. Additionally, the surrounding streets are not safe for children because cars are parked on some sidewalks.

In order to build more connections between local citizens, especially children, in the area, the city promotes healthy eating by putting local produce at the heart of its public space project, while teaching children how to grow vegetables and the importance of a healthy diet.

The tools and examples in the report highlight the types of actions that policy makers and urban planners can use for inspiration to rethink and improve their cities.

Cities in other parts of the world have also come up with other ways to promote health through urban planning and policy, including Buenos Aires, Argentina and Baku, Azerbijian, showing how urban design is crucial to long-term social and health benefits.

Urban design is a key determinant of physical activity and healthy diets, the report concludes, contributing to the prevention and control of NCDs and improving global health.

Image Credits: WHO , WHO.

Combat the infodemic in health information and support health policy reporting from the global South. Our growing network of journalists in Africa, Asia, Geneva and New York connect the dots between regional realities and the big global debates, with evidence-based, open access news and analysis. To make a personal or organisational contribution click here on PayPal.

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Every week there seems to be a new fitness challenge trending online. But one thats managed to remain popular over the last couple of years is the 75 Hard Challenge. On TikTok alone, the hashtag #75Hard has more than 1.2 billion views.

Its easy to see why this particular challenge has remained so popular, with video after video of people showing off their staggering body transformations which they claim are the result of the challenge.

The 75 Hard challenge is not for the faint of heart. In short, it involves doing each of the following daily for 75 days:

If any component is failed, the challenge must start again from day one.

This article is part of Quarter Life, a series about issues affecting those of us in our twenties and thirties. From the challenges of beginning a career and taking care of our mental health, to the excitement of starting a family, adopting a pet or just making friends as an adult. The articles in this series explore the questions and bring answers as we navigate this turbulent period of life.

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The creator of this challenge claims that completing it will allow you to change your life forever and lead to career success, greater confidence and better relationships alongside being physically fit. Theres currently no scientific evidence to support these claims.

Although the requirements of the 75 Hard challenge are pretty outlandish by most peoples standards, seeing the transformations and online testimonials of how the challenge changed lives may explain why many continue to be curious about it.

Heres what to know if youre thinking about giving it a try.

The two main components of the 75 Hard challenge (eating right and exercising regularly) are of course good for your health. Plenty of research shows that proper diet and regular exercise lowers the risk of obesity and can prevent chronic and age-related diseases, including some cancers and cardiovascular disease.

But in order for diet and exercise to be effective, they must be done in a safe way.

When exploring the safety (and injury risk) of exercise, one of the most important considerations is physical load. This is the combination of how much, how hard, and how often you exercise.

If you have a high physical load (such as exercising intensely seven days a week), you are more likely to suffer from injuries, illness or other issues such as overtraining syndrome. Overtraining syndrome typically happens when you train too much and and recover too little between exercise. It can lead to fatigue, which may also increase risk of injury.

Previous injuries, age, and even weight can also further increase your risk of injury. These factors will also determine whether or not you can tolerate a high training load.

For most people, training twice a day for 75 days is likely to be too much for them. To reduce the risk of injury its widely recommended to split training sessions up and schedule in rest and recovery days.

Not recovering properly or giving yourself rest days may also affect your fitness and may actually make it harder to see the results you might be hoping to see when following the 75 Hard challenge.

Diet and sleep also have a large effect on your ability to recover well and fuel exercise. But everyones needs are different, so its important to listen to your body. Many generic diets wont work for everyone, so adapt the diet you follow as necessary.

From a psychological perspective, we can also recognise the potential positive impact of fitness challenges such as 75 Hard on wellbeing, self-esteem and mental health.

But a persons success in completing a challenge like 75 Hard may be underpinned by the type of motivation they have for doing so. According to the self-determination theory, every person has a different type of motivation for doing something.

These range from more beneficial to less beneficial types. Its not simply about how much motivation a person has for an activity, but what the quality of that motivation is like.

Beneficial, or quality, types of motivation describe people who do an activity for an intrinsic (internal) reason. For example, they do it because they enjoy exercise or they want to learn new ways of feeling healthy.

Less beneficial types of motivation are when a person does something because of an extrinsic (external) reason. Examples of external reasons include feelings of guilt or shame (such as coercion from others or feeling bad about the way they look), or to receive external rewards such as money or recognition.

If a person has enough of either type of motivation, its probably the motivation needed to get them through the challenge. But the more important issue is whether or not the person maintains the healthy behaviour after finishing the challenge.

Beginning any diet or exercise programme is difficult. New exercisers often hold unrealistic expectations of what they can achieve, which can lead them to have trouble prioritising and scheduling exercise. Maintaining lifestyle changes can also be challenging.

Extrinsic reasons for doing something often lead to dropout. Yet when a person does something for intrinsic reasons, they are more likely to stick with it and can maintain the positive outcomes such as physical fitness and weight loss. This may be even more likely if a person has access to ongoing support following a structured exercise program.

For some people, the 75 Hard challenge may kickstart them into improving their fitness and lifestyle. But being able to maintain that level of activity may depend heavily on the reasons why they are doing it. The rigid list of tasks and consecutive daily nature of the programme may also may it difficult (and even dangerous) to complete.

Anyone contemplating the 75 Hard challenge should seek advice from their healthcare provider or a fitness trainer, and perhaps consider adapting the tasks to suit their fitness level or personal goals.

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75 Hard: what you need to know before taking on this viral fitness challenge - The Conversation

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The BMJ study that followed more than 200,000 participants for over 25 years found an increased risk of developing bowel cancer when over-processed foods were a prevalent part of their diets, especially in men (per CNN). Consumption of highly processed foods by both genders leads to obesity, inflammation, and cardiovascular disease, which is associated with increased cancer risk.

According to Eureka Alert, analysis of study results showed that men consuming processed meats, ready-made meals, and sugary beverages had the strongest association with the development of colorectal cancer. There was no direct link between women consuming processed foods and bowel cancer. This could be attributed to women's choice of ultra-processed foods such as yogurt which might counter the effects of other more harmful counterparts. More research is needed to identify whether women's lessened risk of developing bowel cancer from processed foods was affected by uncontrolled influences or by chance.

The study directly linked nutrient-lacking foods to an increased risk of developing chronic diseases that can shorten the lifespan of both men and women (per CNN). Cardiovascular disease was the most prevalent of the comorbidities caused by an unhealthy diet, especially when foods low in nutrients were also ultra-processed. Returning to a diet of whole foods and reserving ultra-processed foods for a rare treat can help clear the path to a longer, healthier life.

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New Study Reveals A Link Between Ultra-Processed Foods And Cancer Risk - Tasting Table

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Whole grains are grains of any cereal that have all the three parts - endosperm, germ, and bran intact unlike refined grains that do not have germ and bran. For boosting your overall health and avoiding risk of lifestyle diseases, health experts all over the world recommend adding more of whole grains to the diet. It is said that at least half of all the grains one eats must be whole grains. Barley, brown rice, buckwheat, millet, oatmeal, popcorn, whole wheat flour, bread and crackers are some of the ways to incorporate whole grains to your diet. (Also read: National Nutrition Week 2022: Keto to Atkins; 5 diets you must avoid)

Whole grains have an array of benefits from high fibre that helps you feel full and satiated to complex carbs that help in controlling blood sugar levels and also lower risk of heart disease, diabetes, cancer and other health issues.

Nutritionist Lovneet Batra in her recent Instagram post talked about the health benefits of whole grains.

Whole Grains are considered to have low glycaemic index, and therefore help manage blood glucose levels better. Further, it's important to supply the body with the key nutrients needed for managing blood sugar levels. The presence of minerals such as magnesium and chromium, phytochemicals, organic acids and enzyme inhibitors in wholegrain foods along with its high fibre content, all work together in stabilizing sugar levels.

According to studies, intake of whole grain and bran intakes are consistently associated with a 16-30%lower risk of cardiovascular and coronary heart disease. Furthermore, certain compounds in whole grains, such as fiber, vitamin K, and antioxidants, can reduce your risk of stroke.

Whole grains contain compounds called lignans which have a weak hormone-like effect that may help you achieve a better hormonal balance. These grains are also valuable sources of vitamin B6 which is thought to play a useful role in managing hormones and alleviating premenstrual symptoms like bloating, mood swings and period pains.

Inflammation is at the root of many chronic diseases. Whole grain foods have been reported to affect serum levels of inflammatory cytokines. So, consider adding whole grains to your diet every day.

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