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Q. My granddaughter says she cant have gluten anymore. I want to support her the best I can. What do I need to know?

A. May is Celiac Disease Awareness Month, making it the perfect time to learn more about celiac disease and what it means to follow a gluten-free diet. Celiac disease and gluten intolerance are two conditions that are more common than many people realize. Some individuals may not even know that they have celiac disease or gluten intolerance. It is good to learn more about celiac disease and gluten intolerance so that you can help your granddaughter to live a healthy life.

What is the difference between celiac disease and gluten intolerance? Celiac disease is an autoimmune disease in which when a person eats gluten, the body responds in an inappropriate way that causes damage to the small intestine. Someone who has a gluten intolerance may experience many of the same symptoms as someone with celiac disease, but there is no damage that occurs in the small intestine. In addition, someone who has celiac disease must avoid even the smallest amount of gluten for their entire life. Someone who has a gluten intolerance may actually tolerate various amounts of gluten and their intolerance may resolve or change over time.

What is gluten and what does it mean to follow a gluten-free diet? Gluten is the protein component in the grains wheat, barley and rye. When following a gluten-free diet, all of these grains and any component or derivative of them must be avoided. For individuals with celiac disease, cross contamination is also a concern. Therefore, regular oats are often avoided because of their high risk of cross contamination. In addition, keeping a clean kitchen and sometimes having separate cooking implements may be necessary. It is important to learn how to read labels properly and take care when eating food prepared outside of the home.

Are there any nutrients to pay closer attention to when following a gluten-free diet? Any dietary restrictions, including gluten, can put individuals at greater risk of certain nutrient deficiencies. Many gluten-free baked products can be lower in fiber content than the gluten products they are meant to replace. Focusing on including other high-fiber foods that are naturally gluten-free is a good way to counteract this lack of fiber in the baked goods. Other nutrients to pay attention to are vitamins D, B12 and folate. Including a variety of fish, dairy and legumes in the diet can help increase the consumption of these nutrients, as well as others, in a naturally gluten-free way.

What resources are there available to help with a transition to a gluten-free diet? Navigating any dietary restrictions can be overwhelming, especially when just starting out. Take advantage of any resources available including complimentary shopping tours or nutrition consultations.

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FOXBORO -- Mac Jones looks a little different headed into his second season, and his teammates have noticed.

"He's in the best shape of his life," receiver Kendrick Bourne said. "I think he's been here all offseason with (strength and conditioning coach) Moses (Cabrera). He looks really good. His stomach is gone, and he looks really good. He's definitely a pro's pro now."

Jones acknowledged that he's worked hard to alter his diet now that he's through his whirlwind rookie year and has a chance to start the 2022 season with his feet firmly planted on the ground. Together with team nutritionist Ted Harper and others, he's been able to change his body to better prepare himself for offseason work, but he also has a plan to strike a balance between thinning out too much and still being able to take the punishment that comes along with his job.

"I think every year you want to do a self-diagnosis of how you felt for the games, your body fat, all that stuff," Jones said. "For me, cleaning up my diet -- I've probably learned more this offseason than I ever have about my diet, sleep, nutrition, wellness, all that stuff. I've taken what I've learned that I feel will help me and applied it. Obviously, listening to Ted and everybody, following their plan, eating healthy, taking out a lot of the things that are bad for my diet.

"At the same time, I need to maintain my weight and be able to take hits. It's a fine line for every player. Every player is different. For me, I've definitely trimmed down on the body fat a little bit. I'll get a chance to bulk back up before the season starts and be able to absorb the hits."

Jones also acknowledged that he spent time with renowned throwing coach (and friend of the Next Pats and Patriots Talk podcasts) Tom House, who has worked extensively with Tom Brady over the years. Observers will have a better opportunity to see how Jones' arm looks during training camp when he's moved off his spot and occasionally under some duress. But it's clear Jones was busy working on preparing himself for his second season.

Here are a few other observations from Monday's practice:

-- Players not seen at the workout: defensive lineman Byron Cowart, kicker Nick Folk, defensive lineman Lawrence Guy, receiver N'Keal Harry, offensive lineman Chasen Hines, outside linebacker Matt Judon, linebacker Harvey Langi, kicker Quinn Nordin, outside linebacker Ronnie Perkins, safety Adrian Phillips, offensive lineman Andrew Stueber, linebacker Jahlani Tavai and tackle Isaiah Wynn.

Damien Harris spent a moment getting his leg stretched out at one point. He was limited late last season with a hamstring issue but stayed in the practice and didn't appear limited after the fact.

Some players who appeared limited during the session were rookie wideout Tyquan Thornton and rookie corner Marcus Jones.

Patriots Talk: Patriots' coaching plan of attack should be a concern for Mac Jones | Listen & Subscribe | Watch on YouTube

-- This was our first opportunity to see DeVante Parker (No. 11), Jabrill Peppers (No. 3), Terrance Mitchell (No. 39) and Malcolm Butler (No. 4) on the field as the team's two biggest offseason veteran acquisitions.

Mack Wilson (No. 30) was also heavily involved at the inside linebacker spot, getting some coaching from Bill Belichick at one point when the head coach took a moment away from coaching the offense.

-- Parker and Brian Hoyer connected for the longest play of the day for the offense, with Parker sneaking behind the secondary for a more than 50-yard touchdown.

-- During one-on-one drills in the red zone, Kendrick Bourne and Rhamondre Stevenson both came up with impressive one-handed catches on jump balls. JJ Taylor also climbed the ladder with his small frame to come away with another eye-opening grab.

-- Mac Jones seemed to take the blame for a false start penalty that sent the entire offense for a lap midway through the practice. Prior to that, Jones and rookie center Kody Russey botched a snap. Jonnu Smith also had to run a lap after a false-start penalty.

-- Centers got to work in with the 7-on-7 offensive periods in an apparent change from how things have been done previously in Foxboro. Typically, those players worked with offensive linemen until it was time for 11-on-11 work. With more snapping reps in mind, apparently, centers got to figure into what have long been portions of practice dominated by skill guys.

-- Cole Strange factored into the offensive line mix early, and Jack Jones -- the corner drafted in the fourth round out of Arizona State -- saw plenty of action in team periods as well. Jones also caught punts late in the practice. Jones is light -- he weighed 171 pounds at the combine -- but the 5-foot-11 cover man saw time as a boundary corner.

-- At linebacker, Ja'Whaun Bentley and Raekwon McMillan saw plenty of early work. McMillan said after that he was essentially a full go after tearing his ACL prior to the start of last season. Mack Wilson and Josh Uche also saw work as off-the-ball 'backers. Uche has been an edge defender primarily during his time in New England, but he played off the ball at Michigan and certainly has the athletic ability to track sideline to sideline. It'll be interesting to see how he's used moving forward as he spent time both on the edge and off the ball Monday. Cam McGrone was not active during team drills but he spoke to reporters after practice.

-- Malcolm Perry, who signed a futures contract with the Patriots earlier this year, took some quarterback reps during the drills period of practice. He played quarterback at Navy but since entering the league as a seventh-round pick for Miami, he has been primarily a wideout in his time with the Dolphins, Patriots and Saints.

-- Watching the practice from high in the bleachers along the practice field sidelines? Longtime Patriots running backs coach Ivan Fears. We haven't heard official word from Fears that he's retired, but that's our understanding of the situation. Still, he apparently wants to be able to take in what's going on out there. Running backs coach Vinnie Sunseri ran the show for that position Monday.

-- Joe Kim looked like he was running the defensive line practice with defensive line coach DeMarcus Covington attending the inaugural Coach and Front Office Accelerator program at the NFL meetings in Atlanta. He's there with dozens of other potential head coach and general manager prospects who will have the opportunity to meet and start to build relationships with NFL owners. Patriots director of pro scouting Steve Cargile was also scheduled to take part in the program.

The NFL is committed to diversity and inclusion, and this program is the latest in a series of steps designed to improve our hiring practices and create opportunities for advancement, said NFL Commissioner Roger Goodell. The program helps ensure that clubs receive exposure to high-performing, up-and-coming NFL talent and candidates get a chance to learn the business on a working level from team owners and executives.

-- The Patriots ran sprints -- not on the hills behind the practice fields but on the fields themselves -- for an extended period of time after the practice. That kind of workout early in the offseason has, in the past, at times served as a wake-up call for veterans new to the team. It brings to mind one story relayed by Brandon LaFell and Darrelle Revis back in 2014. That offseason, they left the facility one day and told each other they better win a Super Bowl given how hard they were working at that point in the year. (They did.)

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Patriots OTA observations: Mac Jones in great shape thanks to improved diet - NBC Sports Boston

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Heatwaves of over 40 degrees Celsius have been hitting many parts of India and health experts warn that when the body temperature rises above 40 degrees Celsius, a life-threatening condition known as heat stroke occurs, which is why we must seek specific fruits and vegetables to cool off during these swampy days of summer and revive and rejuvenate our spirits. Health experts have revealed that infants and older people are more prone to the adverse effects of heatwave because in infants the central nervous system is not very well developed and in the older people, they have poor adaptability to temperature control and it becomes difficult for them to maintain or regulate the body temperature effectively.

According to medical experts, if there's a sudden change of temperature, it could lead to a heat stroke. Like if you're traveling in an AC bus or working in a office with high or very low temperatures and then you suddenly step out and get exposed to heat, in such instances, it becomes very difficult for the body to regulate temperature and therefore it can lead to a heat stroke.

In an interview with HT Lifestyle, Neha Premjee, Ayurvedic Nutritionist and Wellness Expert, revealed, According to Ayurveda, summer is the pitta season which means it corresponds to the element of fire hence, you need to have cooling foods to balance your body. Focus on foods like watermelon, celery, lettuce, cucumber, drink green juices and foods like raw salads for lunch, which especially are extremely pacifying for the pitta dosha. Also, make sure that you remain hydrated and make sure you are drinking things like chaas and coconut water that also pacifies the pitta dosha.

Certified Nutritionist Garima Goyal advised, First of all, being hydrated is very important. Due to work pressure and sedentary lifestyle, people often forget to drink water or enough water. At least 3 to 4 litres of water everybody should have in the summer. Secondly, have foods which are good for your gut health in summer. Curd, yogurt, salads, fruits like watermelon and musk melon which contain more water should be consumed. A person should avoid eating meat spicy, oily and deep fried food. Electrolytes are very important to feel energised. Lemon water, mint water and cucumber water can be consumed. All sorts of things including more water can be consumed to avoid heat strokes.

She listed 3 things to stay healthy and fit amid heatwave in India:

1. Coconut Water - It is high in various critical minerals and vitamins, thanks to its 94 per cent water content. One glass of coconut water a day can keep you hydrated and cool all day.

2. Buttermilk - Buttermilk is a cooling agent filled with a variety of nutrients and is an age-old home cure to protect yourself from the effects of the heat.

3. Watermelon - Watermelon is an antioxidant-rich summer fruit with cooling characteristics that might help you feel better within. Watermelon juice or slices, which contain 92 per cent water, assist in overcoming the heat and reduce bloating.

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Diet and nutrition tips to stay healthy and fit amid heatwave in India - Hindustan Times

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Iron is a nutrient that is as important as it gets, opines Dietician Vidhi Chawla. Between maintaining a healthy diet and engaging with some physical exercise, you might forget to include iron in your diet. The lack of iron in your diet can cause health issues such as iron deficiency and anaemia. Anaemia is a condition where your body's blood lacks an adequate amount of healthy red blood cells, which carry oxygen to the bodys tissues.

All about iron deficiency: anaemia

Iron-deficiency anaemia is most common and as the name implies, it occurs due to insufficient iron, due to the lack of blood supply and the lack of iron-rich food in the diet. Iron is one of the essential nutrients that is needed for the growth and development of the body as it makes the haemoglobin, myoglobin and some hormones. Usually, the symptoms of iron deficiency anaemia are mild at the starting stage. As the deficiency increases, the symptoms become more evident.

Some of the symptoms one with iron deficiency anaemia might experience are weakness, pale skin, headache, chest pain, extreme fatigue and chest pain. A diet appropriate for anaemia will also look at combating these symptoms.

How to reduce the risk of iron deficiency anaemia

You can reduce your risk of iron deficiency anaemia by including iron-rich food in your daily diet. There are two sources of iron in the diet which are heme and non-heme. Heme iron can be found in animal products such as meat and seafood. This iron is well absorbed by our bodies. The non-heme iron is from plant sources like leafy greens. This type of iron isnt absorbed well by our bodies, compared to heme irons.

Heme iron sources include:

Poultry

Beef

Meat and meat liver

Tuna

Oysters and mussels

Non-heme iron sources include:

Lentils

Beans

Nuts and seeds

Spinach and greens

Breakfast cereals

The key to improving your bodys absorption of iron is to add some vitamin C to your diet. The impact will be higher if vitamin C is added along with non-heme iron. Some of the vitamin C sources are cauliflower, citrus rich fruits, broccoli, brussels sprouts, watermelon, bell peppers, and berries (strawberries, raspberries, blueberries), potatoes, tomatoes, pineapple and melons.

To conclude, it is a well-known and straight fact that anaemia cannot be overcome with a particular food or dietary supplement. It needs an overall or a combination of food intake regularly!

Also Read:Type 2 Diabetes: Symptoms, causes and types of this condition

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Here's how you can fight anemia with the right diet and nutrients - PINKVILLA

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After receiving a cancer diagnosis, like mesothelioma, there are many changes a patient will undergo, both physically and mentally, during their treatment journey. Of the many important factors that play a role in a patients prognosis, no other may be as under appreciated nor as important as nutrition. Nutrition and diet can either help or hurt a patients treatment and recovery process. Therefore, proper nutrition and healthy meals are crucial factors in keeping a health mind and healthy lifestyle. But with so many options the task can be daunting. This is why we dive in and answer 5 diet and nutrition questions and give you 5 tips specific to mesothelioma and cancer patients.

A good mesothelioma diet can help manage treatment side effects, increase energy and muscle tone, and reduce inflammation. When diagnosed, mesothelioma patients should eat a well-rounded diet to stay in good health. Eating high-protein foods, healthy fats, whole grains, and getting a sufficient amount of vitamins and minerals is essential. Mesothelioma caregivers can provide patients with sufficient meals if a patient is unable to do so themself, but it is always best to ask a doctor specializing in your cancer.

For instance, when suggesting a diet for a chemotherapy patient, medical professionals recommend certain foods to better ensure they are healthy. Patients that commit to eating foods that benefit their lungs and mental health can expect an easier recovery and the possibility of a better prognosis.

Just as there are foods that assist patients during their journey with mesothelioma, there are also foods that patients should avoid. Because mesothelioma patients have a compromised immune system, they should avoid foods that will negatively affect their prognosis. Generally, it is recommended to avoid highly refined, processed foods as well as fried foods that contain hydrogenated oils. Specific foods that mesothelioma patients should avoid include:

There are many side effects associated with mesothelioma treatment that would require treatment in a medical center. Common side effects of chemotherapy treatment include nausea, vomiting, and mouth tenderness. However, there are certain foods and diets, such as soft foods and nutritional supplements for cancer patients, that can help combat these nasty side effects.

The physical and mental health effects that mesothelioma has on patients can lead to another side effect loss of appetite. If a patient struggles with the loss of appetite due to treatment, a mesothelioma diagnosis can cause weight loss. There are some guidelines to ensure a patient gets the proper nutrition including:

These are all guidelines that patients can follow, but they are dependent on the mesothelioma stage, age, and gender of a patient. Patients should consult with a registered dietician or mesothelioma specialist to determine what is right for them. By doing this, patients can maintain their health and avoid unwanted consequences thanks to eating healthy and being wise with their meals. Eating right may sound easy, but ultimately its up to you to take control of your health.

Madeline works for the patient advocate team and writes about asbestos exposure and mesothelioma. She is passionate about helping families in the mesothelioma community.

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5 Nutrition and Mesothelioma Diet Tips for Patients - Mesothelioma Hub

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If youve heard of fiber, youve probably heard that its a nutrient that fills you upand sends you to the bathroom. But what you might not know is that most Americans (runners included!) dont get enough fiber in their diets. Thats a problem not only for your gut, but for your overall health and performance.

We spoke to two registered dietitians and dug into the research to find out exactly what is fiber, why its so important, and how runners can incorporate high-fiber foods into their diets without disrupting their training.

All the yummy, energizing fruits and veggies that we love contain carbohydrates, and fiber is one of them. Fiber is a type of carbohydrate that plays a role in maintaining overall health, and it comes in three different formssoluble, insoluble, and functional. Each type plays a different role in keeping you healthy.

Soluble fiber is the type that dissolves in liquid and that includes the liquid in our stomach and our gastrointestinal tract, Kelly Jones M.S., R.D., C.S.S.D., sports dietitian and professor of nutrition and exercise at Bucks County Community College tells Runners world. When soluble fibers dissolve, it forms a gel-like texture that helps your body absorb other nutrients and slows down digestion, she says.

Insoluble fibers are the opposite. Kristin Kabay, M.S., R.D., C.S.S.D., sports dietitian and marathon runner explains, theyre not dissolved in water. They kind of act like a broomcombing through your intestines, and just sweeping everything out. This type of fiber is the one that clears your body of toxins, regulates bowel movements, and prevents constipation.

Lastly, functional fibers are supplements added into packaged foods by manufactures, likely to help some people kick up their fiber intake, Kabay says. You can spot some of these additive ingredientslike soluble corn fiber or enriched wheat flouron the nutrition label of some packaged foods.

Eating foods overloaded with functional fiber, especially if you have a sensitive digestive tract, can cause constipation or bloating, says Jones. If youre seeing that one type of fiber was added to a product, and youre not seeing other whole plant foods on your ingredient list, then you know that that might be an overload of the type of fiber that can impact your digestive health, she adds.

Luckily, fruits and veggies are rich in soluble and insoluble fibers, Kabay says, so you dont have to track how much of each fiber you eat.

Eating the right amount of fiber each day31 grams for men and 25 grams for women according to the USDAcan yield a ton of different health benefits. The number-one reason fiber is so important, Kabay says, is because it can be incredibly beneficial to lots of different organ systems through the body, including your gut and heart.

Research backs up fibers many benefits. For starters, a recent study published in the journal American Society for Microbiology found an association between a high-fiber diet and fewer antibiotic-resistant microbes in the gut. This shows that fiber may help fight antibiotic resistance which is what prevents bacteria, viruses, and fungi from effectively responding to antibiotics.

In terms of heart health, a recent prospective study published in the journal Nutrients found eating natural sources of dietary fiber, such as legumes, fruits, vegetables, and nuts had a protective effect against cardiovascular disease. Plus, a meta-analysis published in the Journal of Diabetes Investigation associated a higher intake of fiber with lower risk for type 2 diabetes with an emphasis on the protective effects of berries, green leafy vegetables, yellow vegetables, and cruciferous vegetables.

Whats more, Kabay says upping your intake of fiber can help lower cholesterol and blood sugar levels, as well as decrease your risk for colon cancer. Also, Jones points to research that shows increasing your fiber intake can improve your mental health.

If you dont eat enough fiber in your diet, Jones says, you may experience the following symptoms:

While it may seem like adding a bunch of high-fiber foods to your diet at once would be the easiest way to approach increasing your fiber intake, it probably isnt the smartest.

Jones says eating too much fiber at one time can cause digestive issues. To avoid this, gradually increase the amount of fiber you eat each day and focus on eating the fruits and vegetables you like most.

As a runner, its all about timing. Kabay suggests saving high-fiber foods for a postrun meal or snack to avoid any discomfort or an unplanned pitstop on the road. Practice eating foods with fiber before a run if youre going to have them on race day.

Having a more sensitive digestive tract doesnt mean you have to avoid high-fiber foods entirely, Jones says, even if youve been diagnosed with irritable bowel syndrome. Instead, just be mindful of what you eat around run time and see how your body reacts with different foods.

Youre not going to be able to dramatically increase your fiber intake overnight. However, you can slowly incorporate high-fiber foods, like the ones on this list, to make sure youre getting sufficient fiber.

*Fiber numbers based on the USDA FoodData Central

A medium-size artichoke contains about 7 grams of fiber. There are a ton of different ways you can sneak this vegetable in your diet. You can pair it with spinach for a tasty snack or add it as a pizza topping.

Jones says the best thing about classic oats is you can enjoy them anytimea sweet bowl for breakfast or savory for dinner. Plus, just a 1/2-cup serving contains 4 grams of fiber. Top it with fruit and you get even more.

Just a cup contains 7 grams of fiber. For breakfast, you can mix this vegetable in with your oatmeal, or whip up a batch of pumpkin muffins.

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If youre looking for a quick fix for your digestive issues, then youve probably solicited prunes or prune juice for help, because just one 1/4 cup contains about 3 grams of fiber. This is a great snack for those who struggle with constipation when traveling. Pack this fruit along with some water to munch on as you travel. Jones says it will help get things moving along a bit smoother.

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Raspberries are one of the highest fiber fruits that you can find, packing 8 grams per cup. There are a ton of different ways you can add them to your diet, whether you mix into yogurt, a smoothie, oatmeal, or just munch on them for a snack.

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A cup of blueberries contains about 4 grams of fiber. Make blueberry muffins, add them to smoothies, or just eat them as a snack with other berries. Plus, theyre filled with tons of antioxidants that your body needs for fighting free radicals and staying healthy.

Add avocado to salads, whip up some guac, or spread it on whole wheat toast. A half of a medium-size avocado has 7 grams of fiber.

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Theres a wide variety of dates, but Medjool dates are a bit softer and sweeter, Kabay says. Just two dates will provide you with 3 grams of fiber. Pack these for some fuel on longer runs or save them as a postrun snack.

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You dont have to go nuts with this snack, just one ounce of almonds (about 23 in total) has nearly 4 grams of fiber. Mix them into trail mix with dried fruit to get carbs, protein, and healthy fat in one snack.

Jones says lentils are great for runners because they come in a ton of different varietiesred, green, brown, and yellow. One cup of cooked lentils contains more than 15 grams of fiber, and theyre also rich in iron and protein.

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If you ask UFC Welterweight Champion Kamaru Usman (and UFC President Dana White), the fighter who proudly goes by "the Nigerian Nightmare" is the best pound-for-pound fighter in the world. In our latest installment of Men's Health Gym & Fridge, the 35-year-old fighter took us through the gym routine, health-conscious diet, and cheat meals that helped get him in shape to claim that crown.

After waking up at 6 A.M., preparing breakfast, and taking his seven-year-old daughter to school, Usman is in the gym. Arguably the most important part of his workout is the warmups, where he'll do fire hydrant workouts to warm up his glutes. Next, he incorporates some functional lifts that help him work on how his body will move in a real fight. Of all of his workouts, it's his wrestling practices he enjoys the most. One of those practices that helps build his forearms dates back to his college days when he would hold a weight plate in between the index finger and thumb on each of his hands until "either my fingers were about to fall off or I'd drop the plates."

In March, the short-tempered former UFC featherweight and lightweight champion Conor McGregor requested a title fight with Usman in March. While Usman doesnt reveal what workouts hed do to face off against McGregor, he does say he works out to have the endurance to go five rounds because you never know when somebody with a loudmouth, maybe an Irish accent, may want to try you.

As far as what's in the fridge of a champion such as Usman, you'll find many water options. Usman loves to start his day with an omelet made of eggs, spinach, peppers, avocado, and either wheat toast or croissant for the day of fights. Then, when it gets closer to fight time, hell scarf down some pasta with red tomato sauce, a relatively light meal so his body can absorb it quickly before he gets into the octagon for combat. Even the most disciplined fighters need a sweet escape from their health-conscious choices, and Usman's cheat meal is unlike anything you may have ever heard of.

"Chocolate chip, Oreo, Reese's cookie muffins. Just think about that cookie muffins."

It's worked for him so far, and it doesn't seem like he'll be changing up anytime soon.

Watch the rest of the video above.

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Several decades of nutrition research have shown us that no one-size diet fits all and since we are all unique, healthcare nutrition which applies to all doesn't fit everyone. Many factors come into play as to why it may happen but the main reason has something to do with our genes or genetic makeup.

Genomic testing determines the interplay between genes, nutrition and health. It helps personalise the diet and nutrition and provides you with a blueprint for optimal health and wellness.

What do genomic tests evaluate?

Genomic tests identify the specifics of our DNA, in terms of change in our chromosomes, associated genes and/or protein . Nutrigenetic DNA tests examine the genes and variants of these genes involved in specific nutrients and their metabolism.

What can genomic testing tell you?

Genomic testing can reveal a wide range of information, from your ancestry to your health and family history. For instance, genetic testing can screen and diagnose complex diseases, find out the risk and predisposition to disease, identify hereditary disease patterns and even help in creating a course on treatment, revealing a proclivity for nutrient deficiency or toxicity, food sensitivities and even whether you're at risk for nutrition-related diseases.

In an interview with HT Lifestyle, Dr Saima Naz Khan, Senior Manager- Scientific Affairs at Genes2Me Pvt Ltd, revealed, Every individual requires a balanced diet which should comprise macronutrients (carbohydrates, proteins, fats and fibers) and micronutrients (minerals and vitamins) but no individual neither requires nor responds to the exact amount of these nutrients; therefore, theres no one-size-fits-all diet. While several factors are at play, genetics plays a crucial role in our nutrition. Genomic testing can reveal why certain nutrients or diets works for an individual and why it doesnt work for others. There are nutrigenomics services that are truly useful for anyone who wants to be proactive about their health.

She added, A nutrigenomics counsellor may be able to advise you on certain eating patterns that will or will not work well for you based on your individual genetic makeup. For example, because of genomic tendencies for fat metabolism, gene variants may indicate that your body would not benefit from a vegan diet or would not adapt well to a keto diet. A nutrigenomic test can identify your personal best sources of macronutrients and micronutrients. Choosing a diet based on your genetic tendencies can help you achieve your health objectives.

Elaborating upon the same, Dr Akansha Sahay, General Physician at Tattvan E-clinic, said, Nutrigenomics, a science that studies interaction of nutrition and genes is flourishing and changing lives. DNA test for diet and nutrition can give us information about foods that can be healthy for us and ones which can pose a risk of various health conditions. Choosing a diet based on your genetic tendencies can help you to achieve your desired health goals.

She listed the factors whose information can be provided by DNA testing:

1. Vitamin and mineral deficiencies - calcium, iron, vitamin A, vitamin B, and more.

2. Bone mineral density (BMD)

3. Body Mass Index (BMI)

4. Response of macronutrients like carbohydrates, protein, fats and fibers on your weight.

5. Salt intake and blood pressure sensitivity

What is a DNA-based diet?

Dr Akansha Sahay explained, These diets are based on nutrigenomics, the study of the relationship between nutrition and the human genome. Examining ones DNA can help determine which diet would be most appropriate for ones health. A genetic test is undertaken to determine the correlation between a persons genes and nutrition level for their overall health. This info is primarily used by experts to pinpoint the best diet for them. Nutrigenomics is a wonder by which we can even correct cardiovascular disease, obesity, type 1 diabetes and other lifestyle diseases,Your DNA can influence not only your food behaviour, but is also capable of altering the expression of various hormones and enzymes critical to metabolism. These determine your response to diet, predisposition to weight gain and metabolism.

She said, Nutrigenomics (also known as nutritional genomics) is broadly defined as the relationship between nutrients, diet and gene expression. Phenylketonuria is an example of single gene mutation. About the examples of nutrigenomics, she said, Phenylketonuria patients should avoid phenylalanine-rich food. Many Asian populations have the problem of deficiency of the aldehyde dehydrogenase enzyme, which is responsible for metabolism of ethanol.

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The investigators will look at diets impact on mobility, physical and cognitive function, as well as on pain, fatigue, sleep, mood and anxiety, in people with multiple sclerosis

Brooks Wingo, Ph.D., Photography: Andrea Mabry Brooks Wingo, Ph.D., associate professor in theDepartment of Occupational Therapy, and Amy Goss, Ph.D., assistant professor in theDepartment of Nutrition Sciences, are part of a team awarded a $3.9 million grant from the U.S. Department of Defense.

The investigators will look at diets impact on mobility, physical and cognitive function, as well as on pain, fatigue, sleep, mood and anxiety, in people with multiple sclerosis.

Wingo is the principal investigator of this four-year project that comes through the Multiple Sclerosis Research Program. It is a follow-up to a pilot trial conducted by Wingo and Goss that was the first to look at the feasibility of the dietary protocol to be used in the current trial. They will be studying a calorie restriction diet and a low glycemic load diet.

The project, titled Impact of diet quality and calorie restriction on physical function and patient-reported outcomes in multiple sclerosis, is a multisite effort that collaborates with investigators at Washington University in St. Louis, as well as scientists with UABs Marnix E. Heersink School of Medicine and School of Public Health.

The study will be conducted at two sites across the United States and will recruit 100 individuals with multiple sclerosis for a randomized controlled trial. Over the course of eight months, participants will be supplied with food via grocery delivery services following a meal plan designed by the studys registered dietitians.

For the first 16 weeks, the trial will focus on maintaining the participants weight, with participants randomized to follow either a low glycemic load or standard glycemic load diet. The second half of the study will follow the same glycemic load patterns, but all study participants will reduce their calorie intake by 500 per day.

By analyzing four distinct treatments, we are hopeful to determine if weight loss is needed to improve MS outcomes, and if improving food quality leads to separate and additional benefits, Wingo said.

Wingo and her team are embarking on a multidisciplinary approach, making the trial one of the most multifaceted and rigorous studies conducted on diet interventions in MS.

Our primary outcome is physical function, Wingo said. But we will also assess cognitive function and collect blood work and imaging to assess other changes.

A new approach, utilizing the Washington University team, uses neuroimaging to assess some of the participants neuroinflammation in response to the diet, and all trial participants will undergo a full-body MRI analysis.

Charged with overseeing the development of participants dietary protocols, Goss will use MRI analysis to assess body fat distribution and how organ lipid fat deposits or other body fat deposits are linked to poor metabolic health outcomes.

Amy Goss, Ph.D., Photography: Katherine MullenGoss explains that those with MS often have gait and balance disorders combined with losing weight, they are at a greater risk of losing muscle mass, which could worsen their mobility. The imaging analysis will allow Goss to assess whether participants selectively lose fat and maintain muscle mass with a lower glycemic load diet.

This study is unique because it is highly translatable, said Goss, who also serves as assistant director of the Metabolism Core in the UAB . We not only have the potential to change the lives of the people directly involved in the study but hopefully to improve health outcomes for all people living with MS. Our findings could possess the potential to change clinical care when it comes to multiple sclerosis.

The study is designed to maximize adherence. In addition to food supply, participants will receive weekly phone calls with a team member to go over goals and meal preparation. They will also log their meals inside a research portal, making it user-friendly on both sides of the study.

Co-investigators at UAB include John R. Rinker II, M.D., associate professor in the Marnix E. Heersink School of Medicine, who has participated in multiple studies of diet and exercise for MS and worked on the pilot trial, and Stacey Cofield, Ph.D., associate professor, Department of Biostatistics in the School of PublicHealth, and associate dean, Recruitment, Retention and Diversity,who has expertise in clinical trial design, management and analysis in MS including multisite trials and patient registry studies.

The grants are awarded to projects that the competitive review process finds innovative, high-risk, high-reward research and complement work being done at the National Institutes of Health. It is administered by the U.S. Department of Defense and funded by the U.S. Congress as part of the Congressionally Directed Medical Research Program.

The projected launch date for the program is November 2022.

Link:
UAB investigators receive $3.9 million Department of Defense grant to study interventions for those with multiple sclerosis - University of Alabama at...

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It's an all-too-common story. A patient loses weight after changing his or her diet and physical activity.

Donna Ryan

Comprehensive lifestyle intervention (behavior changes around diet and physical activity) is foundational to weight loss efforts, including perhaps the addition of drugs, devices, or surgery. These interventions have been shown to produce weight loss associated with many health benefits, and medical cost savings.

The patient is delighted, feels better, and now "knows what to do" to avoid regaining weight. But in the reduced-weight state, the patient experiences biologic and physiologic changes that can't be perceived by them, but which drive weight regain.

Thus, we usually watch the patient slowly and inexorably regain all of the lost weight. This is demoralizing to patients, who frequently blame their "resolve." Understanding the biologic defense of body fat mass is essential to understanding the weight regain phenomenon and to helping patients succeed with long-term maintenance of weight loss.

When patients are at a reduced weight, we can measure changes in hormones of the gut-brain axis that regulate food intake, and we can measure changes in subjective reports of hunger around a meal. These changes drive increased food intake in the weight reduced state. We can also measure changes in resting metabolic rate and muscle efficiency caused by weight reduction, and this reduced energy expenditure also drives weight gain.

What is going on here?

Even the very best lifestyle interventions are associated with weight regain, usually beginning after 1 year. Adding physical activity produces more weight loss than diet alone, but both diet only and diet plus exercise strategies are challenged by weight regain. In fact, across 29 long-term weight loss studies, regain of more than half of the lost weight occurred by 2 years, and 80% of lost weight was regained by 5 years.

A seminal study by Sumithran and colleagues provides insight into the biology of weight regain, describing the effect of weight loss on gut hormone responses (which drive hunger and satiety). In this study, 50 patients who were overweight or obese entered a metabolic unit and received a very-low-energy diet for 10 weeks. The mean weight loss was 14%. Then, the participants were allowed to be free-living but continued counseling was provided to support weight loss maintenance. At week 62 (1 year out of the unit), weight regain was 5% on average, with the mean weight loss down to 8% from baseline.

The investigators assessed hormonal and appetite changes in response to the reduced weight state, first at 10 weeks and then at 62 weeks.

Researchers found that levels of leptin, the hormone produced by body fat that signals satiety, changed with weight loss. The 13% weight loss at 10 weeks led to a 64% reduction in leptin levels. And even with some weight regain, when weight loss was down to 8% at 62 weeks, the leptin level was still reduced by 35%.

When leptin levels fall, energy is conserved via a reduction in resting energy expenditure the body acts as if it is in starvation mode.

For other relevant hormones, weight loss at both 13% and 8% led to significant reductions in levels of peptide YY, cholecystokinin, insulin (P <.001 for all comparisons), and amylin (P =.002). These hormones also all promote satiety. Conversely, there was an increase in levels of ghrelin (P <.001) at both points, the hormone that promotes hunger. This would drive increased food intake.

Perhaps not unexpectedly, the study found an increase in subjective appetite that increased with weight loss.

Thus, patients with weight loss have a "double whammy": They have changes both in appetite regulation and energy expenditure that favor weight regain.

There is also no doubt that the modern environment is obesogenic. Changes in food and physical activity continue to drive increased intake, decreased activity, and ultimately weight gain. Behavioral factors may also play a role, and it is safe to say that we do not understand all of the factors that drive weight regain.

There are, however, some individuals who have been successful in maintaining large weight losses (> 30 lb) over 10 years. These individuals are part of the National Weight Control Registry (NWCR), which was founded in 1993 to identify successful weight-loss maintainers and describe strategies they use to achieve and maintain weight loss.

Although some weight regain occurred over time, these individuals were able to maintain 74% of their initial weight loss at 10 years, and 88% of them had maintained a 10% weight loss at year 10.

Noteworthy is that the individuals who had larger initial weight losses at entry into the NWCR maintained larger weight losses throughout the entire follow-up period. The participants reported high levels of physical activity (approximately 2000 kcal expended per week), low calorie and fat intake, high levels of dietary restraint, and low levels of disinhibition. In addition, most participants reported weighing themselves several times a week (Klem et al; McGuire et al; Thomas et al).

Understanding the physiologic, psychosocial, and environmental determinants of individual variability is an active area of obesity research.

The best and most important strategy is to continue patient contact after weight loss.

Medications approved for chronic weight management (orlistat, phentermine-topiramate, naltrexone-bupropion, liraglutide, and semaglutide) promote weight loss maintenance if they are taken long-term. For all of the medications, studies of 3 years' duration document weight loss maintenance, as well as weight regain if the medications are discontinued.

Other important strategies include approaching maintenance differently from active weight loss. Dietary approaches and promoting physical activity, such as in the NWCR, would be useful. Other behavioral techniques such as cognitive restructuring (small weight gain is not failure and re-initiation of lifestyle measures is possible) and relapse prevention (maintaining contact with patients and not waiting until large regain has occurred to intervene) are also key.

Patients need to understand the challenges facing them, so do discuss the biological challenges that losing weight brings.

Don't let patients blame themselves. It is biology, not willpower! If you understand the biology of weight regain, you will expect patients to be challenged by regain and you can intervene early.

So first and foremost, keep the patients coming back.

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Continued here:
Why Is Long-term Weight Loss So Difficult? It's Biology, not Willpower! - Medscape

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