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It is aptly said that weight loss is 80% dieting and 20% working out. I never myself followed any fancy, strict dieting or eating pattern, but just made sure that I replaced all my foods with homemade meals, cooked food in less oil and mostly had healthier versions. During my journey, I also ensured that I did not skip any meals. On the contrary, I really enjoyed my dieting style.

My breakfast: I used to start my day with lukewarm water+ one tablespoon honey+ lemon and 3 dates.

Then, I would have a cup of lukewarm milk (without cream or sugar). If I was hungry, I would have poha/upma/daliya/moong chilla.

My lunch: I totally stopped having wheat flour chapatis and started to have jowar rotis (1 and a half), 2 bowls of daal, a big bowl of vegetable salad and whatever vegetable curry was made at home. I also stopped consuming white rice and potato consumption.

My dinner: I made sure to finish dinner by 7 p.m., no matter what schedule or appointments I had. It used to be mostly light, such as oatmeal, moong dal khichdi with plenty of vegetables in it (but did not include rice in the preparation), paneer burji or tikki (100 grams of paneer) or any legumes or idlis.

Pre-workout meal: It is the same as my morning drink.

Post-workout meal: Apple cider vinegar followed by sattu drink.

Low-calorie meals I swear by: Oats/idli/moong dal chilla/any paneer dish.

I hardly ever had any cheat meals during the journey.

Apart from this, here are a few basic diet rules that I made sure to follow:

-Stopped consumption of white sugar or any sugary drinks or ice cream

-Reduced my salt intake

-Stop having any sort of packaged or outside food

-Portion control while you eat is a must

-Drink plenty of water (3-4 litres per day)

-Complete ur last meal (dinner ) of the day by 7 pm or latest by 8 pm.

-Eat plenty of green vegetables, plenty of salads in both major meals.

-Reduce Carbohydrates and fats, increase protein intake and whole grain.

-Never keep yourself starved or skip any meal, it will only add to ur irritability, instead have some healthy eating snacks

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Weight loss story: "I gave up white rice and potatoes for 4 months to lose 20 kilos" | The Times of India - Times of India

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More feed ingredients to work with means more resiliency for the industry

Insects can provide new solutions for animal diets and many benefits, but the industry faces challenges too, according to Stephanie Collins of Dalhousie University in Nova Scotia, Canada.

Collins, faculty member of Dalhousies Department of Animal Science and Aquaculture, spoke during the Alltech ONE Virtual Experience.

Its important for us to remember that agriculture is constantly working on developing new tools, new technology in terms of animal nutrition, also new feed ingredients, and looking for different solutions with worldwide applications, Collins said. One of these new feed ingredients or classifications of new feed ingredients is insects. And, actually, within insects, there are a number of different species that we could feed. And within those species, there are different products that we can derive from them. And each one of these new feed ingredients adds to our available tools. They add to our list of resources and give us more power when we are formulating our animal diets.

Having new feed ingredients like insects helps keep the industry resilient.

The more feed ingredients we have available for our use, the more resilient we are able to be, she said.

Benefits of feeding insects to animals include that they require little land and water, can be farmed vertically and can divert post-consumer food was to develop a high-value feed ingredient. However, barriers remain.

Key barriers to use of insect products in poultry diets right now would include availability, and cost is fairly high on the list, Collins said. Additionally, a lot of these feed ingredients are novel feed ingredients. And depending on where they are produced, there is regulatory approval thats required before they can be included in animal diets.

Because many regulatory approvals require production data, there is much research being done in this area.

The chitin in insects exoskeletons is an insoluble carbohydrate that is thought to contain antimicrobial properties, as well as a bioactive component, Collins said.

The protein value is quite strong in some of these products, but additionally, if we were to include a high-chitin product that has a number of antimicrobial properties, this could be a tool that we use to influence bird health throughout the production cycle, she said.

Nutrient composition can vary between species of insect, as well as across life stages and depending upon rearing conditions. And, for each insect, form of presentation can vary, Collins said.

A full fat insect meal is quite common. However, in an animal like a laying hen perhaps, fat composition may limit inclusion of that product in the diet. So, a defatted insect meal might be something more beneficial. And from defatting an insect meal, we can end up with an oil product, which could be used as an energy source, she said.

Collins said she doesnt expect to see insect-based protein replace other protein products, but to be a good option for alternatives.

I dont see us completely replacing one plant-based protein product with an insect-based protein product, she said. But I could see people formulating diets based on cost, based on nutrients, based on additional bioactive or antimicrobial capacity, and finding a diet that works for your chickens.

Collins said growth of insect meal use in global feed production will depend on availability of insect species and feedstock for those insects.

I believe that developed countries do have an opportunity to be a prime user of insect protein, she said. And thats because we produce a fair amount of waste. And this is food waste that could be upcycled into a high-value product. And doing so, if we were to take this feed ingredient and feed it to our animals, it would be environmentally sustainable. And also could be useful in terms of health benefits for our poultry.

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Insect meal expands alternative options for poultry diets - FeedStrategy.com

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Date: 24 June 2021Time: 13:00-14:30 CESTRegister: https://who.zoom.us/webinar/register/WN_xo5EhsYGTqSKvltphGJ9ug

The World Health Organization will host the Summit for Health: For a healthy and resilient future in Small Island Developing States (SIDS) as a virtual event on 28-29 June 2021. The Summit will be an important opportunity to discuss SIDS food systems and encourage SIDS to engage in the Food Systems Summit. SIDS unique ecosystems hold rich potential to support healthy and sustainable diets thanks to their terrestrial and marine biodiversity. However, for many SIDS, the coexistence of undernutrition, micronutrient deficiencies, overweight and obesity, and diet-related noncommunicable diseases is evident at the population, community and even household level.

Young people have an important role in our food systems and can significantly act upon its success for a healthy and sustainable future. However, young people are often left out of the decision-making processes that affect them and their future, even though agriculture remains the dominant source of young peoples employment in low- and middle-income countries. Nevertheless, youth movements have a huge political impact across the globe, e.g., the school strike for climate. Food systems transformation for better planetary and peoples health needs a similar youth movement to shake up political will and hold decision makers accountable. The Act4Food Ac4Change is a global group of young people who are passionate about creating fairer, healthier and more sustainable food systems.

The year 2021 is a pivotal moment to turn this trend around as SIDS work to build forward from the wide-ranging consequences of COVID-19. The UN Food Systems Summit in September 2021, the 26th Climate Change Conference in November 2021 and the Nutrition for Growth Summits in December 2021, are critical opportunity for stepping up commitment to implement nourishing actions. Young people are the next generations powerful voice. Collective demand calling for our food systems to deliver healthy and sustainable diets should be heard in this nutrition year of action, at the mid-way point of the UN Decade of Action on Nutrition.

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Building towards healthy and sustainable food systems in Small Island Developing States: listening to voices from young people - World Health...

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Most of us don't really understand cancer: What it is, where it comes from, and how to, if not fully prevent it, or at least lower our odds of ever being told we have it. Dr. Jason Fung has written a comprehensive book, The Cancer Code, that looks at cancer in its entirety, from the earliest science surrounding the discovery and treatments of cancer, up to current-day medical researchon the latest treatments, approaches, and potential preventative measures to take against this devastating disease. On every page,he debunks what we thought we knew as "fact," including thenew understanding that cancer is within us and part of us. Whether it evershows up and causes us troubleis another story.

Spoiler alert: Cancer is not something that happens to us, due to our genetic code or toxic load, or other factors. It's a constantly playing symphony of cellular growth and suppression that iscontinuallytaking place in our bodies. It's always there, as cells grow, multiply and die, rarely expressed loudly enough to be heard. Whether cancer gets out of control, causing tumors of "liquid" cancers of the blood, is largely due to factors thatallow our bodies to control cancer and cart it safely off for disposal, or allow it to gain a foothold and grow,and eventually metastasize and find footholds in new regions of the body.

Whether we "getcancer" is in large part (but not always) a result of factors that are due to cellular changes that get "turned on" or "turned off" by behavior that is within our own control,namely: Not smoking, eating a healthy whole-fooddiet, and practicing stress coping mechanisms, including getting enough sleep, according to Dr. Fung.

"Thirty years agopeople thought that getting cancer was the result ofone of these unlucky genetic lotteries and that once you got it there was nothing you can do about it," Dr. Fung says. But there is an interplay between the pro-cancer and anti-cancer events in the body. Some things are going to make it better and some things are going to make it worse."

There are of course rare cancers, childhood cancers, and genetically triggered cancers that are unlucky events, he concedes, and those are not "made worse" by diet and behavior. But those are such rare events that to understand cancer, it makes more sense to look at the vast majority of cases, which happen by the hundreds of thousands, not the handful, each year.

Since the 1970s, when President Nixon declared a "War on Cancer," cancer rates have shot updespite the billions of dollars spent on research and treatment breakthroughs that have helped elongate survival rates. By now, scientists had predicted we would have found a cure forcancer. But even billions of dollars later, cancer is still with us, and other than adrop in lung cancer rates, due to smoking cessation trends,cancer has been on the march, with ratesrising, especially among those cancers that are related to obesity and type 2 diabetes, creating a clear link between diet and cancer risk.

The Western or American diet, heavy in meat, saturated fat, added sugar, processed ingredients, and packaged food, and lacking in nutrients, fiber and adequate intake of whole foods such as vegetables, fruit, whole grains, and nuts and seeds is one cancer culprit, Fung says. A Harvard study found that people who follow a plant-based diet have lower rates of cancer as well heart disease.

"When you look at the data of people in Africa back before they started eating a European diet, theyrarelygot cancer. And then when these populations started to westernize they started to get cancer. It's the same for Japanese women, who never got cancer in Japan, but when they moved to America and beganeating an American diet,started to get cancer." Some people add stress as a factor that bumps up the cancer rate since stress suppresses the immune system. The point is, Dr. Fung says. when it comes to risk, "there are lifestyle behaviorsthat play a role. There are lifestyle factors that impactwhether we get cancer."

There are pro-cancer and anti-cancer events in the body and the immune system is orchestrating what happens when a cell dies and needs to be carted away, or grows too rapidly and needs to be neutralized. "Anything that strengthens our immune systems is an anti-cancer factor since our immune system is our first line of defense against runaway cells," Dr. Fung explains.

Soanything that inflames our bodies, hampers our immunity, and contributes to the over-zealous growth of cells can contribute to the growth of cancer. "That includes diet, and specifically processed foods, and simply too much food, in the form of eating larger portions and more food more frequently throughout the day."

If you take an immune-suppressing drug that could wipe out your anti-cancer defenses. That's why transplant patients have such a high risk of cancer. Your immune system is affected by stress, sleep, and overall health.

For those who read this and think that genetics causes cancer, Dr. Fung says it is one part of the picture since while genetics can make someone predisposed to cancer, it does not necessarily lead to cancer, and onlyfive percent of cancers are attributable to genetics.

Cancer has grown inthe US by 84 percent from 1969 until 2014 and only took a minor dip in the intervening years due to smoking cessation trends. Once lung cancer retreated, the statistics on cancer started to look better, but other than smoking, which accounts for 35 percent of attributable risk for cancer, the second largest risk factor is obesity.

People who have type 2 diabetes and are overweight have twice the risk of cancer than those without type 2 diabetes or obesity. Dr. Fung believes that the connection is simple: Insulin is a growth hormone. It's one of several nutrient sensors that, when we eat, urge the cells to grow.

Dr. Fung points out that tobacco has beenthe biggest single contributor to cancer in our lifetime, accounting for 35 percent of the attributable risk, but right on its heels is our American diet, full of processed food and too much fat, sugar, and meat, whichaccounts for30 percent of total attributablecancer risk.

As the use of tobacco has dropped, the cancer rate for lung cancer hasfallen, but this leaves a disturbing new reality exposed: Those with thehighest riskfor cancer used to be smokers but as their numbers decline, it is clear that people who are overweight or obese, witha BMI of 30 or over, have twice the rate of some cancers than those who maintain a healthy weight. Obesity islinked to a higher risk of getting 13 types of cancer, the CDC tells us, and Dr. Fung points outthat this is not coincidental, scientifically speaking.

People with type 2 diabetes have twice as high a risk of developing certain cancers as those without type 2 diabetes, Dr. Fung, explains. He trained in internal medicine at the University of Toronto and then practiced nephrologythe study ofkidney diseases such as diabetes and cancerand his observations are backed up by scientific explanations as to why this link between diet and cancer may be happening. The simple explanation is that insulin and other nutrient sensors in the body such as mTOR, which reacts to protein, tell your cells to grow. So when you eat more than you need, your cells are instructed to grow more than is healthy.

When we eat more food in greater portions, or more often than our cells require to be fueled and energized for healthy activity,it prompts an unhealthy level of cell growth, and ultimately this shows up as a tumor or other type of cancer (blood cancers are not tumors but fluid, so to call cancer tumor is simplistic, he explains). Fungacknowledgesthat beyond our diet, there are other factors contributing to our risk of cancer, such as toxins and carcinogens as well asgenetics. But genetics accounts for only aboutfive percent of all cancers, while the other 95 percent of cancers are triggered by environmental or behavioral factors.

Dr. Fung: Nutrition and cancer are related.This is because of nutrients sensors, and how the body reacts to the food we eat. Researchers spend more time looking at cancer growth and not enough time looking at how to prevent it through behaviors we do every day, likeour diet.

Inthe past 30 years, we have found that diet plays a massive role in the occurrence of cancer, almost as much as smoking,

"The role of diet and nutrients in cancer riskcame up in research in the mid-2000s and as a result of this huge study. When the first dietary recommendations were launched in the 1970s, one of the things we thought caused cancer was vitamin deficiencies," according to Dr.Fung. "So we gave daily vitamins to people, especially kids and it didn't work."

Sleep and stress relief are both helpful in bolstering your immune system.Butunderstanding the role of nutrition and cancer is important, and rather than focusing ontaking multivitamins, I would advise that Americans change their diet instead.

People who follow a traditional American diet can increase their cancer risk by eating processed foods, too much food, or eating all the time, Dr. Fung says. While cancer is a disease that is affected by genetics, it is not just about genetics. "Clearly, more than just genetics is at play here," he says. "There is a mutation in a gene and for some women and men,that causes cancer, but that simplistic understanding of cancer is really prevalent. People want more screening, total body MRI. there is a reason these don't work.

But lots of people can get cancerand they don't have the genetic mutation. Soit's about diet and lifestyle or events and genetics together. In Japan, one-third of cancersarenot caused by diet. But when Japanese women move to the United States, theircancer risk goes way up. So the role of genetics versus lifestyle is hard to study because it manifests over a lifetime. There is a tendency to say, about cancer: It's genetic.

"Clearly, that plays a huge role. But you can't do anything about your genes, at this point. So you want to focus on what you can change, and what has been shown to have an impact on lowering your risk. So what is that? Diet.

Other than lung cancer, the rate of cancer rose almost intandem with the rate of obesity in the past 40 years, Dr. Fung writes. "Obesity rose from the '70s and '80s and in the '90s, and so did incidents of cancer. We found a big correlation between obesity and cancer."

The World Health Organization defines 14 types of cancer as obesity-related cancer, he notes. "Breast is one of the big ones and so is colorectal cancer. There is a big change in hormones when you gain weight, and that is what is driving the link between obesity and cancer."

"Intentional weight loss can reduce the risk of cancer death by 40 to 50 percent," he writes inThe Cancer Code.In Europe and North America, 20 percent of incident cancer cases are attributable to obesity, so maintaining a healthy weight is one way to lower your risk at any age.

Lots of factors drive up your risk for cancer, Dr. Fung writes, including high insulin levels, and high nutrientsensors, such as mTOR which responds when we eat protein, and AMPK, a pathway that helps us metabolize all macronutrients. "If you have a high insulin level and high nutrient receptors, then that is going to promote the growth of cancer cells" explains Dr. Fung. "High insulin diet promotes cancer. And if you have cancer then eating to prevent cancer could be enough to tip the balance in your body, and help put cancer back into remission.

Type of diet plays a big role, he says, and people have looked at plant-based diets and found those who eat less meat, dairy, and saturated fat have lower cancer rates: "When you look at vegetarian diets, as opposed to meat-centric diets, cancer risk tends to be a lot lower."

Most food that we buy is packaged (in plastic bags, cardboard boxes, or cans, and made with loads of added sugar, and preserved with chemicals to give it a long shelf life). Process foods disrupt your hormones and send signals to your cells to grow, Dr. Fung explains. Instead, eat whole foods that grow directly out of the ground, and eat less overall.

"The processing of foods is probably the number one thing that is bad for us. It's not a question of meat versus vegetables. If you're vegan you can still be eating processed foods. Donuts can be vegan. It's the ultra-processing of the foods that is the problem. You need to eat natural foods." Dr. Fung says.It's not just how much you eat but how processed your food is."

If you are eating all the time, several snacks and meals throughout the day, then you are constantly signaling the body to grow and grow and grow. And unless you're a kid, you don't want that, Dr. Fung explains. "When you eat macronutrients, especially carbs, that signals insulin, and when you eat protein, that activates another nutrient sensor called mTOR (Mechanistic Target of Rapamycin) which is essential for protein synthesis.A third nutrient sense called AMPK responds to all three macronutrients, carbs, protein, and fat, and works long term. In each case, whenyou keep feeding your body, 10 times a day, and telling the body to grow, grow and grow! then some of that would become cancerous growth," he says.

It makes sense that our cancer rates have climbed as our eating habits have changed, Dr. Fung posits. "In the 1970s, people were eating three times a day, and in the 2000s, people are eating six times a day. Breakfast, snack, lunch, snack, dinner, snack. We don't go more than two hours without eating, most days. There are snacks between halves in soccer games!" Dr. Fung advocates intermittent fasting as a way of lowering your risk of cancer.

It turns out that eating a diet high in vegetables, fruit, whole grains, nuts, seeds, and legumes (in other words natural unprocessed foods) will help shift the gut microbiome, and ultimately the fiber and nutrients in these types of foods will help to limit insulin andmTOR from driving cell growth. You will have plenty of fuel and ready energy, but without the excess that can spark problems. These whole foods (you've heard to eat the color of the rainbow for added phytochemicals and antioxidants) help boost immunity and keep your immune cells running on high alert, ready to take down any suspicious activity they find in the body.

The body cells coordinate growth and nutrient availability. When no nutrients are around, your cells don't want to grow because if they tried, they would die. But when you have an abundance of nutrient sensors and too much growth, then cancer forms, and if your immune system is suppressed or busy, then that is the link to cancer. So when you eat, excessively especially carbs and proteinand mTOR surges and your cells are going to grow excessively and you are going to grow disease.

They found a pathway in the 1960s and it turns out to be an important pathway for cancer. It's called the AMPK pathway and now they have developed drugs that disrupt these pathways but you can't completely wipe them out or your cells would get no energy. They would die.

People with type 1 diabetes, sometimes called childhood diabetes because it's genetic, take insulin. Type 2 diabetes is caused when you produce too much insulin, over time your cells become insensitive to it, which is insulin resistance. As you gain weight, diabetes gets worse and your insulin system essentially stops working properly.

"The way we have treated diabetes is the opposite of what we want to do, which is to get the insulin level low and under control through diet and weight loss," writes Dr. Fung. Instead, we give patients insulin. More insulin will bring blood sugar down which helps your blood sugar level get better but you are treating it as what is called "symptomatic disease."

So as he explains it: While it looks like you're helping to alleviate the symptoms, but actually things are not better. if you give insulin, then blood sugar will get better, but the more insulin you take,the worse it is for you and the higher your cancer risk. The blood sugar will come down but you have not done anything to help cure the disease.

The most important way to treat diabetes is to change the way you eat: Less processed food, less often, and less food. It's the same way to eat to lower your risk of cancer. And the type of food you eatis whole foods: Vegetables, legumes, fruit, nuts, seeds, and whole grains.

One of the things that are part of this idea is only eating when you're hungry and leaving time between meals, says Dr. Fung. People eat all the time but there is a lot that goes into it. If you eat simple carbs, then you are hungry shortly thereafter. "The types of foods you eatcreate different levels of satiety," so choose foods that are high in nutrients and fiber." If you are having a hungry day, he explains, it could be stress or hormones, or lack of sleep. So prioritize sleep and stress management. Clearly, other issues go along with what drives hunger.

Bottom Line: To lower the risk of cancer, eat less processed foods, eat less often and when you do eat, choose foods that are whole foods full of healthy fiber and nutrients. "You need to figure out how and when to eat so that you let your body function at its most healthy and not get the constant bombardment of nutrient sensors telling it to grow. The key is if you are not hungry then you don't need to eat. But if you are hungry then eat really good food."

Read more from the original source:
The Shocking Link Between Cancer and Diet, From a Doctor - The Beet

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While a few meal delivery services existed before the pandemic, COVID-19 has made that business model more popular. Now there are many companies competing in this space, such as Blue Apron, Freshly, HelloFresh, HungryRoot, Sunbasket and others.

Well take a look at some of the main factors to consider as you choose a service, and help you figure out which ones can best accommodate your nutritional requirements, your taste preferences and your budget.

Keith Ayoob, EdD, RD, FAND, a dietitian and Associate Clinical Professor Emeritus at Albert Einstein College of Medicine in New York, New York, suggests starting out by asking yourself an important question: What is it that you want to get out of this service?

If youre looking for a quick meal solution, you may not want to choose a service that provides recipes and a big box of ingredients. Or you may enjoy the cooking part, but hate the prep work, so youll want your ingredients pre-measured.

So, take some time to determine your goalsuch a cost, convenience, or special dietary or health requirements.

Typically, the food from these services costs less per meal than going out to a restaurant, but more than you would spend on groceries you cook on your own: The price usually breaks down to about $10 per individual meal.

Ayoob recommends determining how often you want to eat the services food. You may want to do it every night, or maybe just nights during the week when you work late, or whenever else it makes sense for you.

You also want to factor in things like shipping costs, and are you going to be home to get it, and are you going to have enough room in the fridge, and how long after you get it home are you going to start cooking with it? he added, because you dont want to waste money on food that will go bad before youre able to use it.

Some meal services deliver refrigerated or frozen complete meals, ready to heat and eat. Freshly, for example, delivers entrees that take about three minutes in the microwave. If you are usually short on time, buying full meals might be the way to go.

Other services, such as Blue Apron or Sun Basket, deliver fresh ingredients plus recipes that you use to prepare the food yourself, saving you trips to the grocery store. You can also choose a more limited delivery, such as just a box of vegetables provided by a regional or local source, once or twice a month.

If you know how to cook, its just going to be a convenience, Ayoob said.

If you do like to cook but youre bored with making the same few things, a meal service can give you more options, lead you to discover a new spice, or even introduce you to a new favorite recipe.

Its a great way to build a little repertoire of dishes that you like, Ayoob added.

If the service you choose provides ingredients and recipes, check to see how complex the meals are to prepare; some note the typical preparation and cooking time on the recipe cards.

If youre doing this for convenience and the meal takes an hour and a half, is that going to be convenient for you? Ayoob said. Pick the recipes that look like theyre fairly simple to put together, if thats the need that you have.

Neither prepared meals nor recipes are useful to you if you dont like eating the food. Browse their offerings to make sure theres enough variety to keep you interested; also find out how often new foods are added.

Consider the nutritional quality of the food, tooas a massage therapist, you need to eat a varied diet that will give you the energy to do your job well.

I would definitely recommend something thats going to have a good source of protein, said Hannah Cooper, RD, LDN, a dietitian in Houston, Texas, Thats going to help keep [you] full longer so [youre] not needing tons of snacks [or] running low on fuel during the day.

Lean proteins like chicken, fish and turkey are all good choices, she noted; she also suggests looking for food thats a good source of complex carbohydrates, such as brown rice, sweet potatoes and starchy vegetables.

Most meal services offer multiple food options for those on special diets. For example, HelloFresh has choices for vegetarians, pescatarians, and people counting calories; Freshly includes gluten- and peanut-free choices.

While not all are low-fat or low-carb, foods from meal services can work for you if you are trying to lose weight. Most provide the calories and other nutrition info on their websites so you can fit them into your overall diet. Portions are controlled, which also helps.

Somebody has already portioned it out for you, so you can be really assured that if it says its four ounces of chicken, its four ounces of chicken. And that can be a really good tool in two ways, Ayoob said. One, you know how much youre getting; secondly, visually you get a chance to have a working acquaintance with what four ounces really looks like. And if its different than what you thought it was, thats a wake-up call.

Do you want a recurring subscription plan, or a buy-as-you-go plan? If its a subscription, how often can you change your food options? What if you want to skip a week or two?

Where do the ingredients come from? Are they locally sourced? Organic?

Can you recycle the boxes and ice packs? Meals or ingredients are typically delivered in a box with several ice packs, plus some insulation. You can usually save and re-use the ice packs, but you can only use so many before you run out of freezer space. Check the companys website for details on how to recycle the packaging, if possible.

Whether you use a meal service as an occasional complement to your own cooking or as your complete source of food, the criteria here can help guide you toward the right service for youone that gives you a good value for your money, time and nutritional needs.

Allison M. Payne is an independent writer and editor based in central Florida. Her recent articles for MASSAGE Magazine include Claim Your Google My Business Page to Get Free Publicity for Your Massage Practice and The Self-Employed MTs Guide to Getting Health Insurance.

See original here:
Dinner, Coming Right Up: How to Choose the Meal Delivery Service That's Right for You - Massage Magazine

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When it comes to fitness and anything associated with the fascinating and, let's face it, at times ~bizarre~ world of wellness, Kourtney Kardashian is right up there. The reality star is known for her love of maintaining optimal health (even setting up Goop-rivalling site, Poosh), getting a sweat on and eating a nutritious diet and let's be honest, she's in great shape because of it!

However, that's not to say everything Kourt does should be taken as gospel (she once confessed to hanging upside-down for 20 minutes a day during her teen years, in an attempt to grow longer hair and let's not forget the *flat tummy shakes* era). Plus, of course there's no such thing as a 'one size fits all' approach when it comes to health. That said, it can still be interesting to learn more about how other people (celebrities included) exercise and incorporate more of the good stuff into their diets.

It's also important to stress that beauty comes in all shapes, sizes, colours and creeds - this article isn't to say WE MUST ALL LOOK LIKE KOURTNEY KARDASHIAN NAKED, but is rather just a little nosey into a celebrity's lifestyle that you can cherry pick bits from, should any of it spark your interest.

So, with that in mind, and while in search of general get-up-and-go inspiration, we set out to uncover as much as we could about how Kourtney Kardashian moves her body, the diet she follows and any cool tricks she's shared about fitness along the way...

What is Kourtney Kardashian's workout regime?

Having previously once said she'd work out every day if she could, Kourt averages around six sessions a week (however, it's important to note, that rest days are vital for recovery and avoiding injury - so depending on what those workouts involve, you could run the risk of overdoing it if you tried the same!).

While in the gym, Kourtney tends to favour HIIT workouts (High Intensity Interval Training), often led by PTs Don Brooks (AKA Don-A-Matrix) or Amanda Lee, the latter of whom told ELLE that Kourtney's workout routines are "mostly geared towards toning, lifting, tightening and fat-burning, even though that's not a main goal." She's also a fan of getting stuck into some intense treadmill workouts too, on days that she's wanting to accommodate more cardio into her routine.

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A typical HIIT circuit devised by Lee consists of plenty of jumping squats into jumping lunges, burpees, work with resistance bands, mountain climbers into push-ups and, we'd hazard a guess, a whole lot of sweat.

When training with Brooks, who devised the Matrix Method, Kourt's workouts are split into quarters (like an NFL match), with each quarter honing in on a different area of the body and focussing on two separate moves. The aim is to complete each move 20 times to finish a move 'cycle', with each 'cycle' being repeated three times to officially master the quarter. Sisters Khloe and Kim are also fans of this muscle-building approach.

Often joined by her Poosh co-founder, Sarah Howard, Kourtney is known for regularly posting about her reformer Pilates sessions sometimes saying she'll even do two sessions a day. She even has a somewhat scary-looking home machine to practice on, which no doubt makes it easier to fit them in.

Although it looks like (and can be) a challenging workout, reformer Pilates is also an excellent option for those looking to improve their posture or slowly ease their way back in to working out following an injury. It's also a brilliant way to tone up the entire body.

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As well as getting in those regular training sessions (note: pretty much always with a workout buddy for motivation), Kourtney generally keeps up an active lifestyle by taking long hikes in the Californian hills, swimming and running around in her gigantic garden after her three children.

Fans of KUWTK will know that Kourtney is often teased by her sisters for her largely gluten-free, dairy-free, sugar-free, organic diet. She's very anti-artificial produce and encourages her three children, Mason, Penelope and Reign to eat similarly (bar the odd treat). While going gluten-free when you don't have coeliac disease has become somewhat of a meme these days, Kourtney says it works for her. So who are we to judge?

On the subject of being gluten-free, Kourt admits that's a little tougher than forgoing dairy, but says she's found bakeries that make alternative chocolate cookies and cakes, so she doesn't feel totally deprived.

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Back in the pre-Poosh days where she had her own app, the mother-of-three revealed that she typically has an avocado pudding or a banana spinach shake for breakfast, and that lunch and dinner would often be crudits with hummus and a gluten-free rice tortilla with turkey meat, or one of the Kardashian's now infamous gigantic salads.

As for snacks? It's said that she sticks to fruit and veg or hunts out all-natural sweets, but during a trip to Disneyland or the cinema, she'll have popcorn or churros. "Yes, indulging every once in a while is self-care," Kourt also wrote on Poosh. "Whether you follow a strict diet or not, we all deserve days off. No guilt and no boundaries."

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In the past, Kourtney has also championed dabbling with a Ketogenic diet (which some say is helpful for those with PCOS, with weight loss and for reducing inflammation). For the reality star, however, she says Keto was recommended to her by a doctor so that she could have a 'metal detox' (who knew that was a thing?) and to feel her best before summer.

Writing on Poosh, she said, "[My doctor] tested my muscles and found that I had high levels of mercury and lead in my system... My body never looked better than when I did the Keto diet two and half years ago, when I did it for two months [and] in my experience, it's the best method to train my body to curb sugar cravings, burn fat and kick-start weight loss."

While on Keto, Kourt says she eats little to no carbs, no grains, beans, or legumes, and focuses on high fat and protein-heavy foods. A typical day for her would involve an avocado smoothie for breakfast (complete with MCT oil, bone broth powder, and blue-green algae), lunch would be a protein-based salad (e.g. turkey with mixed greens, cheese and egg whites) and dinner would be chicken or salmon, plus cauliflower or broccoli rice. Snacks would be limited to green tea, or nuts.

Kourtney KardashianInstagram

However, not everybody is a fan of the Keto diet. For insance, when speaking to Cosmopolitan previously, PT Max Bridger said he doesnt recommend it at all: "It isnt something we think is ideal for health, fat loss or muscle gain goals. Its unsustainable; its not compatible with normal life, especially when you consider things like family, friendship and professional circles, which all make it very difficult."

Bridger added, "In theory, eating this way causes the body to become more efficient at burning stored body fat and you lose weight quickly, but in reality ketosis is unachievable for many people even on a true ketogenic diet due to their genetics."

In another Poosh blog post, Kourtney said she starts her day by drinking collagen powder mixed with water (something we all know Jennifer Aniston is a big advocate of too) on an empty stomach. "Collagen helps me feel full and balances insulin levels, which can help avoid sugar crashes," says Kourtney. "It also helps my body recover more quickly from my intense workouts by supporting my bones and joints."

Vital Proteins Beauty Collagen

32.00

So there you have it - a snippet into life la Kourtney. Anyone else feeling motivated to go and beast a HIIT class now? See you soon, endorphins.

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Disadvantages of overdoing a probiotic-rich diet

1. Side Effects

A probiotic rich diet will help you keep your immune system strong. Having said that, excess probiotics, or in rare cases, probiotics may lead to increase in bloating, flatulence, headache and cause allergic reactions as well, adds Kamna Bhandari, lifestyle coach and co-founder, Intermittent Fasting & Mindful Living. To mitigate the probability of side effects, start with probiotics in small doses and slowly increase consumption over a few weeks.

2. Not for Everyone

For immunocompromised individuals, microbes, even those that are usually considered neutral or beneficial, can at times cause infections such as septicaemia, fungemia, abscesses, myo-endocarditis (infection of the heart), or pancreatitis. Probiotics may overstimulate the immune system or disrupt metabolic pathways for some people, cautions nutritionist Ryan Fernando. Avoid probiotics if you are immunocompromised, have specific gastrointestinal disorders, or are extremely ill in other ways. Pregnant women, babies, and young children should use probiotics with caution, and premature infants should never be given them.

3. Needs to be Supplemented with a Balanced Diet

While probiotics have numerous benefits, they work best with a balanced diet for all round nutrition, says Pallav Bihani, founder, Boldfit.

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SAN DIEGO, June 22, 2021 /PRNewswire/ --Petco Health and Wellness Company, Inc. (NASDAQ: WOOF), a complete partner in pet health and wellness, today announced the expansion of its curated nutrition assortment to include: WholeHearted Plus, an extension of Petco's WholeHearted private label brand; True MealsTM Dog Foodin partnership with Tyson Pet Products, Inc.; and new veterinary diet offerings.

WholeHearted Plus, which is now available at Petco, includes affordable, high-quality dog and puppy dry and wet food. The dry food contains tender protein shreds along with crunchy kibble, while the wet food includes delicious veggies and rice along with broth and meat to help support lean muscles and provide energy. Additionally, True Meals Dog Food, which can be found exclusively at Petco, features nutrient-dense, minimally processed recipes for adult dogs and puppies. The line of complete and balanced dog foods bridges the gap between kibble and fresh dog food, providing an elevated meal experience for dogs.

Petco's expanded veterinary diet solutions, which are formulated to treat a variety of common issues such as digestive problems, obesity and allergies, can help optimize pets' overall health and wellbeing. At Petco's full-service vet hospitals and vaccination clinics, licensed veterinarians can partner with pet parents to find the right diet for their pets. Petco aids pet parents in the veterinary approval process for vet diet formulas, enabling seamless prescription refills and sharing deals that help make these tailored nutrition options affordable.

Comprehensive product offerings across WholeHearted Plus, True Meals Dog Food and veterinary diets include:

Nutrition is the foundation of physical health, one of the pillars of Petco's Whole Health philosophy, an industry-leading framework created with the focus to improve pets' overall wellbeing. Petco has been committed to leading pet nutrition standards since the company became the first and only national retailer to no longer sell food and treats containing artificial colors, flavors and preservatives* for dogs and cats, and continues to reinvent the category with new, affordable and convenient options to support overall pet health and wellness. Additionally, Petco committed to the complete removal of artificial colors, preservatives and flavors from food for aquatic life and small animals, such as rabbits, guinea pigs and reptiles, by the end of 2021.

With Pals Rewards, pet parents earn 5% back every day, a free eighth bag of dry dog or cat food, a free eighth groom, a birthday gift for their pet and 35% off their first repeat delivery order with free shipping.** For more information about Petco's new nutrition offerings, visit petco.com. The company offers a variety of safe, convenient ways to shop, including in Petco pet care centers, onlineand in thePetco app, as well as via curbside pick-up, same-day delivery and repeat delivery.

*See how Petco defines artificial ingredients atPetco.com/nutritionstandards.**See Pals Rewards terms and conditions for full details.

About Petco, The Health + Wellness Co.Petco is a category-defining health and wellness company focused on improving the lives of pets, pet parents and our own Petco partners. Since our founding in 1965, we've been striving to set new standards in pet care, delivering comprehensive wellness solutions through our products and services, and creating communities that deepen the pet-pet parent bond. We operate more than 1,500 Petco locations across the U.S.,MexicoandPuerto Rico, including a growing network of more than 100 in-store veterinary hospitals, and offer a complete online resource for pet health and wellness atpetco.comand on thePetco app. In tandem withPetco Love(formerlythe Petco Foundation), an independent nonprofit organization, we work with and support thousands of local animal welfare groups across the country and, through in-store adoption events, we've helped find homes for more than 6.5 million animals.

Contact:Yvonne Tarrab[emailprotected]

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Introduction

Metabolic syndrome (MetS), obesity, and diabetes are simultaneous global epidemics.1,2 Previous studies have suggested that lifestyle interventions can effectively reduce body weight, prevent the onset of diabetes, and improve blood pressure and lipid profile.37 In Japan, the Ministry of Health, Labour and Welfare started the Specific Health Checkup and Specific Health Guidance projects in 2008 to reduce and/or treat MetS.8 The Specific Health Checkup includes annual laboratory tests, questionnaire-based health assessments, and physical examination to evaluate MetS risk. The Specific Health Guidance includes advice on energy restriction and physical activity (see Supplementary Materials) and was developed for high risk participants. As these interventions are recognized as complicated and challenging to adhere to, face-to-face individual behavioral counseling is recommended.9 Although preliminary evaluation studies have reported that the participants of the Specific Health Guidance program achieved body weight reduction (on average, 1.98 kg for men and 2.25 kg for women) and improvement in plasma glucose, blood pressure, and lipid profile;10,11 a recent large-scale evaluation revealed no association between the Specific Health Guidance and clinically meaningful weight loss or improvement of other cardiovascular risk factors.12 The Specific Health Guidance involves lifestyle interventions such as energy restriction and encouragement of physical activity, which are perceived as troublesome and difficult to maintain.13,14 This suggests that novel methods of effective implementation are needed.11,15 Therefore, we developed a novel 3-month intervention program, consisting of non-energy-restricted moderately low-carbohydrate diet education only.16 We named the diet (roughly 70130 g/day of carbohydrate intake) LOCABO, and the evaluation program the LOCABO challenge. LOCABO has a target carbohydrate content of 2040 g per meal. Furthermore, consuming confectionary amounting to 10 g of carbohydrates per day was permitted, resulting in a total carbohydrate intake goal of 70130 g/day.1618

Recently, Hyde et al compared low (45 g/day), moderate (234 g/day), and high (420 g/day) carbohydrate diets in a 4-week crossover study. In this feeding trial, a low-carbohydrate diet appeared superior to a moderate- and high-carbohydrate diet at reversing MetS.19 However, Johnston et al have reported that a ketogenic diet (<50 g/day of carbohydrates) yields no metabolic advantage over a non-ketogenic low-carbohydrate diet.20 Although the reasons for the difference between these two studies are unclear, one of these may be the difference in the study design: one was a feeding study19 and the other did not include feeding.20 In fact, Harvey et al have reported that adherence to the allocation of carbohydrate was more easily achieved in moderately low-carbohydrate diet and low-carbohydrate diet groups compared to the ketogenic diet group.21 Furthermore, Li and Heber commented that following a ketogenic diet requires the supervision of a physician and a registered dietitian.22 Given these considerations, we decided to retain the carbohydrate intake within a lower limit to prevent ketogenesis (>20 g/meal) and remain consistent with the definition of a low-carbohydrate diet (<130 g/day).23,24 The aim of this study was to evaluate the influence of the LOCABO challenge on improving the markers of MetS. To the best of our knowledge, this is the first study to evaluate the influence of moderately low-carbohydrate diet education incorporated into an intervention for MetS traits, such as overweight, dysglycemia, and dyslipidemia, in Japan. As MetS has also been known to have a bidirectional relationship with sleep apnea,25 we also evaluated sleep quality in this study.

This was a 12-week interventional cohort study. The study cohort was recruited from two companies, Hinomaru Kotsu Co. Ltd, which is one of the largest taxi companies in Tokyo, and Lawson Inc., one of the largest convenience store chains in Japan. As an interventional method similar to the Specific Health Guidance, the companies adopted the LOCABO challenge for their taxi drivers and convenience store staff. Recruitment took place twice per year, and each round enrolled 1030 participants. The upper limit on the number of participants (30) was set based on our capacity to maintain effective communication between the participants and study staff. Between spring 2016 and fall 2018, a total of six recruitment rounds took place, involving taxi drivers and convenience store staff who are shift workers and had difficulty in maintaining regular eating and exercise habits. The participating companies identified workers who were interested in the LOCABO challenge through office posters and intranet magazines. They were then included in the study based on the eligibility for the Specific Health Guidance program. To eliminate the effect of medication on the study results, subjects who took antidiabetic and anti-hyperlipidemic drugs were excluded from this study. The inclusion criteria of this study has been detailed separately and provided as Supplementary Materials. This study was approved by the Institutional Review Board of the Kitasato Institute Hospital (Approval Study No. 18049). The study was performed in accordance with the Declaration of Helsinki. All participants were informed about the risks, benefits, and aims of the LOCABO challenge and were informed that they could withdraw at any time without any consequence. To prevent pressure from employers, participants provided their consent as part of their first food intake record.

Based on the findings of our previous study, we anticipated a change in HbA1c level of 0.60.0% in participants with diabetes.16 Furthermore, we anticipated a dropout rate of 20%. Considering these factors, we required 92 participants, while ensuring that the study meets the following parameters: = 0.05, power = 0.90, and correlation = 0.40. Therefore, we decided to recruit participants over 3 years (6 enrollment rounds), from spring 2016 to fall 2018.

The LOCABO challenge began with an on-site seminar about the effectiveness, safety, and dietary pattern of the LOCABO diet. In this 60-minute seminar, we explained to the participants the burden of diabetes and MetS, showed them the results of our previous trial,16 and discussed food selection, including introducing restaurants that had LOCABO-compliant menus. Subsequently, participants were asked to record their food intake and body weight self-measurements and either email or fax these records to the study team every week for 12 weeks. The study team subsequently reviewed the participants records and responded with comments or suggestions on the same sheet, within 3 days. The participants were advised to maintain their habitual physical activity and asked not to initiate any medication for diabetes and hyperlipidemia during the 12-week study period. Details of the seminar can be found in the Supplementary Materials, and the design of the study in the Figure 1.

Figure 1 Schematic study design. Each participant provided a record of the food consumed by them and the researchers responded to them with comments and suggestions every week during the study period.

At the first and final session, we prepared a Specimen Measurement Office,26 where we measured participants hemoglobin (Hb) A1c and lipid profile (Cobas b101, Roche Diagnostics Japan, Tokyo) using fresh capillary blood. We evaluated the change in HbA1c and lipid profile (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], and triglycerides [TG]) of all the participants. We evaluated the body weight and BMI data of the 46 participants who allowed to measure their body weight at baseline and in the final session. Furthermore, in trials conducted in 2016, we introduced a home-based sleep apnea test using a sleep-monitoring machine (WatchPAT, Philips Japan, Inc., Tokyo). WatchPAT can continuously measure oxygen saturation through pulse oximetry (SpO2) and sleep stage through heart rate, and thus, is able to evaluate the apnea-hypopnea index (AHI), the lowest SpO2, and deep sleep percentage. The reliability of WatchPAT is well established.27 In this study, we did not calculate energy and macronutrients intake using food record and did not evaluate adherence to LOCABO because our education to limit carbohydrate intake was not an aim but was rather a method to improve subjects outcome.

The normality of the data was evaluated using the Skewness/Kurtosis test. Since all variables except LDL-C were not normally distributed, we compared each variable before and after intervention using the Wilcoxon signed-rank test. For each variable, statistical procedures were based on complete before and after values. We performed a subgroup analysis of the data from the participants whose variables were abnormal at baseline: HbA1c 6.0% or 5.6%, TC 200 mg/dL, LDL-C 120 mg/dL, HDL-C <40 mg/dL, TG 150 mg/dL, BMI 25 kg/m2, AHI score 5, lowest SpO2 <90%, and deep sleep percentage <13%. We performed statistical analysis using STATA version 13 (StataCorp LLC, TX, USA). The significance level for statistical tests was set at p<0.05.

We enrolled 101 participants during 20162018. No adverse event or change in medication was reported during the LOCABO challenge. The results of the whole cohort are shown in Table 1. There were no significant changes in any of the variables of interest (HbA1c, TC, LDL-C, HDL-C, and TG). However, subgroup analysis of the data from the participants whose variables were abnormal at baseline revealed significant changes in all variables of interest (Table 2). In particular, participants with HbA1c 6.0% at baseline showed a reduction in median HbA1c from 6.7% to 5.8% (z=3.958; p=0.0001).

Table 1 Measurements Before and After 12 Weeks of Following a Moderately Low-Carbohydrate Diet (Median [Quartile])

Table 2 Measurements Before and After 12 Weeks of Following a Moderately Low-Carbohydrate Diet in the Subgroup with Abnormal Results at Baseline (Median [Quartile])

The median body weight and BMI reduced from 82.5 kg and 27.3 kg/m2 to 79.7 kg and 26.9 kg/m2 (z=4.628 and z=4.645; p<0.0001), respectively (Table 1). The mean body weight change was 3.55 4.42%, with a median of 3.64% (quartile range 5.680.77%) reduction. Among the participants with a BMI 25 kg/m2 at baseline, the average body weight and BMI reductions were comparable with the reduction reported for the whole cohort (Table 2).

The 2016 sleep study involved 40 participants. Data from one participant could not be included due to problems with equipment. Thus, data from 39 participants were evaluated, revealing a significant change in the AHI score (from 24.1 to 17.1, z=2.610; p=0.0091) (Table 1). When we selected participants with abnormal values at baseline, statistical analysis also revealed a significant improvement in the deep sleep percentage (from 10.4% to 18.2%, z=2.366; p=0.018) (Table 2).

Previously, Riccardi and Rivellese proposed low-saturated fat, low-carbohydrate, and low-glycemic index diets for the dietary treatment of MetS.28 Although recent American Heart Association guidelines recommend the replacement of saturated fat,29 several studies have described that the replacement of saturated fat with carbohydrates is associated with no improvement or even an increase in cardiovascular risk.3032 Furthermore, a low-fat diet is recognized as a meaningless intervention for cardiovascular disease risk management.33 Thus, we evaluated a low-carbohydrate diet in this study. Furthermore, we did not adopt a ketogenic diet. Although Saslow et al have reported a ketogenic diet to be superior in comparison with a moderately low-carbohydrate diet,34,35 there are several reports of ketoacidosis in subjects without diabetes who follow a ketogenic diet.3639 Following a ketogenic diet requires the supervision of a physician and a registered dietitian.22 Thus, we adopted LOCABO.

In this study, LOCABO was associated with improving body composition and AHI scores. In addition, the HbA1c, lipid profile, and deep sleep percentage improved in participants with abnormal values at baseline. Importantly, for participants whose values of the aforementioned biomarkers were abnormal at baseline, the means of the post-intervention results for HbA1c, LDL-C, HDL-C, and deep sleep percentage were all within the normal range, suggesting both a significant and a clinically relevant change. According to a previous report,40 a 24% body weight reduction corresponds to a 46 mmHg reduction in systolic and diastolic blood pressure. Although this study did not measure blood pressure, it is theorized that the 3.55 4.42% body weight reduction reported in this study may correspond to a proportional blood pressure reduction. These observations suggest that LOCABO is an effective method to treat and/or prevent MetS among Japanese workers.

The reason for stagnation in MetS prevalence in Japan is thought to be low participation in the Specific Health Guidance program.810,12 In our study, although the questionnaire was not an established one and the data were not shown, 50% of the participants felt that it was easy to follow LOCABO, while 68% found it easier to follow it compared to other dietary approaches they had previously attempted. These findings suggest that LOCABO is a suitable method for improving participation in the Specific Health Guidance program.

Recently, one Iranian group reported the association of low-carbohydrate diet score with cardiovascular risk factors and sleep status.41,42 According to this group, although low-carbohydrate diet score did not show statistically significant association with cardiovascular risk factors,41 there were associations with better sleep status.42 However, since their study had a cross-sectional design, further research will be needed to validate their findings.

The strength of our study is that this is the first study to show the influence of LOCABO in improving the biomarkers of MetS in Japan. Previously, a low-carbohydrate diet has been shown to improve glycemia.43 However, few studies to date have evaluated the effect of a low-carbohydrate diet on the risk of developing MetS or diabetes.44 To the best of our knowledge, this is the first study to evaluate the influence of moderately low-carbohydrate diet education on these outcomes in Japan, as well as to report the influence of LOCABO on sleep apnea and sleepiness. Recently, Shinoda et al have reported a 73.5% prevalence of sleep apnea in Japanese individuals with a BMI of 2025 kg/m2, and an 86.5% prevalence in Japanese individuals with a BMI of 2530 kg/m2 who also had diabetes.45 In our cohort (median BMI: 27.3 kg/m2), 34 among 39 (87.1%) participants had sleep apnea (AHI score >5). Although MetS and diabetes are different conditions, their prevalence was similar in the present study.45 In the present cohort, the AHI score significantly improved (median change from 24.1 to 17.1), consistent with the improvement reported in a previous meta-analysis, where it was 6.04 in seven randomized clinical trials and 12.26 in nine before-after studies.46 To assess the changes in SpO2 and deep sleep percentage accurately, studies with larger samples are required to allow for age- and gender-stratified analysis.47

This study has some limitations. First, there was no control group; thus, we cannot exclude the possibility that factors other than LOCABO, such as counseling alone, also affected the results. Second, the sample size in the sub-analysis was small. Third, the participants had to apply to enroll in the study; this could have introduced a selection bias in the study sample because individuals who were more motivated to achieve changes in body weight, dysglycemia, and dyslipidemia, than the general population who were likely to enroll in the Specific Health Guidance program. However, 68% of participants felt that it was easier to follow LOCABO than other dietary approaches. In fact, we recently reported that LOCABO could maintain its effect on HbA1c improvement over 36 months17 and that even Michelin-star restaurants could serve moderately low-carbohydrate menus.48 These studies have shown that adherence to LOCABO may be relatively easy and that it may confer long-term health benefits. Selection bias is unlikely to have significantly affected the data, in particular, for the groups involving taxi drivers and convenience store staff. Fourth, the study duration of 12 weeks is short and we cannot rule out the seasonal change. The achievement rates of HbA1c, blood pressure, and LDL cholesterol were lowest in winter and highest in summer.49 We recruited participants in spring and fall in this study. Thus, the influence of seasonal change must be limited. Finally, our study findings might have limited generalizability. In this study, dietary education was delivered by SY, who is accustomed to delivering low-carbohydrate diet education. However, in Japan, the majority of registered dietitians are not accustomed to it. Furthermore, Sato et al reported that weight reduction achieved with a moderately low-carbohydrate diet at 6 months was not maintained at 12 months.50,51 However, other studies have shown long-term improvement as a result of a moderately low-carbohydrate diet at 2452 and 36 months.17 Furthermore, a systematic review of studies involving patients with type 2 diabetes in Japan revealed that a moderately low-carbohydrate diet was superior to an energy-restricted diet.53 Thus, it is important that registered dietitians in Japan are able to adequately provide low-carbohydrate diet education.

LOCABO could be a potential intervention method for preventing and treating MetS. Japanese companies, health insurance associations, registered dietitians, and health care providers should recognize that consumption of a moderately low-carbohydrate diet could be a potential method to improve markers of health associated with MetS. Nevertheless, to confirm the present study findings, randomized clinical trials that compare the effects of a moderately low-carbohydrate diet and an energy restriction-based diet on MetS are needed.

This study was approved by the Institutional Review Board of the Kitasato Institute Hospital (Approval Study No. 18049) and was performed in accordance with the Declaration of Helsinki. Informed consent was obtained from all participants involved in the study.

The authors thank the participants for their cooperation. The authors thank Editage for English language editing. This study received funding from the Eat, Fun, and Health Association.

SY received a lecture fee from Ely Lilly, Japan. The authors report no other conflicts of interest in this work.

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2. Scheen AJ, Van Gaal LF. Combating the dual burden: therapeutic targeting of common pathways in obesity and type 2 diabetes. Lancet Diabetes Endocrinol. 2014;2(11):911922. doi:10.1016/S2213-8587(14)70004-X

3. Knowler WC, Barrett-Connor E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393403.

4. Tuomilehto J, Lindstrom J, Ericksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344(18):13431350. doi:10.1056/NEJM200105033441801

5. Pan XR, Li GW, Hu YH, et al. Effects of diet and exercise in preventing NIDDM in people with impaired glucose tolerance. The Da Qing IGT and Diabetes Study. Diabetes Care. 1997;20(4):537544. doi:10.2337/diacare.20.4.537

6. Shai I, Schwarzfuchs D, Henkin Y, et al. Weight loss with a low-carbohydrate Mediterranean, or low-fat diet. N Engl J Med. 2008;359(3):229241. doi:10.1056/NEJMoa0708681

7. Esposito K, Maiorino MI, Petrizzo M, Bellastella G, Giugliano D. The effects of a Mediterranean diet on the need for diabetes drugs and remission of newly diagnosed type 2 diabetes: follow-up of a randomized trial. Diabetes Care. 2014;37(7):18241830. doi:10.2337/dc13-2899

8. Kohro T, Furui Y, Mitsutake N, et al. The Japanese national health screening and intervention program aimed at preventing worsening of the metabolic syndrome. Int Heart J. 2008;49(2):193203. doi:10.1536/ihj.49.193

9. Japanese Ministry of Health, Labor and Welfare. The standard program of the Specific Health Checkup and Guidance 2018 edition. P1-4. Home page of MHLW; 2018. Available from: https://www.mhlw.go.jp/file/06-Seisakujouhou-10900000-Kenkoukyoku/03.pdf. Accessed February 23, 2021. [in Japanese].

10. Tsushita K, Hosler SA, Miura K, et al. Rationale and descriptive analysis of Specific Health Guidance: the nationwide lifestyle intervention program targeting metabolic syndrome in Japan. J Atheroscler Thromb. 2018;25(4):308322. doi:10.5551/jat.42010

11. Nishizawa H, Shimomura I. Population approaches targeting metabolic syndrome focusing on Japanese trials. Nutrients. 2019;11(6):E1430. doi:10.3390/nu11061430

12. Fukuma S, Iizuka T, Ikenoue T, Tsugawa Y. Association of the National Health Guidance intervention for obesity and cardiovascular risks with health outcomes among Japanese men. JAMA Intern Med. 2020;180(12):16301637. doi:10.1001/jamainternmed.2020.4334

13. Stunkard AJ. The current status of treatment for obesity in adults. Res Publ Assoc Res Nerv Ment Dis. 1984;62:157173.

14. Lustig RH. The neuroendocrinology of childhood obesity. Pediatr Clin North Am. 2001;48(4):909930. doi:10.1016/S0031-3955(05)70348-5

15. Noguchi M, Kojima S, Sairenchi T, et al. Japan trial in high-risk individuals to accelerate their referral to physicians (J-HARP)a nurse-led, community-based prevention program of lifestyle-related disease. J Epidemiol. 2020;30(4):194199. doi:10.2188/jea.JE20180194

16. Yamada Y, Uchida J, Izumi H, et al. A non-calorie restricted low-carbohydrate diet is effective as an alternative therapy for patients with type 2 diabetes. Intern Med. 2014;53(1):1319. doi:10.2169/internalmedicine.53.0861

17. Sanada M, Kabe C, Hata H, et al. Efficacy of a moderately low carbohydrate diet in a 36-month observational study of Japanese patients with type 2 diabetes. Nutrients. 2018;10(5):E528. doi:10.3390/nu10050528

18. The Eat, Fun, and Health Association; 2021. Available from: https://locabo.net/about/. Accessed February 23, 2021. [in Japanese].

19. Hyde PN, Sapper TN, Crabtree CD, et al. Dietary carbohydrate restriction improves metabolic syndrome independent of weight loss. JCI Insight. 2019;4(12):e128308. doi:10.1172/jci.insight.128308

20. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, Sears B. Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets. Am J Clin Nutr. 2006;83(5):10551061. doi:10.1093/ajcn/83.5.1055

21. Harvey CC, Schofield GM, Zinn C, Thornley SJ, Crofts C, Marien FLR. Low-carbohydrate diets differing in carbohydrate restriction improve cardiometabolic and anthropometric markers in healthy adults: a randomized clinical trial. PeerJ. 2019;7:e6273. doi:10.7717/peerj.6273

22. Li Z, Heber D. Ketogenic diet. JAMA. 2020;323(4):386. doi:10.1001/jama.2019.18408

23. Bantle JP, Wylie-Rosett J, Albright AL, et al. Nutrition recommendations and interventions for diabetes2006: a position statement of the American Diabetes Association. Diabetes Care. 2006;29(9):21402157.

24. Accurso A, Bernstein RK, Dahlqvist A, et al. Dietary carbohydrate restriction in type 2 diabetes mellitus and metabolic syndrome: time for a critical appraisal. Nutr Metab (Lond). 2008;5:9. doi:10.1186/1743-7075-5-9

25. Borel AL. Sleep apnea and sleep habits: relationships with metabolic syndrome. Nutrients. 2019;11(11):E2628. doi:10.3390/nu11112628

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Amazons fitness wearable/platform Halo may have had a quiet start, but the company is expanding its features. Its announced Movement Health, which aims to gauge and assess your functional fitness capabilities, which includes stretching, twisting pushing, pulling and more. In short, it's concerned with the kind of everyday movement and exertions that happen outside the gym and away from your yoga mat. (The Halo will still track your workouts, though.)

As Amazon puts it, good movement health can help reduce aches and pains in areas like your neck and shoulders, which are often affected by too much desk work and otherwise staying put for too long. It's notable as it attempts to focus on the daily movement of everyone, instead of fitness exercises.

The Halo app will guide users through a movement assessment first. This includes balancing on one leg, squats, reaches and lunges. The app will record your movement through your smartphone camera and Amazons machine learning and computer vision tech will evaluate your performance. Youll get a score out of 100, plus details on stability, posture and more. The breakdown also encompasses specific body parts: your core, hips, lower body, and shoulders. The company says this initial test takes under 10 minutes. Similar movement assessing apps and tech have appeared before, but Halo's best feature might be how it tries improve how you move.

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The app will show you how to improve your weaker areas and score through a personalized program of corrective exercises. Again, these shouldnt take long between 5 and 10 minutes. While you repeat these (Amazon recommends three times a week), you can subsequently reassess your movement score every few weeks and get new exercise recommendations. The exercises are guided by Dr. Kelly Starrett, a pro athlete coach and physical therapist, who worked with Amazon on this new Halo feature.

Movement Health will roll out to the Halo app for subscribers in the next few weeks.

All products recommended by Engadget are selected by our editorial team, independent of our parent company. Some of our stories include affiliate links. If you buy something through one of these links, we may earn an affiliate commission.

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Amazon adds fitness tests and posture-improving exercises to its Halo app - Engadget

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