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By PA/TPN, in Lifestyle 02-10-2020 01:00:00 0 Comments

We're frequently told that the key to weight loss is simple - just eat less and move more. Yet with obesity rates as they are, it's clear that for many people, it's really not that simple at all.

There is, of course, another option for those who are seriously obese or overweight and conservative methods alone haven't worked - and that's weight loss surgery, also known as bariatric or metabolic surgery.

But why is surgery sometimes deemed necessary, and what does it involve? Here, metabolic surgery pioneer Professor Francesco Rubino, lead of The London Bridge Hospital Metabolic and Bariatric Centre, part of HCA Healthcare UK, and chair of bariatric and metabolic surgery at King's College London, shares his views...

Why can it be so hard for some people to lose weight and keep it off?

"Severe obesity is a disease, not a lifestyle choice. Research shows that when we lose weight by diet, our body reacts by activating mechanisms that defend against that. In fact, hunger-stimulating hormones typically increase after diet-induced weight loss and our body also tends to reduce the amount of energy it utilises, making it difficult to maintain weight loss in the long-term," says Rubino.

"These effects are not under control of our willpower and are ingrained in our biology. This explains why people who try diets almost invariably regain weight at some point. This isn't necessarily a lack of self-discipline, or a person's fault, as most people think, but the result of the way our biology works, defending a set, narrow range for body weight. In people with severe obesity, this set point is too high but the mechanisms that normally defend against weight loss are still working and powerful, thus frustrating voluntary efforts to lose weight by eating less and exercising more."

What is weight loss surgery?

There are different variations of weight loss surgery. The two most common are gastric bypass surgery, which divides the stomach into two smaller pouches and re-routes the small intestine, and sleeve gastrectomy surgery, a procedure that removes part of the stomach and shapes it as a tube or 'sleeve'.

"They were originally designed to reduce the size of the stomach but they actually change the physiologic mechanisms that regulate appetite, satiety and sugar metabolism," Rubino explains. "There isn't a single procedure that fits everyone's needs. Different procedures have different actions, which may result in different potential to improve metabolic conditions associated with obesity, beyond weight loss," he adds. "Hence, the choice of procedure needs to be thoroughly discussed with a specialist and must be tailored to the individual patient's need."

Why is weight loss surgery so effective?

"In the 1950s, when bariatric surgery was first introduced, understanding of the functions of the gastrointestinal (GI) tract was quite rudimental - it was considered a mere digestive organ. So it made logical sense to think that by physically limiting the size of the stomach, or bypassing large portions of the intestine, one would be able to reduce the amount of food you can eat or the calories the body can absorb. Research over the last two decades, however, has shown this isn't true," Rubino explains.

"The GI tract is a complex, sophisticated endocrine and metabolic organ, something akin to a computer - some call it the 'second brain' - that receives input from the food we eat and sends signals to other organs to regulate body weight as well as sugar metabolism. Signals from the gut can inform the brain about calorie intake and accordingly regulate hunger and satiety. Other signals reach the liver and pancreas, where they can influence the production or action of insulin.

"This explains why gastrointestinal - bariatric/metabolic - surgery is so effective in inducing and maintaining weight loss, and also why it can dramatically improve other metabolic diseases, especially type 2 diabetes. Research has clearly shown bariatric surgery reduces or abolishes the very mechanisms that normally resist weight loss. In fact, the changes in hunger and satiety hormones that follow bariatric surgery are exactly opposite to those elicited by dietary interventions."

Is metabolic surgery really just a lazy way of losing weight?

"Some argue that diet and exercise, rather than expensive surgery, should be used to treat diabetes or severe obesity. This idea is both ill-conceived and ill-informed. In fact, there's definitive evidence that where surgery is indicated by current guidelines, lifestyle interventions alone are no longer sufficient to achieve adequate disease control," says Rubino. "On the other hand, in people with mere overweight or mild, uncomplicated obesity (BMI under 35 without other metabolic disease), surgery isn't indicated and isn't a replacement for a healthy lifestyle, which can still be effective in preventing progression towards more severe obesity.

"Hence, suggesting lifestyle interventions and not surgery should be the way to treat severe obesity is at odds with both scientific evidence and logic. Suggesting use of only lifestyle interventions in people with severe obesity (a full-blown disease) is tantamount to suggesting one should use lifestyle changes instead of surgery or chemotherapy to treat cancer."

Who can have the surgery?

There's a range of criteria for having weight loss surgery on the NHS. These include having a BMI of over 40, or having a BMI of 35-40 if you've already developed health complications that may improve with weight loss. Patients will need to be committed to long-term healthy changes after the surgery too.

"Recent clinical trials have shown that in patients with type 2 diabetes and obesity, metabolic surgery is more effective than any other available therapy," says Rubino. "Currently, the National Institute for Health and Care Excellence (NICE) and international guidelines recommend metabolic surgery be considered to treat type 2 diabetes patients and those with a BMI of 30 or over. However, only 0.2% or less of eligible patients have access to such surgery."

Who shouldn't have the surgery?

A number of factors can deem people unsuitable for surgery too, including: "People who don't suffer from severe obesity or its complications. Bariatric surgery is generally safe but this doesn't mean it's an appropriate or proportionate approach to deal with less severe overweight levels, where lifestyle changes have been shown to prevent progression toward severe obesity or diabetes in many patients," says Rubino.

"Also, people who are candidates for surgery but would be unsafe to operate on. Though bariatric surgery is less life-threatening than obesity or diabetes, it's still major surgery and requires general anaesthesia," he adds. "And people with conditions that can undermine compliance with nutritional supplementation. Bariatric surgery can alter the absorption of certain vitamins and micronutrients, s o patients need to rigorously take nutrient supplements, lifelong."

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When is it time for weight loss surgery? - The Portugal News

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The best way to eat now is under much debate, as keto dieters line up against plant-based eaters, the low-fat camp has their studies to wave at the low-carb believers. So, we turned to Dr. Andrew Freeman, a well-respected cardiologist, for his expert advice on how to eat to be heart-healthy, avoid cancer, lose weight, and feel great. Dr. Freeman, who is in the Division of Cardiology andDepartment of Medicine at the National Jewish Health in Denver, says you have to try to eat the way our ancestors did: Mostly plant-based, avoiding processed foods and eat as manynatural foods as possible. "They were hunter-gatherers, but mostly gatherers," Freeman explains.

When it comes to whether to try to follow a ketogenic diet and avoid carbs, his view is: "Avoid Carbage, which is the carbs that are garbage," or highly processed foods like white bread, white rice, packaged foods, and added sugar. When it comes to trying to lose weight and be healthy, he adds, rather than cut out an entire food group like carbs, take what he calls the Goldilocks approach: Not too many carbs and not too few, but just the right amount, and focus on legumes, whole grains, vegetables, and fruit, especially the kind you could pick.

First, it's important to analyze your lifestyle and dietary habits and cut out the processed food, the sodas, or the chips, packaged snacks, or sugary sweets. I would advise someone to look at the easy fixes first. When people realize they are consuming 1,000 calories a day in soda, that's an easy one to cut out. I would encouragesomeone who wants to be heart-healthy to go as plant-based as possible. If you think about how our ancestors ate: Back then you ate what you found and it was mostly plant-based foods.

I would not say the modern ketogenic diet is terrible, but for most people, the implementation of keto is hardly healthful. It usually involves a lot of processed meat, like bacon. Plus, eliminating foods that we know are beneficial like vegetables and fruitsbecause they have carbohydratesturns out not to behealthyeither.

We know that processed meatcontains carcinogens, and you want to stay away from carcinogens since they cause cancer. When it comes to keto dieting I have nothing against it specifically, but it's the way most people do it that does not make sense to me. They wrap scallops in bacon and eat lots of processed meat. They lose weight but eventually, their cholesterol goes up. We don't know enough about the ketogenic diet, long term, to say it is unhealthy in itself. But the foods that people eat on it have been studied, and there is plenty of research that shows processed meat leads to heart disease and a higher risk of cancer.

There are some people who don't do well with keto. Some end up with digestive issues. So while we don't have enough data to say keto itself is the problem, it's well known that a diet high in meat and dairy leads to diseases like heart disease and cancer. So it's great to be skinny but it's not great to be skinny and get cancer.

The data we have from some years ago shows that a lower carbohydrate diet is worse for you in terms of health outcomes. I tell people: Don't go too low in carbs, since it appears to be unhealthy to eat all thatfat and protein. Take the Goldilocks approach to carbs, which is not too little... Not too much. Just the right amount. And make sure those carbs come from whole grains, from vegetables, fruit, and from legumes.

There are enormous health benefits from eating legumes, like lentils, beans, and pulses. The end of the day human physiologybenefits from these types of natural foods, and we arerapidly moving toward recommending a diet that is plant-rich and low in processed food. I would also recommend that for weight loss, add bouts of intermittent fasting. That's how humans lived. Long ago,theyhad to survive in the natural world, and they ate things they could find in nature or they grew them. It turns out that beans are some of the healthiest foods you could eat, especially lentils. These are high in fiber, fill you up, and have plenty of protein.

Our ancestors lived the way we are supposed to live: from the food you could gather. The natural way to eat is plant-based, with a little intermittent fasting thrown in. It turns out this is how our ancestors ate and it works. They had to be hunter-gatherers but they were much more likely to be gatherers. If they did get a piece of meat it was a rarity and a small amount.

If you combine a mostly plant-based diet with intermittent fasting, you will be healthy and maintain a healthy weight. That's how I eat (though I don't quite do intermittent fasting). I'm up early and cranking all day but if I had a less demanding lifestyleI would do that every day. And I do make it a point to exercise and try to be mindful. But back to our ancestors: Back then, you ate what you found.

You need to get exercise every day. Think about this: We know that all-natural food looked different way back then. Try picking organic strawberriesthey are tiny nothings. So we spent a lot of time and effort picking fruit. Things didn't look like they do today in the store. The natural food was smaller and had more nutrients. But it took energy to pick those berries and get enough calories to survive. So when you look at our ancestors they were using a lot of energy to get their food. Not like today when you walk into a store and it's all laid out for you.

When you look at the healthiest people in the Blue Zones [Dan Buettner's book about longevity patterns and what people who live long healthy lives have in common] they all are physically active, have strong social networks, enjoy quality sleep. If you look at their diet, the one commonality is that they don't drink too much alcohol and they eat mostly plants.

Read this article:
The Healthiest Way to Eat to Prevent Disease, Says a Cardiologist - The Beet

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As you get older, you need to work out and stay active and healthy as best as possible.

The most obvious reason would be to prioritize our health. Health is undeniably wealththats not up for debate.

But have you ever wondered what staying active does to our bodies and mind as we grow older? Very few people think long term when it comes to our bodies.

The fact is that weight training as we get older not only builds strength and muscle, but also builds motivation, confidence, improved blood flow, improved cardiorespiratory endurance, brain function, mobility and so much more. Cardio is also still important and should be continued for its health benefits. Interval training, which involves high intensity cardio with easier periods create the after-burner effect, pumps up the fat burn.

Ask yourself this: Wouldnt it be nice to look better and feel better? Or even walk up two flights of stairs without panting for breath? Or dramatically reduce the chances of lifestyle diseases, such as various cancers, obesity, blood clots, and fragile bones?

Its actually very straightforward, but its your choice whether you ignore healthy benefits by sitting on the chair watching Netflix or spend an hour a day improving your health and strength now and in the long term.

Theres is something uniquely beautiful and inspiring about a person who grows from their struggles and uses the lessons they learn in life to spread wisdom. To me it doesnt matter what you went through or how far you fell, but about you being an example that shows the outside world that its possible to rise, win and succeed regardless of your age.

Health is wealth folks, dont take it for granted. If you feel lost in the jungle of weight loss and finding a sustainable lifestyle, then do some research and choose a routine suited for your lifestyle.

Stop being afraid of what could go wrong. The truth is that most of the things you worry about, dont happen. And of the few things that do happen, the majority of people they happen to discover they could handle them better than they would have imagined possible. This means that much of what we worry about is just our fearful mind punishing us with misconception. If we worry less and do more, everything will turn out just fine. And if it doesnt, you just learnt a valuable lesson.

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Staying active is a long term investment - Stabroek News

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According to the findings of a new study, controlling blood sugar levels improved the ability to clearly think, learn and remember among people with type 2 diabetes who were overweight. But losing weight, especially for people who were obese, and increasing physical activity produced mixed results.

"It's important to properly control your blood sugar to avoid the bad brain effects of your diabetes," said Owen Carmichael, Ph.D., Professor and Director, Biomedical Imaging at Pennington Biomedical Research Center."Don't think you can simply let yourself get all the way to the obese range, lose some of the weight, and everything in the brain is fine. The brain might have already turned a corner that it can't turn back from," added Carmichael. The new paper examined close to 1,100 participants in the Look AHEAD (Action for Health In Diabetes) study. One group of participants was invited to three sessions each year that focused on diet, physical activity, and social support.

The other group changed their diet and physical activity through a program designed to help them lose more than 7 per cent of their body weight in a year and maintain that weight loss. Cognitive tests - tests of thinking, learning, and remembering - were given to participants between 8 to 13 years after they started the study. The research team theorised that people with greater improvements in blood sugar levels, physical activity and weight loss would have better cognitive test scores.

This hypothesis proved partially true. Reducing your blood sugar levels did improve test scores. But losing more weight and exercising more did not always raise cognitive test scores."Every little improvement in blood sugar control was associated with a little better cognition," Dr Carmichael said. "Lowering your blood sugar from the diabetes range to prediabetes helped as much as dropping from prediabetes levels to the healthy range." More weight loss was either better or worse depending on the mental skill involved, Dr Carmichael said. People who lost more weight improved their executive function skills: short-term memory, planning, impulse control, attention, and the ability to switch between tasks. But their verbal learning and overall memory declined.

"The results were worse for people who had obesity at the beginning of the study. That's a 'too little, too late' type of message," he said. "People with diabetes who let their obesity go too far, for too long may be past the point of no return, cognition-wise." Increasing physical activity also generated more benefits for people who had overweight compared to those with obesity, the study shows.

Finding a way to offset the health effects of type 2 diabetes is vital. More than 25 per cent of U.S. adults 65 or older have type 2 diabetes. The disease doubles the risk of cognitive impairment and dementia, including Alzheimer's disease, and greatly increases health care needs and costs. (ANI)

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Study reveals enhancing blood sugar control boosts brain health for people with type 2 diabetes - Devdiscourse

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Nursing homes and long term care facilities have just received updates on visitation guidance. Many of these facilities are on lockdown and two are currently undergoing outbreaks.

The Iowa Department of Public Health (IDPH) and the Iowa Department of Inspections and Appeals (DIA) are updating guidance for long-term care facilities to comply with new requirements from the Centers for Medicare and Medicaid Services (CMS). This updated guidance aligns with federal regulations to balance resident and staff safety with quality of life.

This guidance allows flexibility and additional clarity around allowable indoor visitation, allows increased access to important quality of life services such as access to barbers and beauticians, and it further expands the definition of compassionate care visits. The term does not exclusively refer to end-of-life situations. Examples of other types of compassionate care situations include:

The updated guidance provides reasonable ways a nursing home can safely facilitate in-person visitation to address the psychosocial needs of residents. Physical separation from family and other loved ones has taken a physical and emotional toll on residents. Residents may feel socially isolated, leading to increased risk for depression, anxiety, and other expressions of distress. Residents living with cognitive impairment or other disabilities may find visitor restrictions and other ongoing changes related to COVID-19 confusing or upsetting.

Nursing home residents derive value from the physical, emotional, and spiritual support they receive through visitation from family and friends. In light of this, CMS revised their guidance regarding visitation in nursing homes during the COVID-19 public health emergency. Visitation may occur through different means based on a facilitys structure and residents needs, such as in resident rooms, dedicated visitation spaces and outdoors.

Except for ongoing use of virtual visits, facilities may still restrict visitation due to the COVID-19 county positivity rate, the facilitys COVID-19 status, a residents COVID-19 status, visitor symptoms, lack of adherence to proper infection control practices, or other relevant factors related to the COVID-19 public health emergency. However, facilities may not restrict visitation without a reasonable clinical or safety cause, consistent with federal regulations.

The new guidance is specifically targeted at long-term care facilities (e.g., nursing homes). Other facilities or congregate care settings, such as assisted living or residential care facilities, may choose to follow an independently developed framework for easing restrictions. Guidance from the Centers for Disease Control (CDC) regarding COVID-19 mitigation strategies for assisted living congregate settings can be found online:

The State has and will continue to collaborate with federal partners, long-term care associations, and stakeholders on how to responsibly ease restrictions in long-term care facilities while COVID-19 remains a concern in communities across the state.

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New Visitation Guidance Given to Area Long Term Care Facilities - KIOW

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Cloe Poisson :: CTMirror.org

Health care workers at Golden Hill Rehab Pavilion in Milford react with heart hands to a group of Democratic State Senators and State Representatives who visited the facility in May.

Health experts around the world recognized early in the COVID-19 pandemic that older people were most at risk of becoming seriously ill and dying from the new coronavirus.

But despite those early findings, thousands of Connecticut residents in long-term care facilities have died.

A final state-commissioned report released Thursday concluded that many early efforts focusing on coordination and resources for hospitals hampered Connecticuts preparedness and response to the COVID-19 outbreak in long-term care facilities.

Long-term care facilities were not recognized as critical health care assets in the states emergency preparedness plans, nor were long-term care facilities representatives at the table at the beginning of the outbreak, wrote the authors of the 157-page analysis.

Mathematica, a third-party policy research consulting company, was commissioned by Gov. Ned Lamonts administration for $450,000 to provide an assessment of the states pandemic response and improvement strategies, especially when it comes to protecting older residents.

About 72% of the states 4,432 total deaths from COVID-19 as of July 30 were people in nursing homes and assisted living facilities.

Mathematica delivered an interim report in August with some preliminary findings and recommendations.

During a daily media briefing Thursday, Lamont said that the final report contained nothing that surprising and noted that Connecticuts COVID-19 infection and fatality rates were similar to those of neighboring states New York, Massachusetts and Rhode Island.

Lamont said the pandemics spread in places like Italy earlier this year informed the decision to ramp up hospital capacity.

But I dont think that was at the expense of the nursing homes. I mean, very early on we were one of the first to say no visitations, just given the nature of the spread, he said. We were one of the very first to have COVID-only facilities. First wings, and then facilities themselves just to make sure those with infections were segregated from the rest of the community.

Deidre Gifford, acting commissioner for the state Department of Public Health, said the state was learning a lot at the beginning of the pandemic.

And so we took steps as we learned that they needed to be taken, she said. As we learned about the nature of the infectivity and the spread and where it was happening, we took those steps.

Report authors also concluded that long-term care facilities, with a lack of knowledge about how the virus spread, did not take prompt and immediate action to limit entry to their buildings, enforce staff screening measures, and implement universal mask wearing early on.

Facilities also lacked personal protective equipment, or PPE, some failed to make equipment accessible to staff, and family members reported problems with getting information about their loved ones.

The state granted long-term care providers immunity from liability during the pandemic, which removed a critical mechanism for holding facilities accountable for negligence, authors wrote.

Nursing homes in communities with widespread COVID-19 transmission among the general population had more cases and deaths, according to the report. Facilities with residents who left the building for medical care like dialysis or cancer treatment also had more cases and deaths.

One key finding of the report was that restrictions on visitors at nursing homes and assisted living facilities had adverse effects on residents. As of mid-April, about 53% of residents reported symptoms of depression, which only began to decline in May when the state allowed outdoor visits to take place.

Rates of unplanned weight loss among older residents nearly doubled after the peak of the COVID-19 outbreak, according to the report.

Mairead Painter, the states long-term care ombudsman, said the report highlights the concerns for the well-being of elderly residents.

We know that COVID-19 has increased risks associated with long-term care settings where residents were required to be isolated from loved ones and peers, she said. For months, advocates have been saying that this isolation has had unintended consequences beyond the risk of infection, and we need to better understand the full picture.

Gifford and DPH recently relaxed visitor restrictions at nursing homes and assisted living facilities to again allow in-person, indoor visits as long as certain conditions are met.

Painter hopes that issues of weight loss and depression are monitored more closely going forward.

We know that many precautions will remain in place for months to come. Due to these necessary precautions, individual nursing homes need to have appropriate staffing levels to meet the residents individualized needs, including social, emotional, she said.

The report includes short- and long-term recommendations both for the state and for the long-term care industry. They include:

Gifford said the state has already completed or is in the process of completing nearly all of the recommended actions outlined in the report. A new DPH order will require nursing homes to have a 30-day supply of PPE on hand by Oct. 16, and Gifford said state inspectors will check.

Matt Barrett, president and CEO the Connecticut Association of Health Care Facilities/Connecticut Center for Assisted Living, and Mag Morelli, president of LeadingAge Connecticut, said in a joint statement that the Mathematica report is well-timed given that facilities are adopting new visitation guidance and enhancing prevention actions.

Connecticut nursing homes are already implementing internal reviews, conducting surveillance testing of staff, magnifying efforts to double down on infection prevention and control practices, and participating in new training modules provided by the federal government, they wrote.

The organization leaders warned that until a vaccine is approved and distributed, the pandemic will continue to affect communities and long-term care facilities.

That became evident recently when a third nursing home in Greater Norwich reported an outbreak involving more than half its population, with 56 new cases among residents and staff.

The Connecticut Mirror reports that the outbreak at Harrington Court Nursing Home in Colchester comes on the heels of recent outbreaks at managed care facilities in Groton and Norwich all within the past two months.

Connecticut Publics Patrick Skahill contributed to this report.

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Report: In early stages of COVID-19, nursing homes overlooked as state focused on hospitals - The CT Mirror

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You may have heard the saying, If all you have is a hammer, everything looks like a nail. As a nutritionist I will admit that I am a bit of a hammer. If someone asks, How do I get more energy? I will likely respond, Eat clean and stay hydrated. What about having better brain function?someone asks. Watch those blood sugar highs and low might likely be my response.

Keep tabs on your blood pressure, cholesterol and blood sugar could be the difference in overcoming a COVID19 infection.

But what about this COVID -19 epidemic, could nutrition play a role in its outcome? Would it make a difference if we were equally focussed on our diet and immune system as much as preventing contracting the virus with social distancing, hygiene, and masks?

Statistics

Thailands mortality rate from COVID-19 stands at one of the lowest in the world at 1.7% (global average was estimated at around 6%). However, among the deceased 41% had diabetes, 36% had high blood pressure, 18% had hyperlipidemia, and 14% had heart diseases.

When divided by age group, those who are over 70 had the highest mortality rate at 12.1%, followed by those aged 50-59 (4%) and 60-69 (3.7%), while the group with the lowest risk is 20-29 years old at 0.2%.

Among the deceased, 41% had diabetes, 36% had high blood pressure, 18% had hyperlipidemia, 14% had heart diseases.

The CDC also recently released statistics that 94% of those who died had more than one underlying medical condition. When this figure is connected with the statistic that those people over 70 have the highest rates of mortality it stands out that health is a key player in COVID Mortality for those under 70 years of age.

COVID-19 and metabolic syndrome

So I was thrilled to read a recent editorial from Dr Maryanne Demasi in the British Medical Journal titled; COVID-19 and metabolic syndrome: could diet be the key?

Dr Demasi starts by sharing the now-familiar statistics of the vast majority of people hospitalised and dying from COVID-19 as having pre-existing conditions including:

These conditions make up what is known as metabolic syndrome, and include high blood pressure, low good cholesterol, high blood sugar, high waist circumference.

Perhaps this may help to explain Thailands lower rate of mortality as Thailand has about half the Metabolic Syndrome cases of the US and UK about 16% compared to the US and UK with over 32%.

What causes Metabolic Syndrome

Dr Demasi goes on to say metabolic syndrome is related to insulin resistance. The most significant factor that determines blood glucose levels is the consumption of carbohydrates, refined carbs, starches and simple sugars.

She believes one of the problems facing people now is that people who are confined to nursing homes, hospitals and self-isolating are stockpiling non-perishable staple foods which are generally high carbohydrate like pasta, bread, rice and cereals and increasing their mortality risk.

Are you at risk of Metabolic Syndrome?

I highly recommend every year people doing an annual health check-up and getting your labs done. We are blessed when it comes to medical tourism in Phuket. With International Hospitals offering health checks along with many walk-in clinics. Here are some of the tests related to metabolic syndrome:

Fasting Blood Sugar, HBA1c (long term blood sugar), Full lipid (Cholesterol markers), Fasting Insulin along with getting your waist circumference measured (men should be under 90cm, women under 85cm) and blood pressure taken.

What do you do if these markers are high?

Naturally, talk to your doctor about solutions but here are 3 strategies to help using diet (regular exercise and good sleep naturally also help):

The key to long-term health success comes from firstly ownership of your health, so I highly recommend to get your labs done. If the results are not in your favour then make it very clear why health is important. Then comes the plan. Find the strategies that will work long term and become healthy habits. Finally, you need to make yourself accountable to follow through maybe also share your goals with a friend, partner or coach and make those strategies become life-long habits. Good health to you!

Craig Burton (BSc, NASM, CISSN) is a practicing Clinical and Sports Nutritionist with over 20 years experience as a health practitioner. He holds an array of qualifications in nutrition, as well as in health, fitness, mental and lifestyle coaching. To find out more about Craig or contact him go to http://www.craigburtoncoaching.com

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Healthy Habits: COVID-19 and Metabolic Syndrome, could diet help? - The Phuket News

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With the US president, Donald Trump, testing positive for coronavirus, speculation has begun regarding possible outcomes. The reality is, its impossible to say for certain what will happen to an individual once theyve contracted COVID. Some people may have no symptoms at all, while others may have far worse outcomes. Its one of the many mysteries of the virus that scientists worldwide are working around the clock to untangle.

When it comes to risk, there are some things we do know, but many that remain uncertain. There are also some things we can change and some that were stuck with. Its now common knowledge that age is the most important factor driving the risk of worse outcomes from COVID. Being male, living with obesity, being from a non-white ethnic group and having long-term conditions such as diabetes and heart disease also increase risk.

The increased risk with age is striking people 80 and older are estimated to be 70 times more likely to die than those under 40. In the UK, being aged 70 or older classes people as clinically vulnerable, or moderately at risk. In the USA, eight out of every ten deaths attributed to COVID have been of people 65 and older.

By contrast, obesity is estimated to increase risk of death from COVID by almost 50%, and type 2 diabetes is estimated to double the risk.

These are only the headline factors different medications may affect risk, as may a host of other factors which will vary from person to person and include things such as viral load, meaning how much of the virus a person is exposed to in the first place.

Linked to many of these risk factors is also the key, but complex, issue of socioeconomic status with people from less advantaged groups suffering a disproportionate burden of COVID disease and death.

Some of the above risk factors are non-modifiable, which means, essentially, were stuck with them. You cant change how old you are. The good news, however, is that action can be taken to address some of the others. Raised body weight, for example, is driven by a complex system of socioeconomic, commercial, environmental and genetic factors, but governments can roll out policies to help address some of these. There are also evidence-based methods available to support healthy weight loss.

When covering Trumps risk factors, one is less spoken of but weighs heavily in his favour his socioeconomic status. People from less-advantaged groups are at greater risk from COVID.

If one teases this out, the health benefits of higher socioeconomic status turn out to be down to a number of factors, including a lower risk of contracting the disease in the first place (often linked to socioeconomic factors such as occupation or where you live). Other factors at play include the presence and treatment of underlying health conditions, the relative risk of exposure to air pollution and other environmental threats to health and, crucially, access to healthcare.

For people with the most severe forms of COVID, treatment with the drug dexamethasone can reduce risk of death by up to one-third. Socioeconomic status is one of the factors determining who gets the best treatment for COVID, particularly in countries where there is no universal healthcare including the US.

When the UKs prime minister, Boris Johnson, contracted COVID this year, it was described as a wake-up call, particularly in regards to obesity. The prime minister himself has raised body weight as an issue, and attributes his severe infection to that risk factor.

It remains to be seen how Trump reacts, both physically and politically, to his own infection. There is no doubt that, due to his position, he will be receiving every aspect of healthcare he could wish for. By contrast, millions of Americans cannot access basic care, including access to essential medications such as insulin for type 1 diabetes (Trump recently asserted insulin is priced as cheaply as water, which unfortunately is far from true), let alone intensive care during the acute phase of a pandemic.

While the press focuses on the risk factors that may put Trump at greater risk of severe infection, we should not forget those modifiable and strikingly inequitably distributed factors which work in his favour. Focus should be not only on treating the virus, but on mending the broken system that has allowed it to claim the lives of 207,000 Americans and counting.

Read more here:
Donald Trump has been diagnosed with COVID let's talk risk factors - The Conversation UK

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Gaps in Care Solutions, My Care Checklist and Claims Analytics and Insightsnow provide employers and health plans an integrated end-to-end solution to close care gaps.

Latest innovations integrate human-centered design with AI and business strategy to deliver health and wellbeing solutions that meet users where they are today while generating actionable insights that drive sustainable health outcomes

PROVIDENCE, R.I., Oct. 02, 2020 (GLOBE NEWSWIRE) -- Virgin Pulse, the leading global provider of corporate health and wellbeing solutions, today delivered its highly anticipated Winter 20 launch, the latest and most significant innovation expansion in the companys history. Available immediately, Winter20is focused onunifying and simplifyinga usershealth journey by integrating health, wellbeing, safety, benefits navigation and care guidance into a seamless, intelligently orchestrated user experience. Expandingthe companys Homebase for Health vision,Winter 20 empowersorganizations and health planstoreduce healthcare costs and benefits confusion by directing users to the care they need, when they need it.

Unveiled 18 months ago as the companys long-term vision,Homebase for Healthaimsto drive user engagement with a goal of accelerating populationhealth outcomes by reducing the friction and complexity inherent intodaysfragmentedbenefits ecosystems. This complexity is preventing employees, employers, health plans and membersfrom understanding, utilizing and maximizing their health and wellbeing benefits - and costing organizations billions of dollars each year in medical costs, lost productivity and increased turnover.

While health plans and employers are continually working tooptimizetheir benefitsprogramsand deliver personalized health and wellbeing, individuals are challenged to stay apprised ofthebenefits and wellness offerings available to them. Manylack informationand guidanceonhow to use them.Proactively directing them tohigh-valuebenefits- especially those focused on providingphysical, mental and emotional support-hasbecome atoppriorityfor organizationsand health plansduring the pandemic.And, as COVID-19 continues, organizations are looking to extend their wellbeing programs and initiatives to address more urgent health issues, specifically chronic disease conditions.

Empowering health plans and employers to take care of their members and employees, respectively, especially now, is our top priority.Prior to COVID, more than 60% of Americans had at least one chronic condition. That number has increased significantly in the past several months and we are seeing firsthand COVIDs devastating impact on those with chronic conditions like diabetes,said DaveOsborne, CEO of Virgin Pulse. At-risk populations need access to resources and benefits to help them mitigate and reverse chronic conditions, but those benefits quickly become expensive shelf-ware and their potential for driving positive outcomes goes unrealized if theyarentdelivered in a personalized, well-orchestrated and easily consumable way.A Homebase for HealthTM approach allows organizations to reap the benefits of healthier, happier employees and members, increased productivity and prospects of bending the long-term healthcare cost curve.

User Experience Key to Engagement and Outcomes Health plan members and employees today expecttheir health and wellbeing apps to reflectthe same seamless, personalized experiencespopular consumer technology brands likeApple,Amazon, Uber and Peloton. Like these and many other consumer app experiences, Winter 20 and Homebase for Health are heavily rooted inthe concept of design-thinking, a human-centered, iterative process that focuses on empathy, engagement and motivation.

Solving the complex health and wellbeing challenges organizations and users are facing today requires a deep understanding of the problems and realities of the people for whom we are designing solutions, said Ron Hildebrandt, Virgin Pulses Chief Product Officer. Delivering a personalized experience focused on helping users achieve specific health outcomes requires intelligent and continuous orchestrationof data, including from third-party and partner programs, at every touchpoint of the user journey. Homebase forHealthTMfacilitates this bymerging the bestconsumer experience with longitudinal health and wellbeing data, AI-powered recommendations and behavior change expertise. The more users engage, the more personal their experience becomes, and that is the key to keeping them connected with care and wellbeing solutions throughout their health journey.

Winter 20 Highlights:Virgin Pulses latestinnovations reflect a member-centric approach, whereevery aspect of a member's experience is focused on their specific circumstances - their challenges, resources, interests, patterns, personal goals and future needs. That information isfurtherinfusedwithAI, data and healthcare innovation to orchestrate hyper-personalized member experiences and interventions that deliver sustainable health outcomes, including chronic condition reversal.

According to Hildebrandt,Daily engagement is at the core of everything we build.We know that providing the bestuserexperience from the first touchpoint propels the engagement flywheel. That initial engagement is critical for driving health outcomes for members and financial results for clients.

User Experience and InnovationDesigned to streamline and simplify thehealth journey, thenewHomebase for HealthUserExperience(UX) intelligently guides users across the complete suite of wellbeing, social, health and benefit resources and integrated programs; improves discoverability and navigation so members better understand where tostart or what to do the most relevant and meaningful offerings when they need them most.

The new user experience also includes an integrated Benefits-First Navigation Experience featuring:

Health Innovation: AddressingUrgent and Emerging NeedsMembers cannowaccessmulti-modalconditionmanagementexperiencesbeyond thephysiciansoffice.

Building Health Equity for a Diverse and Inclusive CultureWhile the impact of social determinants on health has been widely acknowledged, COVID-19 has exposed widespread racial disparities, especially in healthcare. Due to systemic discrimination and long-standing institutional policies, a larger percentage of Black, Indigenous and Latinx communities have been disproportionately harmed by the virus. Organizations are increasingly recognizing that health and wellbeing are about more than just physical health and that diversity, equity and inclusion must be foundational to any health and any wellbeing program or initiative:

COVID-19 Innovation Updates

More Information:

About Virgin PulseVirgin Pulse is the worlds largest, most comprehensive digital health, wellbeing and engagement company. Founded as part of Sir Richard Bransons Virgin Group, the company is focused on motivating users to achieve better health outcomes. Fusing high-tech, high-touch, AI and data, Virgin Pulse delivers the industrys only true Homebase for HealthTM that supports clients and members across the entire health, wellbeing and benefits lifecyclefrom screening and assessment to activation, behavior change and the adoption of sustainable, healthy habits to benefits navigation, condition management, gaps in care closure and digital therapeutics. Today, 12 million+ users in more than 190 countries, spanning over 3,300 organizations rely on Virgin Pulses digital and live solutions to change their livesand businessesfor good. To learn more, visitVirginPulse.comand follow us onTwitterorLinkedIn.

Media ContactVirgin Pulse703-622-3605press@virginpulse.com

A video accompanying this announcement is available at

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Photos accompanying this announcement are available at

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User Experience and Health Innovation at the Core of Virgin Pulse's Winter '20 Launch; Addition of Gaps in Care, Claims Analytics, Benefits...

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By Anahad OConnor

Intermittent fasting is a trendy weight loss strategy. But a new study found that a popular form of intermittent fasting called time-restricted eating produced minimal weight loss and one potential downside: muscle loss.

The new research, published in JAMA Internal Medicine, is one of the most rigorous studies to examine time-restricted eating, which involves fasting for 12 or more hours a day. Many followers of the diet, which has been popularized in best-selling diet books and touted by celebrities, routinely skip breakfast and eat all their meals between roughly noon and 8 p.m., resulting in a daily 16-hour fast.

Research over the years has suggested that the practice spurs weight loss and improves metabolic health, although much of the data has come from animal experiments or small studies of relatively short duration in humans. Experts say the diet works because it allows people the freedom to eat what they want so long as they do it in a narrow window of time, which leads them to consume fewer calories over all.

But the new research found that overweight adults who were assigned to routinely fast for 16 hours daily, eating all their meals between noon and 8 p.m., popularly known as the 16:8 diet, gained almost no benefit from it. Over the course of the three-month study, they lost an average of just 2 to 3 and a half pounds only slightly more than a control group and most of the weight they shed was not body fat but lean mass, which includes muscle.

While it is normal to lose some muscle during weight loss, the fasting group lost more than expected. That is concerning because muscle provides many health benefits: It protects against falls and disability as people age, and it is linked to lower mortality. It also increases metabolism and can help prevent weight that is lost during dieting from returning later on. The researchers speculated that one reason for the muscle loss may have been that the fasting diet led people to consume less protein.

My bias was that this works and Im doing it myself, and so I was shocked by the results, he said.

But some experts cautioned that the study was too short for a weight loss trial. They said it was likely that the fasting group would have showed greater weight loss had the study been longer and included more participants. They also pointed out that previous research has shown that people do better when they consume the bulk of their calories relatively early in the day, which is when our bodies are better able to metabolize food, rather than skipping breakfast and eating most of your food in the afternoon and evening, which goes against our biological clocks.

Fasting became popular for health reasons after small studies suggested it promotes longevity and a wide range of metabolic benefits, such as improved cholesterol profiles and reductions in insulin resistance.

It could be that the benefits of time-restricted eating are smaller than we thought, or that you just get better results when you eat earlier in the day, said Courtney Peterson, a researcher at the University of Alabama at Birmingham who studies intermittent fasting and who was not involved in the new study. The jury is still out.

Many cultures around the world practice fasting for religious or spiritual reasons. But fasting became popular for health reasons after small studies suggested it promotes longevity and a wide range of metabolic benefits, such as improved cholesterol profiles and reductions in insulin resistance. Some of the other common forms of intermittent fasting are alternate day fasting, in which followers eat no more than 500 calories every other day, and the 5:2 diet, which entails eating normally for five days a week and fasting for two.

Many people, however, have trouble going an entire day with little or no food. Krista Varady, a professor of nutrition at the University of Illinois, Chicago, has found in her research that people lose weight more slowly with time-restricted eating than other forms of fasting but that it is generally the easiest form of fasting to adopt. People tend to eat 300 to 500 calories fewer per day when they restrict themselves to an eight-hour window, said Varady, who was not involved in the new research.

The best part is there are no limitations during the window, she said. There is no carb or calorie counting, and people dont have to switch out all the food in their pantries.

Varady said she is planning to start a yearlong study of time-restricted eating in the near future. I find it fascinating that this diet has become so popular and there are so few studies, she said.

Weiss got interested in time-restricted eating after learning about research that showed that mice provided round-the-clock access to high-fat, high-sugar foods got fat and sick, while mice that ate the same foods in an eight-hour daily window were protected against obesity and metabolic disease. In his own experience, Weiss found that skipping breakfast and eating between noon and 8 p.m. was not very difficult.

He wanted to see whether the diet could be a simple prescription for people to lose weight, so for the current study, he and a colleague, Dylan Lowe, designed an experiment: They recruited 116 overweight and obese adults and split them into groups. One group, which served as controls, was told to eat three structured meals daily. The other group was assigned to eat all their food between noon and 8 p.m., with only noncaloric beverages like tea and black coffee permitted outside that window.

The researchers chose noon to 8 p.m. because it would be more socially acceptable for participants to skip a meal in the morning rather than in the evening, when they might be sitting down to dinner with family or friends. We wanted to make this something that was simple enough that people could actually do, Weiss said.

By IANS

The road to a happier you is right nutrition and mindful eating as well as staying away from too much of caffeine and sugar, suggests Rueben Ghosh, Co-Founder and Culinary Director at Yumlane and Kashmiri Barkakati, food expert at Momspresso. Here's how to do it right.

Consuming legumes will keep the blood sugar stable throughout the day, fostering happier mood, a key nutrient in creating a healthier gut.

Although a Western concept, wraps have surely found its popularity in India in the form of Frankie and rolled food items. The Kathi rolls are one example amongst the many variants and experiments with the delicacy in India. Consisting of various ingredients that could be included with the flatbread, chapatti or paratha like paneer, onions, green peas, ginger, garlic, mayonnaise or even mutton, a quick bite of this delicacy will appetize one's stomach and effectively boost one's mind into focusing on their work later.

Leafy greens like spinach and Kale are extremely important in keeping brain functioning at its best with its Vitamin B. It produces Serotonin, a mood-enhancing chemical that helps lift our moods and keep depression at bay.

Whole grains are a great source of vitamin B, which are key nutrients to a good mood. Studies have proven that B6 deficiencies lead to stress, depression and irritability. Pack whole grains into your diet. Eliminating carbohydrate completely may not be a good idea.

In the end, the fasting group lost an average of two pounds, only half a pound more than the controls. When the researchers looked at participants who had visited their lab for extensive testing, they found that the fasting group had little or no improvement in most of their metabolic markers, though they did tend to lose more weight, a little over 3 and a half pounds. That was roughly 2 and a half pounds more than the control group, a difference that fell narrowly short of being statistically significant. But 65% of the weight that the fasting group lost was from lean mass more than double what is considered normal for weight loss.

Weiss said it is possible that the fasting group lost an unusual amount of muscle because skipping breakfast each day caused their overall protein intake to fall. But that could potentially be avoided: Other studies have found that people can maintain muscle while fasting by doing resistance training and consuming more protein during their eating windows. Weiss said the findings need to be explored further, but for now he remains skeptical of time-restricted eating.

This was a short study, but it was enough of a study that to me it calls into question whether this works and if it does work, then the magnitude of the benefit is very small, he said.

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Trying out intermittent fasting to lose weight? There's a potential downside to it - Economic Times

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