Category Archives: Diet And Food

Editors note: This is the last in a three-part series of articles following a heart transplant journey.

Throughout the journey related to my husband Brandons heart transplant, which he received May 1 at Integris Baptist Medical Center, I have learned a lot and have seen some interesting sights. During Brandons hospitalization post-transplant, we had education classes to learn about necessary lifestyle changes. Here are a few:

Sun sensitivity: Transplant patients are highly sensitive to UV rays. Brandon invested in a black, large-brimmed hat, a cool-wicking, long-sleeved shirt with UV protection, polarized wraparound sunglasses and multiclava scarves (to protect against against germs in crowds). Some people jokingly told him he looked like an old-timey robber or the invisible man. He said he felt like a vampire, because he immediately felt sapped by the sun and could see his skin turn a little pink sometimes. Wearing sunscreen was also suggested.

Diet change: In addition to continuing his low-sodium diet, we learned that certain foods and restaurants are off-limits.

First, no buffets or places that have food items sitting out in the open, due to possible bacterial cross contamination. Second, no grapefruits or pomegranates, due to possible interaction with medications.

Third, vegetables must be eaten cooked, and salads cant be eaten in restaurants because of the threat of bacteria. Any salads eaten must be prepared fresh in a clean environment with clean hands.

No drinking fountains: This should be self explanatory.

Denervated heart: In the process of doing a heart transplant, a certain nerve has to be cut. This leads to transplant patients having a slower reaction time when something distressing or surprising happens. It also means recovery from those experiences takes longer.

I also had some unique experiences at the hospital, mainly during his rejection episode. Here are a few:

Therapy dogs: During my husbands hospitalization for rejection, I saw eight therapy dogs. The first was a white golden doodle named Mavee, followed by a Great Pyrenees, a black lab, two Burmese mountain dogs, a red-brown golden doodle, a hound and German Shepherd mix and a Shelty.

I first saw Mavee the day after Brandons cardiac arrest, which happened June 23 after he suffered a seizure during an IV infusion treatment. She added sunlight to my sad day and helped me feel a little better. After that, I actively sought out the dogs when they were nearby.

Geese herding: When we started going to the hospital for medical appointments a lot, I would often see Canada geese on the premises. Eventually, I started counting the geese. They always acted casually and took forever to cross roadways.

One day upon arriving at the hospital, I saw a group of about 30 to 40 geese walking in the main hospital entrance and exit areas. Two employees one at the head and one at the back of the gaggle were attempting to herd all of them back to safety, while conducting traffic.

I overheard one employee say, Did you hiss at me? to a young goose, then reassure the goose that he was trying to help it. It was the highlight of my day.

Cleaning conundrums: The night of my husbands cardiac arrest, someone moved a recliner into a waiting room so I could sleep somewhat comfortably. I left for breakfast that morning, and when I got back, it was gone.

A family member told me a janitorial employee saw it, got mad and moved it immediately before cleaning the room.

Later, we moved to a waiting room on the other side that had three round tables with big lamps on each one. One lamp had no light bulb. I had to work, so I moved it safely up onto a wide window ledge, with the cord placed beside it.

Then I moved the table in front of my seat, placed my work computer on top and straddled the table. After I was finished working, I put everything safely back in its place.

Every time, the janitorial employee had the urge to move them back. Brandon later told me he overheard some nurses talking about it, and I said, That was me!

Definition of home: Three weeks was the length of time it took before I started referring to the hospital as my second home during Brandons second hospital stint. When people asked why we were there, I replied, We live here.

I had to go home nearly each night to care for our son, but over the entirety of both stays, I had to travel almost daily to Oklahoma City to see Brandon. So, the hospital became my daytime home.

Thankfully, my whole family is back home now, and I hope it stays that way for a long time.

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Lessons learned during the transplant process - Norman Transcript

I started to think about livinga very long life. What would it require?

133 years old is the aspirational age I choseafterreading Dan Sullivan, and his ideas of how to extend our lives byfirst setting a goal. You are supposed to select a number beyond the currentlife expectancy that you want to live to, and then make a choice about how youwill spend those extra years.

Then I came across Dr. Jeffery Gladdens Apex Longevity clinic, which aimsto reverse engineer your health so that you can be the robust state of a33-year-old for all of those remaining years.

So I set about to get myself healthier in my new commitment toliving an extraordinarily long life.

______

I stopped drinking entirely. With the exception of an annual bender with mywife and friends at New Orleans Jazz Fest.

And I started doing more yoga, eating more vegetables.

I even crawl on the floor with my trainer so that at somefuture date when my sons mature enough to have their own families, Ill be ableto crawl on the floor with my grandkids.

What Im trying to tell you is, I did very human things to offsetdeath. Things both normal and bizarre in order to make me feel hopeful ofliving until 133.

And the truth is I was pretty healthy until 8pm every singleday.

But at 8pm,I wanted crackers and cookies.

Dont we all? No?

______

On a recent business trip to Dallas, I stopped in on Dr. Gladdensclinic and decided to do some testing.

And then, about 6 weeks ago, I got a call from one of the doctorsthat scared the shit out of me.

Let me just say this: when you invest in the act of going to alongevity clinic you automatically think youve got the system beat. Just byshowing up and charging the credit card youve received insurance against theinevitable.

So the lead doctor from the clinic after Ive come and gone andIm safely back in Columbus, Ohio calls me and says: Ive got your results,and its not good.

He might have even used the word crisis, but I instantly wentdeep inside to my daydreaming inner child. A very quiet place.

Its a technique I learned to use in fearful or uncomfortablesituations. I literally stop hearing the person, or anything else in the world,and yet, I can give all the head-nods, and uh-huhs necessary to get to theend.

After a very long pause in which I was far, far away, I finallywhispered unconsciously, What does that mean, not good?

To which he says, You need an echogram and a CAT scan, you arenot in immediate danger, but Id like it done in the next fewdays.

Which isit?!? The next few days or Im not in immediate danger?

Is thisbecause of the cookies?

______

From daydreamer mode, I immediately went into my second mostfamiliar default: the catastrophic,Im-about-to-die mode.

I scheduled the CAT scan and started hugging my wife so much Imsure it was annoying. And I kissed my kids with a severity that probablyconfused them.

In those few short days between the call and the test, either atthe dinner table, or as I was drifting asleep, everything would turn cinematic,and I would think:

Is this it? Is this the last moment of my life?

Heart attack now?

What about now?

I would blink, surprised I was still alive. Without a singleflutter in my chest.

______

Then, the test itself. Itself, a test of mortality. I went intothe bright white tube thinking I dont know what they are going to find. All ofthis just as Im getting my groove with life.

______

I think you probably know where this is headed.

I did not go straight into surgery. In fact, there was zeroevidence that I was going to have a catastrophic ending.

I was going to live, in fact. They found pretty much nothing wrongwith me, a bit of plaque that if cookies and crackers continue to be thepreferred diet, Id likely have an issue about 20 years down the road.

______

So what was this week-long experience about?

I determined that it was a nudge from the Universe.

How do you want to shift right now?

The Universe asked me. It could all be over tomorrow, but if its not, how do you want to live?

Well, in that case, I have a long-winded response back to theUniverse:

Share.

So Ive committed myself to shifting my work, to writing more,sharing myself more openly on this and other platforms, and to telling thetruth about how Im doing.

Service.

And I am opening up time in my schedule to work one-on-one withpeople. Many people have served as my transformational teacher/coach/guide, andto give back, Ive got to start doing this for others.

Go directly toward that which fills your soul.

Ive always gone the round about way to my greatest goals andpassions, instead of moving directly toward my desires. And so I ended up helpingpeople through building buildings, or satisfying my creative itch through thedesign ofthose buildings. Instead of just helping people and doingart.

Self-work.

Even helping others can be a bit of an escape from the real workwe are here to do.So I will continue to look at myself, embrace theresistance, see it as the way through the suffering to freedom. And recognizethat everything is so perfect and beautiful exactly as it is. The I amthat is my essence, the one aligned with my soul, let it shine.

Being good to my body.

The cookies and crackers have got to go. The running has to comeback. The bosu ball instead of the couch. Those things that keep both the mindand the body healthy.

The Ultimate Gift to My Health? Forgiveness.

I will live longer, but not just because of the 70 supplements Imnow taking daily, but because of the big giant ball of forgiveness and lovethat Ive embraced in my body. Deep in my body, so deep that it wants to loveall of the pieces of me and everyone around me.

______

Going to the longevity clinic worked, btw. Not as insuranceagainst death, but it taught me to reconcile my goal with my reality. Living along life is what I was looking for, and the truth is, Ive since learned whatI need to do.

Ive mostly learned that living a long life is a nice idea, a goodgoal, but if you arent awake, free or loving enough to really enjoy it, whywould you aspire?

For me, I had to get scared enough in order to really understand how to extend my life. Whether it works or not, I had to get to a deeper why about what it means to be alive.

Go here to read the rest:
My Path to Being 33 Years Old Until Im 133 Years Old - Thrive Global

When Tallman Trask III came to Duke as executive vice president in the summer of 1995, his first assignment was figuring out how to feed the 1,500 incoming students who were weeks away from descending on East Campus for the inaugural freshman campus experience.

The decision to house all first-year students on East was itself a momentous and somewhat controversial decision for the university, and when Trask arrived in August the project was over-budget and behind schedule.

So Trask and his team worked round-the-clock to set up the dining spaces and systems that would ensure students could get breakfast, lunch and dinner, hot and on time. When the students did show up, they had no idea how close they had come to a diet of dry cereal and peanut butter and jelly sandwiches.

Tallman will rightfully be remembered at Duke for his steady transformation of our campus

Now, almost 25 years later, some of the children of those East Campus pioneers are eating, living, studying and performing in impressive new buildings that bear Trasks imprimatur. They are also connected to digital networks and services that were conceived and built under his leadership. And they take full advantage of a downtown Durham that he helped reimagine and undergird through a financial foundation including an endowment that has grown ten-fold since 1995 that he kept secure through some of the greatest economic disruptions of the last half-century.

Its been a rewarding ride, said Trask, who will retire as Dukes longest-serving chief financial and administrative officer in the fall of 2020.

Tallman will rightfully be remembered at Duke for his steady transformation of our campus, as he delivered a modern, indeed spectacular physical plant that better promotes the health and well-being of all who work and live here, said President Vincent E. Price. But many of his most meaningful contributions arent marked on any campus map: he helped grow and solidify our resource base to better serve our academic mission; he safely guided us through the financial crisis; and he championed renewed investments in financial aid, downtown Durham and environmental sustainability. Tallman has also provided invaluable mentorship and leadership to an entire generation of Duke employees. We are so very grateful for his service.

Trask is responsible for the budget, financial affairs, procurement, debt, campus planning, architecture, maintenance and construction, real estate, human resources, academic and administrative computing, audit, safety and security, and auxiliary services.

He is an ex-officio member of the Board of Trustees committees on Resources and Audit and Compliance. He also serves on the DUMAC Board of Directors, the Duke University Health System finance committee, and holds a faculty appointment as adjunct professor in the Program in Education.

Trask has played a key role in the development of downtown Durham, most notably working closely with business and civic leaders to resuscitate the long-abandoned American Tobacco Company complex. He helped create a public-private partnership that led to moving a significant number of Duke employees and offices to the center of the city, and the creation of a vibrant commercial and entertainment district.

The success of American Tobacco and the Durham Performing Arts Center, also championed by Trask and supported by a significant investment from Duke, sparked a renaissance in Durham. Today, Duke has more than 3,000 employees occupying more than two million square feet of leased office and lab space downtown.

A third-generation native Californian, Trask graduated from Occidental College, received an MBA from Northwestern University and a Ph.D. from UCLA. He came to Duke from the University of Washington, where he was executive vice president from 1987-1995. He had previously served as vice chancellor for academic administration at UCLA.

Trask serves on the Research Triangle Foundation Board of Directors and its executive committee and chairs its investment committee. He was elected an honorary member of the American Institute of Architects in 2003. The American Dance Festival dedicated its 2010 season to him, and in 2013 he was named Terry Sanford Citizen of the Year by the Durham Boy Scouts.

A search committee to identify his successor will be announced shortly.

See the original post here:
Duke Executive Vice President Tallman Trask III to Retire in 2020 - Duke Today

That way, I would know if I was on the right track in solving a problem. So, I will try to give the answers first.

Tokeep your brain (and yourself as a whole) healthy, know the answers to thequestions:

Whatis thehealth of my heart and circulation?

Whatcan I do, or what can I do differently to keep my circulation working as safelyand efficiently as possible?

Fundamentally,these are the only questions I ever get asked. The questions are simple, butthe answers are different for all of us.

Afew definitions are in order. First of all, what is a stroke? Technicallyspeaking, we call a stroke acerebrovascular accident. (As you can see, doctors love to confuse things byusing Latin and Greek. I supposed lawyers are just as bad.) Cerebro means brain. Vascular means blood vessel, or refersto circulation.

Andaccident, well, that always means something bad.

Astroke is damage to the brain caused by a problem with blood flow to the brain.

Thisis why cardiovascular doctors (also known as cardiologists) have always beenresponsible for preventing strokes, although they are not the doctors calledwhen you have a stroke. The doctors called when you have a stroke areneurologists (brain specialists). They should not be the first doctor you seeto prevent a stroke. Hopefully, you will never need to see one. You should seeyour primary care doctor or a cardiologist first.

Astroke is not a heart attack. Sometime in the past 50 years, our medicalvocabulary became even more confusing than it already was. The terms stroke andheart attack became interchangeable. They have a lot in common, but they aredifferent things. A stroke is brain damage. A heart attack is heart damage.

Cardiologistsprevent both. Historically we just have not been very aggressive about preventingstrokes. Having a stroke means you have had brain damage, which means aneurologist (a brain specialist) will need to help you. Preventing a strokemeans keeping your circulation healthy, which is not a job for a brainspecialist. Its a job for a circulation specialist (that is, a cardiologist).

Biologicallyspeaking, there are several types of strokes, but most of them are caused by aclot jamming up the blood flow to the brain. Those clots tend to come from theheart or the big blood vessels leading to the brain (the carotid arteries), orthey can form in the smaller blood vessels within the brain. No matter what,you dont want blood clots in your brain. Thats a stroke.

Thereare also bleeding strokes, but they are not the common ones. In fact, manybleeds in the brain start as a clot. We tend to fear bleeding, but in fact,clots are a much, much bigger problem.

Clotscan be prevented. Thats part of how we prevent strokes.

Acommon question is what are the signs of a stroke? Well, the whole goal is tonot have a stroke in the first place, but it is worth knowing what happens whenyou do clot off part of your brain. Remember, a stroke is brain damage. So,whatever part of the brain you damage may not work quite right again. It maynot work at all.

Picka function that your brain controls. If you clot off the part of the brain thatcontrols that function, it wont work. Just about anything related to brainfunction can be lost by a stroke.

Forexample, you may lose the ability to speak, to understand words, to see, toswallow, to move your arm or leg. You may not think right. You may be confused.Your face may droop. You may collapse. For better or worse, most strokes dontkill you. They just take something away, usually forever.

Ifyou have a stroke, you will get to know a neurologist all too well. They arethe experts who can tell you just how much of your brain has been damaged andhow likely you are to recover what you have lost.

Thereare many books to help you understand how to recover from brain damage. Thebook I wrote with Kristin E. Thomas, MD, YouCan Prevent a Stroke, is not one of them. I find them all a littledepressing.

Ifyou do have a stroke, sometimes dramatic things can be done to try to rescueyour brain. Several new studies have been published about some of thesehigh-tech procedures (where tubes get stuck into your head to suck out clots,or clots are melted with drugs). One of my favorite patients recently asked meabout these treatments. He wanted to know what was the best way to treat astroke. The answer was really quite simple.

Thebest way to treat a stroke is to not have one in the first place.

Whatis a TIA? TIA stands for transient ischemic attack. They are often referred toas ministrokes. Transient implies that you have symptoms that come and go.They are not permanent. Ischemic means some part of your body did not getenough blood. In this case, we are talking about part of the brain not gettingblood. Attack, well, thats got to be bad.

ATIA is a transient ischemic attack, or ministroke, where symptoms spontaneouslyrecover without permanent damage.

Havinga TIA means that some part of your brain did not get enough blood, and itdidnt work. Like with a stroke, any part of the brain may be at risk. Thedifference between a TIA and a stroke is that a stroke leaves evidence ofpermanent damage.

Usually,that evidence of a TIA is seen with an MRI scan of your brain. If you havesymptoms of some part of your brain not working, and the symptoms get better,and a brain scan shows no evidence of permanent damage (that is, a stroke),then consider yourself lucky. You have had a TIA. You have dodged a bullet. Youneed to think very hard about how you, and your doctor, are going to preventyour stroke, because it is coming.

Youdo not need to wait for symptoms before you actively prevent a stroke.

Ascenario we see every day involves seemingly cryptic or mysterious terminologyon a brain scan (MRI) report. Someone undergoes a brain MRI and there isevidence of an old stroke, or many old strokes. The MRI is read as smallvessel ischemic disease or age-related atrophy. All of this means that atsome point, the brain did not get enough blood flow, blood flow wasinterrupted, or brain circulation clotted. It is entirely possible, andactually quite common, to find brain damage on MRI that you were neversymptomatically aware of.

Inthe past, we often felt that these abnormal scans, in which the damage shownnever presented symptomatically, were much like the proverbial tree falling ina forest. If no one is there to hear the tree fall, does it make a noise? Ifyou never have any symptoms, does it matter that the MRI says you had a stroke?

Ifenough trees fall in the forest, theres no more forest. If enough of yourbrain gets damaged, you will eventually become demented.

Vasculardementia is the loss of brain function, especially the ability to think, due toinadequate or interrupted blood flow.

Thereare actually several ways in which we can become demented. We tend to use termslike Alzheimers and dementia interchangeably, but technically they aredifferent. Dementia means that your brain doesnt work. Alzheimers is aspecific disease in which unusual proteins build up in the brain for unknownreasons.

Wehave no good way of preventing or treating Alzheimers. But some of what wethink of as Alzheimers is actually vascular dementia. And Mother Nature saysyou can have both. We may not be able to prevent Alzheimers, but there is alot that we can do to prevent vascular dementia.

Weused to say that old folks simply became senile. The inference was that theirmemory was gone. Their ability to think rationally was gone. They were maybe alittle goofy if not downright crazy. It finally evolved into an insult. Ifanyone was ever confused or forgetful, they were accused of being senile.

Well,technically, senile just means old.

Naturalaging predictably changes circulation. As circulation changes, blood flow tothe brain can become less reliable. Clots form. Blood flow can be interrupted.The heart may not pump enough blood to the brain, and the brain suffers. Thenyou can in fact become senile if you develop vascular dementia.

Ageis going to change circulation. It should come as no surprise that the brainsuffers when circulation is inadequate.

Senilityis vascular dementia. If you want to avoid it, keep the circulation to yourbrain healthy.

Perhapsthe most important point is this: We do not need to simply accept growing oldthe way our grandparents did. We have the ability to keep the effects of timein check (at least when it comes to the heart and circulation). But we need tomake the choice to be an active participant. We can prevent the changes to theheart and circulation that lead to strokes, brain damage, and vasculardementia. They do not prevent themselves.

Thebasics of prevention are already mentioned above: Know your heart and vascularhealth, and ask if you are doing everything you can to keep things working.Well, how does one do that?

1.Establish a relationship with a physician.

2.Know the health of your heart.

3.Know the health of your arteries.

4.Know the regularity of your heartbeat.

5.Know if its time to take a medicine to prevent plaque in your arteries andwhether you need a pill to prevent a blood clot.

Thisis what we now call the Foxhall Formula, or protocol. It is a short list ofsteps everyone can take to make sure they are preventing strokes.

Toprevent strokes, it may not take a whole village, but it does take a goodrelationship with a doctor. There are things you will need to do, and thingsyou will need your doctor to do with you.

Noticethe list does not mention diet or exercise. Of course, fitnesshelps everything. A rational diet is important (more on that later), but ifa magic fruit existed to keep our arteries perfectly clean and plaque free, Idlike to think we would have found it by now.

Thelist does include a lot of questions to be answered; fortunately they are alleasy to answer but you have to ask.

Thisexcerpt is adapted from You Can Prevent aStroke, by Joshua S. Yamamoto and Kristin E. Thomas and is printed withpermission from RosettaBooks.

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5 Actions to Take Now to Prevent Stroke and Vascular... - Massage Magazine

Individuals assigned to a reduced-calorie Mediterranean diet, physical activity, and behavioral support were more likely to adhere to the program than those who were just advised to follow an unrestricted Mediterranean diet, according to new findings.

Overall, there was significantly greater increase in adherence to the energy-reduced Mediterranean diet at 12 months. Improvements in diet quality, energy intake, and cardiovascular risk factors also were observed in the group consuming the reduced-calorie diet.

"The trial is ongoing," explained study author MiguelA. Martnez-Gonzlez, MD, PhD, MPH, professor and chair of preventive medicine and public health at the University of Navarra, Spain. "These are only preliminary 1-year results, and we will be assessing cardiovascular events during a 6-year period."

The findings were published October15 in JAMA.

The energy-reduced Mediterranean diet (er-MedDiet) features more restrictive limits for red and processed meats, butter, margarine, cream, and carbonated sweetened drinks than an unrestricted Mediterranean diet. It also recommends individuals not add sugar to beverages, limit white bread and refined cereals, and consume more whole grains. The authors hypothesized that an er-MedDiet may be the optimal model for overweight or obese individuals, and this served as the rationale for the current PREDIMED-Plus trial.

But a major challenge in evaluating nutritional interventions using a complete dietary pattern, as opposed to a single food or component, is participant adherence. However, initial results from a pilot study of 626 overweight/obese adults in this trial showed that good adherence is feasible. At 12 months, the intervention group also had decreased adiposity and improved cardiovascular risk factors.

In the current trial, Martinez-Gonzalez and colleagues examined adherence and changes in risk factors after 12 months, but in a cohort about 10 times larger than the pilot.

A total of 6874 adults, 55 to 75 years of age, with metabolic syndrome but without CVD were randomly assigned to an intervention that followed an er-MedDiet, promoted physical activity, and provided behavioral support (n= 3406) or to an energy-unrestricted Mediterranean diet (n= 3468).

All participants received allotments of extra-virgin olive oil (1L/month) and nuts (125g/month). The primary outcome was 12-month change in adherence, measured with the er-MedDiet score (range, 0- 17; higher scores indicate greater adherence; minimal clinically important difference, 1point).

The mean er-MedDiet score in the intervention group increased from 8.5 at baseline to 13.2 at 12 months and from 8.6 to 11.1, respectively, in the control group (between-group difference, 2.2; 95% CI, 2.1- 2.4; P< .001).

The improvements observed in the er-MedDiet score in the intervention group represented a significant 55% relative increase over 12 months (95% CI, 55%- 56%; P< .001).

The authors also noted that there were significant reductions in the consumption of specific foods or food groups at the time of the interim analysis. Baseline consumption of refined grains, for example, was 779g/week for both groups, but after 12 months had dropped by 535g/week in the intervention group and 226g/week in the control group, for a significant between-group difference of 309g/week (95% CI, 340- 277; P<.001).

Significant reductions in red meat consumption were also observed, with a between-group difference of 39g/week (95%CI, 51- 28; P< .001) at 12 months.

Some of the greatest increases in intake were observed for vegetables, with a mean baseline consumption of 2168g/week for participants in the intervention group and 2130 g/wk in the control group, and within-group differences after 12 months of 347 g/wk and 137 g/wk, respectively. The between-group difference of 210 g/wk was significant (95% CI, 157-263; P <.001).

Finally, when looking at CVD risk factors at 12 months, there were "significant and clinically meaningful" favorable changes for the intervention vs the control group as far as body weight, waist circumference, body mass index, high-density-lipoprotein cholesterol (HDL-C), non-HDL-C, total cholesterol:HDL-C ratio, triglycerides, and systolic and diastolic blood pressure.

"In my opinion, there is a need to include further nutritional support in health centers, including hiring dietitians," Martnez-Gonzlez told theheart.org| Medscape Cardiology. "This is costly, but the CV events are even more expensive."

In an accompanying editor's note, Philip Greenland, MD, Northwestern University Feinberg School of Medicine, Chicago, and senior editor of JAMA, notes that these interim results are "meaningful in several ways."

First, the greater adherence to diet among patients in the intervention group provides reassurance that this approach is having a measurable effect on diet and body weight. "This is an important intermediate step but not yet sufficient to inform new dietary recommendations," says Greenland.

"Second, the authors have demonstrated in this study and previous research that large-scale dietary intervention studies are practical if carefully conducted. The long-term main endpoint results are eagerly awaited."

The study was supported by the European Research Council, CIBER Fisiopatologade la Obesidady Nutricin and Instituto de Salud CarlosIII through the Fondode Investigacin para laSalud, which is cofunded by the European Regional Development Fund, the Recercaixa, the SEMERGEN grant, the International Nut and Dried Fruit Council-FESNAD, an AstraZeneca Young Investigators Award, grants from the Consejerade Saludde la Junta de Andaluca, a grant from the Generalitat Valenciana, and a grant of support to research groups 35/2011 (Balearic Islands Gov; FEDER funds).

Martnez-Gonzlez reported having no disclosures; several coauthors disclose relationships with industry, as noted in the paper. Greenland has no disclosures.

JAMA. 2019;322:1486-1499 and 1500. Abstract, Editor's note

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Intervention Ups Adherence to Low-Cal Mediterranean Diet - Medscape

What if your doctor failed to talk to you about the most important threat to your health? Wouldnt you worry about the quality of your health care? Poor quality diet is a leading cause of death in the United States, but it is unlikely that your doctor has the knowledge to even begin a meaningful conversation about your nutrition or to make an appropriate dietary referral.

Most doctors lack the knowledge necessary to offer nutrition advice to patients; indeed, fewer than 14 percent of physicians report feeling equipped to advise on diet or the connection between food and health. This is unsurprising given that, for example, 90 percent of cardiologists in a recent survey reported receiving minimal or no instruction on nutrition during medical training.

Yet it is also concerning. Obesity, type-2 diabetes, heart disease, cancer, and stroke, which are leading causes of death in the United States, all are closely linked to diet and nutrition.

Nearly 40 percent of adults and 18 percent of children are obese, and these numbers are increasing; almost 10 percent of Americans suffer from diabetes, compared with less than 1 percent just 50 years ago. Even more concerning, more than one-third of Americans have pre-diabetes.

A focus on treatment rather than prevention has led to medical education that ignores the central role that food plays in health. The average U.S. medical school devotes less than 1 percent of total lecture hours to nutrition. Accreditation requirements for medical residencies and fellowships do not include nutrition.

The standardized exams that medical students must pass to become board certified lack questions that test the ability to advise patients on diet. And to date, no state requires continuing medical education in nutrition or diet-related disease as part of the ongoing education for physicians to maintain licensure.

This dangerous gap in their education means that doctors do not learn the basic guidance in the U.S. Dietary Guidelines for Americans, or stay apprised of the latest nutrition science. Accordingly, they fail to recognize, and are unable to convey to patients, the importance of diet to health. This means fewer referrals to nutritionists, even when diet plays a vital role in their patients health.

The lack of nutrition education during medical training is also a costly mistake. Health-care spending has skyrocketed Medicare benefit payments exceeded $730 billion in 2018 and account for nearly 15 percent of all federal spending.

At its current rate, Medicare spending will exceed $1 trillion in the next 10 years. Diet-related diseases account for 5 of the 8 most common conditions among Medicare beneficiaries, so its clear that as the prevalence of diet-related diseases increase, health-care spending increases.

Fortunately, we can change this troubling status quo. Opportunities exist for policymakers at the state and federal level, as well as the bodies responsible for testing and accreditation, to make systemic changes to medical training.

For example, state legislatures and Congress can offer grants to medical schools to develop curricular content; the American Council of Graduate Medical Education can amend residency requirements to require competency in diet and nutrition; and testing organizations like the National Board of Medical Examiners and the American Board of Medical Specialties can incorporate nutrition-focused content on step and board examinations, respectively.

Perhaps the most logical and effective solution is to ask Congress to spend our health-care dollars more wisely. Medicare is the single largest source of federal funding for graduate medical education, providing more than $10 billion to eligible programs in fiscal year 2015.

This funding comes with no strings attached, i.e. no curricular requirements or performance benchmarks, and certainly no expectation that residents or fellows receive education in nutrition.

Rather than spend a whole lot more on Medicare to treat diet-related diseases down the road, Congress should leverage this funding to require nutrition education for residents and fellows. These policies and others are explored in a recent report from the Harvard Law School Food Law and Policy Clinic.

The education of doctors is a critical issue with universal implications for our national health. When it comes to the care we receive at each doctors visit, we reap what we sow. By not insisting that physicians receive at least foundational education in nutrition, we produce a medical system that is focused almost exclusively on drugs and devices, and in which the most costly diseases continue to grow.

Alternatively, by helping physicians understand the connection between food and health, we can produce better individual patient outcomes, improve population health, and change our nations health-care landscape for the better.

Emily M. Broad Leib, J.D., is an assistant clinical professor of law at Harvard Law School and the director of the Harvard Law School Food Law and Policy Clinic. Stephen Devries, M.D., is a preventive cardiologist and executive director of the nonprofit Gaples Institute for Integrative Cardiology. Walter Willet, M.D., Ph.D., is a professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health and a professor of medicine at Harvard Medical School.

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Our diets are killing us and doctors aren't trained to help | TheHill - The Hill

The New York Times recently reported that those who eat their biggest meal in the early hours have better success losing weight. Buried in the article was a comment which would catch the attention of anyone who has had close contact with Theravadin monastics, or, like me, has been one:

The lowest B.M.I.s were recorded in the fraction of peopleabout 8 percent of the total samplewho finished lunch by early afternoon and did not eat again until the next morning, fasting for 18 to 19 hours.

This is a similar eating practice followed by Theravadin monasticsbhikkhus and bhikkhuniswho follow the dietary rules of the Vinaya, the monastic code believed to have been written by the Buddha himself. According to the Vinaya, monastics can eat food only between dawn and noon.

Although this diet was intended to meet the specific needs of the Buddhist community in 5th-century India, some lay people have chosen to take on a version of the practice. Theres even a book advocating the Buddhas diet.

The original logic of the monastic eating practice aimed to avoid causing aggravation to both monastics and laypeople, as explained in the Latukikopama Sutta (MN 66). The diet is neither intended as a health regimen, nor explicitly, as some have claimed, as an expression of a middle way between indulgence and asceticism. While its true that Buddhist monastic life was generally designed to be such a middle way, originally the Buddha allowed his monastics to go on alms round whenever they pleased. The Latukikopama Sutta explains that the Buddha forbade monastics from going on alms rounds after noon to avoid dangers that they might meet later in the daystumbling into natural dangers in the dark, being propositioned for a tryst in the twilight hours, random hooligansand to prevent inconveniencing or frightening lay people.

Considering that weight loss is only a significant issue in societies of satiety, the following of the bhikkhu diet as a health regimen is almost certainly an innovation of modern Western Buddhism. Some Theravadin lay people do follow the bhikkhu diet for a day every quarter moon as part of uposatha practice, where some monastic rules are followed for the sake of cleansing the defilements of the mind and making good karma, but not to slim their waistlines.

Since Im an ex-monastic, you might think that I am against the use of the bhikkhu diet as a mere dieting toolbut youd be wrong. I have used it that way myself from time to time, and recently, several weeks before I read the Times article, I had decided to take it on indefinitely.

The reason was simple: approaching 41 years of age, I found myself overweight and feeling the stressful, impermanent, and uncontrollable nature of my body. I needed to do something.

When I was a monk, the dietary rule turned out to be a profound practice for me. Learning how to tolerate hunger for hours a day became training for tolerating difficult emotions and physical pain. Restricting eating to the morning acts on your desire like focusing a camera lens: the way that the mind relates to the craving for pleasure and safety becomes clearer and easier to witness.

To use a metaphor of Ajahn Chah, the great Thai Forest teacher, the eating rule is like a Thai lizard hunter. He finds the mound where the lizard lives and closes off all the holes but one, then he waits, watching that one hole. Sooner or later the lizard comes out where he can catch it. In the same way, when you stop foraging for food whenever you want and limit yourself to the morning only, you can see your minds behavior around food more clearly.

Related: Dogen Said Not to Waste a Single Grain of Rice. Heres How.

As a layperson, following the bhikkhu diet is of course much more difficult. As a monk, I did not have to cook dinner for others while I myself was not eating or resist the urge to wake up my brain with a meal when I had to stay up late at night working. It was initially difficult as a layperson to adjust to the need to schedule a reasonable amount of healthy food before the noon cutoff. It was also hard to acclimatize myself to the season of hunger that began sometime in the late afternoon and continued until nighttime. After a week or two, however, the diet was feeling energizing. I was losing weight. There was an ironic, one might even say Epicurean, enjoyment in being able to eat freely in the morning, and also in not having to think about food after noon.

A sense of excitement began to grow about the diet. After feeling a little tired in the first week, I did as the monastics do: I began taking tonics in the late afternoon and evening (sugar, honey, and medicine are allowed according to all the different lineages). I would have tea and honey or a particular scandalous treat that is allowed for monastics courtesy of a loophole: dark chocolate. Due to the ingredients of pure dark chocolate being cocoa (a medicine) and sugar, monks in the Thai Forest tradition munch on the little dark squares at tea time. This might make us on the diet seem like dandies to you, but believe mewhen dark chocolate is the only food stuff you are allowed, its flavor begins to turn ascetic pretty quickly.

That adjustment made, I began to settle into the diet comfortably, at least for the most part. I slipped occasionally due to a birthday party dinner or needing to work late at night. I decided to accept that there might be a cheat day once a week, a practice actually recommended in The Buddhas Diet as good for your metabolism.

I also began to feel the mood that comes from settling into any difficult discipline, a mixture of increased self-confidence, self-respect, and a decrease in the kind of anxiety that results from not feeling able to rely on oneself. Other benefits included increased mental clarity and lightness in the latter half of the day, and better sleep at night.

Clark Strand, another ex-monk who tried the bhikkhu diet and wrote about it in Tricycle, fell off the wagon after a few months and gave it up. The friend whose bhikkhu practice inspired Strand to stop eating after noon also happens to be my former abbot, Thanissaro Bhikkhu. After Strand began eating after noon again, Ajahn Thanissaro reportedly told Strand, Its supposed to be part of a whole lifestyle. You take the bhikkhu out of the bhikkhu diet and all youve got is this guy who wont eat anything after twelve noon because it keeps his weight down. Hard to have much commitment to that!

Time will tell how I fare, but Im inclined to think that Ajahn Thanissaro was right. Neither the Times nor even a slim waistline is enough inspiration to keep on the bhikkhu diet. So although one might take up the bhikkhu diet out of a desire for health, longevity in its embrace will require seeing its personal spiritual benefits (and I think its clear that it would not be beneficial for everyone). It will also require having a little of the bhikkhu or bhikkhuni in you. But then isnt that supposed to be true of every follower of the Buddha?

[This article was first published in 2017.]

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I Tried the Buddhist Monk DietAnd It Worked - Tricycle

The study, published in theJournal of Physiology, fed male mice a poor-quality low protein diet which was found to impair the way blood vessels functioned in their offspring, a key indicator of heart disease.

The research team, led by experts from the University of Nottingham's School of Medicine, noted the growing evidence suggesting maternal diet and well-being at the time of conception can impact offspring development and may often lead to cardiovascular conditions and metabolic disease in later life. However, they noted that little research has been done into the impact of a father's diet and the effects this can have on the cardiovascular health of his offspring.

"Our findings indicate that a poor quality paternal low-protein diet may have altered the genetic information carried in the sperm or the composition of the seminal plasma, commented Dr Adam Watkins, lead author of the study. Our study shows that a father's diet at the time of conception may affect how the blood vessels form, which then leads to permanent changes in how the blood vessels work, resulting in 'programmed cardiovascular ill-health in his offspring.

"These findings are significant for people's health, as it shows that some conditions are attributed to a disturbance in early development processes which can be affected by a father's diet."

Study details

Using a mouse model to explore the long-term cardiovascular health of offspring from males fed a poor quality, low protein diet, the new study aimed to bridges gap in understanding of the impact of paternal diet on offspring health.

Mice were fed a controlled normal protein diet (18% protein) or low protein (9% protein) diet for a minimum of 7 weeks prior to conception.

Results showed that the poor-quality diet may have altered the genetic information carried in the sperm which changed the way blood vessels formed in the developing foetus, and so affected the cardiovascular function in the offspring.

The study also showed that the fluid the sperm are carried in, the seminal plasma, also influenced offspring cardiovascular health. The researchers looked at the effect of low protein diets on both the sperm and seminal fluid of male mice studying the impact on offspring in four conditions: when the sperm was from a dad with a poor diet, when the seminal fluid was, when both were, and when neither was.

They found that the heart health of offspring was negatively impacted when there was mismatch between the sperm and seminal fluid, meaning that one was from a poor dietary dad and the other from a dad with a normal diet, or vice versa.

Watkins and colleagues noted seminal fluid suppressed maternal uterine inflammatory and immunological responses that are essential for a healthy pregnancy.

"It is important that we understand how and why paternal diet impacts on the offspring, so we can suggest preventative measures for couples who are trying to conceive, such as dietary recommendations, said Watkins.

Men on crash diets may be affected by the findings, said the team, noting that the quality of seminal fluid changes quickly, while sperm only changes after a few months meaning that there might be a mismatch in the first few months of a diet, and this time may coincide with when they are trying to conceive.

The findings may have also implications for couples using assistive reproductive technologies such as IVF because IVF uses only the sperm, and this might result in a mismatch between the quality of sperm and seminal fluid, they added.

Source: The Journal of PhysiologyPublished online, Open Access, doi: 10.1113/JP278270Paternal diet impairs F1 and F2 offspring vascular function through sperm and seminal plasma specific mechanisms in miceAuthors: Hannah L. Morgan, et al

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Dads diet may have long-term impact on baby's health - NutraIngredients.com

The quest to lose weight is immensely exhausting, to say the least. Something similar happened with 34-year-old Mangesh Singh who tried gymming for 7 years but to no avail. He even tried swimming and several other diets to lose weight, but he did not find anything even remotely sustainable. This is his incredibly motivating journey of losing 20 kilos in just 2 months. Here is how he did this.Name: Mangesh SinghOccupation: IT Head

Age: 34 years

Height: 5 feet 5 inches

Highest weight recorded: 103 kgs

Weight lost: 20 kgs

Duration it took me to lose weight: 2 months

The turning point: There wasnt any particular moment that led to the realisation that I needed to lose weight but actually a series of events. For example, I am the youngest in my family but because of all the excess weight, I used to look overweight. I also tried to go for a morning walk daily but I could not continue it.

In addition to several diets, I also tried working out in a gym for seven straight years but to no avail. Those diets were not sustainable and I gained double the weight after stopping them. While looking for a sustainable diet plan, I stumbled upon the intermittent fasting which is the 16/8 plan.

While I was very sceptical about following it initially, I witnessed incredible weight loss after following this diet. The best part? I felt extra energetic throughout the day and my focus also improved.My breakfast: I do not eat anything in the morning.My lunch: 2 boiled eggs with fruits

My dinner: 1 bowl of dal, a portion of brown rice, one chapati and a portion of chicken/fish

Pre-workout meal: I do not eat anything before working outPost-workout meal: I vouch on chana sattu drinkI indulge in: I have an eating window of eight hours, so I dont really avoid eating any specific food during that time.

My workout: I go for a walk in the evening.

Fitness secrets I unveiled: I have realised that contrary to popular notions, it is very crucial to eat on time to lose weight. However, at the same time, it is important to cut down all the junk and processed food items.

How do I stay motivated? Once I began to see the change in my energy levels, it was enough to keep me motivated to continue my journey to lose weight and stay fit.

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Weight loss story: I followed THIS simple diet to lose 20 kilos in just 2 months! - Times of India

The claim of raw pet food advocates is that eating raw meat is what dogs are supposed to do, since they descended from wolves. But according to Tufts University and the World Small Animal Veterinary Association, theres no science to back up this claim. On the Tufts Veterinary Medical Center blog, Petfoodology, its clinical nutrition team notes that while its true wolves eat raw meat, the average life span of a wolf in the wild is only a few years. In turn, what works for a wolf doesnt work for a dog that you hope has a long, healthy life.

That researchers also note that, in their own clinical practice, theyve seen a number of commercial raw meat diets whose nutrient profiles either dont make sense or dont meet current nutritional requirements, despite labeling to the contrary. Many raw meat diets are very high in fat compared to typical canned and dry diets, and they lack the vitamins and minerals dogs need for a balanced diet.

In the end, giving dogs a raw food diet is an attempt by owners to give dogs the best life they can. Traditional dog food is sometimes recalled for Salmonella, too, and some dog food marketed as grain free has been linked to canine dilated cardiomyopathy, a disease of cardiac muscle. Pet food trends also tend to mimic human health food trends the raw pet food diet mirrors the Paleolithic diet, cans like Fancy Feast emerged after people got into gourmet food in the 1980s, and the desire for grain free came from our own rejection of gluten.

But good intentions dont always equate to healthy choices. For now, scientists say raw pet food is something to be cautious about both for our pets sakes and our own.

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Raw pet food: The trendy diet can put humans and animals in danger - Inverse