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Q&A: How new blood testing could help doctors better treat obesity – American Medical Association

Posted: May 10, 2021 at 1:51 am

With more than 1 billion people worldwide living with obesity and predictions that 50% of American adults will have obesity by 2030, a physician-owned company is aiming to soon provide doctors with an easy-to-use tool to help diagnose and treat this global public health epidemic.

Phenomix Sciences was founded by National Institutes of Health (NIH)-funded obesity experts and Mayo Clinic physician-scientists Andres Acosta, MD, PhD, and Michael Camilleri, MD, in Rochester, Minnesota, in 2017. Health2047, the wholly-owned innovation subsidiary of the AMA created to overcome systemic dysfunction in the U.S. health care, recently launched the company.

Through a decade of research, Drs. Acosta and Camilleri identified four obesity phenotypes and treatments that work best to help patients fight obesity based on which phenotype or phenotypes they have. Work is well underway to make the company's MyPhenome test commercially available by the end of 2021. The test allows a physician to order a blood test that identifies the phenotype or phenotypes the patient has, giving the physician and patient a roadmap for how best to help the patient lose weight and keep it off.

Drs. Acosta and Camilleri led a team that co-wrote a recent study in the journal Obesity showing the prevalence of obesity phenotypes and their association with weight loss. In 450 patients, 27% had more than one phenotype and only 15% didn't show signs of any of the phenotypes. It found that this individualized treatment was associated with a 1.75-fold greater weight loss after a year. Dr. Acosta recently took time to speak with the AMA about his research and Phenomix Sciences.

AMA: Why you were interested in this research?

Dr. Acosta: On average, the adult with obesity is trying four to five diets per year. And unfortunately, most people lose some weight initially and then regain it all back, or they may not lose any weight. We keep thinking that one treatment is going to fit all people. But when we go to the real world, unfortunately a new diet or new medication works great for a few and very bad for the majority.

So, how do we actually address this problem that the one-size-fits-all approach is not working? We decided to take a step back and actually study what we're calling obesity types or obesity phenotypes. We decided to look at the components of food intake and energy expenditure.

AMA: Your team has discovered four primary types of obesity, as explained at the Phenomix website. Tell our physician readers more about these phenotypes.

Dr. Acosta: The first one is patients who do not feel full. These are the patients who keep coming for seconds and thirds within a meal. They just don't have that sensation of fullness. We call that "Hungry Brain" because the signal is supposed to come from our stomach to our brain, and the brain needs to say, "I feel full, stop." That signal is wrong in these individuals.

The second group of individuals is folks who eat, feel full, but then within an hour or two they feel hungry again. These patients have a problem with their gut. The gut needs to send signals to the brain and tell the brain, I want to stay feeling full because I need time to digest my meal. Unfortunately, these signals are not coming out of the gut to the brain. We call that "hungry gut."

Then there are the folks who are eating for their emotions. They have a good day, they want to eat something. They have a bad day, they want to eat something. And they look for food to cope with life. We call that "emotional hunger."

The last group is what brings most of my patients to the clinic. They are the ones who come in and say "Doc, I have a problem with my metabolism." This group should be burning more calories and they're not. They're just storing those calories. We call this the "slow burn" phenotype.

And your question may be, when we ask about phenotype, who cares what phenotype I have? It matters because we have multiple studies all the way from randomized placebo-controlled trials, observational studies, and now a trial that was developed in the clinicreal world evidence.

It matters because we can actually select the right therapy for these individuals and enhance the amount of weight loss and not only enhance it a little bit, but actually almost double the amount of weight that they're going to lose with these interventions. It identifies who is going to be successful with a tailored approach and walks away from this one-size-fits-all approach.

AMA: Can you give me an example of some of the different ways a physician would approach treatment once they know the phenotype?

Dr. Acosta: Based on our current studies, particularly the initial randomized placebo-controlled trials that we performed, we came up with a working hypothesis or a working algorithm that physicians can use. I've been using it in my clinic to help us guide therapy. So, for example, patients with a hungry brain will have their unique, hungry-brain diet to help make them feel full for the purpose of getting to that sensation of fullness.

Then the FDA [Food and Drug Administration]-approved medication that will likely work the best for these patients, as we've shown in our studies, is phentermine-topiramate extended release. We have also FDA-approved devices, and I think most likely they will respond better to a vagal B block or an endoscopic sleeve gastroplasty. And the surgical approach that most likely will be successful in this is the laparoscopic sleeve.

For patients with emotional hunger, I think it's essential that these patients have a diet that is low on calories, and they really focus on trying not to seek food to cope with their emotions. It's when cognitive behavioral therapy and group therapies might be ideal. And then we have a medication that is FDA-approved for obesity, which is now naltrexone bupropion sustained-release, and this may likely be the best medication.

AMA: If I'm a practicing physician, how will Phenomix work?

Dr. Acosta: The hope is that within the next six months, Phenomix will have these tests commercially ready. You will be able to reach out to Phenomix Sciences and set up a way to order the test. My hope is that this will be as simple as doing a lipid panel. The physician orders the test, the physician gets the results, and then, together with the patient, there's a discussion about what is the best option for the patient, and what the patient wants to do.

AMA: How do you believe this will change the way obesity is understood and treated by physicians in practices across the country?

Dr. Acosta: It just is a game changer in the conversation with our patients, because I see all sorts of patients struggling with obesityrural, urban, all ethnicities, all raceswho feel they are failing. We keep telling them, "You need to be healthy. You need to lose weight." They try and they fail.

So, when suddenly you tell your patients, "Hey, hold on, I think your lack of success is because there is a problem in your brain that is not allowing you to feel full. Let me help you with a tailored diet, let me help you with a medication, let me help you with surgery," the conversation changes as to what the underlying problem is. We remove the stigma about obesity and we start talking obesity as a disease.

Also, we help physicians who are very busy, who need to address multiple problems during a clinical visit by giving them the tools to say, "Let's focus on this problem of obesity with this solution and with this follow-up," just as we do for every other disease.

My huge hope and wish is that these phenotype-guided approach will help insurance companies to say: We should cover obesity. We should take obesity seriously. We should cover reimbursement for obesity so physicians can address it.

AMA: What excites you the most about the technology and the ability to treat people on such an individualized level?

Dr. Acosta: It is how my patients are changing the conversation about this topic. It's not aboutdid I lose weight? Did I gain weight since the last appointment?

It's about my hungry brain, it's about my hungry gut, it's about my underlying pathophysiological problem. My patients are coming back and telling me, "This is working. Or, no, it's not working, and I'm still struggling. How can you help?"

I love this patient of mine who came in one day and told me, "For the first time in my life, I know what it is to feel full. You have changed my life."

AMA: How has Health2047's partnership helped Phenomix?

Dr. Acosta: We are academicians and physician-scientists in academic settings. We are doing all the discoveries and it takes sometimes more than a decade to translate to help patients. I was extremely excited when we started talking with Health2047 and learned how they're helping physician-scientist entrepreneurs like myself by bringing the resources needed to accelerate the translation of these technologies from a lab and academic setting to the real world, so patients and physicians can benefit from that.

I think that's what we have achieved and what we are achieving. Health2047 has brought a significant amount of resources to this technology, and to the company to develop the technology. I'm honored to have them as partners in this company and this endeavor.

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Side Effects of Giving up Yogurt, According to Science | Eat This Not That – Eat This, Not That

Posted: May 10, 2021 at 1:51 am

Whether you're taking the plunge into veganism, or trying to figure out if some of the reported health benefits of yogurt are actually true, people have a variety of reasons for giving up yogurt. This popular dairy product is made through the bacterial fermentation of milk and can be made with a variety of flavors and toppings. It's an easy, healthy breakfast or snack option for some, but for others, it can be affecting their bodies in negative ways.

While there are some benefits to giving up yogurtespecially for those who are lactose-intolerantthere are perks attached to continuing to eat the delicious dairy product. It's good for your health, and you might just run into a future royal while at a yogurt shop. By giving up yogurt, you could be missing out on some of the beneficial nutrients that come with enjoying a bowl of yogurt regularly.

Here's what you need to know about giving up yogurt, and for even more healthy eating tips, be sure to read up on our list of The 7 Healthiest Foods to Eat Right Now.

A 2009 study from Future Medicine suggests that as people age, they more frequently suffer from lactose intolerance, which means their bodies are ill-equipped to digest lactosethe main carbohydrate found in dairy products. Lactose intolerance can lead to a host of symptoms, including inflammation.

Giving up yogurt can help to reduce inflammation, according to Heather Hanks, a nutritionist with Instapot Life.

"Many people do not realize that they are sensitive to dairy, and although yogurt is better tolerated because it contains probiotics, it can still be a source of inflammation if you are sensitive to cow's milk," Hanks says. "Additionally, many brands of yogurt contain added sugars, so giving up yogurt with cow's milk and added sugars could also help reduce inflammation in the gut, improving total body health."

Here are 9 Signs of Lactose Intolerance You Should Never Ignore.

It's well-known that yogurt helps you stay, well, regular. Yogurt is packed with probiotics, which are live microorganisms that are beneficial for digestive health. The food not only aids constipation in eaters, but it can also help prevent diarrhea, according to Harvard Health.

With all of the digestive help that comes with yogurt, it's safe to say that consumers might get a bit irregular once they give yogurt up. Hanks recommends finding probiotics in other food sources to help maintain regularity.

"If you have been using yogurt to help stay regular, then you may find that taking a probiotic supplement or getting your probiotics elsewhere, such as in sauerkraut, can help," Hanks says. Or turn to one of these 11 Probiotic Foods for Gut Health That Aren't Yogurt.

Those who have a sensitivity to dairy products don't only have symptoms in their digestive systems. Dairy sensitivity can also be shown through acne outbreaks in those who consume dairy products. A study from the University of Copenhagen linked dairy consumption in people ages 7 to 30 and an increase in acne. So giving up yogurt, as well as other dairy products, might just lead to the end of acne problems for some.

"It doesn't work for everyone, but it's worth a trysimply lowering that dairy intake may just lead to clear skin," says Kathryn McDavid, CEO of Editor's Pick.

Here are 10 Foods Making Your Acne Even Worse.

Calcium is one of the biggest benefits of consuming dairy products. The mineral is responsible for so many of the body's functions, including being a pretty big component of the makeup of our teeth and bones. So when you're cutting yogurt from your diet, make sure you have another source of calcium in there to take its place, because it's vital to maintaining health.

"By removing yogurt from the diet, one is potentially reducing their protein and calcium intake, both of which are essential for building and maintaining strong bones," says Christine Randazzo Kirschner, RD, nutritionist, and co-founder of Amenta Nutrition.

Calcium also has additional benefits that need to be considered when cutting yogurt from your diet, according to Kirschner.

"Calcium also helps blood clots, is essential for cardiac function, keeps nerves working properly, and may help reduce blood pressure," Kirschner says.

We're all typically looking for a little more pep in our step once we hit the middle of the day, and instead of getting caffeine jitters from having your second, third, or fourth cup of coffee for the day, another way to get more a bit more energy is by cutting out your daily yogurt, according to Niyla Carson, a nutritionist at Fast Food Menu Prices.

"Yogurt contains amino acids, which basically makes us a bit lazy," Carson says. "So, if we cut off our daily dose of yogurt, our energy for the day might go up a bit."

In particular, Greek yogurt contains tryptophan, a type of amino acid that is found in many high-protein items like turkey, chicken, and eggs. Tryptophan helps to produce melatonin, a hormone that helps put you to sleep. This is also why some dietitians recommend enjoying yogurt as a sweet treat at the end of the day.

Along with yogurt, here are the 40 Best and Worst Foods to Eat Before Sleep.

Did you know several store-brand yogurts contain more sugar than a Twinkie? If you find yourself reaching for yogurts with candy or sugary-flavored yogurts on the shelves, it's likely that giving up yogurt will help you decrease the sugar intake in your diet.

"Although healthy yogurt options don't have many additives, make sure to watch out for those with high sugar content, as it could do more harm than good," says Carson.

A study by the Poznan University of Life Sciences found that even in women who are not committed to a regular diet, cutting out some excess sugars can lead to a more healthy lifestyle.

There are a lot of benefits to eating yogurt, and one of the largest ones is that it contains a lot of calcium and a lot of protein, both of which are extremely important for maintaining proper dental health.

"Calcium works by maintaining bone density and protein strengthens your gums," says Max Harland, the CEO of Dentaly. "Plus, yogurt's high probiotic content promotes healthy bacteria in your mouth that eliminates issues like bad breath."

Harland also said that yogurt helps to balance the pH in mouths, which helps lead to fewer cavities.

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Can aquaculture save a species from extinction? – The Fish Site

Posted: May 10, 2021 at 1:51 am

Several aquaculture initiatives aim to reverse the decline of the Totoaba, a fish species that is only found in Mexican waters and has nearly been fished to extinction.

Karlotta Rieve

Endemic to the Sea of Cortez (which is also known as the Gulf of California) Totoaba (Totoaba macdonaldi) can grow to two metres, weigh 130 kg and live to 30 years. The species was listed as critically endangered in 1976. Although fishing for the species has been prohibited since then, poaching has dramatically increased, due to the value of the species on the black market.

However, it is not the meat the fishermen and smugglers are after, but the fishs exceptionally large swim bladder. Dried, it is considered a gourmet food and highly sought by Asian black market, where it is known as fish maw. With prices reaching $9,000 per kilogram, it is often termed the cocaine of the sea.

The illegal fishing methods used to catch Totoaba are also considered to be the main reason for the decline of the critically endangered Vaquita, a charismatic dolphin-like mammal that shares the same habitat as the Totoaba, but that is another story. What this article aims to highlight is the exceptional work both public and private aquaculture institutions in Mexico are doing to restock the Totoaba in the wild and ultimately build a sustainable commercial aquaculture sector around it.

Karlotta Rieve

There are currently three hatcheries in the country that work with Totoaba, both for restocking purposes and for commercial aquaculture production the faculty of Marine Sciences in Ensenada of the State University of Baja California (UABC), the Aquaculture Institute of the State of Sonora (IAES) and the private aquaculture enterprise Earth Ocean Farms.

Dr Conal True and the research team from the UABC were first to spawn the Totoaba successfully in captivity and have since spearheaded the academic research into the species. They released the first juveniles 15 years ago and their restocking programme has since greatly contributed to stabilising the wild Totoaba stocks. Ensuring genetic diversity and traceability of the Totoaba coming out of the institute's labs has always been high on the agenda. Thanks to genetic markers they found a few Totoaba that were part of one of the first generations to be released 15 years ago have now become wild broodstock. And the researchers continue to look for more recaptures.

The Mexican federal government and the state of Baja California have invested close to $5 million in a new campus hatchery capable of producing 1 million juveniles a year once it is in full operation. Housed in a 3000 m2 building, with more than 1000 m3 total tank volume it includes modern lab facilities, a pilot feed production unit and teaching spaces. Another major objective of the new hatchery is to train future aquaculture professionals in both Totoaba early stage rearing and on-growing techniques. The university staff are convinced that the new laboratory will prevent the extinction of the Totoaba for good.

This guarantees adequate and also state-of-the-art installations to support both scaled production and research in Totoaba for another 20 years, at least from the public side, says Dr True, who has dedicated 28 years of his academic career to hatching and raising the species.

The number that will be released for restocking purposes depends on the assessment of the wild population. Through breeding a large variety of families and continuous recapture studies, the team aim to ensure genetic diversity. They expect to be releasing less than 200,000 juveniles annually into the Sea of Cortez. Consequently, the majority of the fingerlings produced in the new hatchery are destined for private grow-out facilities, which aim to produce Totoaba as a commercial aquaculture species.

Karlotta Rieve

Earth Ocean Farms, which is located in La Paz, in Baja California Sur, has been trailblazing the commercial efforts of cultivating Totoaba for more than eight years now, using pioneering submersible offshore cages, the latest breeding technologies and best-practice processing techniques, for which they were recently BAP certified.

Besides selling Totoaba in restaurants and retail outlets across Mexico, they have from the beginning supported the restocking of wild populations by releasing thousands of juvenile Totoaba into their natural habitat and working with local schools to educate the upcoming generations on the importance of wildlife preservation. So far, Earth Ocean Farms has released over 100,000 juveniles back into the wild and is committed to the protection of this unique Mexican species.

Further north in the Sea of Cortez, in Baja California, a new company has joined the efforts of turning the Totoaba into a popular farmed consumer fish. With a concession to farm the species on 52 hectares off the coast of San Felipe, Aquario Oceanico started pilot operations three years ago. They source their juveniles from the new hatchery at the UABC and transport them a few hundreds kilometres across the peninsula, in collaboration with the university. Much of the expertise and some of their farm tech, like the sea cages, originally came from a tuna ranching businesses in Ensenada.

Equally the grow-out feed is specially sourced from a company in Ensenada that specialises in marine feed diets that include wild-harvested kelp from the Pacific coast. Again, the credit for finding an adequate diet for this unique species goes to research conducted at Mexican universities.

Karotta Rieve

According to the experts Totoaba are well suited to aquaculture, due to their relatively fast growth rates, reaching a commercial size of 3 kg in only 18 months, if given the right feed formulation and feeding regime. Furthermore, the Mexican culinary industry now recognises the high quality white flesh of the Totoaba as an exciting new product. Yet, the main constraint is still that none of the commercial grow-out farms are able to sell Totoaba products anywhere outside of the country, due to the trade ban for the species.

These companies therefore depend strongly on the status of the wild population of Totoaba, which, as some studies indicate, has reached a stable level. Yet, due to the uncertainty of the commercial regulations around this species and to ensure profitability of the business, Earth Ocean Farms has successfully diversified its portfolio, adding Pacific red snapper, while Acuario Oceanico has begun developing oyster farming beside their Totoaba cages. Both these products are eligible for international sale.

Nevertheless it is clear that, alongside the academic institutions in the country, the main objective of these companies is to ensure that responsible aquaculture can mean a bright future for a unique species like the Totoaba - both in the wild and on farms.

With a strong interest in the future of food supply, Karlotta is currently deep-diving into the aquaculture industry, eager to understand the potential and challenges of farmed seafood better. As a freelancer she usually works with mapping innovation trends for corporates and connecting them to startups in the food and retail world

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Should we rethink the role of carbs in obesity? – Medical News Today

Posted: May 10, 2021 at 1:50 am

For decades, the causes of obesity and the most effective way to lose weight have been the subject of fierce debate among scientists and healthcare professionals.

According to one theory, known as the carbohydrate-insulin model, food and drink that contain large amounts of carbohydrates cause a spike in circulating insulin levels.

The hormone drives fat cells, or adipocytes, to store the excess calories, which reduces the availability of these energy sources for the rest of the body.

This, in turn, increases hunger and slows metabolism, which leads to weight gain over time.

Dietitians often cite the carbohydrate-insulin model to explain the success of high fat, low carbohydrate diets such as the ketogenic diet.

Unlike carbohydrates, dietary fat does not cause a spike in insulin levels immediately after a meal.

On the other side of the debate, the energy balance model makes less of a distinction between fat and carbohydrates.

This model focuses instead on the balance between total calorie intake through eating and drinking, and total calorie expenditure through physical activity.

According to this model, if calorie intake exceeds expenditure, the result will be weight gain over time. But if expenditure exceeds intake, the eventual outcome will be weight loss.

Writing in the journal Science, two scientists argue that the carbohydrate-insulin model is overly simplistic.

John Speakman, from the University of Aberdeen in the United Kingdom, and Kevin Hall, of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, MD, do not dispute the success of high fat, low carb diets for some individuals.

They also acknowledge that insulin plays an important role in body fat regulation.

But they question whether the effect of insulin on adipocytes after eating food high in carbohydrates is solely responsible for weight gain.

They write:

[W]e propose that the role of insulin in obesity may be better understood by considering its action on multiple organs that is driven by factors mostly independent of carbohydrate intake. Reconsidering the role of insulin may improve our understanding of the causes of obesity and its treatment.

They cite a 2020 study in mice that compared the effect of 29 different diets on body fat.

Of these, 16 diets maintained a constant intake of protein while varying the relative contribution of fat and carbohydrate to total calorie intake.

The carbohydrate-insulin model predicts that the more carbohydrates are in a diet, the higher insulin levels will climb after eating.

As a result, according to the model, the mice should lay down more fat and increase their total calorie intake.

However, after 12 weeks roughly equivalent to 9 years in humans mice that ate high carb diets consumed fewer calories and had gained less fat and overall body weight.

This was despite having higher circulating insulin levels following eating.

Acknowledging that studies in mice may not reflect what happens in humans, the authors cite research in people that produced similar results.

For example, another recent study compared the effect of two diets on people with excess weight.

Each diet lasted for 2 weeks. One comprised around 10% carbohydrate and 75% fat, while the other consisted of approximately 75% carbohydrate and 10% fat.

Participants were allowed to eat as much or as little as they wanted.

As predicted by the carbohydrate-insulin model, the high carb diet resulted in a larger spike in insulin levels following meals.

However, participants on the high carb diet consumed fewer calories and reported that they felt just as satisfied after eating compared with those on the low carb diet.

Only the high carb diet resulted in a significant loss of body fat.

Speakman and Hall argue that insulin affects many organs around the body, and not just after mealtimes.

They write that its role in regulating body fat is best understood as part of a dynamic network of factors controlling and mediating the effects of energy imbalance.

For example, they say high insulin levels, combined with signals from fat tissue, tell the brain to reduce energy intake when the amount of body fat rises above a critical threshold.

David Ludwig, M.D., Ph.D., professor of nutrition at Harvard School of Public Health in Boston, MA, a leading proponent of the carbohydrate-insulin model, questioned the research cited in the article by Speakman and Hall.

He told Medical News Today that the study in mice was strongly biased because the low carb diets contained large amounts of saturated fat.

In rodents, saturated fat causes severe inflammation and metabolic dysfunction, precluding a meaningful test of the [carbohydrate-insulin model], he said.

He added that other studies have found that rodents on high carb diets rapidly develop obesity.

He also challenged the validity of relatively short studies in humans, such as the 2-week study cited by Speakman and Hall, which he said do not give the body sufficient time to adapt to the change in nutrients.

His own meta-analysis suggests that longer studies consistently show higher energy expenditure on low carb diets.

Several reviews of clinical trials have shown that low carb, high fat keto diets promote weight loss.

Prof. Naveed Satar from the Institute of Cardiovascular and Medical Science at the University of Glasgow in the U.K. told Medical News Today that low carb diets can help people lose weight.

He believes the diets owe their success to lower total calorie intake as a result of reduced appetite, but not from how some experts envisioned the workings of the carbohydrate-insulin model.

People who go on low carb diets tend to eat less as they increase protein intake, which tends to suppress appetite a little, he explained.

He added that his own research suggests that the excess calorie intake of individuals with excess weight tends to come from fat rather than sugar.

This suggests that, along with reduced calorie intake, reduced fat intake should remain an important component of weight-loss diets.

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Things to Know About the Ketogenic (Keto) Diet Pancreatic Cancer Action Network – Pancreatic Cancer Action Network

Posted: May 10, 2021 at 1:50 am

The ketogenic, or keto, diet has a lot of people talking, so we wanted to know what the hype was about and what you should know about the hot diet.

We turned to Maria Petzel,senior clinical dietitian for the Pancreas Surgery Program at MD Anderson Cancer Center and an emeritus member of PanCANs Scientific and Medical Advisory Board, for answers.

Petzel: What many people are calling a keto diet lately is actually just a low-carb diet more like Atkins or South Beach.

A true ketogenic diet, which is designed to achieve ketosis, must be extremely low in carbohydrates (about 5 10% of calories would come from carbs), controlled in protein and extremely high in fat.

In a low carb diet like the South Beach Diet or Atkins Diet, about 20 30% of calories come from carbs, and protein isnt restricted.

In comparison, in a typical healthy diet, 45 65% of calories come from carbohydrates.

Petzel: The key to burning body fat is to eat fewer total calories (from any source) than you take in. For those losing weight on a ketogenic diet, it is because they have a deficit of calorie intake compared to calories burned. Often, being in ketosis will suppress the appetite, leading to lower total calorie intake in general.

PanCAN: Is It Safe?

Petzel: We do not know much about the long-term effects of the diet. There are concerns that it could be harmful to the heart and liver. The lack of fiber in the diet can lead to issues with constipation, which could exacerbate other conditions like diverticulitis.

Following a diet that basically cuts out an entire nutrient category and therefore almost all grains, beans and lentils, most fruits, and some vegetables can lead to vitamin and mineral deficiencies.

Petzel: If patients are on pancreatic enzyme replacement therapy, they will likely need to adjust their enzyme consumption to account for the increased dietary fat. Higher fat diets, like keto, can be harder to tolerate for some patients with pancreatic cancer, even with enzyme adjustment.

Also, the level of fat required for a true ketogenic diet has the potential to displace adequate protein intake.

Overall, the ketogenic diet poses a high risk of weight loss in patients, especially for those experiencing fat malabsorption.

We recommend that adults eat a plant-based diet that includes a wide variety of plant proteins from nuts, seeds, beans and legumes, whole grains, non-starchy vegetables and fruit, Petzel says. We recommend adults get at least five servings of fruits and vegetables a day, along with plant proteins and whole grains adding up to at least 30 grams of fiber per day. Research supports this as the optimum diet for weight management and cancer risk reduction.

And its important to talk to your doctor or dietitian before making changes to your diet especially for pancreatic cancer patients.

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Opinion | Post-Covid, the Weight Loss Industry Wants You to Diet – The New York Times

Posted: May 10, 2021 at 1:50 am

Perhaps youve heard someone bemoan the quarantine 15 gained during lockdown, or of struggles to flatten the curve of a body that looks different after a year inside.

It was inevitable. The pandemic has made us more sedentary, and many of us have sought comfort in eating. We are languishing, as Adam Grant wrote recently, living in the void between depression and flourishing the absence of well-being. And where theres insecurity and unhappiness, there are companies looking to make money. So here come the weight-loss profiteers, the misery merchants dressed up as purveyors of wellness.

Theyre looking to make back whatever money they missed out on during 2020 and then some. In a normal year, the weight-loss business ramps up in January and goes strong through spring and into summer. Last year was not normal. There was stress snacking and procrasti-baking. There was no shedding for the wedding in a year when most weddings were postponed or drastically downsized; no pre-high-school-reunion crash diet or worrying if Grandma would body-shame you at Thanksgiving. The closest we got to beach season was tut-tutting at the Kardashians private-island getaway last fall.

And honestly, with a pandemic to worry about, getting bigger didnt seem like an especially big deal. Its no surprise that many weight-loss companies took a financial hit. According to Marketdata Enterprises, a research firm, the overall U.S. diet industry reached a new peak of $78 billion in 2019, but it lost 21 percent of its value in 2020.

Was that dip matched by concurrent weight gain among Americans who suddenly couldnt make it to their weekly weigh-ins or stock up on their meal-replacement shakes? Depends on whose data you believe. A study published in the journal Obesity found a global decline in some healthy behaviors: Respondents ate more processed food and exercised less. And a recent survey from the market research firm Ipsos found that about a third of Americans said they had gained weight during the pandemic.

But research from a company that makes internet-connected scales, Withings, painted a different picture. The French company analyzed data from five million smart scales, hybrid smartwatches and smart thermometers, and found that people actually lost weight in 2020, or were more likely than in other years to hit their weight-loss goals, if they had them. (Of course, those who own such devices are a self-selecting group that most likely were trying to lose weight.)

In any case, the weight-loss industry isnt going to let a lack of data dull its zeal to convince Americans that yes, we got fat, and that now we need to get up off our couches and get back into shape by buying their app, or signing up for their meal-delivery service or enrolling in their program. These corporate entities have been joined by the freelance scolds, the people who are not going to miss a chance to feel superior to their friendly neighborhood fatties. Magazines are full of diet-app roundups. Here is the famous physician wagging her finger at Krispy Kreme for offering free doughnuts to the vaccinated.

My Twitter feed is suddenly full of ads for intermittent fasting apps; on Instagram, its wall-to-wall shapewear and fat-shredding supplements. Then theres the Facebook friend who really wants to talk about the Keto diet, or Optavia, or the Beachbody plan, and would be happy to bring me into the fold. (Yes, the weight-loss industry has branched into multilevel marketing.)

You can consume a lot of this marketing without ever hearing the words weight or diet or calories. The diet industry has gotten impressively subtle, even as its incessantly in your face. Buzzwords like wellness and strength have replaced diet and calories. Its all about being the best you that you can be a you that is significantly thinner than the you right now.

I have one word for you: Resist.

As we should all know by now, diets dont work in the long term. Studies show that 41 percent of dieters gain back more weight over the next five years than they lost, and that dieters are more likely than nondieters to become obese over the next one to 15 years. For some, the language of diet culture can be downright dangerous, contributing to life-threatening eating disorders.

Theres nothing wrong with taking action to improve your health. Want to add more fruits and vegetables to your diet, or get back to regular workouts? Go for it. Get outside, now that we can do that again. But you dont need to enroll in a program, download an app or buy frozen meals to do any of this.

After everything weve endured and as the crisis still rages around the world each of us should cherish the body that got us through it, rather than punish it for failing to fit into last years skinny jeans.

Jennifer Weiner is the author of the upcoming novel That Summer.

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The Real Life Diet of Russell Westbrook, Who Uses Push-Ups to Wake Up – GQ

Posted: May 10, 2021 at 1:50 am

For the fourth time in the last five seasons, Washington Wizards guard Russell Westbrook is averaging a triple-double (meaning his per game average for points, rebounds, and assists is in the double digits.) Oscar Robertson is the only other player to have accomplished this feat, and he did it once, in 1962. Westbrook is also now just three triple doubles shy of passing Oscar Roberston for the most in NBA history. Breaking a record that until recently was thought to be untouchable requires oodles of basketball talent, and also Energizer Bunny levels of energy. Westbrook has both. At 32, hes still playing more than 35 minutes a game, thanks to a dialed-in diet and routine that involves wake-up push ups, less sleep than youd expect, hydrating with Flow Alkaline Water, and a pregame PB&J (two actually) that hes been having since high school. GQ caught up with Westbrook to learn what powers one of the NBAs most productive players.

For Real-Life Diet, GQ talks to high-performing people about their diet, exercise routines, and pursuit of wellness. Keep in mind that what works for them might not necessarily be healthy for you.

GQ: What time does your day usually start?

Russell Westbrook: Well, given that I have little children in the house, it starts pretty early. 6:30 or 7:00. That varies if I'm in season, so that can change, but normally about 7:00 AM.

Was it later before the kids?

No, it was about the same. I'm an early bird, I like to get up early, get my day started early.

What's the first thing you usually do in the morning?

Sometimes I do push-ups to wake my body up. That's how I start most of the time.

How many push ups will you usually do?

That varies too, based on how long Ive been up that night. But I try to knock out anywhere between 25 and 50, get my blood flow moving.

How many hours of sleep are you aiming to get?

Probably about five or six. If I get more than that, I'm very grateful.

That's not a ton of sleep.

Yeah, you know, I feel like when I sleep longer, I don't feel the best. Going nonstop, that's kinda how my life is. That's kinda how I function.

Did you used to sleep longer?

I'll get seven or eight hours of sleep every once in a while, but that's not my norm by any means. I've alway been kind of like this: stay up late, but I'm up early.

What's breakfast?

That's my favorite meal of the day, so I usually eat a really big breakfast. Fruit. Green juice, orange juice. Breakfast can vary, I pretty much eat anything: omelette, avocado toast, pancakes, waffles, hash browns.

As the day progresses, what are you eating for lunch and dinner?

Fish for lunch. Salad for lunch. Snacks I like to eat are peanuts, parfaits, yogurt, smoothies when I can. Dinner, lots of veggies, pasta. Right now I can only eat fish, no meat for awhile.

Why only fish?

I wanted to change up some things. I wanted to lose some weight, but also keep my strength and body together. So I am trying something new. Especially throughout the season, as I get older, I have to figure out better ways to keep my body in the right shape and healthy, to be able to do what I want to do, especially while playing.

You're obviously still playing at an incredibly high level. It sounds like you've had to tweak your diet and workout to maintain that endurance as you've gotten older?

I wouldn't say that's the case. I was fine before, I just wanted to lose some weight because I felt like I was too heavy. It was a personal feeling for me. That was kind of the only reason behind it, honestly.

If you have a late game, will you eat after?

It's tough for me to eat after games. I'll eat when I can. I'll do smoothies or shakes, just to recover. It takes me a while to wind down, and eat. But eventually I'll get some food in my system, for the next day.

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Over the Counter: Debunking online nutrition trends – MetroWest Daily News

Posted: May 10, 2021 at 1:50 am

Gary Kracoff and John Walczyk| Daily News Correspondents

During the course of the COVID-19 pandemic, many of us have either gained weight or taken the time to get into shape and in some cases, a little of both. Regardless, weve all been inundated with information and claims about popular diet trends in the news or on social media.

The best advice when it comes to crafting a healthy diet isnt to trust an online trend, but to instead seek guidance from a dietitian trained to help us focus on being healthy, which is far more important than simply losing weight. They can answer questions about dietary and lifestyle factors, like stress, that affect health and can help build a personalized, long-term plan that includes proper caloric intake, optimized supplementation and prioritizes whole foods. Here are some insights from the dietitians we work with to debunk three popular diet trends:

Everyone should do intermittent fasting. This type of fasting can vary; for example, an individual can restrict eating during given times of the day or days of the week. These fasting patterns are based on circadian biology the notion that our body runs on a clocklike cycle and that there are ideal windows for calorie intake that can optimize liver function, the microbiome and digestion.

More: Over the Counter: Take tea time seriously during COVID-19 pandemic

While there can be benefits of this type of diet for some people intermittent fasting can support sustained weight loss for people who are obese its not meant for everyone. If you are pregnant or breastfeeding, have had an eating disorder, are chronically stressed, or dont sleep well, this may not be right for you. Intermittent fasting should not be a first step for people new to diet and exercise.

Keto is the best way to lose weight. Keto diets are based on the fact that some fats are very good for us, like those from avocados, olives and coconuts, and they shift calorie intake to a fat-heavy diet (up to 80%) with very low carb intake (as little as 5%). When compared to the standard American diet, which is high in carbs and sugars, a keto diet will keep blood sugar balanced, break down adipose tissue (stored fats in our body) and burn those good fats as energy.

More: Over the Counter: Five Tips to keep up the fight against COVID-19

While a keto diet can lead to great benefits, like weight loss due to breaking down adipose tissue, better energy and decreased chronic inflammation, its more of a quick-fix solution and not a long-term lifestyle. A keto diet typically works better for men and is not recommended for people with hormonal imbalances or kidney or liver disease.

Going vegan is better for me and the environment. The health and well-being of our environment is closely connected to all facets of human activity, including what and how we eat. Eating meat for instance, can be harmful for the environment because its production involves pollutants like pesticides to grow feed, methane produced by animals and carbon dioxide from transportation.

More: Over the Counter: Natural ways to keep your bones strong

But that doesnt mean cutting meat from the menu is the only way to improve our diets and save the planet we just have to be mindful of where our food comes from. As a whole, we all could consume more vegetables say, by having one vegetarian meal each week but we can still savor meat in moderation. Incorporating beans and lentils will ensure adequate protein when we cut out some meats. Buying local, in-season foods and organic, humanely sourced meat will also improve your diets impact on the environment.

Taken together, we have to understand that diets should be designed for an individuals own goals and lifestyle. There is and never will be a one-size-fits-all miracle diet. By working with a dietitian and prioritizing nutrition, youll be well on your way to looking and more importantly feeling healthier.

Gary Kracoff has a degree in naturopathic medicine and is a registered pharmacist and John Walczyk is a compounding pharmacist at Johnson Compounding & Wellness in Waltham, Mass. For more information, visit Readers with questions about natural or homeopathic medicine, compounded medications, or health in general can e-mail or call 781-893-3870.

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Effects of a silage diet on the gut bacteria of horses explored in study – Horsetalk

Posted: May 10, 2021 at 1:50 am

The Lachnospiraceae family was statistically more abundant in horses fed hay, researchers said, while it was the least abundant in horses fed silage. (File image)

The abundance of a key bacterial family that inhabits the equine gut fell away significantly in horses fed silage, when compared to those given hay or grass, researchers found.

The decline seen in the abundance of Lachnospiraceae in horses fed silage was a significant finding, according to the researchers, as it may indicate inflammatory changes, as revealed by previous studies on humans.

Other than that, the silage diet did not generate any other apparent imbalance within the equine fecal microbiota in comparison with the other two common forages.

Further investigation is necessary to look at whether the decrease of Lachnospiraceae in the intestinal microbiota is correlated with a compromised gastrointestinal health of horses that are fed silage in the long term, the study team said.

Lachnospiraceae are found in the gut of many mammals. In humans, the Lachnospiraceae have shown an ability to convert lactate to butyrate, which is critical in the maintenance of healthy intestines and the reduction of the risk of intestinal inflammation.

Lachnospiraceae are also involved in the production of short-chain fatty acids (SCFA), which act as growth factors for a healthy gut lining.

Yiping Zhu and his colleagues, in a study reported in the journal Animals, said horses are hindgut fermenters characterized by a complex family of microorganisms the microbiota mostly comprising anaerobic microorganisms that facilitate the digestion of a high-fiber diet.

The intestinal microbiota also affects the hosts immune system, influences the animals metabolism, and helps in the detoxification of harmful substances.

Therefore, any disruption to it can have major consequences on overall health.

Diet, they noted, can have a significant effect on the intestinal microbiota, with changes capable of triggering the likes of colic, metabolic syndrome and laminitis.

There is evidence that changes in dietary patterns alter the colonic microbiota, subsequently leading to changes in colonic pH and fermented products, and some of these changes may predispose horses to colic, they said.

Understanding the impact of different dietary patterns on the intestinal microbiota will help to reveal connections between diet and the overall health of horses.

In their study, the researchers investigated the effects of three different forage feeds grass, silage, and hay on the fecal microbiota of horses.

The study involved 36 healthy horses at the Guanzhong Stud farm in Shanxi province, China.

They were divided into three groups, with one group put on a grass diet (local pasture ryegrass), another receiving ryegrass silage, and the third receiving only second-cut ryegrass hay.

Fecal samples were collected after eight weeks from each horse and analyzed using high throughput sequencing to learn more about the bacteria present.

The authors described a range of changes in bacterial composition between the diets.

The Lachnospiraceae family was statistically more abundant in horses fed hay, while it was the least abundant in horses fed silage.

Streptococcaceae species, considered a core microbial component in equine intestinal microbiota, were present in significantly lower quantities in the feces from horses fed pasture grass as compared to those from horses fed hay or silage.

The Oscillospiraceae was another bacterial family with significantly different levels between groups. It was the most abundant in horses managed on pasture and least abundant in the hay group, which indicated that its presence could have been influenced by different diets.

This study revealed some characteristic findings on the fecal microbial composition in horses that were given each type of diet and showed significant differences between the groups, the study team said.

For the first time, baseline information has been established on the fecal microbiota of horses fed silage, they said.

They hoped that the information could be used to help balance the intestinal microbiota in horses that are fed mainly silage in combination with other types of forages in order to maintain intestinal health.

The authors noted that the body condition score of all the horses did not change and their body weight remained relatively stable throughout the feeding trial.

Throughout the trial, physical examinations were unremarkable for each horse, and no clinical abnormalities were observed.

The study team said more studies are warranted to further define the impact of the silage diet on equine intestinal health.

The study team comprised Yiping Zhu, Xuefan Wang, Shulei Chen and Jing Li, all with the College of Veterinary Medicine at the China Agricultural University in Beijing; Liang Deng with the College of Animal Husbandry and Veterinary Medicine at Shenyang Agricultural University; and Chunyan Zhu, with the Shanghai Center of Agri-Products Quality and Safety.

Zhu, Y.; Wang, X.; Deng, L.; Chen, S.; Zhu, C.; Li, J. Effects of Pasture Grass, Silage, and Hay Diet on Equine Fecal Microbiota. Animals 2021, 11, 1330.

The study, published under a Creative Commons License, can be read here.

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PETA names rescued mother cow Kim Kowdashian, thanks reality star for dairy-free diet – The Indian Express

Posted: May 10, 2021 at 1:50 am

Social media is abuzz with Mothers Day wishes. People for the Ethical Treatment of Animals (PETA) settled for a unique wish. They rescued a mother cow and christened her Kim Kowdashian. Sharing the picture of the cow, they wrote, For mothers day, PETA India names rescued mother cow Kim Kowdashian after reality TV star Kim Kardashian. It ended with a shout-out at the end: Thanks for promoting a dairy-free diet @KimKardashian!

For the uninitiated, the reality star follows a plant-based diet. Earlier this year, she had shared picture on Instagram where she looked stunning wearing a white crop paired with cargo pants, and heels. The outfit highlighted her toned figure, and it was difficult not to notice her abs. Plant-based diet does a body good, read the caption.

Prior to this, Kim had shared that though she enjoyed eating many foods, her diet was mostly plant-based. I eat mostly plant based. No meat anymore. Oatmeal and vegan sausage for breakfast, vegan tacos are my fave for lunch! Salads are good too! she told a fan on social media.

I hate HOT anything! I hate Spicey anything. I know this is going to be very unpopular to so many but I just dont like it. Regular Cheetos for me or Cheetos puffs are my absolute fave, she said further.

Wondering what plant-based diet really means? Find out everything about it here.

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