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How ultra-processed food took over your shopping basket – The Guardian

Posted: February 13, 2020 at 12:46 am

Nearly three decades ago, when I was an overweight teenager, I sometimes ate six pieces of sliced white toast in a row, each one slathered in butter or jam. I remember the spongy texture of the bread as I took it from its plastic bag. No matter how much of this supermarket toast I ate, I hardly felt sated. It was like eating without really eating. Other days, I would buy a box of Crunchy Nut Cornflakes or a tube of Pringles: sour cream and onion flavour stackable snack chips, which were an exciting novelty at the time, having only arrived in the UK in 1991. Although the carton was big enough to feed a crowd, I could demolish most of it by myself in a sitting. Each chip, with its salty and powdery sour cream coating, sent me back for another one. I loved the way the chips curved like roof tiles would dissolve slightly on my tongue.

After one of these binges because that is what they were I would speak to myself with self-loathing. What is wrong with you? I would say to the tear-stained face in the mirror. I blamed myself for my lack of self-control. But now, all these years later, having mostly lost my taste for sliced bread, sugary cereals and snack chips, I feel I was asking myself the wrong question. It shouldnt have been What is wrong with you? but What is wrong with this food?

Back in the 90s, there was no word to cover all the items I used to binge on. Some of the things I over-ate crisps or chocolate or fast-food burgers could be classified as junk food, but others, such as bread and cereal, were more like household staples. These various foods seemed to have nothing in common except for the fact that I found them very easy to eat a lot of, especially when sad. As I ate my Pringles and my white bread, I felt like a failure for not being able to stop. I had no idea that there would one day be a technical explanation for why I found them so hard to resist. The word is ultra-processed and it refers to foods that tend to be low in essential nutrients, high in sugar, oil and salt and liable to be overconsumed.

Which foods qualify as ultra-processed? Its almost easier to say which are not. I got a cup of coffee the other day at a train station cafe and the only snacks for sale that were not ultra-processed were a banana and a packet of nuts. The other options were: a panini made from ultra-processed bread, flavoured crisps, chocolate bars, long-life muffins and sweet wafer biscuits all ultra-processed.

What characterises ultra-processed foods is that they are so altered that it can be hard to recognise the underlying ingredients. These are concoctions of concoctions, engineered from ingredients that are already highly refined, such as cheap vegetable oils, flours, whey proteins and sugars, which are then whipped up into something more appetising with the help of industrial additives such as emulsifiers.

Ultra-processed foods (or UPF) now account for more than half of all the calories eaten in the UK and US, and other countries are fast catching up. UPFs are now simply part of the flavour of modern life. These foods are convenient, highly profitable, strongly flavoured, aggressively marketed and affordable and on sale in supermarkets everywhere. The foods themselves may be familiar, yet the term ultra-processed is less so. None of the friends I spoke with while writing this piece could recall ever having heard it in daily conversation. But everyone had a pretty good hunch what it meant. One recognised the concept as described by the US food writer Michael Pollan edible foodlike substances.

Some UPFs, such as sliced bread or mass-produced cakes, have been around for many decades, but the percentage of UPFs in the average persons diet has never been anything like as high as it is today. It would be unusual for most of us to get through the day without consuming at least a few ultra-processed items.

You might say that ultra-processed is just a pompous way to describe many of your normal, everyday pleasures. It could be your morning bowl of Cheerios or your evening pot of flavoured yoghurt. Its savoury snacks and sweet baked goods. Its chicken nuggets or vegan hotdogs, as the case may be. Its the doughnut you buy when you are being indulgent, and the premium protein bar you eat at the gym for a quick energy boost. Its the long-life almond milk in your coffee and the Diet Coke you drink in the afternoon. Consumed in isolation and moderation, each of these products may be perfectly wholesome. With their long shelf life, ultra-processed foods are designed to be microbiologically safe. The question is what happens to our bodies when UPFs become as prevalent as they have done.

Evidence now suggests that diets heavy in UPFs can cause overeating and obesity. Consumers may blame themselves for overindulging in these foods, but what if it is in the nature of these products to be overeaten?

In 2014, the Brazilian government took the radical step of advising its citizens to avoid UPFs outright. The country was acting out of a sense of urgency, because the number of young Brazilian adults with obesity had risen so far and so fast, more than doubling between 2002 and 2013 (from 7.5% of the population to 17.5%). These radical new guidelines urged Brazilians to avoid snacking, and to make time for wholesome food in their lives, to eat regular meals in company when possible, to learn how to cook and to teach children to be wary of all forms of food advertising.

The biggest departure in the Brazilian guidelines was to treat food processing as the single most important issue in public health. This new set of rules framed unhealthy food less in terms of the nutrients it contains (fats, carbohydrates etc) and more by the degree to which it is processed (preserved, emulsified, sweetened etc). No government diet guidelines had ever categorised foods this way before. One of the first rules in the Brazilian guidelines was to avoid consumption of ultra-processed products. They condemned at a stroke not just fast foods or sugary snacks, but also many foods which have been reformulated to seem health-giving, from lite margarines to vitamin-fortified breakfast cereals.

From a British perspective where the official NHS Eatwell guide still classifies low-fat margarines and packaged cereals as healthier options it looks extreme to warn consumers off all ultra-processed foods (what, even Heinz tomato soup?). But there is evidence to back up the Brazilian position. Over the past decade, large-scale studies from France, Brazil, the US and Spain have suggested that high consumption of UPFs is associated with higher rates of obesity. When eaten in large amounts (and its hard to eat them any other way) they have also been linked to a whole host of conditions, from depression to asthma to heart disease to gastrointestinal disorders. In 2018, a study from France following more than 100,000 adults found that a 10% increase in the proportion of UPFs in someones diet led to a higher overall cancer risk. Ultra-processed has emerged as the most persuasive new metric for measuring what has gone wrong with modern food.

Why should food processing matter for our health? Processed food is a blurry term and for years, the food industry has exploited these blurred lines as a way to defend its additive-laden products. Unless you grow, forage or catch all your own food, almost everything you consume has been processed to some extent. A pint of milk is pasteurised, a pea may be frozen. Cooking is a process. Fermentation is a process. Artisanal, organic kimchi is a processed food, and so is the finest French goats cheese. No big deal.

But UPFs are different. They are processed in ways that go far beyond cooking or fermentation, and they may also come plastered with health claims. Even a sugary multi-coloured breakfast cereal may state that it is a good source of fibre and made with whole grains. Bettina Elias Siegel, the author of the recent Kid Food: The Challenge of Feeding Children in a Highly Processed World, says that in the US, people tend to categorise food in a binary way. There is junk food and then there is everything else. For Siegel, ultra-processed is a helpful tool for showing new parents that theres a huge difference between a cooked carrot and a bag of industrially produced, carrot-flavoured veggie puffs aimed at toddlers, even if those veggie puffs are cynically marketed as natural.

The concept of UPFs was born in the early years of this millennium when a Brazilian scientist called Carlos Monteiro noticed a paradox. People appeared to be buying less sugar, yet obesity and type 2 diabetes were going up. A team of Brazilian nutrition researchers led by Monteiro, based at the university of Sao Paulo, had been tracking the nations diet since the 80s, asking households to record the foods they bought. One of the biggest trends to jump out of the data was that, while the amount of sugar and oil people were buying was going down, their sugar consumption was vastly increasing, because of all of the ready-to-eat sugary products that were now available, from packaged cakes to chocolate breakfast cereal, that were easy to eat in large quantities without thinking about it.

To Monteiro, the bag of sugar on the kitchen counter is a healthy sign, not because sugar itself has any goodness in it, but because it belongs to a person who cooks. Monteiros data suggested to him that the households who were still buying sugar were also the ones who were still making the old Brazilian dishes such as rice and beans.

Monteiro is a doctor by training, and when you talk to him, he still has the idealistic zeal of someone who wants to prevent human suffering. He had started off in the 70s treating poor people in rural villages, and was startled to see how quickly the problems of under-nutrition were replaced by those of tooth decay and obesity, particularly among children. When Monteiro looked at the foods that had increased the most in the Brazilian diet from cookies and sodas to crackers and savoury snacks what they had in common was that they were all highly processed. Yet he noticed that many of these commonly eaten foods did not even feature in the standard food pyramids of US nutrition guidelines, which show rows of different whole foods according to how much people consume, with rice and wheat at the bottom, then fruits and vegetables, then fish and dairy and so on. These pyramids are based on the assumption that people are still cooking from scratch, as they did in the 50s. It is time to demolish the pyramid, wrote Monteiro in 2011.

Once something has been classified, it can be studied. In the 10 years since Monteiro first announced the concept, numerous peer-reviewed studies on UPFs have been published confirming the links he suspected between these foods and higher rates of disease. By giving a collective name to ultra-processed foods for the first time, Monteiro has gone some way to transforming the entire field of public health nutrition.

As he sees it, there are four basic kinds of food, graded by the degree to which they are processed. Taken together, these four groups form what Monteiro calls the Nova system (meaning a new star). The first category group 1 are the least processed, and includes anything from a bunch of parsley to a carrot, from a steak to a raisin. A pedant will point out that none of these things are strictly unprocessed by the time they are sold: the carrot is washed, the steak is refrigerated, the raisin is dried. To answer these objections, Monteiro renamed this group unprocessed and minimally processed foods.

The second group is called processed culinary ingredients. These include butter and salt, sugar and lard, oil and flour all used in small quantities with group 1 foods to make them more delicious: a pat of butter melting on broccoli, a sprinkling of salt on a piece of fish, a spoonful of sugar in a fruit salad.

Next in the Nova system comes group 3, or processed foods. This category consists of foods that have been preserved, pickled, fermented or salted. Examples would be canned tomatoes and pulses, pickles, traditionally made bread (such as sourdough), smoked fish and cured meats. Monteiro notes that when used sparingly, these processed foods can result in delicious dishes and nutritionally balanced meals.

The final category, group 4, is unlike any of the others. Group 4 foods tend to consist largely of the sugars, oils and starches from group 2, but instead of being used sparingly to make fresh food more delicious, these ingredients are now transformed through colours, emulsifiers, flavourings and other additives to become more palatable. They contain ingredients unfamiliar to domestic kitchens such as soy protein isolate (in cereal bars or shakes with added protein) and mechanically separated meat (turkey hotdogs, sausage rolls).

Group 4 foods differ from other foods not just in substance, but in use. Because they are aggressively promoted and ready-to-eat, these highly profitable items have vast market advantages over the minimally processed foods in group 1. Monteiro and his colleagues have observed from evidence around the world that these group 4 items are liable to replace freshly made regular meals and dishes, with snacking any time, anywhere. For Monteiro, there is no doubt that these ultra-processed foods are implicated in obesity as well as a range of non-communicable diseases such as heart disease and type 2 diabetes.

Not everyone in the world of nutrition is convinced by the Nova system of food classification. Some critics of Monteiro have complained that ultra-processed is just another way to describe foods that are sugary or fatty or salty or low in fibre, or all of these at once. If you look at the UPFs that are consumed in the largest quantities, the majority of them take the form of sweet treats or sugary drinks. The question is whether these foods would still be harmful if the levels of sugar and oil could be reduced.

The first time the nutrition researcher Kevin Hall heard anyone talk about ultra-processed food, he thought it was a nonsense definition. It was 2016 and Hall who studies how people put on weight at the National Institute of Diabetes and Digestive and Kidney Diseases at Bethesda, Maryland was at a conference chatting with a representative from PepsiCo who scornfully mentioned the new Brazilian set of food guidelines and specifically the directive to avoid ultra-processed foods. Hall agreed that this was a silly rule because, as far as he was concerned, obesity had nothing to do with food processing.

Anyone can see that some foods are processed to a higher degree than others an Oreo is not the same as an orange but Hall knew of no scientific proof that said the degree of processed food in a persons diet could cause them to gain weight. Hall is a physicist by training and he is a self-confessed reductionist. He likes to take things apart and see how they work. He is therefore attracted to the idea that food is nothing more than the sum of its nutrient parts: fats plus carbs plus protein and fibre, and so on. The whole notion of ultra-processed foods annoyed him because it seemed too fuzzy.

When Hall started to read through the scientific literature on ultra-processed foods, he noticed that all of the damning evidence against them took the form of correlation rather than absolute proof. Like most studies on the harmful effects of particular foods, these studies fell under the umbrella of epidemiology: the study of patterns of health across populations. Hall and he is not alone here finds such studies less than convincing. Correlation is not causation, as the saying goes.

Just because people who eat a lot of UPFs are more likely to be obese or suffer from cancer does not mean that obesity and cancer are caused by UPFs, per se. Typically, its people in lower economic brackets who eat a lot of these foods, Hall said. He thought UPFs were being wrongly blamed for the poor health outcomes of living in poverty.

At the end of 2018, Hall and his colleagues became the first scientists to test in randomised controlled conditions whether diets high in ultra-processed foods could actually cause overeating and weight gain.

For four weeks, 10 men and 10 women agreed to be confined to a clinic under Halls care and agreed to eat only what they were given, wearing loose clothes so that they would not notice so much if their weight changed. This might sound like a small study, but carefully controlled trials like this are considered the gold standard for science, and are especially rare in the field of nutrition because of the difficulty and expense of persuading humans to live and eat in laboratory conditions. Barry Popkin, a professor of nutrition at the University of North Carolina, has praised Halls study published in Cell Metabolism for being as good a clinical trial as you can get.

For two weeks, Halls participants ate mostly ultra-processed meals such as turkey sandwiches with crisps, and for another two weeks they ate mostly unprocessed food such as spinach omelette with sweet potato hash. The researchers worked hard to design both sets of meals to be tasty and familiar to all participants. Day one on the ultra-processed diet included a breakfast of Cheerios with whole milk and a blueberry muffin, a lunch of canned beef ravioli followed by cookies and a pre-cooked TV dinner of steak and mashed potatoes with canned corn and low-fat chocolate milk. Day one on the unprocessed diet started with a breakfast of Greek yoghurt with walnuts, strawberries and bananas, a lunch of spinach, chicken and bulgur salad with grapes to follow, and dinner of roast beef, rice pilaf and vegetables, with peeled oranges to finish. The subjects were told to eat as much or as little as they liked.

Hall set up the study to match the two diets as closely as possible for calories, sugar, protein, fibre and fat. This wasnt easy, because most ultra-processed foods are low in fibre and protein and higher in sugar. To compensate for the lack of fibre, the participants were given diet lemonade laced with soluble fibre to go with their meals during the two weeks on the ultra-processed diet.

It turned out that, during the weeks of the ultra-processed diet, the volunteers ate an extra 500 calories a day, equivalent to a whole quarter pounder with cheese. Blood tests showed that the hormones in the body responsible for hunger remained elevated on the ultra-processed diet compared to the unprocessed diet, which confirms the feeling I used to have that however much I ate, these foods didnt sate my hunger.

Halls study provided evidence that an ultra-processed diet with its soft textures and strong flavours really does cause over-eating and weight gain, regardless of the sugar content. Over just two weeks, the subjects gained an average of 1kg. This is a far more dramatic result than you would expect to see over such a short space of time (especially since the volunteers rated both types of food as equally pleasant).

After Halls study was published in July 2019, it was impossible to dismiss Monteiros proposition that the rise of UPFs increases the risk of obesity. Monteiro told me that as a result of Halls study, he and his colleagues in Brazil found they were suddenly being taken seriously.

Now that we have evidence of a link between diets high in UPFs and obesity, it seems clear that a healthy diet should be based on fresh, home-cooked food. To help champion home cooking among Brazilians, Monteiro recruited the cookery writer Rita Lobo, whose website Panelinha (network) is the most popular food site in Brazil, with 3m hits a month. Lobo said that when she tells people about UPFs, the first reaction is panic and anger. They say: Oh my God! Im not going to be able to eat my yoghurt or my cereal bar! What am I going to eat? After a while, however, she says that the concept of ultra-processed foods is almost a relief to people, because it liberates them from the polarities and restriction created by fad diets or clean eating. People are thrilled, Lobo says, when they realise they can have desserts again, as long as they are freshly made.

But modern patterns of work do not make it easy to find the time to cook every day. For households who have learned to rely on ultra-processed convenience foods, returning to home cooking can seem daunting and expensive. Halls researchers in Maryland spent 40% more money purchasing the food for the unprocessed diet. (However, I noticed that the menu included large prime cuts of meat or fish every day; it would be interesting to see how the cost would have compared with a larger number of vegetarian meals or cheaper cuts of meat.)

In Brazil, cooking from scratch still tends to be cheaper than eating ultra-processed food, Lobo says. UPFs are a relative novelty in Brazil and memories of a firm tradition of home cooking have not died yet here. In Brazil, it doesnt matter if you are rich or poor, you grew up eating rice and beans. The problem for you [in the UK], Lobo remarks, is that you dont know what your rice and beans is.

In Britain and the US, our relationship with ultra-processed food is so extensive and goes back so many decades that these products have become our soul food, a beloved repertoire of dishes. Its what our mothers fed us. If you want to bond with someone who was a child in the 70s in Britain, mention that you have childhood memories of being given Findus Crispy Pancakes and spaghetti hoops followed by Angel Delight for tea. I have noticed that American friends have similar conversations about the childhood joys of Tim-Tams chocolate biscuits. In the curious coding of the British class system, a taste for industrial branded foods is a way to reassure others that you are OK. What kind of snob would disparage a Creme Egg or fail to recognise the joy of licking cheesy Wotsit dust from your fingers?

I am as much of a sucker for this branded food nostalgia as anyone. There is a part of my brain the part that is still an eight-year-old at a birthday party that will always feel that Iced Gems (ultra-processed cookies topped with ultra-processed frosting) are pure magic. But Ive started to feel a creeping unease that our ardent affection for these foods has been mostly manufactured by the food corporations who profit from selling them. For the thousands of people trapped in binge-eating disorder as I once was UPFs are false friends.

The multinational food industry has a vested interest in rubbishing Monteiros ideas about how UPFs are detrimental to our health. And much of the most vociferous criticism of his Nova system has come from sources close to the industry. A 2018 paper co-authored by Melissa Mialon, a Brazilian nutritionist, identified 32 materials online criticising Nova, most of which were not peer-reviewed. The paper showed that, out of 38 writers critical of Nova, 33 had links to the ultra-processed food industry.

For many in the developing world, the prevalence of ultra-processed foods is making it hard for those on a limited budget to feed their children a wholesome diet. Victor Aguayo, chief of nutrition at Unicef, tells me over the phone that across the developing world, as ultra-processed foods become cheaper and other foods, such as vegetables and fish, become more expensive, the UPFs are taking up a bigger volume of childrens diets. Whats more, the pleasurable textures and aggressive marketing of these foods makes them appealing and aspirational both to children and parents, says Aguayo.

Soon after the arrival in Nepal of brightly coloured packages that, as Aguayo describes them, look like food for children: the cookies, the savoury snacks, the cereals, aid workers started to see an epidemic of both overweight and micronutrient deficiency including anaemia among Nepalese children under the age of five.

Aguayo says there is an urgent need to change the food environment to make the healthy options the easy, affordable and available ones. Ecuador, Uruguay and Peru have followed Brazils example in urging their citizens to steer clear of ultra-processed foods. Uruguays dietary guidelines issued in 2016 tells Uruguayans to base your diet on natural foods, and avoid the regular consumption of ultra-processed products. How easy this will be to do is another matter.

In Australia, Canada or the UK, to be told to avoid ultra-processed food as the Brazilian guidelines do would mean rejecting half or more of what is for sale as food, including many basic staples that people depend on, such as bread. The vast majority of supermarket loaves count as ultra-processed, regardless of how much they boast of being multiseed, malted or glowing with ancient grains.

Earlier this year, Monteiro and his colleagues published a paper titled Ultra-processed foods: what they are and how to identify them, offering some rules of thumb. The paper explains that the practical way to identify if a product is ultra-processed is to check to see if its list of ingredients contains at least one food substance never or rarely used in kitchens, or classes of additives whose function is to make the final product palatable or more appealing (cosmetic additives). Tell-tale ingredients include invert sugar, maltodextrin, dextrose, lactose, soluble or insoluble fibre, hydrogenated or interesterified oil. Or it may contain additives such as flavour enhancers, colours, emulsifiers, emulsifying salts, sweeteners, thickeners and anti-foaming, bulking, carbonating, foaming, gelling and glazing agents.

But not everyone has time to search every label for the presence of glazing agents. A website called Open Food Facts, run by mostly French volunteers, has started the herculean labour of creating an open database of packaged foods around the world and listing where they fit into on the Nova system. Froot Loops: Nova 4. Unsalted butter: Nova 2. Sardines in olive oil: Nova 3. Vanilla Alpro yoghurt: Nova 4. Stphane Gigandet, who runs the site, says that he started analysing food by Nova a year ago and it is not an easy task.

For most modern eaters, avoiding all ultra-processed foods is unsettling and unrealistic, particularly if you are on a low income or vegan or frail or disabled, or someone who really loves the occasional cheese-and-ham toastie made from sliced white bread. In his early papers, Monteiro wrote of reducing ultra-processed items as a proportion of the total diet rather than cutting them out altogether. Likewise, the French Ministry of Health has announced that it wants to reduce consumption of Nova 4 products by 20% over the next three years.

We still dont really know what it is about ultra-processed food that generates weight gain. The rate of chewing may be a factor. In Halls study, during the weeks on the ultra-processed diet people ate their meals faster, maybe because the foods tended to be softer and easier to chew. On the unprocessed diet, a hormone called PYY, which reduces appetite, was elevated, suggesting that homemade food keeps us fuller for longer. The effect of additives such as artificial sweeteners on the gut microbiome is another theory. Later this year, new research from physicist Albert-Lszl Barabsi will reveal more about the way that ultra-processing actually alters food at a molecular level.

In a two-part blog on ultra-processed foods in 2018 (Rise of the Ultra Foods) Anthony Warner (who tweets and campaigns as Angry Chef), a former food industry development chef, argued that Nova was stoking fear and guilt about food and adding to the stress of already difficult lives by making people feel judged for their food choices. But having read Kevin Halls study, he wrote an article in May 2019 admitting: I was wrong about ultra-processed food it really is making you fat. Warner said the study convinced him that eating rate, texture and palatability of UPFs lead to overeating, and ended with a call for more research.

Hall tells me that he is in the process of constructing another study on ultra-processed food and obesity. This time, the people on the ultra-processed diet would also be eating larger amounts of unprocessed foods, such as crunchy vegetables with low energy density, while still getting more than 80% of their calories from ultra-processed food equivalent to adding a side salad or a portion of broccoli to your dinner of frozen pizza. This is much closer to how most families actually eat.

Even if scientists do succeed in pinning down the mechanism or mechanisms by which ultra-processed foods make us gain weight, its not clear what policy-makers should do about UPFs, except for giving people the support and resources they need to cook more fresh meals at home. To follow the Brazilian advice entails a total rethink of the food system.

For as long as we believed that single nutrients were the main cause of poor diets, industrial foods could be endlessly tweaked to fit with the theory of the day. When fat was seen as the devil, the food industry gave us a panoply of low-fat products. The result of the sugar taxes around the world has been a raft of new artificially sweetened drinks. But if you accept the argument that processing is itself part of the problem, all of this tweaking and reformulation becomes so much meaningless window-dressing.

An ultra-processed food can be reformulated in countless ways, but the one thing it cant be transformed into is an unprocessed food. Hall remains hopeful that there may turn out to be some way to adjust the manufacture of ultra-processed foods to make them less harmful to health. A huge number of people on low incomes, he notes, are relying on these relatively inexpensive tasty things for daily sustenance. But he is keenly aware that the problems of nutrition cannot be cured by ever more sophisticated processing. How do you take an Oreo and make it non-ultra-processed? he asks. You cant!

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How ultra-processed food took over your shopping basket - The Guardian

What Mongolia’s Dairy Farmers Have to Teach Us About the Hidden History of Microbes – Discover Magazine

Posted: February 13, 2020 at 12:46 am

In the remote northern steppes of Mongolia, in 2017, anthropologist Christina Warinner and her colleagues were interviewing local herders about dairying practices. One day, a yak and cattle herder, Dalaimyagmar, demonstrated how she makes traditional yogurt and cheeses.

In spring, as livestock calve and produce the most milk, Mongolians switch from a meat-centered diet to one based on dairy products. Each year, Dalaimyagmar thaws the saved sample of the previous seasons yogurt, which she callskhrngo. She adds some of this yogurt to fresh milk, over several days, until it is revived. With this starter culture, she is then able to make dairy products all summer.

Afterward, as the anthropologists drove their struggling vehicle up steep hills back to their camp, graduate student and translator Bjrn Reichardt had a realization. Khrngo is also the Mongolian word for wealth or inheritance.

In Mongolia, dairy products are vital dietary staplesmore than70 are made and consumed. From a certain perspective, then, the double meaning of khrngo was unsurprising.

But there was some irony at work. In Mongolia, most herders have no idea that the khrngo is, in fact, made up of a wealth of microbes. And that lack of knowledge could be a problem. Not only do these microbes bring benefits to the health, diet, and food practices of Mongoliansas well as a distinctive taste endemic to their cuisinebut they could be lost as Western industrial practices come to the country.

The Heirloom Microbes project has sampled a range of Mongolian dairy products, several of which are shown here.(Heirloom Microbes Project.)

Its become a dual mission of Warinners to not only help Mongolians value their microbial riches, but also explore the impact these regional microbes have had on human history. Bacteria are amazing, overlooked, and misunderstood, says Warinner, who splits her time between the Max Planck Institute for the Science of Human History in Jena, Germany, and Harvard University in Cambridge, Massachusetts.

Warinner and her collaborator, Jessica Hendy, an archaeological scientist at the University of York, started theHeirloom Microbes projectin 2017 to identify and preserve rare microbes, specifically the bacteria that turn lactose into lactic acid, the first step in transforming milk into yogurts and cheeses. In the process, they hope to understand which microbes were unique to specific early dairy communitiesand how they spread from one region to the next.

Combining interests in ancient diets, traditional cultural practices, and gut microbiomes, the Heirloom Microbes project collaborators are blazing a trail that traces the origins of dairyingand promises to reveal previously unknown microbial influences on human culture. The project has sampled dairy products from several parts of the world, including the European Alps and Jordan.

But the project team has focused on Mongolia, a country where traditional dairying practices from nomadic herding communities remained largely intact. Along the way, they have realized they may be sampling what are effectively endangered microbes if the worlds remaining traditional dairying societies industrialize.

Warinner, who calls herself a molecular archaeologist, set out to investigate past human diets more than 10 years ago. She found a goldmine of information trapped in the tartar on skeletal teeth, including the individuals DNA, the oral bacteria they carried, and clues to that persons eating habits.

Thats why Warinner teaches her archaeology students to wield an unusual tool: a dental scalar. Researchers use this hooked metal instrument, commonly found at dentists offices, to scrape ancient tartar from exhumed remains. The calcified microbial biofilm on teeth effectively offers researchers dietary sedimentary layers for each individual that can be preserved for centuries.

When the decayed plaque is particularly tough to dislodge, Warinner pops the ligament-free tooth out, cleans it, and puts it backwithout damaging the skeleton itself. (Following training, her students receive a Dental Hygienist to the Dead certificate.)

Warinner first started scraping the hardened calculus from medieval skeletons in England, Germany, and Greenland to study ancient periodontal disease. Results from Greenland, however, yielded truly unbelievable results:milk proteinson teeth from Vikings who lived roughly 1,000 years ago. Convinced it must be a mistake, Warinner ignored the Greenland data for a year.

When she eventually re-ran the samples and got the same exact results, Warinner was flummoxed. When I realized it might be real, I almost scared myself, she says. What if we could reconstruct dairying in the past? Dairy, she realized, could serve as a window into human dietsand the practices supporting those dietsthrough time.

Milk proteins trapped in layers of tartar would allow Warinner to not only determine which animal produced the milk, but also date milk consumption across space and time, something that had previously only been attemptedby tracing milk fatsin ancient pottery. This new approach provided scientists with a way to extract evidence of milk directly from the mouths of past people, Hendy notes.

Milk and the microbes behind dairy products are intriguing objects of study on many levels, say Hendy and Warinner. For one, Hendy says, Humans are the only species to drink another mammals milk.

Even more intriguing is why early societies would practice dairying for thousands of years when they could not easily digest lactose, the sugar in milk. For decades, scholars thought that dairying increasedafterhumans evolved a gene to digest milk.

The majority of the world is lactose intolerant (map percentages indicate the overall rate of lactose intolerance in each region).(NmiPortal/Wikimedia Commons)

But that presumption was overturned once the extent of lactose intolerance was documented. In fact, research suggests that dairying was practiced for 4,000 years before the emergence of a mutation that allowed lactose digestion.

Even today, the majority of people around the planet65 percentare lactose intolerant, meaning their bodies struggle to break down the sugar lactose found in fresh milk. (Mongolia offers a stark example: Consumption of dairy products in Mongolia remains extraordinarily high, despite the fact that 95 percent of Mongolians are lactose intolerant.)

Milk continues to be an incredibly fraught food,a lightning rodfor discussions around nutrition and health. Its either a superfood or the worst thing in the world, Warinner says.

Dairying is this amazing invention that people came up with in prehistory, she adds, but its a complete puzzle why and how it worked. In addition, dairy products were among the earliest manufactured foods.

And that is the work of microbes. Cheese doesnt exist in the wild, Warinner says. Milk itself is highly perishable and goes bad in hours.

Through trial and error, humans figured out how to harness bacteria to consume the lactoseand thereby acidify and ferment milk into cheeses and yogurt, respectively.

People from deep prehistory, millennia ago, were domesticating microbes they didnt even know existed, Warinner says. It must have seemed magical to them.

In fact, Warinner notes, this microbe-driven approach was likely among the earliestand most importantfood storage mechanisms in ancient times. Warinner and Hendy soon turned their interest to identifying early dairy microbes. If they could find milk proteins in skeletal tartar, they hoped to find DNA from the lactic acid bacteria.

In arid or grassland steppe regions like Mongolia, there would have been few shelf-stable foods several millennia ago. Dairying proved transformative. Given the harsh and arid environment, barren landscape, and limited foodstuffs, it is hard to imagine how Genghis Khan could have conquered Asia and Eastern Europe without portable, probiotic-rich, high-calorie cheese, explains Warinner.

Mongolians milk all seven livestock species in the country: cows, sheep, goats, horses, yaks, reindeer, andas shown herecamel.(Heirloom Microbes Project.)

And the menu of dairy options is vast. Mongolians milk every one of the seven livestock species in the country: cows, sheep, goats, horses, yaks, reindeer, and camel.

From that native diversity, Mongolian milk products have a distinctiveterroir, or characteristic flavor infused by the environment producing the food. Aaruul, which are dried, hardened curds eaten as a snack, have a pungent, tangy flavor. Shimiin arkhi is yogurt made from yaks or cows milk that is distilled to make a vodka. Airag is a fermented mares milk liquor that is light and bubbly. People listen to mares milk ferment and say, Its alive when they hear it fizzing, Hendy says.

Mongolians hand down starter bacterial cultures, the khrngo, from generation to generationand typically the work is carried out by women. They often receive starter cultures from their mothers, who received it from their grandmothers, Reichardt says. There is a chance that these microbes are hundreds of years old and still alive today.

But when Warinner and Hendy first asked to collect dairy microbes in Mongolia, the nomadic herders denied their products had any bacteria in them. In Mongolia, microbiology is taught from a clinical perspectivenamely, that bacteria only cause disease, Warinner says.

She found that herders were unaware of beneficial or food microbes. They also did not know that the hides and wooden vessels used to store starter cultures were crucial to maintaining these bacterial populations over time. Unbeknownst to contemporary and early herders, the porous, organic materials used as containers were inadvertently inoculated with the lactic acid bacteria over and over again. As a result, the containers themselves helped desirable microbial populations persist over timein part because nothing else, including pathogens, could grow in the containers.

In Khvsgl, Mongolia, herder Gerel scrapes curds from the inside of her century-old still after makingshimiin arkhi, a vodka from distilled cow or yak yogurt.(Heirloom Microbes Project.)

Pathogens are like weeds, they are the first to grow, whereas lactic acid bacteria are like old-growth trees, Warinner explains. If you get the lactic acid bacteria established, theyll prevent weeds from growing. In short, the traditional nomadic dairy model promotes the growth of good bacteria that naturally outcompete pathogens.

Still, that hasnt stopped the spread of western practices, including industrialized dairy cultures. The Heirloom Microbes project has not found traditional practices to be as prevalent in the other regions the team has studied, such as Jordan and the European Alps, as compared to Mongolia. The concern, as stated in their project grant, is that with contemporary food globalization and industrialization, traditional methods of dairying and their unique microbial cultures are being lost at an alarming pace.

While traditional practices continue in isolated pockets in Jordan and the Alps, those practices can be, in part, a tourist attraction. European countries largely industrialized their dairying procedures in the 1970s and 1980s. In contrast with traditional methods using heirloom bacterial cultures, industrial practices begin with sterilization and then introduce lab-grown, high-performing bacterial cultures. In these industrialized systems, everything has to be constantly killed in large partbecausethe first things to come back are pathogens.

For Warinner and her colleagues, helping Mongolian herders and policymakers understand the benefits of the traditional methods has become even more urgent as the first steps toward dairy industrialization begin in Mongolia. Most notably, European lab-grown starter cultures are being introduced into the region.

Bacteria are amazing, overlooked, and misunderstood, says anthropologist Christina Warinner.

Warinner does not think the lab-grown strains, produced under highly controlled conditions, will fare well in Mongolia simply because they lack the regions traditional diversity. These are cultures developed in a completely different environment, she says. Industrial methods of sanitation are not easily implemented on the steppe and doing so would disrupt the microbial ecologies that support traditional Mongolian dairying, she notes. I fear that well-intentioned attempts to introduce such techniqueswithout consideration of their cultural contextwould actually reduce the safety of the dairy products and radically transform and undermine the lives of nomadic herders.

Hendy adds that microbes may not only support the process of dairying but also play a role in peoples health and digestion. Microbes in traditionally made dairy foods help maintain a healthy gut microbiome, which could be alteredto unknown effectby a switch to industrialized microbial cultures.

Over the past three years, the Heirloom Microbes project team has scraped tartar from roughly 200 skeletal remains around the world. As they piece together ancient microbial sequences in the tartar, they will start this summer to sample the microbiomes of both Mongolian nomadic herders and urban dwellers to determine whether herders gut microbes have played an unrecognized role in their dairy digestion.

As a growing body of research makes clear, the gut microbiome exerts a shocking degree of control over many aspects of our healthfrommood to immune function to pain. It may even shape seemingly unrelated aspects of our behavior, includingsocial interactions.

Mongolian researcher Soninkhishig Tsolmon has documented nutrition in her homeland for the last 20 years. It has not been easy. With few resources or existing studies available, Tsolmon has focused on the dietary differences between nomadic and urban people.

Tsolmon suspects that many traditional foods could reveal intriguing health and microbial connectionsbut time is running out. In addition to looming industrialization, climate change is transforming the landscape under herders feet.

Were starting to lose traditions, Tsolmon says. Mongolians have traditional ways of using meat and milk. The traditional meat-based diet in the winter is replaced with fermented dairy products in the summer that, elders say, eliminate the toxins from a winters worth of meat eating. She adds, Im afraid that some bacteria are disappearing.

To help stem the loss, Tsolmon, Warinner, and their colleagues created opportunities to share knowledge between the scientists and the herders. In July, for example, the researchers held a Seeing Microbes workshop in villages near Mongolias Lake Khuvsgul.

There the group showed local herders microscopic images of the bacteria in their dairy products. We explained how their practices maintain plenty of good microbes in their productsand that microbes dont just cause disease, explains translator and graduate student Zoljargal Enkh-Amgalan. They were proud of their way of life and how pastoralism and dairying still exist, she adds.

At another meeting earlier last summer, traditional steppe herders, cheesemakers from the Swiss Alps, the Heirloom Microbes team, businesspeople, and government officials came together for a traveling conference held in both Mongolia and Kyrgyzstan. The German Federal Ministry of Education and Research and the European Research Council funded the meetings.

These disparate groups shared their insights on traditional practices and the science underpinning their success. While traditional dairying practices, which go back at least 5,000 years, have not been studied intensively, they are clearly adapted to the Mongolian landscape and sustainable, explains Warinner.

Warinner believes the deep time emphasis that her discipline brings to such discussions is especially valuable. Anthropology matters. Archaeology matters, she says. We work to understand humans in the past and how we are todayin order to inform public opinion and government policies. That perspective can help counterbalance the ways in which globalization and well-intentioned interventions may, intentionally or not, threaten traditions, with complex consequences.

In addition to educating Mongolians about the science underpinning their ancestral practices, Warinner and colleagues hope they will take stock of the microbes that have played a starring, yet unsung, role in their nutrition and health. It is ironic that Mongolia has this very deep tradition of dairying that is so central to identity, culture, and historyand yet possesses no archive or any centralized collection of the many bacterial cultures. The Heirloom Microbes project collaborators hope to develop and maintain a storehouse of these resources for Mongolia.

We live in a microbial world, Warinner says. We are only now realizing how integral microbes are to being human. Put another way, science is just starting to uncover the degree to which microbial cultures have shaped human cultures.

This work first appeared on SAPIENS. Read the original here.

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What Mongolia's Dairy Farmers Have to Teach Us About the Hidden History of Microbes - Discover Magazine

How this personal trainer stays healthy when traveling – NBC News

Posted: February 13, 2020 at 12:44 am

As a personal trainer and weight-loss coach, my clients and followers are often curious about how I do it. What theyre asking is how I manage to maintain my weight, health and fitness regimens while Im on the road traveling and attending social events with a cocktail in hand. Many people are surprised to find out that I do not spend hours a day in the gym; I dont avoid cheese or wine; I love pizza; and sometimes my workout of the day is a 30-minute meditation.

I am no stranger to a jam-packed schedule or being surrounded by temptations. My motive for sharing a couple of days in my life is to demonstrate that with a little forethought, planning and commitment, I am able to balance the chaotic parts of my life with my health goals while still enjoying myself. No restrictions, no diet mentality, and no strenuous workouts. I hope you enjoy this sneak peek and are able to glean some inspiration for your own busy lives!

Arrive at the West Palm Beach airport ready to fly back to Chicago after spending two days with my newborn niece, my sister and my brother-in-law. My sister and her husband are wine connoisseurs, so I wanted to be able to enjoy some wine even though I had two video shoots later in the week. I also needed to focus on not feeling bloated and looking tight and toned because as we all know, the camera adds 10 pounds! I cut out cheese, but still had a couple of glasses of wine each night. I know that cheese makes me feel bloated, so I made a deal with myself: I would allow myself to indulge in some wine, but skip the cheese.

Brought a full water bottle to the airport and chugged it before security. Even if I forget to drink it, the alarm goes off on security so I have to chug or toss it. Then I refill it before boarding the plane.

I order groceries via Amazon Prime to make detox soup tonight to avoid dialing for takeout when I get home. Usually after flights I am starving, so if I dont have fresh groceries waiting for me when I arrive home, I am reaching right for the delivery menu. I also love my detox soup, so if I know I have all the ingredients to whip it up quickly, I will be craving a bowl!

I also sign up in advance for meditation class and schedule my workout in the morning in my calendar (only 30 minutes, so Ill make it count.) The workout is a HIIT workout that includes strength training, cardio bursts and abs.

Order 2 glasses of water, no ice, when the beverage cart comes. I also eat my protein bar that I brought from my sisters house. I avoid airplane food when possible because of the high sodium, which causes my face to look bloated (and my body to feel bloated!). For my clients who are a bit more vain, this speaks to them in the moment more so than just avoiding airplane calories. They want to look more defined in their face and not bloated (and so do I, especially when filming!).

I make sure Ive downed my water bottle, and then refill it again in the airport for the ride back to my apartment. Drinking half your body weight in ounces of water per day is the rule of thumb, but while traveling I try to drink double this. The dry airplane air not only affects my skin but also affects my digestion, so this is why I make sure I'm hydrated.

I make detox soup. Sometimes I have two servings of this if Im really hungry. For some reason, I am always hungrier on travel days. I know that if I have an endless pot of this soup, Ill go back for seconds because its hot and fresh rather than going for something pre-packaged (and higher in calories, sodium or fat!). Here is the rough recipe I follow (but you can also add in any veggies you have on hand):

This is a super quick, one-pot soup. Throw everything except the zucchini noodles into the pot and let it simmer. Keep it on low for 10 minutes, then add in the zucchini noodles and cook for about 15 more minutes. However, if Im in a rush Ill just add in the zucchini noodles up front and cook the whole pot for 15 minutes. If you want the noodles harder, dont keep them in as long. If you want them softer, keep them in the pot for however long you want!

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Reading in bed. (Im a night owl!)

I do my workout to wake me up instead of starting the day with a cup of coffee. If I drink too much coffee, it can cause me to feel anxious and a little jittery. So on days when I am doing a fitness shoot or a TV segment, I regulate my coffee intake and use my workout as a morning boost instead.

Two hard boiled eggs and gluten-free toast for breakfast. I read somewhere that eggs help with brain function, plus they are filling, so I am obsessed with eating eggs on tape days! I take my vitamins (which I organize for the week in my vitamin organizer on Sundays).

Drink a black coffee.

I spend $20 for an 8-ounce piece of salmon, quinoa and veggies from a local healthy food restaurant and pick it up on my way home from the TV station. It's pricey, but I make two meals out of it. This is my go-to because its the perfect mix of protein, nutrient-dense and fiber-filled veggies, and grains.

On a typical client call we will go through the basics about what theyve eaten throughout the past week, how their workouts have gone, and how theyve felt emotionally about themselves. Then we make a plan for the upcoming week and also, most importantly, we discuss any issues that may be preventing them from succeeding in following through on our plan such as travel, dinners out, family obligations, social outings, etc.

I take a break to eat lunch and then pack my suitcase for a quick trip to New York plus wrap up my leftover lunch to eat on the plane. When traveling, I always pack my sound machine, slippers and under eye patches to aid in sleep and comfort (which means fewer under-eye bags while traveling). Plus I never leave the house without my water bottle.

I have extra time before my flight boards, so I do some laps around the terminal. I make an effort to pull my suitcase with my left hand because my right arm is bigger and stronger. (My right bicep is measurably larger than my left; in fact, I do 7.5-lb dumbbell curls with the left arm and 5-lb curls with the right!). Im trying to even them out, but Im right-handed so everyday activities like carrying my purse or a suitcase cause my right arm to be bigger.

Chug two glasses of water from the beverage cart. Stink up the plane as I open up my leftover salmon, veggies and quinoa. I have some clients who are self-conscious about bringing food on a flight the smell only lasts for a few minutes, and you can apologize to your seatmates (like I do!) before you open the container. Another reason I Iike to bring food on the plane is that if I dont eat it, Ill waste it! I dont go through the hassle of bringing a frozen pack to keep my food cold, so after a couple of hours out, itll be spoiled. Just one more motivator to get my fix of protein and veggies and eat that meal.

I packed a Kind Bar (dark chocolate!) to eat once I get back to the hotel as a nighttime snack. Theres 7 grams of protein so its a filling snack (unlike chips!) and I look forward to eating chocolate. I then take a shower, put on my slippers and read to fall asleep.

Wake up, drink water I cant figure out the in-room coffee maker at hotel.

I drink two extra glasses of water since I cant have my cup of coffee before I leave. Ill never say NO to extra hydration! Its a great way to start the day, too, because your body can become dehydrated while sleeping after not drinking water for 7+ hours.

Leave hotel with my luggage and change of clothes for photo shoot. Stop at overpriced NYC coffee shop, get a large iced coffee and two hard boiled eggs. These eggs, placebo or not, are a must when I am filming because my mind needs to be sharp and in the moment. Especially when youre on live TV, there is no room for stutters or mistakes! When the taping is done, I look forward to having a piece of gluten-free pizza and a glass of wine even though Im a health and fitness guru, I still love my pizza and vino! And allowing myself to enjoy them both as a treat in moderation keeps me from ever feeling deprived. Plus, after a hectic few days, I think I deserve it.

Want more tips like these? NBC News BETTER is obsessed with finding easier, healthier and smarter ways to live. Sign up for our newsletter and follow us on Facebook, Twitter and Instagram.

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How this personal trainer stays healthy when traveling - NBC News

Self-Neglect Among Seniors Is A Growing, Hard-To-Spot Problem That Leads To Downward Spiral, Report Says – Kaiser Health News

Posted: February 13, 2020 at 12:44 am

Being unable to provide themselves with food, follow medication schedules and maintain homes are growing problems for the elderly, according to HHS. Public health news is on epilepsy, breastfeeding, obesity, risks of parabens, sugary drinks, rare childhood cancer, teen depression, skin lightening, miscarriages, longevity and exercise, heart disease symptoms in women, and stroke recovery, as well.

The Wall Street Journal:Growing Risk To Americas Seniors: ThemselvesRising numbers of older adults are unable to care for themselves, often leading to serious health problems and even death, according to state and local government agencies. So-called self-neglect cases generally involve the inability to perform essential self-care, such as providing oneself with food, shelter, personal hygiene, medication and safety precautions. Seniors who no longer drive, for example, are often unable to get to medical appointments, exacerbating health problems that can render them incapable of caring for themselves. A fall can result in a hip fracture leaving one bedridden and unable to care for oneself. Failure to pay bills for the phone or other utilities could lead to service cutoffs. Forgetting to pay rent could lead to the loss of a home. (Hayashi, 2/11)

The Associated Press:Epilepsy Treatment Side Effect: New Insights About The BrainThough Genette Hofmann is still using her brain, last month she donated a bit of it to science. Hofmann needed the surgery her Seattle surgeon was looking deep into her brain, where he found the trigger for the epileptic seizures that had disrupted her life for 30 years. But to get there, he teased out a bit of healthy tissue the size of a lima bean, and with her blessing quickly sent it to some researchers, who were eager to study brain cells while they were still alive. (2/11)

NPR:Why Breastfeeding Rates Are Lower Among Black MomsTo explain the persistence of lower rates of breastfeeding among black mothers, we should look to systemic and historic factors rather than individual choice. That's the argument of Skimmed: Breastfeeding, Race, and Injustice (Stanford University Press) by law professor Andrea Freeman, which provides in-depth historical, socioeconomic and legal context that sheds new light on black motherhood. (July, 2/11)

The New York Times:Combining Aerobics And Weights Tied To Optimal Weight ControlTo stave off obesity, we might want to both stride and lift, according to an important, large-scale new study of how different types of exercise affect the incidence of obesity in America. The study, which involved health records for almost 1.7 million men and women, indicates that people who exercise in almost any way are less likely to be obese than those who are sedentary. But the study also finds that the odds of being normal weight are greatest for those who complete both aerobic exercise and weight training, at least occasionally. (Reynolds, 2/12)

Reuters:Mother's Beauty Products Might Impact Girls' Weight GainMothers who use beauty products containing chemicals known as parabens during pregnancy may be more likely to have overweight daughters, a small study suggests. Babies tended to be heavier at birth, and more likely to become overweight by age 8, when mothers used makeup, lotions and other common beauty products containing parabens while pregnant, the study found. One of these chemicals, butylparaben, was associated with excess weight only in girls. (2/11)

The New York Times:Sugary Drink Consumption Plunges In Chile After New Food LawFour years after Chile embraced the worlds most sweeping measures to combat mounting obesity, a partial verdict on their effectiveness is in: Chileans are drinking a lot fewer sugar-laden beverages, according to study published Tuesday in the journal PLOS Medicine. Consumption of sugar-sweetened drinks dropped nearly 25 percent in the 18 months after Chile adopted a raft of regulations that included advertising restrictions on unhealthy foods, bold front-of-package warning labels and a ban on junk food in schools. (Jacobs, 2/11)

CNN:Three Young Brothers Are Fighting The Same Rare Childhood CancerThree brothers, none of them older than 5, are battling the same type of rare childhood cancer. Aaron and Angie Rush have three boys -- Tristen, 5, Caison, 3, and Carter, 7 months -- and all have been diagnosed with retinoblastoma. (Hughes, 2/11)

CNN:Keep Your Teen Moving To Reduce Risk Of Depression, Study SaysScience shows moderate to vigorous aerobic exercise is good for us -- it improves sleep; lowers blood pressure; protects against heart disease, diabetes and cancer; reduces stress; boosts mood; and fights anxiety and depression. It's especially important in adolescence, where the first signs of depression often begin, studies show. But unless your child is an athlete, it can be tough to wean them away from social media and the ever-present screen to swim laps or go for a blood-pumping jog. (LaMotte, 2/11)

MPR:Redefining Beauty: Advocates Work To Make Skin Lightening A Public Health IssueAmira Adawe is on a mission to ensure those who are black and brown love the skin theyre in. This week, the state recognized Adawes work and awarded her nonprofit, The BeautyWell Project, a $55,000 grant to continue educating communities of color about the negative health effects of using products to lighten their skin. The grant was one of four allocated by the state Health Department to help communities begin to talk about the often taboo topic as a public health issue. (Zehn, 2/11)

NBC News:Many Miscarriages Are Still A Mystery. A New Test Could Give Women Faster Answers.While miscarriages occur in up to a quarter of known pregnancies and about 1 percent of women experience three or more miscarriages it is rare for patients to learn the reason why. Chromosomal abnormalities are by far the most common cause, but genetic tests on fetal tissue cost thousands of dollars, and results can take weeks. In most cases, genetic testing is not even offered until a patient has had three or more miscarriages. Advances in rapid genetic testing may change that. By combining several new technologies, Dr. Zev Williams, director of the Columbia University Fertility Center in New York, has developed what he says is a faster, cheaper method to test fetal tissue for genetic abnormalities. (Chuck, 2/10)

CNN:Good News For Trump: Playing Golf May Help Older Adults Live Longer, Study SaysPresident Trump has spent more than 260 days at one of his golf clubs during his first three years in office as of February 2, according to CNN's tally. Now he can rest easy knowing that time hasn't gone to waste, according to preliminary research, which found that playing golf at least once a month can lower older adults' risk of premature death. (Rogers, 2/12)

CBS News:Women Face Some Unique Risks For Heart Disease. Here Are Symptoms To Look Out For.Heart disease is typically thought of as a male disease, but it's also the leading cause of deathfor women, killing nearly 420,000 women in the U.S. each year. Understanding the risk can help women take steps to protect their health. The most common sign or symptom of heart disease is chest pain but that's not always the case for women, explains CBS News medical contributor Dr. Tara Narula, who is a cardiologist.(McNamara, 2/11)

ABC News:Mindfulness Helps Obese Children Lose Weight And Decrease Anxiety: StudyThere may be a new secret ingredient to the tried and true methods of diet and exercise for weight loss. A new study has shown that mindfulness can aid in weight loss for obese children who also have anxiety. "Childhood obesity not only leads to chronic medical conditions such as diabetes and high blood pressure, it also leads to poor self-esteem and depression," said Dr. Mona Degan, a primary care physician practicing in Los Angeles. (Safai, 2/11)

CNN:Being An Optimist Will Help Recovery After Stroke, Study SaysHaving a stroke is no laughing matter. But if you can stay optimistic about your recovery, a new study says you may be able to speed up your healing and reduce disability. Higher levels of optimism in stroke survivors was associated with reduced stroke severity, less physical disability and lower levels of inflammation at the end of three months, according to preliminary research presented at the American Stroke Association's 2020 International Stroke Conference on Wednesday. (LaMotte, 2/12)

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Self-Neglect Among Seniors Is A Growing, Hard-To-Spot Problem That Leads To Downward Spiral, Report Says - Kaiser Health News

Study Suggests Link Between Asthma and Afib – Everyday Health

Posted: February 13, 2020 at 12:44 am

Can a disease that affects your lungs also increase your risk for certain heart conditions? A new study suggests that people with persistent asthma are 1.5 times more likely to develop atrial fibrillation (afib) later in life than people without asthma. Afib is a type of cardiovascular disorder that causes your heart to beat very quickly and the upper and lower chambers not to work together properly.

These findings should lead healthcare providers to be on the lookout for signs of atrial fibrillation in their patients who have persistent asthma, says Nazem Akoum, MD, the director of the atrial fibrillation program and an associate professor of medicine at the UW School of Medicine in Seattle. Dr. Akoum was not involved in the study.

Although there are no immediate changes in screenings or guidelines around asthma and afib, this relationship will be something providers consider in patients with asthma, according to Akoum. Were going to be looking for this much more carefully in that group, says Akoum.

A diagnosis of atrial fibrillation indicates that someone is at increased risk for heart failure and stroke, too, he adds.

This data isnt the first to suggest that asthma may increase afib risk. But, significantly, this study is one of the first to look at such a large, diverse sample in the United States, explains Matthew Tattersall, DO, an assistant professor of cardiovascular medicine at the University of Wisconsin in Madison and the lead author of the research.

In the retrospective analysis, published online earlier this month in Circulation: Arrhythmia and Electrophysiology, investigators used data from 6,615 individuals in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. No one in the group had heart disease at the start of the study; 150 people had persistent asthma (defined as disease severe enough to require daily controller medications); and 497 people had intermittent asthma (defined as disease that caused bouts of shortness of breath and coughing but didnt require those individuals to have to take a daily medication to control their asthma).

The authors hypothesized that underlying common inflammatory processes in asthma and afib might make the latter more common among people with asthma, Dr. Tattersall says.

The participants in the group represented a diverse sample. The average age of the participants was 62; 53 percent were women; 27 percent were African American; 22 percent were Hispanic; and 12 percent were Chinese.

Investigators followed the participants for an average of 12.9 years and used electrocardiogram results, hospital discharge diagnoses, and Medicare claims data to determine if someone developed atrial fibrillation. After controlling for several factors including smoking status, alcohol consumption, education level, blood pressure, and the presence of diabetes or sleep apnea, the analysis revealed that the incidence of afib was about the same for people without asthma and for people with intermittent asthma about 11 cases per 1,000 persons per year.

But in the group with people with more persistent asthma, there were 19 cases per 1,000 persons per year, representing a nearly 1.5 times increased risk.

Prior studies looking at the association between atrial fibrillation and asthma were done in Japan, Norway, and England, Tattersall notes. They were population studies that were able to include a large number of people, but they didnt have the diverse population included in this research, he explains.

RELATED: Asthma Complications You Might Run Into Now and Later

Those studies also didnt have access to the kind of granular detail that we have in MESA; we have access to lab work and imaging for the subjects. We were able to look at a lot of different features that may contribute to the development of atrial fibrillation, as well as adjust for a lot of different factors that other studies werent even able to look at, says Tattersall. Both these features add to the strength of the study, he says.

The diverse sample helps show that this effect isnt just happening in people of one race or ethnicity, Akoum says. Thats very important.

The data suggests more research is needed to understand whether specific races or genders are more affected than others.

Looking at gender differentials deserves more attention, Tattersall says. We observed a trend that suggests that women with asthma in particular seem to have a higher risk for afib compared with women without asthma. It would be interesting to see if that trend was present in larger studies, he says.

The new study showed an association between persistent asthma and developing atrial fibrillation, but the findings also raise some additional questions about that relationship.

Because the researchers had access to participants blood samples in this study, the researchers could study potential mediators of this relationship between asthma and heart arrythmia, says Akoum. They actually looked at inflammatory biomarkers from the blood and showed that this relationship between persistent asthma and atrial fibrillation was not explained by these inflammatory biomarkers, he says. The bottom line is, the data suggests theres a correlation between the two conditions, but it doesn't show not whats causing that correlation, Akoum says.

Further investigation is needed to understand the steps that lead us from a respiratory problem to a cardiac problem, but we do know from these results that it cant all be explained by inflammation, says Akoum.

The other question that needs further study is whether controlling asthma through treatment will reduce the risk of atrial fibrillation and all its potential consequences, like heart failure and stroke, says Akoum. That piece is not proven, he says.

Further research is also needed to unravel the different risks associated with the different types of asthma. For example, is there a specific type of asthma that is at higher atrial fibrillation risk? says Tattersall.

We know that grouping asthma as a singular entity is probably not the best way to think about the condition, says Tattersall. There are specific forms of asthma and each are treated a little bit differently, he says.

RELATED: A Guide to Asthma Treatment

Patients with more severe forms of asthma should be aware that there is an increased risk for atrial fibrillation, and that they should talk with their doctor about how diet and exercise might help minimize that risk, says Tattersall.

There has been a lot of data that has come out that suggests there are modifiable risk factors in developing atrial fibrillation, according to Tattersall. One of the largest modifiable risk factors that can make the biggest difference was exercise and weight loss, he says.

Tattersall references the ARREST AF Cohort Study, published in December 2014 in the Journal of the American College of Cardiology (JACC), and another trial known as the LEGACY study, published in May 2015 in JACC. In both those studies, people who lost weight and exercised actually improved their atrial fibrillation, notes Tattersall. Combined with that, we know that in certain forms of asthma, maintaining an ideal body weight can also help improve symptoms, he says.

According to the American Lung Association, extra weight increases the risk of asthma and of more severe asthma thats harder to control with medication.

RELATED: Your Everyday Guide to Living Well With Asthma

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Study Suggests Link Between Asthma and Afib - Everyday Health

People: Adele Revealed Her Significant Weight Loss in Leopard Print Dress in Photo Taken at Oscars After-Party – AmoMama

Posted: February 13, 2020 at 12:43 am

Adele looked unrecognizable as she showed off the results of her weight loss journey while wearing a tight-fitted leopard print dress at an Oscar after-party.

On Sunday,Adeleavoided making an appearance on the red carpet for the 2020 Awards. However, she was spotted enjoying the night out atGuy Oseary's Oscars after-party.

Polish televisionhost, Kinga Rusin was fortunate enough to bump into Adele, who showed off her slim figure in a skin-tight leopard print dress.

According toPEOPLE, Kinga revealed that she spotted Adele wearing a pair of slippers that were being handed out to guests at the party, and the two women got lost in a conversation talking about shoes.

In the picture, the two women posed side by side as Adele showed off figure in an embellished body hugging leopard print dress that showed off her cinched waist.

In the months since Adele announced her divorce fromSimon Konecki, who is the father of her seven-year-old, she has been working hard ongetting into shape, and flaunting her newly single revenge body. A source at the partyrevealed:

"[Adele]looked striking and so tallhad a tiny waist and beautiful hourglass figure in a beaded leopard dress. She took her shoes off and danced on the dance floor. She sat with Nicole Richie and was chatting for a while."

Reports, suggest that she has lost almost 100 lbs since embracing a healthier lifestyle, and incorporating an intense fitness routine.

Adele has joined the ranks of Kate Winslet, Jennifer Aniston and Madonna inusing a Pilates reformer to get in shape. She has also been drinking less alcohol, eating healthier, and doing CrossFit training.

Earlier in the year, another source toldPEOPLEthat Adele's latest transformation is less about losing weight. Instead, she is doing it to be healthy not only for herselfbut also for her son, Angelo. The source explained:

"[Adele] now loves her physical transformation too. She is more confident, dresses differently and she just seems happier overall."

Adele is known for making award-winning albums from her songs about heartbreak and breakups. While fans sympathize with her over her divorce, many can't wait to hear how the past few years are going to translate into another hit album.

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People: Adele Revealed Her Significant Weight Loss in Leopard Print Dress in Photo Taken at Oscars After-Party - AmoMama

The Continuing Growth Story of Weight Loss Management Market? – Nyse Nasdaq Live

Posted: February 13, 2020 at 12:43 am

Latest Study on Industrial Growth ofGlobal Weight Loss Management Market2020-2025. A detailed study accumulated to offerLatest insights about acute features of the Weight Loss Management market. The report contains different market predictions related to market size, revenue, production, CAGR, Consumption, gross margin, price, and other substantial factors. While emphasizing the key driving and restraining forces for this market, the report also offers a complete study of the future trends and developments of the market. It also examines the role of the leading market players involved in the industry including their corporate overview, financial summary and SWOT analysis.

The Major Players Covered in this Report: Cybex International, Ediets.Com, Inc., Equinox, Inc., Amer Sports, Apollo Endosurgery, Inc., Jenny Craig, Johnson Health Technology Co., Ltd., Atkins Nutritionals, Inc., Brunswick Corporation, Covidien PLC, Herbalife Ltd., Nutrisystem, Inc., Olympus Corporation, Technogym SPA, Kellogg, Weight Watchers International, Inc., Ethicon, Fitness First Group & Golds Gym

Weight Loss Management Market Study guarantees you to remain / stay advised higher than your competition. With Structured tables and figures examining the Weight Loss Management, the research document provides you a leading product, submarkets, revenue size and forecast to 2025. Comparatively is also classifies emerging as well as leaders in the industry.Click To get SAMPLE PDF (Including Full TOC, Table & Figures)

This study also covers company profiling, specifications and product picture, sales, market share and contact information of various regional, international and local vendors of Global Weight Loss Management Market. The market opposition is frequently developing greater with the rise in scientific innovation and M&A activities in the industry. Additionally, many local and regional vendors are offering specific application products for varied end-users. The new merchant applicants in the market are finding it hard to compete with the international vendors based on reliability, quality and modernism in technology.

This research report categorizes the global Weight Loss Management market by players/brands, region, type and application. This report also studies the global market status, competition landscape, market share, growth rate, future trends, market drivers, opportunities and challenges, sales channels, distributors and Porters Five Forces Analysis.

In 2017, the global Weight Loss Management market size was million US$ and is forecast to million US in 2025, growing at a CAGR of from 2018. The objectives of this study are to define, segment, and project the size of the Weight Loss Management market based on company, product type, application and key regions.

Read Detailed Index of full Research Study at @https://www.htfmarketreport.com/reports/1357422-global-weight-loss-management-market-2

The titled segments and sub-section of the market are illuminated below:

In-depth analysis of Global Weight Loss Management market segments by Types: , Weight Loss Diet, Fitness Equipment & Surgical Equipment

In-depth analysis of Global Weight Loss Management market segments by Applications: Fitness Centers, Slimming Centers, Consulting Services & Online Weight Loss Programs

Major Key Players of the Market: Cybex International, Ediets.Com, Inc., Equinox, Inc., Amer Sports, Apollo Endosurgery, Inc., Jenny Craig, Johnson Health Technology Co., Ltd., Atkins Nutritionals, Inc., Brunswick Corporation, Covidien PLC, Herbalife Ltd., Nutrisystem, Inc., Olympus Corporation, Technogym SPA, Kellogg, Weight Watchers International, Inc., Ethicon, Fitness First Group & Golds Gym

Regional Analysis for Global Weight Loss Management Market:North America (United States, Canada and Mexico)Europe (Germany, France, UK, Russia and Italy)Asia-Pacific (China, Japan, Korea, India and Southeast Asia)South America (Brazil, Argentina, Colombia etc.)Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)

Furthermore, the years considered for the study are as follows:Historical year 2013-2017Base year 2018Forecast period** 2018 to 2023 [** unless otherwise stated]

**Moreover, it will also include the opportunities available in micro markets for stakeholders to invest, detailed analysis of competitive landscape and product services of key players.

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Guidance of the Global Weight Loss Management market report:

Detailed considerate of Weight Loss Management market-particular drivers, Trends, constraints, Restraints, Opportunities and major micro markets. Comprehensive valuation of all prospects and threat in the Global Weight Loss Management market. In depth study of industry strategies for growth of the Weight Loss Management market-leading players. Weight Loss Management market latest innovations and major procedures. Favorable dip inside Vigorous high-tech and market latest trends remarkable the Market. Conclusive study about the growth conspiracy of Weight Loss Management market for forthcoming years.

What to Expect from this Report On Weight Loss Management Market:

1. A comprehensive summary of several area distributions and the summary types of popular products in the Weight Loss Management Market.2. You can fix up the growing databases for your industry when you have info on the cost of the production, cost of the products, and cost of the production for the next future years.3. Thorough Evaluation the break-in for new companies who want to enter the Weight Loss Management Market.4. Exactly how do the most important companies and mid-level companies make income within the Market?5. Complete research on the overall development within the Weight Loss Management Market that helps you elect the product launch and overhaul growths.

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Detailed TOC of Weight Loss Management Market Research Report-

Weight Loss Management Introduction and Market Overview Weight Loss Management Market, by Application [Fitness Centers, Slimming Centers, Consulting Services & Online Weight Loss Programs]

Weight Loss Management Industry Chain Analysis Weight Loss Management Market, by Type [, Weight Loss Diet, Fitness Equipment & Surgical Equipment]

Industry Manufacture, Consumption, Export, Import by Regions (2013-2018) Industry Value ($) by Region (2013-2018)

Weight Loss Management Market Status and SWOT Analysis by Regions

Major Region of Weight Loss Management Marketi) Global Weight Loss Management Salesii) Global Weight Loss Management Revenue & market share Major Companies List Conclusion

Thanks for reading this article; you can also get individual chapter wise section or region wise report version like North America, Europe or Asia.

About Author:HTF Market Report is a wholly owned brand of HTF market Intelligence Consulting Private Limited. HTF Market Report global research and market intelligence consulting organization is uniquely positioned to not only identify growth opportunities but to also empower and inspire you to create visionary growth strategies for futures, enabled by our extraordinary depth and breadth of thought leadership, research, tools, events and experience that assist you for making goals into a reality. Our understanding of the interplay between industry convergence, Mega Trends, technologies and market trends provides our clients with new business models and expansion opportunities. We are focused on identifying the Accurate Forecast in every industry we cover so our clients can reap the benefits of being early market entrants and can accomplish their Goals & Objectives.

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The Continuing Growth Story of Weight Loss Management Market? - Nyse Nasdaq Live

How Ultimate Performance Training Helped This Guy Get Ripped – Men’s Health

Posted: February 13, 2020 at 12:43 am

Stephen Nutall was always a healthy eater. He didn't snack, consumed very little sugar, and avoided soda. However, the 42-year-old noticed the weight creeping up and his clothes fitting just a bit tighter than he liked.

"Looking back, I struggled with portion control and a more balanced diet," he tells Men's Health. I probably ate too little for breakfast and lunchoften to fit in with a busy work schedulebut then overate late in the evening after long days at work."

The accountant, who lives in Manchester, England, looked into Ultimate Performance, a nearby gym that specializes in body transformations. Nutall ate a heavy lunch the day of his UP consultation, which led him to sign up.

"I had a burger, fries, and beer, and remember feeling awfulboth physically and how that made me feel about myself," he says. "Enough was enough!"

In June of 2019, Nutall began working with his trainer, Anthony Paulhe, who provided him with a meal plan that included recommended servings of lean meat, vegetables, and carbohydrates. At the time, he weighed 205 pounds and had 23 percent body fat.

"It was really challenging at first as they were bigger meals for breakfast and lunch, which required more shopping, food prep, and general organization," says Nutall. "However, my wife was very supportive. Ive also started to do more cooking and meal prep for both me and Maggie, and now we really enjoy the food were eating and cooking for one another."

He also met with Paulhe three times a week, focusing on resistance training and HIIT, and went for jogs on his own time. However, Nutall says one tiny change made the largest impact: walking. He aimed to log at least 10,000 steps each day and did this by taking public transportation instead of driving and by walking at lunch and after work.

"I used the stairs at work and even went for walks late at night when I got home after long days to get the steps in," he says. "I think that made a big difference to the weight loss and is now a part of my normal routine."

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These tiny tweaks delivered instant results, according to Nutall.

"I could see results from the second week," he says.

By the end of September, Nutall weighed 167 pounds and was super lean with only 8.2 percent body fat.

"Now Im fitter, stronger, and leaner than Ive ever been at the age of 42," he says. "I genuinely never thought I would get a six pack!"

More importantly, Nutall says losing weight has improved his confidence and cut down on how often he gets sick. His success has even inspired others to make lifestyle changes.

"The reactions of friends and work colleagues has been fantasticmany have decided to go on their own fitness plan as it is possible to change!"

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How Ultimate Performance Training Helped This Guy Get Ripped - Men's Health

How to lose weight while you sleep with these 5 bedtime drinks – The Sun

Posted: February 13, 2020 at 12:43 am

WOULDN'T it be great if weight loss was so straight forward that you could even do it in your sleep?

Well, it kind of is.

1

One easy way you can improve the quality of your sleep and boost your weight loss is by sipping on certain beverages before you hit the hay.

In particular, they can help your body blitz fat, especially around your belly, and lower stress levels.

Here, we take you through the five best drinks that will help you maximise weight loss while you sleep and get more zzzs too...

A glass of milk can help you get shut eye because it's brimming with calcium and something called tryptophan.

Experts say calcium helps the brain to use the amino acid tryptophan to create the substance melatonin, which is well known for inducing sleep.

On top of this, high levels of calcium consumption can help to get rid of body fat, especially around the tummy area.

A 2010 study, carried out by researchers from the University of Negev, Israel, even claimed that drinking just two glasses of milk each day will help you lose weight.

They found that adults who drank the most milk almost two glasses a day and had the highest vitamin D and calcium levels, lost an average of almost 12lb after two years.

Chamomile tea is often nicknamed the "sleepy tea" for a reason.

It's been used for centuries as a sleep aid, thanks to healing ingredients like apigenin and bisabolol.

In particular, the Romans, Greeks and Egyptians all used chamomile as a dressing for wounds to help them heal quicker.

Nowadays, it's known to help soothe muscle spasms, which makes it the ideal pre-bed drink.

It can also help to ease belly cramps, IBS, indigestion and gas.

Drinking a small glass of 100 per cent grape juice before bed can apparently help you blitz body fat while you sleep.

Research has claimed eating or drinking simple carbs, which are found in grape juice, triggers insulin secretion at night.

Insulation regulates the bodys circadian rhythms - the 24-hour cycles that dictate everything from when we feel sleepy to when our immune cells are most active.

Plus, grapes are packed with antioxidants which convert calories storing white fat, into calorie burning brown fat.

Many people think soy protein shakes are just for weightlifters in the gym - however they are also perfect for slimmers.

This is because soy in milk or protein power form is packed full with the amino acid tryptophan.

Tryptophan is said to decrease cortisol levels in people which which helps bust fat.

Even though metabolism slows down when you sleep, it still keeps working, and your protein shake will be digested and absorbed as youre getting to sleep.

Kefir is a milky, yogurt-like drink made from fermented milk.

It holds a lot of the same health benefits as milk, and is a good source of calcium and protein.

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However it also holds some additional benefits, such as probiotics.

These "friendly bacteria" are known for helping to ease the symptoms of IBS and reducing bloating and digestive distress.

The drink also helps to improve your sleep and enhance your exercise performance.

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How to lose weight while you sleep with these 5 bedtime drinks - The Sun

Im gobsmacked: Government criticised for calorie-shaming weight loss poster – The Independent

Posted: February 13, 2020 at 12:43 am

The government has been criticised over new eat a little less posters which state: Just 100 extra calories a day could mean 10lbs of weight gain a year.

The poster, commissioned by the Public Health Agency (PHA)in Northern Ireland, shows what 100 calories looks like in four different snacks.

It includes pictures of three and a half cocktail sausages, three sweets, one digestive biscuit or one medium latte drink.

Sharing the full story, not just the headlines

Vanessa from Belfast posted a photograph of the poster on her social media, with the caption: I just saw this poster at a bus stop talking about how 3 wee sausages or 1 f**king digestive biscuit will make you gain 10lbs Im actually gobsmacked?

What does this achieve other than make those with eating disorders and compulsive calorie counters feel worse?

The 30-year-old toldThe Independent: "My first reaction was to laugh, but it quickly turned to concern for young people and all those suffering or recovering from eating disorders.

"To frame a biscuit and a half as having the potential to gain 10lbs of weight in a year could be incredibly damaging to compulsive calorie counters and those with body image issues.

"I think this has the potential to be incredibly dangerous to young people in general. I'm sure my younger self would have taken it very hard, it's easy to imagine young girls and women going to bed hungry afraid three sweets or a hot chocolate will be the 100 calories that will 'push them' over an intake limit," she adds.

Others replied to Vanessa's tweet, agreeing. One said: Seeing this could f**k a lot of people in recovery up as well! Like if I was caught off guard by this in public I doubt Id handle it well tbh.

Others commented saying they had also seen the posters: Literally saw this today, its the same with the whole you can lose 10 million stone if you stop taking sugar in your tea like its hardly going to kill you?

Near-universal criticism from ED [eating disorder] specialists to include calorie content on publicly-distributed health materials, but good job Department of Health, said another.

Another said: The eat a little less turns me too like why not make it about healthy choices if u r that concerned with peoples weight instead of telling them to restrict their intake Im fuming [sic].

Tom Quinn, director of external affairs at Beat, the UKs leading eating disorder charity, told The Independent: It is important that messages aimed at reducing obesity consider the impact they may have on individuals at risk of developing an eating disorder.

Focusing solely on calorie counting, rather than healthy and balanced eating, is unhelpful and could be harmful for those already unwell or vulnerable.

Public health professionals must move away from obesity-shaming to emphasising healthy behavioural changes and instilling confidence into people.

A spokesperson for the PHA toldThe Independent: Obesity is a major public health challenge facing Northern Ireland. Currently more than three in five people are classed as being overweight or obese, and it is now the norm rather than the exception to carry excess weight.

Extras is part of the Choose to Live Better campaign which is targeted at members of the general population who are overweight or obese. Previous phases of the public information campaign focused on waist measurement, physical activity as well as nutrition.

Extras aims to encourage people to think about the unnecessary extras eg snacks, nibbles, second helpings, etc. they eat and show how easy it is to gain weight if they consume more food than they require to maintain a healthy weight .

A number of concepts were tested with the public and extras tested positively because it focused on small changes. The message eating an extra 100 calories each day means gaining an unwanted 4.5kg (10lbs) each year and showing visually what 100 calories looks like was seen as a positive, theyadded.

The PHA confirmed that this is a re-run of a previous campaign, and will be shown on TV, radio and outdoor advertising.

The PHA was established in 2009 under the health and social care body in Northern Ireland, to oversee a major reform of health infrastructure in the region.

On their website they say their purpose is to: Protect and improve the health and social wellbeing of our population and reduce health inequalities through strong partnerships with individuals, communities and other key public, private and voluntary organisations.

Similar campaigns run by Public Health England have previously been criticised: in January 2018 a campaign was criticised after encouraging parents to only give children snacks with fewer than than 100 calories.

If you have been affected by any of the issues mentioned in this article, you can contact the following organisations for support: the BEAT helpline on0808 801 0677 or Mind on 0300 123 3393.

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Im gobsmacked: Government criticised for calorie-shaming weight loss poster - The Independent


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