Diabetes is a troublesome disorder that can cause havoc on the body. According to the International Diabetes Federation, approximately463 million adultswere living with diabetes in 2019 and by 2045 this number is set to rise to700million.

Furthermore, theproportion ofpeople with type 2 diabetes is increasingin most countries. Now, a new study has found that "fat over-spills from the liver into the pancreas" may be what is responsible for triggering type 2 diabetes.

RELATED:WEIGHT TRAINING CAN CONTROL DIABETES IN OBESE PEOPLE

The research followeda group of people who had type 2 diabetes but had lost weight and successfully reversed the condition.The researchers uncovered that type 2 diabetes is caused as a response to too much fat in the body.

We saw that when a person accumulates too much fat, which should be stored under the skin, then it has to go elsewhere in the body. The amount that can be stored under the skin varies from person to person, indicating a personal fat threshold above which fat can cause mischief," said in a statementProfessor Roy Taylor, from theNewcastle University Institute of Translational and Clinical Research,

When fat cannot be safely stored under the skin, it is then stored inside the liver and over-spills to the rest of the body including the pancreas. This clogs up the pancreas, switching off the genes which direct how insulin should effectively be produced, and this causes Type 2 diabetes.

The study brings good news for type 2 diabetes sufferers as it indicates that the condition is reversible. In fact,previous Newcastle studies that found that type 2 diabetes can be reversed led to the large DiRECT trial.

This trial found that weight loss techniques combined with a low-calorie diet resulted in a remission of type 2 diabetes.

This means we can now see type 2 diabetes as a simple condition where the individual has accumulated more fat than they can cope with," said Taylor.

Importantly this means that through diet and persistence, patients are able to lose the fat and potentially reverse their diabetes. The sooner this is done after diagnosis, the more likely it is that remission can be achieved.

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Excess Fat That Spills From the Liver into the Pancreas May Cause Type 2 Diabetes - Interesting Engineering

Q: My veterinarian says my bird is fat. Is that really something I need to worry about?

A: You bet! Obesity is as much an issue in pet birds as it is in dogs and cats. An overweight bird can be predisposed to metabolic diseases such as diabetes. He can also become arthritic or develop fatty liver disease.

Certain species tend to be more likely to grow tubby Amazon parrots, parakeets, canaries, cockatoos and Quaker parakeets but any bird can gain too much weight if he's allowed to eat whatever he wants. Pet birds may start out on good diets but become choosy with age, deciding they are going to eat only one or two types of food.

Don't let your bird get away with that. He's most likely to have a balanced diet if he eats a variety of foods. A pelleted diet supplemented by healthy food from your own plate is the best way to feed him. Birds can and will eat pasta, cooked chicken, scrambled eggs, beans and most fruits and vegetables. Avian expert and veterinarian Scott Weldy said most birds do well on a diet of 70 percent to 80 percent pelleted food and 20 percent to 30 percent fresh or cooked food.

Avoid giving birds avocado, onion, mushrooms or chocolate, all of which have toxic effects. Highly salted foods are a no-no as well.

What's the key to determining if your bird is overweight? Birds with cleavage rivaling that of a Hollywood starlet are too fat. Birds should be lean and sleek, with no cleavage at all, Weldy said. If you can't feel your bird's keelbone because it's covered by a layer of fat, talk to your veterinarian about ways to help him get back to a healthy weight.

THE BUZZ

A dog-friendly movie house in Plano, Texas, is to bark for. The unique theater, K9 Cinemas, is open six days a week to people and their dogs. For $15, people and their dogs can lounge on leather couches and drink free wine (for the humans) on Friday and Saturday nights when movies are shown. On weekdays, K9 Cinemas serves as a co-working space where people can work in the company of their dogs. A courtyard is available where pets can relieve themselves during intermission and, of course, owners are expected to pick up after them. The only drawback? "The dogs bark when a dog on the screen barks," said theater owner Eric Lankford in an interview with the Houston Chronicle.

Could your dog talk to you one day? Speech pathologist Christina Hunger created a device, based on one used with humans who are nonverbal, that just might enable that. Her Voice Output Communication Aid has allowed her to teach her blue heeler-Catahoula mix, Stella, to communicate such desires as "look" or "come eat" or "play." To learn more, visit Hunger's website at hungerforwords.com or see hunger4words on Instagram.

Watch out for the Yule Cat if you're in Iceland over the holidays that is, unless you're wearing new clothes. The giant feline is said to lie in wait for and eat people who have not received new clothes before Christmas Eve. Is the Yule Cat real or simply a ploy by retailers to encourage gifts of clothing? The story is said to be an old tradition, begun by farmers to give their workers an incentive to finish processing shorn wool before the holiday. Diligent employees received new clothes, but slackers were threatened with the monstrous cat. Just in case, be sure you have some new togs in case your tabby decides to import the tradition.

Pet Connection is produced by a team of pet-care experts headed by veterinarian Marty Becker and journalist Kim Campbell Thornton of Vetstreet.com. Joining them is dog trainer and behavior consultant Mikkel Becker. Send pet questions to askpetconnection@gmail.com.

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Avian obesity is a thing: Pet Connection - Entertainment & Life - GoErie.com

Dr. William ONeill // Photograph courtesy of Henry Ford Health System

Dr. William ONeill, who specializes in cardiology at Detroits Henry Ford Hospital, developed a method of cardiogenic shock treatment that brought the conditions previously unstable survival rate up to a steady 72%. This year, he received an Excellence in Care Award for the innovation, which has been implemented in hospitals across the country. Find out more about the Excellence in Care Awards here.

Dr. William ONeill: Its an area where you can make a huge and immediate impact you could truly save lives.

There are a lot of people we saved that didnt have any other hope. One young woman went into cardiac arrest 45 minutes after delivering her baby. We used advanced support devices, and she survived. Shes able to be at home and be a mother to her infant daughter.

Providing hope for people who didnt have any. There have been scores of people Ive seen who other doctors told they have no hope, and we gave that to them.

Understanding that youre mortal and that there will be complications. Understanding that sometimes there will be bad outcomes and dealing with that mental stress.

Heart disease is the No. 1 killer; its rampant everywhere. [In] Detroit, theres a chronic lack of medical care, uncontrolled hypertension, bad diets, smoking, pollution all those things contribute. So, were seeing people with heart disease in their early 40s and 50s.

The big three: exercise, diet, and controlling cholesterol.

Im honored to accept it on behalf of our team at the Henry Ford Center for Structural Heart Disease and across Henry Ford Health System. You cant practice medicine in isolation these days. In the advanced, pioneering work were doing, having a strong team of people is essential.

Link:
Dr. William O'Neill on the Most Rewarding Parts of Working in Cardiology - Hour Detroit Magazine

Written by Nell Greenfieldboyce Dec. 24, 2019

Shepherds in Christmas Nativity scenes that were painted, carved or sculpted hundreds of years ago sometimes have throats with large, abnormal growths.

These are realistic depictions of goiter, an enlargement of the thyroid gland caused by iodine deficiency. The condition was common in those days in northern Italy, where the soil and water are depleted of iodine.

"Goiter is more often seen in poor people," says retired surgeon Renzo Dionigi of the University of Insubria in Varese, Italy, who notes that the working classes in this region would historically not have a varied diet that might supply this vital nutrient.

"That's why, probably, the poor shepherds are depicted with goiters," he says.

He and his son, an endocrine surgeon named Gianlorenzo Dionigi, have for years enjoyed studying art and looking for signs of medical conditions. In the Sacri Monti ("Sacred Mountains") of Piedmont and Lombardy, they have visited chapels and churches created in the 16th and 17th centuries.

"In all the Sacri Monti that I and my son visited, we have been able to observe representations of goiters very, very often," says the elder Dionigi.

In one Nativity tableau from 1694, for example, a young horn player with a large goiter plays for the Holy Family. And in one fresco over the main door of the Aosta Cathedral, a shepherd with goiter plays his bagpipe for the newborn Jesus.

Dionigi and his son also recently reported on two wooden shepherds, both with enormous goiters, that were once part of a 16th-century Nativity scene.

This father and son are not the only surgeons interested in spotting goiter in artwork. Another recent report noted a large, obvious goiter on one of the shepherds visiting the baby Jesus in the 16th-century Adoration of Shepherds by Renaissance painter Alessandro Bonvicino.

Beyond Nativity scenes (where goiter isn't actually all that common, according to Dionigi), some historians of art and medicine seem to see almost any thick neck as evidence of goiter.

"The representation of thyroid swelling in art is a debated issue and has found considerable attention in the medical literature," one review article noted in 2018.

Dionigi thinks a putative goiter should count only if the artwork clearly and unambiguously shows the disease state.

"The real goiter is when the painter or the sculptor wants to depict the person with the goiter," he says.

Massive goiters sometimes show up on artists' portrayals of tormentors and executioners, apparently as a symbol of evil. But often, goiter just indicates that a person is poor or needy.

In one 17th-century terra-cotta sculpture from northern Italy, a person with an enormous goiter begs St. Francis for healing. "That's the hugest goiter I have ever seen in any sculpture," says Dionigi. "The size of that goiter in that sculpture is something like half a meter."

Dionigi's favorite artistic goiter appears on a woman portrayed in The Crucifixion of St. Andrew, by Caravaggio, at the Cleveland Museum of Art.

Not too long ago, goiters were a common sight in the United States. Before iodized salt became available in the 1920s, the U.S. had a "goiter belt" around the Great Lakes and the Northwest region of the country.

And iodine deficiency isn't just a medical condition of the past.

About a third of the world's population currently lacks adequate iodine, says Angela Leung, an endocrinologist at UCLA and the VA Greater Los Angeles Healthcare System.

"That just ranges from very mild forms of iodine deficiency to more moderate subtypes," she says, noting that the body needs iodine to make thyroid hormone. Goiter seems to occur when the thyroid tries to bulk up to create more of it.

Goiter is one manifestation of not having enough thyroid hormone, she says, but other symptoms include fatigue, weight gain, sluggishness and dry skin.

In addition, thyroid hormone is needed for fetal brain development. The World Health Organization says that iodine deficiency is "the world's most prevalent, yet easily preventable, cause of brain damage."

The most common and effective public health measure to counter iodine insufficiency is to iodize salt. "Not all countries have chosen to universally iodize their salt," says Leung.

In the U.S., about 70% of household salt available in grocery stores is iodized. Nonetheless, certain groups might be vulnerable to iodine deficiency, such as pregnant women or people on restricted diets, like vegans, says Leung.

It is possible to overdo iodine consumption and end up with too much thyroid hormone.

"Getting the right balance is what we are striving for," says Leung, "but we're certainly not there yet on a global scale."

Overdoing iodine was clearly not a danger for the folks who lived in Italy during the Renaissance at least not for those influencing the religious artists who wanted to depict shepherds.

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Why Certain Poor Shepherds In Nativity Scenes Have Huge, Misshapen Throats | NPR - KCRW

Did you grow up eating low-salt food because someone in your family had high blood pressure (BP)? If yes, youre probably luckier than you realise.

One in four Indian adults has hypertension. Increasingly people in the 25-34 age group are falling prey to this disease that increases wear and tear in the blood vessels. Though there are many reasons for this, a high-salt diet is not blameless.

Heres how it affects your health:

Ever noticed how you feel thirsty after going through a bag of chips? Regular salt contains roughly 40% sodium (the rest is chlorine). When we consume a lot of salt in a short time, the body tries to dilute the sodium in our blood with water. When the amount of water in the blood rises, the overall volume of blood increases. Now the heart has to pump more. Hardworking as it is, the heart likes to work just the right amount. Too much strain on the heart can weaken the heart muscle, or even lead to heart failure.

Salt poisoning isn't only real, it's already affecting public health in evident ways. Image: WWW

Research has also linked high-salt diets to increased risk of kidney disease, brain stroke, diabetes, dementia and poorer bone health.

High BP affects every organ in the body, especially the heart. BP is measured in millimetres of mercury - any reading over 140/90 is considered high. This reading means that blood vessels withstand at least 140 mm of pressure every time the heart contracts and 90 mm when it relaxes.

Over time, the blood vessels become rigid as a result of high pressure. This sets off a vicious cycle. High BP makes the blood vessels rigid, and rigid blood vessels increase BP further and high BP also increases the chances of cholesterol plaque buildup in the arteries which can become choked. This, in turn, can lead to a host of problems like heart attack and brain stroke.

Between 2009 and 2011, German scientists ran a bunch of tests on astronauts on two simulated missions to Mars over 105 days and 205 days, respectively (the second mission was for 520 days, but the scientists studied the astronauts for a little less than half that duration). Every 30-60 days, the scientists changed the amount of salt in the astronauts diet. The variations were 12 grams of salt a day, 9 grams daily or 6 grams per day.

At the end of the period, they found a connection between high salt intake and water retention in the kidneys not only did the test subjects have less water in their pee for days when they ate more salt, but they also started drinking less water because their kidneys were retaining water already.

The scientists found one more thing: changing the amount of salt in the daily diet also triggered a change in the production of two hormones aldosterone, which cleans the sodium out of the kidneys, and glucocorticoids, which keeps the metabolism ship-shape. This hormonal imbalance, they said, can cause a range of metabolic disorders, from diabetes to metabolic syndrome.

Salt affects the excretion of calcium through our pee. More salt equals more calcium loss equals loss of bone density, and potentially, the formation of kidney stones. Its fitting that the way to pass the smaller kidney stones is to drink lots of water, which also improves the overall salt-water balance in the blood.

Scientists at New Yorks Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, and the Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimers Disease Research Center, Washington University, have found that the more salt you eat, the more tau proteins build up in your brain. Usually, tau proteins help the brain cells get nutrition. But when theres an imbalance of tau proteins, it can lead to a decline in brainpower. The scientists published their research inNature Neuroscience- a peer-reviewed journal - in October 2019.

For more information, please read our article onRock Salt: Benefits and Side-effects.

Health articles in Firstpost are written by myUpchar.com, Indias first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

Updated Date: Dec 24, 2019 12:28:59 IST

Tags : Effects Of Too Much Salt, Healthy Diet, High In Salt, High-Salt Diet, Low-Salt Diet, Salt, Salt Health Effects, Salt Health Problems, Side-Effects Of Salt

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Diets low in salt aren't just 'good for health' they keep life-threatening conditions at bay - Firstpost

Its that time of year again to reflect on New Years resolutions. The Cambridge dictionary defines a resolution as a promise to yourself to do or to not do something orstopdoing somethingbad, which sounds simple enough right?

But according Psychology Today, only 41% of Americans make New Years resolutions and only 8% achieve their resolutions. Not the most promising statistics.

Making a New Year's resolution is great in theory, but what makes the biggest difference in whether you achieve your goal is if it becomes a long-term positive change. New Years doesnt need to be the only time to make self-improvements.

Mypatient Luis Salazar made a monumental transformation that has lasted for more thaneight years and he plans on making it last a lifetime. I sat down with him to talk about his journey and share it with you as a source of motivation and inspiration.

Emily Rubin:When didyour weight become an issue?

Luis Salazar: I was an overweight child and through my first year of college. In 2011, at the age of 20, I was diagnosed with prediabetes, fatty liver, high blood pressure and multiple GI problems. I was also clinically depressed and didn't like my body.

ER: What was your diet like at this point?

LS: Prior to my weight loss journey, my diet consisted of lots of fast food, soda and candy. Breakfast would be two donuts and a coke. For lunch, I would typically go to a fast food restaurant eat a burger with fries with another coke. Dinner was take-out Chinesefood or pizza. I would also snack all day on copious amounts of candy and soft drinks.

ER: What were your previous diet attempts?

LS: I tried Slim Fast, the South Beach Diet and the Atkins Diet. I also tried the "oatmeal diet" which just consisted of eating only oatmeal for every meal.

ER:What was your light bulb moment that pushed you to lose weight?

LS: I was at my primary care physicians office and my blood pressure was 200/90 because of my family history and previous [blood pressure] readings, I was put on blood pressure medications. I remember in my head thinking, "I'm way too young to be on medications."

At 20 years old, I had a multitude of conditions due to my poor dietary habits. All of this was very alarming to me that I had let myself get this heavy. Mentally, I was depressed and not happy with my life. After that day a coworker, who was also struggling with weight, and I decided we were going to diet and workout together to hold each other accountable.I wanted to make this change to better myself and lead to a healthier lifestyle.

ER:How much did you lose and how long did it take?

LS: I lost over 150 pounds in just over a year.I've kept the weight off since 2012.

ER: What is your diet now?

LS: Instead of counting calories, I count mymacronutrients (macros) grams of proteins, carbs and fats.Depending on my training schedule or goals, my ratios for grams may change. It's been super helpful and has taught me that youre not meant to be depriving your body, youre meant to be feeding it to perform.

During my weight loss journey I met with you and you showed me that I was eating too little and restricting my calories. You really helped me find a balance to support my activity level.

ER:How do you maintain your weight?

LS: Along with counting macros, I work out five to six times a week. My exercise of choice is CrossFit, which has brought such immense happiness to my life with all the challenges and goals Ive accomplished.

ER:What kept you motivated when you were down?

LS: My biggest motivation was myself. I was my own cheerleader. I wanted to change my body and my mind. I was so used to overeating and living unhappily. I always envisionedthe light at the end of the tunnel. I would set small achievable goals to reach. Once I hit one, I'd strive to hit another.

ER: What is the biggest struggle: food, exercise, temptation?

LS: My biggest struggle is definitely food. I always have to remind myself to eat smart, make healthy choices and eat in moderation.

ER:How has your weight loss affected your relationships?

LS: Weight loss has had a major effect on my relationships. I'm so much happier and energetic. I've also become way more social and outgoing. When I was overweight, I found myself wanting to just stay home and be alone. After losing weight, I wanted to meet new people. It gave me the confidence to be myself and live my life to the fullest.

ER:Who are your biggest supporters?

LS: My biggest supporters are most definitely my mother and friends. Part of the reason I love CrossFit so much is the community. I've been able to meet people from all walks of life and of all fitness levels. It is a very encouraging environment and it pushes me to be better every day.

ER:What are your biggest accomplishments?

LS: I've ran the Broad Street Run seven years in a row. I've done three half marathons. I've competed and placed in several CrossFit and strongman competitions. For the last year, I've been coaching CrossFit at Subversus Fitness. I coach around 10-15 hours every week. It gives me such happiness to show people the amazing abilities of the body and how fitness can make you better in many ways.

ER: What is your New Years Resolution?

LS: This year my resolution is to continue sharing knowledge of fitness and health with others. It brings me great joy to see how being healthy and staying active has made people so much happier. I want to continue to set a goal to be consistent with my training and tracking.

Emily Rubin, R.D., has been a registered dietitian with Thomas Jeffersons division of gastroenterology and hepatology for 18 years. She is the dietitian for its celiac center, Fatty Liver Center and Weight Management Center. She is also the public relations chair for the Philadelphia Dietetic Association. She will be writing occasionally on topics related to nutrition and dieting.

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Jefferson Health patient who lost 150 pounds encourages others to keep their New Year's resolutions - PhillyVoice.com

Hunger once seemed like a simple problem. Around the globe, often in low-income countries, many people didn't get enough calories.

But increasingly, hunger exists side-by-side with obesity. Within the same community, some people are overweight while others don't have enough to eat.

And the tricky part: You can't "fix" hunger by just feeding people empty calories. You've got to nourish people with healthy, nutrient-dense foods, so they don't become obese.

A new report published in The Lancet shines a spotlight on this paradox. The dual problems of undernourishment and obesity often referred to as the double burden of malnutrition.

For example, people can begin life not getting enough calories and become stunted below average height for age but by adulthood can become overweight due to an abundance of cheap calories.

Similarly, an obese teenager even in a wealthy country like the U.S. can easily grow overweight from eating junk food yet still be deficient in micronutrients that are key for optimal health.

"The new nutrition reality is about countries having not just undernutrition or just having obesity but about ... the combination of both," says Corinna Hawkes, a report author, and director of the Centre for Food Policy at City, University of London.

The report finds an estimated 2.3 billion children and adults are overweight and more than 150 million children are stunted. The problem, researchers say, is that the ideal diet includes plenty of fruits and vegetables, whole grains and beans, but much of the globe has developed a taste for snack foods full of refined carbohydrates and sugar.

"The poorest low- and middle-income countries are seeing a rapid transformation in the way people eat, drink and move at work, home, in transport and in leisure," says report author Barry Popkin, a professor of nutrition at the University of North Carolina, Chapel Hill. "The new nutrition reality is driven by changes to the food system, which have increased availability of ultra-processed foods that are linked to increased weight gain."

Popkin and his co-authors argue that systematic changes are needed to fix the problem: Everything from changing food production and processing to how foods are priced, labeled and marketed.

"All relevant policies and investments must be radically re-examined," says Francesco Branca, Director of the Department of Nutrition for Health and Development at the World Health Organization.

And, given that poor diets are now linked to more deaths than smoking, there's an urgency, researchers say.

"We can no longer characterize countries as low-income and undernourished, or high-income and only concerned with obesity. All forms of malnutrition have a common denominator: food systems that fail to provide all people with healthy, safe, affordable and sustainable diets," Branca says.

We asked experts and thinkers in global nutrition to share initiatives and policies aimed at tackling the problem. Some are old, some old; all these efforts take on urgency given the scope of the problem.

Grow healthier foods

Focusing on the production and distribution of nutrient-dense foods is a good place to start, says Danielle Nierenberg, president and founder of Food Tank. She points to the work of the World Vegetable Center, which helps farmers in Asia and Africa grow an array of vegetables in an effort to prevent micronutrient deficiencies and malnutrition.

"One of the most interesting things they do is help provide resources for women farmers to create value-added products, like vegetable powders. These have the dual benefit of preventing food loss and waste, and providing essential nutrients throughout the year, as well as a source of income," Nierenberg says.

She says in addition to projects like this, the group works to improve vegetable breeding practices.

"This focus on veggies will help transform diets and health but only if governments and policy makers realize their importance," Nierenberg says.

She also points to the work of the International Center for Research in the Semi-Arid Tropics' (ICRISAT) Smart Food project that is promoting grain crops like millets and sorghums to improve nutrition. Both are nutrient-dense and provide a mix of fiber, protein and micro-nutrients.

"Milllets and sorghums have long been neglected and they have an image problem they're thought of as 'birdseed' or considered poor people's foods," Nierenberg says. "But they're highly nutritious, they have a low glycemic index, they're resilient to drought and disease and they're delicious."

Money talks

To address obesity and poor nutrition, we can't rely on people to use willpower to make healthier choices, says Will Masters, professor in the Friedman School of Nutrition and Science Policy at Tufts University. Instead, he argues that government regulations and taxes can play a key role in shifting what we eat and drink.

He points to the U.K., where the government introduced a tax on sugary drinks that took effect in 2018. The policy was structured to give manufacturers an incentive to redo their products: When a company reduces sugar in its products below a certain threshold, they can avoid the tax.

There's already some evidence that the policy has led to changes on store shelves. The U.K. grocery retailer Tesco reformulated all 251 of its house brand sodas to reduce sugar and avoided the levy. "Tesco customers are now consuming on average over 20% less sugar from our soft drinks than in 2011," a Tesco executive told The Guardian in 2016.

"It's a clear example where taxes are a stick that leads the company to dial down the sugar in these beverages, " Masters says.

Governments can also design food subsidy programs that encourage healthier eating among low-income beneficiaries of government food aid. The idea is that people who are low-income beneficiaries of government food aid don't just need calories they need nourishment. And they may need to be educated on how to get it.

Professor Hawkes, who is one of the authors of the new Lancet report, cites Egypt and Mexico as examples. In Mexico, "people who received cash [for food] also received training and education about healthy eating," she says.

With a change in government in Mexico last year, these programs are in flux. In the U.S, the Women, Infants and Children (WIC) federal nutrition program also combines food assistance with nutrition education and support for low-income moms.

Promote breastfeeding

To prevent undernutrition early in life, there are increasing efforts to promote breastfeeding around the globe, says Jessica Fanzo, professor of global food and agricultural policy and ethics at Johns Hopkins University. The added benefit is that breastfeeding can also help protect against obesity and type 2 diabetes later in life.

"There is strong evidence suggesting that exclusively breastfeeding children has both short-term and long-term benefits to child health and nutrition," Fanzo says.

She points to the growth of the Baby-Friendly Hospital Initiative, which was started by WHO and UNICEF back in the early 1990s, in an effort to promote breastfeeding. A hospital or clinic maternity ward can be designated "baby-friendly" when it implements a series of steps such as not accepting free or low-cost baby formulas, helping mothers start breastfeeding within a half-hour of birth, giving newborns no food or drink other than breastmilk (unless medically necessary), keeping babies in the room with their mothers to encourage breastfeeding on demand and giving no pacifiers to babies.

The program has been implemented in hospitals and clinics in many countries, and has been shown to be effective in helping women both initiate breast feeding and stick with it. Fanzo says it's one evidence-based way to promote health and good nutrition.

Invest in farmers

To transform the food system, governments have to help farmers, especially in low- and middle-income countries, says Ertharin Cousin, a distinguished fellow at the Chicago Council on Global Affairs and former executive director of the World Food Programme.

She says there are lots of initiatives that can work aid to secure financing, technologies to improve storage so farmers don't lose their harvests, access to improved seeds and fertilizer.

Cousin says there are lots of unfunded business opportunities within the food and agricultural sectors. Together with a group of partners, earlier this year she started a hybrid nutrition impact fund, Food Systems for the Future (FSF) Institute. She says the goal is to improve nutrition outcomes for underserved and low-income communities.

Get to know your veggies

Imagine growing vegetables that you never eat. That's the reality for some farm families in the highlands of Guatemala.

"Many of these moms work in the fields tending to a marvelous variety of vegetables that are largely grown for export," says Roger Thurow, a senior fellow at the Chicago Council on Global Affairs who focuses on food and agriculture.

There's a big opportunity, he says, to improve nutrition by making people more comfortable using vegetables in the kitchen. He points to the Nutrition Rehabilitation Program by Primeros Pasos, a clinic in the western highlands of Guatemala that teaches families the importance of eating the nutrient-dense crops around them. The moms in the program attend regular nutrition classes, which include cooking lessons.

Within the U.S., the group Share Our Strength operates Cooking Matters in cities throughout the country. Classes are held to teach families who have very limited budgets to shop for and cook healthy meals. It's one of a growing number of programs aimed at changing behavior by teaching people how to cook and educating them about the important health benefits of good nutrition

Thurow writes in his book, The First 1,000 Days, about other initiatives, including a home visitation program in Chicago to help support and educate moms in low-income neighborhoods about the importance of good nutrition. In his book he describes a doula a health worker who assists a woman during pregnancy and delivery bringing a bag of fresh produce to pregnant women when she comes to see them.

"It's basically house-to-house combat against malnutrition," Thurow says.

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Malnutrition Hits The Obese As Well As The Underfed - Vermont Public Radio

Not to jinx it at this late hour but, against all odds, it looks like our species will make it to 2020. Time to break out the organic, sustainably sourced champagne. (It may taste like carbonated vinegar, but at least its still reassuringly expensive.) But what then? Will humanity manage to stick it out for a few more millennia? Not if we dont manage to stay healthy in the short term.

To that end, and as in years past, weve reached out to several prominent personalities in the health and fitness world (generously defined) to get theirtake on what we might expect in the year ahead.

The Second Running Boom, according to stats collected by RunningUSA, peaked back in 2013, when 19 million people signed up for U.S. road races. Thats roughly when the headlines about how too much running would kill you hit their peak, and also when Eliud Kipchoge made his marathon debut. Since then, numbers have been steadily ebbing: they hit 18.1 million in 2018. But the bleeding has almost stopped, andbuoyed by the persistent failure of studies to find any evidence that even extreme amounts of running will kill you and the persistent brilliance of Kipchoge2020 will be the year that the trend finally turns around. Lapsed runners will return to the fold, new runners will discover the Trial of Miles, and hardcore veterans will redouble their efforts. The year will reach its apogee in December when Kipchoge, while delivering his Nobel Peace Prize acceptance speechin Oslo, actually levitates from the stage (though the usual cynics will maintain that this feat is somehow linked to the bluish flame that, from certain angles, appears to flicker from the soles of his sneakers).

Alex Hutchinson, OutsideSweat Science columnist and author of Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance

I expect that people will become increasingly focused on trying to move more throughout the day. Not working out, not even going for a walk, but just taking time throughout the day to stand up from a chair and move around for a few minutes. Research shows that our bodies arent designed to be in one place for hours at a time. And of course, a short break is good for our brains.

Gretchen Rubin, author of The Happiness Project

In 2020, we will start to see a big increase in the number of people working out using virtual training programs in their homes. Indoor cycling programs like Peloton and Zwift were just the beginning. Now, with programs like those by Mirror and Tonal, your gym and trainer are coming to you, right in the comfort of your home. The big question is whether or not people will find these as fun and effective without the live person and community aspects of going to the gym.

Andy Petranek, co-founder of the Whole Life Challenge

I think that in the post-Vaporfly world we are going to see a shoe arms race as other companies jump in and the discussion about possible regulation of shoe tech heats up. I think this is going to spill over to other areas of equipment as people and companies seek novel ways to improve efficiency.

Dr. Michael Joyner, physiologistat the Mayo Clinic

In my crystal ball, Im seeing much greater attention from Big Agriculture to how its practices affect climate change, along with increasing public demand for sustainable regenerative agriculture, meaning farming practices that sequester carbon, replenish nutrients in soil, and protect water resources. Its about time!

Marion Nestle,professor of nutrition, food studies, and public health at NYU, emerita, and author of Unsavory Truth: How Food Companies Skew the Science of What We Eat

Are interval workouts better for you than running long distances? Is breakfast the most important meal of the day, or is extending your overnight fast better? Which one is the evil ill to all of our problems this year: fat, sugar, or animal proteins? If there's one thing I'm sure of, its that in 2020 we will continue our back and forth arguments over what the next superfood, super-exercise, and super-supplement are. Its in our nature to get lost in the details of exercise and diet advice, while forgetting that there is no easy answer when it comes to health and fitness. And that were a diverse group of individuals, so what works for you may not work for me. My hope is that the big picture makes a comeback. Instead of trying to hack or detail our way to health and wellbeing, we settle on the few very basic things that work: move, eat real food, sleep, form real bonds and relationships, go outside.

Steve Magness, Track and Field and Cross-Country Coach at the University of Houston, and co-author of The Passion Paradox and Peak Performance

I predict a continuation of last years sentiment that women are a lot like people. We will see a wave of men vocally supporting womens sports, sharing their female sports heroes, and emphatically demanding that everyone stop boxing in the potential reach of women athletes to only female fans. This massive tide of allyship will have a profound effect on the economics of womens sports. Megan Rapinoe and Sue Bird will parachute into the World Series, mid-play, and do an open arm salute.

Lauren Fleshman, retired professional track and field athlete and co-founder Picky Bars

The main trend I see continuing, since I think itsalready underway, is kind of a reversal of what happened in the last two decades: for a long time, mainstream fitness was training in your grungy gym with other human-beings, everyone kind of struggling along together. During that period, fringe fitness was using fancy gadgets and devices and technologies to boostyour training. Then, sometime in the last few years, that completely flipped. Now mainstream is training with fancy gadgets (or in specific classes) and it is only the fringe folks who are training in low-tech, grungy gyms. I think this niche will continue to grow: the return of the garage gym kind of thing. I sense that, increasingly, people are getting sick of their health and fitness being just another part of living a productive, measured, and polished life. I dontthink this kind of back-to-basics training will be mainstream again anytime soon, but I do think more people will bounce back in this direction. In running, in strength training, in cycling. You name it. Im not against stuff like Peloton. Anything that gets someone moving who otherwise wouldntbe moving is a good thing. I just think high-tech fancy fitness is saturated and people are getting sick of being measured and compared in every element of their life... For all of Crossfitsfaults (such as coming after me on Twitterfor saying that walking is the best exercise there is and gets you 99 percent of the way there, which I stand by), they do a really nice job of keeping things low-tech, hard, and community-oriented. Instead of constantly criticizing, other fitness movements could learn from this.

Brad Stulberg, OutsideDo It Better columnist and co-author of Peak Performance

I think people are a bit fed up and just want to know what works. Theres ample opportunity to teach the consumer and exercise-goer instead of simply offering another product. Running will still continue to be big this year, especially going into an Olympic year. We will also continue to see the rise of disciplines outside of the fitness space but are still connected to itthink mindfulness and recovery. These arent fads and are truly here to stay.Joe Holder, fitnessand wellness columnist for GQ

People will look up from their smart watches and phones and actually speak to each other more in 2020. (A person can hope, right?)

Dr. Jordan Metzl, bestselling author and sports medicine physician

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These Will Be the Biggest Health Trends of 2020 - Outside