Safe swallowing depends on the coordination of many muscles in the face, mouth and throat.

The medical name for swallowing difficulty is dysphagia. Dysphagia can occur at any stage of life, from birth through old age. Swallowing may be impaired because of prematurity or developmental difficulty; stroke or neurological disease; respiratory illness like COPD or emphysema; cancer; head injury; surgery; injury to the face, mouth or neck; weakness or incoordination from other sources; and other reasons.

A person with dysphagia may have food and liquid enter the lungs instead of the stomach, which is called aspiration. A person may aspirate without being aware of any swallowing difficulty because of impaired sensation or thinking. If dysphagia is not treated effectively, a person may either develop aspiration pneumonia, which is a serious medical condition, or become choked on food lodged in the airway.

Possible signs of dysphagia include:

Coughing, choking or strangling while eating, drinking or taking medicine.

Wet voice quality or chest congestion after eating or drinking.

Pneumonia, breathing difficulty, chest pain or rattling in the lungs.

Spitting food out of the mouth or pushing the tongue out of the mouth.

More trouble chewing or swallowing than usual.

Food sticking in the mouth or throat after meals.

Food coming back through the nose or mouth.

Not being able to swallow saliva or drooling.

Decreased intake of food or liquid; unexplained weight loss, malnutrition or dehydration.

Becoming more tired or short of breath while eating.

Taking a long time to finish a meal or giving up part way through.

When a person has signs of dysphagia, a physician may order an evaluation of swallowing ability. The medical professional who evaluates and treats dysphagia is a speech-language pathologist. A swallow evaluation may take place in an office or an X-ray department.

After being evaluated, dysphagia may be treated by strengthening muscles, compensating for weakness or changing the diet. Also, these simple guidelines may help make eating and drinking more safe:

Be fully awake and alert before eating or drinking.

Eat in a quiet, non-stressful environment with no distractions; turn off the television; do not hold a conversation while eating.

Take your time; do not rush; chew thoroughly.

Take small bites and sips.

Sit straight up any time you eat or drink; never eat while lying down.

Sit up for 20-30 minutes after eating.

If you begin to cough or strangle, stop eating or drinking until the sensation has passed; do not take a sip of liquid.

Brush your teeth and gums regularly.

There are times when a person cannot swallow any item safely or take in enough food or liquid to meet the bodys needs. If this happens, a physician may recommend an alternative feeding method, like a nasogastric or gastrostomy tube. These tubes bypass the normal swallow structures to provide food and liquid directly into the stomach. Even if one of these methods is used, a person may continue to work with the speech-language pathologist to improve swallowing abilities.

If you have signs of dysphagia, the first step to eating and drinking safely is to contact your physician and discuss your concerns.

Lisa Renfroe is a speech-language pathologist with Acute Rehabilitation at North Mississippi Medical Center.

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Swallowing difficulty is serious but treatable - Northeast Mississippi Daily Journal

Professional athletes dont get to the top by accident. It takes superhuman levels of time, dedication, and focusand that includes paying attention to what they put in their bellies. In this series, GQ takes a look at what pro athletes in different sports eat on a daily basis to perform at their best. Heres a look at the daily diet of pasta-loving Olympic track star Christian Taylor.

Christian Taylor was on top of the world after winning his first gold medal in triple jump at the 2012 London Olympics. Then, knee issues put into question whether the USA Track and Field star would ever be able to jump at a competitive level again. But instead of just hanging up his spikes, Taylor and his coach devised a plan: No more pasta. No more pizza. No more carbs, which were causing inflammation in his joints. That change, combined with a new jumping pattern, allowed Taylor to go on and win a second gold medal in Rio. We caught up with the gravity-defying champ while training in the Netherlands to discuss how his new diet reinvigorated his career and why so many Olympians love McDonalds.

GQ: Youve now won back-to-back gold medals at the Olympics. Is there a celebratory meal that has become a ritual for you?

Christian Taylor: Its pretty cool to be able to have that conversation. [Laughs] In 2012 I went to a burger place with my parents and I just had a regular cheeseburger with avocados, bacon, literally the works. In Brazil, I just had a rack of ribs and some fries. Nothing in particular, but its that point where youre no longer eating to eat. You can finally enjoy food and not feel guilty about things. I actually was eating McFlurries before the London Olympics, though.

McFlurries from McDonalds? Seriously?

It was my first Olympics. I was so nervous that I actually was having a lot of McFlurries while I was in the Olympic Village. Going into the London games I was so strict on my diet and watching all of my calories and everything that I just had to find something that would help ground me a little bit. So I figured maybe a little ice cream here and there would calm my nerves down and make me feel regular again, because I was so strict going in.

Ive actually heard before that there is always a McDonalds in the Olympic Village, but I just assumed no Olympic athlete would be touching that stuff after working so hard to get to this point. Are you guys really chowing down on McDonalds?

Oh, yeah! McDonalds is probably the most popular food source at the Village. Especially in Brazil. The food was a little different and so I think people wanted to play it safe. Also in Beijing, I was hearing so much about McDonalds. McDonalds is probably the hardest line to get into because everyone is eating there.

Thats insane. In your experience between London and Rio, how was the food aside from the McDonalds at the Olympic Village? Did you typically get all your food from right there, or were you able to explore off-site and experience some of the local establishments? Or maybe you just bring a ton of your own food in?

Both London and Rio had the cafeteria setup where you can go and get almost everything. Theres pizza stations and carb loads, meat loads, things like that. Ive grown fond ofin London and in Brazil it was almost like an outdoor grill setting where you could get grilled chicken, grilled fish, even shrimp. But in London especially I was exploring a lot. The Tube is super easy to get the hang of and everyone speaks English. I would just go around and say, Hey, what would you recommend around here? Everyone would have the best spot. So in London I was exploring a lot. Brazil, with the safety issues I was a little I just wanted to play it safe and didnt explore so much. And when I did, I was going to the Nike hospitality or the USA house, places like that.

I think most people often forget that track and field athletes are competing in different championship events all year long, and its not just the Olympics every four years. But does your diet change at all once you have the Olympics approaching?

For me, its all about consistency. Im very mindful of the things that I am putting into my body. My coach is really big on lowering the carb intake because I have bad knees and bad joints. The carbs really sit and cause a lot of inflammation in my joints. So focusing my diet on getting meats, vegetables, and fruits is really important. Dont get me wrong, I do have my cheat days. After a hard Saturday workout, say it was a really solid week, Im going to have a slice of cake. Im going to have something to reward myself. But I cant say that my diet would change in an Olympic year as opposed to the year after or the year before. The only real difference would be the week or two weeks before where Im going crazy mentally with stress or anticipation and I say, Let me have an ice cream to bring me back down.

Between the London and Rio games, you started dealing with some knee issues and ultimately ended up completely reversing your jumping pattern. Were there any dietary changes that coincided with the leg switch?

Actually, that was the point when I found out that the carbs were interfering with my total recovery. When I say I love carbs, I love pizza. I love pasta. I love sandwiches. They fill me up and I prefer that over eating chicken and fish and things like that. But when I was eating so much of that, I couldnt recover as well. Thats when we found out that my joints were becoming so inflamed that if I jumped on a Monday, I couldnt jump again until Friday because my knee would swell up or my ankle would swell up. Thats when my coach said, Let's try to alter your diet a little bit and see what response we get. He saw me eating at lunch a big plate of pasta. At dinner I would have a ton of fries and maybe a steak or something like that. He said instead of having the pasta, maybe we could do a salad. Instead of having the fries, maybe we could do asparagus or a zucchini mix or something like that. And that ended up being way better for me. When I was jumping on a Monday, by Wednesday I was ready to go again. I was definitely missing the pasta and stuff, but I told myself that if Im going to compete at a high leveland now with changing legs I was given this second chancehow am I going to make the best out of this? If thats the biggest sacrifice I have to make, Im willing to do it.

"I find the prettier the dinner can be, the more colors that are involved, the better it can be."

Take me through your day-to-day diet. Are you a lunch/breakfast/dinner kind of guy, or do you prescribe to another method?

On a typical training day, for breakfast I would have two eggs with spinach. It doesnt matter how I do it. Some days scrambled, some days over easy, others an omelet. I love avocado so I try to incorporate avocado in three to four meals out of the day. Some fruits. Bananas, pears, apples. Something thats not too heavy but can also fill me up for the two hours of training I have. Then between my running and jumping session I have an hour to and hour-and-a-half before my weight session. Thats when I would have a protein shake and lunch. Lunch would consist usually of a salad with some kind of meat or eggs. If I know I have a bigger lifting session afterwards I would usually have chicken, beef, or lamb. I always try to get a little protein in there but the salad keeps it light. Again, Ill have fruit in my salad. Some strawberries, peaches, mangoes, pineapples. Some sunflower seeds. I love feta cheese, so I throw some feta cheese in there. After weights I usually have a protein bar and banana. Just something to get me over the hump between lunch and dinner. Plus Ill try to load up on water, trying to replace all the water that Ive lost throughout the day.

With dinner, its very important to keep in mind whatever the session I have the next day. If I were having a lot of running the next day then I would usually have fish or chicken. Something that could break down a little quicker, versus if I know that I have a slower tempo day or something thats not so intense. Then I would have some kind of steak or lamb again, because I dont need to feel super light the next day. Then just a ton of vegetables, tomatoes, cucumbers. I try to get some color. I find the prettier the dinner can be, the more colors that are involved, the better it can be.

Youve already mentioned your love for ice cream. Are you ever indulging in some dessert?

My dessert would be some fruit. Pineapple is usually very sweet. Coconut, things like that are usually my dessert.

Youre currently training in the Netherlands. You lived in London. Youve lived in the States. Youve travelled all over the world competing. You seem like a good person to askwhere is the best place in the world to get food?

I would have to say Barcelona, hands down. I mean, they love seafood. It just seems so fresh. And the spices! No matter what kind of mood Im in, Ive had really good experiences there. Whether its the lobster, whether its the prawns. I was there two weeks ago and I was just in heaven. Barcelona, Spain would be my number one choice. Second would be Tokyo.

When you have an event in those cities does it make it that much harder to stick to your diet?

Absolutely. When you know its right outside the hotel or right outside the Village, you can always find an excuse to go and enjoy yourself. The good thing is when Im wearing the USA gear it does remind me what Im there for. This is not a holiday. This is work.

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The Real-Life Diet of Christian Taylor, Who Ditched Carbs and Feels Fantastic - GQ Magazine

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The Venezuela Diet, By Remy Power Line (blog) The Venezuela Diet, By Remy. I've been waiting for this. Or at least something like it. Take it away, Remy! An error occurred. Try watching this video on http://www.youtube.com, or enable JavaScript if it is disabled in your browser. Share · Email · Tweet ... and more »

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By Thursday, the White House's original explanation for why President Trump fired FBI Director James Comey he just followed the recommendation of Deputy Attorney General Rod Rosentstein was defunct, despite White House officials like Vice President Mike Pence and Deputy Press Secretary Sarah Huckabee Sanders standing by it until Thursday, when Trump himself threw that rationale out the window. "Oh, I was gonna fire regardless of recommendation," Trump told NBC News' Lester Holt.

Trump went on to suggest that the FBI's investigation into possible collusion between his campaign and the Russian government, which Comey was leading, played at least some part in his decision. "Regardless of recommendation I was going to fire Comey, knowing there was no good time to do it," Trump said. "And in fact when I decided to just do it, I said to myself, I said, you know, this Russia thing with Trump and Russia is a made-up story, it's an excuse by the Democrats for having lost an election that they should have won."

After Trump explained his theory that it is very hard for Republicans to win the Electoral College, he said he knew firing Comey in the middle of the Russia investigation might "confuse people," he wants the investigation "to be absolutely done properly," and he'd considered the idea to "expand that, you know, lengthen the time because it should be over with, in my opinion, should have been over with a long time ago." Trump decided not to "lengthen out the investigation," he said, because "I have to do the right thing for the American people."

Huckabee Sanders, whose job it is to clarify White House positions, did her best at Thursday afternoon's press briefing. "We want this to come to its conclusion, we want it to come to its conclusion with integrity," she said of the investigation. "And we think that we've actually, by removing Director Comey, taken steps to make that happen."

CNN called that "a surprising admission from the White House that Comey's sudden dismissal on Tuesday may have an effect on the Russia probe." Typically, the White House firing an FBI director investigating the president or his associates, with the stated reason that it would hasten the end of that investigation, would be frowned upon in legal circles. Peter Weber

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A gluten-free diet could actually raise the risk of obesity, study reveals - The Week Magazine

Nutritional challenges detoxes, cleanses, juice fasts are known for taking over offices, CrossFit boxes, and other communal spaces that thrive on both peer support and competition. The Whole30 Program is of that ilk. The 30-day, highly restrictive diet is less known for the foods it allows (small portions of meat and seafood, some fruit, vegetables, eggs, and natural fats) and more for whats off the table: sugar, alcohol, grains, legumes, dairy, soy, and any junk foods made with approved ingredients (even Whole Foods fanciest plantain chips are a no-go).

Its a tough plan to follow, which is at least part of the appeal. Jamey Rice, RD, LD, Nutrition Coach and Sports Dietitian at IMG Academy in Bradenton, Florida, sees guys attempt diets like the Whole30 to measure their motivation and will power. Others hope to drop pounds or remedy skin and digestive issues. While the goals are valid, the approach, for most people, is misguided.

Youre unlikely to do any significant damage in 30 days, but Rice points out that slashing whole food groups can, over time, lead to nutrient deficiencies. Without fortified grains, she says, youre going to be missing some iron and a lot of those key minerals that are important for overall health, for blood flow, for wellness, for those healthy red blood cells. And dairy is a key source of calcium and protein for many people. Its true that those nutrients can be supplemented with the right combination of fruits and vegetables, but without the input of a dietitian, you may fall short of your recommended daily requirements.

And thats the other thing that makes Rice wary of the Whole30: most dieters are doing it without the support and guidance of a medical professional. Elimination diets can pinpoint sensitivities and intolerances to certain foods, but they need to be managed by a doctor or dietitian who can provide supervision and run labs as needed.

Despite the red flags, Whole30 has a few positive attributes. Rice appreciates the month-long moratorium on weighing oneself and taking measurements, as constant assessment can be discouraging and cause people to lose sight of their long-term goals. She also likes the whole foods approach. Theyre really trying to focus on lean meats and fruits and vegetables, and going back to the basics, which is what most of us need to be doing, she says. Still, the risks outweigh the benefits.

The better approach:Rice explains that it really depends on your goals and lifestyle, but shes seen many athletes achieve long-term success with flex dieting. On this type of plan, dieters track their macronutrients, or macros carbohydrates, proteins, and fats. The prescribed mix is tailored to the individual, their physical make-up, and their level and type of daily activity. And it allows for some real-life flexibility; as long as you account for the extra fat and carbs, you can have the occasional slice of birthday cake.

Apps like MyFitnessPal and My Macros simplify food logging, while commercial meal plans grounded in macro-tracking like Renaissance Periodization, Eat to Perform, and Designed to Fit Nutrition provide more personalization and, in some cases, one-on-one coaching with a credentialed expert, which Rice believes is crucial. It comes down to if theyre able to accurately calculate their macros as well, she says. When Im in a facility like this and I can help people do that, its a lot more effective than if theyre trying to assess their own needs and they arent really sure how to go about it. Avoid cookie-cutter templates and work directly with a registered dietitian (R.D). Or, if you follow an intense training cycle, you may want to seek out a certified specialist in sports dietetics (C.S.S.D.).

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Is It Time to Ditch Your Whole30 Diet? - Men's Journal

(HealthDay)The concept of counting calories to lose weight is based on a pound of fat being equal to 3,500 calories, so that cutting 500 calories a day means you should lose about one pound a week.

(HealthDay)The diet followed by people who live in countries around the Mediterranean Sea has been shown to be more than just delicious. The so-called Mediterranean diet can help you limit daily calories so you can lose ...

Data from a large UK survey on the eating habits of very young children (aged 4-18 months) show that overweight children consume larger meals, but do not eat more frequently, than healthy weight children. This study of the ...

(HealthDay)Parents might order fewer calories for their children if menus included calorie counts or information on how much walking would be required to burn off the calories in foods, according to a study published online ...

Improving health can be as easy as opening the freezer door. "Save time, save money, boost nutrition and control portions by eating low-calorie, frozen foods," advises Jessica Bartfield, MD, internal medicine.

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Stop sabotaging your diet - Medical Xpress

A new study, published in the British Medical Journal, found that gluten-free diets could increase the risk of heart attack for people who don't have celiac disease.

"Any time a study like this comes out, that's great," said Olson, marketing specialist with the North Dakota Wheat Commission and immediate past chairwoman of the national Wheat Foods Council.

The study's conclusion: "Long-term dietary intake of gluten was not associated with risk of coronary heart disease. However, the avoidance of gluten may result in reduced consumption of beneficial whole grains, which may affect cardiovascular risk. The promotion of gluten-free diets among people without celiac disease should not be encouraged."

The study examined more than 100,000 people without a history of heart disease. It began in 1986 and was updated every four years until 2010.

The size and length of the study make it particularly meaningful, Olson said.

Celiac disease

Celiac disease, also known as gluten intolerance, prevents people from digesting gluten normally. Gluten is a protein found in wheat, barley, rye and other grains. The condition damages the surface of the small intestines and blocks the ability to absorb certain nutrients.

The disease also is associated with an increased risk of coronary heart disease, which is reduced with a gluten-free diet, the study notes.

Estimates of the number of Americans with celiac disease vary, with some as high as 3 million and others much lower. Some people the number is unclear also have a condition called non-celiac gluten sensitivity, in which gluten causes some symptoms even though celiac disease isn't present.

Whatever the actual number of people with celiac disease or non-celiac gluten sensitivity, they're exceeded by the number of Americans who are wary of eating gluten. Twenty-one percent of people surveyed say they "actively try to include gluten-free foods in their diet," according to a 2015 Gallup Poll.

Other surveys estimate that roughly one in three Americans are trying to cut back or eliminate gluten from their diet.

That's bad for farmers who raise wheat especially in North Dakota, which typically leads the nation in production of hard red spring wheat, prized by millers for its gluten strength.

When consumers avoid gluten, "It damages markets and market share. It's just one more thing our dedicated producers have to worry about," said Neal Fisher, administrator of the North Dakota Wheat Commission.

The new study and other studies released previously show that, "Unless you have celiac disease, you shouldn't avoid wheat foods or gluten. In fact, it's quite beneficial to most people's health," Fisher said.

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Study: Gluten-free diet could be risky - Daily Republic

Street work throughout San Jose is set to beginthis summer after the City Council approved $7.7 million in road maintenance and improvement costs at a May 2 meeting.

About 89 miles of major streets across the city, including Minnesota, Curtner, Hicks and Hamilton avenues in District 6, will beresurfaced and get new markings when completed, according to a transportation department memo.Theyre amongfour major pavement projects scheduled forthis year.

Leigh, Union, Jarvis and Narvaez avenues in districts 9 and 10 are slated for work as well.

But the biggest change will happenon Hedding Street, which first must be resealed to extend itslife and reduce long-term maintenance costs. After that, the travel lanes will bereduced from four to three with a center lane along a 1.4-mile stretch from Winchester Boulevard to Coleman Street. However, some lanes approaching signalized intersections such as Winchester, Monroe Street and Bascom and Coleman avenues will be left alone to accommodate heavy traffic.

Plans for the lane reduction began in 2012, when the stretch of Hedding between highways 87 and 101 was narrowed to one lane each way. Buffered bike lanes and enhanced crosswalks will also be added as part of a citywide effort to make it safer for pedestrians, bicyclists and motorists.

District 6 Councilwoman Devora Dev Davis said thats been a common wish of neighbors in the Rose Garden area.

When I was campaigning and knocking on doors in that neighborhood there were a lot of requests for additional safe crosswalks, Davis said in an interview.

Some residents reaffirmed that sentiment at a community meeting held last week at Hoover Middle School in the Rose Garden neighborhood, but others felt differently. The latter lamented the loss of on-street parking at the intersections of Winchester, The Alameda, Monroe and Bascom, and expressed concern about people cutting through side streets to avoid traffic.

I heard from residents who were concerned about possible diversions of traffic to other streets, Davis said. But I also heard from a lot of residents that theyre excited about the prospect of a safer street, the accessibility of that neighborhood to the north getting to the school, as well as the Rose Garden.

I also heard from commuters that commute by bike that they will do so more often because they have a safer way to do so, she added.

Various factors were considered before the decision was made to proceed with the project, including existing vehicle speeds, traffic volume and collision history, according to transportation department staff. Division manager Jessica Zenk said pedestrian safety in particular has been one of the key drivers for the change, noting that a pedestrian was hit and killed by a car in January at the intersection of Hedding and Bellerose Drive.

A construction schedule has not yet been set, but because four schoolsBellarmine College Preparatory, Lincoln High School, Hoover Middle School and Trace Elementary Schoolare all close to Hedding, Davis said the city aims to do the workonce summer break arrives. The project will be funded from the citys general fund and capital improvements program and Measure B revenue.

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San Jose: Road diet, bikes lanes planned for Hedding - The Mercury News

WEDNESDAY, May 10, 2017 (HealthDay News) -- Warding off the joint pain of gout may be as easy as eating right, a new study suggests.

Gout, a joint disease that causes extreme pain and swelling, is caused by excess uric acid in the blood. It's the most common form of inflammatory arthritis, and its incidence has risen among Americans over recent decades, Harvard researchers noted.

But the DASH (Dietary Approaches to Stop Hypertension) diet -- which is high in fruits and vegetables, and low in salt, sugar and red meat -- can lower levels of uric acid in the blood.

The American Heart Association has long supported the DASH regimen as a way to help avoid heart disease.

"Conversely, the [unhealthy] Western diet is associated with a higher risk of gout," said Dr. Hyon Choi, of Harvard Medical School in Boston, and colleagues. The "Western" diet describes the fatty, salty, sugar-laden fare of many Americans.

One nutritionist wasn't surprised by the new findings, pointing out that the DASH diet is low in compounds called purines, which break down to form uric acid.

"I can see how the DASH diet may benefit someone with gout," said Jen Brennan, clinical nutrition manager at Lenox Hill Hospital in New York City. "The DASH diet avoids excessive consumption of red and organ meats known to have high purine levels."

Brennan added that the DASH diet "also encourages high intake of fruits and vegetables. We want to encourage fluids and vitamin C for these patients to help rid the body of uric acid, and fruits/vegetables can support this."

In their study, the Harvard researchers analyzed data from more than 44,000 men, aged 40 to 75, who had no prior history of gout. The men provided information about their eating habits every four years between 1986 and 2012.

Over the study period, more than 1,700 of the men developed gout.

During 26 years of follow-up, those who followed the DASH diet -- high in fruits, vegetables, legumes, nuts, low-fat dairy products and whole grains, and low in salt, sugary drinks and red and processed meats -- were less likely to develop gout than those who ate a typical Western diet, the findings showed.

The Western diet is high in items such as red and processed meats, French fries, refined grains, sweets and desserts.

The study wasn't designed to prove a cause-and-effect relationship. However, the findings suggest that the DASH diet may provide "an attractive preventive dietary approach for the risk of gout," the researchers concluded.

Choi's team noted that many people who have high uric acid levels also have elevated blood pressure, or "hypertension" -- another reason to switch to the healthier DASH diet.

According to the study's lead author, Sharan Rai, of Massachusetts General Hospital, "The diet may also be a good option for patients with gout who have not reached a stage requiring [uric acid]-lowering drugs, or those who prefer to avoid taking drugs." Rai is with Mass General's division of rheumatology, allergy and immunology.

"And since the vast majority of patients with gout also have hypertension, following the DASH diet has the potential of 'killing two birds with one stone,' addressing both conditions together," Rai said in a hospital news release.

However, more studies are needed to track the diet's effectiveness in curbing gout flare-ups, the researchers said.

Dana Angelo White is a registered dietitian at Quinnipiac University in Hamden, Conn. She called the new study "another win for the DASH diet, a sensible plan that emphasizes whole foods and a healthy balance of all major food groups. I'm pleased to see a study that highlights the benefits beyond cardiovascular health. If more people ate this way, we would continue to see decreases in all kinds of chronic illness."

The study was published online May 9 in the BMJ.

The U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases has more on gout.

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Eat This Diet to Lower Your Odds for Painful Gout - Arizona Daily Star