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Older patients’ and their family caregivers’ perceptions of food, meals and nutritional care in the transition between hospital and home care: a…

Posted: March 18, 2020 at 3:47 am

We present our findings through four overarching and interrelated themes and sub-themes that emerged from the interviews (see Table4).

Most of the patients found that their nutritional status was deteriorating. Their family caregivers agreed: Her nutritional status is much poorer than it used to be. I think its due to her old age. She has lost a lot of weight the last 3 years; she eats less and is less active (FCG8). The patients described struggling with on-going health problems: My health is still very poor because I have cancer in my whole body (P9). They also experienced new health problems: Since I came home from the hospital, my mouth and tongue have suddenly become very sore. It really hurts and I cant taste the food. I dont understand what causes it (P5). All of the patients described challenges related to food and meals. Most of the patients described a lack of appetite, and many said they never felt hungry: I eat and it doesnt really taste bad, but. .. A lot of strange things have happened to me. It is just like I dont feel much like eating anymore. I dont know why. .. I probably dont want to become fat again (P8). Some patients experienced reduced appetite due to nausea, and some had difficulties chewing or swallowing food due to tooth problems, dysphagia and sore mouth and tongue. Patients also described that food no longer tasted like it used to: The food doesnt taste [like] much. I have been wondering about that. .. I make ham with mayonnaise and spices, but it just doesnt taste [like] anything. It may be due to the medications (P3). In general, the patients took many medications. Some of these had to be taken before food, some with food and some after food. Having to plan meals according to medications seemed to negatively influence their nutritional situations. They also described not being able to cook anymore because of functional limitations. Several patients made statements along the lines of I only eat because I have to. The patients understood that food was a necessity for their well-being, but the challenges described above made it difficult for them to ensure sufficient food intake: I feel full so quickly, and I cant force myself to eat, that cant be right, thats ridiculous (P8). One patient described becoming very ill because he could not eat enough: I was very sick and felt so dizzy that I almost didnt know where I was. This happened because I ate too little (P9).

Most of the patients had recently lost weight; this was a fact they were aware of, but for most, they were not worried. The weight loss only seemed to become problematic when it became visible to others or was related to practical problems such as not having any clothes to wear: I dont feel that I am undernourished. The only problem I can think of is that I dont have anything to wear, because all my clothes are too big (P14).

Many of the patients that lived alone experienced loneliness, and this seemed to affect their appetite and meal experience. Several patients described eating alone as depressing: I am very fond of food, and when I eat homemade bread with butter and honey, I feel that my mood gets better. But I can be quite depressed at times. .. I think it is pretty lonely being here all alone (P6). Some also talked about their inability to participate in social activities, such as going to a cafeteria with friends or to dinners, because of restricted mobility. They talked about eating more when they ate together with someone; this was also the family caregivers impression. One patient was interested in eating at a senior centre but was put off by the idea because she had been told there would be many people with dementia there. Some of the patients occasionally ate at a local nursing home for variety from the meals at home and to socialise, but this was not necessarily a good experience: A lot of the people there already know each other, and they sit together and talk. When I come from outside I dont know anyone and end up sitting alone. That feeling of loneliness hurts. I eat my food fast and then I leave (P3).

Most of the patients were very pleased with the care they received in hospital. The healthcare personnel were focused on their nutritional needs and the nurses tried their best to provide them with food to their liking. Some of the patients had a consultation with a nutritionist during their stay and were prescribed nutritional drinks and instructions on how to enrich their meals. However, they did not seem to follow these instructions at home after discharge. The care at home seemed to lack respect or consideration for each patients unique needs and preferences concerning food and meals. One patient said, No one has been here and told me that you need more of this and that and that we need to make your food richer in calories. It is more like, What do you want? And then thats what you get (P13). None of the patients could remember home care services asking them about their nutritional problems, the reasons behind the problems or discussing possible solutions. They believed that many of the staff lacked competence about nutrition and knowledge about their nutritional needs and preferences. The home care staff were often students studying other fields than healthcare who were working part time in home care while studying. The patients said that qualified nurses seldom visited them: The nurses seldom stop by. They are supposed to be here twice a week, but that doesnt happen very often (P13). In general, the patients experienced few changes in their care between the first and the second interview.

The food they were served by home care usually consisted of slices of bread for breakfast and lunch and ready-made meals heated up in the microwave for dinner. Some of the patients thought this food was ok, but several of the patients disliked these meals: I can actually make sandwiches on my own. I cant stand the sandwiches they prepare for breakfast and put in the fridge the night before. The next morning, they are ice cold and I think they are horrible (P14). Especially, the food prepared for dinner was problematic for some. All the patients living alone described eating ready-made meals for dinner regularly, and they described cooking as pressing a button on the microwave. They felt that because these meals had to be made within the sparse time the home care services had for each of them, their diets were limited. One patient said, I had to get a microwave oven, because that was the first thing they (homecare services) asked for when they started coming here. I dont like such food. I want to make homemade food. I dont know what kinds of food I am supposed to buy. I cant eat only ready-made meals. First of all, I cant stand the taste of these ready meals, and secondly, I find them too expensive (P1). The family caregivers explained that they bought these microwave meals for practical reasons even though they generally knew that the patients were not fond of them. Several patients described being served tasteless meals and food they disliked, which resulted in a reduced food intake: We get some fish cakes without taste with grated carrot without any dressing, with potato and maybe a spoonful of butter. You dont enjoy that. It doesnt taste anything. Then I just eat a little and leave the rest (P3).

Many of the patients described a longing for tasteful meals; this was often traditional foods or food normally served during holidays. The patients also described pleasurable meal experiences: Patient: You know, I get so happy when the food finally tastes good and we get a tasty sauce or something. Aah. .. today we had herring with onions, red beets and sour cream and I had two filets and two potatoes. Today the food was lovely and it made me happy. Interviewer: Im glad to hear that you had a good meal. Patient: Yeah, that is so important for my wellbeing and everything (P3). Tasteful meals, meals made by family caregivers and eating in social settings seemed to stimulate the patients appetite and inspire them to eat more: The other day I really ate too much for dinner. My daughter served fried sausages with red cabbage and potatoes and it was just so good! (P13).

The patients reported that care was organised in a way that seemed to lack respect for their daily routines. Home care staff often did not turn up when they were supposed to, and patients described not being able to go out because they had to wait for staff, which restricted their freedom: On Sundays, they phone me at quarter to twelve and say, Hi, we are a bit delayed today. They come to make me breakfast at quarter past twelve! It is a bit like that. It is often because of shortage of staff (P13). The patients also told stories of home care services not turning up at all. Additionally, when they tried to phone them, they could not reach anyone: It is impossible to call them, and no one answers the phone during the day. No one. You cant get hold of anyone (P13). One patient who was almost blind and unable to prepare food experienced this several times. Fortunately, she could call her daughter who lived close by for help. When home care staff did not show up or did not turn up at the right time, the patients were not in charge of their life situations.

Sometimes, the home care visits were scheduled too early or too late and were not in accordance with the patients preferences. When being dependent on help for meals, bad timing of the meals could result in patients not eating for many hours or eating less: I dont eat much besides dinner. I: At what time is that? P: At one oclock, that is a ridiculous time. .. I set my alarm clock at 1011, I then get up and sort out my medication and Im not hungry, and then I just wait for dinner. If dinner had been at three oclock instead, I would have made some breakfast (P3). The patients reported that the care services were always in a rush, not having time to care for them or talk to them: For many people living alone, the only human conversation they have during a day is with the people from home care services. I think it is important that they take the time to talk to these people, not just rush in, make food and goodbye (P13).

Most of the patients were striving to maintain independence and control, and they wanted to manage their food and meals themselves; however, they needed help. For some, becoming dependent on help from others was an inner struggle: When you are used to managing everything yourself and then you suddenly become dependent on help to prepare a sandwich. Can you imagine? It is a bit depressing just thinking about it (P13). One patient valued her independence so much that she kept her problems with food and meals hidden from her family for a long time and rejected care services help. One of her family caregivers said, She never told us about her problems. They reduced the home care from every two weeks to every third week. The weaker she got the less help she received. But then they told us in one of the meetings that she has been offered help several times, but she has not been interested. She prefers to manage on her own (FC14).

The patients emphasised the importance of having a voice in the matter of food and meals I want to have a say in the matter too (P15) and the importance of being able to eat the food they wanted whenever they wanted. The patients who needed assistance preparing meals did not have this freedom; they had to eat what the care services could manage to prepare within their short timeframe.

Although the patients expressed a desire to be independent, they were not offered any self-management support from the care services. They were dependent on additional help from family caregivers, neighbours and friends to manage their daily lives, to understand information and to communicate with healthcare services, indicating a paternalistic approach to care. These disempowering experiences with home care resulted in dissatisfaction with care.

The patients described a lack of mutual comprehension of information about their health, treatment and care. They told stories about not understanding or remembering information they received in hospital. In fact, most of the patients who received a consultation with a nutritionist in hospital could not remember the content of this conversation: Two nutritionists came to talk to me when I was in hospital. Interviewer: what did they say? Patient: I dont know, it was so complicated, I just gave up (P9). The reasons they gave for this were that they were too ill, there were too many different people involved in their care and that they experienced medical terminology and information overload. Many of the patients were not able to understand the written information they received in hospital: I received a lot of written information, but I dont understand half of it (P8). Family caregivers generally had to help the patients communicate with the healthcare services and explain written information.

The patients experienced a lack of essential information about their own treatment. One patient who was seriously malnourished and almost blind could not obtain information about her nutritional treatment. During the first interview, she showed us an envelope she had received at the hospital; it contained a detailed nutritional plan that she was supposed to follow. She had no previous knowledge of this plan and could not remember if anyone at the hospital had informed her about it. She was not able to read it herself because of her poor eyesight. Her daughter, who did all her food shopping, had not been informed. She said, They have made her a nutritional plan. It must be this one. They didnt talk her to about it they just put it in the envelope with the rest of the papers (FC13). The patient was supposed to inform the home care services about this nutritional plan herself, but as she did not know she had received it, the care services were not informed and did not provide her with this necessary treatment.

The patients said that no one had talked to them about the risks associated with weight loss. Interviewer: did the doctor tell you why it is important not to lose any more weight? Patient: No, he did not. He is so thin, and probably thinks I shouldnt be any bigger (P8). Several of the patients were happy to finally have lost some weight: I dont understand why this has happened, but I am happy that my waistline is reduced. It doesnt bother me that I lose some weight (P3).

The lack of mutual comprehension undermined the patients involvement in their healthcare decisions. Many experienced a lack of shared decision-making, and for some, this caused distress. For instance, decisions about their nutritional care were made without consulting them; receiving help against their will caused resistance: Patient: They have started to prepare sandwiches for me, but I have told them to stop doing that. I can manage on my own. Interviewer: Did they start doing this after you came home from hospital? Patient: Yes, but I dont know who have told them to do that (P9). Another patient said, I dont know whats wrong with me. I just got a prescription for some new vitamin tablets. They cost a lot and I have refused to pay for them. I need an explanation of whats going on (P3).

The patients experienced a way of communicating that lacked respect and sensitivity to their needs and values. The dialogue about food and meals with the home care services generally consisted of What have you eaten?, What would you like to eat? and It is important that you eat. Some of the patients found this stressful. One family caregiver said, They constantly urge her to eat and she says that she is fed up by it. Thats what they do, the people that visit her in the morning and the afternoon (FC14). Some felt like they were disrespected in the dialogue about food and meals or that food and medication was served to them without them agreeing to be helped or in a way that felt violating. One patient said, Would you believe it, they went over and felt the casserole to see if it was warm. It was just like they didnt believe us (P10). Another patient said, They gave me some vitamin B and said you should take these. I dont understand why. They just give me the pills and say take these, and then they leave (P2). Another patient experienced poor communication with the home care services when they just stopped visiting him without telling him why. He suspected that it was because they meant he could manage without help. The poor communication negatively affectedthe participants perceptions of thenutritional care.

Not being provided with care according to their individual needs at home resulted in patients being dependent on additional support from family caregivers, friends or neighbours. All of the family caregivers that participated in this study regularly did the grocery shopping for the patients. Occasionally, they brought homemade food and accompanied the patients during meals. They provided support that was essential for the patients nutritional well-being; still, they were generally not involved or informed by the healthcare services about nutritional care, and some lacked knowledge about the patients nutritional situations and needs: I really think you need to be good at asking the right questions to get the information you need as a family caregiver. I myself may also seem a bit ignorant about these things? (FC1). One family caregiver described conflicting opinions between her and her mother about how much help she needed with meals at home: They used to come four times a day, and then she told them that she only needed them to come three times a day. Sometimes when I come to visit around six oclock she says, Im so hungry, they havent been here. It was her that wanted them to come three times a day. But now I have asked them to change back to four visits a day so they can cook for her (FC6).

Although the caregivers were generally thankful for the care that was provided to their loved ones, some family caregivers experienced disempowerment during meetings with the care services and felt they were not given the necessary support as caregivers. They felt it was demanding and sometimes exhausting caring for their loved ones because the care services were not able to provide care according to the patients needs. One daughter said, I am her only family and I just cant take it anymore. It is so exhausting, especially since she is so depressed (FC6). When the patients were living together with or close to family caregivers, home care services relied on the caregivers to provide nutritional care, which in some cases resulted in inadequate patient follow-up and burdened the family caregiver: I experience that they keep on asking me to do things. And then I find out that that no, that is not my responsibility (FC6).

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Older patients' and their family caregivers' perceptions of food, meals and nutritional care in the transition between hospital and home care: a...

What Is The Best Diet During Ovarian Cancer Treatment? – SurvivorNet

Posted: March 18, 2020 at 3:46 am

The Best Foods to Eat During Ovarian Cancer Treatment

Diet and cancer are always confusing for a lot of us. When it comes to diet during ovarian cancer treatment, maintaining balance is key.

There havent been specific foods that have been shown to have more benefit than others, says Jessica Perreau, a family nurse practitioner at Texas Oncology in San Antonio. So we just recommend just a well-balanced diet overall.

Eating a well-balanced diet which includes a healthy combination of carbohydrates, proteins, fruits, vegetables, sugars, and fats will keep your body healthy overall, and in much better shape to tolerate your treatment.

Perreau does share several foods that can be smart to avoid or limit during ovarian cancer, including:

Learn more about SurvivorNet's rigorous medical review process.

There havent been specific foods that have been shown to have more benefit than others, says Jessica Perreau, a family nurse practitioner at Texas Oncology in San Antonio. So we just recommend just a well-balanced diet overall.

Perreau does share several foods that can be smart to avoid or limit during ovarian cancer, including:

Learn more about SurvivorNet's rigorous medical review process.

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What Is The Best Diet During Ovarian Cancer Treatment? - SurvivorNet

Whats the Difference Between a Plant-Based and Vegan Diet? – EcoWatch

Posted: March 18, 2020 at 3:46 am

Competing Designs?

The river-cleaning project is part of The Ocean Cleanup's overall goal to reduce the amount of trash in the ocean. CEO Boyan Slat founded the organization in 2013 to create an open-ocean device that would remove all plastic in the Great Pacific Garbage Patch in five years. After many iterations and much media attention and criticism from scientists, a 160-meter (525-foot) test design collected and retained ocean plastic for the first time in October last year.

Over the course of the project, many scientists encouraged the organization to focus its efforts on rivers, where they said a cleanup device would be more effective. TOC took heed in 2015, when it began developing the Interceptor.

The Interceptor is powered by solar panels atop its white exterior shell. Each device's unique number is painted on one of its long sleek sides, facing to the banks of the river. At water level, a long waste barrier protrudes upstream, allowing the force of the current to push trash toward the device's mouth. There, a conveyor belt lifts debris out of the water and deposits it onto a platform inside the device that shuttles trash to one of six dumpsters. Once the containers are full, a local team takes them to shore to be emptied.

The latest Interceptor design can extract 50,000 kilograms (110,000 pounds) of plastic per day double that under "optimal conditions" and can hold 50 cubic meters (1,770 cubic feet) of garbage, according to TOC's website. The prototype in Jakarta has about one-fourth to one-fifth that capacity, and holds the trash in small crates instead of dumpsters. As a result, it needs to be maintained and emptied more frequently.

During the Interceptor's splashy unveiling event last October in Rotterdam, Slat called it the first "integrated system that you can bring anywhere in the world and install within days."

That's just not so, according to John Kellett, founder and president of Clearwater Mills LLC. In 2014, Kellett installed a device called the Waterwheel Powered Trash Interceptor in the Jones River in Baltimore, Maryland. This device, dubbed "Mr. Trash Wheel," uses booms to funnel trash to its mouth and a conveyor belt to lift trash out of the water. A key difference from TOC's Interceptor is that a water wheel powers the conveyor belt and solar-powered water pumps keep the wheel going when the current is weak. Due to its success, Baltimore now has three trash wheels, and Clearwater Mills is working in California, Texas and Panama to bring its design worldwide.

"They were aware of our efforts, experience and success when they developed their river device in secret and publicly dismissed it while borrowing heavily from our technology," Kellett told Mongabay of TOC.

In an email addressing these claims that Kellett shared with Mongabay, he informed TOC that Clearwater Mills had patented its device's design more than a decade ago. Kellett also told TOC that he thought their changes "make it more expensive, less effective and harder to maintain."

"We would love to see that the resources and efforts allocated to this global crisis are used effectively and that we are not duplicating efforts or working at cross purposes," he told Mongabay.

Worp acknowledged that the two devices share similar elements, but said TOC started its design from scratch. "It would be like saying one car is the same as all the others," he said. "We obviously know about the other systems that are out there, but we've really taken this from a different angle to find a scalable, high capacity, high efficiency solution."

According to Kellett, TOC has approached some of the organizations that Clearwater Mills is working with outside Baltimore to offer them an Interceptor instead. Worp denied this, and told Mongabay that his team doesn't see any other solutions as competitive.

Getting the Public Involved in Trash

For both organizations, finding a solution to river pollution goes beyond the cleanup devices.

"They're providing an opportunity to educate the public and inspire people to become part of the solution," Kellett said of the three devices his company deployed in Baltimore, which have spurred countless local environmental activities and educational programs.

According to Worp, several school groups have visited the Interceptor prototype in Jakarta. Community engagement is important to The Ocean Cleanup because it ultimately relies on local organizations to operate and maintain the devices.

Some scientists are skeptical about TOC's goal of targeting so many rivers in vastly different parts of the world. Andrew Gray, a hydrologist at the University of California, Riverside, studies small mountainous watersheds that expel a large amount of sediment to the ocean during strong storms. These storms can be destructive to any man-made device, he said.

"[These storms] that are probably discharging most of the plastics, are the kinds of events that you're not going to have a trash boom up because the hydrodynamics are far too aggressive," he said.

Gray also said the Interceptor would need to be incredibly versatile to accommodate a variety of river sizes.

Win Cowger, a graduate student in Gray's lab, pointed out the unpredictability of natural systems.

"Whenever you apply one solution one device to a broad range of ecosystems and a broad range of circumstances, it tends to have some implications that you might not have expected," he said.

Rainy Days in Jakarta

Early this year, Jakarta experienced one of its worst flooding disasters in recent years. Torrential rain, with a record-breaking intensity, showered Greater Jakarta for almost 16 hours through New Year's Eve and into New Year's Day. Most of the city's rivers flooded their surroundings. The Interceptor was found damaged after its waste barrier broke loose.

The water volume in the Cengkareng drain increased significantly, but never overflowed its banks, according to Muhammad Khusen, the leader of a waste-collecting worker group in the subdistrict where the Interceptor is located. He said it was the river's strong current that damaged the device's waste barrier, but TOC engineers were able to repair it the following day.

When Mongabay visited the device a few weeks later, in February, the rains were constant, albeit less intense than at the start of the year. While the Interceptor was undamaged, waste had piled up on the barrier and clogged up the device's opening.

Workers were using long poles to try to break up the clog, which included a lot of large organic material like branches, bamboo and banana tree trunks, and feed the debris bit by bit into the Interceptor.

A team of three workers has been assigned to collect the trash and maintain the device every day, Khusen said. But on the day of Mongabay's visit, he had to call in reinforcements. As many as 10 workers were on hand throughout the afternoon to help clean up the collected debris after an earlier attempt failed to get much done. When the workers went home at 3 p.m., only about 20 percent of the trapped debris had been taken out.

Workers and officials told Mongabay it was impractical to collect all of the trapped debris, largely because of the configuration of the device. For instance, Khusen said the waste-trapping barrier was so thin that his crew couldn't stand on it to push or pull the debris into the device's mouth. He said he preferred pontoon-style barriers they can stand on.

Another challenge is the 2-meter (6.6-foot) opening of the processor, which Khusen said is too small for large waste to freely pass. Sometimes, he said, he has to call in additional human resources to handle big items, like a sofa, spring bed, and even a dead cow that turned up.

"I thought this device was sophisticated," Khusen told Mongabay. "Apparently, there's still so much manual work needed. I'd say it still has a lot of shortfalls."

Lambas Sigalingging, head of operations at the North Jakarta water department, shared similar sentiments. Lambas said the device's lack of movement made it unsuitable for rivers in Jakarta that rarely have much current unless it rains.

"So, if we don't [actively] catch the debris, how is it going to clean itself? Meanwhile, the Interceptor is standing still," he told Mongabay in a phone interview. "This device would be effective, I think, if the current was strong."

Lambas said Jakarta's environment agency owns three waste-trapping barriers installed upstream from the Interceptor in the Cengkareng drain. His own team operates other devices in the city's rivers, including garbage-collecting boats made by the German company BERKY, excavators, and floating polyethylene barriers. Some of these needed less labor to operate than the Interceptor, he said.

Lambas said he has shared the challenges his team faces operating the Interceptor with The Ocean Cleanup team at meetings. But he said he hasn't seen much improvement to the device yet. According to Lambas, the device's trial run has been extended twice first until December and then until this April.

"But I must stress this with you: I'm not the one to say whether the Interceptor is effective or efficient," Lambas said. "I can't answer that because there's the [TOC] research team that assesses its efficiency and effectiveness."

Worp said the Interceptor is effective in the Cengkareng drain and has removed a large amount of trash that the booms upstream could not. He also told Mongabay that TOC is talking with operators in Jakarta to assess what happened during the heavy rains earlier this year, and that his team does respond to feedback from workers. For example, he said, TOC replaced labor-intensive collection bags with crates last year.

He also reiterated that the device in Jakarta is a prototype, and the lessons learned from it have led to adjustments to the second generation of Interceptors, such as the ability to accommodate larger debris loads.

However, he admitted the Interceptor will not suit every river. "It is definitely not the solution for all, and we will be looking at further solutions as we tackle more and more rivers going forward," he said.

According to TOC's website, the group is now coordinating with governments around the world to begin deploying Interceptors on a large scale.

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Whats the Difference Between a Plant-Based and Vegan Diet? - EcoWatch

Fight Coronavirus with an Improved Diet- Here is What to Do? – Spark Health MD

Posted: March 18, 2020 at 3:46 am

Coronavirus cases are spreading like anything and even the developed countries have failed to control it. The uncertainty about this virus and its spread are causing a big hurdle in eliminating the virus completely. But there is one thing that could help that is by eating healthy.

As you know, the human immune system fights against all pathogenic attacks and prevents from catching an infection. A research study shows that improved nutritional guide improves the function of the immune system.

A diet that is enriched with A, B, C, D, and E, and certain minerals such as iron, selenium, and zinc can help to fight against coronavirus infection.

Vitamin A- it improves the inner lining and structure of the skin as well as the gut. It also maintains the structure or respiratory system and acts as the first barrier in case of any foreign attack on the body. It is responsible for antibody production which could fight against the pathogens i.e. coronavirus in case of an infection.

The natural sources of vitamin A are eggs, nuts, whole grains, tofu, legumes, and cheese. Some vegetables such as pumpkin and carrots are loaded with a natural pigment called beta-carotene which is later on converted into vitamin A by the body.

Also read- New Guidelines on COVID-19 During Pregnancy Issued by RCOG, UK

Vitamin B- vitamin B6, B9, and B12 are directly involved in immune response in case of a pathogenic attack. These vitamins produce and control the activity of Natural killers or NK cells. These NK cells attack the pathogens and initiate a process called apoptosis.

The natural sources of vitamin B6 and B9 include leafy vegetables, nuts, chicken, fruits, meat, and cereals. Vitamin B12 can be obtained from animal products such as meat and dairy products.

Vitamins C and Vitamin E- these vitamins help to prevent oxidative stress. This oxidative stress shows up whenever the body experiences an imbalanced level of free radicals an antioxidant inside the human body. The free radicals otherwise can cause damage to cell walls and internal inflammation, leading to a number of health complications. Adding vitamin C and vitamin E helps to prevent the body from oxidative stress buildup. These two produce cells that are a part of natural immunity i.e neutrophils, lymphocytes andphagocytes, all of which are helpful in case of a coronavirus attack.

The natural sources of vitamin C are citrus fruits, broccoli, berries, tomatoes, etc and vitamin E can be obtained from nuts, vegetable oils, and green veggies.

Vitamin D-is required to attack and kill the pathogens in case of microbial infection. The natural source of vitamin D is sunlight which allows the human body to yield this vitamin from various food sources i.e. dairy. In case someone has is suffering from a vitamin D deficiency, the only thing that could help is dietary supplements.

Also read- Six US states have Closed Schools to Control Coronavirus Spread

Minerals (Iron, zinc, selenium)- all of these minerals are required by the body to perform its functions well. Iron, for example, helps to kill and eliminate pathogens from the body. It also helps in enzyme regulation. Zinc is required to maintain the structural integrity of all cellular linings. Zinc and selenium both could act as antioxidants and prevent oxidative damage.

The natural sources of iron are meat, legumes, grains. Zinc can be obtained from seafood sources, nuts and meats. Selenium is typically found in nuts and mushrooms.

All in all these nutrients are required for overall good health. In the events of the recent coronavirus outbreak, it is necessary to take care of your diet and make sure that one is eating a sufficient amount of these necessary vitamins and minerals. Pregnant women, children, and older adults are at a higher risk of coronavirus thus require special dietary guidelines to follow.

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Fight Coronavirus with an Improved Diet- Here is What to Do? - Spark Health MD

California’s obsession with unhealthy diets are a longtime fad – The Daily Titan

Posted: March 18, 2020 at 3:46 am

Its no secret that California is one of the most influential states in the nation. Along with having the largest economy in the nation, when compared to the rest of the world, California ranks 5th in thriving economies, according to Business Insider.

To simply put it, the state could rule itself and still be capable of not just surviving, but perhaps prospering.

It has sun-kissed beaches, known to Southern California locals as some of the best in the world, and a collection of the most strikingly beautiful native redwoods that tower amongst the Northern California hills.

The landscapes are eclectic, people-friendly and its vibes are just uncharacteristically good. Its safe to say that from the Bay Area to Los Angeles, California has it all and its Instagram game is arguably always on point.

The Golden State has an image to uphold, one that is maintained from history to the modern media. Its the epicenter of film and television; synonymous with fame and fortune not to mention the fantasy ideals that accompany them.

Theres an inherent expectation that people from California are wealthy, which doesnt seem so far-fetched considering the sum of monetary circulation in the state alone. The high cost of living proves that nearly a quarter of the nations richest people live in California, according to Forbes. Looking at the booming tech industry in Silicon Valley and the celebrity status of LA, it seems understandable.

But the requirements to be a Californian dont end with money. They perpetuate the notion that people are also naturally more attractive than those in other states, setting both unrealistic and unhealthy standards of beauty.

These physical ideals have many people consistently manufacturing new ways to lose weight and maintain the idealized beauty standards that society has portrayed, not limited to but including: tan, blond and more often than not, skinny.

Its the skinny part that has stood out throughout history to be non-negotiable, especially in the eyes of many Southern Californians.

Fad diets arent new; theyve been a topic of conversation since the early 1800s when the creator of graham crackers, Sylvester Graham, became an advocate for the benefits of vegetarianism. His detailed push for Americans to eat a low-fat, fiber-rich and meatless diet was only the first step into a multibillion-dollar industry that began to succeed by preying upon the average persons deepest insecurities.

Since then, fad diets have become a staple in the health and wellness industry. But many of these diets, which often fall under the guise of cleanses, produce only temporary weight changes.

They emphasize shedding pounds and changing sizes almost exclusively. These fad diets highlight the speed at which this can be done with little to no regard to an extended plan for sustainability, a distinction made by a University of California Santa Barbara article that outlined the fad dieting epidemic the nation faces.

A majority of these diets stem from California, the same star-studded epicenter that most trends emerge from. Unlike the horrors of denim on denim, this is one fad that seems to have a tighter grip on the minds of society.

At this point, there is almost no denying that these diets are harming a whole new generation of impressionable Californians.

While Northern California has its fair share of diet-obsessed people who have managed to digitize dieting through intermittent fasting, its Southern California whose under researched and overpriced obsession with green juice cleanses are teaching young people that being healthy equates to rarely eating or not eating at all.

With its inclusion of several major beach cities and their proximity to Hollywood, there are many reasons Southern California seems to breed an unhealthy number of eating disorders. The expectation to be conventionally attractive is simply higher with more exposure to people who seem to be naturally perfect.

There is no question that social media has made a sizable impact when it comes to body image standards. Although there are examples of influencers who use their platform for good, promoting body positivity and sustainable healthy living, there are just as many who are not credible and advertise products for monetary compensation alone.

It is this constant exposure to carefully curated healthy lifestyles that is causing clinically diagnosed disorders, including a newly researched orthorexia, a new fixation with healthful eating that is becoming particularly detrimental, according to the National Eating Disorder Association.

Turning to a life fueled by exclusively whole wheat avocado toast and green juice may seem like the glamorous Californian dream, but in a time when fueling our bodies and immune systems is of the utmost importance, please be kind to the hunger of the body.

Its important to understand the difference between fad diets and simple healthy diets, which maintain a certain degree of integrity, focusing on lifestyle changes to promote health on a long-term scale.

It ultimately comes down to finding a proper balance which many people struggle their whole lives to find. But, always remember that before a healthy body comes a healthy mind.

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California's obsession with unhealthy diets are a longtime fad - The Daily Titan

How to live longer: Avoid this type of diet if you want to increase your life expectancy – Express

Posted: March 18, 2020 at 3:46 am

Diet can play a crucial part in your overall health. Its no surprise then what you put inside your body can affect your longevity. Which diet is best avoided?

Researchers from the University of Aberdeen state: Restricting the intake of calories has been practiced as a method for increasing both the length and quality of life for over 500 years.

Basing their research on animal studies over the past 100 years, theyve concluded that lifelong caloric restriction may extend life by up to 50 percent in rodents.

The researchers added: This effect is matched by profound impacts on age related diseases, including reduced risk of cancer, neurodegenerative disorders, autoimmune disease, cardiovascular disease and type 2 diabetes.

Researchers from the Washington University School of Medicine shifted the focus of calorie restriction to humans.

They concluded: Data from human studies indicate that long-term calorie restriction with adequate intake of nutrients results in a reduced risk of developing type 2 diabetes, hypertension, cardiovascular disease and cancer.

However, the researchers do state that its possible that the benefits the practitioners experienced while restricting their calorie intake could be because of the high-quality, vegan diets they consumed.

Both studies imply that the secret to longer life may be to avoid overeating.

Calories are usually written as kcal or kJ on the nutrition label found on food packets.

This can be found under the energy heading. Be aware, though, most calories are given per 100 grams or 100ml, and so don't refer to the calories found in the whole packet.

The NHS have a calorie checker that can tell you how many calories there are in over 150,000 different foods and drinks.

Apps are also available to download to track your calorie intake.

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How to live longer: Avoid this type of diet if you want to increase your life expectancy - Express

Summer Diet Tips: This Quick And Easy Cucumber Sabzi Is Perfect To Welcome The New Season – NDTV Food

Posted: March 18, 2020 at 3:46 am

Highlights

Gone are the days of the chilly shivers of winters; the nature is on a transition mode to welcome the bright summer days. Summer heat, sweat and dehydration go hand in hand. Every phenomenon is interconnected; hence proper hydration during this time is a must. Other than good amount of water, there are several veggies that help in hydrating our body and one of the most common one is cucumber. This crunchy and cool vegetable is an intrinsic part of our summer diet in several forms.

A member of the gourdfamily, cucumber is famed for being rich in vitamins and minerals and help in maintaining body's water balance on hot days. From being gut-friendly to boosting weight loss,this vegetable has several health benefits. As per experts, cucumber, due to its silica-content, may also help in preventing and removing tan and dead cells from skin.

Cucumbercan be a part of a person's regular summer diet in forms ofsalad, raita, smoothie, detox water, juice etc. But did you ever know, it can also be a stand-alone sabzi (side dish) for your meals? There are days when you don't like to having anything heavy due to the extreme heat. This 'kheere ki sabzi' comes to rescue then! It soothes your stomach and cools your body down. The best part is, it takes very less time and ingredients to get prepared.

Also Read:Brave This Hot Weather With These Cool Cucumber Drinks

Cucumber- two to three

Five spice blend (panch phoron)- one teaspoon (click here for panch phoron recipe)

Dry red chilli- two

Gingerpaste- two teaspoons

Turmeric(haldi) powder- half teaspoon

Cumin (jeera) powder- one teaspoon

Salt- to taste

Sugar- to taste (may be half teaspoon)

Refined oil- one tablespoon

Ghee- one teaspoon (for flavour)

Grate the cucumbers finely. Keep it aside without straining the excess water.

Heat oil in a pan (kadhai) and add panch phoron and red chillies to it.

Once the red chillies turn brown, add the ginger paste and saut for a minute or two.

Add the grated cucumber and mix with the panch phoron and ginger paste.

Now, add haldi powder, jeera powder, salt and sugar to it and stir.

Keep stirring until the water released from cucumber is soaked well and the sabzi turns semi-dry/dry (as you like it).

Once you are happy with the consistency of the sabzi, turn the flame off.

Add a teaspoon of ghee and close the lid.

You also add some green chillies if you want extra heat. But we suggest avoiding having extra spice during summers.

Enjoy the 'kheere ki sabzi' hot with chapatti or rice. Try this recipe at home and let us know your feedback. Enjoy!

About Somdatta SahaExplorer- this is what Somdatta likes to call herself. Be it in terms of food, people or places, all she craves for is to know the unknown. A simple aglio olio pasta or daal-chawal and a good movie can make her day.

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Summer Diet Tips: This Quick And Easy Cucumber Sabzi Is Perfect To Welcome The New Season - NDTV Food

Stay healthy at home: the nutritionist-approved working from home diet | London – Evening Standard

Posted: March 18, 2020 at 3:43 am

The latest lifestyle, fashion and travel trends

No more commuting and the opportunity to wear your pyjamas to work.Working from home might sound like a dream come true on paper. But if youre not used to the structure of setting up a home working routine, it can be difficult to keep things in order.

Aside from the isolation and lack of structure, diet can be one of the biggest challenges when you work from home. Nutritionist Kim Pearsonis here to help, with advice to ensure working from home doesnt derail your diet.

Keep Structure

With easy access to your kitchen, cupboards full of snacks and nobody else waiting until 1pm to eat their lunch, it can be easy to eat your way through your new working from home day. But just because your day isnt broken up by commutes, meetings and lunch hours doesnt mean you shouldnt structure it as if it is. Set a time for breakfast, lunch and to finish working and stick to them.

Repurpose Your Commute

If you are used to a lengthy commute, it can be tempting to use this time to lie in bed scrolling for pandemic updates. Instead, aim to use this time productively. Get out for a walk in your nearest park or use your commute time to meal plan and prep. How about switching that 30-minute central line journey for putting on a healthy slow cooker dinner that you can enjoy that evening?

Stock Up

Buy (a sensible amount of) healthy ingredients to stock up your cupboards for the week so that you can throw together something quick and easy for lunches. Boil eggs and roast some veg (in your repurposed commute slot) to throw together with salad leaves and olive oil dressing for a quick lunch later in the day.

Clear Out

As well as making sure your cupboards are stocked with healthy essentials, if there are trigger foods that will tempt you to snack or over-indulge, make sure theyre not in the house. In an office full of people around its a lot easier to just take one biscuit, but when youre working from home, once you open the packet the people to biscuit ratio isnt so favourable from a health point of view.

Beat Boredom

Its normal to break up your office working day with coffee breaks, chats with teammates, trips to the shops and meetings. Your at-home work day will look very different, and boredom can turn into snacking. Learn what your triggers are for eating when youre not actually hungry and break up your working day with things like meditation, going for a short walk or domestic tasks like putting the washing on or doing the hoovering.

Dont Eat at Your Desk

Turning your home desk into a snack table is not the best idea. Eat any meals in the place youd usually eat and avoid grazing, set out times for eating and try to avoid getting into the habit of completing a task and rewarding yourself with a snack.

Home alone: how to cope with self-isolation

If your desk is right by the kitchen this will be even harder if you can position yourself further away you might want to consider this. Overcoming the urge to snack really is the biggest challenge. If you are a chronic snacker, make sure you have healthy options, such as olives, unroasted nuts and vegetable crudits, all of which are better than crisps, nuts and biscuits.

Coffee Breaks

As well as constant grazing, it can be easy to punctuate your new working day with a lot of coffee breaks. Try to be mindful of how much caffeine youre consuming, and when, as drinking it too late into the day can affect your sleep. Try switching to decaf or try some new herbal teas.

Kim Pearson is a qualified nutritionist and weight loss expert based on Londons Harley Street. She consults clients in London and internationally via her virtual consulting room. For more information about Kim and the services she offers, visit her website kim-pearson.com.

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Stay healthy at home: the nutritionist-approved working from home diet | London - Evening Standard

Working Out on Keto: All You Need to Know – Healthline

Posted: March 18, 2020 at 3:43 am

The very low carb, high fat, moderate protein ketogenic diet has been linked to a long list of potential health benefits, ranging from improved blood sugar control to decreased hunger levels (1, 2).

However, its effect on athletic performance remains a subject of controversy.

While some claim that keto can boost fat burning and enhance endurance, others note that it could drain energy levels and make muscle growth more challenging.

This article reviews some of the ways that the ketogenic diet could affect your workout.

Studies show that the ketogenic diet may improve several aspects of athletic performance.

Although the ketogenic diet may not be suitable for high intensity bursts of activity, some studies have found that it may enhance performance for endurance athletes.

For example, one study in 39 athletes noted that being in a metabolic state of ketosis improved physical endurance due to the bodys ability to use fat as an alternative source of energy (3).

However, this was observed in the context of providing ketone supplements not through following the ketogenic diet.

Another study in 20 endurance athletes had similar findings, reporting that following a ketogenic diet for 12 weeks improved performance, body composition, and fat burning during exercise (4).

Whats more, one review reported that increased levels of ketone bodies from supplements may speed muscle recovery and reduce the breakdown of protein following endurance exercise (5).

On the other hand, some research has found that it could negatively affect performance in endurance athletes by impairing energy utilization and speeding time to exhaustion (6, 7).

Therefore, more studies are needed to determine whether the ketogenic diet offers any added benefits over other diets for endurance athletes.

Some research indicates that following a ketogenic diet may help boost fat burning during exercise.

In fact, one small study in competitive race walkers showed that the diet increased the bodys ability to burn fat while working out, even during a range of different intensities of physical activity (6).

However, the ketogenic diet ultimately impaired exercise performance in these athletes.

Another study in 22 athletes found that switching to a ketogenic diet increased fat burning over a 4-week period (8).

Of course, its important to keep in mind that the ketogenic diet comprises mostly fat, which may explain why more fat is burned during exercise.

Additionally, note that fat contains a significantly higher number of calories per gram than carbs or protein (9).

Therefore, just like any other diet, creating a calorie deficit by adjusting your intake to consume fewer calories than you burn is still necessary if youre looking to lose weight on the ketogenic diet (10).

Several studies have found that the ketogenic diet could help speed up post-workout muscle recovery.

For instance, one small study reported that the ketogenic diet led to self-perceived improvements in recovery and inflammation after exercise in five athletes (7).

However, its important to note that they also experienced reductions in other measures of performance, and there was no control group, which could skew results (7).

Another study in off-road cyclists noted that the ketogenic diet reduced levels of creatine kinase and lactate dehydrogenase two enzymes used to measure muscle damage (11).

Furthermore, a mouse study showed that following a ketogenic diet for 8 weeks increased muscle recovery following exhaustive exercise (12).

Limited research suggests that the keto diet could benefit endurance, fat burning, and muscle recovery but may impair other aspects of performance. More research is needed to determine whether it may be more beneficial than other diets in this regard.

Although there are several potential benefits of the ketogenic diet for exercise performance, there are a few drawbacks to consider as well.

The ketogenic diet involves severely restricting your intake of carbs, which are your bodys main source of energy.

Therefore, switching to a ketogenic diet can negatively affect athletic performance and energy levels, especially as your body first begins adapting to using fat for fuel instead of carbs.

One small study in five people evaluated the effects of the ketogenic diet on athletic performance over 10 weeks. At the beginning of the study, athletes experienced decreased energy levels, which gradually increased back to normal over time.

Although they also experienced weight loss and self-perceived improvements in recovery and inflammation, they had difficulty performing high intensity bouts of activity throughout the study (7).

Whats more, other research suggests that increased levels of ketones in the blood could increase feelings of fatigue and decrease the desire to exercise (13, 14).

While the ketogenic diet may be fine if youre looking to maintain muscle mass, maximizing muscle growth may be a bit more challenging.

This is partially because muscle growth requires a good amount of protein, which is necessary to promote muscle synthesis and tissue repair (15).

Although exact macronutrient ratios can vary on the ketogenic diet, some versions of the diet may involve restricting protein intake.

Additionally, ketogenic diets are often low in calories, which can make it more difficult to consume enough protein and build muscle mass.

Consuming a higher number of calories than you expend throughout the day is necessary to maximize muscle growth (16).

The ketogenic diet can be low in calories, which could make it harder to increase your muscle mass. It may also decrease energy levels, especially when first getting started.

Carbs are the main source of energy for high intensity activities, such as sprinting, boxing, swimming laps, or jumping rope (17).

Therefore, following a low carb ketogenic diet may not be well suited for these types of activity.

Instead, try incorporating a variety of low intensity, steady state activities into your workout routine to get the most bang for your buck on the ketogenic diet.

Jogging, biking, rowing, and doing yoga are just a few examples of physical activities that may be especially beneficial on keto.

While you can also include any other activities that you enjoy as part of your workout routine, you may find some high intensity exercises a bit more difficult on the ketogenic diet.

The ketogenic diet may be better suited for low intensity, steady state forms of physical activity than high intensity bursts of exercise.

Some research suggests that the ketogenic diet might speed muscle recovery, boost fat burning, and enhance endurance.

On the other hand, it could impair muscle growth and reduce energy levels, especially during high intensity bouts of physical activity.

Sticking to low intensity, steady state activities during your workout is a simple strategy that can help maximize the many potential benefits of the ketogenic diet.

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Working Out on Keto: All You Need to Know - Healthline

Motivation: How to get it, keep it and use it, even during a pandemic when you may need it most – WSMV Nashville

Posted: March 18, 2020 at 3:43 am

We've all done it. We've chosen a diet or workout plan that will get us in shape; said we're going to spend less time on our cellphones and more time reading; or committed to making the most out of our day by being as productive as possible.

But now, as the coronavirus continues to spread across the globe, it can be difficult to find the motivation to set and achieve goals, especially when the future feels uncertain.

Maybe now, due to restrictions on some activities, there are some goals you can't pursue. But for others, this could be an ideal time to work on yourself.

You suddenly have the opportunity to spend more time exercising outside, to pick up the book you've been meaning to read or get your attic organized. If your goal has been to eat a healthier diet, you can now focus on learning how to nurture yourself with homemade meals instead of gravitating toward sugary snacks at work.

While it can be hard to find and maintain the motivation to make a habit stick, experts have some motivational secrets to propel you through the quicksand of inertia to achieve your goals.

The typical advice for finding motivation is to "keep your eyes on the prize," to remind yourself of your ultimate goal. However, a recent study found that the secret to accomplishment may be to focus on effort first and rewards last.

"Rewards are not always enough, because when we move on from deciding to do [something], our focus changes," said Agata Ludwiczak, lead author of the study and research fellow from Queen Mary University of London.

"When deciding, we tend to concentrate on and base our decisions on rewards. When executing an action, we switch our attention to the effort required," Ludwiczak said. "If this effort is more than we anticipated, we might abandon the task, deciding it's not worth it."

To investigate the relationship between effort and reward, researchers presented participants with an exercise of physical effort (squeezing a joystick), and a form of mental effort (solving mathematical equations). They were also presented with combinations of high or low effort and high or low financial rewards and asked to choose which they wanted to attempt.

The study found that although participants were guided by high effort and high financial reward, their performance ultimately depended on the amount of effort they had to expend rather than their initial desire for that reward.

The authors hypothesize that the parts of the brain involved in reward processing seem to be particularly active during choice, but less active during execution.

To combat this mental tendency and achieve a goal, the study's results suggest following two steps: First, when deciding between goals, consider how much work each option involves so you're mentally ready for the degree of difficulty. Second, when things get hard as we work toward our goal, we should focus on the end reward, rather than the effort.

Imagining the reward in these moments can help you to push through when you need the help.

What could also work at this stage is distraction -- taking your mind off effort and focusing on something else -- or giving yourself small rewards as you exert effort, Ludwiczak said.

"Some people already intuitively implement this advice -- they listen to music when studying or exercising, which provides distraction and immediate rewards," Ludwiczak said.

After you've finally accomplished your goal, getting hit by life's problems can make it difficult to stay on track and remember why you started working toward your goal in the first place.

If you've achieved a goal to eat healthy, science says that a healthy diet may help you to stay motivated by reducing inflammation in the body. Inflammation has been found to have an effect on the brain's dopamine system, which determines motivational drive and how the brain perceives the value of investing effort in the pursuit of rewards, according to a 2019 report.

Dopamine release creates feelings of satisfaction and reward, which motivate you to repeat a specific behavior.

Inflammation may alter dopamine by depleting an enzyme called BH4, which helps regulate functions of the heart, brain, gut and reproductive systems, and is also essential for the synthesis of dopamine, the report said.

In this way, it's not that the reward becomes less valuable or alluring -- it's that inflammation may reduce the amount of effort the brain expends by increasing the perceived cost of the effort itself. In this case, motivation becomes less related to a matter of preference -- "Will I?" -- and more related to perceived ability -- "Can I?"

Studies testing the strengthening or reduction of dopamine in humans have shown "a real shift in an individual's willingness to expend efforts for rewards," said Michael Treadway, author of the study, a clinical psychologist and associate professor in Emory University's Department of Psychology.

Foods that can increase dopamine levels include almonds, bananas, avocados, eggs, fish, beans and chicken. Exercising, getting enough sleep, meditation and listening to music can also help raise dopamine levels, according to recent studies.

Engaging in these activities and eating a healthy diet can set you off on a cycle in which being healthier helps you to stay motivated and vice versa.

In addition to a routine and a healthy diet, working toward a goal with others can also help you to stay motivated, as it keeps you accountable to someone other than yourself. Focusing on what the achievement will mean to you once it happens is also productive, according to ReachOut, an Australian mental health organization for youth.

Finding a reward you want to aim for is key in maintaining motivation, Ludwiczak said, as we want rewards, but usually not at all costs, so making sure we don't waste our effort is important.

"Think about hiking," she said. "When you're setting out on an adventure, you need your backpack, supplies and equipment, but you also need a compass to tell you where you're heading. Without one or the other it is not likely to be a very successful trip."

By putting in effort every day, reminding yourself of the rewards when life gets rough and utilizing diets or activities that raise your dopamine levels, you may increase your chances of staying motivated, turning tasks from difficult to doable, even during a global pandemic.

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Motivation: How to get it, keep it and use it, even during a pandemic when you may need it most - WSMV Nashville


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