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After assisting in bariatric surgeries, OR nurse chooses it for herself to lose weight – Knowridge Science Report

Feb 19th, 2017
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It wasnt long into her tenure as an operating room nurse that Mandy Pate, R.N., realized the same type of bariatric surgery she helped doctors perform on others could benefit her as well.

Despite countless efforts to lose weight, insatiable cravings left the 36-year-old unable to shed pounds.

All I could think about was food; it was like a junkie needing their fix, says Pate, who, at her heaviest, had 333 pounds on her 5-foot-3-inch frame. If all of a sudden a brownie sounded good, I would have to go to the store to get one. The urge was that strong.

Its why Pate, a Michigan Medicine employee since 2008, sought out more information about receiving a sleeve gastrectomy herself.

In the surgery, about 80 percent of the stomach is removed, greatly reducing its storage capacity and, as a result, limiting production of the hunger-producing hormone ghrelin.

Unlike a gastric bypass, in which the stomach is divided in two and the small intestine is rearranged to connect to both parts, a sleeve gastrectomy is less likely to cause dumping syndrome a condition where food moves into the small bowel too fast after eating.

Both surgeries are permanent and have a one-year mortality rate of 0.1 percent.

At Michigan Medicine, sleeve gastrectomy has surpassed gastric bypass as the most common procedure for patients seeking weight-loss options. Gastric bypass was the subject of an extensive New York Times story last year that focused on two Michigan patients.

Like those featured in the Times, Pates decision was a big one.

If youre going through something thats changing your body, its obviously scary, she says. But I was really excited because I thought, This is going to be what I need; this is going to work. If Im positive, Im going to have a positive outcome.

Now at 160 pounds and with a new attitude toward food and fitness, the Ann Arbor resident is happy to share her experience with patients at Michigans Adult Bariatric Surgery Program.

But shes quick to emphasize that the surgery is not some magic cure. Lifelong lifestyle changes are necessary. Emotional reactions to a new body and relationship with food must also be addressed.

Still, I tell people it saved my life, says Pate, who recently spoke more about her journey.

As an adult, how did your weight affect you?

Pate: I had a lot of joint pain standing on my feet all day. It would be hard to stand and move around in the operating room. I really loved my job; it was creating an issue.

Join a Twitter chat about bariatric surgery, with patients, physicians and other health care providers, this Sunday, Feb. 12 from 9 to 10 p.m. EST, at #obsm and @obsmchat.

I would come home and I couldnt even walk. I would have really bad reflux at night where I would aspirate and choke. I was getting concerned I would end up dying of a massive heart attack if I didnt get my weight under control.

How did you move forward with getting the surgery?

Pate: You dont just make an appointment. Theres a lot of work patients go through. I had to go to an information session and see a physicians assistant.

I had a three- to four-hour psychological exam to ensure I understood the changes I had to make and to make sure I didnt have any other eating disorders that would eliminate me from surgery. I also had to attend two support group meetings.

Some insurance companies require months of documented attempts at weight loss to prove youve done everything else you can do. My body mass index was almost at 60, which was high enough my insurance company said I didnt need to.

Finally, I had to have a sleep study done because they thought I had sleep apnea, which I did. Once my case was submitted and reviewed by everyone who saw me, I scheduled my surgery. I started the process in December 2013 and had surgery that April.

What did surgery preparation involve?

Pate: Once I got my surgery date, I had to go to a four-hour nutrition class. Two weeks before the surgery, I went on a high-protein liquid diet. It was very strict no fruits, no vegetables.

The purpose is to shrink the liver and make it flexible so they can move it out of the way to operate on the stomach. It also shows the team youre committed to making dietary changes.

Could you describe your operation and recovery?

Pate: Basically, theyre removing about 80 percent of a stomach to restrict how much you can eat. It was laparoscopic surgery with six small incisions. In the end, the stomach kind of resembles the shape of a banana. You feel fuller faster and youre not eating as much.

The operation took less than two hours, maybe an hour and a half. I was in the hospital for two nights, and I went home on the third day.

I was on a liquid diet for two weeks, then a puree diet for two weeks, then a soft-food diet for a month. I had a very smooth surgery and recovery.

How did you feel?

Pate: Right away, I had a lot of energy. They tell you to start walking 30 minutes a day after surgery. About six weeks later, I committed myself to going to the gym for an hour each day after work, really doing cardio and weights.

And I wasnt hungry at all. I didnt believe people in the support group who said that. But I could have gone all day without eating or drinking anything. Its important for post-op patients to keep drinking fluids or they can become dehydrated quickly.

Still, for me, it was calming to not have food on my mind all the time.

How did surgery change your diet?

Pate: Because I didnt have a lot of the cravings, I started making changes to my diet. I didnt bring anything sweet into the house that would be a trigger.

I would get creative, making spaghetti squash instead of noodles. My tastes changed. I ended up craving things like fruits and vegetables. I dont even want the pasta anymore.

One-half to a cup of food is as much as I can handle. I usually do 2 ounces of meat protein first and then vegetables. Were taught not to eat rice, pasta, crackers, pretzels or bread. They balloon in the stomach and you cant get the other nutrients you need.

What downsides have you experienced?

Pate: Because you lose weight so quickly, you have a lot of excess skin. Also, I wouldnt always see the weight loss like other people saw it. I would think I looked exactly the same.

In the past year, Ive had three plastic surgeries to remove excess skin from my arms, legs and abdomen. Thats been a tremendous help. Now, I can see my hard work and I look how I should after losing 170 pounds.

At your day job, what do you tell others considering bariatric surgery?

Pate: A lot of patients are afraid theyll break the bed or fall off the table or people will make fun of them. I always try to reassure my patients that were going to take good care of them, that Ill be with them, the beds will hold them and all that stuff.

I also tell them its OK if you have weight-loss surgery; its nothing to be ashamed about. It doesnt mean youre any less of a failure than someone who does it with diet and exercise alone. Theres nothing wrong with going to an informational session and seeing if its right for you.

Want more Weight Loss news? Follow Knowridge Science Report onFacebook.

News source:Michigan Health. The content is edited for length and style purposes. Figure legend: This Knowridge.com image is credited to Michigan Health.

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The Hairy Bikers on dropping the pounds: ‘We had to lose weight or we’d be dead’ – Mirror.co.uk

Feb 19th, 2017
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We hear the Hairy Bikers before we see them. The clomp-clomp of sturdy boots on the rickety staircase of the photo studio announces their arrival. Then its like the room shrinks not only are Si King, 49, and Dave Myers, 59, big bears of men, but their personalities make them larger than life.

After a mini kerfuffle as they both attempt to take the same spot on the couch, the pair plonk themselves down and were relieved to see theyre exactly as they seem on TV just as hairy, just as down-to-earth, just as funny

In fact, the latter makes them the perfect guys to model this years Comic Relief merchandise, including an apron designed by photographer Rankin. And the apron, it seems, is fitting in more ways than one. Not only are Si and Dave capable of cooking up a casual feast or two, theyre also keen to tell us that theyre a pair of domestic gods.

“Were both pretty handy with a hoover, we keep tidy houses,” says Dave. “A few years ago, I came off my bike and broke my arms. Si picked me up from the hospital and asked what he could do to help. I said, ‘What am I going to do about the ironing?’ because even though I look like a bucket of rags a lot of the time, I do like everything neat. God love him, I dont think hed ironed a shirt in his life and”

“Hes very particular about how he folds his shirts, you see, and he kept telling me off!” interjects Si. “But then he teases me about my scented candles and my penchant for soft furnishings Ive got so many bloody cushions, theres nowhere to sit!”

On first impressions, they arent the kind of blokes youd imagine obsessing over the folding of shirts, or plumping up co-ordinated scatter cushions. Hairy, yes; bikers, yes; but they also have something of the old English gent about them.

Dave is wild and slightly scruffy, as if hes just blown in from a motorbike ride around some windy Highland road except for his twiddled moustache, which lends him the air of an eccentric Edwardian. Meanwhile, Si or Kingy, as Dave calls him has his silver hair tied back in a ponytail, his beard neatly trimmed, and his tweed waistcoat in place. They have an endearing way of glancing at each other for confirmation before they speak. Although Sis the quieter of the two, Dave is careful never to speak over his old friend, regularly trailing off mid-sentence in order to coax out Sis opinion.

“Dave shaved his beard off once,” Si says suddenly, leaning forwards with a conspiratorial shake of his head. “I just couldnt stop staring at him and thinking, ‘Who are you?’ It was just a big dumpling face.”

These days Dave and Si are looking distinctly less dumpling-like. Its been a few years since they lost 6 stone between them, but unlike so many celebs with diet books, theyve kept it off. Dave once tipped the scales at 18 stone, while Si weighed in at a bulky 19.5 stone.

“We were filming in America and I noticed we were casting shadows like Walnut Whips! The sensible thing to do was go on a diet, so we started rewriting recipes and were better cooks because of it,” Dave says.

Nowadays the scales hover around the 15 stone mark, and the lads are off their statins and blood pressure medication. The Bikers became famous as a pair of food-loving fellas, so turning themselves into healthy-eating gurus was risky would the public still watch their shows if they werent travelling the world and ordering extra mains “for the table” at every pit stop along the way?

“One of our catchphrases was ‘a big knob of butter’ and we knew we had to rein it in,” says Dave, slinging an arm casually over the side of the sofa. “We were morbidly obese. If wed continued to pile it on in the way wed been doing, we wouldnt have had a career anyway you cant if youre dead!”

“We knew we were never gonna be Twiggy,” adds Si. “Were fighting middle-aged spread, and a lot of people are in the same boat.”

A turning point came while on the road: Dave sneaked to Sis hotel room late at night to score some high blood pressure medication after he ran out. Although they laughed about it, Si was struck by the thought that he might not be there to see his kids grow up.

Si was then a hands-on dad to three young sons, Alex, Dylan and James with (now ex) wife Jane, while Dave had recently married long-term partner Liliana, becoming a stepfather to Sergui, 26, and Iza, 21. He met Lili when they were filming The Hairy Bikers in Romania and she was the manager of a hotel they were staying at. They became pen pals and the rest, as they say, is history.

What followed was a diet show that shed the pounds quicker than you can say extra fries with that. When The Hairy Dieters: Fast Food toppled 50 Shades Of Grey from the bestsellers list, the lads knew theyd struck a chord with the nation by making good, old fashioned food, just with fewer calories. But they havent turned into skinny-mini bores, thankfully, with their recent cookbook, The Hairy Bikers Comfort Food, a carb-heavy love-in.

Its the life of wanderlust, eating and biking, that they dreamed up when they first met 22 years ago in the unlikeliest of places the set of a Catherine Cookson TV adaptation. Back then, Si was the assistant director and Dave was a prosthetic make-up artist.

“At lunch most of the crew were ordering salads and mineral water, while I was having a curry and two pints of larger,” recalls Si. “When Dave came in, he took one look at my lunch and went, ‘Ill have what hes having!’ Pretty quickly we discovered we both loved eating, drinking and motorcycling.”

After persuading their TV pals at the BBC to make a pilot a cringeworthy affair neither Si nor Dave can bear to watch now the Bikers became famous faces overnight.

“I was working on Spooks at the time,” grins Dave. “I was taking Anna Chancellor to the hairdressers and shes used to being noticed, but this time people were stopping me in the street.”

Dave and Si both take fame in their stride, unfazed by the attention they receive from their adoring fans, continuing to be the cheekiest of chaps. Well, you can take the boys out of the North, but you cant take the North out of the boys.

Weekend away or Sunday brunch at home?

S: It depends what Im feeling like. Sunday brunch at home sometimes.

D: For me, because Im away so much, Sunday brunch at home. But for my wife, probably a weekend away!

Hungover or fresh as a daisy?

D: Theres a fair chance of being hungover on a Sunday. Depends where Ive got to be. If Ive got the day off, Ill have a lie-in.

What couldnt you get through the weekend without?

D: Food shopping on a Saturday I love it.

S: A good couple of hours practising on the drums. Thats a big treat, that.

D: Thats why you live in the middle of a field!

Gym day or lazy day?

S: Depends what you fancy. In the summertime well go canoeing and swimming.

D: Id say lazy day. Youve got a hangover, havent you? But when we were filming our Comfort Food show, we did meet down the gym in the evenings.

Running errands or pampering?

D: Running errands. Theres always a lot to catch up on.

S: Theres food to buy!

Sunday lunch at home or pub roast?

D: Sunday lunch at home. Well get chicken Ive loved it ever since I was a kid. We call it plumpy chicken; fat chicken with roasties, stuffing and veg.

S: At home chicken or a piece of sirloin.

What did you do last Sunday?

S: I was flying back from Australia, where I was visiting my partner. I was asleep somewhere over Singapore, probably!

D: Ive got a house in the Loire Valley in France and we were there. I cooked white fish from the market, and we ate quite a lot of cheese afterwards. Then went for a long walk.

Dave says: “I love the way Comic Relief is in the National Calendar. Its entertaining, and a lot of people put a lot of effort into it. Its just a fun time of year, and people really look forward to it.

Si says: “We always do something for Comic Relief with the kids, so it will be funny to see our faces on the posters this year!”

Hairy Bikers wear limited edition HomeSense aprons, designed by celebrated British photographer Rankin, to support Red Nose Day 2017. The apron is part of a range of products available in HomeSense stores.

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Balloon joins gastric sleeve, bypass, band as Siouxland weight loss tool – Sioux City Journal

Feb 19th, 2017
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DAKOTA DUNES, S.D. — A silicon balloon, which is less invasive than other weight loss procedures, made its debut at Midlands Clinic in 2016.

ORBERA, an intragastric balloon, has been used for weight loss worldwide for years, but the device, which has been placed more than 220,000 times in patients’ stomachs, didn’t gain U.S. Food and Drug Administration approval until August 2015.

William Rizk, a bariatric surgeon who is offering the device atMidlands Clinicalong with his colleague Keith Vollstedt, said a previous gastric balloon was an option in Siouxland 20 years ago, but he said that particular model had a much higher complication rate than that of ORBERA.

“This new balloon is made of different material and instead of being filled with air it’s filled with saline. It tends not to leak or deflate like the old ones did,” he said.

“I think we kind of gave it a try 20 years ago and it didn’t work so well, so we kind of shelved it.”

Laparoscopic sleeve gastrectomy is the most popular weight loss surgery in the United States, topping laparoscopic gastric bypass, which is the most effective and most invasive, and laparoscopic gastric banding, which has declined in popularity, according to Rizk.

He said ORBERA will appeal to patients with a BMI between 30 and 40 who don’t qualify for weight loss surgery. The balloon,which Rizk likens to a breast implant, takes up space in the stomach, causing the patient to feel full after consuming a smaller amount of food. ORBERA, which isn’t covered by health insurance, must be paired with a dietary coaching program to ensure success.

“If someone has diabetes or high blood pressure and their BMI is 32 and we can get them with this tool to lose 40 pounds, that would really dramatically improve their health,” Rizk said.

ORBERA is inserted with a scope through the esophagus into the stomach while the patient is sedated. Then the balloon is inflated with 600 milliliters of saline to about the size of a grapefruit. The procedure takes about 15 minutes, according to Rizk. Patients can return home about two hours later.

“When you start losing weight the first few pounds come off rather quickly. When you place the balloon, the first week is kind of an adaptation phase,” he said.

“There can be some symptoms of nausea in the first week, which really limits how much people can eat. Maintaining hydration is really important.”

The balloon stays in place for six months, then Rizk said it’s punctured and retrieved in a procedure similar to the one used during insertion.

The FDA trial that assessed the safety and effectiveness of ORBERA showed patients with the device who participated in diet and exercise lost 3.1 times more weight than people who just tried to lose weight with diet and exercise alone.

Ayear later, Rizk said trial participants who had the balloon gained back a small amount of weight, but maintained the majority of their weight loss and still managed to lose more weight than participants who relied on diet and exercise alone.

“It’s another kind of weapon in our arsenal or tool in our toolbox,” he said. “For a specific patient it can be really good, but as the BMI gets higher, that balloon may not be appropriate.”

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Dr. Nishant Rao of Diet Doc Prefers Balanced Diet Planning for Weight Loss Over the Alkaline Diet – Marketwired (press release)

Feb 19th, 2017
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ATLANTA, GA–(Marketwired – February 15, 2017) – Honduran naturalist and holistic health guru, Dr. Sebi might have been best known for his claims that individuals should be only consuming foods that are identified as ‘alkalizing plant foods (the alkaline diet)’ to support the claim on his website that, “These foods control the acid level in the body, which protects against harmful mucus buildup that compromises organs and leads to the development of disease.” Dr. Nishant Rao — Medical Director of the nationally recognized weight loss program, Diet Doc believes that this particular claim isn’t backed up by the facts. “The truth is that food has a very minor impact on the acid level within the body, which is in fact controlled by the lungs and the kidneys.” Dr. Rao continues, “The body’s normal acidic range is extremely narrow 7.35 to 7.45. Additionally, the pH for blood (which Dr. Sebi’s diet is presumably referring to) is different from that of various cells in various parts of the body.” Blood pH is highly regulated by the body, to the point where severe health issues can occur if it is thrown out of range.

Also, Dr. Rao warns that dieters should be aware of additional claims that aren’t entirely factual. “Sebi’s dietary information includes a few dubious statements such as, ‘fruit contains protein’.” Dr. Rao states that, “The diet’s focus on vegetables that offer very little protein will produce weight loss, but that weight will primarily be muscle and will be very short lived, in addition to an overall negative effect on health and hormones.” Dr. Rao believes that rather than merely attempting to eat an alkaline-based diet, individuals should opt for doctor-supervised diet planning that can be individual-specific in order to tackle one’s dietary needs. While consuming more fruits and vegetables is always a good choice, overall it is more beneficial health-wise to create a nutritionally balanced diet to address the entire body’s needs. Diet Doc offers unlimited dietary consulting with nutritional coaches and medical weight loss experts to help you lose weight quickly and safely. Rather than a one-size-fits all mentality, Diet Doc wants to assess your previous weight loss struggles and create specific diet plans based on your body chemistry.

All patients can get started immediately, with appetite suppressants and clinical weight loss aids conveniently shipped to their homes or offices. New Diet Doc patients can call or easily and effortlessly visit https://www.dietdoc.com to complete an initial comprehensive, yet simple, health questionnaire and schedule an immediate personal, no-cost consultation. Diet Doc Physicians all received specialized training in nutritional science and fast weight loss. Diet Doc reviews each patient’s health history to create a personalized diet plan geared for fast weight loss, or that addresses life-long issues causing weight loss to slow down or stop. Nutritionists work personally with each patient and use their own algorithm to craft meal and snack plans that are compatible with each patient’s age, gender, activity level, food preferences, nutritional needs and medical conditions. They combine these state of the art diet plans with pure, prescription diet products that enable their patients to resist the temptation to reach for sugary snacks, eliminate fatigue and curb the appetite. Over 97% of Diet Doc patients report incredible weight loss results with the majority losing 20 or more pounds per month.

At Diet Doc, all patients gain unlimited access to the best minds in the business. Their staff of doctors, nurses, nutritionists and coaches are available 6 days per week to answer questions, offer suggestions, address concerns and lend their professional guidance and support. Because of this, more and more people are turning to Diet Doc for their weight management needs. Diet plans are tailored to be specific to the needs of those of any age, gender, shape or size and for those who are struggling to lose that final 10-20 pounds to those who must lose 100 pounds or more. Call today to request a private, confidential, no-cost online consultation.

About the Company:

Diet Doc Weight Loss is the nation’s leader in medical, weight loss offering a full line of prescription medication, doctor, nurse and nutritional coaching support. For over a decade, Diet Doc has produced a sophisticated, doctor designed weight loss program that addresses each individual specific health need to promote fast, safe and long term weight loss.

Twitter: https://twitter.com/DietDocMedical

Facebook: https://www.facebook.com/DietDocMedicalWeightLoss/

Linkedin: https://www.linkedin.com/company/diet-doc-weight-loss?trk=biz-brand-tree-co-logo

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Why calorie-restricted diets could be a bad idea – Irish Times

Feb 19th, 2017
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The nearest animal-relative to humans studied on increasing lifespan is the monkey. Two US research teams have now reported that calorie-restricted monkeys are living longer than controls

I assume that most people, if offered an easy formula to lengthen their lifespan while retaining good health, would grab the opportunity with both hands. A formula is now potentially available to lengthen human lifespan in the form of a calorie-restricted diet, although this is not yet proven.

The calorie-restricted diet is also difficult to tolerate. However, the good news is that significant health benefits can be realised by adopting more moderate diets and healthy habits.

In 1935, CM Crowell, MP McCay and LA Maynard reported (Journal of Nutrition, Vol 10) that reducing the calorie intake of rats, in a diet otherwise adequate in vitamins and minerals, nearly doubled their lifespan.

It was later shown that a calorie-restricted diet beginning in early adulthood not only increased rats lifespans but also reduced the incidence of spontaneous cancers arising by more than 50 per cent.

We now know that calorie-restricted diets lengthen the lifespan of a wide variety of organisms, including yeast, worms, flies, rodents, fish and primates.

The body needs energy to carry out its various activities and it derives this energy from food. The energy is measured in units called calories. In a healthy balanced diet a man needs about 2,500 kilocalories (kcal) a day and a woman about 2,000 kcal to maintain body weight. A calorie-restricted diet typically limits daily calories to 1,800kcal (men) and 1,500kcal (women).

Ingested food is burned in the body to release the energy required to do essential work. This food-burning process generates a class of chemicals called reactive oxygen species that can damage the cell.

You can visualise reactive oxygen species as maniacal scissors that, unless neutralised, fly about randomly snipping and damaging cell structures. A class of chemical in the cell called antioxidants can neutralise reactive oxygen species, but do so less effectively when levels of these chemicals are high oxidative stress.

Biochemical studies (eg Huiru Tang and others, Journal of Proteome Research, 2016) have shown that low calorie diets reduce oxygen stress and disturbance of energy metabolism. However much of the biochemistry that underpins the effects of calorie-restricted diets has yet to be discovered.

Because calorie-restricted diets lengthen the lifespan of such a wide range of organisms, it is reasonably anticipated that they will also lengthen human lifespan, but science has yet to determine this.

The nearest animal-relative to humans studied in this regard is the monkey. Macaque monkeys live about 26 years in captivity. Two trials began in the US in the 1980s but not all the monkeys have died yet. Both research teams have now reported that calorie-restricted monkeys are living longer than controls.

Calorie-restricted males are living two years and females living six years longer on average than controls, as well as having lower rates of cancer and heart disease (Julie Mattison and others, Nature Communications, published online, January 17th). The longevity improvements in the calorie-restricted monkeys are very modest compared to the effects seen in mice.

The monkey results extrapolate to a calorie-restricted diet induced human lifespan lengthening of about nine years.

Caloric restriction delays ageing of model organisms, but whether it works in nonhuman primates has been controversial.

Here, the authors pool and reanalyse data from two long-running primate studies, concluding that moderate caloric restriction indeed improves health and survival of rhesus monkeys.

A few thousand people worldwide are now on calorie-restricted diets, hoping for longer and healthier lives. However there are difficulties associated with this diet. It must be carefully formulated to ensure it is nutritionally adequate in all respects, apart from energy calories.

Unpleasant side effects are not uncommon feeling hungry and cold, reduced libido, low energy, reduced inclination to exercise and more. One wonders why anyone would want an extra nine years of that.

I strongly advise against going on a calorie-restricted diet given current limited knowledge of its effects in humans, but, if you are determined to go ahead, it is essential that you first consult your GP, who will refer you to a specialist in nutrition for expert advice on formulating the diet.

My advice on diet/lifestyle is eat a wide variety of whole foods in moderation, mostly plants, and take plenty of aerobic exercise and light resistance exercise (weights). This lifestyle has no unpleasant side effects, is relatively easily sustained and there is extensive evidence that it is good for your health.

William Revile is an emeritus professor of biochemistry at UCC, http://understandingscience.ucc.ie

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Four easy flat tummy tricks – SDE Entertainment News (satire) (press release) (blog)

Feb 19th, 2017
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Photo:www.realbuzz.com

On the fitness wish list for many men and women is attaining washboard abs. Unfortunately, once fat deposits are made in the abdominal region, it is very difficult to get rid of them. In fact, medical professionals say that fat cells once formed, they can only shrink in size but not eliminated. Don’t fret though; it can still be achieved with some effort. Assuming your diet is at least 90 per cent clean, here are a few fitness tips to embrace to get that coveted flat tummy.

1. Keep walking

Walks are a great exercise for whittling down your waistline. Walking is an aerobic exercise that contributes to total body fat burn especially the very dangerous visceral fat. Visceral fat is the one that wraps around your internal organs. Walking increases your metabolism and heart rate. A study shows that having three short fast paced walks and two longer slow paced walks weekly lost five times more belly fat than those who did attended gym five times a week. Best time to do your walks is in the morning before breakfast. This is because the workout on an empty stomach will burn the stored fats. Replenish afterwards with a healthy high protein meal to build muscle.

2. Squat away

Squats have gained popularity lately for building your glutes. What isn’t mentioned a lot is that they also work on your abdominals. As the muscles in your legs contract, your core muscles get fired up to withstand the pressure from the effort. A squat can be done by either holding a weight to your chest or just using your body weight and sitting on an imaginary chair.

3. Do some deadlifts

All you need is a kettlebell or weights to do this effectively. This exercises targets all your core muscles successfully tightening them. Deadlifts are simply done by picking a weight off the ground using good form such that you use your hip and leg muscles instead of the lower back. Good thing about this exercise is that you can do it at home.

4. Watch your posture

Sometimes all you need to do is to adjust your posture to eliminate the pooch. Your back should be straight and your core muscles tight. Maintain this deportment as you sit down at your desk or when walking around.

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Salud America!: On SA’s Need for Safe, Accessible Recreation Spaces – Rivard Report

Feb 19th, 2017
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Commentary By Amanda Merck, MPH | 10 hours ago

Kathryn Boyd-Batstone / Rivard Report

Runners charge up one of the many uphills along the Mission Reach trail.

Updated 2 hours ago

For San Antonio tobe at itshealthiest, its residentsneed and deserve safe places to move more and sit less.

However, there is inequity in the citysplaces designated for walking, biking, playing, and being active. City officials mustlook beyond maps of facility locations to the context of real people trying to make healthy life choices.

For example, a map of the Howard W. Peak Greenway Trail System shows an emerald necklace going around and through San Antonio. Yet, these trails are only open from sunrise to sunset, which means they are open less than 12 hours per day for six months out of the year.

Many working families striving tobe more active and less sedentaryare unable to access the trails within this limited window. Southside residents, in particular, face additional barriers because the southern-most access point of the Mission Trail off Villamain Road is only open between 9 a.m. and 5 p.m.

Thats why I asked the San Antonio mayoral candidates about their plans to solve this inequity at the recent town hall forum hosted by the Rivard Report at the Pearl Stable.

What are you going to do to transform our incredible trail system from a recreational facility to a health and transportation facility that is safe and accessible for everyone? I asked Mayor Ivy Taylor, District 8 Councilman Ron Nirenberg, and Bexar County Democratic Party Chairman Manuel Medina.

Listen to their full responses to the questions here.

Heres a quick snapshot of their responses:

I dont know about the hours that it should be open or not, because certainly we also want to make sure that anyone thats out there is safe, Taylor said.

It needs to [be] more than just a system that connects one park to another, Nirenberg said.

We need to make it easier for people to get to them, Medina said.

None of the candidates mentioned expanding hours, lighting, or patrolling trails, but we cannot ignore the great need for access to safe, active places.

Why? Heres a quick biology lesson (from someone who is not a biologist):

Our cardiovascular system is our lifeline for delivering oxygen, vitamins, minerals, proteins, hormones, and other chemicals to our organs, muscles, bones, and all other tissues. It also is our lifeline for getting rid of carbon dioxide and other waste. Our veins and arteries are constantly squeezing and releasing vasoconstriction and vasodilation to pump our nutrient- or waste-filled blood. Like any muscle atrophies without use, our blood vessels lose function and become less effective without physical activity. However, the exact mechanism through which this occurs is complex and not fully understood.

Basically, sitting increases inflammation, which damages the inner walls of your vessels (endothelium). Moderately intense physical activity, however, preserves the inner walls of these vessels and prevents plaque buildup and hardening.

These benefits are separate from the numerous other benefits obtained from variousother chemical, molecular, and biological processes that occur when you are physically active, such as reduced risk for diabetes, stroke, cardiovascular disease, depression, osteoporosis, and manytypes of cancer.

The good news is that walking works regardless of weight status or diet, and you can walk or be active in short bursts throughout your day without having to depart from your normal daily routine.

If you have access to safe places, that is.

Educating people about the trails is moot when they are closed for half the day. Similarly, considering the trails as a resource for connectivity isnt painting a complete picture because they are only open part-time, which is counterproductive to the essences of connectivity.

Arecent SA2020 report identified four indicators in San Antonio that have stopped progressing or are going in the wrong direction: public transportation, obesity, air quality, and walkability. According to the report there is a need to continue to make both behavioral and systemic changes in our policies and infrastructure in order to make lasting change.

I hope our city leaders consider making lasting infrastructure changes.

In the case of our greenway trail system, the infrastructure is mostly in place, so its a matter of opening it to the public to use at whichever times accommodatetheir busy schedules.

Kathryn Boyd-Batstone / Rivard Report

Broadway Street was closed for Sclova so hundreds of bikers could safely ride the streets.

While there are incredible programs and events across the cityFitness in the Park, Sclova, Fit Pass, Fit Family Challenge, San Antonio Walks, Mobile Fit, Walk This Way, and many more permanent infrastructure like trails and sidewalks need to be safe and accessible year-round.

I also hope our leaders can distinguish the line between physical activity for health and for exercise or recreation, which are historically only accessible for the privileged and less available for residents living in underserved areas. Physical activity for health includes walking, biking, dancing, playing, skating, doing yoga, swimming, and many otheractivities.

People of color and low-income populations are disproportionately burdened by pedestrian injuries and deaths.

According to Salud America!s research review on active spaces and Latino kids, fewer Latinos (70%) than whites (82.5%) describe having neighborhoods with safe places for kids to walk and play.

Studies show that walkable neighborhoods provide many economic, safety, environmental, health, and social benefits; however, not all neighborhoods in San Antonio are created equal, with many low-income, predominantly Latino neighborhoods lacking safe, walkable infrastructure.

Inequity in access to safe places to walk, bike, and play can be seen on the South, West, and East sides of San Antonio. Lack of safe places to be active means people living in these areas face disparities in obesity, heart disease, and diabetes.

Some bright spots are occurring:In February 2017, State Rep.Celia Israel(D-Austin)proposed House Bill 1368 to lower the default speed limit in urban areas from 30 mph to 25 mph, as well as House Bill 1745 to allow cities to lower speed limits on certain highways withoutthe costly burdens mandated bycurrent legislation. Making it easier for cities to lower speed limits is critical because most crashes involving pedestrians or cyclists occur on arterial or collector roadways where default speeds are far greater than 30 mph.

District 5 Councilwoman Shirley Gonzales is leading the San Antonio Vision Zero initiative, with the goal to eliminate traffic fatalities, especially those of pedestrians.

According to SA2020, San Antonio continues to make progress on Complete Streets, but not at a rate great enough to meet the 2020 goal. When the City didnt meet Dignowity Hill residents standards for a street construction project, urban planners and residents got involved by requesting and successfully gaining more walkable streetscape elements.

Regardless, safe places to walk and be active are big part of public health and equity issues that need attention.

San Antonians would surely like to hearthat City leaders are working to improve equitable access to health facilities, includingexpanded hours, lighting, and safety. Research shows that scheduling park programs later in the evening keeps parks occupied bypeople engaging in beneficial activities, thusdeterring undesirable ones.

San Antonio has a new set of bond measureson the ballot in May.Its vital for community members to get involved and keep the focus on the real-life context in which these projects will be completed. Fifty-two plus miles of trails sounds great on paper and look awesome on a map, but if people cant walk their dogs on them before or after work, they representa missed opportunity.

Salud America! has a bank of resources and nationwide stories to help community members work with City leaders to increase access to safe places to walk and play, particularly in Latino communities.

Follow Salud America!on Twitter, Facebook, YouTube, Instagram, and Pinterest and register on our site. You can connect with local groups and organizations that are already working to make the healthy choice the easy choice, such asthe Active Living Council of San Antonio,a public-private partnership of policymakers, business leaders, school administrators, program providers, and community membersthatdeveloped the Active Living Plan for a Healthier San Antonio.Or you can learn from case studies of successful healthy change across the country.

Together, we canprioritize equitable access to safe, active places in San Antonio and beyond.

Amanda Merck is a content curator/research area specialist for Salud America! at the Institute for Health Promotion Research at the UT Health Science Center at San Antonio.

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Salud America!: On SA’s Need for Safe, Accessible Recreation Spaces – Rivard Report

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Adding oats and other myths about feeding competition horses debunked – Horse & Hound

Feb 19th, 2017
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Feeding is a complicated science never more so than with a competition horse aiming for peak performance. Emily Bevan sorts the facts from the fiction

One of the golden rules of feeding is to be consistent, so making any sudden changes to your horses diet, particularly ahead of a competition when you are wanting him to perform at his best, is never a good idea.

An abrupt dietary change can increase the risk of colic, plus during exercise horses, like humans, use stored energy sources not energy directly from their previous meal, says Spillers competition nutritionist Yvonne Judith. This instant energy may also cause behavioural issues in some horses the last thing you want before a competition.

For a horse to safely receive the full energy benefits that oats provide, he would need to be consuming them daily, rather than just on or before competition day.

Oats are a great way of adding quick-release energy into the diet for horses who can be lethargic or lacking in energy, but this should not be seen as a substitute for ensuring adequate fitness, says Katie Grimwood, a nutrition advisor from Baileys Horse Feeds.

While all riders and owners are aware of the importance of hydration, many withhold water after exercise as they believe its not safe for a horse to drink if hes hot and sweaty.

This really is an old wives tale, says Yvonne Judith. First, cool the horse down until its nostrils are not flaring and its heart rate is back to normal, then offer water.

A horses thirst instinct is at its highest after exercise so its important to make the most of this opportunity to rehydrate your horse.

As long as the breathing rate has reduced theyshould be offered water, little and often and preferably at an ambient temperature, until they are no longer thirsty, says Anne Priestman, UK national sales manager at Gain Horse Feeds.

Molasses is a byproduct of sugar cane or beet so naturally has a high sugar content. While sugar is fine in moderation, many riders and owners believe the high sugar levels in molasses will give their horse too much energy on competition day. However, what they dont realise is that molasses is already included in most competition mixes in a diluted state to bind the ingredients and dampen the mixture to reduce dust.

Molasses gets blamed for a myriad of problems, including hyperactivity, says Saracen Horse Feeds senior nutritionist Lizzie Drury. Molasses supplies the horse with digestible energy because it is composed entirely of sucrose, glucose and fructose. The amount of molasses in a typical helping of a concentrate feed cannot, however, induce hyperactivity.

Its important to look at the sugar content in your horses diet as a whole rather than singling out specific ingredients.

TopSpecs nutrition director Nicola Tyler adds: Molasses contains approximately 50% sugar and its contribution to the total level of sugar in the diet should be calculated before ruling it out.

Horses are trickle feeders and need to have regular access to forage to keep their gut mobile. Forage also contains all the essential nutrients a horse requires and should form the basis of every horses diet. One of the main components of forage is fibre.

Fibre supports the way that the horse has evolved to graze and provides a bulk to the feed to maintain and support digestive health, says Katie Grimwood. It can also allow the horse to better utilise the nutrients received through the concentrate feed.

There is a common belief that forage shouldnt be fed to a horse while travelling or before competition as it gives them colic or slows them down.

Article continues below…

The opposite is actually true, says Yvonne Judith. A lack of fibre can increase the risk of gastric ulcers and colic. Fibre does bind water in the gut but the slight increase in weight will not impact performance.

Its important to take advice from a nutritionist to ensure you are feeding a balanced diet and are not wasting money on fad products or supplements.

There is a belief among lower level competitors that feeding a certain product or supplement can help your horse to gain topline without supporting the diet with a structured exercise plan. As a result, owners can be tempted to load the horse up on excess ingredients that he doesnt actually need, says Blue Chip Feeds Emma Nicholls.

Protein is one of the key supplements owners often include, believing it helps condition muscle.

While protein is required to build muscle tone and topline and is needed for the growth and repair of body tissues, feeding protein alone is not sufficient to promote topline and should be used in combination with correct training, explains Katie Grimwood.

If your horse is consuming a balanced diet he should be receiving the nutritional support he needs for all areas of development.

Topline develops from the correct working of the horses muscles along the spine to build a top line. Quality amino acids are required to help build muscle and feeding the correct diet according to the horses requirements should provide these amino acids, without the need for additional supplements, says Anne Priestman.

Grassroots competitors are often nave in what they are feeding their horses and think that when they step up a level they need to increase their horses feed intake, says Emma Nicholls. The overriding message is my horse needs more energy so I will up his feed rather than looking at the type of feed he requires.

Understanding your horses dietary requirements is essential if he is to perform to his best and maintain a healthy weight. Advice from a nutritionist can not only help to ensure your horse consumes the correct feed, but also that he receives the appropriate quantities.

Another common misconception is that feeding high energy feeds can help to improve energy levels without causing weight gain, explains Katie Grimwood.

Calories are just units of energy, so high energy feeds are also high in calories. Although feeds such as competition mixes or straight oats can work to an extent, if used they should be incorporated as part of a fully balanced diet and in combination with a suitable fitness regime.

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While a bran mash may be considered a warm, comforting treat and it can help increase your horses water intake, if it is not a regular component of his diet it has no place in his feed bucket.

Abrupt dietary changes are never a good idea and bran is no exception. Bran is not balanced, especially in terms of calcium and phosphorus, and can actually be quite abrasive on the digestive system, says Yvonne Judith. Also be warned: some products marketed as mashes, especially within Europe, can be very high in starch which could contribute to colic, tying up or behavioural problems.

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This article was first published in the 2 February issue of Horse & Hound magazine

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TOWIE’s Gemma Collins slips into skinny jeans and shirt as she continues to flaunt weight loss – Mirror.co.uk

Feb 19th, 2017
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Gemma Collins has continued to flaunt her weight loss with two new photos showing her slimmed down figure.

The TOWIE star – who has been open in the past about her weight struggles – has been widely praised by fans this week after unveiling a svelte new look on Instagram.

Gemma, 36, struck a pose on Sunday during a break in filming what appeared to be a St Patricks Day party, wearing skinny ripped black trousers and a green blouse.

You are looking amazing, Gemma. You have lost so much weight, you look fabulous! wrote one fan.

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Another said: You look really good, well done on the weight loss.

Gemma also shared a selfie earlier in the day, showing her wearing ripped jeans and a slouchy coral jumper.

Again she was inundated with praise from fans calling her inspirational and motivational, as well as throwing out words like amazing, incredible and beautiful.

Ever since Gemma found fame on The Only Way Is Essex she has been open about struggling with her weights and the various diets and exercise regimes shes tried over the years.

Most recently she signed up for ITVs Sugar Free Farm.

Gemma said on Channel 5s In Therapy that her weight has always fluctuated and often mirrors her feelings. I felt guilty. I used to feel so empty. I had this terrible feeling inside me and the more I ate, the more it went away, she said.

She also admitted she would get offers from agents if she were to “gain and lose” weight.

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In 2015 she lost three stone in four weeks after signing up for a juice retreat run by Juice Master Jason Vale.

At the time, he told us: She lost two-and-a-half to three stone in total in four weeks, living on nothing but freshly pressed juice.

She has been doing exercise as well but not military-style. None of it is forced. Nobody can force Gemma to do anything, frankly.

He continues: I deal with the psychology of addiction first. She has really got it now. She knows the difference between a diet mentality and a freedom mentality.

“A diet mentality is when you say: I want it but I cant have it. She can have anything she wants but she doesnt want to now.

“She realises crisps are the cause of the problem. The need for junk food is caused by junk food. Shes getting her head around that.

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World’s fattest woman loses ONE STONE A DAY waiting for life-saving weight loss surgery – Mirror.co.uk

Feb 19th, 2017
Comments Off on World’s fattest woman loses ONE STONE A DAY waiting for life-saving weight loss surgery – Mirror.co.uk

The world’s fattest woman – who had to be lifted out of bed by a crane – has lost a whopping one stone a DAY as she waits for a life-saving weight loss op.

Seventy-eight stone Eman Ahmed was flown from her home in Egypt to India on a specially modified cargo plane to undergo a series of operations to help her lose weight.

And since being put on a special 1,200 calorie a day diet the weight has been falling off.

Medics today said in her first five days at the hospital she lost a staggering 66lbs – more than 13lbs a day – after being put on a liquid diet.

Doctors aim to reduce her weight by 200 kg this year so she can fit on the operating table.

Bariatric surgeon Dr Muffazal Lakdawala said: “We need to get her in shape for the surgery.

“The operation table can take the weight of 450 kg but the width of the elevator is only 141 cm. Eman is currently 151 cm in width.”

Eman was reportedly born with elephantiasis – a parasitic infection which causes extreme swelling in a person’s limbs and arms.

She has been heavy all her life and by the time she was 11 she was too heavy to walk, and had to crawl to get around.

She suffered a cerebral stroke as a child which left her bed-ridden and she piled on the pounds.

Her family posted a desperate plea online to Egyptian president Abdel Fattah el-Sisi asking for medical assistance.

After hearing about her case, Dr Lakdawala agree to help her free of charge.

She was then lifted out her home by a crane after the walls of her room were knocked down to bring her out.

She was placed in a mini-truck at Chhatrapati Shivaji International airport and transported to Saifee Hospital in Mumbai India on Saturday.

But Dr Lakdawala stressed how dangerous the operations could be for her – and how life threatening doing nothing might be.

He said: “Her life is at risk. She is a living time bomb.

“We have to take special precautions in this case to ensure there are no problems in the lung or the risk of a blood clot.”

Eman has been put on a 1,200-calorie per day high protein and fibre diet, and is fed every two hours.

She is also undergoing two sessions of physiotherapy a day and is now able to lift her limbs higher and sleep better.

She is currently undergoing tests with the hope of having surgery in a few weeks time.

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