Feel Great, Lose Weight – by Dr. Rangan Chatterjee
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We all know that losing weight sustainably tends to be harder than simply losing weight. We know that weight loss needs to come with lifestyle change. But how to get there?
One of the biggest problems that we might face while trying to lose weight is that our “metabolic thermostat” has got stuck at the wrong place. Trying to move it just makes our bodies think we are starving, and everything gets even worse. We can’t even “mind over matter” our way through it with willpower, because our bodies will do impressive things on a cellular level in an attempt to save us… Things that are as extraordinary as they are extraordinarily unhelpful.
Dr. Rangan Chatterjee is here to help us cut through that.
In this book, he covers how our metabolic thermostat got stuck in the wrong place, and how to gently tease it back into a better position.
Some advices won’t be big surprises—go for a whole foods diet, avoiding processed food, for example. Probably not a shocker.
Others are counterintuitive, but he explains how they work—exercising less while moving more, for instance. Sounds crazy, but we assure you there’s a metabolic explanation for it that’s beyond the scope of this review. And there’s plenty more where that came from, too.
Bottom line: if your weight has been either slowly rising, or else very stable but at a higher point than you’d like, Dr. Chatterjee can help you move the bar back to where you want it—and keep it there.
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How Primary Care Is Being Disrupted: A Video Primer
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How patients are seeing their doctor is changing, and that could shape access to and quality of care for decades to come.
More than 100 million Americans don’t have regular access to primary care, a number that has nearly doubled since 2014. Yet demand for primary care is up, spurred partly by record enrollment in Affordable Care Act plans. Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades.
KFF Health News senior correspondent Julie Appleby breaks down what is happening — and what it means for patients.
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Primary Care Disrupted
Known as the “front door” to the health system, primary care is changing. Under pressure from increased demand, consolidation, and changing patient expectations, the model of care no longer means visiting the same doctor for decades. KFF Health News looks at what this means for patients.
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Hannah Norman Video producer and animator Oona Tempest Illustrator and creative director KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
Subscribe to KFF Health News’ free Morning Briefing.
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Tranquility by Tuesday?
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I Know How She Does It: How Successful Women Make The Most of Their Time
This is Laura Vanderkam, author of “Tranquility By Tuesday” (amongst other books). Her “thing” is spending more time on what’s important, and less on what isn’t. Sounds simple, but she’s made a career out of it, so condensed here for you are…
Laura’s 7 Keys To Productivity
Key One: Plan your weeks on Fridays
You don’t want your Monday morning to be a “James Bond intro” (where everything is already in action and you’re just along for the ride, trying to figure out what’s going on). So, take some time last thing each Friday, to plan ahead for the following week!
Key Two: Measure what matters
Whatever that means to you. Laura tracks her use of time in half-hour blocks, and likes keeping track of streaks. For her, that means running daily and keeping a log of it. She also keeps track of the books she reads. For someone else it could be music practice, or a Duolingo streak, or eating fruit each day.
On which note…
“Dr. Greger’s Daily Dozen” is simpler than most nutrition trackers (where you must search for everything you eat, or scan barcodes for all ingredients).
Instead, it keeps track of whether you are having certain key health-giving foods often enough to maintain good health.
We might feature his method in a future edition of 10almonds, but for now, check the app out for yourself here:
Get Dr. Greger’s Daily Dozen on iOS / Get Dr. Greger’s Daily Dozen on Android
Dr. Greger’s Daily Dozen @ Nutrition Facts
Key Three: Figure out 2–3 “anchor” events for the weekend
Otherwise, it can become a bit of a haze and on Monday you find yourself thinking “where did the weekend go?”. So, plan some stuff! It doesn’t have to be anything out-of-this-world, just something that you can look forward to in advance and remember afterwards. It could be a meal out with your family, or a session doing some gardening, or a romantic night in with your partner. Whatever makes your life “living” and not passing you by!
Key Four: Tackle the toughest work first
You’ve probably heard about “swallowing frogs”. If not, there are various versions, usually attributed to Mark Twain.
Here’s one:
“If it’s your job to eat a frog, it’s best to do it first thing in the morning. And if it’s your job to eat two frogs, it’s best to eat the biggest one first.”
Top Productivity App “ToDoist” has an option for this, by the way!
Laura’s key advice here is: get the hard stuff done now! Before you get distracted or tired and postpone it to tomorrow (and then lather rinse repeat, so it never gets done)
10almonds Tip:
“But what if something’s really important but not as pressing as some less important, but more urgent tasks?”
Simple!
Set a timer (we love the Pomodoro method, by the way) and do one burst of the important-but-not-urgent task first. Then you can get to the more urgent stuff.
Repeat each day until the important-but-not-urgent task is done!
The 10almonds Team
Key Five: Use bits of time well
If, like many of us, you’ve a neverending “to read” list, use the 5–10 minute breaks that get enforced upon us periodically through the day!
- Use those few minutes before a meeting/phonecall!
- Use the time you spend waiting for public transport or riding on it!
- Use the time you spent waiting for a family member to finish doing a thing!
All those 5–10 minute bits soon add up… You might as well spend that time reading something you know will add value to your life, rather than browsing social media, for example.
Key Six: Make very short daily to-do lists
By “short”, Laura considers this “under 10 items”. Do this as the last part of your working day, ready for tomorrow. Not at bedtime! Bedtime is for winding down, not winding up
Key Seven: Have a bedtime
Laura shoots for 10:30pm, but whatever works for you and your morning responsibilities. Your morning responsibilities aren’t tied to a specific time? Lucky you, but try to keep a bedtime anyway. Otherwise, your daily rhythm can end up sliding around the clock, especially if you work from home!
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I can’t afford olive oil. What else can I use?
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If you buy your olive oil in bulk, you’ve likely been in for a shock in recent weeks. Major supermarkets have been selling olive oil for up to A$65 for a four-litre tin, and up to $26 for a 750 millilitre bottle.
We’ve been hearing about the health benefits of olive oil for years. And many of us are adding it to salads, or baking and frying with it.
But during a cost-of-living crisis, these high prices can put olive oil out of reach.
Let’s take a look at why olive oil is in demand, why it’s so expensive right now, and what to do until prices come down.
Joyisjoyful/Shutterstock Remind me, why is olive oil so good for you?
Including olive oil in your diet can reduce your risk of developing type 2 diabetes and improve heart health through more favourable blood pressure, inflammation and cholesterol levels.
This is largely because olive oil is high in monounsaturated fatty acids and polyphenols (antioxidants).
Some researchers have suggested you can get these benefits from consuming up to 20 grams a day. That’s equivalent to about five teaspoons of olive oil.
Why is olive oil so expensive right now?
A European heatwave and drought have limited Spanish and Italian producers’ ability to supply olive oil to international markets, including Australia.
This has been coupled with an unusually cold and short growing season for Australian olive oil suppliers.
The lower-than-usual production and supply of olive oil, together with heightened demand from shoppers, means prices have gone up.
We’ve seen unfavourable growing conditions in Europe and Australia. KaMay/Shutterstock How can I make my olive oil go further?
Many households buy olive oil in large quantities because it is cheaper per litre. So, if you have some still in stock, you can make it go further by:
- storing it correctly – make sure the lid is on tightly and it’s kept in a cool, dark place, such as a pantry or cabinet. If stored this way, olive oil can typically last 12–18 months
- using a spray – sprays distribute oil more evenly than pourers, using less olive oil overall. You could buy a spray bottle to fill from a large tin, as needed
- straining or freezing it – if you have leftover olive oil after frying, strain it and reuse it for other fried dishes. You could also freeze this used oil in an airtight container, then thaw and fry with it later, without affecting the oil’s taste and other characteristics. But for dressings, only use fresh oil.
I’ve run out of olive oil. What else can I use?
Here are some healthy and cheaper alternatives to olive oil:
- canola oil is a good alternative for frying. It’s relatively low in saturated fat so is generally considered healthy. Like olive oil, it is high in healthy monounsaturated fats. Cost? Up to $6 for a 750mL bottle (home brand is about half the price)
- sunflower oil is a great alternative to use on salads or for frying. It has a mild flavour that does not overwhelm other ingredients. Some studies suggest using sunflower oil may help reduce your risk of heart disease by lowering LDL (bad) cholesterol and raising HDL (good) cholesterol. Cost? Up to $6.50 for a 750mL bottle (again, home brand is about half the price)
- sesame oil has a nutty flavour. It’s good for Asian dressings, and frying. Light sesame oil is typically used as a neutral cooking oil, while the toasted type is used to flavour sauces. Sesame oil is high in antioxidants and has some anti-inflammatory properties. Sesame oil is generally sold in smaller bottles than canola or sunflower oil. Cost? Up to $5 for a 150mL bottle.
There are plenty of alternative oils you can use in salads or for frying. narai chal/Shutterstock How can I use less oil, generally?
Using less oil in your cooking could keep your meals healthy. Here are some alternatives and cooking techniques:
- use alternatives for baking – unless you are making an olive oil cake, if your recipe calls for a large quantity of oil, try using an alternative such as apple sauce, Greek yoghurt or mashed banana
- use non-stick cookware – using high-quality, non-stick pots and pans reduces the need for oil when cooking, or means you don’t need oil at all
- steam instead – steam vegetables, fish and poultry to retain nutrients and moisture without adding oil
- bake or roast – potatoes, vegetables or chicken can be baked or roasted rather than fried. You can still achieve crispy textures without needing excessive oil
- grill – the natural fats in meat and vegetables can help keep ingredients moist, without using oil
- use stock – instead of sautéing vegetables in oil, try using vegetable broth or stock to add flavour
- try vinegar or citrus – use vinegar or citrus juice (such as lemon or lime) to add flavour to salads, marinades and sauces without relying on oil
- use natural moisture – use the natural moisture in ingredients such as tomatoes, onions and mushrooms to cook dishes without adding extra oil. They release moisture as they cook, helping to prevent sticking.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Accredited Practising Dietitian and Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Aging Backwards – by Miranda Esmonde-White
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In this book, there’s an upside and a downside to the author’s professional background:
- Upside: Miranda Esmonde-White is a ballet-dancer-turned-physical-trainer, and it shows
- Downside: Miranda Esmonde-White is not a scientist, and it shows
She cites a lot of science, but she either does not understand it or else intentionally misrepresents it. We will assume the former. But as one example, she claims:
“for every minute you exercise, you lengthen your life by 7 minutes”
…which cheat code to immortality is absolutely not backed-up by the paper she cites for it. The paper, like most papers, was much more measured in its proclamations; “there was an association” and “with these conditions”, etc.
Nevertheless, while she misunderstands lots of science along the way, her actual advice is good and sound. Her workout programs really will help people to become younger by various (important, life-changing!) metrics of biological age, mostly pertaining to mobility.
And yes, this is a workout-based approach; we won’t read much about diet and other lifestyle factors here.
Bottom line: it has its flaws, but nevertheless delivers on its premise of helping the reader to become biologically younger through exercises, mostly mobility drills.
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What are ‘Ozempic babies’? Can the drug really increase your chance of pregnancy?
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Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.
We’ve heard a lot about the impacts of Ozempic recently, from rapid weight loss and lowered blood pressure, to persistent vomiting and “Ozempic face”.
Now we’re seeing a rise in stories about “Ozempic babies”, where women who use drugs like Ozempic (semaglutide) report unexpected pregnancies.
But does semaglutide (also sold as Wegovy) improve fertility? And if so, how? Here’s what we know so far.
Remind me, what is Ozempic?
Ozempic and related drugs (glucagon-like peptide-1 receptor agonists or GLP-1-RAs) were developed to help control blood glucose levels in people with type 2 diabetes.
But the reason for Ozempic’s huge popularity worldwide is that it promotes weight loss by slowing stomach emptying and reducing appetite.
Ozempic is prescribed in Australia as a diabetes treatment. It’s not currently approved to treat obesity but some doctors prescribe it “off label” to help people lose weight. Wegovy (a higher dose of semaglutide) is approved for use in Australia to treat obesity but it’s not yet available.
How does obesity affect fertility?
Obesity affects the fine-tuned hormonal balance that regulates the menstrual cycle.
Women with a body mass index (BMI) above 27 are three times more likely than women in the normal weight range to be unable to conceive because they are less likely to ovulate.
The metabolic conditions of type 2 diabetes and polycystic ovary syndrome (PCOS) are both linked to obesity and fertility difficulties.
Women with type 2 diabetes are more likely than other women to have obesity and to experience fertility difficulties and miscarriage.
Similarly, women with PCOS are more likely to have obesity and trouble conceiving than other women because of hormonal imbalances that cause irregular menstrual cycles.
In men, obesity, diabetes and metabolic syndrome (a cluster of conditions that increase the risk of heart disease and stroke) have negative effects on fertility.
Low testosterone levels caused by obesity or type 2 diabetes can affect the quality of sperm.
So how might Ozempic affect fertility?
Weight loss is recommended for people with obesity to reduce the risk of health problems. As weight loss can improve menstrual irregularities, it may also increase the chance of pregnancy in women with obesity.
This is why weight loss and metabolic improvement are the most likely reasons why women who use Ozempic report unexpected pregnancies.
But unexpected pregnancies have also been reported by women who use Ozempic and the contraceptive pill. This has led some experts to suggest that some GLP-1-RAs might affect the absorption of the pill and make it less effective. However, it’s uncertain whether there is a connection between Ozempic and contraceptive failure.
Some women have reported getting pregnant while taking the contraceptive pill and Ozempic. Cottonbro Studio/Pexels In men with type 2 diabetes, obesity and low testosterone, drugs like Ozempic have shown promising results for weight loss and increasing testosterone levels.
Avoid Ozempic if you’re trying to conceive
It’s unclear if semaglutide can be harmful in pregnancy. But data from animal studies suggest it should not be used in pregnancy due to potential risks of fetal abnormalities.
That’s why the Therapeutic Goods Administration recommends women of childbearing potential use contraception when taking semaglutide.
Similarly, PCOS guidelines state health professionals should ensure women with PCOS who use Ozempic have effective contraception.
Guidelines recommended stopping semaglutide at least two months before planning pregnancy.
For women who use Ozempic to manage diabetes, it’s important to seek advice on other options to control blood glucose levels when trying for pregnancy.
What if you get pregnant while taking Ozempic?
For those who conceive while using Ozempic, deciding what to do can be difficult. This decision may be even more complicated considering the unknown potential effects of the drug on the fetus.
While there is little scientific data available, the findings of an observational study of pregnant women with type 2 diabetes who were on diabetes medication, including GLP-1-RAs, are reassuring. This study did not indicate a large increased risk of major congenital malformations in the babies born.
Women considering or currently using semaglutide before, during, or after pregnancy should consult with a health provider about how to best manage their condition.
When pregnancies are planned, women can take steps to improve their baby’s health, such as taking folic acid before conception to reduce the risk of neural tube defects, and stopping smoking and consuming alcohol.
While unexpected pregnancies and “Ozempic babies” may be welcomed, their mothers have not had the opportunity to take these steps and give them the best start in life.
Read the other articles in The Conversation’s Ozempic series here.
Karin Hammarberg, Senior Research Fellow, Global and Women’s Health, School of Public Health & Preventive Medicine, Monash University and Robert Norman, Emeritus Professor of Reproductive and Periconceptual Medicine, The Robinson Research Institute, University of Adelaide
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What is a virtual emergency department? And when should you ‘visit’ one?
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For many Australians the emergency department (ED) is the physical and emblematic front door to accessing urgent health-care services.
But health-care services are evolving rapidly to meet the population’s changing needs. In recent years, we’ve seen growing use of telephone, video, and online health services, including the national healthdirect helpline, 13YARN (a crisis support service for First Nations people), state-funded lines like 13 HEALTH, and bulk-billed telehealth services, which have helped millions of Australians to access health care on demand and from home.
The ED is similarly expanding into new telehealth models to improve access to emergency medical care. Virtual EDs allow people to access the expertise of a hospital ED through their phone, computer or tablet.
All Australian states and the Northern Territory have some form of virtual ED at least in development, although not all of these services are available to the general public at this stage.
So what is a virtual ED, and when is it appropriate to consider using one?
Shutterstock/Nils Versemann How does a virtual ED work?
A virtual ED is set up to mirror the way you would enter the physical ED front door. First you provide some basic information to administration staff, then you are triaged by a nurse (this means they categorise the level of urgency of your case), then you see the ED doctor. Generally, this all takes place in a single video call.
In some instances, virtual ED clinicians may consult with other specialists such as neurologists, cardiologists or trauma experts to make clinical decisions.
A virtual ED is not suitable for managing medical emergencies which would require immediate resuscitation, or potentially serious chest pains, difficulty breathing or severe injuries.
A virtual ED is best suited to conditions that require immediate attention but are not life-threatening. These could include wounds, sprains, respiratory illnesses, allergic reactions, rashes, bites, pain, infections, minor burns, children with fevers, gastroenteritis, vertigo, high blood pressure, and many more.
People with these sorts of conditions and concerns may not be able to get in to see a GP straight away and may feel they need emergency advice, care or treatment.
When attending the ED, they can be subject to long wait times and delayed specialist attention because more serious cases are naturally prioritised. Attending a virtual ED may mean they’re seen by a doctor more quickly, and can begin any relevant treatment sooner.
From the perspective of the health-care system, virtual EDs are about redirecting unnecessary presentations away from physical EDs, helping them be ready to respond to emergencies. The virtual ED will not hesitate in directing callers to come into the physical ED if staff believe it is an emergency.
The doctor in the virtual ED may also direct the patient to a GP or other health professional, for example if their condition can’t be assessed visually, or if they need physical treatment.
The results so far
Virtual EDs have developed significantly over the past three years, predominantly driven by the COVID pandemic. We are now starting to slowly see assessments of these services.
A recent evaluation my colleagues and I did of Queensland’s Metro North Virtual ED found roughly 30% of calls were directed to the physical ED. This suggests 70% of the time, cases could be managed effectively by the virtual ED.
Preliminary data from a Victorian virtual ED indicates it curbed a similar rate of avoidable ED presentations – 72% of patients were successfully managed by the virtual ED alone. A study on the cost-effectiveness of another Victorian virtual ED suggested it has the potential to generate savings in health-care costs if it prevents physical ED visits.
Only 1.2% of people assessed in Queensland’s Metro North Virtual ED required unexpected hospital admission within 48 hours of being “discharged” from the virtual ED. None of these cases were life-threatening. This indicates the virtual ED is very safe.
The service experienced an average growth rate of 65% each month over a two-year evaluation period, highlighting increasing demand and confidence in the service. Surveys suggested clinicians also view the virtual ED positively.
The right advice could tell you whether you need to visit hospital in person or not. 1st footage/Shutterstock What now?
We need further research into patient outcomes and satisfaction, as well as the demographics of those using virtual EDs, and how these measures compare to the physical ED across different triage categories.
There are also challenges associated with virtual EDs, including around technology (connection and skills among patients and health professionals), training (for health professionals) and the importance of maintaining security and privacy.
Nonetheless, these services have the potential to reduce congestion in physical EDs, and offer greater convenience for patients.
Eligibility differs between different programs, so if you want to use a virtual ED, you may need to check you are eligible in your jurisdiction. Most virtual EDs can be accessed online, and some have direct phone numbers.
Jaimon Kelly, Senior Research Fellow in Telehealth delivered health services, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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