Fasting, eating earlier in the day or eating fewer meals – what works best for weight loss?
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Globally, one in eight people are living with obesity. This is an issue because excess fat increases the risk of type 2 diabetes, heart disease and certain cancers.
Modifying your diet is important for managing obesity and preventing weight gain. This might include reducing your calorie intake, changing your eating patterns and prioritising healthy food.
But is one formula for weight loss more likely to result in success than another? Our new research compared three weight-loss methods, to see if one delivered more weight loss than the others:
- altering calorie distribution – eating more calories earlier rather than later in the day
- eating fewer meals
- intermittent fasting.
We analysed data from 29 clinical trials involving almost 2,500 people.
We found that over 12 weeks or more, the three methods resulted in similar weight loss: 1.4–1.8kg.
So if you do want to lose weight, choose a method that works best for you and your lifestyle.
Eating earlier in the day
When our metabolism isn’t functioning properly, our body can’t respond to the hormone insulin properly. This can lead to weight gain, fatigue and can increase the risk of a number of chronic diseases such as diabetes.
Eating later in the day – with a heavy dinner and late-night snacking – seems to lead to worse metabolic function. This means the body becomes less efficient at converting food into energy, managing blood sugar and regulating fat storage.
In contrast, consuming calories earlier in the day appears to improve metabolic function.
However, this might not be the case for everyone. Some people naturally have an evening “chronotype”, meaning they wake up and stay up later.
People with this chronotype appear to have less success losing weight, no matter the method. This is due to a combination of factors including genes, an increased likelihood to have a poorer diet overall and higher levels of hunger hormones.
Eating fewer meals
Skipping breakfast is common, but does it hinder weight loss? Or is a larger breakfast and smaller dinner ideal?
While frequent meals may reduce disease risk, recent studies suggest that compared to eating one to two meals a day, eating six times a day might increase weight loss success.
However, this doesn’t reflect the broader research, which tends to show consuming fewer meals can lead to greater weight loss. Our research suggests three meals a day is better than six. The easiest way to do this is by cutting out snacks and keeping breakfast, lunch and dinner.
Most studies compare three versus six meals, with limited evidence on whether two meals is better than three.
However, front-loading your calories (consuming most of your calories between breakfast and lunch) appears to be better for weight loss and may also help reduce hunger across the day. But more studies with a longer duration are needed.
Fasting, or time-restricted eating
Many of us eat over a period of more than 14 hours a day.
Eating late at night can throw off your body’s natural rhythm and alter how your organs function. Over time, this can increase your risk of type 2 diabetes and other chronic diseases, particularly among shift workers.
Time-restricted eating, a form of intermittent fasting, means eating all your calories within a six- to ten-hour window during the day when you’re most active. It’s not about changing what or how much you eat, but when you eat it.
Animal studies suggest time-restricted eating can lead to weight loss and improved metabolism. But the evidence in humans is still limited, especially about the long-term benefits.
It’s also unclear if the benefits of time-restricted eating are due to the timing itself or because people are eating less overall. When we looked at studies where participants ate freely (with no intentional calorie limits) but followed an eight-hour daily eating window, they naturally consumed about 200 fewer calories per day.
What will work for you?
In the past, clinicians have thought about weight loss and avoiding weight gain as a simile equation of calories in and out. But factors such as how we distribute our calories across the day, how often we eat and whether we eat late at night may also impact our metabolism, weight and health.
There are no easy ways to lose weight. So choose a method, or combination of methods, that suits you best. You might consider
- aiming to eat in an eight-hour window
- consuming your calories earlier, by focusing on breakfast and lunch
- opting for three meals a day, instead of six.
The average adult gains 0.4 to 0.7 kg per year. Improving the quality of your diet is important to prevent this weight gain and the strategies above might also help.
Finally, there’s still a lot we don’t know about these eating patterns. Many existing studies are short-term, with small sample sizes and varied methods, making it hard to make direct comparisons.
More research is underway, including well-controlled trials with larger samples, diverse populations and consistent methods. So hopefully future research will help us better understand how altering our eating patterns can result in better health.
Hayley O’Neill, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University and Loai Albarqouni, Assistant Professor | NHMRC Emerging Leadership Fellow, Bond University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Hidden Risk of Stretching: Avoiding Hamstring Injuries in Yoga
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What is Yoga Butt
Have you ever experienced a mysterious pain while stretching, or perhaps during yoga? You might be dealing with “yoga butt,” a common—although rarely discussed—injury. In the below video, the Lovely Liv from Livinleggings shares her journey of discovering, and overcoming, “yoga butt”.
Dealing With Yoga Butt
Yoga butt, or proximal hamstring tendinopathy, occurs when the hamstrings are overstretched without adequate strengthening. Many yoga poses help stretch the hamstrings, but often don’t focus on strengthening said hamstrings; this imbalance is what can lead to damage over time.
To help prevent Yoga butt, it’s essential to balance stretching with strengthening. You can look into incorporating hamstring-strengthening exercises like Romanian deadlifts, hamstring curls, and modified yoga poses into your routine.
(If you’re new to strengthening exercises, we recommend reading Women’s Strength Training Anatomy Workouts or Strength Training for Seniors).
Watch the full video to learn more and hopefully protect yourself from long-term injuries:
Let us know your thoughts, and whether you have any other topics you’d like us to cover.
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In This Oklahoma Town, Most Everyone Knows Someone Who’s Been Sued by the Hospital
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McALESTER, Okla. — It took little more than an hour for Deborah Hackler to dispense with the tall stack of debt collection lawsuits that McAlester Regional Medical Center recently brought to small-claims court in this Oklahoma farm community.
Hackler, a lawyer who sues patients on behalf of the hospital, buzzed through 51 cases, all but a handful uncontested, as is often the case. She bantered with the judge as she secured nearly $40,000 in judgments, plus 10% in fees for herself, according to court records.
It’s a payday the hospital and Hackler have shared frequently over the past three decades, records show. The records indicate McAlester Regional Medical Center and an affiliated clinic have filed close to 5,000 debt collection cases since the early 1990s, most often represented by the father-daughter law firm of Hackler & Hackler.
Some of McAlester’s 18,000 residents have been taken to court multiple times. A deputy at the county jail and her adult son were each sued recently, court records show. New mothers said they compare stories of their legal run-ins with the medical center.
“There’s a lot that’s not right,” Sherry McKee, a dorm monitor at a tribal boarding school outside McAlester, said on the courthouse steps after the hearing. The hospital has sued her three times, most recently over a $3,375 bill for what she said turned out to be vertigo.
In recent years, major health systems in Virginia, North Carolina, and elsewhere have stopped suing patients following news reports about lawsuits. And several states, such as Maryland and New York, have restricted the legal actions hospitals can take against patients.
But with some 100 million people in the U.S. burdened by health care debt, medical collection cases still clog courtrooms across the country, researchers have found. In places like McAlester, a hospital’s debt collection machine can hum away quietly for years, helped along by powerful people in town. An effort to limit hospital lawsuits failed in the Oklahoma Legislature in 2021.
In McAlester, the lawsuits have provided business for some, such as the Adjustment Bureau, a local collection agency run out of a squat concrete building down the street from the courthouse, and for Hackler, a former president of the McAlester Area Chamber of Commerce. But for many patients and their families, the lawsuits can take a devastating toll, sapping wages, emptying retirement accounts, and upending lives.
McKee said she wasn’t sure how long it would take to pay off the recent judgment. Her $3,375 debt exceeds her monthly salary, she said.
“This affects a large number of people in a small community,” said Janet Roloff, an attorney who has spent years assisting low-income clients with legal issues such as evictions in and around McAlester. “The impact is great.”
Settled more than a century ago by fortune seekers who secured land from the Choctaw Nation to mine coal in the nearby hills, McAlester was once a boom town. Vestiges of that era remain, including a mammoth, 140-foot-tall Masonic temple that looms over the city.
Recent times have been tougher for McAlester, now home by one count to 12 marijuana dispensaries and the state’s death row. The downtown is pockmarked by empty storefronts, including the OKLA theater, which has been dark for decades. Nearly 1 in 5 residents in McAlester and the surrounding county live below the federal poverty line.
The hospital, operated by a public trust under the city’s authority, faces its own struggles. Paint is peeling off the front portico, and weeds poke up through the parking lots. The hospital has operated in the red for years, according to independent audit reports available on the state auditor’s website.
“I’m trying to find ways to get the entire community better care and more care,” said Shawn Howard, the hospital’s chief executive. Howard grew up in McAlester and proudly noted he started his career as a receptionist in the hospital’s physical therapy department. “This is my hometown,” he said. “I am not trying to keep people out of getting care.”
The hospital operates a clinic for low-income patients, whose webpage notes it has “limited appointments” at no cost for patients who are approved for aid. But data from the audits shows the hospital offers very little financial assistance, despite its purported mission to serve the community.
In the 2022 fiscal year, it provided just $114,000 in charity care, out of a total operating budget of more than $100 million, hospital records show. Charity care totaling $2 million or $3 million out of a $100 million budget would be more in line with other U.S. hospitals.
While audits show few McAlester patients get financial aid, many get taken to court.
Renee Montgomery, the city treasurer in an adjoining town and mother of a local police officer, said she dipped into savings she’d reserved for her children and grandchildren after the hospital sued her last year for more than $5,500. She’d gone to the emergency room for chest pain.
Dusty Powell, a truck driver, said he lost his pickup and motorcycle when his wages were garnished after the hospital sued him for almost $9,000. He’d gone to the emergency department for what turned out to be gastritis and didn’t have insurance, he said.
“Everyone in this town probably has a story about McAlester Regional,” said another former patient who spoke on the condition she not be named, fearful to publicly criticize the hospital in such a small city. “It’s not even a secret.”
The woman, who works at an Army munitions plant outside town, was sued twice over bills she incurred giving birth. Her sister-in-law has been sued as well.
“It’s a good-old-boy system,” said the woman, who lowered her voice when the mayor walked into the coffee shop where she was meeting with KFF Health News. Now, she said, she avoids the hospital if her children need care.
Nationwide, most people sued in debt collection cases never challenge them, a response experts say reflects widespread misunderstanding of the legal process and anxiety about coming to court.
At the center of the McAlester hospital’s collection efforts for decades has been Hackler & Hackler.
Donald Hackler was city attorney in McAlester for 13 years in the ’70s and ’80s and a longtime member of the local Lions Club and the Scottish Rite Freemasons.
Daughter Deborah Hackler, who joined the family firm 30 years ago, has been a deacon at the First Presbyterian Church of McAlester and served on the board of the local Girl Scouts chapter, according to the McAlester News-Capital newspaper, which named her “Woman of the Year” in 2007. Since 2001, she also has been a municipal judge in McAlester, hearing traffic cases, including some involving people she has sued on behalf of the hospital, municipal and county court records show.
For years, the Hacklers’ debt collection cases were often heard by Judge James Bland, who has retired from the bench and now sits on the hospital board. Bland didn’t respond to an inquiry for interview.
Hackler declined to speak with KFF Health News after her recent court appearance. “I’m not going to visit with you about a current client,” she said before leaving the courthouse.
Howard, the hospital CEO, said he couldn’t discuss the lawsuits either. He said he didn’t know the hospital took its patients to court. “I had to call and ask if we sue people,” he said.
Howard also said he didn’t know Deborah Hackler. “I never heard her name before,” he said.
Despite repeated public records requests from KFF Health News since September, the hospital did not provide detailed information about its financial arrangement with Hackler.
McAlester Mayor John Browne, who appoints the hospital’s board of trustees, said he, too, didn’t know about the lawsuits. “I hadn’t heard anything about them suing,” he said.
At the century-old courthouse in downtown McAlester, it’s not hard to find the lawsuits, though. Every month or two, another batch fills the docket in the small-claims court, now presided over by Judge Brian McLaughlin.
After court recently, McLaughlin, who is not from McAlester, shook his head at the stream of cases and patients who almost never show up to defend themselves, leaving him to issue judgment after judgment in the hospital’s favor.
“All I can do is follow the law,” said McLaughlin. “It doesn’t mean I like it.”
About This Project
“Diagnosis: Debt” is a reporting partnership between KFF Health News and NPR exploring the scale, impact, and causes of medical debt in America.
The series draws on original polling by KFF, court records, federal data on hospital finances, contracts obtained through public records requests, data on international health systems, and a yearlong investigation into the financial assistance and collection policies of more than 500 hospitals across the country.
Additional research was conducted by the Urban Institute, which analyzed credit bureau and other demographic data on poverty, race, and health status for KFF Health News to explore where medical debt is concentrated in the U.S. and what factors are associated with high debt levels.
The JPMorgan Chase Institute analyzed records from a sampling of Chase credit card holders to look at how customers’ balances may be affected by major medical expenses. And the CED Project, a Denver nonprofit, worked with KFF Health News on a survey of its clients to explore links between medical debt and housing instability.
KFF Health News journalists worked with KFF public opinion researchers to design and analyze the “KFF Health Care Debt Survey.” The survey was conducted Feb. 25 through March 20, 2022, online and via telephone, in English and Spanish, among a nationally representative sample of 2,375 U.S. adults, including 1,292 adults with current health care debt and 382 adults who had health care debt in the past five years. The margin of sampling error is plus or minus 3 percentage points for the full sample and 3 percentage points for those with current debt. For results based on subgroups, the margin of sampling error may be higher.
Reporters from KFF Health News and NPR also conducted hundreds of interviews with patients across the country; spoke with physicians, health industry leaders, consumer advocates, debt lawyers, and researchers; and reviewed scores of studies and surveys about medical debt.
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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Gravitas – by Caroline Goyder
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A no-nonsense guide to (more than!) public speaking that isn’t just “tell jokes in your speech and imagine the audience naked”.
Because this isn’t just about speech-writing or speech delivery, so much as giving you important life skills. The kind that weren’t taught in school, but that nevertheless make a huge impact on success… whether you’re giving a presentation or hosting a party or negotiating a deal or just attending a social event. Or making a phonecall, even.
Whereas a lot of books of this kind treat “the audience” as a nebulous and purely responsive passive crowd of extras, Goyder does better. People are individuals, even if they’re all facing the same way for a moment. She works with that! She also teaches how to deal with not just hecklers, but also simply those people who sap your confidence and find fault with you and anything you do or say.b
Bottom line is: if you for whatever reason communicate with people, and would like them to think better of you, this is the book for you.
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Unleashing Your Best Skin – by Jennifer Sun
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The author, an aesthetician with a biotech background, explains about the overlap of skin health and skin beauty, making it better from the inside first (diet and other lifestyle factors), and then tweaking things as desired from the outside.
In the broad category of “tweakments” as she puts it, she covers most of the wide array of modern treatments available at many skin care clinics and the options for which at-home do-it-yourself kits are available—and the pros and cons of various approaches.
And yes, those methods do range from microneedling and red light therapy to dermal fillers and thread lifts. Most of them are relatively non-invasive though.
She also covers common ailments of the skin, and how to identify and treat those quickly and easily, without making things worse along the way.
One last thing she also includes is dealing with unwanted hairs—being a very common side-along issue when it comes to aesthetic medicine.
The book is broadly aimed at women, but hormones are not a main component discussed (except in the context of acne), so there’s no pressing reason why this book couldn’t benefit men too. It also addresses considerations when it comes to darker skintones, something that a lot of similar books overlook.
Bottom line: if you find yourself mystified by the world of skin treatment options and wondering what’s really best for you without the bias of someone who’s trying to sell you a particular treatment, then this is the book for you.
Click here to check out Unleashing Your Best Skin, and unleash your best skin!
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Health Insurers Limit Coverage of Prosthetic Limbs, Questioning Their Medical Necessity
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When Michael Adams was researching health insurance options in 2023, he had one very specific requirement: coverage for prosthetic limbs.
Adams, 51, lost his right leg to cancer 40 years ago, and he has worn out more legs than he can count. He picked a gold plan on the Colorado health insurance marketplace that covered prosthetics, including microprocessor-controlled knees like the one he has used for many years. That function adds stability and helps prevent falls.
But when his leg needed replacing last January after about five years of everyday use, his new marketplace health plan wouldn’t authorize it. The roughly $50,000 leg with the electronically controlled knee wasn’t medically necessary, the insurer said, even though Colorado law leaves that determination up to the patient’s doctor, and his has prescribed a version of that leg for many years, starting when he had employer-sponsored coverage.
“The electronic prosthetic knee is life-changing,” said Adams, who lives in Lafayette, Colorado, with his wife and two kids. Without it, “it would be like going back to having a wooden leg like I did when I was a kid.” The microprocessor in the knee responds to different surfaces and inclines, stiffening up if it detects movement that indicates its user is falling.
People who need surgery to replace a joint typically don’t encounter similar coverage roadblocks. In 2021, 1.5 million knee or hip joint replacements were performed in United States hospitals and hospital-owned ambulatory facilities, according to the federal Agency for Healthcare Research and Quality, or AHRQ. The median price for a total hip or knee replacement without complications at top orthopedic hospitals was just over $68,000 in 2020, according to one analysis, though health plans often negotiate lower rates.
To people in the amputee community, the coverage disparity amounts to discrimination.
“Insurance covers a knee replacement if it’s covered with skin, but if it’s covered with plastic, it’s not going to cover it,” said Jeffrey Cain, a family physician and former chair of the board of the Amputee Coalition, an advocacy group. Cain wears two prosthetic legs, having lost his after an airplane accident nearly 30 years ago.
AHIP, a trade group for health plans, said health plans generally provide coverage when the prosthetic is determined to be medically necessary, such as to replace a body part or function for walking and day-to-day activity. In practice, though, prosthetic coverage by private health plans varies tremendously, said Ashlie White, chief strategy and programs officer at the Amputee Coalition. Even though coverage for basic prostheses may be included in a plan, “often insurance companies will put caps on the devices and restrictions on the types of devices approved,” White said.
An estimated 2.3 million people are living with limb loss in the U.S., according to an analysis by Avalere, a health care consulting company. That number is expected to as much as double in coming years as people age and a growing number lose limbs to diabetes, trauma, and other medical problems.
Fewer than half of people with limb loss have been prescribed a prosthesis, according to a report by the AHRQ. Plans may deny coverage for prosthetic limbs by claiming they aren’t medically necessary or are experimental devices, even though microprocessor-controlled knees like Adams’ have been in use for decades.
Cain was instrumental in getting passed a 2000 Colorado law that requires insurers to cover prosthetic arms and legs at parity with Medicare, which requires coverage with a 20% coinsurance payment. Since that measure was enacted, about half of states have passed “insurance fairness” laws that require prosthetic coverage on par with other covered medical services in a plan or laws that require coverage of prostheses that enable people to do sports. But these laws apply only to plans regulated by the state. Over half of people with private coverage are in plans not governed by state law.
The Medicare program’s 80% coverage of prosthetic limbs mirrors its coverage for other services. Still, an October report by the Government Accountability Office found that only 30% of beneficiaries who lost a limb in 2016 received a prosthesis in the following three years.
Cost is a factor for many people.
“No matter your coverage, most people have to pay something on that device,” White said. As a result, “many people will be on a payment plan for their device,” she said. Some may take out loans.
The federal Consumer Financial Protection Bureau has proposed a rule that would prohibit lenders from repossessing medical devices such as wheelchairs and prosthetic limbs if people can’t repay their loans.
“It is a replacement limb,” said White, whose organization has heard of several cases in which lenders have repossessed wheelchairs or prostheses. Repossession is “literally a punishment to the individual.”
Adams ultimately owed a coinsurance payment of about $4,000 for his new leg, which reflected his portion of the insurer’s negotiated rate for the knee and foot portion of the leg but did not include the costly part that fits around his stump, which didn’t need replacing. The insurer approved the prosthetic leg on appeal, claiming it had made an administrative error, Adams said.
“We’re fortunate that we’re able to afford that 20%,” said Adams, who is a self-employed leadership consultant.
Leah Kaplan doesn’t have that financial flexibility. Born without a left hand, she did not have a prosthetic limb until a few years ago.
Growing up, “I didn’t want more reasons to be stared at,” said Kaplan, 32, of her decision not to use a prosthesis. A few years ago, the cycling enthusiast got a prosthetic hand specially designed for use with her bike. That device was covered under the health plan she has through her county government job in Spokane, Washington, helping developmentally disabled people transition from school to work.
But when she tried to get approval for a prosthetic hand to use for everyday activities, her health plan turned her down. The myoelectric hand she requested would respond to electrical impulses in her arm that would move the hand to perform certain actions. Without insurance coverage, the hand would cost her just over $46,000, which she said she can’t afford.
Working with her doctor, she has appealed the decision to her insurer and been denied three times. Kaplan said she’s still not sure exactly what the rationale is, except that the insurer has questioned the medical necessity of the prosthetic hand. The next step is to file an appeal with an independent review organization certified by the state insurance commissioner’s office.
A prosthetic hand is not a luxury device, Kaplan said. The prosthetic clinic has ordered the hand and made the customized socket that will fit around the end of her arm. But until insurance coverage is sorted out, she can’t use it.
At this point she feels defeated. “I’ve been waiting for this for so long,” Kaplan said.
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.
This article first appeared on KFF Health News and is republished here under a Creative Commons license.
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11 Things That Can Change Your Eye Color
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Eye color is generally considered so static that iris scans are considered a reasonable security method. However, it can indeed change—mostly for reasons you won’t want, though:
Ringing the changes
Putting aside any wishes of being a manga protagonist with violet eyes, here are the self-changing options:
- Aging in babies: babies are often born with lighter eyes, which can darken as melanocytes develop during the first few months of life. This is similar to how a small child’s blonde hair can often be much darker by the time puberty hits!
- Aging in adults: eyes may continue to darken until adulthood, while aging into the elderly years can cause them to lighten due to conditions like arcus senilis
- Horner’s syndrome: a nerve disorder that can cause the eyes to become lighter due to loss of pigment
- Fuchs heterochromic iridocyclitis: an inflammation of the iris that leads to lighter eyes over time
- Pigment dispersion syndrome: the iris rubs against eye fibers, leading to pigment loss and lighter eyes
- Kayser-Fleischer rings: excess copper deposits on the cornea, often due to Wilson’s disease, causing larger-than-usual brown or grayish rings around the iris
- Iris melanoma: a rare cancer that can darken the iris, often presenting as brown spots
- Cancer treatments: chemotherapy for retinoblastoma in children can result in lighter eye color and heterochromia
- Medications: prostaglandin-based glaucoma treatments can darken the iris, with up to 23% of patients seeing this effect
- Vitiligo: an autoimmune disorder that destroys melanocytes, mostly noticed in the skin, but also causing patchy loss of pigment in the iris
- Emotional and pupil size changes: emotions and trauma can affect pupil size, making eyes appear darker or lighter temporarily by altering how much of the iris is visible
For more about all these, and some notes about more voluntary changes (if you have certain kinds of eye surgery), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
Understanding And Slowing The Progression Of Cataracts
Take care!
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