Citicoline: Better Than Dietary Choline?

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Citicoline: Better Than Dietary Choline?

Citicoline, also known as cytidine diphosphate-choline (or CDP-Choline, to its friends, or cytidine 5′-diphosphocholine if it wants to get fancy) is a dietary supplement that the stomach can metabolize easily for all the brain’s choline needs. What are those needs?

Choline is an essential nutrient. We technically can synthesize it, but only in minute amounts, far less than we need. Choline is a key part of the neurotransmitter acetylcholine, as well as having other functions in other parts of the body.

As for citicoline specifically… it appears to do the job better than dietary sources of choline:

❝Intriguing data, showing that on a molar mass basis citicoline is significantly less toxic than choline, are also analyzed.

It is hypothesized that, compared to choline moiety in other dietary sources such as phosphatidylcholine, choline in citicoline is less prone to conversion to trimethylamine (TMA) and its putative atherogenic N-oxide (TMAO).

Epidemiological studies have suggested that choline supplementation may improve cognitive performance, and for this application citicoline may be safer and more efficacious.❞

~ Synoradzki & Grieb

Source: Citicoline: A Superior Form of Choline?

Great! What does it do?

What doesn’t it do? When it comes to cognitive function, anyway, citicoline covers a lot of bases.

Short version: it improves just about every way a brain’s healthy functions can be clinically measured. From cognitive improvements in all manner of tests (far beyond just “improves memory” etc; also focus, alertness, verbal fluency, logic, computation, and more), to purely neurological things like curing tinnitus (!), alleviating mobility disorders, and undoing alcohol-related damage.

One of the reasons it’s so wide in its applications, is that it has a knock-on effect to other systems in the brain, including the dopaminergic system.

Long version: Citicoline: pharmacological and clinical review, 2022 update

(if you don’t want to sit down for a long read, we recommend skimming to the charts and figures, which are very elucidating even alone)

Spotlight study in memory

For a quick-reading example of how it helps memory specifically:

Citicoline and Memory Function in Healthy Older Adults: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Keeping dementia at bay

For many older people looking to improve memory, it’s less a matter of wanting to perform impressive feats of memory, and more a matter of wanting to keep a sharp memory throughout our later years.

Dr. Maria Bonvicini et al. looked into this:

❝We selected seven studies including patients with mild cognitive impairment, Alzheimer’s disease or post-stroke dementia

All the studies showed a positive effect of citicoline on cognitive functions. Six studies could be included in the meta-analysis.

Overall, citicoline improved cognitive status, with pooled standardized mean differences ranging from 0.56 (95% CI: 0.37-0.75) to 1.57 (95% CI: 0.77-2.37) in different sensitivity analyses❞

Source: Is Citicoline Effective in Preventing and Slowing Down Dementia?-A Systematic Review and a Meta-Analysis

The researchers concluded “yes”, and yet, called for more studies, and of higher quality. In many such studies, the heterogeneity of the subjects (often, residents of nursing homes) can be as much a problem (unclear whether the results will be applicable to other people in different situations) as it is a strength (fewer confounding variables).

Another team looked at 47 pre-existing reviews, and concluded:

❝The review found that citicoline has been proven to be a useful compound in preventing dementia progression.

Citicoline has a wide range of effects and could be an essential substance in the treatment of many neurological diseases.

Its positive impact on learning and cognitive functions among the healthy population is also worth noting.❞

Source: Application of Citicoline in Neurological Disorders: A Systematic Review

The dopamine bonus

Remember how we said that citicoline has a knock-on effect on other systems, including the dopaminergic system? This means that it’s been studied (and found meritorious) for alleviating symptoms of Parkinson’s disease:

❝Patients with Parkinson’s disease who were taking citicoline had significant improvement in rigidity, akinesia, tremor, handwriting, and speech.

Citicoline allowed effective reduction of levodopa by up to 50%.

Significant improvement in cognitive status evaluation was also noted with citicoline adjunctive therapy.❞

Source: Citicoline as Adjuvant Therapy in Parkinson’s Disease: A Systematic Review

Where to get it?

We don’t sell it, but here’s an example product on Amazon, for your convenience

Enjoy!

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  • More research shows COVID-19 vaccines are safe for young adults

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    What you need to know

    • Myocarditis, or inflammation of the heart muscle, is most commonly caused by a viral infection like COVID-19, not by vaccination.
    • In line with previous research, a recent CDC study found no association between COVID-19 vaccination and sudden cardiac death in previously healthy young people.
    • A COVID-19 infection is much more likely to cause inflammation of the heart muscle than a COVID-19 vaccine, and those cases are typically more severe.

    Since the approval of the first COVID-19 vaccines, anti-vaccine advocates have raised concerns about heart muscle inflammation, also called myocarditis, after vaccination to suggest that vaccines are unsafe. They’ve also used concerns about myocarditis to spread false claims that vaccines cause sudden deaths, which is not true.

    Research has consistently shown that cases of myocarditis after vaccination are extremely rare and usually mild, and a new study from the CDC found no association between sudden cardiac death and COVID-19 vaccination in young adults.

    Read on to learn more about myocarditis and what the latest research says about COVID-19 vaccine safety.

    What is myocarditis?

    Myocarditis is inflammation of the myocardium, or the middle muscular layer of the heart wall. This inflammation weakens the heart’s ability to pump blood. Symptoms may include fatigue, shortness of breath, chest pain, rapid or irregular heartbeat, and flu-like symptoms.

    Myocarditis may resolve on its own. In rare cases, it may lead to stroke, heart failure, heart attack, or death.

    What causes myocarditis?

    Myocarditis is typically caused by a viral infection like COVID-19. Bacteria, parasites, fungi, chemicals, and certain medications can also cause myocarditis.

    In very rare cases, some people develop myocarditis after receiving a COVID-19 vaccine, but these cases are usually mild and resolve on their own. In contrast, a COVID-19 infection is much more likely to cause myocarditis, and those cases are typically more severe.

    Staying up to date on vaccines reduces your risk of developing myocarditis from a COVID-19 infection.

    Are COVID-19 vaccines safe for young people?

    Yes. COVID-19 vaccines have been rigorously tested and monitored over the past three years and have been determined to be safe for everyone 6 months and older. A recent CDC study found no association between COVID-19 vaccination and sudden cardiac death in previously healthy young adults.

    The benefits of vaccination outweigh any potential risks. Staying up to date on COVID-19 vaccines reduces your risk of severe illness, hospitalization, death, long COVID, and COVID-19-related complications, such as myocarditis.

    The CDC recommends people 65 and older and immunocompromised people receive an additional dose of the updated COVID-19 vaccine this spring—if at least four months have passed since they received a COVID-19 vaccine.

    For more information, talk to your health care provider.

    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Not all ultra-processed foods are bad for your health, whatever you might have heard

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In recent years, there’s been increasing hype about the potential health risks associated with so-called “ultra-processed” foods.

    But new evidence published this week found not all “ultra-processed” foods are linked to poor health. That includes the mass-produced wholegrain bread you buy from the supermarket.

    While this newly published research and associated editorial are unlikely to end the wrangling about how best to define unhealthy foods and diets, it’s critical those debates don’t delay the implementation of policies that are likely to actually improve our diets.

    What are ultra-processed foods?

    Ultra-processed foods are industrially produced using a variety of processing techniques. They typically include ingredients that can’t be found in a home kitchen, such as preservatives, emulsifiers, sweeteners and/or artificial colours.

    Common examples of ultra-processed foods include packaged chips, flavoured yoghurts, soft drinks, sausages and mass-produced packaged wholegrain bread.

    In many other countries, ultra-processed foods make up a large proportion of what people eat. A recent study estimated they make up an average of 42% of total energy intake in Australia.

    How do ultra-processed foods affect our health?

    Previous studies have linked increased consumption of ultra-processed food with poorer health. High consumption of ultra-processed food, for example, has been associated with a higher risk of type 2 diabetes, and death from heart disease and stroke.

    Ultra-processed foods are typically high in energy, added sugars, salt and/or unhealthy fats. These have long been recognised as risk factors for a range of diseases.

    Bowl of chips
    Ultra-processed foods are usually high is energy, salt, fat, or sugar. Olga Dubravina/Shutterstock

    It has also been suggested that structural changes that happen to ultra-processed foods as part of the manufacturing process may lead you to eat more than you should. Potential explanations are that, due to the way they’re made, the foods are quicker to eat and more palatable.

    It’s also possible certain food additives may impair normal body functions, such as the way our cells reproduce.

    Is it harmful? It depends on the food’s nutrients

    The new paper just published used 30 years of data from two large US cohort studies to evaluate the relationship between ultra-processed food consumption and long-term health. The study tried to disentangle the effects of the manufacturing process itself from the nutrient profile of foods.

    The study found a small increase in the risk of early death with higher ultra-processed food consumption.

    But importantly, the authors also looked at diet quality. They found that for people who had high quality diets (high in fruit, vegetables, wholegrains, as well as healthy fats, and low in sugary drinks, salt, and red and processed meat), there was no clear association between the amount of ultra-processed food they ate and risk of premature death.

    This suggests overall diet quality has a stronger influence on long-term health than ultra-processed food consumption.

    Man cooks
    People who consume a healthy diet overall but still eat ultra-processed foods aren’t at greater risk of early death. Grusho Anna/Shutterstock

    When the researchers analysed ultra-processed foods by sub-category, mass-produced wholegrain products, such as supermarket wholegrain breads and wholegrain breakfast cereals, were not associated with poorer health.

    This finding matches another recent study that suggests ultra-processed wholegrain foods are not a driver of poor health.

    The authors concluded, while there was some support for limiting consumption of certain types of ultra-processed food for long-term health, not all ultra-processed food products should be universally restricted.

    Should dietary guidelines advise against ultra-processed foods?

    Existing national dietary guidelines have been developed and refined based on decades of nutrition evidence.

    Much of the recent evidence related to ultra-processed foods tells us what we already knew: that products like soft drinks, alcohol and processed meats are bad for health.

    Dietary guidelines generally already advise to eat mostly whole foods and to limit consumption of highly processed foods that are high in refined grains, saturated fat, sugar and salt.

    But some nutrition researchers have called for dietary guidelines to be amended to recommend avoiding ultra-processed foods.

    Based on the available evidence, it would be difficult to justify adding a sweeping statement about avoiding all ultra-processed foods.

    Advice to avoid all ultra-processed foods would likely unfairly impact people on low-incomes, as many ultra-processed foods, such as supermarket breads, are relatively affordable and convenient.

    Wholegrain breads also provide important nutrients, such as fibre. In many countries, bread is the biggest contributor to fibre intake. So it would be problematic to recommend avoiding supermarket wholegrain bread just because it’s ultra-processed.

    So how can we improve our diets?

    There is strong consensus on the need to implement evidence-based policies to improve population diets. This includes legislation to restrict children’s exposure to the marketing of unhealthy foods and brands, mandatory Health Star Rating nutrition labelling and taxes on sugary drinks.

    Softdrink on supermarket shelf
    Taxes on sugary drinks would reduce their consumption. MDV Edwards/Shutterstock

    These policies are underpinned by well-established systems for classifying the healthiness of foods. If new evidence unfolds about mechanisms by which ultra-processed foods drive health harms, these classification systems can be updated to reflect such evidence. If specific additives are found to be harmful to health, for example, this evidence can be incorporated into existing nutrient profiling systems, such as the Health Star Rating food labelling scheme.

    Accordingly, policymakers can confidently progress food policy implementation using the tools for classifying the healthiness of foods that we already have.

    Unhealthy diets and obesity are among the largest contributors to poor health. We can’t let the hype and academic debate around “ultra-processed” foods delay implementation of globally recommended policies for improving population diets.

    Gary Sacks, Professor of Public Health Policy, Deakin University; Kathryn Backholer, Co-Director, Global Centre for Preventive Health and Nutrition, Deakin University; Kathryn Bradbury, Senior Research Fellow in the School of Population Health, University of Auckland, Waipapa Taumata Rau, and Sally Mackay, Senior Lecturer Epidemiology and Biostatistics, University of Auckland, Waipapa Taumata Rau

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • 5 dental TikTok trends you probably shouldn’t try at home

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    TikTok is full of videos that demonstrate DIY hacks, from up-cycling tricks to cooking tips. Meanwhile, a growing number of TikTok videos offer tips to help you save money and time at the dentist. But do they deliver?

    Here are five popular dental TikTok trends and why you might treat them with caution.

    1. Home-made whitening solutions

    Many TikTok videos provide tips to whiten teeth. These include tutorials on making your own whitening toothpaste using ingredients such as hydrogen peroxide, a common household bleaching agent, and baking soda (sodium bicarbonate).

    In this video, the influencer says:

    And then you’re going to pour in your hydrogen peroxide. There’s really no measurement to this.

    But hydrogen peroxide in high doses is poisonous if swallowed, and can burn your gums, mouth and throat, and corrode your teeth.

    High doses of hydrogen peroxide may infiltrate holes or microscopic cracks in your teeth to inflame or damage the nerves and blood vessels in the teeth, which can cause pain and even nerve death. This is why dental practitioners are bound by rules when we offer whitening treatments.

    Sodium bicarbonate and hydrogen peroxide are among the components in commercially available whitening toothpastes. While these commercial products may be effective at removing surface stains, their compositions are carefully curated to keep your smile safe.

    2. Oil pulling

    Oil pulling involves swishing one tablespoon of sesame or coconut oil in your mouth for up to 20 minutes at a time. It has roots in Ayurvedic medicine, a traditional medicine practice that originates from the Indian subcontinent.

    While oil pulling should be followed by brushing and flossing, I’ve had patients who believe oil pulling is a replacement for these practices.

    There has been some research on the potential of oil pulling to treat gum disease or other diseases in the mouth. But overall, evidence that supports the effectiveness of oil pulling is of low certainty.

    For example, studies that test the effectiveness of oil pulling have been conducted on school-aged children and people with no dental problems, and often measure dental plaque growth over a few days to a couple of weeks.

    Chlorhexidine is an ingredient found in some commercially available mouthwashes.
    In one study, people who rinsed with chlorhexidine mouthwash (30 seconds twice daily) developed less plaque on their teeth compared to those who undertook oil pulling for eight to 10 minutes.

    Ultimately, it’s unlikely you will experience measurable gain to your oral health by adding oil pulling to your daily routine. If you’re time-poor, you’re better off focusing on brushing your teeth and gums well alongside flossing.

    3. Using rubber bands to fix gaps

    This TikTok influencer shows his followers he closed the gaps between his front teeth in a week using cheap clear rubber bands.

    But this person may be one of the lucky few to successfully use bands to close a gap in his teeth without any mishaps. Front teeth are slippery and taper near the gums into cone-shaped roots. This can cause bands to slide and disappear into the gums to surround the tooth roots, which can cause infections and pain.

    If this happens, you may require surgery that involves cutting your gums to remove the bands. If the bands have caused an infection, you may lose the affected teeth. So it’s best to leave this sort of work to a dental professional trained in orthodontics.

    4. Filing or cutting teeth to shape them

    My teeth hurt just watching this video.

    Cutting or filing teeth unnecessarily can expose the second, more sensitive tooth layer, called dentine, or potentially, the nerve and blood vessels inside the tooth. People undergoing this sort of procedure could experience anything from sensitive teeth through to a severe toothache that requires root canal treatment or tooth removal.

    You may notice dentist drills spray water when cutting to protect your teeth from extreme heat damage. The drill in this video is dry with no water used to cool the heat produced during cutting.

    It may also not be sterile. We like to have everything clean and sterile to prevent contaminated instruments used on one patient from potentially spreading an infection to another person.

    Importantly, once you cut or file your teeth away, it’s gone forever. Unlike bone, hair or nails, our teeth don’t have the capacity to regrow.

    5. DIY fillings

    Many people on TikTok demonstrate filling cavities (holes) or replacing gaps between teeth with a material made from heated moulded plastic beads. DIY fillings can cause a lot of issues – I’ve seen this in my clinic first hand.

    While we may make it look simple in dental surgeries, the science behind filling materials and how we make them stick to teeth to fill cavities is sophisticated.

    Filling a cavity with the kind of material made from these beads will be as effective as using sticky tape on sand. Not to mention the cavity will continue to grow bigger underneath the untreated “filled” teeth.

    I know it’s easy to say “see a dentist about that cavity” or “go to an orthodontist to fix that gap in your teeth you don’t like”, but it can be expensive to actually do these things. However if you end up requiring treatment to fix the issues caused at home, it may end up costing you much more.

    So what’s the take-home message? Stick with the funny cat and dog videos on TikTok – they’re safer for your smile.The Conversation

    Arosha Weerakoon, Senior Lecturer and General Dentist, School of Dentistry, The University of Queensland

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Thai-Style Kale Chips

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    …that are actually crispy, tasty, and packed with nutrients! Lots of magnesium and calcium, and array of health-giving spices too.

    You will need

    • 7 oz raw curly kale, stalks removed
    • extra virgin olive oil, for drizzling
    • 3 cloves garlic, crushed
    • 2 tsp red chili flakes (or crushed dried red chilis)
    • 2 tsp light soy sauce
    • 2 tsp water
    • 1 tbsp crunchy peanut butter (pick one with no added sugar, salt, etc)
    • 1 tsp honey
    • 1 tsp Thai seven-spice powder
    • 1 tsp black pepper
    • 1 tsp MSG or 1 tsp low-sodium salt

    Method

    (we suggest you read everything at least once before doing anything)

    1) Pre-heat the oven to 180℃ / 350℉ / Gas mark 4.

    2) Put the kale in a bowl and drizzle a little olive oil over it. Work the oil in gently with your fingertips so that the kale is coated; the leaves will also soften while you do this; that’s expected, so don’t worry.

    3) Mix the rest of the ingredients to make a sauce; coat the kale leaves with the sauce.

    4) Place on a baking tray, as spread-out as there’s room for, and bake on a middle shelf for 15–20 minutes. If your oven has a fierce heat source at the top, it can be good to place an empty baking tray on a shelf above the kale chips, to baffle the heat and prevent them from cooking unevenly—especially if it’s not a fan oven.

    5) Remove and let cool, and then serve! They can also be stored in an airtight container if desired.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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  • Covering obesity: 6 tips for dispelling myths and avoiding stigmatizing news coverage

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    When researchers looked at news coverage of obesity in the United States and the United Kingdom a few years ago, they found that images in news articles often portrayed people with larger bodies “in a stigmatizing manner” — they emphasized people’s abdomens, for example, or showed them eating junk food, wearing tight clothes or lounging in front of a TV. 

    When people with larger bodies were featured in photos and videos, nearly half were shown only from their necks down or with part of their heads missing, according to the analysis, published in November 2023. The researchers examined a total of 445 images posted to the websites of four U.S. news outlets and four U.K. news outlets between August 2018 and August 2019.

    The findings underscore the need for dramatic changes in the way journalists report on obesity and people who weigh more than what medical authorities generally consider healthy, Rebecca Puhl, one of the paper’s authors, told The Journalist’s Resource in an email interview.

    “Using images of ‘headless stomachs’ is dehumanizing and stigmatizing, as are images that depict people with larger bodies in stereotypical ways (e.g., eating junk food or being sedentary),” wrote Puhl, deputy director of the Rudd Center for Food Policy and Health at the University of Connecticut and a leading scholar on weight stigma.

    She noted that news images influence how the public views and interacts with people with obesity, a complicated and often misunderstood condition that the American Medical Association considers a disease.

    In the U.S., an estimated 42% of adults aged 20 years and older have obesity, a number researchers predict will rise to 50% over the next six years. While the disease isn’t as common in other parts of the planet, the World Obesity Federation projects that by 2035, more than half the global population will have obesity or overweight.

    Several other studies Puhl has conducted demonstrate that biased new images can have damaging consequences for individuals affected by obesity.

    “Our research has found that seeing the stigmatizing image worsens people’s attitudes and weight bias, leading them to attribute obesity to laziness, increasing their dislike of people with higher weight, and increasing desire for social distance from them,” Puhl explained.

    Dozens of studies spotlight problems in news coverage of obesity in the U.S. and abroad. In addition to stigmatizing images, journalists use stigmatizing language, according to a 2022 research review in eClinicalMedicine, a journal published by The Lancet.

    The research also suggests people with higher weights feel excluded and ridiculed by news outlets.

    “Overt or covert discourses in news media, social media, and public health campaigns included depictions of people with overweight or obesity as being lazy, greedy, undisciplined, unhappy, unattractive, and stupid,” write the authors of the review, which examines 113 academic studies completed before Dec. 2, 2021.

    To help journalists reflect on and improve their work, The Journalist’s Resource asked for advice from experts in obesity, weight stigma, health communication and sociolinguistics. They shared their thoughts and opinions, which we distilled into the six tips that appear below.

    In addition to Puhl, we interviewed these six experts:

    Jamy Ard, a professor of epidemiology and prevention at Wake Forest University School of Medicine and co-director of the Wake Forest Baptist Health Weight Management Center. He’s also president of The Obesity Society, a professional organization of researchers, health care providers and other obesity specialists.

    Leslie Cofie, an assistant professor of health education and promotion at East Carolina University’s College of Health and Human Performance. He has studied obesity among immigrants and military veterans.

    Leslie Heinberg, director of Enterprise Weight Management at the Cleveland Clinic, an academic medical center. She’s also vice chair for psychology in the Cleveland Clinic’s Center for Behavioral Health Department of Psychiatry and Psychology.

    Monu Khanna, a physician in Missouri who is board certified in obesity medicine.

    Jenn Lonzer, manager of the Cleveland Clinic Health Library and the co-author of several academic papers on health communication.

    Cindi SturtzSreetharan, an anthropologist and professor at the Arizona State University School of Human Evolution and Social Change. She studies the language people of different cultures use to describe human bodies.

    1. Familiarize yourself with recent research on what causes obesity and how obesity can affect a person’s health. Many long-held beliefs about the disease are wrong.

    Journalists often report incorrect or misleading information about obesity, possibly because they’re unaware that research published in recent decades dispels many long-held beliefs about the disease, the experts say. Obesity isn’t simply the result of eating too many calories and doing too little exercise. A wide range of factors drive weight gain and prevent weight loss, many of which have nothing to do with willpower or personal choices.

    Scholars have learned that stress, gut health, sleep duration and quality, genetics, medication, personal income, access to healthy foods and even climate can affect weight regulation. Prenatal and early life experiences also play a role. For example, childhood trauma such as child abuse can become “biologically embedded,” altering children’s brain structures and influencing their long-term physical and mental health, according to a 2020 research review published in the journal Physiology & Behavior.

    “The causes of obesity are numerous and each individual with obesity will have a unique set of contributors to their excess weight gain,” Jamy Ard, president of The Obesity Society, wrote to The Journalist’s Resource.

    The experts urge journalists to help dispel myths, correct misinformation and share new research findings. News outlets should examine their own work, which often “ignores the science and sets up situation blaming,” says Leslie Heinberg, director of Enterprise Weight Management at the Cleveland Clinic.

    “So much of the media portrayal is simply ‘This is a person who eats too much and the cure is simply to eat less or cut out that food’ or something overly, overly simplistic,” Heinberg says.

    Journalists need to build their knowledge of the problem before they can explain it to their audiences. Experts point out that educating policymakers, health care providers and the public about obesity is key to eliminating the stigma associated with having a larger body.

    Weight stigma alone is so physically and emotionally damaging that 36 international experts issued a consensus statement in 2020 to raise awareness about it. The document, endorsed by dozens of medical and academic organizations, outlines 13 recommendations for eliminating weight bias and stigma.

    Recommendation No. 5: “We call on the media to produce fair, accurate, and non-stigmatizing portrayals of obesity. A commitment from the media is needed to shift the narrative around obesity.”

    2. Use person-first language — the standard among health and medical professionals for communicating about people with chronic diseases.

    The experts we interviewed encourage journalists to ditch the adjectives “obese” and “overweight” because they are dehumanizing. Use person-first language, which avoids labeling people as their disease by putting the person before the disease.

    Instead of saying “an obese teenager,” say “a teenager who has obesity” or “a teenager affected by obesity.” Instead of writing “overweight men,” write “men who have overweight.”

    Jenn Lonzer, manager of the Cleveland Clinic Health Library, says using “overweight” as a noun might look and sound awkward at first. But it makes sense considering other diseases are treated as nouns, she notes. Journalists would not typically refer to someone in a news story as “a cancerous person,” for example. They would report that the individual has cancer.

    It’s appropriate to refer to people with overweight or obesity using neutral weight terminology. Puhl wrote that she uses “people with higher body weight” or “people with high weight” and, sometimes, “people with larger bodies” in her own writing.

    While the Associated Press stylebook offers no specific guidance on the use of terms such as “obese” or “overweight,” it advises against “general and often dehumanizing ‘the’ labels such as the poor, the mentally ill, the disabled, the college-educated.”

    The Association of Health Care Journalists recommends person-first language when reporting on obesity. But it also advises journalists to ask sources how they would like to be characterized, provided their weight or body size is relevant to the news story.

    Anthropologist Cindi SturtzSreetharan, who studies language and culture, says sources’ responses to that question should be part of the story. Some individuals might prefer to be called “fat,” “thick” or “plus-sized.”

    “I would include that as a sentence in the article — to signal you’ve asked and that’s how they want to be referred to,” SturtzSreetharan says.

    She encourages journalists to read how authors describe themselves in their own writing. Two books she recommends: Thick by Tressie McMillan Cottom and Heavy: An American Memoir by Kiese Laymon.

    3. Carefully plan and choose the images that will accompany news stories about obesity.

    Journalists need to educate themselves about stigma and screen for it when selecting images, Puhl noted. She shared these four questions that journalists should ask themselves when deciding how to show people with higher weights in photos and video.

    • Does the image imply or reinforce negative stereotypes?
    • Does it provide a respectful portrayal of the person?
    • Who might be offended, and why?
    • Can an alternative image convey the same message and eliminate possible bias?

    “Even if your written piece is balanced, accurate, and respectful, a stigmatizing image can undermine your message and promote negative societal attitudes,” Puhl wrote via email.

    Lonzer says newsrooms also need to do a better job incorporating images of people who have different careers, interests, education levels and lifestyles into their coverage of overweight and obesity.

    “We are diverse,” says Lonzer, who has overweight. “We also have diversity in body shape and size. It’s good to have images that reflect what Americans look like.”

    If you’re looking for images and b-roll videos that portray people with obesity in non-stigmatizing ways, check out the Rudd Center Media Gallery. It’s a collection of original images of people from various demographic groups that journalists can use for free in their coverage.

    The Obesity Action Coalition, a nonprofit advocacy organization, also provides images. But journalists must sign up to use the OAC Bias-Free Image Gallery.

    Other places to find free images: The World Obesity Image Bank, a project of the World Obesity Federation, and the Flickr account of Obesity Canada.

    4. Make sure your story does not reinforce stereotypes or insinuate that overcoming obesity is simply a matter of cutting calories and doing more exercise.

    “Think about the kinds of language used in the context of eating habits or physical activity, as some can reinforce shame or stereotypes,” Puhl wrote.

    She suggested journalists avoid phrases such as “resisting temptations,” “cheating on a diet,” “making excuses,” “increasing self-discipline” and “lacking self-control” because they perpetuate the myth that individuals can control their weight and that the key to losing weight is eating less and moving more.

    Lonzer offers this advice: As you work on stories about obesity or weight-related issues, ask yourself if you would use the same language and framing if you were reporting on someone you love.

    Here are other questions for journalists to contemplate:

    “Am I treating this as a complex medical condition or am I treating it as ‘Hey, lay off the French fries?’” Lonzer adds. “Am I treating someone with obesity differently than someone with another disease?”

    It’s important to also keep in mind that having excess body fat does not, by itself, mean a person is unhealthy. And don’t assume everyone who has a higher weight is unhappy about it.

    “Remember, not everyone with obesity is suffering,” physician Monu Khanna wrote to The Journalist’s Resource.

    5. To help audiences understand how difficult it is to prevent and reduce obesity, explain that even the places people live can affect their waistlines.

    When news outlets report on obesity, they often focus on weight-loss programs, surgical procedures and anti-obesity medications. But there are other important issues to cover. Experts stress the need to help the public understand how factors not ordinarily associated with weight gain or loss can influence body size.

    For example, a paper published in 2018 in the American Journal of Preventive Medicine indicates adults who are regularly exposed to loud noise have a higher waist circumference than adults who are not. Research also finds that people who live in neighborhoods with sidewalks and parks are more active.

    “One important suggestion I would offer to journalists is that they need to critically explore environmental factors (e.g., built environment, food deserts, neighborhood safety, etc.) that lead to disproportionately high rates of obesity among certain groups, such as low-income individuals and racial/ethnic minorities,” Leslie Cofie, an assistant professor at East Carolina University, wrote to The Journalist’s Resource.

    Cofie added that moving to a new area can prompt weight changes.

    “We know that immigrants generally have lower rates of obesity when they first migrate to the U.S.,” he wrote. “However, over time, their obesity rates resemble that of their U.S.-born counterparts. Hence, it is critical for journalists to learn about how the sociocultural experiences of immigrants change as they adapt to life in the U.S. For example, cultural perspectives about food, physical activities, gender roles, etc. may provide unique insights into how the pre- and post-migration experiences of immigrants ultimately contribute to the unfavorable trends in their excessive weight gain.”

    Other community characteristics have been linked to larger body sizes for adults or children: air pollution, lower altitudes, higher temperatures, lower neighborhood socioeconomic status, perceived neighborhood safety, an absence of local parks and closer proximity to fast-food restaurants.

    6. Forge relationships with organizations that study obesity and advocate on behalf of people living with the disease.

    Several organizations are working to educate journalists about obesity and help them improve their coverage. Five of the most prominent ones collaborated on a 10-page guide book, “Guidelines for Media Portrayals of Individuals Affected by Obesity.”

    • The Rudd Center for Food Policy and Health, based at the University of Connecticut, “promotes solutions to food insecurity, poor diet quality, and weight bias through research and policy,” according to its website. Research topics include food and beverage marketing, weight-related bullying and taxes on sugary drinks.
    • The Obesity Society helps journalists arrange interviews with obesity specialists. It also offers journalists free access to its academic journal, Obesity, and free registration to ObesityWeek, an international conference of researchers and health care professionals held every fall. This year’s conference is Nov. 2-6 in San Antonio, Texas.
    • The Obesity Medicine Association represents health care providers who specialize in obesity treatment and care. It also helps journalists connect with obesity experts and offers, on an individual basis, free access to its events, including conferences and Obesity Medicine Fundamentals courses.
    • The Obesity Action Coalition offers free access to its magazine, Weight Matters, and guides on weight bias at work and in health care.
    • The American Society for Metabolic and Bariatric Surgery represents surgeons and other health care professionals who work in the field of metabolic and bariatric surgery. It provides the public with resources such as fact sheets and brief explanations of procedures such as the Roux-en-Y Gastric Bypass.

    For further reading

    Weight Stigma in Online News Images: A Visual Content Analysis of Stigma Communication in the Depictions of Individuals with Obesity in U.S. and U.K. News
    Aditi Rao, Rebecca Puhl and Kirstie Farrar. Journal of Health Communication, November 2023.

    Influence and Effects of Weight Stigmatization in Media: A Systematic Review
    James Kite; et al. eClinicalMedicine, June 2022.

    Has the Prevalence of Overweight, Obesity and Central Obesity Leveled Off in the United States? Trends, Patterns, Disparities, and Future Projections for the Obesity Epidemic
    Youfa Wang; et al. International Journal of Epidemiology, June 2020.

    This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.

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  • From banning junk food ads to a sugar tax: with diabetes on the rise, we can’t afford to ignore the evidence any longer

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    There are renewed calls this week for the Australian government to implement a range of measures aimed at improving our diets. These include restrictions on junk food advertising, improvements to food labelling, and a levy on sugary drinks.

    This time the recommendations come from a parliamentary inquiry into diabetes in Australia. Its final report, tabled in parliament on Wednesday, was prepared by a parliamentary committee comprising members from across the political spectrum.

    The release of this report could be an indication that Australia is finally going to implement the evidence-based healthy eating policies public health experts have been recommending for years.

    But we know Australian governments have historically been unwilling to introduce policies the powerful food industry opposes. The question is whether the current government will put the health of Australians above the profits of companies selling unhealthy food.

    benjamas11/Shutterstock

    Diabetes in Australia

    Diabetes is one of the fastest growing chronic health conditions in the nation, with more than 1.3 million people affected. Projections show the number of Australians diagnosed with the condition is set to rise rapidly in coming decades.

    Type 2 diabetes accounts for the vast majority of cases of diabetes. It’s largely preventable, with obesity among the strongest risk factors.

    This latest report makes it clear we need an urgent focus on obesity prevention to reduce the burden of diabetes. Type 2 diabetes and obesity cost the Australian economy billions of dollars each year and preventive solutions are highly cost-effective.

    This means the money spent on preventing obesity and diabetes would save the government huge amounts in health care costs. Prevention is also essential to avoid our health systems being overwhelmed in the future.

    What does the report recommend?

    The report puts forward 23 recommendations for addressing diabetes and obesity. These include:

    • restrictions on the marketing of unhealthy foods to children, including on TV and online
    • improvements to food labelling that would make it easier for people to understand products’ added sugar content
    • a levy on sugary drinks, where products with higher sugar content would be taxed at a higher rate (commonly called a sugar tax).

    These key recommendations echo those prioritised in a range of reports on obesity prevention over the past decade. There’s compelling evidence they’re likely to work.

    Restrictions on unhealthy food marketing

    There was universal support from the committee for the government to consider regulating marketing of unhealthy food to children.

    Public health groups have consistently called for comprehensive mandatory legislation to protect children from exposure to marketing of unhealthy foods and related brands.

    An increasing number of countries, including Chile and the United Kingdom, have legislated unhealthy food marketing restrictions across a range of settings including on TV, online and in supermarkets. There’s evidence comprehensive policies like these are having positive results.

    In Australia, the food industry has made voluntary commitments to reduce some unhealthy food ads directly targeting children. But these promises are widely viewed as ineffective.

    The government is currently conducting a feasibility study on additional options to limit unhealthy food marketing to children.

    But the effectiveness of any new policies will depend on how comprehensive they are. Food companies are likely to rapidly shift their marketing techniques to maximise their impact. If any new government restrictions do not include all marketing channels (such as TV, online and on packaging) and techniques (including both product and brand marketing), they’re likely to fail to adequately protect children.

    Food labelling

    Food regulatory authorities are currently considering a range of improvements to food labelling in Australia.

    For example, food ministers in Australia and New Zealand are soon set to consider mandating the health star rating front-of-pack labelling scheme.

    Public health groups have consistently recommended mandatory implementation of health star ratings as a priority for improving Australian diets. Such changes are likely to result in meaningful improvements to the healthiness of what we eat.

    Regulators are also reviewing potential changes to how added sugar is labelled on product packages. The recommendation from the committee to include added sugar labelling on the front of product packaging is likely to support this ongoing work.

    But changes to food labelling laws are notoriously slow in Australia. And food companies are known to oppose and delay any policy changes that might hurt their profits.

    A woman holding a young boy while looking at products on a supermarket shelf.
    Health star ratings are not compulsory in Australia. BLACKDAY/Shutterstock

    A sugary drinks tax

    Of the report’s 23 recommendations, the sugary drinks levy was the only one that wasn’t universally supported by the committee. The four Liberal and National party members of the committee opposed implementation of this policy.

    As part of their rationale, the dissenting members cited submissions from food industry groups that argued against the measure. This follows a long history of the Liberal party siding with the sugary drinks industry to oppose a levy on their products.

    The dissenting members didn’t acknowledge the strong evidence that a sugary drinks levy has worked as intended in a wide range of countries.

    In the UK, for example, a levy on sugary drinks implemented in 2018 has successfully lowered the sugar content in UK soft drinks and reduced sugar consumption.

    The dissenting committee members argued a sugary drinks levy would hurt families on lower incomes. But previous Australian modelling has shown the two most disadvantaged quintiles would reap the greatest health benefits from such a levy, and accrue the highest savings in health-care costs.

    What happens now?

    Improvements to population diets and prevention of obesity will require a comprehensive and coordinated package of policy reforms.

    Globally, a range of countries facing rising epidemics of obesity and diabetes are starting to take such strong preventive action.

    In Australia, after years of inaction, this week’s report is the latest sign that long-awaited policy change may be near.

    But meaningful and effective policy change will require politicians to listen to the public health evidence rather than the protestations of food companies concerned about their bottom line.

    Gary Sacks, Professor of Public Health Policy, Deakin University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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