To Err Is Human; To Forgive, Healthy
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How To Forgive (And Why)
There’s an old saying that holding onto a grudge is like drinking poison and expecting the other person to die. If only it were so simple and easy as just choosing to let go!
But it’s not, is it?
When people have wronged us and/or wronged our loved ones, it’s hard to forgive, especially if they have not changed. For that matter, it can be hard to forgive ourselves for mistakes that we made, too.
Either way, “drinking that poison” can be close to literal, in terms of what harboring such anger and resentment can do for our cortisol levels.
So, what to do about it?
If you have a dialogue with the person, our previous article on communication may help a lot.
If you don’t, there are various other angles that can be taken:
The Unsent Letter
You can even send it, if you like, but it’s not the point here. The idea is to write to the person, expressing your grievances. But, (as per the above-linked article on communication) try to focus at least as much on your feelings as their actions. “When you did/said x, I felt y”, etc.
This is important for helping you process your feelings. If you send the letter, it’s also important for the other person to be able to understand your feelings.
Sometimes, we feel the things we do so strongly because we don’t have an outlet for them. Pouring out our emotions in such a fashion, on the other hand, means (to labor the metaphor) they’re no longer bottled up. Even just in and of itself, that can provide us a lot of relief.
And when we the negative emotions are no longer such high pressure, it can be easier to let go of them.
Mindfulness
Following on from the above idea, a good strategy can be simply sitting and feeling everything you need to feel, noticing it without judgement, like a curious observer.
Sometimes what we need is just to be heard, and that starts with hearing ourselves.
Compassion
There’s a Buddhist exercise that involves actively feeling compassion for three people: a loved one, a stranger, and an enemy. Many people report that it’s actually harder to feel compassion for a random stranger, than an enemy. Why? Because we don’t know them; we don’t know what’s good and bad about them in our estimation.
If you’re reading this because you want to be able to gain the peace of being able to forgive someone (even if that someone is yourself), then in at least some respect right now, that person is in the “enemy” category. So how do we unpack that?
To err is human. Everybody screws up sometimes. And also, everyone has a reason (or a complex of reasons) for acting the way they do. This does not mean that those reasons excuse the behavior, but it can explain it.
You don’t get angry at a storm for soaking you through. Even if you might not understand the physics of it in the way a meteorologist might, you understand that there were things that led to that, and you were just in the wrong place at the wrong time.
So why do we get angry at someone else for wronging us? Even if we might not understand the personal background of it in the way their psychologist or therapist might, we (hopefully) understand that there were things that caused them to be the way they were, and we were just in the wrong place at the wrong time.
And ourselves? We probably know, when we made a mistake, why we made it. Maybe we were afraid, insecure, reactive, forgetful, or too focused on some other thing. Whatever it was, we did our best at the time and, apparently, our best wasn’t as good as we’d like.
If we didn’t deserve forgiveness, we wouldn’t be critical of our past selves in the first place.
And, the science is very clear that it’s important for our health for other reasons besides cortisol management, too.
And as for others? They did the best they knew how. Maybe they were afraid, insecure, reactive, forgetful, or too focused on some other thing. Same story, different character.
Remembering that can be key to “accepting the apology we never received”.
Forgiving without forgetting
Developing the ability to forgive is a useful tool for our own mental health. It doesn’t mean we must or even should make ourselves a doormat.
“I forgive you” does not have to mean a clean slate; it means remembering that the thing happened, and just not holding on to the anger/resentment associated with it.
It may be water under the bridge now, but it might have been a devastatingly destructive wave at the time, and continuing to acknowledge truth that is sensible. Just, from a position of peace now, hopefully.
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The Magic of L-theanine
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All The Benefits Of Caffeine And More, Without The Drawbacks? What’s The Catch?
It just takes one extra supplement.
For many of us, our morning brew is practically a ritual, but caffeine can also cause all kinds of problems ranging from caffeine jitters to caffeine crashes to caffeine addiction and withdrawal. Surely, something could be better?
Well, yes it could! You doubtlessly know about green tea’s antioxidant properties, but its amino acid, l-theanine (which can be taken as a supplement with coffee, if you don’t enjoy green tea) has so much more to offer:
- L-theanine has been found to reduce stress responses—and let’s face it, when we most want/need a coffee is often when facing stress
- It also reduces anxiety, making it a very safe “downer” without the problems of, for example, alcohol—or other potentially addictive substances
- It’s far more than just that, though! Paradoxically, l-theanine also improves alertness (what other calming things promote alertness? Not so many)
- Part of its trick is that it also improves accuracy—whereas stimulants like caffeine may produce a twitchy, jumpy, responsiveness, l-theanine’s signature effect is a calm state of sharp readiness. Caffeine works by stimulating the adrenal gland and increasing blood pressure, while simultaneously blocking adenosine receptors so that your body doesn’t notice its own tiredness—which is why you’re likely to crash later, when the tiredness that had been masked, all hits at once. Instead, l-theanine taken with caffeine acts as a moderator of that, making for a longer, gentler curve. In terms of subjective experience, what this can mean for many people is: no more caffeine jitters!
- All this means that while l-theanine can boost all kinds of cognitive function, including alertness and accuracy, many like to take in the evening as it can also promote a good night’s sleep, ready to be at your best the next day.
- How much to take? 200mg is a commonly used dosage, which in supplement terms is usually a single capsule. A lot easier to take than the 40 cups of green tea that this dosage would otherwise be!
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What you need to know about H5N1 bird flu
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On May 30, the Centers for Disease Control and Prevention reported that a Michigan dairy worker tested positive for H5N1 bird flu. It was the fourth person to test positive for H5N1 in the United States, following another recent case in Michigan, an April case in Texas, and an initial case in Colorado in 2022.
H5N1 bird flu has been spreading among bird species in the U.S. since 2021, killing millions of wild birds and poultry. In late March 2024, H5N1 bird flu was found in cows for the first time, causing an outbreak in dairy cows across several states.
U.S. public health officials and researchers are particularly concerned about this outbreak because the virus has infected cows and other mammals and has spread from a cow to a human for the first time.
This bird flu strain has shown to not only make wild mammals, including marine mammals and bears, very sick but to also cause high rates of death among species, says Jane Sykes, professor of small animal medicine at the University of California, Davis, School of Veterinary Medicine.
“And now that it has been found in cattle, [it] raises particular concern for spread to all the animal species, including people,” adds Sykes.
Even though the risk for human infection is low and there has never been human-to-human transmission of H5N1, there are several actions you can take to stay protected. Read on to learn more about H5N1 bird flu and the current outbreak.
What is H5N1?
H5N1 is a type of influenza virus that most commonly affects birds, causing them severe respiratory illness and death.
The H5N1 strain first emerged in China in the 1990s, and it has continued to spread around the world since then. In 1997, the virus spread from animals to humans in Hong Kong for the first time, infecting 18 people, six of whom died.
Since 2020, the H5N1 strain has caused “an unprecedented number of deaths in wild birds and poultry in many countries,” according to the World Health Organization.
Even though bird flu is rare in humans, an H5N1 infection can cause mild to severe illness and can be fatal in some cases. It can cause eye infection, upper respiratory symptoms, and pneumonia.
What do we know about the 2024 human cases of H5N1 in the U.S.?
The Michigan worker who tested positive for H5N1 in late May is a dairy worker who was exposed to infected livestock. They were the first to experience respiratory symptoms—including a cough without a fever—during the current outbreak. They were given an antiviral and the CDC says their symptoms are resolving.
The Michigan farm worker who tested positive earlier in May only experienced eye-related symptoms and has already recovered. And the dairy worker who tested positive for the virus in Texas in April only experienced eye redness as well, was treated with an antiviral medication for the flu, and is recovering.
Is H5N1 bird flu in the milk we consume?
The Food and Drug Administration has found traces of H5N1 bird flu virus in raw or unpasteurized milk. However, pasteurized milk is safe to drink.
Pasteurization, the process of heating milk to high temperatures to kill harmful bacteria (which the majority of commercially sold milk goes through), deactivates the virus. In 20 percent of pasteurized milk samples, the FDA found small, inactive (not live nor infectious) traces of the virus, but these fragments do not make pasteurized milk dangerous.
In a recent Infectious Diseases Society of America briefing, Dr. Maximo Brito, a professor at the University of Illinois College of Medicine, said that it’s important for people to avoid “drinking unpasteurized or raw milk [because] there are other diseases, not only influenza, that could be transmitted by drinking unpasteurized milk.”
What can I do to prevent bird flu?
While the risk of H5N1 infection in humans is low, people with exposure to infected animals (like farmworkers) are most at risk. But there are several actions you can take to stay protected.
One of the most important things, according to Sykes, is taking the usual precautions we’ve taken with COVID-19 and other respiratory viruses, including frequent handwashing, especially before eating.
“Handwashing and mask-wearing [are important], just as we learned from the pandemic,” Sykes adds. “And it’s not wearing a mask at all times, but thinking about high-risk situations, like when you’re indoors in a crowded environment, where transmission of respiratory viruses is much more likely to occur.”
There are other steps you can take to prevent H5N1, according to the CDC:
- Avoid direct contact with sick or dead animals, including wild birds and poultry.
- Don’t touch surfaces that may have been contaminated with animal poop, saliva, or mucus.
- Cook poultry and eggs to an internal temperature of 165 degrees Fahrenheit to kill any bacteria or virus, including H5N1. Generally, avoid eating undercooked food.
- Avoid consuming unpasteurized or raw milk or products like cheeses made with raw milk.
- Avoid eating uncooked or undercooked food.
- Poultry and livestock farmers and workers and bird flock owners should wear masks and other personal protective equipment “when in direct or close physical contact with sick birds, livestock, or other animals; carcasses; feces; litter; raw milk; or surfaces and water that might be contaminated with animal excretions from potentially or confirmed infected birds, livestock, or other animals.” (The CDC has more recommendations for this population here.)
Is there a vaccine for H5N1?
The CDC said there are two candidate H5N1 vaccines ready to be made and distributed in case the virus starts to spread from person to person, and the country is now moving forward with plans to produce millions of vaccine doses.
The FDA has approved several bird flu vaccines since 2007. The U.S. has flu vaccines in stockpile through the National Pre-Pandemic Influenza Vaccine Stockpile program, which allows for quick response as strains of the flu virus evolve.
Could this outbreak become a pandemic?
Scientists and researchers are concerned about the possibility of H5N1 spreading among people and causing a pandemic. “Right now, the risk is low, but as time goes on, the potential for mutation to cause widespread human infection increases,” says Sykes.
“I think this virus jumping into cows has shown the urgency to keep tracking [H5N1] a lot more closely now,” Peter Halfmann, research associate professor at the University of Wisconsin-Madison’s Influenza Research Institute tells PGN. “We have our eyes on surveillance now. … We’re keeping a much closer eye, so it’s not going to take us by surprise.”
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Powered by Plants – by Ocean Robbins & Nichole Dandrea-Russert
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Of the two authors, the former is a professional public speaker, and the latter is a professional dietician. As a result, we get a book that is polished and well-presented, while actually having a core of good solid science (backed up with plenty of references).
There’s an introductory section that’s all about the “notable nutrients”, that will be focused on in the ingredients choices for the recipes in the rest of the book.
The recipes themselves are simple enough to do quickly, yet interesting enough that you’ll want to do them, and certainly they contain all the plant-based nutrient-density you might expect.
Bottom line: if you’d like to expand your plant-based cooking with a focus on nutrition and ease without sacrificing fun, then this is a great cookbook for that.
Click here to check out Powered by Plants, and get powered by plants!
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Spermidine For Longevity
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small 😎
❝How much evidence is there behind the longevity-related benefit related to spermidine, and more specifically, does it cause autophagy?❞
A short and simple answer to the latter question: yes, it does:
Spermidine: a physiological autophagy inducer acting as an anti-aging vitamin in humans?
For anyone wondering what autophagy is: it’s when old cells are broken down and consumed by the body to make new ones. Doing this earlier rather than later means that the genetic material is not yet so degraded when it is copied, and so the resultant new cell(s) will be “younger” than if the previous cell(s) had been broken down and recycled when older.
Indeed, we have written previously about senolytic supplements such as fisetin, which specialize in killing senescent (aging) cells earlier:
Fisetin: The Anti-Aging Assassin
As for spermidine and longevity, because of its autophagy-inducing properties, it’s considered a caloric restriction mimetic, that is to say, it has the same effect on a cellular level as caloric restriction. And yes, while it’s not an approach we regularly recommend here (usually preferring intermittent fasting as a CR-mimetic), caloric restriction is a way to fight aging:
Is Cutting Calories The Key To Healthy Long Life?
As for how spermidine achieves similarly:
Spermidine delays aging in humans
However! Both of the scientific papers on spermidine use in humans that we’ve cited so far today have conflict of interests statements made with regard to the funding of the studies, which means there could be some publication bias.
To that end, let’s look at a less glamorous study (e.g. no “in humans” in the title because, like most longevity studies, it’s with non-human animals with naturally short lifespans such as mice and rats), like this one that finds it to be both cardioprotective and neuroprotective and having many anti-aging benefits mediated by inducing autophagy:
A review on polyamines as promising next-generation neuroprotective and anti-aging therapy
(the polyamines in question are spermidine and putrescine, which latter is a similar polyamine)
Lastly, let’s answer a few likely related questions, so that you don’t have to Google them:
Does spermidine come from sperm?
Amongst other places (including some foods, which we’ll come to in a moment), yes, spermidine is normally found in semen (in fact, it’s partly responsible for the normal smell, though other factors influence the overall scent, such as diet, hormones, and other lifestyle factors such as smoking, alcohol use etc) and that is how/where it was first identified.
Does that mean that consuming semen is good for longevity?
Aside from the health benefits of a healthy sex life… No, not really. Semen does contain spermidine (as discussed) as well as some important minerals, but you’d need to consume approximately 1 cup of semen to get the equivalent spermidine you’d get from 1 tbsp of edamame (young soy) beans.
Unless your lifestyle is rather more exciting than this writer’s, it’s a lot easier to get 1 tbsp of edamame beans than 1 cup of semen.
Here are how some top foods stack up, by the way—we admittedly cherry-picked from the near top of the list, but wheatgerm is an even better source, with cheddar cheese and mushrooms (it was shiitake in the study) coming after soy:
Frontiers in Nutrition | Polyamines in Food
Alternatively, if you prefer to just take it in supplement form, here’s an example product on Amazon, giving 5mg per capsule (which is almost as much as the 1 cup of semen or 1 tbsp of edamame that we mentioned earlier).
Enjoy!
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How weight bias in health care can harm patients with obesity: Research
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Patients who weigh more than what medical authorities generally consider healthy often avoid seeing doctors for fear of being judged, insulted or misdiagnosed, decades of research find. Meanwhile, academic studies consistently show many health care professionals discriminate against heavier patients and that weight bias can drive people with obesity to gain weight.
Weight bias refers to negative attitudes, stereotypes and discrimination aimed at individuals with excess body fat. When scholars reviewed 41 studies about weight bias in health care, published from 1989 to 2021, they found it comes in many forms: contemptuous language, inappropriate gestures, expressing a preference for thinner patients, avoiding physical touch and eye contact, and attributing all of a person’s health issues to their weight.
“Weight bias has been reported in physicians, nurses, dietitians, physiotherapists, and psychologists, as well as nutritionists and exercise professionals, and it is as pervasive among medical professionals as it is within the general population,” write the authors of the research review, published in 2021 in the journal Obesity.
That’s a problem considering an estimated 4 out of 10 U.S. adults aged 20 years and older have obesity, a complex and often misunderstood illness that the American Medical Association voted in 2013 to recognize as a disease. By 2030, half of U.S. adults will have obesity, researchers project in a 2020 paper in the International Journal of Epidemiology.
Worldwide, the obesity rate among adults aged 18 and older was 13% in 2016, according to the World Health Organization. If current trends continue, the World Obesity Federation projects that, by 2035, 51% of the global population will be living with overweight or obesity.
The harms of weight bias
Weight stigma — the societal devaluation of people perceived to be carrying excess weight — drives weight bias. It’s so physically and emotionally damaging that a panel of 36 international experts issued a consensus statement in 2020 to raise awareness about and condemn it. Dozens of medical and academic organizations, including 15 scholarly journals, endorsed the document, published in Nature Medicine.
The release of a consensus statement is a significant event in research, considering it represents the collective position that experts in a particular field have taken on an issue, based on an analysis of all the available evidence.
Research to date indicates heavier individuals who experience weight bias and stigma often:
- Avoid doctors and other health care professionals, skipping routine screenings as well as needed treatments.
- Change doctors frequently.
- Are at a higher risk for depression, anxiety, mood disorders and other mental health problems.
- Avoid or put off exercise.
- Consume more food and calories.
- Gain weight.
- Have disrupted sleep.
The consensus statement notes that educating health care providers, journalists, policymakers and others about obesity is key to changing the narrative around the disease.
“Weight stigma is reinforced by misconceived ideas about body-weight regulation and lack of awareness of current scientific evidence,” write the experts, led by Francesco Rubino, the chair of metabolic and bariatric surgery at Kings College London.
“Despite scientific evidence to the contrary, the prevailing view in society is that obesity is a choice that can be reversed by voluntary decisions to eat less and exercise more. These assumptions mislead public health policies, confuse messages in popular media, undermine access to evidence-based treatments, and compromise advances in research.”
Weight bias and stigma appear to stimulate the secretion of the stress hormone cortisol and promote weight gain, researchers write in a 2016 paper published in Obesity.
A. Janet Tomiyama, a psychology professor at UCLA who directs the university’s Dieting, Stress, and Health research lab, describes weight stigma as “a ‘vicious cycle’ — a positive feedback loop wherein weight stigma begets weight gain.”
“This happens through increased eating behavior and increased cortisol secretion governed by behavioral, emotional, and physiological mechanisms, which are theorized to ultimately result in weight gain and difficulty of weight loss,” Tomiyama writes in her 2014 paper, “Weight Stigma is Stressful. A Review of Evidence for the Cyclic Obesity/Weight-Based Stigma Model.”
The consensus statement spotlights 13 recommendations for eliminating weight bias and stigma, some of which are specifically aimed at health care providers, the media, researchers or policymakers. One of the recommendations for the health care community: “[Health care providers] specialized in treating obesity should provide evidence of stigma-free practice skills. Professional bodies should encourage, facilitate, and develop methods to certify knowledge of stigma and its effects, along with stigma-free skills and practices.”
The one recommendation for the media: “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.”
Why obesity is a complicated disease
It’s important to point out that having excess body fat does not, by itself, mean an individual is unhealthy, researchers explain in a 2017 article in The Conversation, which publishes research-based news articles and essays. But it is a major risk factor for cardiovascular disease, including stroke, as well as diabetes, some types of cancer, and musculoskeletal disorders such as osteoarthritis.
Doctors often look at patients’ body mass index — a number that represents their weight in relation to their height — to gauge the amount of fat on their bodies. A BMI of 18.5 to 24.9 is ideal, according to the U.S. Centers for Disease Control and Prevention. A BMI of 25.0 to 29.9, indicates excess body fat, or “overweight,” while a BMI of 30 and above indicates obesity.
In June, the American Medical Association announced a new policy clarifying how BMI can be used to diagnose obesity. Because it’s an imperfect measure for body fat, the organization suggests BMI be used in conjunction with other measures such as a patient’s waist circumference and skin fold thickness.
Two specialists who have been working for years to dispel myths and misconceptions about obesity are Fatima Cody Stanford, an obesity physician and associate professor at Harvard Medical School, and Rebecca Puhl, the deputy director of the Rudd Center for Food Policy and Obesity at the University of Connecticut.
Cody Stanford has called obesity “a brain disease” because the brain tells the body how much to eat and what to do with the food consumed. One pathway in the brain directs the body to eat less and store less fat, she explains in a February 2023 podcast produced by the American Medical Association.
“For people that signal really great down this pathway, they tend to be very lean, not struggle with their weight in the same way that people that have excess weight do,” she says during the podcast, adding that people with obesity receive signals from an alternate pathway that “tells us to eat more and store more.”
Academic studies demonstrate that a wide variety of factors can affect weight regulation, including sleep quality and duration, gut health, genetics, medication, access to healthy foods and even early life experiences.
For example, a 2020 paper in the journal JAMA Network Open suggests female infants born by cesarean delivery have a higher risk of obesity during adulthood than female infants born by vaginal delivery. The study of 33,226 U.S. women born between 1946 and 1964 found that a cesarean delivery is associated with an 11% higher risk of developing obesity and a 46% higher risk of developing type 2 diabetes.
Scholars have also found that traumatic childhood experiences such as abuse and neglect are linked to adult obesity, according to a research review published in 2020.
Income inequality seems to play a role as well. When researchers from the Johns Hopkins Bloomberg School of Public Health studied the link between income inequality and obesity for a sample of 36,665 U.S. adults, they discovered women with lower incomes are more likely to have obesity than women with higher incomes.
Their analysis indicates the opposite is true for men, whose odds of obesity rise with their income, the researchers write in a 2021 paper in the International Journal of Environmental Research and Public Health.
Weight bias among doctor trainees
While scholars have learned a lot about obesity and weight bias in recent decades, the information might not be reaching people training to become doctors. A study published in October finds that some resident physicians believe obesity to be the result of poor choices and weak willpower.
Researchers asked 3,267 resident physicians who graduated from a total of 49 U.S. medical schools a series of questions to gauge their knowledge of obesity and attitudes toward heavier patients. What they learned: Nearly 40% of resident physicians agreed with the statement, “Fat people tend to be fat pretty much through their own fault.” Almost half agreed with the statement, “Some people are fat because they have no willpower.”
The study also reveals that about one-third of participants said they “feel more irritated when treating an obese patient than a non-obese patient.”
“Notably, more than a quarter of residents expressed slight-to-strong agreement with the item ‘I dislike treating obese patients,’” the researchers write.
Another takeaway from the paper: Resident physicians specializing in orthopedic surgery, anesthesiology and urology expressed the highest levels of dislike of heavier patients. Of the 16 medical specialties represented, residents in family medicine, psychiatry and pediatrics reported the lowest levels of dislike.
Kimberly Gudzune, medical director of the American Board of Obesity Medicine, asserts that doctors and medical students need to be educated about obesity. The topic “is grossly neglected” in medical schools and medical training programs worldwide, research has found.
Many physicians don’t understand obesity, Gudzune explains in a July 2023 interview on the internal medicine podcast “The Curbsiders.”
“I think back to when I was a medical student, when I was a resident, I really didn’t learn much about obesity and how to treat it, yet it’s a problem that affects the majority of our patients,” she tells podcast listeners. “I think there’s a lot of evidence out there showing that primary care physicians don’t really know where to start.”
In 2011, the American Board of Obesity Medicine established a program through which doctors could become certified in obesity medicine. Since then, a total of 6,729 U.S. doctors have earned certification, the vast majority of whom specialize in family and internal medicine.
What health care providers think
The experts who created the consensus statement on weight bias and stigma noted health care providers’ shortcomings in the document. They write that the common themes they discovered in the research include “contemptuous, patronizing, and disrespectful treatment” of patients, a lack of training, poor communication and assumptions about weight gain.
Puhl, the deputy director of the Rudd Center at the University of Connecticut, is a pioneer in weight bias research and one of the experts who wrote the consensus statement. During an episode of “The Leading Voices in Food,” a podcast created by Duke University’s World Food Policy Center, she shares details about what she has learned over the years.
“[Health care providers’] views that patients with obesity are lazy or lacking control, are to blame for their weight or noncompliant with treatment,” she says during the interview. “We know, for example, that some physicians spend less time in their appointments with patients [who] have a larger body size. They give them less education about health. They’re more reluctant to perform certain screenings. They talk about treating patients with obesity as being a greater waste of their time than providing care to thinner patients. And we know that patients seem to be aware of these biases from providers and that can really contribute to patients avoiding health care because they just don’t want to repeat those negative experiences of bias.”
To set the record straight, the experts who wrote the the consensus statement listed the following five common assumptions as being “at odds with a definitive body of biological and clinical evidence.”
1. Body weight = calories in – calories out.
This equation oversimplifies the relationship between body weight and energy consumed and used, the experts write. “Both variables of the equation depend on factors additional to just eating and exercising. For instance, energy intake depends on the amount of food consumed, but also on the amount of food-derived energy absorbed through the gastrointestinal tract, which in turn is influenced by multiple factors, such as digestive enzymes, bile acids, microbiota, gut hormones, and neural signals, none of which are under voluntary control.”
2. Obesity is primarily caused by voluntary overeating and a sedentary lifestyle.
According to the experts, overeating and forgoing exercise might be symptoms of obesity rather than the root causes. There are many possible causes and contributors “including geneticand epigenetic factors, foodborne factors, sleep deprivation and circadian dysrhythmia, psychological stress, endocrine disruptors, medications, and intrauterine and intergenerational effects. These factors do not require overeating or physical inactivity to explain excess weight.” they write.
3. Obesity is a lifestyle choice.
“People with obesity typically recognize obesity as a serious health problem, rather than a conscious choice,” the experts write. “Given the negative effects of obesity on quality of life, the well-known risks of serious complications and reduced life expectancy associated with it, it is a misconception to define obesity as a choice.”
4. Obesity is a condition, not a disease.
The criteria generally used to determine disease status “are clearly fulfilled in many individuals with obesity as commonly defined, albeit not all,” the experts explain. “These criteria include specific signs or symptoms (such as increased adiposity), reduced quality of life, and/or increased risk of further illness, complications, and deviation from normal physiology — or well-characterized pathophysiology (for example, inflammation, insulin resistance, and alterations of hormonal signals regulating satiety and appetite).”
5. Severe obesity is usually reversible by voluntarily eating less and exercising more.
“A large body of clinical evidence has shown that voluntary attempts to eat less and exercise more render only modest effects on body weight in most individuals with severe obesity,” the experts write. “When fat mass decreases, the body responds with reduced resting energy expenditure and changes in signals that increase hunger and reduce satiety (for example, leptin, ghrelin). These compensatory metabolic and biologic adaptations promote weight regain and persist for as long as persons are in the reduced-energy state, even if they gain some weight back.”
Health care facility improvements
The expert panel also determined that many health care facilities aren’t equipped to treat people with obesity. Examination gowns, blood pressure cuffs, chairs and examination tables often are too small, patients have reported.
When researchers from the University of Minnesota, Minneapolis Veterans Affairs Medical Center and Mayo Clinic studied the quality of care that patients with obesity receive, they learned that a clinic’s physical environment can have a big effect on a patient’s experience.
They write in a 2015 study published in Obesity Reviews: “Waiting room chairs with armrests can be uncomfortable or too small. Equipment such as scales, blood pressure cuffs, examination gowns and pelvic examination instruments are often designed for use with smaller patients. When larger alternatives are not available, or are stored in a place that suggests infrequent use, it can signal to patients that their size is unusual and that they do not belong. These experiences, which are not delivered with malicious intent, can be humiliating.”
When medical equipment is the wrong size, it may not work correctly. For instance, chances are high that a blood pressure reading will be inaccurate if a health care professional uses a blood pressure cuff that’s too small on a patient with obesity, a 2022 paper finds.
To create a comfortable environment for patients with high body weights, the Rudd Center for Food Policy and Obesity recommends that health care facilities provide, among other things, extra-large exam gowns, chairs that can support more than 300 pounds and do not have arms, and wide exam tables that are bolted to the floor so they don’t move.
The consensus statement also recommends improvements to health care facilities.
“Given the prevalence of obesity and obesity-related diseases,” the 36 international experts write, “appropriate infrastructure for the care and management of people with obesity, including severe obesity, must be standard requirement for accreditation of medical facilities and hospitals.”
Source list:
Weight Bias Among Health Care Professionals: A Systematic Review and Meta-Analysis
Blake J. Lawrence; et al. Obesity, November 2021.Joint International Consensus Statement for Ending Stigma of Obesity
Francesco Rubino, et al. Nature Medicine, March 2020.Perceived Weight Discrimination and Chronic Biochemical Stress: A Population-Based Study Using Cortisol in Scalp Hair
Sarah E. Jackson, Clemens Kirschbaum and Andrew Steptoe. Obesity, December 2016.Weight Stigma is Stressful. A Review of Evidence for the Cyclic Obesity/Weight-Based Stigma Model
A. Janet Tomiyama. Appetite, November 2014.Association of Birth by Cesarean Delivery with Obesity and Type 2 Diabetes Among Adult Women
Jorge E. Chavarro. JAMA Network Open, April 2020.Adverse Childhood Experiences and Adult Obesity: A Systematic Review of Plausible Mechanisms and Meta-Analysis of Cross-Sectional Studies
David A. Wiss and Timothy D. Brewerton. Physiology & Behavior, September 2020.Income Inequality and Obesity among U.S. Adults 1999–2016: Does Sex Matter?
Hossein Zare, Danielle D. Gaskin and Roland J. Thorpe Jr. International Journal of Environmental Research and Public Health, July 2021.Comparisons of Explicit Weight Bias Across Common Clinical Specialties of U.S. Resident Physicians
Samantha R. Philip, Sherecce A. Fields, Michelle Van Ryn and Sean M. Phelan. Journal of General Internal Medicine, October 2023.Impact of Weight Bias and Stigma on Quality of Care and Outcomes for Patients with Obesity
S.M. Phelan; et al. Obesity Reviews, April 2015.One Size Does Not Fit All: Impact of Using A Regular Cuff For All Blood Pressure Measurements
Tammy. M. Brady; et al. Circulation, April 2022.This article first appeared on The Journalist’s Resource and is republished here under a Creative Commons license.
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How the stress of playing chess can be fatal
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The death of a chess player in the middle of a match at the world’s most prestigious competition may have shocked those who view the game as a relaxing pastime. Kurt Meier, 67, collapsed during his final match in the tournament and died in hospital later that day. But chess, like any other game or sport, can lead to an immense amount of stress, which can be bad for a competitor’s physical health too.
We tend to associate playing sport or games with good health and well-being. And there are a countless number of studies showing playing games has an association with feeling happier. While this argument is true for recreational players, the story can be different for the elite, where success and failure are won and lost by the finest margins and where winning can mean funding and a future, and losing can mean poverty and unemployment. If this is the case, can being successful at a sport or game actually be bad for you?
Competitive anxiety
Elite competition can be stressful because the outcome is so important to the competitors. We can measure stress using a whole range of physiological indicators such as heart rate and temperature, and responses such as changes in the intensity of our emotions.
Emotions provide a warning of threat. So if you feel that achieving your goal is going to be difficult, then expect to feel intense emotions. The leading candidate that signals we are experiencing stress is anxiety, characterised by thoughts of worry, fears of dread about performance, along with accompanying physiological responses such as increased heart rate and sweaty palms. If these symptoms are experienced regularly or chronically, then this is clearly detrimental to health.
This stress response is probably not restricted to elite athletes. Intense emotions are linked to trying to achieve important goals and while it isn’t the only situation where it occurs, it is just very noticeable in sport.
The causes of stress
It makes more sense to focus on what the causes of stress are rather than where we experience it. The principle is that the more important the goal is to achieve, then the greater the propensity for the situation to intensify emotions.
Emotions intensify also by the degree of uncertainty and competing, at whatever level of a sport, is uncertain when the opposition is trying its hardest to win the contest and also has a motivation to succeed. The key point is that almost all athletes at any level can suffer bouts of stress, partly due to high levels of motivation.
A stress response is also linked to how performance is judged and reported. Potentially stressful tasks tend to be ones where performance is public and feedback is immediate. In chess – as with most sporting contests – we see who the winner is and can start celebrating success or commiserating failure as soon as the game is over.
There are many tasks which have similar features. Giving a speech in public, taking an academic examination, or taking your driving test are all examples of tasks that can illicit stress. Stress is not restricted to formal tasks but can also include social tasks. Asking a potential partner for a date, hand in marriage, and meeting the in-laws for the first time can be equally stressful.
Winning a contest or going on a date relate to higher-order goals about how we see ourselves. If we define ourselves as “being a good player” or “being attractive or likeable” then contrasting information is likely to associate with unpleasant emotions. You will feel devastated if you are turned down when asking someone out on a date, for instance, and if this was repeated, it could lead to reduced self-esteem and depression.
The key message here is to recognise what your goals are and think about how important they are. If you want to achieve them with a passion and if the act of achieving them leads to intense and sometimes unwanted emotions, then it’s worth thinking about doing some work to manage these emotions.
Andrew Lane, Professor in Sport and Learning, University of Wolverhampton
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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