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LIZANDRASHAW's Photo LIZANDRASHAW Posts: 902
8/1/17 8:14 P

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I really love that you can get a measurable improvement in health with a change in diet in just 7 to 10 days. How awesome!

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An educational initiative at Touro University College of Osteopathic Medicine is reducing medical students' negative attitudes toward people with obesity, a finding researchers hope will translate into better outcomes for patients struggling with weight, according to research published in The Journal of the American Osteopathic Association.

Drawing a parallel to the medical community's approach to common mental illnesses, researchers suggest that shifting physicians' perspective from individual responsibility to a treatable condition may finally slow decades of rising obesity rates.

"We know there are economic, cultural, political and environmental elements causing this problem, yet our approach to treatment puts sole responsibility on the patient's behavior," says Michael Clearfield, DO, Dean of Touro University's College of Osteopathic Medicine. "It's not unlike the way we treated depression 40 years ago. Only, instead of telling people to 'get over it', we say, 'just eat right and exercise.'"

The curriculum, which launched in 2012, measures medical students' attitudes on the Fat Phobia Scale, which identifies biased beliefs in stereotypes, such as obese people are "lazy" and have "poor self-control." The students then received instruction on the causes and treatments of obesity, with follow up testing on their knowledge and attitudes toward obesity for every year of medical school. Those who completed the program significantly reduced their bias by an average of 7 percent.

Changing hearts and minds

Dr. Clearfield noted that confronting physicians' conscious and unconscious biases may change the dynamic for their patients.

"Sometimes physicians don't believe that obese people will take care of themselves, so they spend less time with them and, as a result, they miss things in their examinations," says Dr. Clearfield.

He adds that patients pick up on physicians' attitudes and feel embarrassed and unwelcome, and so they often stop following medical advice and maybe stop going in for checkups all-together.

Touro University's obesity education curriculum focuses on the complexities of obesity, with diet being only one contributing factor. The curriculum also emphasizes a focus on attaining health instead of weight loss, as well as the recognition of incremental improvements.

"With an improved diet, we can get measurably healthier in just 7 to 10 days. From an osteopathic perspective, we need to acknowledge the importance of those small steps so physicians don't give up on patients and patients don't give up on themselves."

Based on the results from the four year study, Touro plans to expand its curriculum to an online platform, making it available to other medical schools and residency programs. Ultimately, they intend to study its impact on patient outcomes.

An alarming history Back in 2000, the obesity rate in the U.S. went from 15 percent -- where it had been for decades -- to nearly 23 percent. Despite two decade-long government programs focused on encouraging weight loss, the rate has steadily risen to between 37 and 38 percent.

Dr. Clearfield sees this as evidence for physicians to reconsider their approach. "I think it's pretty obvious that what we've been doing isn't working."

Story Source:

Materials provided by American Osteopathic Association. Note: Content may be edited for style and length.

Journal Reference:

Gregory G. Gayer, Jennifer Weiss, Michael Clearfield. Fundamentals for an Osteopathic Obesity Designed Study: The Effects of Education on Osteopathic Medical Students’ Attitudes Regarding Obesity. The Journal of the American Osteopathic Association, 2017; 117 (8): 495 DOI: 10.7556/jaoa.2017.099

"Old age is no place for sissies." -- Bette Davis


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7/15/17 1:44 P

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A recent study from the University of Nebraska-Lincoln has given new meaning to the concept of brain power by suggesting that physical strength might stem as much from exercising the nervous system as the muscles it controls.

Over the past few years, researchers have found evidence that lifting more repetitions of lighter weight can build muscle mass just as well as fewer reps of heavier weight. Even so, those who train with heavier weight still see greater gains in strength than those who lift lighter loads.

But if strength differs even when muscle mass does not, what explains the disparity?

Nathaniel Jenkins and his colleagues may have uncovered some answers by measuring how the brain and motor neurons -- cells that send electrical signals to muscle -- adapt to high- vs. low-load weight training. Their study suggests that high-load training better conditions the nervous system to transmit electrical signals from the brain to muscles, increasing the force those muscles can produce to a greater extent than does low-load training.

Muscles contract when they receive electrical signals that originate in the brain's neuron-rich motor cortex. Those signals descend from the cortex to the spinal tract, speeding through the spine while jumping to other motor neurons that then excite muscle fibers.

Jenkins found evidence that the nervous system activates more of those motor neurons -- or excites them more frequently -- when subjected to high-load training. That increased excitation could account for the greater strength gains despite comparable growth in muscle mass.

"If you're trying to increase strength -- whether you're Joe Shmoe, a weekend warrior, a gym rat or an athlete -- training with high loads is going to result in greater strength adaptations," said Jenkins, an assistant professor of exercise physiology at Oklahoma State University who conducted the research for his dissertation at Nebraska.

The dissertation randomly assigned 26 men to train for six weeks on a leg-extension machine loaded with either 80 or 30 percent of the maximum weight they could lift. Three times per week, the participants lifted until they could not complete another repetition. Jenkins was able to replicate the findings of several previous studies, seeing similar growth in muscle between the two groups but a larger strength increase -- roughly 10 pounds' worth -- in the high-load group.

But the researchers also supplied an electric current to the nerve that stimulates the quadriceps muscles used in leg extensions. Even at full effort, most people do not generate 100 percent of the force their muscles can physiologically produce, Jenkins said. By comparing the force of a participant's "hardest" unassisted kick with the maximum force they can generate when aided by electric current, scientists can determine how much of that capacity a person has reached -- a measure known as voluntary activation.

When adjusting for baseline scores, the researchers found that the voluntary activation of the low-load group increased from 90.07 to 90.22 percent -- 0.15 percent -- over a three-week span. The high-load group saw their voluntary activation jump from 90.94 to 93.29 percent, a rise of 2.35 percent.

"During a maximal contraction, it would be advantageous if we are activating -- or more fully activating -- more motor units," Jenkins said. "The result of that should be greater voluntary force production -- an increase in strength. That's consistent with what we're seeing."

Jenkins also tested his hypothesis another way, asking participants from both groups to kick out at 10-percent intervals of their baseline strength -- from 10 percent all the way up to 100 percent -- after three and six weeks. If high-load training does improve muscle efficiency better than low-load training, he reasoned, then high-load lifters should also use a smaller proportion of their strength -- that is, exhibit lower voluntary activation -- when lifting the same relative weight.

That's what the data generally showed. Voluntary activation in the low-load group did decrease slightly, from an average of about 56 percent at baseline to 54.71 percent after six weeks. But it decreased more in the high-load group, dropping from about 57 to 49.43 percent.

"If we see a decrease in voluntary activation at these sub-maximal force levels, that suggests that these guys are more efficient," Jenkins said. "They are able to produce the same force, but they activate fewer motor units to do it."

Placing electrodes on the participants to record the electrical signatures of their quadriceps reinforced those results. High-load training led to a substantially larger drop in electrical activity after six weeks, the study reported, and that activity was lower across most levels of exertion.

"From a practical standpoint, that should make the activities of daily living easier," Jenkins said. "If I'm lifting sub-maximal loads, I should be able to do more repetitions with fewer motor units active, so maybe I fatigue a little bit slower."

Jenkins maintained that low-load training remains a viable option for those looking to simply build mass or avoid putting extreme stress on joints, a priority for older adults and people rehabbing from injury. Still, he said, the new study lends even greater credence to the notion that when it comes to building strength -- especially amid a busy schedule -- heavier is better.

"I don't think anybody would argue (with the idea) that high-load training is more efficient," Jenkins said. "It's more time-efficient. We're seeing greater strength adaptations. And now we're seeing greater neural adaptations."

Jenkins detailed his findings in the journal Frontiers in Physiology. He authored the paper with former doctoral adviser Joel Cramer, associate professor of nutrition and health sciences; Terry Housh, professor of nutrition and health sciences; Nebraska doctoral students Amelia Miramonti, Ethan Hill, Cory Smith; and doctoral graduate Kristen Cochrane-Snyman, now at California State Polytechnic University.

Story Source:

Materials

provided by University of Nebraska-Lincoln.

"Old age is no place for sissies." -- Bette Davis


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7/1/17 1:20 P

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Older, fitter adults experience greater brain activity while learning

Older adults who experience good cardiac fitness may be also keeping their brains in good shape as well.

In what is believed to be the first study of its kind, older adults who scored high on cardiorespiratory fitness (CRF) tests performed better on memory tasks than those who had low CRF. Further, the more fit older adults were, the more active their brain was during learning. These findings appear in the journal Cortex. Difficulty remembering new information represents one of the most common complaints in aging and decreased memory performance is one of the hallmark impairments in Alzheimer's disease.

Healthy young (18-31 years) and older adults (55-74 years) with a wide range of fitness levels walked and jogged on a treadmill while researchers assessed their cardiorespiratory fitness by measuring the ratio of inhaled and exhaled oxygen and carbon dioxide. These participants also underwent MRI scans which collected images of their brain while they learned and remembered names that were associated with pictures of unfamiliar faces.

The researchers found that older adults, when compared to younger adults, had more difficulty learning and remembering the correct name that was associated with each face. Age differences in brain activation were observed during the learning of the face-name pairs, with older adults showing decreased brain activation in some regions and increased brain activation in others. However, the degree to which older adults demonstrated these age-related changes in memory performance and brain activity largely depended on their fitness level. In particular, high fit older adults showed better memory performance and increased brain activity patterns compared to their low fit peers. The increased brain activation in the high fit older adults was observed in brain regions that show typical age-related decline, suggesting fitness may contribute to brain maintenance. Higher fit older adults also had greater activation than young adults in some brain regions, suggesting that fitness may also serve a compensatory role in age-related memory and brain decline.

According to the researchers this study highlights that CRF is not only important for physical health, but is also associated with brain function and memory performance. "Importantly, CRF is a modifiable health factor that can be improved through regular engagement in moderate to vigorous sustained physical activity such as walking, jogging, swimming, or dancing. Therefore, starting an exercise program, regardless of one's age, can not only contribute to the more obvious physical health factors, but may also contribute to memory performance and brain function," explained corresponding author Scott Hayes, PhD, assistant professor of psychiatry at Boston University School of Medicine and the Associate Director of the Neuroimaging Research for Veterans Center at the VA Boston Healthcare System.

The researchers caution that maintaining high levels of fitness through physical activity will not entirely eliminate or cure age- or Alzheimer's disease related decline, but it may slow down the decline. Future studies following individuals' fitness and physical activity levels, memory, and brain function over the course of years would more directly address this issue.

Story Source:

Materials provided by Boston University Medical Center. Note: Content may be edited for style and length.

"Old age is no place for sissies." -- Bette Davis


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6/28/17 11:23 P

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Scientific statement on obesity's causes
June 26, 2017
The Endocrine Society

Summary:
A new Scientific Statement calls for more research aimed specifically at understanding the underlying mechanisms that make it difficult to maintain long-term weight loss.
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FULL STORY
A new Scientific Statement issued by the Endocrine Society calls for more research aimed specifically at understanding the underlying mechanisms that make it difficult to maintain long-term weight loss.

Despite decades of research and billions of dollars spent each year on treatment, understanding of the underlying causes of obesity remains limited. One in three American adults is affected by obesity, and it costs an estimated $147 billion a year to treat obesity and its consequences in the United States, according to the Centers for Disease Control and Prevention.

Growing evidence suggests obesity is a disorder of the body's intricate energy balance systems. Once an individual loses weight, the body typically reduces the amount of energy expended at rest, during exercise and daily activities while increasing hunger. This combination of lower energy expenditure and hunger creates a "perfect metabolic storm" of conditions for weight gain.

"Because of the body's energy balance adjustments, most individuals who successfully lose weight struggle to maintain weight loss over time," said Michael W. Schwartz, M.D., of the University of Washington in Seattle, Wash., and the chair of the task force that authored the Society's Scientific Statement. "To effectively treat obesity, we need to better understand the mechanisms that cause this phenomenon, and to devise interventions that specifically address them. Our therapeutic focus has traditionally been on achieving weight reduction. Most patients can do this; what they have the most trouble with is keeping the weight off."

"Healthcare providers and patients need to view this tendency as the body's expected response to weight loss, rather than as a sign of a failed treatment regimen or noncompliance with treatment," Schwartz said.

The Society's statement also calls for additional research into factors influencing obesity;

Interactions between genetics, developmental influences and the environment. Though a substantial portion of obesity risk is conveyed by genes, researchers have not yet been able to identify all of the relevant genes and to understand the nature of their interactions with developmental processes and the environment.
The effect of endocrine-disrupting chemicals such as bisphenol A on obesity.
The microbiome, or bacteria in the gut, and its interactions with the endocrine and digestive systems as well as the brain.
The reasons behind the therapeutic success of bariatric surgery.
The role that diet composition plays in the development of obesity.
Biological markers and predictors for diabetes, heart disease and other conditions that often develop in conjunction with obesity.
The effects of socioeconomic status on obesity risk.
Brain imaging to better understand appetite and feeding behavior.

Materials provided by The Endocrine Society. Note: Content may be edited for style and length.

"Old age is no place for sissies." -- Bette Davis


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6/17/17 3:34 P

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An hour per week at the gym lowers the risk of metabolic syndrome
Date: June 13, 2017

Less than one hour of resistance exercise training per week lowers the risk of developing metabolic syndrome (cardiovascular risk factors such as overweight, high blood pressure and elevated blood sugar). This was shown by a study involving more than 7,000 participants from the Aerobics Center Longitudinal Study (ACLS) in the USA. The beneficial effects of resistance exercise were independent from the amount of aerobic exercise, such as running or cycling. An international team of researchers, led by Esmée Bakker of Radboudumc published these findings on June 13 on the website of Mayo Clinic Proceedings.

Moderate volumes of aerobic exercise training yield important health benefits. Previous studies showed that only 15 minutes a day of moderate-intensity exercise can lower the risk of premature mortality from cardiovascular disease. Research on the health benefits of exercise is usually based on endurance training, such as running and cycling. Resistance exercise, or weight training was already known to reduce the risk of type 2 diabetes or to improve bone health, but nothing was known about its effects on the development of metabolic syndrome.

Metabolic syndrome

Radboudumc researchers are now collaborating with British, Spanish and American colleagues to study the effects of resistance exercise in 7,418 middle-aged men and women aged who underwent preventive examinations. in a hospital in the United States between 1987 and 2006. At the beginning of the study, all participants were healthy without metabolic syndrome. The researchers looked at the onset of metabolic syndrome.

An hour per week at the gym

During the study, 15 percent of the participants developed metabolic syndrome. Participants who complied with resistance exercise guidelines (two or more sessions per week) had a 17 percent lower risk of developing metabolic syndrome. Resistance exercise for even less than one hour per week was associated with a 29 percent lower risk. The analysis did account for influence of other healthy behaviors, such as smoking and regular endurance training.

More intensive resistance exercise training was not associated with any additional health benefits. It also made little difference if people did resistance exercise only on weekends or spread throughout the week. Doing both resistance and aerobic exercises provided the greatest benefits as the best exercise modality for the prevention of metabolic syndrome.

Doctor's recommendations

"Few studies have reported on the health effects of resistance exercise, and this is the first such study concerning metabolic syndrome," stated Esmée Bakker, the lead author of the study. "Our results indicate that a modest amount of resistance exercise, such as two 30-minute sessions per week, has the most beneficial effect. These findings should be included in the standard medical recommendations for preventing metabolic syndrome and future cardiovascular disease."

Story Source:

Materials provided by Radboud University Nijmegen Medical Centre. Note: Content may be edited for style and length.

Journal Reference:

Esmée A. Bakker, Duck-chul Lee, Xuemei Sui, Enrique G. Artero, Jonatan R. Ruiz, Thijs M.H. Eijsvogels, Carl J. Lavie, Steven N. Blair. Association of Resistance Exercise, Independent of and Combined With Aerobic Exercise, With the Incidence of Metabolic Syndrome. Mayo Clinic Proceedings, 2017; DOI: 10.1016/j.mayocp.2017.02.018

"Old age is no place for sissies." -- Bette Davis


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6/17/17 3:30 P

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Rethinking exercise: Replace punishing workouts with movement that makes you happy
Date: May 23, 2017

Many women start fitness programs to lose weight, and when they don't, they feel like failures and stop exercising.

And then, months or a year later, they do the same thing again -- creating a vicious cycle that fails to consider what might be leading to short-term motivation, says Michelle Segar, director of the University of Michigan's Sport, Health, and Activity Research and Policy Center.

In a new study funded internally by the National Cancer Institute, Segar and co-investigators analyzed what women say makes them feel happy and successful, and how their expectations and beliefs about exercise foster or undermine those things.

"A new understanding of what really motivates women might make an enormous difference in their ability to successfully incorporate physical activity into their daily routine -- and have fun doing it," said Segar, who is also a researcher at the U-M Institute for Research on Women and Gender.

The findings, which will appear in the journal BMC Public Health, show that both active and inactive women report the same ingredients for feeling happy and successful:

Connecting with and helping others be happy and successful.

Being relaxed and free of pressures during their leisure time. Accomplishing goals of many sorts (from grocery shopping to career goals).

But the study also found that for inactive women, their beliefs and expectations about exercise actually thwarted the things that make them feel happy and successful:

They believe "valid" exercise must be intense, yet they want to feel relaxed during their leisure time.

They feel pressured to exercise for health or to lose weight, yet during their leisure time they want to be free of pressures. Success comes from achieving goals, yet their expectations about how much, where and how they should be exercising means they can't achieve these goals.

"The direct conflict between what these low-active women believe they should be doing when they exercise, and their desire to decompress and renew themselves during leisure time, demotivates them," Segar said. "Their beliefs about what exercise should consist of and their past negative experiences about what it feels like actually prevents them from successfully adopting and sustaining physically active lives."

Segar and co-investigators Jennifer Taber, Heather Patrick, Chan Thai and April Oh conducted eight focus groups among white, black and Hispanic women aged 22-49 who were either categorized as "high active" or "low active."

While the findings about happiness and success seemed to hold true for both groups in the different demographics, low-active women held distinctly different views than high-active women about exercising.

"We've all been socialized to exercise and be physically active for the last 30 years," said Segar. "The traditional recommendation we've learned to believe is that we should exercise at a high intensity for at least 30 minutes, for the purpose of losing weight or improving our health. Even though there are newer recommendations that permit lower intensity activity in shorter durations most people don't know or even believe it."

This more traditional message has worked for a small minority of the population, but more generally it has failed to increase population physical activity, she says.

"This traditional approach to exercising might actually harm exercise motivation. Our study shows that this exercise message conflicts with and undermines the very experiences and goals most women have for themselves," she said.

The exceptions found in the study were among the more active participants, who held more flexible views of exercise. They expressed that it "was not the end of the world" if they had to skip exercising once in awhile. They made exercise more of a "middle priority," which took the pressure off and left room for compromise when schedules and responsibilities did not permit planned exercise to occur.

The high-active women seemed to have more positive feelings from exercising, in contrast to most of the low-active women, who, in general, tended to dread the very idea of it.

"There are important implications from this study on how we can help women better prioritize exercise in their day-to-day life," Segar said. "We need to re-educate women they can move in ways that will renew instead of exhaust them, and more effectively get the message across that any movement is better than nothing. To increase motivation to be physically active, we need to help women to want to exercise instead of feeling like they should do it."

This can be achieved by:

Re-educating women that movement can and should feel good to do.
Promoting physical activity as a way to connect with important others.

Reframing physical activity as a vehicle that helps women renew and re-energize themselves to better succeed at their daily roles and goals.

Explain physical activity as a broad continuum that counts all movement as valid and worth doing.

Story Source:

Materials provided by University of Michigan. Note: Content may be edited for style and length.

Journal Reference:

Michelle Segar, Jennifer M. Taber, Heather Patrick, Chan L. Thai, April Oh. Rethinking physical activity communication: using focus groups to understand women’s goals, values, and beliefs to improve public health. BMC Public Health, 2017; 17 (1) DOI: 10.1186/s12889-017-4361-1

"Old age is no place for sissies." -- Bette Davis


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5/13/17 3:57 P

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Couch potatoes face same chance of dementia as those with genetic risk factors: Research
January 10, 2017
Source: McMaster University

Sedentary older adults with no genetic risk factors for dementia may be just as likely to develop the disease as those who are genetically predisposed, according to a major study which followed more than 1,600 Canadians over five years.

The findings, published in the Journal of Alzheimer's Disease, shed new light on the relationship between genes, lifestyle risk factors and dementia.

Researchers, who tracked participants in the Canadian Study of Health and Aging, found that while carriers of a variant of the 'apolipoprotein E' genotype are more likely to develop dementia, inactivity dramatically increases the risk for non-carriers.

"The important message here is that being inactive may completely negate the protective effects of a healthy set of genes," says Jennifer Heisz, an assistant professor in the Department of Kinesiology at McMaster University and co-author of the study.

"Given that most individuals are not at genetic risk, physical exercise may be an effective prevention strategy, " she says.

Approximately 47.5-million people worldwide are living with dementia. That number is expected to surge to 115.4 million by the year 2050. With no known cure, there is an urgent need to explore, identify and change lifestyle factors that can reduce dementia risk, say researchers.

"Although age is an important marker for dementia, there is more and more research showing the link between genetic and lifestyle factors," said Parminder Raina, a co-author and professor in the Department of Health Evidence and Impact at McMaster. "This research shows that exercise can mitigate the risk of dementia for people without the variant of the apolipoprotein genotype. However, more research is needed to determine the implications from a public health perspective."

"A physically active lifestyle helps the brain operate more effectively. However, if a physician were to ask us today what type of exercise to prescribe for a patient to reduce the risk of dementia, the honest answer is 'we really don't know'," says Barbara Fenesi, a postdoctoral fellow at McMaster University and lead author on the study.

In a separate ongoing study, researchers are comparing the possible benefits of high-intensity training (HIIT) versus moderate continuous training (MCT) and stretching in older adults.

"Old age is no place for sissies." -- Bette Davis


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