MADISON, W.Va. (AP) — If you want to understand why U.S. life expectancy is declining, West Virginia is a good place to start.
The state is a bellwether of bad health, portending major problems years before they became severe nationally.
“It seems that the worst outcomes happen here first,” said Dr. Michael Brumage, a West Virginia University public health expert who formerly ran the health department in Charleston. “We’re the canary in the coal mine.”
The drug overdose death rate for all Americans today is where West Virginia’s rate was 10 years ago. The nation’s suicide rate is where West Virginia’s was nearly 20 years ago.
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Obesity was common in West Virginia before it became widespread in the rest of the country. And life expectancy started tumbling in the Mountain State before it began falling across the U.S.
Maggie Hill has lived in the state for all of her 67 years. Sitting in her cabin in the town of Madison recently, she ticked off the many deaths that have befallen her family: An older brother drowned in a flood in 1977. A sister died in a house fire. Two siblings, both smokers, died of lung cancer. Two others were stillborn. Her first husband died of congestive heart failure.
Then there were the suicides. Two of her three sons shot themselves to death, one of them after losing his job. Her second husband died the same way, using a gun in their bedroom closet one Sunday morning while she was still in bed.
“I don’t think people have a lot to live for,” she said. “I really and truly don’t see things getting better.”
After decades of steady increases, U.S. life expectancy has been declining since 2014. A government report released last month said the trend continued last year, driven in part by suicides and drug overdoses — the so-called diseases of despair.
What else is driving the decline? Experts say America’s obesity problem has worsened the diabetes death rate and helped stall progress against the nation’s leading killer, heart disease.
West Virginia eclipses most other states in the percentage of people affected by diabetes, heart disease and obesity. It has had the nation’s highest rate of drug overdose deaths for years running. It also has the highest obesity rate and the highest rates of diabetes and high blood pressure. Adding to those woes is the highest suicide rate among states east of the Mississippi River.
Earlier this fall, U.S. health officials released for the first time life expectancy predictions at a neighborhood level. An Associated Press analysis of the data found wide disparities in cities and towns. Among states, the AP found, Hawaii had the highest life expectancy. West Virginia was the second lowest, behind Mississippi.
Mississippi, Oklahoma and a few other states suffer death and disease rates that are about as bad — or sometimes worse. But those places have unusually large populations of low-income black or Native American people, who suffer a disproportionate share of disability, disease and death.
West Virginia is 94 percent white. That makes it a telling indicator. Nearly 80 percent of the Americans who die each year are white people, and death rates rose in white men and women last year but were flat or falling in blacks and Hispanics.
So white deaths — particularly those of people who are not elderly — are mainly responsible for the nation’s declining life expectancy.
Ten years ago, The Associated Press described Huntington, West Virginia, and its environs as the unhealthiest place in America , based on health survey data from the Centers for Disease Control and Prevention that put it at the bottom of the charts in more than a half-dozen measures, including the highest proportions of people who were obese, had diabetes and had heart disease.
The AP report, and others like it, drew widespread attention that peaked in 2010, when celebrity chef Jamie Oliver staged a reality TV show in Huntington to teach people how to eat better.
The attention was not entirely welcomed. It felt like outsiders coming in to criticize and perpetuate “hillbilly” stereotypes, said Steve Williams, who was elected Huntington’s mayor in 2012.
But Williams said it also was motivating, prompting changes in school food and even improvements to parks and sidewalks.
“We get slammed all the time with obesity,” said Andy Fischer, a financial adviser who organized a 2,500-person community walking program. “We’ve got to get better.”
These days, the Huntington area looks somewhat better in government health surveys. For example, the region’s obesity rate is only a few percentage points above the national median — instead of 10 or 20 points.
That said, it’s clear the Huntington area still has some big problems. It ranks among the worst metro areas in measures like the percentage of adults who smoke, have high blood pressure and have had a stroke.
OPIOIDS AND OBESITY
About the time Huntington was trying to tackle its weight problem, it was rocked by a new crisis — opioid addiction.
West Virginia now has the distinction of having the nation’s highest drug overdose death rate. Last year, for the first time, the state’s body count surpassed 1,000. The epidemic also produced ripple effects such as a spike in the number of children taken into foster care because of dead or addicted parents.
In the last two years, no West Virginia county has seen more overdose deaths than Cabell County, which includes Huntington.
One of the grimmest spots has been Huntington’s West End — some locals call it “the Worst End.” The AP analysis of neighborhood-level death data found the area had a life expectancy at birth of only 62 years, 16 years shorter than national life expectancy.
Huntington’s reputation crystalized on a chaotic Monday in August 2016, when emergency responders saw 28 overdoses over six hours — including two deaths.
The city soon became known as America’s overdose capital. As documentary crews descended, Huntington tried to confront the problem. Among the efforts were quick-response teams charged with finding people days after they were treated for an overdose. The teams include a police officer, a clergy member, a paramedic and a treatment counselor who hand out overdose-reversing naloxone and provide information about treatment. They also direct people to a needle-exchange program run by the Cabell-Huntington Health Department.
One of the key figures in the program is Thommy Hill, a former drug dealer who has become its gatekeeper and central cog. He knows every drug user who visits and constantly tries to persuade them to try treatment — arranging immediate transportation and handing them a backpack full of clothes if they agree.
One morning in late October, bantering with a man who had come in for fresh needles, Hill lit up when the visitor mentioned a past vacation. Hill pitched him a one-week stay at a treatment hospital, joking that “people will wait on you hand and foot.”
A few minutes later, he explained: “It’s all about treating them like people. They don’t get a lot of that.”
Something seems to be working. Non-fatal overdoses in Huntington have fallen and are on track to be 40 percent lower than 2017, city officials said. They are optimistic deaths will be down this year, too.
“If we can turn around overdose numbers here, we can do it anywhere,” Surgeon General Dr. Jerome Adams said in May at a health summit in Huntington.
Politicians including President Donald Trump have decried the opioid epidemic, prioritizing it over other health crises. But obesity still presents a towering threat.
West Virginians exercise less than other Americans. They eat fruits and vegetables less often. Only Mississippi has a larger proportion of adults drinking soda and other sugar-sweetened beverages each day.
In some cases, state policies are not helping.
For example, bariatric surgery can help certain obese people for whom conventional diet and exercise programs have no lasting effect. But West Virginia’s Medicaid program has unusually harsh cost-control barriers that make it difficult for severely obese people to get approved for surgery, according to a recent analysis by George Washington University.
Then there’s the soda tax, which health advocates say can give consumers second thoughts about choosing those drinks. Last year, Gov. Jim Justice proposed raising it from 1 cent per 16.9-ounce bottle to a penny per ounce. It failed in the Republican-controlled Legislature.
SIGNS OF CHANGE
There are some signs of hope in West Virginia. In October, health advocates held a conference on obesity in the South in West Virginia’s capital city. It was a surprisingly upbeat meeting.
The South has long had the highest obesity rates in the country, and nowhere has adult obesity been more common than in West Virginia. But future-focused projects are popping up all over the state, aimed at getting kids to embrace exercise and healthy eating.
“We want to give people hope that we can be knocked off the unhealthiest list” of states, said Kayla Wright, director of an organization called Try This West Virginia that’s funding many of them.
One grant paid for high school students to build a 5K trail and explore creating a teen cross-country running group. Another grant went toward restoring a greenhouse and helping people learn to garden.
Many of the projects are baby steps, but conference participants cited a few places where progress seems broader. Huntington is one, they say.
Another is Mingo County, in the southwest corner of the state, deep in the heart of coal country. Life expectancy there has never been high. Jobs in the lumber and coal industries were notoriously dangerous. Doctors could be hard to find. And there was violence: The deadly Hatfield-McCoy feud played out in those hills, as did bloody labor battles between miners and coal companies.
The largest municipality in the county, Williamson, became known in the last decade as a center for the abuse of prescription opioid painkillers. (Some called the 3,000-person town “Pilliamson.”)
But while the drug crisis was playing out, some local leaders — led by a young doctor named C. Donovan “Dino” Beckett — built a series of programs aimed at creating a culture of health. It started seven years ago with the opening of a free clinic that later became the Williams Health and Wellness Center. That spawned a community garden and a vegetable delivery service, a running club and once-a-month 5K races that draw a few hundred runners. Also in the works, for next year, is a federally funded treatment program for people addicted to drugs.
So far, perhaps the most successful program is one that sends health workers to the homes of diabetics.
Jamie Muncy is one success story.
The 48-year-old lost his job three years ago when the mine he was working in shut down. Last fall, he had just pulled out of a long-term habit of pain pills and other drugs when he bizarrely tore a tendon in his foot while picking up a piece of paper at a post office.
It was so painful he rarely walked, but he continued to eat terribly. Out of a job and with his marriage in ruins, “I had no motivation” to be healthy, he said. “I didn’t care.”
By January, the 5-foot-3 former mine foreman ballooned from 165 pounds to 196. “I was round as I was tall,” he said.
A visit to the Williamson health center revealed he had alarming, diabetes-qualifying blood sugar levels. He’d had mini-strokes in the past, and his physician said a much bigger one was probably on its way if Muncy did not take drastic steps.
The doctor put him on a tight carb-cutting diet, connected him to physical therapy and put him in the home-visit diabetes program.
Now Muncy walks 5 miles a day and is a regular at the farmer’s market. His weight is down to about 145 pounds, he said in a recent interview. He still smokes, though.
AN UNCERTAIN FUTURE
University of Washington researchers recently calculated something called “healthy life expectancy” — the period someone born today could expect to live in relative health. West Virginia, at 62½ years, was the lowest among states.
Clearly, health problems abound.
Black lung disease rates and coal mine injury rates appear to be up.
West Virginia has been at the top of the charts in hepatitis B and C infection rates. Adding to that, the state saw an HIV outbreak last year, and it is still weathering a hepatitis A outbreak — both associated with injection drug users
Maggie Hill, the lifelong West Virginian, has little hope for the future. But she does have Charity.
Charity is a 10-year-old girl Hill adopted about five years ago. Hill’s son had been raising her but lost custody during his ongoing struggle with drug addiction, Hill said.
Hill and Charity live in a small wooded valley with a creek in it — a holler, as they say in West Virginia. Her house is a cabin that from the outside resembles a small, tidy barn. Charity has given her life a purpose, she said.
“I taught her how to survive when I’m gone,” she said. “I have to. She’s going to need to know how to cook. … She needs to know how to keep house. She needs to know how to mow grass, so if she ain’t got a man, she can keep the yard clean. I teach her every bit of this.”
Charity is a good student (“Four A’s and a B on her last report card,” Hill said). And there’s hope that she will do well enough to go to college. Hill is saving for it. “She wants to be a doctor,” Hill said.
If Charity does go to college, some place away from Boone County, Hill says she will move there with her. “If I’m alive,” she said.
AP data journalist Nicky Forster contributed from New York.
The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.
Source: Associated Press
There are tons of supplements out there, promising to do everything from helping power your rides to helping you drop some pounds. But if there’s one thing that’s been proven time and again, it’s that there is no magic pill for weight loss. And yet, “quick fixes” like detox teas keep popping up everywhere.
One we’ve seen recently? Garcinia cambogia extract-an ingredient most commonly found in weight-loss supplements. So what exactly is the deal with this extract? Will it actually work in conjunction with riding and cross training to help you shed a few pounds? Or is it simply another trend? Here’s everything you need to know.
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What exactly is garcinia cambogia?
Garcinia cambogia-a.k.a. Malabar tamarind-is a fruit commonly grown in India and Southeast Asia, according to the National Center for Complementary and Integrative Health (NCCIH). The rind of the fruit is often used to flavor curries and to preserve food.
That rind, however, also contains a chemical called hydroxycitric acid (HCA), which is where the plant’s weight-loss claims come into play-HCA has been studied for weight loss through appetite suppression, per the NCCIH (which is why supplements that contain garcinia cambogia extract are also thought to help you lose weight).
Can garcinia cambogia help you lose weight?
While, yes, there have been studies on garcinia cambogia and weight loss, they haven’t necessarily been reliable (nor are they recent, for that matter).
In a research review set to be published in 2019, researchers found that only five randomized, controlled studies of garcinia cambogia’s effect on weight loss have been done in the last 50 years, according to Scott Kahan, M.D., M.P.H., director of the National Center for Weight & Wellness, who carried out the study. (There have been more than 14,000 studies on unfounded therapies for weight loss in that time, he says.)
What’s more, in those five studies, participants saw very little weight loss. “The most positive study showed that several months of taking garcinia cambogia may lead to one pound of weight loss, at best,” says Kahan-placebo pills were usually more effective.
Is garcinia cambogia harmful?
According to Kahan’s research, there are very few severe side effects of garcina cambogia- he only found a few examples of diarrhea, brain fog and, in rare cases, liver damage. And according to the NCCIH, garcinia cambogia is pretty safe for short-term use (12 weeks or fewer).
But while garcinia cambogia itself may not be terrible, the ingredients it comes packaged with in some weight-loss supplements can be.
In 2017, for example, the Food and Drug Administration (FDA) issued a warning about the weight-loss supplement Fruta Planta Life, which is marketed as “Garcinia Cambogia Premium” and contains garcinia cambogia extract and sibutramine (Meridia), an appetite suppressant that was removed from the market in 2010 due to safety concerns. Sibutramine had been shown to increase the risk of heart attack and stroke, cause jaundice, and trigger seizures-pretty nasty stuff.
Another thing to note: since garcinia cambogia extract diet pills are supplements, not drugs, the FDA doesn’t regulate their use or review their effectiveness or safety unless their use becomes linked to multiple hospitalizations, says Sue Decotiis, M.D., a medical weight-loss expert. That means that it’s up to manufacturers to decide how much garcinia cambogia extract their pills pack, as well as what other health-impacting ingredients (like sibutramine) are added to the mix.
Here’s the bottom line.
It’s best to skip garcinia cambogia. Possible side effects aside, Kahan says any weight-loss supplement containing garcinia cambogia is a waste of money.
And honestly, that goes for weight-loss supplements in general. “Unlike medical therapies, supplements and various diets and practices are not bound by strict requirements for clinical evaluation and evidence,” says Kahan, adding that “it’s unlikely that all the advertised claims are true.”
Basically, diet supplements-including ones containing garcinia cambogia-aren’t worth the risk or money. If you want to lose weight, speak to your doctor first, and focus on combining a healthy, balanced diet with regular exercise, suggests Kahan.
Tara Sol managed to lose weight and change her life in less than a year, but achieving her healthy state was a surprise to Sol herself. “I’d only ever known being overweight,” Sol tells PEOPLE.
She was raised in a household where her diet was primarily convenience foods, like drive-through pickups or pre-packaged microwavable meals. In her family, their Friday tradition was to go to an all-you-can eat buffet, and food was often used as the way her family bonded.
“I saw food used as comfort within my own sister and parents. We’d just sit in front of the TV and I’d eat a half a bag of chips or a box of cookies, or popcorn,” Sol tells PEOPLE. “Also, it was for sure how my dad showed love or affection. It was getting us a candy barwhen we’d go through the cashier line—he would always do that sort of stuff for us. If I got a good report card, I got to choose my restaurant for dinner.”
Once she became an adult, the 36-year-old mother of six began sneaking food and eating it in secret before she would dine with the rest of her family.
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“I would grab a handful of cookies and eat them and then it would be time for us to have dessert and I would eat it,” Sol says. “Nobody knew I already had the four cookies.”
At her heaviest, Sol weighed 261 lbs. “Walking for five minutes was a challenge,” she says. “I couldn’t even bend over to tie my own shoe. That’s how overweight I was.”
Often, she was bullied for her weight, causing her to be “a very introverted and hidden person.”
“I had this dream where I was just in a fat suit, and I could just unzip my suit and walk out and look at the person, and reveal myself to all of those people that would bully me and say mean things about me,” she says. “I’d say, ‘But look at who I really am.’”
Although she had avoided doctors for most of her life because she “didn’t like having to get put on a scale,” in 2014, as a social worker who was employed by a hospital, she had to visit the doctor for routine blood work and they discovered her blood sugar levels were off the charts. They diagnosed her with pre-diabetes before she had her full testing done that gave her a definitive Type 2 Diabetes diagnosis.
“I was in significant denial about my condition and though I took the medication, I did not change my diet or tell a single person about my diabetes diagnosis,” Sol says. “I even stopped going to my doctor. I was lucky that she happened to refill my prescription for a couple of years.”
Sol’s doctor wrote her a letter informing her that she would stop prescribing her oral medications if she didn’t come in for an office visit. “That finally was my rock bottom.”
So the next day, Sol signed up for Real Appeal, a digital weight loss program that provides you with a personal wellness coach, diet tracking, exercise programs, and online group sessions to help you meet your goals. She was initially drawn to this program because she didn’t have to go to weigh-ins in front of other people.
She visited her doctor and asked her for a three-month extension on her prescription refill, and told her about her new weight loss commitment.
Sol started with small, achievable goals, such as moving her body for 60 minutes each day and cardio workouts she could do in her own home. Within three months of starting the program, Sol’s labs were normal and she no longer had Type 2 Diabetes.
“My doctor actually called the lab to make sure it wasn’t an error,” Sol says. “My labs were just so different in just that three months.”
On the first day of her lifestyle change, Sol also set a goal to walk 1,000 miles in one year—a goal she achieved in just 140 days.
“I was getting little bits of hope,” Sol said. “I was getting these tangible, actual, true things that were validating what I was doing and it fueled my fire and I just also wanted to obviously keep going and getting better and better. I made this commitment to my doctor and I wanted to show her I was keeping my end of the deal.”
In just ten and a half months, Sol reached her goal weight, losing 114 lbs. Today, she’s maintaining a healthy weight of 144 lbs., but she says she’s not “hyper focused on a number on the scale.”
In early 2018, Sol had a skin removal surgery, and now, on top of walking, she enjoys mountain biking, hiking and interval training. She also tracks her calories in MyFitnessPal to maintain her healthy eating habits, and tries to slow down when she’s eating a plate of food.
“I can’t be mindless about what I put in my mouth,” she says, but admits that she still loves food and isn’t afraid to indulge every now and then.
She also says her husband and children have been supportive through the journey, and her healthy eating habits have influenced them.
“I want to be a role model,” she says. “They’ve gotten an understanding of what a healthy lifestyle is by being able to watch my transformation.”
She also adds that her weight loss has allowed her to be a more present mom. For Christmas, her family gives experiences instead of gifts, and she’s been able to participate in fun things like snowshoeing and laser tag, which she couldn’t do before.
“They don’t lose me to the bag of chips while I’m vegging out to the Real Housewives on TV,” Sol says. “They actually get a mom that wants to be more interactive with them. I have energy.”
Aside from her family, Sol says that since losing the weight, her life has changed “in any possible way it could change.”
“That whole concept of ‘if you can’t love yourself, no one else can love you’ is so true,” she says. “[I have] better self esteem, and feel that I am worthy of love and affection and people’s attention. Because I feel so much better about myself and I’ve gotten rid of so much of that hate and shame, it’s definitely just changed my world in that I allow people to be part of my life and my journey now where I never did before.”
Ordering through a food delivery service can be a hit-or-miss situation. It could take hours. The restaurant might get your order wrong. Perhaps the food is cold by the time it makes it to your door. I solemnly swear never to complain again about any of these harmless annoyances, though, because a man reportedly found DIRTY UNDERWEAR inside his Uber Eats bag.
According to WFLA, a man named Leo (who asked that his last name not be printed) recently ordered dinner from a Japanese restaurant nearby to his Florida hotel. When the order arrived, he reportedly met the Uber Eats driver outside of the hotel to pick up the food. Leo told the station: “I grabbed the food and right when I got the food she took off running and I was like, ‘that was kind of odd.'”
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Once back in his hotel room, Leo opened the plastic bag to find his food in a brown paper bag-allegedly sitting beside a pair of “thigh-length underwear, clearly stained with what looked like feces.” Initially, Leo thought it was a fancy napkin when he was pulling out the underwear, Newsweek reports. “Disgusting, unhealthful, it’s potentially deadly,” he said.
Per Newsweek, Leo threw the underwear back in the bag and contacted Uber, the restaurant he ordered from, and the police department. All those he spoke to reportedly expressed sympathy, but said there was little they could do about it.
Delish reached out to Uber for more information regarding the incident and we will update this post as we hear back. In a statement to Newsweek, Uber noted that Leo was given a full refund and “the suspect delivery driver had no prior complaints against her.” A spokesperson for Uber also said, “What’s been reported is very concerning. We are reviewing this order and reaching out to all parties involved to help understand what may have occurred. The courier has been removed from the app pending investigation.”
Leo also requested the Bal Harbor Police Department document the incident on a police report, though a BHPD rep told Newsweek, “No other police action is being taken at this time.”
Now that I’ve thoroughly disgusted you out of ordering delivery tonight, here are all kinds of delicious dinners you can make yourself.
Spot quiz: What is the only subject in school that engages a child’s mind, body, and spirit, promotes their physical and emotional health, helps them to learn better and cultivates the character they need to become productive adults? And what subject is consistently underfunded, understaffed and underscheduled?
If you answered physical education to both questions, you get an A grade.
At a time when American children are increasingly absorbed in their screens and one-third are overweight, the need for robust physical education is acute. Last month, the federal government updated its recommendations for physical activity for the first time in 10 years. The guidelines now include recommendations for children as young as age 3, and advise a minimum of 60 minutes per day of moderate to vigorous activity for ages 6-17. Alas, only one in five teenagers meets this standard.
Inactivity has been called “the new smoking,” and the prevalence of obesity and inactivity may well mean children today will lead shorter lifespans than their parents. Children desperately need to learn the importance of physical fitness, how to achieve it, and how to maintain it. Well-taught physical education keeps students moving and motivated, building their competence and confidence so that they can stay fit over a lifetime.
Funding for PE classes is shockingly low
Alas, just when children need it most, PE has slipped to the bottom of the curricular ladder in all too many school districts. It is profoundly shocking that the median PE budget for American schools is only $764 a year, according to the Society of Health and Physical Educators. In a school of 500 students, that means only $1.50 per child for PE, when total per pupil annual expenditures in our public schools often exceeds $12,000.
This is of special concern in the inner city, where families have few fitness resources outside of school. But it is troubling everywhere, as a perfect storm of circumstances has conspired to minimize activity in children’s lives, not only putting them at risk for life-threatening diseases later on, but depriving them of the mental and cognitive benefits we know exercise provides. Harvard neuropsychiatrist John Ratey has called exercise “Miracle-Gro for the brain,” and hundreds of studies show exercise enhances learning as well as emotional healthand social development.
We are also putting unfit children at financial risk as adults. Researchers at Johns Hopkins University have calculated that an overweight individual’s lifetime medical expenses related to his or her excess weight average $62,331, and lost wages around $93,100, roughly double the costs for a person of healthy weight — and enough money to put a child through college or make a down payment on a house.
Traditionally, schools have been instrumental in supporting children’s health, because they are uniquely positioned to reach the maximum number of children over a 12-year period. They help to ensure students are immunized, provide health screenings, and strive to serve nutritional meals. Physical education is every bit as important as the right shots and eating your vegetables, and yet not one state follows the Centers for Disease Control recommendations for time spent in PE at all grade levels. Some children with the means and desire to play sports get exercise that way, but the reality is that 70 percent of children drop out of organized sports by age 13.
Studies show kids in PE continue healthy habits
By contrast, regular PE class means all children can access the myriad benefits exercise provides until they reach adulthood – and beyond. According to the Physical Activity Council, children who have physical education in school are twice as likely to be active outside PE class and to remain active when they become adults. Correlation does not equate to cause, but it makes sense that children who learn good fitness habits in school will practice them out of school, and that a fit childhood sets a foundation for fitness as an adult.
While I appreciate the competing concerns schools must prioritize today, I believe it is time to make physical education a core subject on equal footing with academic classes. It is well established that children have a right to a quality education, and physical education is a fundamental aspect of that right, giving children the knowledge they need to stay healthy and equipping them for life’s challenges by teaching persistence, resilience, and positive thinking.
Our country boasts one of the highest standards of living in the world. Surely we can find a way to give our kids the gift of physical education and fitness. We did it in the past, when schools rallied behind JFK’s call for a fit nation as “a vital prerequisite to America’s realization of its full potential,” and we can do it again today. Indeed, some schools already have, and we can learn from them. All it takes is the will to make it happen, and Americans have always had plenty of that.
William E. Simon Jr., a former assistant U.S. attorney and the 2002 Republican nominee for governor of California, is co-founder of UCLA Health Sound Body Sound Mind and the author of “Break a Sweat, Change Your Life: The Urgent Need for Physical Education in Schools.”
You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @usatodayopinion and in our daily Opinion newsletter. To respond to a column, submit a comment to [email protected]
This article originally appeared on USA TODAY
If you’re one of the millions of people who vow to begin a new eating regime on January 1, the potential weight-loss plans are endless. And as you scroll through your Instagram feed, you’ll likely to see people touting the “amazing” diet that has shrunk their waistlines, boosted their stamina, and taken years off their appearance.
Two of the trendy diets over the last couple of years include keto and paleo. But before you select your 2019 menu, here’s what you need to know about these somewhat similar plans:
Keto Diet 101
Otherwise known as the diet Halle Berry, Vanessa Hudgens, Alicia Vikander, and even Tim Tebow swear by, the ketogenic diet is a low-carb, high-fat plan that forces the body into a state of ketosis, a metabolic process produced in the liver in which your body burns fat for energy instead of carbohydrates, says Katherine Brooking, MS, RD, co-founder of Appetite for Health. On a standard keto diet, calories should comprised of a minimum of 70% fat, 20% protein, and 10% carbohydrates.
Since the body’s preferred fuel source is sugar (glucose) that comes from carbs (i.e., grains, legumes, fruit), this diet presses the body to use glucose stored in our muscles as glycogen for fuel. “What else happens when we break down muscle glycogen? We lose water weight,” explains Good Housekeeping Institute’s Nutrition Director Jaclyn London, MS, RD, CDN. “Our muscles store about 3 grams of water for every gram of glycogen, meaning we can lose quite a bit of weight right away when we tap into glycogen stores for fuel. That’s why someone who loses weight in ‘just one week!’ from a low-carb plan is likely losing water weight, not necessarily real weight that stays off over time, but the immediacy can feel motivating at first.”
As for the menu, Brooking explains that the keto plan allows dieters to consume fish (salmon, oysters, scallops), meat and poultry (pork, lamb, steak, and yes, bacon!), eggs, nuts, non-starchy vegetables (spinach, broccoli, cauliflower, tomatoes), fats and oils (butter, mayo, avocado oil, ghee) and high-fat dairy (full-fat yogurt, heavy cream, cream cheese, hard and soft cheese). Berries and artificial sweeteners can be eaten sparingly.
“The foods to avoid on keto include most fruits (apples, bananas, peaches, oranges), grains (breads, pastas, cereals, and any foods made with wheat, rice, oats, or corn), legumes (all beans), and anything with added sugar (desserts, honey, cane sugar),” Brooking states. Root veggies (potatoes, carrots, turnips), alcohol, sweetened beverages (juice, soda), sweetened sauces and dips (ketchup, BBQ sauce, some salad dressings), and some oils (canola, soybean, peanut) are on the “no” list – along with any low-fat dairy products.
Paleo Diet 101
“The paleo diet is meant to resemble the supposed diet of our long-ago, hunter-gatherer ancestors,” explains Brooking. “The idea behind it is that our Western pattern of eating is contributing to the rise of chronic illness and obesity.”
Also referred to as the Paleolithic diet and caveman diet, this meal plan – which is reportedly a way of eating for Blake Lively and Jessica Biel – focuses on only the foods that were (allegedly) available way back when: poultry (grass-fed meat, fish, seafood), fresh fruits and veggies, eggs, nuts, seeds, and plant-based oils (such as olive, walnut, flaxseed, macadamia, avocado, coconut).
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The foods not allowed on this plan include legumes (peanuts, beans, lentils, tofu), grains, dairy, refined sugar, salt, artificial sweeteners, anything processed, and alcohol. And there’s no need to count calories or figure out proper percentages. (Do you think the cavewomen were keeping track of their caloric intake?) The diet promotes eating whole foods until you’re satisfied.
The Pros and Cons of Keto
The keto diet has a scientific background – but not for weight loss. “Some evidence has found that a keto diet can be effective for patients with epilepsy,” Brooking says. In fact, the Epilepsy Foundation promotes the ketogenic diet as a way to help control seizures – and it’s usually recommended for children who have failed to respond to prescription treatments.
London adds that she found it hard to believe the keto plan was trending as the latest weight-loss fad since it was prescribed to pediatric patients during the time she worked in a hospital. “It was used as an absolute last resort for families who felt otherwise hopeless in the face of a neurological disease, and under strict medical supervision,” she says.
Eating less carbs can be a good thing. People who follow the typical Western diet tend to consume more than the daily recommended amount of carbohydrates (about half of our calories per day, where at least half of these grains derive from whole grains, according to the 2015-2020 USDA Dietary Guidelines for Americans).
However, nearly erasing carbs from an eating plan may be too drastic. “This would be a hard adjustment for most Americans, making the standard keto plan difficult for many to stick with,” Brooking says.
Along with some unpleasant side effects (like constipation, crabbiness, lightheadedness, nausea, fatigue, and bad breath), Brooking also points to the fat content in this eating regime. “Keto does not emphasize healthy fats, and we know that foods high in saturated (such as butter, cheese, and red meat) can increase the risk of heart disease,” she says.
As for the weight loss, it tends to be short-lived. “The same reasons why we see immediate weight loss on carb-restricted diets is the same reason why we see immediate weight gain after adding a seemingly harmless sandwich back into the mix: The water weight comes back instantly with glycogen storage,” London says.
The Pros and Cons of Paleo
Unlike keto, Brooking gives a thumbs up to the back-to-basics approach in this plan. “The pros of paleo are that it focuses on increasing intake of whole foods, all fruits and vegetables, lean proteins, and healthy fats while decreasing consumption of processed foods, sugar, and salt,” she says.
Proponents of paleo claim that it can reduce inflammation, increase energy, help with weight loss, stabilize blood sugar, and even reduce the risk of chronic diseases, but the majority of science doesn’t agree with all of these assertions. The jury is still out on whether or not the paleo diet can have long-term benefits for people with type 2 diabetesand research published The American Journal of Clinical Nutrition states this dietary plan overall “still lacks evidence.”
“When it comes to scientific backing, there is virtually none to support the paleo diet,” London says. “The average lifespan of a hunter-gatherer was about 30 years (lovely, huh?).”
As with the keto plan, London and Brooking are not in favor of nixing grains, dairy, and legumes from the diet. “Despite what paleo advocates claim, these foods are healthful and are good sources of fiber, vitamins, and minerals,” Brooking says.
And London adds: “My biggest gripe with paleo is that it’s generally nutritious, but the model loses me in the elimination factor. Legumes are truly one of the most nutritious foods you can eat, so if you do want a structured plan, you’re better off with a modified approach to paleo that at minimum incorporates legumes for additional protein, calcium, and fiber. Even better: Mediterranean diets, which will give you back the 100% whole grains and low-fat dairy too.”
The Bottom Line
Both registered dieticians find downsides with the keto and paleo plans and feel that eliminating foods that contain essential nutrients – and, in the case of the keto diet, adding in foods that are high in saturated fat – all in the name of weight loss does not equate to a healthy diet.
“To make real, long-term changes, we can’t rely on restriction,” London says. “We have to approach health and weight loss with an understanding of our own lifestyle, and shift toward healthier eating habits through behavior changes that last a lifetime.”
Since eating preferences and dietary needs vary from person to person, it’s advised to check with your doctor before starting any new weight-loss program.
Article originally appeared on Good Housekeeping
Trying (and failing) to lose weight? Setting a specific goal can breathe life into your fitness regime. Personal Trainer Laura Williams has devised the following 7-day fitness plan, so stick with it and expect to see results in as little as a fortnight.
✔️ Regularity and consistency: These are your best friends when it comes to seeing results. The cumulative effect of exercise cannot be underestimated. Schedule exercise sessions in your diary and stick to them no matter what.
✔️ Keep an eye on your diet: If weight loss is your goal, try not to ‘eat your workout’. Never go hungry but avoid high-calorie food rewards (we’re talking post-workout pastries and muffins) and oversized meals. Good post-workout snacks include pitta and humus, a protein smoothie shake or yoghurt and fresh fruit.
✔️ Consistency is key: You can witch sessions around, but try and stick to following a higher intensity day with a lower intensity workout the next day.
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It’s Monday which means a full-on (but easy-to-follow) workout after the weekend. Start with a 4-minute warm up consisting of:
- Easy jogging-on-the-spot
- Shadow boxing
- Shuttle runs
Next, try the following with 30 second intervals for each move:
- Mountain climbers
- Jumping jacks
- 30 seconds rest
- High knee jogging-on-the-spot
- Squats-with-a-jump (at the top)
- 30 seconds rest
- Fast alternating lunges
- Lateral jumps
- 30 seconds rest
- Fast step-ups left leg
- Fast step-ups right leg
- 30 seconds rest
- Reverse lunge with knee drive left leg
- Reverse lunge with knee drive right leg
- Rest and…repeat!
➡️ Interval walking
This is your active recovery day – the perfect excuse to try this calorie busting walk:
🔹 Start by walking at a moderate pace for five minutes to warm up.
🔹 Then speed up so that you can still hold a conversation, but so that your heart rate is raised and you start to break a sweat.
🔹 Hold this pace for three minutes.
🔹 Slow down to a stroll for one minute and repeat.
🔹 Repeat this four minute cycle a total of five times.