How to eat smart to lose weight

Try these simple eating tips for weight loss

If you tried everything for that quick weight loss and still failing in your mission, and loosing weight is your high priority these days. Let us help you in your weight loss. In our opinion to loose weight is very simple. ................... guess what ............ diet ..no....... gym.....no.............................Just eat smart guys

Are you one of the thousands of people out there wondering what the real secrets of eating right are? With so many fad diets and gimmicks available on the TV and in the media today, its hard to sort out fact from fiction................... Have you resolved to lose weight?

Do you think thin = healthy = not eating? ................ Oh hell ..........Get real guys!

Let me explain How "Eating Smart" Can Help You Lose Weight?

Eat smart

Eating right can help you knock off those extra pounds.  So have you taken care of your annual donation to the gym knowing that you’re never going to step into it? Paying that gym membership makes you think “I’ll make it some day”. 

But let’s face it; most of us can barely make the time to draw a deep breath, let alone find a couple of hours, that includes fighting traffic and finding parking space, to work out.  Also many have a mental block about the gym and your body will never respond to anything you force it into.  So what do you do? You learn to compensate.  By eating; only this time correctly. How do you know how to eat smart?

Frequency

Do you wake up sluggish to a large cup of coffee/tea? Do you have a couple of bites for breakfast and then wake up ravenous late in the afternoon to bite into whatever you see? That’s because you probably eat your big meal at sunset.  Now its impossible to change habits overnight, so start slow. Wake up to the heaviest platter and get through the day in descending order.

Go “figure”
First, study your body; structure, metabolism, hunger pangs, thirst, eating patterns.  It’s very important to know when you feel hungry, how much and when not;

Note down the time and contents of your meal for a week so that you realize what you’re chomping and what you’re missing in terms of essential nutrients. Create a basket that includes all food groups; carbohydrates, proteins, vitamins and even fat.  Keeping track of all that you eat is also a foolproof system to put an end to bingeing; once you actually see how much you’re putting into your body, it’ll automatically put your meals into perspective. 

One simple rule: your body burns most calories as soon as you wake and then goes into slow mode thereafter.  So eat your chocolates, fried food, sweets, cakes when you wake up and make the later mouthfuls healthier as the sun goes down.

Eat with your mind
It’s essential to finish with supper at sundown because your fat burning ability vanishes with the sunlight.  And since you’ve had your dinner early, you’re guaranteed to wake up with an appetite.  If you cannot stomach the idea of combine protein, carbohydrates and fats that early, start with a fruit.  High carbs like banana or apple are ideal to kick start that metabolism and also acts as a buffer to that cup you’ll sip on.  Never, I mean Never, begin your day with caffeine as your body will automatically go into slump mode.  Water constitutes 70 per cent of Human body so when we gulp some down as much as possible through the day to eliminate toxins.

The golden Cycle

Every time hunger pangs strike, replace every one out of three meals with water and watch the fat melt away.  If you ever want to lose weight eat!! The 3 W’s are the deal breakers-what, when and where you eat, for e.g eating dal chawal( plain rice with dal) at a restaurant at midnight can do more damage than a big piece of ladoo (sweet) in the morning.  Simply because one, your ability to burn fat at midnight is almost zilch and two even dal may have unhealthy ingredients when made outside whereas the bhaji you fry in good oil at home is absorbed into your system pronto because you’re burning most fat in the morning.

Botox injections can apparently control the heartbeat

Botox injections can apparently control the heartbeat - Hear the word Botox, which is on your mind must be beauty treatments and injections to make skin wrinkle free and youthful. However, recently researchers discovered other benefits of botox injections, which control the erratic heartbeat.

If Botox is injected in the fat around the heart, he will stop the nerve causes the heart rate abysmally. With this injection, the heart rate will return to normal and calm. This treatment is performed on patients who have atrial fibrillation, the heart rate abnormalities.

Atrial fibrillation occurs when the heart chambers to contract is not in harmony. Usually this is caused by an error on the part of the body triggers the heartbeat. This error signal is then sent to the heart tissue and causes it to contract at the wrong time. Such abnormalities increases as a person gets older.

In some cases patients with atrial fibrillation will experience fatigue, weakness, dizziness, and reduced ability to exercise. Other symptoms are loss of blood being pumped around the body. This can be caused by smoking or drinking alcohol.

Botox works by stopping the signals sent between nerve and muscle, as reported by the Daily Mail. When used for beauty treatments, Botox can freeze the muscles around the eyes, mouth, and forehead, thus making wrinkles more subtle and invisible.

This method has been tested on 60 patients who have heart surgery. Atrial fibrillation is one of the side effects of heart surgery, and the condition is likely to get even worse up to 50 percent.

Weak abdominal muscles increases the chances of spinal injury

Low back pain is one of the most common reasons for visiting the family doctor. Most North Americans will suffer from back pain at some point in their lives. Low back pain is a costly disease for the health care system and is a common cause of absenteeism .

Located in the lower back, the lumbar region is composed of vertebrae , muscles and ligaments. The spine has intervertebral discs, small pads made ​​of cartilage which are inserted between the vertebrae (bones of the spine ) . Any injury or disease affecting the muscles , ligaments and intervertebral discs can cause back pain.

People who are overweight , have an incorrect posture or whose back muscles and abdomen are low have a higher risk of injury to the lower back risk.
causes

In most cases it is not possible to find the cause of back pain . However, the most common causes of low back pain is the strain of a muscle or ligament . If back pain occurs suddenly , its usually a sign of muscle tears, ligament sprain or a disc problem . The pressure exerted on the disc and can cause it to swell out , pushing the cartilage on the sides. The cartilage then press on the nerve cord of the spine, causing intense pain.

Cause of injury to players bodybuilding:
1-Failure to perform warm-up exercises adequate and appropriate.
2-Perform Abdominal exercises while the Cotton muscle stressful, A result of the training exercises the back and legs before exercising abdominal exercises.

Many diseases such as osteoporosis , osteoarthritis , fibromyalgia , ankylosing spondylitis and spinal stenosis can cause back pain. Pregnancy can also cause back pain because of overweight , changes in the strength of the muscles and ligaments , and also because the babys head can compress the spinal nerves . Subjects with overweight are also more prone to have back pain due to a lower position and the extra pressure exerted on the discs and muscles.

Some medical conditions (eg . Diseases of the gallbladder and stomach ) can cause back pain. When pain is felt in one part of the body other than where would expect to find, it is described as " erred pain ".

Although rare, there are some potentially serious causes of back pain are not due to back injuries. These include pneumonia, diseases of the gallbladder, kidney infections , stomach problems (eg . Ulcer, appendicitis ) , infection of the spine and tumors.

Vegetable Pulao

Aftet posting two delicious starters, am here to start today my main courses which i would like to serve if ill organise a birthday party for my kid at home. Most of my followers know that am running fun filled blogging marathon for whole month of april and our first weeks theme is occasional foods. Obviously i chosed to cook for a kids birthday party as my daughters birthday is approaching very soon. We cant imagine a party without rice that too for the main course, rice have their important place in South Indian menu. Even we serve rotis,naans or parottas, somehow most of my family members love to have atleast some rice if i invite them for a party or a get together.

Coming to todays post, its a vegetable pulao. I know someone is going to say that she was shocked to see that i didnt posted this usual pulao yet in my space. Yep sometimes its happens, wat to do. This pulao goes for a variety of veggies and gets ready quickly as well as very much easily. A pect one pot meal, usually ill make my pulaos through pressure cooker,but this time for a change i prepared them with heavy bottomed vessel and this method works out wonder too.If you love paneer,you can add them too..Check out the Blogging Marathon page for the other Blogging Marathoners doing BM#27.

2 cups Basmati rice soaked for 30 minutes

2+1/2cups Mixed veggies ( chopped cauliflower, carrots, green peas,babycorns, corn kernels,capsicums,frenchbeans)

1no Onion(sliced)

1tsp Ginger-garlic paste

2nos  Green chili(slit opened)

1no Tomato ( chopped)
1/2tsp Red chilly powder
1tsp Garam masala powder

4cups Water

3 tbsp Oil

Salt

For tempering:

1tsp Cumin seeds

1no Bay leaf

2-3nos Cloves

2nos Cardamoms

 inch cinnamon

Heat oil and fry all the whole spices until they turns brown.

Add the onions and cook until they turns transculent,add the ginger-garlic paste and saute for a minute.

Now add the tomatoes and slit opened green chilies and saute for 2-3 minutes on a low flame.

Finally add all the veggies,red chilly powder,garam masala powder and saute again for few minutes on a low flame.

Add the rice and saute for 2 minutes on a low flame.

Now add the water, sal and cook everything in medium high flame for few minutes and finish the cooking with low flame until the rice gets well cooked.

Serve this pulao with raita of your choice.

FDA Warns LifeScan About Its Meters

On December 7, the FDA sent a warning letter to LifeScan, Inc. concerning possible incorrect measurements on its blood glucose monitors. The letter was posted on the FDAs site on December 20. You can read it here.

The letter was a culmination of correspondence between LifeScan and the FDA which began in April when the FDA sent inspectors to LifeScans California plant. Shortly after that inspection began, LifeScan posted a press release discussing possible issues with its meters:

If you use a OneTouch® Ultra®, OneTouch® FastTake®, InDuo®, EuroFlash®, or SmartScan® Meter, we want to make you aware of two possible issues regarding these products.

1. Your meter is designed to show results in two different units of measure. When setting your meters date and time, it is possible for you to accidentally change the unit of measure.
   
2. Very rarely, an event such as dropping your meter while in use can cause a brief power loss. As a result, the meter may unexpectedly change the unit of measure and/or the code number.

- LifeScan Press Release, April 14, 2005

If youd like to check your meter, visit LifeScans site for more information including correct device settings. Youll find a list of contact phone numbers and an email response form there too.

________
For the FDAs warning letter:
LifeScan, Inc. Warning Letter

For LifeScans page on how to check your meter:
URGENT: MEDICAL DEVICE CORRECTION -- OneTouch® Ultra®, OneTouch® FastTake®, InDuo®, EuroFlash® and SmartScan®

Some news summaries:
FDA Warns About Faulty Blood Sugar Monitors
FDA Warns Maker of Blood-Sugar Monitors

Amla Limonade

Summer is yet to come here, but some healthy summer drinks are always welcome at home.Here we start again a week of blogging marathon with seasonal as theme. Obviously Amla aka gooseberries are seasonal here and they have so many health values.Indian gooseberries are eaten as raw, and also cooked in many other ways, the most famous is the amla pickles.

We get rarely amlas here and its quite expensive here when compared to India, obviously i get rarely and use them immediately.This time without any hesitation i tried making a summer drink with fresh amlas. This lemonade is definitely a thristy quencher, body cooler and definitely a healthy drink. If you get amlas abundantly dont forget to give a try to this reshing lemonade.Check out the Blogging Marathon page for the other Blogging Marathoners doing BM#27.

3nos Gooseberries
1/2cup Sugar
2nos Limes
Water as per need
Ice cubes

Remove the seeds from the gooseberries and grind as fine paste with enough water.

Extract the juice from the grounded amla paste.

Meanwhile squeeze out the juice from the lime and mix the lime juice, amla juice together in a vessel.

Add sugar and enough water to the juice.

Add icecubes and serve immediately.

What Do We Know About Blast Injuries Speculating About the Boston Marathon Bombing

Remains of a low order device

The Disease Management Care Blogs thoughts and prayers go out to the Boston Marathon bombing victims and their families. Like all Americans, it hopes the death rate remains low and is confident that the survivors recovery will be a credit to the world-class skill of the physicians and nurses staffing Bostons ERs, operating rooms and ICUs.

While it was digesting the horrific details, the DMCB was struck by the likelihood that the Afghan and Iraq wars as well as multiple terrorist attacks have enhanced our ability to deal with blast injuries.

What have we learned?

As outlined in this abstract, the initial explosion results in "primary" injury, fragment or shrapnel injuries are "secondary," being bodily thrown results in "tertiary" blunt injury while the burns and other trauma are "quaternary."  Its difficult to survive a primary injury because the supersonic compressive air wave travels though the human body and "shears" any organ with an air/water interface, such the lung and intestines; thats also why ear drums rupture.

According to the CDC, primary injuries are more likely with "high order" explosives such as military grade bombs or TNT.  "Low order" gun powder (the image above is from a "pipe" bomb) or petroleum-based devices are less likely to result in supersonic shock waves. That - and reports of "white smoke" - may account for the initially low mortality rate at the Marathon. Interestingly, body armour does not protect against a primary injury and a ruptured ear drum is a poor predictor of its presence.

Unfortunately, the stress wave can also cause bone fractures and, if severe enough, "transosseous" amputation.  The DMCB was dismayed by reports of some of the victims losing their limbs, which suggests the devices were large if "low-order" bombs.  Amputations were common in the 05 London terror bombings because the victims were in close proximity to the devices and the blast waves were at ground level.  Initial reports from Boston suggest the devices were placed in trash receptacles, which, if it turns out to be true, would fit the pattern.

If victims are in shock from bleeding, the DMCBs uneducated first impulse would be to correct the low blood pressure and give lots of intravenous fluids and blood.  It turns out that combat surgeons have discovered that kind of aggressive therapy can increase the rate of death and complications. The best current approach appears to be the use of "hypotensive resuscitation" and more liberal use of blood products (plasma, platelets and pack cells or whole blood) versus fluids. 

If you live in Boston and want to donate blood, you can check this out.

Given the standard emergency triaging, the DMCB suspects the secondary, tertiary and quaternary victim counts are still being compiled.  In addition, it will be some time before we understand the incidence of traumatic brain injuries and their associated symptoms of unbalance, hampered motor function, disordered vision, decreased communication and depression. The etiology and our ability to predict it remains a topic of research.

Healthy Beverages Ageless

Growing old is something that must happen in living organisms, including humans. But there are some people who look older than age should be due to aging. Conversely there are those who still looked old even though he is old. Some healthy drinks can help you stay young.Why would anyone look old but still young age? This happens because many toxins in the body. To get a healthy and glowing skin, it is important to get rid of harmful toxins from the body acidic.Unhealthy lifestyles and poor eating habits are also the reason behind the fine lines that occur before age. In addition to eating healthy foods, you should also include some healthy drinks in the diet.Here are some healthy drink that can keep you young :

1. White Water
Water is very important to make the body stay hydrated. Water helps the body to get a glowing skin and reduce aging. This is because water helps rid acidic and harmful toxins from the body, it also helps moisturize the skin and opens the pores. Many drinking water can reduce the formation of fine lines and also helped get a glowing skin and shiny.

2. Green tea
This is one healthy drink that is not only good for the skin but also the body. Many dieters drink 2-4 cups of green tea on a regular basis just to burn the fat in their bodies. Green tea contains polyphenols and EGCG (antioxidants) are beneficial for the skin and hair. To have thick hair, wrinkle-free skin and a perfect figure, drinking a cup of green tea on a regular basis.

3. Tomato juice 
These vegetables are rich in antioxidants. Lycopene (antioxidant) against aging and helps maintain radiant skin and perfect. Tomatoes also improves digestion and bowel movement helps remove toxins from the body, which makes the skin wrinkle-free and glowing. If you do not like to eat raw vegetables, though the tomatoes into juice and drink regularly.

4. The hot chocolate 
Caffeine consumption is limited to be good for the heart. If you drink a cup of hot chocolate, you will have a healthy heart and radiant skin.According to many researchers, cocoa has more antioxidants than caffeine that makes it healthier. Studies from Cornell University suggests cocoa has more antioxidants than coffee, red wine and green tea.

Learn the strengths

1) Focus on every rep you do: there is no point doing the exercises mechanically . Feel the muscle working . Develop the habit of isolating yourself while doing a series.

  2 ) Train always at the same time : whenever possible , try to train at the same hour. Your body will get used to be exercised at any given time and automatically enroll all their might .

 3 ) Varies sets and reps : generally not be made less than 3 nor more than 6 sets for a particular exercise . The repetitions should not exceed 15 , but if we vary the number of sets and repetitions within these limits so that the muscle does not get used .

  4) Do not forget the leg work : leg hard work is very demanding, but instead affect the overall growth of all your physique. This large muscle activity and promotes increased respiratory and metabolic function .

  5 ) regulates carbohydrates : if youre the skinny guy with abs always visible and very thin skin , try to eat plenty of carbohydrates such as rice , potatoes , pasta and cereals. On the contrary if you are someone who are somewhat overweight , reduce your intake of carbohydrates and only take them at breakfast and lunch , or get fat .

  6) Protein is the key: the muscles are composed of water and protein , so make sure you do not miss the solid raw material with which to build them. When one does not grow, in most cases sufficient to increase protein intake . With only daily protein intake contributed by foods is not enough. Consume protein powder and tomato smoothie mid-morning and mid afternoon , with at least 30-50 grams of protein per serving .

  7) Do not miss training sessions : miss a workout because of a TV show and soon find valid any excuse to lose another . The results are harvested based on the continuity and repetitive stimuli .

  8) Train with progression : try progressing your previous performance , at least one exercise for each session.

  9) Rest between sessions : the muscles are stimulated during training, but recover and grow after while you rest . Try not to overdo physical activities outside workouts.

  10) Do not smoke : Smoking is injurious to health. Furthermore, negatively affecting appetite and destroys vitamin C in addition to impair the respiratory and pulmonary recovery .

I hope you will be helpful , comment and suggest . And do not forget to share !

Exercise Lowers Risk Of Lung And Colorectal Cancer Among Middle Aged Men

New research conducted by researchers at the University of Vermont reveals that middle-aged men who engage in a lot of cardiovascular exercise are at a reduced risk of suffering from lung and colorectal cancer. In addition, those who exercise are less likely to die from prostate cancer (although their risk of contracting the disease remained the same).

According to the lead author of the study, Susan Lakoski, MD, assistant professor of medicine at the University of Vermont: "While poor fitness is already known to predict future cardiovascular disease, this is the first study to explore fitness as a marker of future cancer risk prognosis.

This finding makes it clear that patients should be advised that they need to achieve a certain fitness level, and not just be told that they need to exercise. And unlike exercise behavior, which relies on patient self-reporting, fitness can be objectively and accurately measured in a clinical setting."

A total of 17,049 men participated in the study. They each received a cardiovascular fitness assessment from the Cooper Institute at a median age of 50. The test involved walking on a treadmill with a variation of different speeds and elevations. They recorded the mens performance with the ratio of metabolic rate (the rate of energy consumption), known as metabolic equivalents or METs.

The team divided the participants into different groups based on their level of fitness. The researchers then analyzed their medical histories to determine whether they had developed either lung, colorectal, or prostate cancer.

In this study, men who were in their 40s who achieved 13.5 minutes in the fitness test belonged to the lowest quintile for fitness as well as men in their 50s who achieved less than 11 minutes.

During the follow-up period of 20 to 25 years, a total of 2,332 men were diagnosed with prostate cancer, 277 were diagnosed with lung cancer and 276 were diagnosed with colorectal cancer.

They adjusted the results of the study for factors such as BMI, smoking habits and age.

The risk of lung or colorectal cancer decreased by 68 and 38 percent among men who were the most physically fit and active compared to those who were not active at all.

The researchers found that physical activity did not have any effect on the rate of prostate cancer diagnosis.

Although its been shown that exercise can reduce the risk of dying from prostate cancer. Previous research has indicated that men with prostate cancer who exercise vigorously have a notably reduced risk of dying from the disease compared to other diagnosed men.

Men who were physically fit at the time they developed cancer had a much higher survival rate and lower risk of dying from the cancers compared to men who were not fit. In fact, a 1MET increase in fitness was associated with a 14 percent reduced risk of dying from the cancer, as well as a 23 percent reduced risk of dying from cardiovascular disease.

In addition, the researchers noted that patients who werent fit yet not obese were still at an increased risk of cardiovascular disease (CVD), suggesting that people should be aware that fitness also impacts risk.

Exercise has been shown to have huge beneficial effects on people diagnosed with cancer and its also been found to help minimize the risk recurrence, or another cancer developing.

7 Ways to prevent cardiovascular disease

7 Ways to prevent cardiovascular disease - Heart disease and stroke are some examples of cardiovascular disease. Stress, lifestyle, and diet are often the cause of this disease. So how do I prevent it? Listen more, as reported by the following Idiva.

Routine inspection

Most cardiovascular diseases strike suddenly without any symptoms. Before its too late, it would be better if your routine check-ups or medical examination to know the hidden risk of cardiovascular disease.

Yoga

Through yoga breathing exercises is one way to prevent cardiovascular disease. Besides being able to launch an oxygen intake through breathing exercises, yoga also reduce stress and prevent cardiovascular disease.

Actively engaged

As already mentioned, an inactive lifestyle to be one of the causes of cardiovascular disease. Theore, how to prevent it is to be actively engaged. For example, to get used to walking more often every day.

Quitting smoking

Smoking is not only bad for the lungs, but also the heart and blood circulation. So if you have a smoking habit, stop start now to prevent cardiovascular disease.

During pregnancy

Research never mentions that during pregnancy a woman who had suffered from pre-eclampsia or swelling of limbs doubled risk of cardiovascular disease. Thus arrived during pregnancy, pregnant women should be extra to maintain good health.

Understanding the symptoms

By understanding the symptoms, cardiovascular disease can be dealt with more quickly. Examples of symptoms of heart disease are pain in the chest area to the left arm and shoulder. In addition, pain in the back, neck, jaw until sometimes also be a symptom of cardiovascular disease in women.

Sun

Vitamin D is an important nutrient for the heart. So make sure you get vitamin D from the sun by sunbathing. Some foods can also be used as an alternative to meet the needs of vitamin D.

So many ways to prevent cardiovascular disease. Come live a healthy lifestyle fitness for your body!

2 cups of milk a day ideal for childrens health new research shows

New research has answered one of the most common questions parents ask their doctors: How much milk should I be giving my children? The answer is two cups per day.

"We started to research the question because professional recommendations around milk intake were unclear and doctors and parents were seeking answers," said Dr. Jonathon Maguire, a paediatrician at St. Michaels Hospital and the lead author of the study.

Dr. Maguire and his team looked at how cows milk affected body stores of iron and vitamin D – two of the most important nutrients in milk – in more than 1,300 children aged two to five years.

The results of the study appeared online in Pediatrics today.

They found that children who drank more cows milk had higher Vitamin D stores but lower iron stores.

"We saw that two cups of cows milk per day was enough to maintain adequate vitamin D levels for most children, while also maintaining iron stores. With additional cows milk, there was a further reduction in iron stores without greater benefit from vitamin D," Dr. Maguire said.

The researchers recruited healthy children during routine doctors appointments between 2008 and 2010. Parents were asked to fill out an extensive questionnaire about their childrens milk drinking habits and other factors that could affect iron and Vitamin D stores. A blood sample was obtained from each child to determine body stores of iron and Vitamin D.

The children were participating in TARGet Kids!, a unique collaboration between childrens doctors and researchers from St. Michaels Hospital and The Hospital for Sick Children. The program follows children from birth with the aim of understanding and preventing common nutrition problems in the early years and their impact on health and disease later in life.

The study also suggested that children with darker skin pigmentation may not have enough vitamin D stores during the winter months. Dr. Maguire suggested that instead of consuming more milk to increase these levels, wintertime vitamin D supplementation may be a more appropriate way of increasing vitamin D stores while preserving iron stores.

"Vitamin D deficiency in children has been linked to bone health issues and iron deficiency has been linked to anemia and delays in cognitive development," Dr. Maguire said. "Being able to answer parents questions about healthy cows milk intake is important to avoiding these potentially serious complications of low vitamin D and iron stores."

6 important reasons to eat blueberries

6 important reasons to eat blueberries - Blueberry, one of the families that are often erred berries contain high antioxidants. There are at least six important reasons why you should eat this one super fruit. What is it? Listen more, as quoted from Care2 follows.

Eye health

Anthocyanins which is one of the compounds in blueberries proved able to protect the retina from damage threat.

Cardiovascular health

Blueberries also proven to improve the balance of body fat, including controlling the levels of bad cholesterol and increase good. In addition, eating blueberries are also good for blood circulation so that the whole fruit is able to maintain cardiovascular health.

Controlling blood sugar

Blueberry - as well as other berries family - are the best foods to control blood sugar levels in order to prevent attacks of type 2 diabetes.

Cognitive gains

Research has shown that regular consumption of blueberries can improve cognitive function in the elderly brain. For example, an increase in memory and other cognitive problems associated with aging.

Anti-cancer agent

Various studies suggest that blueberries including anti-cancer agents breast, colon, esophagus, and small intestine.

High antioxidant

Every organ system and basically get the health benefits of eating blueberries as antioxidants in it are so high. For example, reducing the risk of muscle damage during exercise, protect the nervous system, as well as maintaining digestion.

Blueberries can be enjoyed directly, used as a salad topping, processed into cakes, or consumed as a juice. One way or another, enjoy blueberries and get all the health benefits mentioned above.

The Rise of the Medical Director What One ACOs Good News Tells Us

Medical Directors prepare for battle

The VP of Finance finally agreed to a meeting. In order to make maximum use of their time, however, he had a simple request: submit an agenda of topics first and then hed be happy to let his administrative assistant set up an appointment.

In that game of organizational politics, Finance VP: one. Senior VP and Medical Director: zero.

The lost voice mails. The patronizing glances. The unanswered emails. The skeptical grins. The condescending nods. Every lead doctor, medical director and physician VP is exquisitely familiar with the tut-tuting attitude that lingers just below the surface, ready to spring when their opinion on how to best serve patients bumps into the organizations budgeteers. Those finance guys know that the typical physician is used to spending dollars like a Miami-Dade ICU on a 98 year-old. They know those "white coats" are incapable of understanding costs, margins and cash flow. Better that they get out of the way and let the money experts call the shots, eh?

Call it the clinical-finance tension. Like government revenue vs. cutting taxes. Sales vs. customer service. The DMCBs premium cable TV perences vs. the spouses unreasonable penny-pinching.

Which is one of the reasons why the Disease Management Care Blog found this New York Times article interesting.  If this is any indication of what is going on nationwide in the delivery of medical services, the implication is that the physician leaders perspectives are in the ascendancy in their organizations. Not only is there a pervading belief that keeping patients like Ms. Cline away from the emergency room is important for the bottom line, but that achieving clinical outcomes is no longer secondary to making budget.  While typical news reporters havent picked up on the clinical-finance tension that lurks in health insurance and delivery organizations, the very fact that most of the NYTs interviewing involves physicians is telling.

The playing field is currently level.

Which brings up four points:

1. The DMCB suspects the genesis of the NYT article was this presentation at a recent AHIP meeting.  Thanks to reading the DMCB, you also know that a lot more background detail on the Advocate-BCBS Illinois collaboration is here.

2.  Abstracts, presentations and news articles are one thing, but having results reported in a peer-reviewed setting is another.  The DMCB readers know that theyll withhold final judgment until it sees some transparently presented hard numbers.

3.  While Medical Directors are currently playing on a level playing field, disappointing budget results, financial losses and failure to achieve savings could not only tilt things against the clinicians again, itll quickly undo the merits of "doing the right thing."  That alone is a good reason to hope that the health system "accountability" arrangements like ACOs survive.

4.  The secret sauce to Advocates success?  Care Coordinators.  More on that in tomorrows post.

Exercise may reduce the risk of epilepsy later in life for men

New research suggests that men who exercise vigorously as young adults may reduce their risk of developing epilepsy later in life. The study is published in the September 4, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology. Epilepsy is a brain disease that causes repeated seizures over time.

"There are a host of ways exercise has been shown to benefit the brain and reduce the risk of brain diseases," said study author Elinor Ben-Menachem, PhD, MD, with the University of Gothenburg in Sweden and an associate member of the American Academy of Neurology. "This is the first study in humans to show that exercise may also reduce the risk of epilepsy, which can be disabling and life-threatening."

For the study, 1.17 million Swedish men were given cycle tests that measured cardiovascular fitness when they enlisted for mandatory military service at age 18. The participants were then assessed for epilepsy for an average of 25 years. During follow-up, 6,796 men were diagnosed with epilepsy.

The study found that men who had a high level of fitness were 79 percent less likely to develop epilepsy than those with low fitness levels and 36 percent less likely to develop epilepsy than those with medium fitness levels.

The proportion of men with high fitness who developed epilepsy in the study was 0.48% (2,381 out of 496,973 with high fitness). The proportion of men with medium fitness who developed epilepsy was 0.62 percent (3,913 out of 629,876 with medium fitness). The proportion of men with low fitness who developed epilepsy was 1.09 percent (502 out of 46,230 with low fitness).

The results were lessened only slightly after considering genetic factors and a prior history of traumatic brain injury, stroke or diabetes.

"Exercise may affect epilepsy risk in two ways. It may protect the brain and create stronger brain reserve, or it may simply be that people who are fit early in life tend to also be fit later in life, which in turn affects disease risk," Ben-Menachem said.

Bitter gourd natural diabetes cure

Bitter gourd is a functional vegetable with beneficial effects on health. Bitter gourd is a popular vegetable in some Asian countries, where the health benefits of the plant are well-known—particularly, its ability to lower blood glucose in diabetics. Her is an in depth look how it works to lower your blood sugar levels.

First let us have a look at its nutritional profile:

Nutritional Benefits


Bitter gourds are very low in calories but dense with precious nutrients. It is an excellent source of vitamins B1, B2, and B3, C, magnesium, folate, zinc, phosphorus, manganese, and has high dietary fiber. It is rich in iron, contains twice the beta-carotene of broccoli, twice the calcium of spinach, and twice the potassium of a banana.


Bitter melon contains a unique phyto-constituent that has been confirmed to have a hypoglycemic effect called charantin. There is also another insulin-like compound known as polypeptide P which have been suggested as insulin replacement in some diabetic patients.

How it works for Diabetes

Bitter gourd has been used to treat diabetes in traditional medicine and is now commercially available as tea (from fruits or leaves), juice, extracts, and pills. 

In recent years researchers worldwide have started to focus on the anti-diabetic effects of bitter gourd. The goal is to provide safe and clear preparation and dosage recommendations so that consumers will realize the greatest benefit from consuming fresh bitter gourd or bitter gourd products.

Bitter gourd lowers blood glucose levels!

Bitter gourd is not like most medicinal drugs, which are effective only in one target organ or tissue; rather, it influences glucose metabolism all over the body. Bitter gourd treatments of cell cultures or feeding trials with laboratory animals such as mice or rats show bitter gourd does have blood glucose lowering properties.


Bitter gourd helps to  lower dietary carbohydrate digestion

The starting point of glucose metabolism is your gut, where carbs and sugars are transformed into glucose. From here your digestive system transports glucose to your blood. Researchers have found bitter gourd reduces the amount of glucose that is released into the blood by inhibiting the enzymes that break down disaccharides to two monosaccharides (e.g. glucose).

According to research studies bitter gourd can also influence the transport channels for glucose, which also reduces the amount of glucose transport into the blood. This discovery is very helpful for the treatment of both Type I and Type II diabetic patients and helps to prevent high blood sugar levels after meals.

Bitter gourd contains plant insulin 

Insulin is necessary to lower high blood sugar levels. When your blood sugar increases, pancreas react secreting  insulin in your blood, Insulin helps to transport the sugar from the blood to the skeletal muscle and the fat tissue where it is used to produce energy. Insulin also stops the liver from producing sugar from glycogen storages in your body.

In Type I diabetes, the pancreas does not produce or secrete enough insulin to keep blood sugar levels low. Bitter gourd has been shown to be effective in treating Type I diabetes in rats or mice by increasing pancreatic insulin secretion. Additionally, scientists found an insulin-like molecule in bitter gourd. Although bitter gourd may reduce the number of insulin injections required to manage Type 1 diabetes, it cannot replace insulin treatment completely or heal this form of the disease.

Bitter gourd reverses insulin resistance

In Type II diabetes, the liver, skeletal muscle, and fat tissues do not respond adequately to insulin—they are insulin resistant. Research studies show bitter guard helps to prevent or reverse insulin resistance. Bitter gourd can play a role in the prevention and treatment of Type II diabetes, People with insulin resistance or those with a high risk of developing Type II diabetes have a good chance to prevent and treat the disease without drugs by increasing their physical activity and including bitter gourd in their diet.

Bitter gourd helps to prevent diabetic complications

Consuming bitter gourd can help prevent complications resulting from chronic high sugar concentrations from Type I and Type II diabetes wihich increase the risk of inflammation and oxidation in the whole body, resulting in complications like blindness, diabetic feet, kidney disease, stroke, or heart attack. Consuming bitter gourd not only decreases blood sugar levels, but also has some antioxidative properties.

Bitter gourd can save you from other non-communicable diseases

Becoming overweight is one of the most important risk factors for diabetics. Type II diabetes is often accompanied by hypertension, high plasma cholesterol, or high plasma lipids, these conditions increase the risk of stroke or heart attack. For overweight Type II diabetic patients, bitter gourd helps weight loss,  Also research studies subjected to mice and rats show reduction in hypertension, plasma cholesterol and plasma lipids. There is also evidence that bitter gourd might be effective in cancer treatment.

A humble warning

Please be caul! More bitter gourd does not help more. Although bitter gourd can help prevent insulin resistance or severe diabetic complications, it is important to consider situations in which bitter gourd may be harmful to your health.

Exclusive consumption of bitter gourd, bitter gourd juice, or other bitter gourd products can lead to dangerous hypoglycemia when consumed by diabetic patients under oral drug treatment, in too high dosages, by children, or on a hungry stomach. Pregnant or breastfeeding woman should not consume bitter gourd or bitter gourd products.

Eggless Ragi Chocolate Chips Cinnamon Rolls

Everyone will agree with me if i say nothing can beat the aroma of freshly baked breads at home. I love baking very much, i can even say i talk baking,eat baking,live baking, just like the famous actor Rajinis dialogue. Its really hard for me to keep away from baking and if i feel down immediately ill go for baking. Obviously the bread kneading or whisking makes me happy and keeps me away from my stress. Cinnamon rolls are one of our family favourite, and ill try on making this beautiful rolls as healthy version with whole grains, after Whole wheat cinnamon rolls here comes one more interesting rolls with ragi flour.

After many fails, finally i got the pect measurement myself and fixed it for making these beautiful ragi cinnamon rolls.If am trying anything new in baking, obviously ill add chocolate chips,so that i can feed easily to my kids. Needless to say that these rolls turned out pectly and since there were chocolate chips in it, my kids doesnt hesitate a second to enjoy these healthy version of cinnamon rolls. Initially i was bit anxious about this cinnamon rolls with ragi but trust me they are simple awesome, you can enjoy these cuties without any guilt eventhough the colour will be bit dull than the usual one.

1+1/2cup Ragi flour
1cup All purpose flour
2tbsp Melted butter
1tbsp Active dry yeast
1tbsp Sugar
1tsp Salt
1/2cup Luke warm water
2tsp Cinnamon powder
2tbsp Sugar
2tsp Butter (room temperature)
1/2cup Chocolate chips (freezed for half an hour)
3tbsp Confectioners sugar

In a small bowl, add the active yeast, sugar and salt in luke warm water , give a stir and keep aside, let it sit for 5 minutes until it turns foamy.

Take the all purpose flour,ragi flour and melted butter in an another large bowl..

Gradually add the foamy yeast to the flour and knead as dough.

Dust the dough with enough flour, knead for few minutes until its turns soft.

Arrange the dough in a greased bowl , let it sit for two hours in a warm place..

Once the dough doubled their volume, springle few flour and knead again for few minutes, flatten the dough with a rolling pin.

Brush the butter over the flattened dough and springle the sugar, cinnamon powder,frozen chocolate chips over the dough..

Roll the dough tightly as a loaf...

Slice the dough as 8-9 thick slices.

Arrange those slices over a greased square baking mould..

Cover it with a plastic wrap and let it sit again for an hour until they double their volume.

Preheat the oven to 350F.

Arrange the baking pan in the middle rack and bake the uncooked rolls for 20-25minutes until its turn golden brown.

Let them cool..

Mix the confectioners sugar with few drops of water as thick paste, drizzle over the rolls before serving.

Enjoy!

Palak Channa Pulao Spinach Chickpeas Pulao

Sunday lunch is always my favourite, especially if its something healthy as one pot meal i wont say no. Most of our sunday lunch goes for briyanis, this weekend H was bit busy with some stuffs and he didnt stayed with us for the lunch. Obviously, if the man is not at home who will cook briyanis, i completely skipped briyani and went for an easy breezy green pulao with channa aka chickpeas.My kids loves chickpeas and palak, i know this pulao will be a big hit among them, am not wrong they just loved this healthy and flavourful pulao with papads,none at home complained eventhough i served this pulao just with papads,coz my kids cant imagine their sunday lunch without meats or atleast an egg.

As i told earlier in most of my posts,ill always soak the beans in large quantity,once they get soaked ill pat dry them and immediately ill freeze it for further use. My freezer will always have frozen soaked beans to cook anytime of the day. Many of my blogger buddies told me that they also started following this method now, yep this method is really handy and you just need to pressure cook your beans and add them in your rice dishes or in gravies, wat an easy method na.Coming to this pulao,you can carry this pulao very well in your lunch box and definitely an easy peasy pulao which gets ready in a jiffy.Sending to my own event Healthy Diet-Go green guest hosted by Amurta.

2cups  Cooked rice

1cup Chickpeas (cooked)

1no Onion (large and chopped finely)

3nos Green chillies 

2cups Spinach/palak (chopped)

1tsp Ginger garlic paste

1tsp Garam masala powder

1/2tsp Pepper powder

Salt

Oil

1no Bay leaves

1tsp Shah jeera

Grind the spinach,green chillies together as fine paste.

Heat a heavy bottomed pan, add enough oil, fry the bayleaves,shah jeera until they turns brown.

Add immediately the chopped onions,ginger garlic paste and saute until the onions turns transculent and the raw smell of the ginger garlic paste goes away.

Now add the already prepared spinach puree,garam masala powder to the cooking onions,cook everything in simmer for few minutes.

Finally add the cooked chickpeas, cook for few more minutes.

Add the already cooked rice to this palak-chickpeas mixture, toss everything gently until the rice gets well coated with the masala.

Put off the stove, add the pepper powder, give a gentle toss again.

Serve with your favourite side dish or raitas.

5 Avoid foods that cause flatulence!

Flatulence will make you feel uncomfortable. This health problem occurs because of excess gas in the intestines. Constipation, overeating, poor eating habits, swallowing air, irritable bowel syndrome and PMS (Premenstrual Syndrome) is a common cause of bloating. Certain foods can also cause abdominal bloating due to excess gas in the intestines. Here are some foods that you should avoid because it can cause flatulence, as reported Boldsky.

1. Spicy foods

Spicy foods can increase your metabolism although it tasted delicious. However, spicy foods interfere with the digestive process and can also cause inflammation of the stomach.

2. Cabbage

This is one of the foods that can produce gas as digested slowly, causing bloating

3. Fried foods

Greasy food can not be digested easily, causing gas and bloating.

4. Salt

Foods high in sodium can hold water in the body that cause stomach feels bloated. Avoid salty foods such as processed foods.

5. Dairy products

Lactose intolerance can also increase the risk of stomach bloating. So, you should avoid all dairy products if you suffer from such intolerance.

Here are some foods that can cause flatulence. You can still eat them but in limited quantities.

Aspirin aids woman tackles colon cancer

Aspirin aids woman tackles colon cancer - With low-dose aspirin every other day is known to reduce the risk of colon cancer in women, according to recent research. The results obtained after the researchers observed 40,000 women aged 45 years and over.

However, the effect of aspirin seems not immediately appear. Researchers found that the effects begin to be seen after use for 10 years.

"After observation for 18 years, we found a reduced risk of colon cancer by 20 percent. Was observed over a span of 10-18 years, the reduction could reach 42 percent" said Nancy Cook, professor of Brigham and Womens Hospital and Harvard Medical School, as reported by U.S. News.

Even so, Cook asserts that some aspirin-related risks such as bleeding in internal organs must also be considered. During the aspirin is known to have protective effects against heart disease, but this effect was also seen in colon and rectum cancer.

Researchers found no difference in the risk of death from cancer. Although this study was done on women, but Cook believes that this also applies to women.

To date researchers have suggested taking aspirin to ward off colon cancer in patients. Previous researchers will figure out how to reduce side effects such as bleeding that aspirin can have serious consequences.

Yogurt May Moderate Post meal Blood Sugar

Researchers at the University of Massachusetts Amherst analyzed samples of dairy and soy yogurts. They found ...

" ...that fruit-enriched yogurts - especially those made with blueberries or made from soy - contain active natural compounds that may curb some aspects of diabetes."

Specifically, the yogurts inhibited the action of two enzymes, α-amylase and α-glucosidase, which break down carbohydrates into a form that is easily absorbed. The result is a reduced spike in blood glucose following a meal.

The researchers also found that soy yogurts acted as ACE inhibitors, stalling the action of Angiotensin-I converting enzyme or ACE-I, an enzyme responsible for constricting blood vessels and contributing to high blood pressure.

The study will appear in the December issue of the Journal of Food Biochemistry.

________
For a summary of the study:
Fruit Yogurt Could Play Important Role in Diabetes Management, UMass Amherst Scientists Report

For the study (abstract):
Potential of Select Yogurts for Diabetes and Hypertension Management

work place workouts for obese

Workplace sometimes becomes a place of stress and fatigue. The average adult sits for 8-10 hours a day. Almost 40% of Americans are overweight or obese. Sitting at a computer desk all day can increase the risk for diabetes, metabolic syndrome, heart disease, arthritis, and certain types of cancer.  

People spend hours on the computer with high levels of concentration. This leads to fatigue and tiredness. To keep yourself fresh and energetic during work hours, a few methods can be followed which will give you complete relaxation to the entire body and you can work more efficiently. Here are a few tips to preventing the dreaded “secretary spread” and whittling the waistline while you work. Healthy and easy methods to reduce tiredness while at work Keep a good posture by holding your back straight. This might not be possible always, but keep trying and you can do it. Keep moving your body frequently. During the breaks, stretch your body and relax
Here are a few simple excercises that can be followed during work hours Have a deep seating and Straight up your back. Also Straighten your arms and push down your chair and lift yourself. Now, take deep breaths and Straighten your upper half of the body. Breath for about 5 times. Do this every 40 minutes.
Put your right hand on the back of chair and put your left hand on the right thy, and twist your upper half of the body by applying a little pressure. Move your lower part of the body the other way by breathing out. Do this on both the sides. Breath in while in normal position and breath out while your stretch.
Move to the edge of your seat. Straighten your legs and keep your heels down and toes straight. Bend and move your upper half of the body down as like your navel touch your thigh. You can stop moving down your body as and when you feel. Keep natural breathing while you are bending. Move up slowly. Repeat this 3 times slowly.
Stand up next to a table which is as high as your waist. Stand 1 and half feet away from the table. Put both your hands on the table and open your legs to the breadth of your shoulder. Now slowly straighten your body and legs
Now slowly bend without folding your hands or legs by moving your hip backwards and bringing down your head. You might have to hold your grip properly on the table and rest on your heals. While doing this take deep breaths.
Now after bending, put one of your legs a step forward and stretch further. Do the same for the other leg also.

The Underestimated Power of Online Relationships and the Implications for Population Health Management

Health care in a box?

Macis very upset.  Dopey Kyle, who otherwise seems like a nice guy, has been hot-chatting it up with online girlfriends.  Good thing pop psychologist Dr. Drew can come to the emotional rescue on MTVs "Teen Mom."

The Disease Management Care Blogs response?  Mute and quickly change the channel before the DMCB spouse has one more reason to doubt the intelligence of the male species.

Yet, only the perspicacious DMCB can use this sordid tale to extract an important lesson for the population health management (PHM) community.

Thats because it listened caully to TedMeds Jay Walker, who spoke at the closing plenary session at the Care Continuum Alliances Forum12.  Mr. Walker observed that handheld devices with texting are blurring the lines that separate in-person and virtual relationships.  While 3-D, face-to-face "analog" interactions still count, people are also going online to achieve an astonishing level of digital familiarity and even intimacy with each other.

While regular readers already know that persons turn to trusted in-person as well as virtual "friends" and "communities" for health care advice (past DMCB posts on the topic are here and here), the DMCB may have underestimated the full implications of just how real and behavior-changing an on-line relationship can be. 

No, the DMCB is not suggesting that PHM vendors start hot chatting with clients. 

But it is saying that vendors as well as buyers who discount "remote" web-enabled and text coaching versus in-person services may need to take another look at their future business plans and underlying value propositions. Maci and Kyles dysfunction are teaching us that remote texting has far more "connectedness" potential than generally appreciated. If a social-media-based relationships downsides can capture Maci and Kyles attention, why cant the upsides also be harnessed to change behavior?

We have a lot more to learn about the determinants of on-line relationship building.  Companies that figure it out will win.

Image from Wikipedia

Diabetes Link To Bacteria

Diabetes is often accompanied by chronic low-grade inflammation.  Recent research indicates that inflammation may be linked to molecules derived from bacteria.

It has been hypothesized that bacterial endotoxins, lipopolysaccharides (LPS) located on the outer membrane of Gram-negative bacteria, can increase the risk for type 2 diabetes by activating components of the immune system which promote insulin resistance and other metabolic abnormalities.

In this large prospective study from last year:

Endotoxemia Is Associated With an Increased Risk of Incident Diabetes, Diabetes Care, February, 2011

Endotoxemia was associated with an increased risk for type 2 diabetes. Notably, the increased risk was independent of established diabetes risk factors such as blood glucose, serum lipids, C-reactive protein (CRP), and body mass index (BMI). The risk was also independent of factors known to affect serum endotoxin activity, such as total cholesterol, triglyceride levels, HDL cholesterol levels, and smoking.

"Our results indicate for the first time that endotoxemia is a key player in the pathogenesis of diabetes and that microbes may have a central role."

________
This study from last month:

High Fat Intake Leads to Acute Postprandial Exposure to Circulating Endotoxin in Type 2 Diabetic Subjects, Diabetes Care, December 2011

Found that a high-fat meal elevated levels of endotoxins, especially in people with diabetes.

"These studies have highlighted that exposure to a high-fat meal elevates circulating endotoxin irrespective of metabolic state, as early as 1 h after a meal. However, this increase is substantial in IGT and type 2 diabetic subjects, suggesting that metabolic endotoxinemia is exacerbated after high-fat intake.

In conclusion, our data suggest that, in a compromised metabolic state such as type 2 diabetes, a continual snacking routine will cumulatively promote their condition more rapidly than in other individuals because of the greater exposure to endotoxin."

Previous studies implicated dietary fat in levels of endotoxins (LPS):

"In mice fed a high-carbohydrate diet, the increase in plasma LPS was blunted compared with mice fed a high-fat diet." 
...
"In this large sample of healthy men from a population-based sample, we found a link between food intake and plasma LPS. Experimental data suggest that fat was more efficient in transporting bacterial LPS from the gut lumen into the bloodstream."
- Energy intake is associated with endotoxemia in apparently healthy men, American Journal of Clinical Nutrition, May 2008

How does dietary fat assist endotoxin absorption?  Its been proposed that fat-soluble endotoxins mix with and are absorbed in conjunction with the fat contained in a meal:

"Dietary fat is incorporated from the gut into triglyceride-enriched lipoproteins, chylomicrons, whose formation promotes LPS absorption."
- Endotoxemia Is Associated With an Increased Risk of Incident Diabetes, Diabetes Care, February, 2011

Another hypothesis is that the absorption of endotoxins is assisted by inflammation present in the gut.  This novel study found that orange juice, taken with a meal, could lower levels of circulating endotoxins:

"Whether this increase of endotoxemia is due to the lipid solubility of endotoxin and its absorption into the circulation with the fat contained in the meal or is secondary to other factors such as the inflammation of the intestinal epithelium is not clear. If it is secondary to other factors, the potential antiinflammatory effect of orange juice intake could lower postprandial endotoxin increase."
- Orange juice neutralizes the proinflammatory effect of a high-fat, high-carbohydrate meal and prevents endotoxin increase and Toll-like receptor expression, American Journal of Clinical Nutrition, April 2010

________
The following study found a strong correlation between endotoxins and features of the Metabolic Syndrome (in line with the findings of the study at the top of this post which found an association between endotoxins and type 2 diabetes):

Bacterial Endotoxin Activity in Human Serum Is Associated With Dyslipidemia, Insulin Resistance, Obesity, and Chronic Inflammation, Diabetes Care, August 201

It is known that HDL cholesterol assists in the elimination of endotoxin from the circulation.  (In healthy individuals, endotoxins are bound mainly to HDL).  This study found that diabetic patients with low HDL often had high endotoxin activity.

"Of all the tested clinical variables, the strongest correlation was observed between the LPS/HDL ratio and serum triglyceride concentrations.  High fasting concentrations of triglycerides predict postprandial hypertriglyceridemia and the development of insulin resistance."

The study also found an inverse correlation between serum LPS activity and insulin sentitivity in both diabetic and nondiabetic groups.  High endotoxin activity was linked to insulin resistance.

The contribution of a high-fat diet was also noted:

"Human and animal studies have both highlighted the importance of the composition of the diet for its influence on the endotoxin absorption process. Consumption of an energy-rich high-fat diet may result in increased levels of gut-derived bacterial endotoxins in circulation."

The authors concluded:

"Taken together, these data show that endotoxins derived from gram-negative bacteria are strongly associated with the MetS variables in vivo. These observations may have clinical implications, because high LPS activity is more often found in subjects who show signs of dyslipidemia, insulin resistance, overweight, and inflammation—factors that increase the risk for diverse micro- and macrovascular complications."

Progress is Progress

Last Post Aug 10, 2011

Wt: 337

Morning BG: 113

BP: 147/82

Ankles (scale of 1 to 10) about 2 -- which is great



Today, Aug 22, 2011

Wt: 331

Morning BG: 106

BP: 147/88

Ankles (scale of 1 to 10) about 1.75 -- which is great



I consider this a monumental breakthrough!



Most times when I have not been blogging, that is a big indication that I have been wandering around in a fog -- but this time is different. I have been keeping my daily food journal for about four weeks and today is the start of week 5.



My progress has been extremely slow by some evaluations but I consider progress, even slow progress, to be exactly that: progress. Some people might think that a six pound loss in five weeks is nearly nothing, my former self included but after trying for two years to settle on a program that I could do and stick to (very important) and also see progress in weight loss and blood sugar numbers, I think I have finally found the solution. It is my own modified version of the Carbohydrate Addicts Lifespan Program by Drs Richard and Rachel Heller (http://www.carbohydrateaddicts.com/).



I think I told you I made myself a chart to keep track of things and as I have been going along I have made some chart changes that suited my needs. I think I have the final chart down now. I call it a "chart" because I made it in Excell and it has places for me to record todays date, my daily morning weight, my morning blood pressure and blood sugar readings, along with my pulse (that comes with the BP reading so I just write it down) along with what I call "Ankles" which is my eyeball evaluation of the edema in my legs and ankles. I awake enthusiastic to record my numbers and have been eagerly doing it for four weeks now.



I took the Hellers advice and have weighed myself every day and at the end of the week I calculate the average. (You just have to know that I made an Excell chart for that too!!) I call this one my Progress Chart. Im using my old "standard weight" of 352 as my starting weight and then subtract to find my actual weight loss for the week. The first three weeks my weight really did not change much (15, 14.7, and 14.8 lbs lost) if you round those off I stayed at a 15 pound weight loss for three weeks. I figured that if I was not gaining weight that was progress. Then the next week I suddenly lost two pounds and this morning I went down another 3.7 pounds for a total lost (today) of 21 pounds. I am fully aware and even expecting that will fluctuate up and down over the next week to whatever it ends up to be, but I must say it was a good day when I found that number on my scale for the first time.



The thing that keeps me motivated and on track is the actual elimination of food cravings that has been going on from following the program. As I ate my raw low carb vegetables and proteins I felt fully satisfied and was not craving food. Sanity suddenly showed up. That is what makes the program easy to do and what gives me enthusiasm to continue. I no longer have to fight against my own body and self to stay on the program. Just as Rachel Heller says, it does not take will power to stay on a program that is satisfying, which this one, FINALLY, is.



Since when I started I had already gone through the "withdrawal" and was off of sugar, starches, and any other high carb items from the eight day juice fast, I did not have to spend the first three days fighting withdrawals on the program. It was actually quite easy to begin incorporating satisfying salads and proteins which make me feel good. Literally.



That is not to imply that I did not have any problems, though. The "Reward Meal" was the first daily problem that I encountered. Im not saying this is a bad part of the program, Im just saying it caused me problems. My blood sugars would jump up pretty high after a reward meal, and I had trouble controlling the amount of carbs I was eating. I was not exactly like a kid in a candy store, but I began to see those impulses. Im so glad I was journaling and keeping track of my blood sugars at that time, because I could tell the reward meal was causing me problems by how high my blood sugars went after those meals.



My first program modification then was to reduce the number of reward meals I had. I could not do one every day, my body is too extremely sensitive to carbs to be able to handle that. I had thought that I might have one every three days, but I came across a better solution. I eliminated the "Reward Meal" concept and rules and replaced it with shirataki noodles (SNs) once a day. I have found through blood sugar checking that the SNs do not raise my blood sugars even one point. You would think this might make me "over indulge" but Ive notice I also have some side effects from the SNs so I keep it at once a day.



The side effects are the same as eating other carbs, minus the blood sugar increases. I am not positive yet, but think there might be an effect on the edema. I think my body has had to adjust to this new and foreign-to-my-system food, also, so I am giving it time to adjust. I noticed right away that my sinuses seem to be effected by it with an increase in liquid output and post nasal drip. Ive even noticed a headache on some occasions. I dont seem to be getting the headaches as often now but Ive also noticed that my herniated disc seems to be acting up from the exercise that I am doing which can also cause headaches, so the jury is out on whether it is the noodles or the disc causing those. I need to start doing neck traction again, so I can eliminate that as a possibility.



The good things about the SNs are that they fill me up, satisfy the sense memories, and do not raise my blood sugars. So I use them for the reward meal, at which, I no longer have to be so caul. One package is "one serving" so I can eat all 8.8 ounces and not feel any pangs. It truly is a pleasure food to eat. They are touted as extremely high in fiber. I still have to take magnesium to keep regular but am not having the problem of trying to pass "bricks" as I did so long ago on a low carb/high protein diet. So, for now, I shall continue with the SNs for my reward meals. I suppose I might at some time get tired of "stir fry" which is how I have been cooking them, but there are so many varieties of other ingredients (the protein choices to the veggies and spices) that Im happy and satisfied with it all.



If you would like to check out the Shirataki noodles that I am using for yourself, here is the web site that I ordered them from: http://www.konjacfoods.com/



I am ordering them online because I have not yet found a local source. They have the tofu/shirataki noodles at Whole Foods if you feel OK about eating soy-based foods, but I dont eat soy because I believe it causes some forms of cancer and is simply not good for humans to eat. They are not low in carbs, either. If you do not have those considerations (or simply have not read about them, yet) you can choose to eat them. They are not for me, though. I dont suppose buying one package to try them out would kill you, but why become familiar with and begin to enjoy something that is not good for you? I buy the plain (no tofu) ones online and am happy with them. (for my initial reactions and descriptions of the noodles in more detail see http://blogspot.com/2011/07/shirataki-noodle-verdict-is-in.html .)



Have to go get ready for physical therapy so will leave this for today. Hope you are doing well. I really do. Have a good one,



Be back soon,

Marcia

Health Insurance Rebates A 1 3 Billion Non Event

The Disease Management Care Blog has a lingering weakness for garden statuary. It thinks that nothing quite compliments phlox and snapdragons better than a weenie cherub or squatting amphibian.

The skeptical DMCB spouse disagrees. Tired of  kneeling trolls disturbing her caully laid mulch, she questions whether her husbands admiration for toadstools, rabbits or fairies projects the right level of curbside sophistication. 

Skepticism may also be a reaction of 16 million Americans who are about to discover a health insurance garden gnome rebate check in their mailbox.  According to The Hill, the commercial insurers that havent met the Affordable Care Acts 80 to 85 percent medical loss ratio rule will have to give back a total of $1.3 billion in premium rebates this summer. Whats more, the checks will have to be accompanied by a statement that theyre the result of Affordable Care Act.

The DMCB thinks this will turn out to be a non-event for four reasons:

1) What Does This Really Mean to an Individual?

When the DMCB does the math, $1.3 billion spread over 16 million eligible Americans works out to $81.25.  This article says the amount will be higher at $127.  While the DMCB thinks any free cash is always welcome, its inner behavioral economist doesnt think a check for around a hundred bucks is going to generate much buzz among health care consumers, especially among a population segment that can already afford to buy commercial insurance. 

2) Remember the Tax Rebate Checks of 2008?

Neither can the DMCB. But tracking polls at the time suggested they did little to capture Americas imagination or boost consumer confidence. That doesnt mean that Washington DC doesnt continue believe that giving something for nothing will generate gratitude and votes. All the better if its done just prior to a major election and humiliates health insurers.

3) Speaking of Which....

Why arent the health insurers pushing back by pointing out that the rebates pale next to the cost of the ACAs mandates and that a one-size-fits-all medical loss ratio rule is unfair to the individual insurance market? Could it have something to do with $1 trillion in new business or the threat of being resurrected as an anti-progressive bogeyman? The DMCB calculates that $1.3 billion will be viewed by consumers as the price of doing business with a hostile federal government. 

4) Plus, Is A Billion A Lot?  Really?

The DMCB looks forward to hearing our chattering politicians extol the rebate of "$1.3 billion." While that used to sound like a lot, our unending budget fiasco has since taught Americans that the term "billion" is now synonymous with a federal budget rounding error. Who can forget Harry Reids quote that the billions saved in passing tort orm was insignificant?

Next stop for the DMCB will be a bunch of solar powered lamps and a volleyball-sized mirrored gazing ball.  What the Administration has planned for our health insurers is another matter.

Excess vitamin E intake not a health concern

Despite concerns that have been expressed about possible health risks from high intake of vitamin E, a new review concludes that biological mechanisms exist to routinely eliminate excess levels of the vitamin, and they make it almost impossible to take a harmful amount.

No level of vitamin E in the diet or from any normal use of supplements should be a concern, according to an expert from the Linus Pauling Institute at Oregon State University. The review was just published in the Journal of Lipid Research.

“I believe that past studies which have alleged adverse consequences from vitamin E have misinterpreted the data,” said Maret Traber, an internationally recognized expert on this micronutrient and professor in the OSU College of Public Health and Human Sciences.

“Taking too much vitamin E is not the real concern,” Traber said. “A much more important issue is that more than 90 percent of people in the U.S. have inadequate levels of vitamin E in their diet.”

Vitamin E is an antioxidant and a very important nutrient for proper function of many organs, nerves and muscles, and is also an anticoagulant that can reduce blood clotting. It can be found in oils, meat and some other foods, but is often consumed at inadequate dietary levels, especially with increasing emphasis on low-fat diets.

In the review of how vitamin E is metabolized, researchers have found that two major systems in the liver work to control the level of vitamin E in the body, and they routinely excrete excessive amounts. Very high intakes achieved with supplementation only succeed in doubling the tissue levels of vitamin E, which is not harmful.

“Toxic levels of vitamin E in the body simply do not occur,” Traber said. “Unlike some other fat-soluble vitamins such as vitamins A and D, it’s not possible for toxic levels of vitamin E to accumulate in the liver or other tissues.”

Vitamin E, because of its interaction with vitamin K, can cause some increase in bleeding, research has shown. But no research has found this poses a health risk.

On the other hand, vitamin E performs many critical roles in optimum health. It protects polyunsaturated fatty acids from oxidizing, may help protect other essential lipids, and has been studied for possible value in many degenerative diseases. Higher than normal intake levels may be needed for some people who have certain health problems, and smoking has also been shown to deplete vitamin E levels.

Traber said she recommends taking a daily multivitamin that has the full RDA of vitamin E, along with consuming a healthy and balanced diet.

Soya Upma

Who will say no to a healthy twist to our usual Indian breakfast dishes??that too the usual rava upma as soya upma. Actually this recipe is from Tarladalals healthy breakfast cookbook, this recipe is definitely filled with healtthy and nutritious stuffs in it. I immediately got hooked to this protein rich upma while going through the cookbook and prepared them for my breakfast few days back. Obviously do i need to say anything about this tasty and healthy upma, actually the simplicity of this dish is the highlight of this upma, just cook the soya granules, saute the veggies,mix and toss everything together,thats it, watelse we need for a busy morning breakfast.

If you are a vegetarian or a soya lover like me, this simple upma is definitely a feast for u. You can carry this upma very well even for a lunch, also you can serve them as a snack if you have sudden guests, yep feed your guest with healthy stuffs,am sure they wont hesitate a second to finish their plate. This is my last and third post of this weeks blogging marathon with cooking with cookbooks as theme.Check out the Blogging Marathon page for the other Blogging Marathoners doing BM#25.

1cup Cooked soya granules
1no Onion (big & chopped)
1/2cup Grated carrots
1/2cup Greenpeas
1/4cup Grated cabbage
3nos Green chillies (slit opened)
1tsp Cumin seeds
1tsp Uradal
1/4tsp Asafoetida powder
1tsp Grated ginger
Oil
Salt

Heat the oil in a kadai, let crackle the cumin seeds,uraddal, add the asafoetida ,ginger and green chillies and onions..

Cook everything until the onions turns transculent.

Add the veggies now and saute them for few minute.

Finally add the cooked soya granules and toss everything gently..

Add the salt and mix again well.

Serve hot with your favourite chutney.

Dont worry,if you dont have soya granules, cook the soya chunks in salted boiling water, drain the excess of water, grind it as a coarse paste and use it.