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Physicians encouraged to ease guilt, embarrassment in patients with obesity

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Healio interview

Disclosure:
Stanford claims to have received compensation from Currax Pharmaceuticals.

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A new poll suggests the COVID-19 pandemic may have made the obesity epidemic in the United States worse.

Before the pandemic, the obesity prevalence among American adults was 42.4%, according to the CDC. The new survey of 545 adults with a BMI of at least 27 kg / m2 found that just over half had gained some weight during the pandemic. Of these, nearly three in four had gained 10 or more pounds and half had gained 15 or more pounds.

New data suggests that the obesity epidemic worsened during the COVID-19 pandemic.
Photo source: Adobe Stock

The survey also found that almost one in three patients had never spoken to a doctor about their weight, and more than half of those surveyed said they were “uncomfortable”. To make matters worse, according to the authors of a recent study in BMC Family Practice, “obesity management has not been prioritized or effectively handled in primary care. [and] In 2008 less than 5% of home visits were devoted to obesity. “

Fatima Cody Stanford

Healio Primary Care spoke to Peer Perspective board member Fatima Cody Stanford, MD, MPH, FAAP, FACP, FAHA, FAMWA, FTOS, an obesity medicine physician and director of outside counseling services for Weight Center at Massachusetts General Hospital, on how primary care physicians can discuss weight loss with patients. Stanford also discussed a new online resource for obesity patients as well as other topics.

Healio Primary Care: Can you please describe the new online resource center for patients who want to lose weight?

Stanford: The new resource was developed in conjunction with the Why Weight: Communicate campaign. It’s an educational initiative designed to help you start your conversation with your doctor about your weight. Basically how do you implement this, how do you start this conversation in a productive and helpful way? There are videos, there are conversation starters, all of which are freely available to anyone who visits this site to really have this meaningful conversation.

Healio basic care: How can PCPs initiate conversations about obesity while Avoiding discussions that patients perceive as “fat shaming” “?

Stanford: I think we need to work with family doctors and all doctors to design our environment so that it is safe, warm, supportive and caring.

So one of the most important things you say is, “I’ve noticed that you may be struggling with your excess weight. Would you like to start looking at it today? ”Get an idea of ​​where the patient is. Are you ready to have this conversation – as opposed to assuming you are ready for this conversation – and when you are ready for this conversation do you get a feel for what you are trying to address? I think this gives patients the ability to have their voice and agency to address their obesity or other obesity issues.

Healio basic care: What are the limitations of using BMI to determine healthy weight? What other factors should PCPs consider when assessing patient weight?

Stanford: The BMI is just a calculation that was developed based on the Metropolitan Life Insurance table in the 1930s and 1940s based on actuarial data. How many people died or got sick with certain weight conditions, and that’s how they calculated it. The problem with this is that important parts of the population were not recorded. Black people like me, for example, were not considered [and neither were] Hispanic individuals who make up a sizable part of the United States. The BMI only takes height and weight into account. It doesn’t tell me anything about this weight. Is the weight muscle, is it fat? If so, is it fat that is stored around the organs – what we call visceral adipose tissue? What is it? So the BMI does not give us a complete picture.

Other things I use every single visit to my patients are something simple, like measuring their waist circumference with a tape measure. When we carry weight around our core it is much more damaging to our health, and when I carry weight in my bum, which I do, it is actually not damaging. That’s just muscle tissue and buns. But when it is in your midst around important organs like your heart and liver, it leads to metabolic disorders that lead to a myriad of health problems. I think the BMI is a decent population-based measure, meaning it can provide general information about the population as a whole, but when you’re working with a single patient you just want to focus on that patient and make them so happy, the healthiest weight for them instead of assuming they have to reach a number that doesn’t give us a lot of clear information.

Healio basic care: How can PCPs help patients set a healthy weight goal and plan a realistic weight loss journey?

Stanford: So what I do with my patients, what I think is a good strategy, is first, I never give my patients a target weight – and let me tell you, they have been asking for over 17 or 18 years now: “What weight should I have ? ” The reason I don’t do this is because everyone is different, meaning that every body reacts differently to interventions, be it a lifestyle change, taking medication, or having an operation. So I have to see what is the healthiest weight for her. One thing I recommend is to calculate things like total body weight loss from the first visit and calculate it over time. What we do know is that when someone loses between 5% and 10% of their body weight, it can have positive effects on their health. So that’s a percentage. That 5% to 10% would vary for someone weighing 400 pounds versus someone starting at 200 pounds, and that can lead to things like lower blood pressure, improved blood sugar, or improved cholesterol levels. These things are real and tangible, and we know that 5 to 10% can help people transition to a healthier state not only in relation to obesity but also in relation to other disease processes as well. For some we get as high as 45% – so that’s great, but the goal is these small measurable goals, starting with the goal of at least 5% at the beginning and then moving on.

Healio basic care: What are the best strategies PCPs can share with patients to combat food cravings?

Stanford: I think one of the best strategies family doctors can use is to emphasize the need to consume unprocessed foods. Some of the things that really drive our cravings is the processing of our food; We want our food to look like it does in nature. I take on Cheez-It, for example: they look like nothing in nature, which means they’re probably processed. We want lean protein, whole grains, fruits and vegetables, whole grain breads. If this is our predominant consumption, it can help with our cravings.

For those who are still having problems, they may need medications like Contrave, a drug used to change some of these food cravings. But we have to start with our lifestyle first and then move on to other strategies. And for some, they may even need surgery, and we should realize that different people may need different treatment strategies, but we want to start lifestyle changes at the base of the pyramid and have this meaningful conversation.

Healio basic care: What prescription weight loss treatments do you use in practice? What results have you seen with these treatments?

Stanford: As an obesity medicine doctor, I use every drug currently FDA cleared for the treatment of obesity here in the United States. There are a number of therapies. This campaign is run by the pharmaceutical company Currax, which makes Contrave – a combination of two drugs called bupropion and naltrexone. But on top of that I use all the other active ingredients: Qsymia, a combination of phentermine and topiramate; and Saxenda, a liraglutid, for example.

My goal is to find out what works for the patient, and I can tell you, as someone who has probably prescribed more obesity drugs than most people in this country, that everyone reacts differently to each drug, and sometimes we have to even combine active ingredients. My goal is to simply find out what works for that person and whatever we need to do to work safely for that person to help them achieve a healthy weight and improve their overall health. That is the strategy that we will maintain.

References:

Hales CM et al. Data overview from the National Center for Health Statistics. Obesity and severe obesity prevalence in adults: United States, 2017–2018. https://www.cdc.gov/nchs/products/databriefs/db360.htm. Accessed June 25, 2021.

Hruby A and Hu FB, Pharmaceutical Economics. 2015; doi: 10.1007 / s40273-014-0243-x.

Orjulea-Grimm M, et al. BMC Fam practice. 2021; doi: 10.1186 / s12875-021-01484-j.

Y. Wang et al. Int J Epidemiol. 2020; doi: 10.1093 / ije / dyz273.

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DVIDS – News – Fit for 2022: Commissaries offer plenty of tips, ideas, resources to help patrons improve their health and wellness

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By Kathy Milley, DeCA Public Affairs Specialist

FORT LEE, Va. – The new year is always an exciting time for reflection and recommitment, especially when it comes to wellness. Whatever your health goals for 2022, the Commissary is here to guide you in the right direction with tips, ideas and resources to improve nutrition.

“The health and well-being of our guests is our number one priority, so it’s vitally important to us, too,” said Bonita Moffett, Defense Commissary Agency Sales Manager. We work diligently to offer our customers the right mix of products and resources to support their wellness goals while saving big at checkout.”

According to Deborah Harris, DeCA’s Dietitian and Health and Wellness Program Manager (who holds a Masters of Public Health degree and is a Registered Dietitian and Certified Diabetes Care and Education Specialist), the officer strives for when he commits to a healthier lifestyle and Wellness Goals Keep customers engaged by offering easily identifiable, high-performing foods and easy-to-use, quick meal solutions and wellness resources.

• Dietitian Approved Thumb (DAT): The “Thumbs Up Dietitian Approved” labels on shelves make it easier for shoppers to quickly identify foods with high nutritional value that they can incorporate into healthy eating habits. DAT uses unique software that analyzes and identifies products in most commercial food categories based on up to 86 FDA-defined health attributes. Attributes analyzed vary by food category, but identify dietitian-approved foods that limit added sugars, sodium, and unhealthy fats while containing whole grains, healthy fats, fiber, or lean protein, as well as items that qualify as USDA organic . Once these products are identified, they are marked on consignment shelves with a “Thumbs Up – Dietician Approved” label.

• Thinking Outside the Box Recipes: Preparing nutritious food at home doesn’t have to be difficult or expensive. With “Thinking Outside the Box” recipes, Your Commissary continually offers meal solutions that are quick, healthy and economical, using ingredients that are normally offered to our customers at greater savings. Recipes are always available on commissaries.com under the Healthy Living tab. This library includes quick and easy, nutritionist-approved recipes for appetizers, entrees, salads, sides, and even desserts.

• Commissary CLICK2GO: Use Commissary CLICK2GO, the Commissary’s online ordering service, to instantly add the ingredients of your favorite nutritionist-approved recipe to your virtual shopping cart. With your Commissary CLICK2GO order on Commissaries.com, click on the recipe link (https://shop.commissaries.com/recipes), select the recipe you would like to add to your meal plan for the week and click simply click “Add to Cart” next to each of the ingredients you need to prepare the meal. Preparing nutritious food at home has never been easier.

• Gas Stations: Dietitian-approved gas stations, located near the front checkout aisles at over 170 food service establishments, offer convenient, tasty, nutritious meals and snacks to give customers the convenience they need without the high calories or high cost of a fast food restaurant meal. Customers can expect to see products that offer protein, healthy fat, complex carbohydrates, and a low-calorie form of hydration, such as low-calorie water and sports drinks, deli sandwiches, one-serving hummus, ready-made lean protein, fruit and cheese, no-sugar-added yogurt, Low sugar protein bars or prepared sliced ​​fruits and salads.

• Quick Homemade Meals: Don’t let a lack of time prevent guests from preparing nutritious home-cooked meals. DeCA has created a list of no-fuss entrees (https://commissaries.com/sites/default/files/2019-09/no_fuss_entrees.pdf) selected from the many nutritionist-approved “Thinking Outside the Box” (https://). became. /www.commissaries.com/healthy-living/healthy-eats) Recipes featured on commissaries.com. The list is designed to minimize prep time with quick and easy meal solutions featuring ingredients that will save groceries money. It includes links to recipes for quick preparation using a slow cooker, microwave or pressure cooker; Prepared frozen meals; One-skill meals and entrees with prepared protein like fried chicken and canned tuna.

• Meal Planning: To make meal planning easier, DeCA has created two nutritionist-approved dinner menu plans, including weekly grocery lists, each for an entire month of family meals. These monthly meal plans are available on commissaries.com at these links: Meal Plan #1 (https://www.commissaries.com/sites/default/files/2021-02/nutrition-month-calendar-2b.pdf) and Meal Plan #2 (https://www.commissaries.com/sites/default/files/2021-09/Meal-plan-calendar-with-links.pdf). Choose your preferred plan and simply print out the grocery list for the week, add breakfast and lunch items and your grocery list is ready. You have everything you need for the week. If you want to create your own menu plan tailored to your family’s preferences, use our easy-to-follow planning guide, the Dietitian Approved Menu Planner (https://www.commissaries.com/sites/default/files/ 2019-02 /Dietititan_Approved_Menu_Planner.pdf) and the Weekly Meal Plan Worksheet (https://commissaries.com/sites/default/files/2020-06/Weekly_Meal_Plan_Worksheet.pdf).

“Make fruits and vegetables your favorite snack, experiment with nutritious substitutes like cauliflower rice and zucchini noodles for starchy rice or pasta, or try a new fruit or vegetable each month,” Harris said. “All of these ideas, coupled with our programs that identify high-performing foods, our easy-to-use quick meal solutions, and our many wellness resources, give our customers a head start in achieving their wellness goals while stretching their grocery dollar.”
-DeCA-

About DeCA: The Defense Commissary Agency operates a global chain of commissioners that provide military members, retirees and their families with groceries in a safe shopping environment. Commissioners offer a military advantage and save authorized customers thousands of dollars annually on their purchases compared to similar products at commercial retailers. The reduced prices include a 5% surcharge to cover the cost of new construction and modernization of existing police stations. As a central element of military family support and a valuable part of military salaries and benefits, commissioners contribute to family preparedness, improve the quality of life for the American military and their families, and help recruit the best and brightest men and women for service and to hold country.

Date of recording: 01/20/2022
Release Date: 01/20/2022 17:04
Story ID: 413176
Location: FORT LEE, VA, USA
Web Views: 10
Download: 1

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Hy-Vee HealthMarket Picks and Heart Health

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DAVENPORT, Iowa (KWQC) — Nutritionist Katie Schaeffer of Hy-Vee shares HealthMarket products and a healthy mango salsa!

Top 5 HealthMarket Products

· Food For Life Ezekiel Sprouted Grain Bread

  • Food For Life Ezekiel Bread is made by combining six sprouted grains and legumes (wheat, barley, millet, lentils, soybeans and spelt) that together provide a complete protein. It is free from preservatives.
  • Sprouting grains can help improve digestibility, absorption of nutrients and antioxidants.
  • Each slice of bread contains 3 grams of fiber and 5 grams of protein. Both fiber and protein can help with satiety and support better blood sugar control.

Tumaros Carb Wise Wraps

  • Tumaros Carb Wise Whole Grain Wraps contain 60 calories, 13 grams of carbohydrates, 7 grams of fiber and 5 grams of protein.
  • The lower-calorie yet high-fiber combination is helpful for those trying to lose weight while staying fuller for longer.
  • They can be used for so much more than just packaging. Try them as breakfast burritos, sandwiches, enchiladas, tacos, and fajitas.

· Zevia® Zero Calorie Soda

  • Zevia® – Zero Sugar, Zero Calories and Naturally Sweetened
  • All Zevia® products are kosher, vegan and gluten-free
  • Zevia® drinks are sweetened with stevia leaf extract and contain no additives that many must avoid to manage their ailments.

Banza noodles

  • Banza noodles are made from chickpeas. Chickpeas have been shown to improve blood sugar control. Studies show that eating beans is correlated with a reduced risk of diabetes and cardiovascular disease.
  • Banza is high in fiber and protein (5 grams of fiber and 11 grams of protein per serving). For those looking to go more plant-based, banza can be a helpful addition to a pasta that provides a good amount of protein. It provides 1.5 times more protein and 3 times more fiber than regular pasta.

· Avocado Oil by Chosen Foods

  • Chosen Foods Avocado Oil is 100% pure, naturally refined and always made from perfectly ripened avocados, which are a healthy source of fat.
  • Chosen Foods Avocado Oil is the workhorse of the kitchen. With its neutral flavor, avocado oil can be used in baking, marinades, dressing mixed leafy greens, and pasta salads — the possibilities are endless.
  • With avocado oil’s smoke point of 500°F, it can be used for any cooking purpose, from frying over high heat to grilling or baking.

Healthy You at the Health Fair 2022 – in person!!!

Do you want to start the new year off right? Attend our annual health fair to learn about your nutritionist’s favorite products, get your nutrition questions answered, and receive free samples, recipes, and coupons.

o Event date: Saturday, January 29, 12:00 p.m. – 2:00 p.m

o Locations:

  • Northgate Hy-Vee (1823 East Kimberly Street, Davenport, IA)
  • Devil Glenn Hy-Vee
  • Utica Ridge Hy-Vee
  • Milan Hy Vee
  • Rock Island Hy Vee

Mango Black Bean Salsa

Served 16

Everything you need:

1 medium mango, peeled, seeded and cut into ¾-inch cubes

1 (15 oz) can Hy-Vee black beans, drained and rinsed

1 cup frozen Hy-Vee Select super sweet corn, thawed

¼ cup diced red peppers

¼ cup finely chopped green onion

1 tbsp minced garlic

¼ cup coarsely chopped fresh parsley

3 tbsp fresh lime juice

Sp tsp Hy-Vee salt

¼ tsp ground cumin

Baked tortilla chips for serving

Everything you do:

In a medium-sized bowl, mix all the ingredients. Serve with baked tortilla chips.

_________________________________________________________________________________________________________________________________________________________________________________

· READ NUTRIENT LABELS: Look for foods with 2 grams or less of saturated fat, 0 grams of trans fat, and less than 140 mg of sodium per serving. Choose foods with at least 5 grams of fiber per serving.

· ADD GOOD FATS TO YOUR BASKET: Unsaturated fats like nuts, olive oil, avocados, and salmon can reduce the amount of low-density (“bad”) lipoprotein (LDL) cholesterol in the blood and lower the risk of heart disease.

· CHOOSE WHOLE GRAIN FOODS: Look for the word “whole grain” as the first item in the ingredients list instead of fortified flour or “multigrain”. Whole grains contain the whole grain and are a better source of fiber.

· BEWARE OF HELPFUL INGREDIENTS: Sodium and added sugars can go by many different names. Sodium can be referred to as monosodium glutamate (MSG); Sugar can be high fructose corn syrup, dextrose, or molasses.

LOOK FOR THE HEART TICKET: When you see the heart tick on a food label, it means the product has been certified by the American Heart Association to meet certain nutritional requirements.

  • Heart Check certified foods contain 10% or more of the daily requirement of vitamin A, vitamin C, calcium, protein or fiber. It has 1 gram or less saturated fat per serving, ½ gram or less trans fat per serving, and limits sodium (based on each food category).

Meet your metric screening

When: February 2022

What: Do you want to take control of your health? Come for a Free Biometric Screening with your Hy-Vee Nutritionist! Your dietitian will take a fingerstick blood sample, which is used to measure cholesterol, triglycerides, and glucose levels. They will also measure resting blood pressure, weight and body fat percentage. Appointments will be made based on availability while stocks last! To enroll, visit www.hy-vee.com/health.

Where: Northgate Hy-Vee (1823 East Kimberly Road, Davenport, IA 52803) and Milan Hy-Vee

Copyright 2022 KWQC. All rights reserved.

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The Beef on Plant-Based Meat Alternatives

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Just look at the grocery store shelves and you will see a plethora of plant-based meat alternatives. As more people restrict animal products, companies are offering a wider variety of plant-based foods that mimic the taste of meat.

The non-meat eater population is growing, with 63% of respondents in a recent US consumer survey saying they are eating more plant-based foods. Specifically for plant-based meat alternatives, market research firm SPINS reported that dollar sales for plant-based meat increased 45% from 2019-2020.

People are turning to vegetarian options for many reasons, including environmental sustainability and animal welfare. Plant-based foods generally have a lower environmental impact while providing fiber and other nutrients that may help prevent some chronic diseases.

Research has shown that a greater intake of red and processed meat increases the risk of heart disease. A study of 20,000 people published in the journal European Society of Cardiology showed that people who ate more red meat had smaller heart chambers, poorer heart function and stiffer arteries.

On the other hand, research has linked a plant-based diet to lower cardiovascular risk.

“Everyone should follow a plant-based diet to reduce the risk of cardiovascular disease and certain cancers, and to diversify the bacteria in your gut microbiome,” says Kirsten Straughan, RD, director of the Nutritional Sciences program at the College of Applied Health Sciences University of Illinois Chicago.

If you’re looking to increase plant-based meat alternatives in your diet, you should know what to look for because not all are created equal.

Meat and plant-based diet

You know what you can get from whole plant-based foods — like an apple or a stalk of broccoli — but how healthy are plant-based meat alternatives?

The magic of food technology has transformed plant proteins from soybeans, peas, legumes, nuts, seeds, whole grains and mushrooms, or “mycoproteins,” into a variety of plant-based meat alternatives, from veggie burgers, sausages and hot dogs to fake chicken nuggets and fish fingers.

And just as animal meat is nutritionally different, not all plant-based meat alternatives are created equal.

Recent research in the Journal of the Academy of Nutrition and Dietetics compared the nutritional quality of ground beef alternatives sold by major brands in the US and ground beef made from animal meat.

The plant-based ground beef alternatives tended to contain less saturated fat than ground beef, although levels varied. Some products in the study had as much saturated fat as ground beef.

The plant-based alternatives contained a moderate amount of fiber, which is underconsumed in the US. The results also showed that the plant-based alternatives were good sources of iron, manganese, copper, folic acid, and niacin. However, they contained fewer essential nutrients — protein, zinc and vitamin B12 — than ground beef.

Sodium levels were also higher in plant-based alternatives than animal meat, but salt is usually added to flavor ground beef during cooking.

Plant based diet

Just because products are plant-based doesn’t mean you can be sure you’re getting all the nutrients you need. Consider how these options fit into your broader diet.

“It’s the total diet that counts,” says Penny Kris-Etherton, PhD, RDN, professor of nutrition at Pennsylvania State University, who recently spoke about plant-based meats and reducing cardiovascular risk at the Academy of Nutrition and Dietetics’ Food & Nutrition Conference & Exhibition.

“When you go plant-based, make sure you’re doing it right, because if you’re doing it wrong, you’re not doing yourself any good,” she says.

The food we eat, whether plant or animal, must be nutritionally adequate and in line with current dietary recommendations. “Our goal should be to achieve optimal nutritional quality, whether or not the diet contains animal protein,” says Kris-Etherton.

“Lean beef can provide many nutrients that are either under-absorbed or difficult to obtain,” she says. Lean beef provides protein, easily absorbed iron, zinc, magnesium, selenium, vitamin B12, phosphorus, as well as creatine for muscle growth and maintenance, the antioxidants taurine and glutathione, and conjugated linoleic acid, an important fatty acid.

“Lean beef can be incorporated into a healthy diet that meets all current nutritional recommendations for health promotion and disease prevention,” she says.

If you’re replacing animal meat in your diet, make sure you’re getting a nutritious substitute, says Straughan. “It’s important to read labels,” she says. “Even within brands, look at individual products, look for saturated fat from coconut oil, and look for fiber in the product.”

The bottom line is that eating less red and processed meat — and less animal products in general — can be good for your health, but it’s important to understand whether plant-based meat alternatives hit the nutritional mark for you.

Vicki is a Registered Dietitian, Lifestyle Nutritionist, Author, Culinary and Media Consultant and the author of two books.

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