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   Is "fat but fit" a myth or true? The results of this study suggest that it is a myth. That there is a higher risk of coronary heart disease, and even if everything looks OK initially, it is associated with an eventual metabolic changes (and problems). Just wait a while - as can be seen in the results of this study that followed people from 8 European countries over many years (about 12.2 years). The study found that being normal weight and fit is best, and that "metabolically healthy" obese people were more likely to go on to develop metabolic abnormalities (and become metabolically unhealthy obese people) over the years. Metabolically unhealthy signs included high blood pressure, low HDL-cholesterol, and hyperglycemia (high blood sugar).

Bottom line: aim for normal weight for a lower risk of heart disease (and of course, be physically active and eat a healthy diet - fewer processed foods, and more fruits, vegetables, whole grains, seeds, nuts, and legumes). From Science Daily:

'Fat but fit' are at increased risk of heart disease

Carrying extra weight could raise your risk of heart attack by more than a quarter, even if you are otherwise healthy.Researchers have found that being overweight or obese increases a person's risk of coronary heart disease (CHD) by up to 28 per cent compared to those with a healthy body weight, even if they have healthy blood pressure, blood sugar and cholesterol levels.The findings add to a growing body of evidence that suggests being 'fat but fit' is a myth, and that people should aim to maintain a body weight within a healthy range.

Storing too much fat in the body is associated with a number of metabolic changes, including increased blood pressure, high blood sugar and altered cholesterol levels, which can lead to disease and poor health. However, previous studies have revealed a subset of overweight people who appear to lack the adverse health effects of excess weight, leading to them being classified as 'metabolically healthy obese' in the medical literature, and 'fat but fit' in the media.

Now, a group led by researchers at Imperial College London and the University of Cambridge has shown that despite an apparent clean bill of health, this overweight group is still at increased risk compared to those with a healthy weight. In the largest study of its kind to date, scientists used data from more than half a million people in 10 European countries -- taken from the European Prospective Investigation into Cancer and Nutrition (EPIC) -- to show that excess weight is linked with an increased risk of heart disease, even when people have a healthy metabolic profile.

In the study, published in the European Heart Journal, researchers looked at the link between excess weight and risk of CHD, a condition where not enough blood gets through to the heart due to clogged arteries, leading to heart attacks. After a follow-up period of more than 12 years, a total of 7,637 people in the EPIC cohort experienced CHD events, such as death from heart attack. Researchers then selected a representative group of more than 10,000 individuals as controls, for analysis. Body weight was classified according to definitions from the World Health Organization. Those with a body mass index (BMI) over 30 were classed as obese, while those with a BMI of 25-30 were classed as overweight, and 18.5-25 as normal weight. More than half of the control group (63 per cent) were female, with an average age of 53.6 and an average BMI of 26.1.

Participants were categorised as 'unhealthy' if they had three or more of a number of metabolic markers, including high blood pressure, blood glucose, or triglyceride levels, low levels of HDL cholesterol, or a waist size of more than 37" (94 cm) for men and 31" (80 cm) for women. .... the researchers found that compared to the healthy normal weight group, those classed as unhealthy had more than double the risk of CHD, whether they were normal weight, overweight or obeseHowever, analysis also revealed that within the apparently healthy group there was a significant difference in outcomes for people depending on their weight. The research found that compared to those at normal weight, people who were classified as healthy but were overweight had an increased CHD risk of 1.26 (26 per cent), while those who were healthy but obese had an increased risk of 1.28 (28 per cent). [Original study.]

Image result for gout in toe Gout is something that is not discussed that much, but it has been increasing in recent years and now afflicts about  3.9% of adults in the US. Gout is a form of inflammatory arthritis, characterized by recurrent attacks of pain, tenderness, and swelling of a joint, frequently the joint of the big toe. It is caused by elevated levels of uric acid in the blood (known as hyperuricaemia).

Gout occurs more commonly in men ages 40 and older, who eat a lot of meat and seafood, drink a lot of alcohol (especially beer) or sweetened drinks, have high blood pressure, metabolic syndrome, or are overweight.  Gout used to be known as "the disease of kings" or "rich man's disease". [On the other hand, past research has shown that consumption of coffee, cherries, vitamin C foods, and dairy products, losing weight and physical fitness seems to decrease the risk.]

Recent research showed that the DASH diet reduces blood pressure and reduces uric acid in the blood, which is why a research team (study in The BMJ) now looked at  whether it lowers the risk of gout. The Dietary Approaches to Stop Hypertension or DASH diet is high in fruit, vegetables, whole grains, legumes, nuts, and low-fat dairy, and low in red and processed meats, salt, and sugary drinks. On the other hand, the typical Western diet has higher intakes of red and processed meats, sweetened beverages, sweets, desserts, French fries, and refined grains. The researchers analysed data on a total of 44,444 male health professionals, who had no history of gout at the start of the study. During the 26 years of the observational study, they documented 1731 cases of gout.

The researchers found that eating a more DASH type diet - a diet rich in fruits, vegetables, legumes, nuts, whole grains, and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout. On the other hand, a more 'Western' diet is associated with a higher risk of gout. They found that the effects are dose dependent - the more DASH-type diet, the lower the risk of gout. Bottom line: Once again, eating lots of fruits, vegetables, nuts, legumes, and whole grains is linked to health benefits. From Science Daily:

Diet rich in fruit, vegetables and whole grains may lower risk of gout

A diet rich in fruit and vegetables, nuts and whole grains and low in salt, sugary drinks, and red and processed meats, is associated with a lower risk of gout, whereas a typical 'Western' diet is associated with a higher risk of gout, finds a study published by The BMJ.

Gout is a joint disease which causes extreme pain and swelling. It is most common in men aged 40 and older and is caused by excess uric acid in the blood (known as hyperuricaemia) which leads to uric acid crystals collecting around the joints. The Dietary Approaches to Stop Hypertension (DASH) diet reduces blood pressure and is recommended to prevent heart disease. It has also been found to lower uric acid levels in the blood. Therefore, the DASH diet may lower the risk of gout.

To investigate this further, a team of US and Canada based researchers examined the relationship between the DASH and Western dietary patterns and the risk of gout. They analysed data on over 44,000 men aged 40 to 75 years with no history of gout who completed detailed food questionnaires in 1986 that was updated every four years through to 2012.

Each participant was assigned a DASH score (reflecting high intake of fruits, vegetables, nuts and legumes, such as peas, beans and lentils, low-fat dairy products and whole grains, and low intake of salt, sweetened beverages, and red and processed meats) and a Western pattern score (reflecting higher intake of red and processed meats, French fries, refined grains, sweets and desserts). During 26 years of follow-up, a higher DASH score was associated with a lower risk for gout, while a higher Western pattern was associated with an increased risk for gout.

Image result for gout NHS Credit: Both photos of gout on this page are from NHS.UK

Mediterranean Diet is Healthy Eating – A Good Option for Seniors Another large recent study found that lowering sodium intakes (less than 2500 milligrams per day) wasn't linked to lower blood pressure. Over the course of 16 years, the researchers found that the study participants who consumed less than 2500 milligrams of sodium a day had higher blood pressure than participants who consumed higher amounts of sodium. However, the current 2015-2020 Dietary Guidelines for Americans recommends limiting sodium intake to 2,300 grams a day for healthy people. The researchers felt that based on recent studies with similar findings that the sodium guidelines should be changed.

This 16 year study found that people in the study who had normal intakes of sodium, but also higher intakes of potassium, calcium and magnesium exhibited lower blood pressure over the course of the study. And those people with higher combined intakes of sodium (3717 milligrams per day on average) and potassium (3211 milligrams per day on average on average) had the lowest blood pressure.

Some good potassium foods:  avocado, winter squash, sweet potato, potato, white beans, banana, spinach, salmon, dried apricots, tomato sauce, beans, and milk. Some good magnesium foods: dark leafy greens, nuts, seeds, fish, beans, whole grains, avocados, yogurt, bananas, dried fruit, dark chocolate. Some good calcium foods: milk, cheese, yogurt, kale, sardines, broccoli, white beans, and rhubarb. From Science Daily:

Low-sodium diet might not lower blood pressure: Findings from large, 16-year study contradict sodium limits in Dietary Guidelines for Americans

A new study that followed more than 2,600 men and women for 16 years found that consuming less sodium wasn't associated with lower blood pressure. The new findings call into question the sodium limits recommended by the current Dietary Guidelines for Americans. Lynn L. Moore, DSc, associate professor of medicine at Boston University School of Medicine, will present the new research at the American Society for Nutrition Scientific Sessions and annual meeting during the Experimental Biology 2017 meeting, to be held April 22-26 in Chicago.

"We saw no evidence that a diet lower in sodium had any long-term beneficial effects on blood pressure," said Moore. "Our findings add to growing evidence that current recommendations for sodium intake may be misguided." The 2015-2020 Dietary Guidelines for Americans recommends limiting sodium intake to 2,300 grams a day for healthy people. For the study, the researchers followed 2,632 men and women ages 30 to 64 years old who were part of the Framingham Offspring Study. The participants had normal blood pressure at the study's start. However, over the next 16 years, the researchers found that the study participants who consumed less than 2500 milligrams of sodium a day had higher blood pressure than participants who consumed higher amounts of sodium.

Other large studies published in the past few years have found what researchers call a J-shaped relationship between sodium and cardiovascular risk -- that means people with low-sodium diets (as recommended by the Dietary Guidelines for Americans) and people with a very high sodium intake (above the usual intake of the average American) had higher risks of heart disease. Those with the lowest risk had sodium intakes in the middle, which is the range consumed by most Americans.

The researchers also found that people in the study who had higher intakes of potassium, calcium and magnesium exhibited lower blood pressure over the long term. In Framingham, people with higher combined intakes of sodium (3717 milligrams per day on average) and potassium (3211 milligrams per day on average on average) had the lowest blood pressure.....Moore says that there is likely a subset of people sensitive to salt who would benefit from lowering sodium intake, but more research is needed to develop easier methods to screen for salt sensitivity and to determine appropriate guidelines for intakes of sodium and potassium in this salt-sensitive group of people.

Mediterranean Diet is Healthy Eating – A Good Option for Seniors Nothing new here, but good to have it discussed again: eating foods high in potassium and low in sodium (salt) lowers blood pressure. Why should we care? Hypertension (high blood pressure) is a global health issue. The World Health Organization estimates that hypertension is responsible for at least 51 percent of deaths due to stroke and 45 percent of deaths due to heart disease.

Eating the potassium rich foods seems to be key. Some foods high in potassium: bananas, baked potatoes, sweet potatoes, dark leafy greens (e.g., spinach, kale), tomatoes, mushrooms, beans (e.g., white beans, pinto beans), lentils, nuts, broccoli, apricots, milk. In other words, eat an assortment of fruits, vegetables, beans, and nuts to get potassium. And coincidentally these same foods are low in sodium (salt) - a win-win for heath. From Science Daily:

Fruits and vegetables' latest superpower? Lowering blood pressure

Eating potassium-rich foods like sweet potatoes, avocados, spinach, beans, bananas -- and even coffee -- could be key to lowering blood pressure, according to Alicia McDonough, PhD, professor of cell and neurobiology at the Keck School of Medicine of the University of Southern California (USC). "Decreasing sodium intake is a well-established way to lower blood pressure," McDonough says, "but evidence suggests that increasing dietary potassium may have an equally important effect on hypertension."

McDonough explored the link between blood pressure and dietary sodium, potassium and the sodium-potassium ratio in a review article....McDonough's review found several population studies demonstrating that higher dietary potassium (estimated from urinary excretion or dietary recall) was associated with lower blood pressure, regardless of sodium intake. Interventional studies with potassium supplementation also suggested that potassium provides a direct benefit.

McDonough reviewed recent studies in rodent models, from her own lab and others, to illustrate the mechanisms for potassium benefit. These studies indicated that the body does a balancing act that uses sodium to maintain close control of potassium levels in the blood, which is critical to normal heart, nerve and muscle function. "When dietary potassium is high, kidneys excrete more salt and water, which increases potassium excretion," McDonough says. "Eating a high potassium diet is like taking a diuretic." "If you eat a typical Western diet," McDonough says, "your sodium intake is high and your potassium intake is low. This significantly increases your chances of developing high blood pressure." 

But how much dietary potassium should we consume? A 2004 Institute of Medicine report recommends that adults consume at least 4.7 grams of potassium per day to lower blood pressure, blunt the effects of dietary sodium and reduce the risks of kidney stones and bone loss, McDonough says. Eating ¾ cup of black beans, for example, will help you achieve almost 50 percent of your daily potassium goal. [Original study.]

  Can eating a vegetarian diet lower blood pressure? Both this review and other reviews of studies say YES, that those following vegetarian diets have a lower prevalence of hypertension. Overall, the mean prevalence of hypertension was 21% in those consuming a vegetarian diet and 29% in those consuming a nonvegetarian diet (the differences varied between studies).Those following a vegetarian diet also tended to have a healthier lifestyle. As the researchers point out: blood pressure medicine lowers blood pressure for one day, while lifestyle changes (diet, exercise, not smoking, limiting or avoiding alcohol) can lower blood pressure for life. From Medscape:

Vegetarian Diet: A Prescription for High Blood Pressure?

Hypertension is one of the most costly and poorly treated medical conditions in the United States and around the world. Consequences of hypertension include morbidity and mortality related to its long-term effects, which include stroke, myocardial infarction, renal failure, limb loss, aortic aneurysm, and atrial fibrillation, among many others. Although there is an armamentarium of medications to treat hypertension, we do little for prevention. In this review we examine the relationship between vegetarian and nonvegetarian diets and the prevalence of hypertension. 

Current nonpharmacologic treatments include: physical activity (≥ 30 minutes of moderate-intensity activity on most days of the week); smoking cessation; dietary modification (lower sodium, increased potassium; mainly plant-based foods; low-fat foods; reduced-fat dairy products; moderate amounts of lean unprocessed meats, poultry, and fish; and moderate amounts of polyunsaturated and monounsaturated fats, such as olive oil); weight reduction; management of stress; and limited alcohol consumption.

It is well known that hypertension is modulated by dietary influences. In this review we examine vegetarian, vegan, and nonvegetarian (omnivore) diets and prevalence of hypertension among these dietary populations. A vegetarian diet (ie, lacto/ovo-vegetarian) includes plant foods, dairy products, and eggs (excludes all meat, such as turkey, beef, poultry, seafood, bacon, etc.). A vegan diet is similar to vegetarian, except it further excludes dairy products and eggs (no animal or animal products). On the other hand, an omnivore diet (referred to as nonvegetarians throughout this study) includes both plant and animal foods and products.....The majority of studies included in this review addressed vegetarians and vegans as a single group (vegetarians), whereas others differentiated them. Vegetarian diets are known to be low in saturated fat and cholesterol, high in fiber, low in sodium, and high in potassium. These key elements have been shown to correlate with lower incidence of cancer, heart disease, and other chronic diseases, such as diabetes type II, hypertension, and hyperlipidemia.

The exact percentage of those following a vegetarian or vegan diet in the US is unknown; however, a 2014 study found that 221 of 11,399 adult respondents, from a group generally representing the demographics of the US, identified as vegan (0.5%), vegetarians (1.5%), or meat-eaters (98%). The prevalence of hypertension in the US in 2011 was roughly 33.8%.

The mean prevalence of hypertension in those consuming a vegetarian diet was 21% and 29% in those consuming a nonvegetarian diet. The overall prevalence of hypertension among vegetarians was 33% lower than nonvegetarian diets. These data support the hypothesis of a decreased prevalence of hypertension in those maintaining a vegan or vegetarian diet versus a nonvegetarian diet, in cross-sectional, cohort, and case-control studies, and in those consuming a vegan or vegetarian diet according to an experimental dietary change. The blood pressure benefit is noted to disappear in those reverting back to a nonvegetarian diet. 

Overall, these findings support previous reviews and meta-analyses of vegetarian and nonvegetarian diets and blood pressure. A recent meta-analysis that identified 39 studies with 21,915 participants concluded vegetarian diets were associated with a drop in mean systolic (-5.9 mm Hg) and diastolic (-3.5 mm Hg) blood pressures when compared with nonvegetarians. Other reviews had similar conclusions, showing that vegetarians have a lower blood pressure compared with nonvegetarians. Of the studies that included a vegan diet separate from other vegetarians (eg, lacto/ovo), the data show a significantly lower prevalence of hypertension when compared with nonvegetarians and other vegetarians. However, limited research has been conducted on strict, consistent vegan diets.

There are possible rationalizations for the observed associations between diet and hypertension. First, vegetarians have a lower rate of smoking tobacco. Smoking can increase blood pressure acutely and chronically over time.....Second, vegetarians tend to drink less alcohol compared with nonvegetarians. Alcohol, specifically ≥ 2 drinks/day, increases blood pressure by causing vasodilation, followed by a compensatory increase in blood pressure.....Further, vegetarians have a lower mean BMI when compared with nonvegetarians, which means a lower overall weight....Fourth, vegetarians tend to exercise more than nonvegetarians. Vegetarians reported a greater incidence of physical activity of ≥ 30 minutes of moderate to vigorous activity per day.

A limitation of this study is that it remains unclear whether vegetarians are more health conscious and therefore live healthier lives, or whether a predominant diet of fruits and vegetables is a basis for lower blood pressure.

 An new analysis of published studies found that air pollution is linked to high blood pressure. Yes, breathing polluted air has health effects (here, here, and here). From Science Daily:

High blood pressure linked to short-, long-term exposure to some air pollutants

Both short- and long-term exposure to some air pollutants commonly associated with coal burning, vehicle exhaust, airborne dust and dirt are associated with the development of high blood pressure, according to new research in the American Heart Association's journal Hypertension. "In our analysis of 17 previously-published studies we discovered a significant risk of developing high blood pressure due to exposure to air pollution," said Tao Liu, Ph.D., lead study author and deputy director and epidemiologist of the environmental health division at Guangdong Provincial Institute of Public Health in China.

Researchers performed a meta-analysis of available published studies in the world assessing the health effects of all air pollution on hypertension risk. Meta-analyses combine results from previous studies to estimate the overall effect of a particular variable on a result.....researchers focused on these air pollutants: sulfur dioxide (SO2), which mainly comes from the burning of fossil fuel; nitrogen oxide (NOx), which comes from fossil fuels burned at power plants and vehicle exhaust; Particulate matter (PM) are particles found in the air, including dust, dirt, smoke and liquid droplets. (PM 2.5 is smaller than a speck of dust, and the most common and hazardous type of air pollution. PM10 includes both PM2.5 and PM2.5-10).

The meta-analysis found high blood pressure was significantly associated with: short-term exposure to sulfur dioxide (SO2), PM2.5 and PM10; and long-term exposure to nitrogen dioxide (NO2), which is produced from combustion, and PM10. For the portion of the study that assessed short-term effects of ozone and carbon monoxide exposure, no significant associations were found. Researchers said ozone and carbon monoxide's links to high blood pressure requires further study.

Of the 5,687 air pollution studies initially identified, 17 were the focus of this -- which involves more than 108,000 hypertension patients and 220,000 non-hypertensive controls. High blood pressure was defined as systolic blood pressure more than 140 mm Hg and/or diastolic blood pressure over 90 mm Hg or by antihypertensive drug use. Air pollution exposure was assessed by averaging data from nearest air pollution monitoring stations, or using complex dispersion models or land use regression models.

High blood pressure is a major risk factor for cardiovascular disease and stroke. Previous studies have indicated that air pollution might be a risk factor for hypertension but the results were controversial, Liu said. The mechanism by which air pollution could contribute to the development of high blood pressure includes inflammation and oxidative stress, which may lead to changes in the arteries.

 The researchers go overboard in their claims of what this study shows (after all, only 15 men were in the study, their blood pressure was only slightly elevated, and they were studied only for a short time). But.....what this study does show is that tart cherry juice seems to have some health benefits, such as lowering blood pressure for a while. Even though the researchers received funding from the Cherry Marketing Institute, it doesn't change the fact that cherries are considered healthy foods to eat. Montmorency tart cherries (MCs) are high in numerous phytochemicals (which have health benefits), including flavonoids (isorhamnetin, kaempferol, quercetin, catechin, epicatechin, procyanidins, and anthocyanins).

So check the ingredient list before you buy the tart cherry juice to make sure it is pure juice, and then enjoy a glass knowing that'll it'll benefit (if only temporarily) your blood pressure. From Medical Xpress:

High blood pressure lowers significantly after drinking tart Montmorency cherry juice

Drinking tart Montmorency cherry juice significantly reduces high blood pressure at a level comparable to that achieved by medication, according to new research from Northumbria University, Newcastle.The findings ....found that men with early signs of hypertension - more commonly known as high blood pressure - saw a 7% reduction in blood pressure after drinking Montmorency cherry concentrate when compared to drinking a fruit-flavoured cordial

This reduction is comparable to the level achieved by anti-hypertensive medication. High blood pressure affects over five million people in England and, if left untreated, increases risk of heart attack, heart failure, kidney disease, stroke or dementia. Normal blood pressure is around 120/80 mmHg.

Researchers from Northumbria University's Department of Sport, Exercise and Rehabilitation worked with fifteen participants who were displaying early hypertension with blood pressure readings of at least 130/90 mmHg....were given either 60ml of a Montmorency cherry concentrate or the same amount of a commercially available fruit-flavoured cordial. Blood pressure and blood samples were taken before the cherry concentrate was consumed and blood pressure was measured on an hourly basis thereafter. Blood samples and a series of other cardiovascular screening tests were taken again on a regular basis over the following eight hours.

The researchers found that the participants who were given the cherry concentrate saw a peak reduction in their blood pressure of 7 mmHg in the three hours after consuming the drink. 

Past studies have shown that a reduction of between 5-6 mmHg over a sustained period has been associated with a 38% reduced risk of stroke and 23% reduced risk of coronary heart disease. Interestingly, those participants with blood pressure levels at the higher end of the scale saw the most benefit. The greatest improvement in systolic blood pressure occurred when the phenolic acids, protocatechuic and vanillic, within the cherry concentrate reached their peak levels in the plasma. The researchers believe that these particular compounds are, at least in part, responsible for the reduction.  (Original study)

 This study showed that children reducing sugar consumption (but not fruits), and without reducing calories, after 10 days improved all sorts of metabolic health markers: blood pressure, LDL cholesterol, triglycerides, liver function, fasting blood glucose, and insulin levels. As one of the researchers said: "I have never seen results as striking or significant in our human studies; after only nine days of fructose (sugar) restriction, the results are dramatic and consistent from subject to subject." Once again, not all calories are the same.

On average, the obese children in this study had been getting about 27 percent of their daily calories from sugar, and during the study period it was lowered to about 10 percent of daily calories. By comparison, the average American takes in about 15 percent, though children typically consume much more than this in part because they have the highest intake of sugar-sweetened beverages. In February of this year, the federal government’s Dietary Guidelines Advisory Committee recommended that Americans limit their intake of added sugars to no more than 10 percent of daily calories. From Medical Xpress:

Obese children's health rapidly improves with sugar reduction unrelated to calories

Reducing consumption of added sugar, even without reducing calories or losing weight, has the power to reverse a cluster of chronic metabolic diseases, including high cholesterol and blood pressure, in children in as little as 10 days, according to a study by researchers at UC San Francisco and Touro University California.

"This study definitively shows that sugar is metabolically harmful not because of its calories or its effects on weight; rather sugar is metabolically harmful because it's sugar," said lead author Robert Lustig, MD, MSL, pediatric endocrinologist at UCSF Benioff Children's Hospital San Francisco. "This internally controlled intervention study is a solid indication that sugar contributes to metabolic syndrome, and is the strongest evidence to date that the negative effects of sugar are not because of calories or obesity."

Metabolic syndrome is a cluster of conditions—increased blood pressure, high blood glucose level, excess body fat around the waist, and abnormal cholesterol levels—that occur together and increase risk of heart disease, stroke, and diabetes. Other diseases associated with metabolic syndrome, such as non-alcoholic fatty liver disease and type 2 diabetes, now occur in children—disorders previously unknown in the pediatric population.

In the study, 43 children between the ages of 9 and 18 who were obese and had at least one other chronic metabolic disorder, such as hypertension, high triglyceride levels or a marker of fatty liver, were given nine days of food, including all snacks and beverages, that restricted sugar but substituted starch to maintain the same fat, protein, carbohydrate, and calorie levels as their previously reported home diets.....The study menu restricted added sugar (while allowing fruit), but substituted it by adding other carbohydrates such as bagels, cereal and pasta so that the children still consumed the same number of calories from carbohydrate as before, but total dietary sugar was reduced from 28 to 10 percent, and fructose from 12 to 4 percent of total calories, respectively. The food choices were designed to be "kid food" - turkey hot dogs, potato chips, and pizza all purchased at local supermarkets, instead of high sugar cereals, pastries, and sweetened yogurt.

Children were given a scale and told to weigh themselves everyday, with the goal of weight stability, not weight loss. When weight loss did occur (a decrease of an average of 1 percent over the 10-day period but without change in body fat), they were given more of the low-sugar foods."When we took the sugar out, the kids started responding to their satiety cues," said Schwarz. "They told us it felt like so much more food, even though they were consuming the same number of calories as before, just with significantly less sugar. Some said we were overwhelming them with food."

After just 9 days on the sugar-restricted diet, virtually every aspect of the participants' metabolic health improved, without change in weight. Diastolic blood pressure decreased by 5mm, triglycerides by 33 points, LDL-cholesterol (known as the "bad" cholesterol) by 10 points, and liver function tests improved. Fasting blood glucose went down by 5 points, and insulin levels were cut by one-third. "All of the surrogate measures of metabolic health got better, just by substituting starch for sugar in their processed food—all without changing calories or weight or exercise," said Lustig. "This study demonstrates that 'a calorie is not a calorie.' Where those calories come from determines where in the body they go. Sugar calories are the worst, because they turn to fat in the liver, driving insulin resistance, and driving risk for diabetes, heart, and liver disease."

 Years ago people with asthma were told to limit their exercise, for fear it would set off an asthma attack. Now research suggests that the best thing you can do for asthma (to control symptoms) is to get regular exercise year round - here 30 minutes per day, whether walking, biking, or other moderate activities. From Science Daily:

Just 30 minutes a day: Regular exercise relieves asthma symptoms

Millions of people suffer from asthma. Many report having poor control of their symptoms. Fortunately, new research shows there is a simple antidote: 30 minutes of exercise a day, year-round.

In a study recently published in BMJ Open Respiratory Research, experts from Concordia University, the Hôpital du Sacré-Coeur de Montréal and several other institutions analyzed the exercise habits of 643 participants who had been diagnosed with asthma. Results were overwhelmingly clear: those who engaged in optimal levels of physical activity on a regular basis were nearly two-and-a-half times more likely to have good control of their symptoms, compared with those who did no exercise. The workout doesn't have to be strenuous...."Just 30 minutes a day of walking, riding a bike, doing yoga -- anything active, really -- can result in significant reduction of asthma symptoms."

Traditionally, people with the condition have been discouraged from exercising because of a belief that it triggers shortness of breath and attacks. Bacon explains that simple precautionary measures can be taken to avoid the discomforts that can be caused by physical activity. "The issue of exercise-induced bronchospasm is real -- but if you use your releaver medication, blue puffer, before you exercise, and then take the time to cool down afterwards, you should be okay," he says. "Even if you have asthma, there's no good reason not to get out there and exercise."

That's a message Bacon hopes resonates. Within his sample group of 643 individuals, a whopping 245 reported doing no physical activity. Only 100 said they engaged in the optimal 30 minutes a day...."We need to keep in mind that doing something is better than nothing, and doing more is better than less. Even the smallest amount of activity is beneficial."...."Our study shows that those who were able to engage in physical activity on a regular basis year-round benefit most," says Bacon. If necessary, he suggests finding an indoor place to move, whether it's the gym, a staircase or a shopping mall.

A nice summary article about the benefits and risks of coffee consumption. Summary of effects of drinking coffee1) May potentially increase blood pressure, but also may lower the risk for coronary disease, and protect against heart disease. 2) May cut stroke risk by as much as 25%, 3) Linked to  improved glucose metabolism, reduced risk for type 2 diabetes, and promotion of weight loss in overweight patients. 4) May reduce the risk for several cancers. 5) Appears to slow the progression of dementia and Parkinson's disease. 6) A significantly decreased risk of developing depression. 7) Slows progression in alcoholic cirrhosis, hepatitis C, and NAFLD (non-alcoholic fatty liver disease). 8) May be beneficial in dry-eye syndrome, gout, and in preventing MRSA infection. 9) May increase blood pressure, anxiety, insomnia, tremor, withdrawal symptoms, and potential increased risk of glaucoma. From Medscape:

How Healthy Is Coffee? The Latest Evidence

Earlier this year, the Dietary Guidelines Advisory Committee (DGAC) released a report[1] stating that up to five cups of coffee per day, or up to 400 mg of caffeine, is not associated with long-term health risks. Not only that, they highlighted observational evidence that coffee consumption is associated with reduced risk for several diseases, including type 2 diabetes, cardiovascular disease (CVD), and neurodegenerative disorders. The body of data suggesting that moderate coffee—and, in all likelihood, tea—consumption is not only safe but beneficial in a variety of mental and medical conditions is growing fast.

A 2012 study of over 400,000 people, published in the New England Journal of Medicine, reported that coffee consumption is associated with a 10% reduction in all-cause mortality at 13-year follow-up.... It's important to note that much of the evidence on the potential health effects of coffee, caffeine, and other foods and nutrients is associational and doesn't prove causality—observational investigations come with limitations and often rely on error-prone methods such as patient questionnaires. However, the sheer volume of existing observational data linking coffee and/or caffeine with various health benefits—as well as, in many cases, evidence of a dose response—suggests that the most widely consumed stimulant in the world has positive influences on our health. 

Cardiovascular Disease:...However, when caffeine is ingested via coffee, enduring blood pressure elevations are small and cardiovascular risks may be balanced by protective properties. Coffee beans contain antioxidant compounds that reduce oxidation of low-density lipoprotein (LDL) cholesterol, and coffee consumption has been associated with reduced concentrations of inflammatory markers. Moderate coffee intake is associated with a lower risk for coronary heart disease as far out as 10 years, and data suggest that an average of two cups per day protects against heart failure.

Cerebrovascular Disease and Stroke: The vascular benefits of coffee are not lost on the brain. According to a 2011 meta-analysis, consuming between one and six cups per day reportedly cut stroke risk by 17%. A 22%-25% risk reduction was seen in a large sample of Swedish women followed for an average of 10 years.

Diabetes:...Numerous studies have linked regular coffee drinking with improved glucose metabolism, insulin secretion, and a significantly reduced risk for diabetes. Most recently, findings from a long-term study published this year suggest that coffee drinkers are roughly half as likely to develop type 2 diabetes as are nonconsumers, even after accounting for smoking, high blood pressure, and family history of diabetes.

Cancer: ...Evidence suggests that moderate to heavy coffee consumption can reduce the risk for numerous cancers, including endometrial (> 4 cups/day), prostate (6 cups/day), head and neck (4 cups/day), basal cell carcinoma (> 3 cups/day), melanoma,and breast cancer (> 5 cups/day). The benefits are thought to be at least partially due to coffee's antioxidant and antimutagenic properties.

Neurodegeneration: Beyond the short-term mental boost it provides, coffee also appears to benefit longer-term cognitive well-being. A 2012 study reported that patients with mild cognitive impairment and plasma caffeine levels of > 1200 ng/mL—courtesy of approximately three to five cups of coffee per day—avoided progression to dementia over the following 2-4 years. On a related note, a study from last year reported that caffeine consumption appears to enhance memory consolidation....Caffeinated coffee has long been thought to be neuroprotective in Parkinson disease (PD)....—as well as in multiple sclerosis

Depression: A 2011 study suggests that a boost in coffee consumption might also benefit our mental health: Women who drank two to three cups of coffee per day had a 15% decreased risk for depression compared with those who drank less than one cup per week. A 20% decreased risk was seen in those who drank four cups or more per day. Newer work also suggests that regular coffee drinking may be protective against depression.

Liver Disease: The liver might help break down coffee, but coffee might protect the liver (in some cases). Evidence suggests that coffee consumption slows disease progression in patients with alcoholic cirrhosis and hepatitis C, and reduces the risk of developing hepatocellular carcinoma. A 2012 study reported that coffee intake is associated with a lower risk for nonalcoholic fatty liver disease (NAFLD), while work published in 2014 found that coffee protects against liver fibrosis in those with already established NAFLD.

And That's Not All…: An assortment of other research suggests that coffee intake might also relieve dry-eye syndrome by increasing tear production, reduce the risk for gout, and potentially fight infection. Coffee and hot tea consumption were found to be protective against one of the medical community's most concerning bugs, methicillin-resistant Staphylococcus aureus (MRSA). While it remains unclear whether the beverages have systemic antimicrobial activity, study participants who reported any consumption of either were approximately half as likely to have MRSA in their nasal passages.

And Finally, the Risks: As is often the case, with benefits come risks, and coffee consumption certainly has negative medical and psychiatric effects to consider. Besides the aforementioned potential increase in blood pressure, coffee can incite or worsen anxiety, insomnia, and tremor and potentially elevate glaucoma risk. Also, given the potential severity of symptoms, caffeine withdrawal syndrome is included as a diagnosis in the DSM-5.