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COVID-19 was the first pandemic of the internet age. Beginning at a time of great societal division in the United States (and globally), pandemic responses were further beleaguered by the viral proliferation of information, disinformation, and propaganda-collectively, an "infodemic." Polarized, blinkered views of the crisis precluded a balanced consideration of objectives, opportunities, and ineluctable trade-offs between the risks of actions and corresponding inactions. The results were lapses in both directions, greatly amplifying the pandemic toll. Persistence of this costly fractiousness is now spawning monocular critiques of the pandemic response, with neglect of essential nuance. There is a better pandemic that might have been, and the chance for far better responses to the next- but only if the follies of this history are lessons learned and applied. Failing that, the risk looms that having been amply forewarned of our liabilities, we will fail to be forearmed. [ABSTRACT FROM AUTHOR]

Like every other emergency physician in the country, I occasionally needed to treat epistaxis - a severe nosebleed, or nasal hemorrhage. Like every other emergency physician in the country, I had recourse to a 4% solution of cocaine and cotton swabs for that purpose. Episodically and for years, I have railed against the inconsistences, and even overt illogic, that ensue when we humans make decisions, and policy, independently of principle. In an age where quite fundamental change in prevailing practice is driven by private sector activity, such as the burgeoning array of digital therapeutics[16] - CME sanctimony that precludes education in this watershed is a threat to the standard of care. [Extracted from the article]

This article will discuss the important nutritional values of beef meat, risk factors related to heart diseases and finally the art and science of benefitting from the nutritional values of beef meat, while eluding the risk factors through evidence-based approaches. For beef to take its rightful place in a healthful diet calls for shared responsibility between the beef growers, beef processors, and beef consumers. Meat, even when efficiently produced, is more environmentally costly than even the least efficiently produced vegetarian diet.[15] Eating less red meat is the simplest and most beneficial path, and is environmentally optimal and nutritionally advantageous for many living primarily in middle and high-income countries.[24] To support future modest red meat consumption, improving the environmental efficiency of production systems is paramount. Meat Production has a Hefty Environmental Price Tag Production of red meat, particularly beef, takes a considerable toll on the environment. [Extracted from the article]

Diet quality is now established as the single leading predictor of perennial premature death in modern countries. However, practice at scale in modern medicine is driven as much by financial as clinical imperatives and yet, the ability to quantify the potential ROI of Food as medicine (FaM) interventions is limited by a lack of data. Utilizing a novel advance in dietary assessment and data from the peer-reviewed literature, we constructed and tested a web-based calculator simulating the return-on-investment associated with FaM interventions. [ABSTRACT FROM AUTHOR]

In addition, both stress and sleep deprivation impact food choices through multiple mechanisms, including changes in ghrelin and leptin and a shift in decision making from a thoughtful, reflective approach regulated by the prefrontal cortex to a more reflexive, emotionally driven response from the amygdala and related subcortical structures.[7] [8] This results in a "default to habit" and preference for highly palatable, more energy dense foods.[9] Addressing stress and sleep may be prerequisites to support patient's efforts to engage and sustain (or reengage) in dietary change. Empathy Empathy has been associated with improved physician-patient relationships and health outcomes. Motivational Interviewing, a foundational component of health and lifestyle coaching, and patient centered communication are 2 examples of overlapping frameworks that can facilitate dialogue in an empathetic and nonjudgmental way.[5],[19][20] [21] Both address psychological needs such as autonomy, relatedness and competence that predict greater adherence to recommended health behaviors. Empathy and Language in the Clinician Patient Relationship: Improving the Translation of Evid... Introduction Translating evidence into real life behavior change for patients requires more than just a clear articulation of the strength of the science behind recommendations. [Extracted from the article]

The article presents the interview with David L. Katz, founding director at Yale University/Griffin Hospital, Robert F. Kushner, medical education at Northwestern University Feinberg School of Medicine, and Beth Frates, wellness coach at Wellness Synergy. Topics include the importance of positioning to improve oxygenation was discerned, the increased risk is particularly noted among those with moderate to severe obesity, and the association of COVID-19 is to examine the mechanistic changes.

We updated estimates of adults at risk for coronavirus disease complications on the basis of data for China by using recent US hospitalization data. This update to our previous publication substitutes obesity for cancer as an underlying condition and increases adults reporting any of the conditions from 45.4% to 56.0%. [ABSTRACT FROM AUTHOR]

Per the contribution of Frates and Rifai in I Making the Case for "COVID-19 Prophylaxis" with Lifestyle Medicine i , we know that the generally poor, prior state of health in America contributes considerably to the risk of severe COVID infection.[1] SARS-CoV-2 has proven to be very different diseases in the generally young and vital, and in the elderly individual and those with a heavy burden of chronic disease. Finally, in I Herd Immunity: Knowns, Unknowns, Challenges, and Strategies i , McNaughton takes on the topic of herd immunity, a critical element in getting to an "all clear" that gets all of us - including those most vulnerable to severe COVID infection - our lives back. Decreases in population-level immunity over time due to an influx of free loaders can trigger focal outbreaks around the freeloaders, for example, unvaccinated college freshmen previously protected by the herd immunity of their hometowns can trigger outbreaks at universities.[73] Approximately 4 million immunologically naive infants born in the United States can contribute to waning population-level immunity over time if they are not vaccinated or achieve immunity after infection. The list of unknowns for SARS-CoV-2 and COVID-19 that are important in order to better understand the effective herd immunity threshold for SARS-CoV-2 is long but is being tackled in record time: - How quickly is clinically important viral mutation occurring, and to what degree does this influence effectiveness and duration of immunity?. [Extracted from the article]

An interview with founding director of Yale-Griffin Prevention Research Center David L. Katz is presented. It mentions about his book "The Truth About Food: Why Pandas Eat Bamboo and People Get Bamboozled; and also mentions few of the biggest misconceptions among clinicians when they sit down to address nutrition with their patients.

Nearly 30 years ago, McGinnis and Foege made a seminal contribution to the medical literature with the publication of I Actual Causes of Death in the United States i .[1] Looking past the proximal, but superficial "causes" routinely listed on death certificates, McGinnis and Foege, honoring the path blazed by I Healthy People i objectives, asked: what caused these so-called causes? Time to unbundle diet quality from diet type, and acknowledge that there are many variants on the fundamental theme of eating well. One among these is the many threads of argument tangling up diet type and diet quality into a common, dogmatic knot with the contention that some particular way of eating is "the best.". [Extracted from the article]

Diet is a universal influence on health and one of the major determinants of both years in life (longevity) and life in years (vitality). Diet is also a uniquely complex variable, encompassing nearly infinite variations in composition and concentration, making it difficult to study. Study design and the particular answers at which a given trial is aimed exert considerable influence on findings, and these, in turn, may be influenced by the biases and a priori preferences of researchers, funders, or commentators. To help patients access credible information and make informed lifestyle choices, clinicians must be able to do so themselves, yet the topic to date receives little attention in medical education. This commentary explores barriers to dietary counseling, strategies for improving medical education and clinical practice with respect to nutrition, and the ethical importance of sharing dietary information with patients. [ABSTRACT FROM AUTHOR]

We estimated that 45.4% of US adults are at increased risk for complications from coronavirus disease because of cardiovascular disease, diabetes, respiratory disease, hypertension, or cancer. Rates increased by age, from 19.8% for persons 18-29 years of age to 80.7% for persons >80 years of age, and varied by state, race/ethnicity, health insurance status, and employment. [ABSTRACT FROM AUTHOR]

The power of lifestyle as medicine was perceived thousands of years ago. There is now consistent and compelling science to support the important influence of lifestyle on health. Approximately 80% of chronic disease and premature death could be prevented by not smoking, being physically active, and adhering to a healthful dietary pattern. Cardiovascular disease, diabetes, stroke, dementia, and cancer are all influenced by lifestyle choices. Despite the ample evidence about what behaviors promote health, confusion still prevails among the general population. This is particularly true with regard to diet. Confusing nutrition messages from scientists, the media, the food industry, and other sources have made it all but impossible for any single authority to convey persuasively the fundamentals of healthful eating. The case is made here that a global coalition of diverse experts has the power to do what no individual can: clarify and popularize an understanding of the fundamentals of a health-promoting, sustainable pattern of diet and lifestyle, and rally the general public to their consistent support. [ABSTRACT FROM AUTHOR]

Where's the Beef? While much of the world will need to reduce beef intake substantially to remain within planetary tolerances, the beef that is produced could be better directed to those populations most apt to benefit. Through the lens of human health effects alone, beef has been a contentious topic. [Extracted from the article]

Obesity and related cardiometabolic liabilities were pandemic before ever SARS-CoV-2 was, and the interactions between pandemics both acute and chronic are of outsized importance. To date, the COVID19 pandemic is something of a Rorschach test. As a result, obesity is in turn associated with poor COVID outcomes in some countries, and favorable COVID outcomes in others. [Extracted from the article]

Objectives: Our objective was to create and explore potential uses of a composite "Healthy Lifestyle" measure based on Healthy People 2020 (HP2020) Objectives for behaviors shown to be associated with morbidity and mortality.Methods: Data were from the 2013 Behavioral Risk Factor Surveillance System (N=412,942) on five modifiable behaviors with HP2020 Objectives (leisure time exercise, eating fruits and vegetables 5 or more times/day, getting ≥7h of sleep/24h, not smoking and not drinking excessively). These indicators were combined to form an all-or-none composite Healthy Lifestyle (HLS) measure. Associations between the HLS measure and demographic and other measures, plus details of component measures, were reported.Results: Results indicated that only 7.7% of adults reported a HLS with wide variation among states and demographic groups. Both unadjusted and logistic regression results found associations between a HLS and better health, lower rates of chronic disease and better access to health care. Over one fourth of all respondents (28.0%) needed to only improve fruit and vegetable consumption to be practicing a HLS.Conclusions: In conclusion, few adults were practicing five behaviors that are generally recognized as healthy. All-or-none metrics like this HLS measure offer a fresh perspective on modifiable behaviors and the need for improvement. Examination of measure components can help explain demographic differences and identify strategies for improvement. [ABSTRACT FROM AUTHOR]

Fascination with the idea that some diet is "best" is, literally, perennial.[1] Popular interest in a parade of food and ingredients as contenders for silver bullet or scapegoat is seemingly as persistent.[2],[3] These 2 fixations of popular culture pose a singular challenge to nutritional epidemiology. The sine qua non of interpretable epidemiologic research is to compare 2 groups alike in "all ways but one."[10] If we want to understand what a given food does to biomarkers, other aspects of diet must be matched. The literal translation, however, of this slightly grammatically handicapped French expression is: " I I don't know what." i When the effects of food or ingredient A on health outcomes are being tested, but the addition of that food causes reductions in the intake of food B-there is more than one variable in motion. [Extracted from the article]

Diabetes, particularly type 2 diabetes, is epidemic in the United States among adults and children alike, and increasingly prevalent around the world. On its current trajectory, the increasing incidence of diabetes has the potential to ravage both public health and economies. There has, however, been evidence for decades that lifestyle has enormous potential to prevent chronic disease, diabetes included. Studies suggest that the combination of tobacco avoidance, routine physical activity, optimal dietary pattern, and weight control could eliminate as much as 80% of all chronic disease, and 90% of cases of diabetes specifically. None of these factors is necessarily easily achieved, but most are simple. Diet, on the other hand, is complex, and arguments abound for competing diets and related health benefits. From an expansive review of relevant literature, the case emerges that the overall theme of optimal eating for human beings is very well established, whereas the case for any given variation on that theme is substantially less so. Once the theme of healthful eating is acknowledged, the challenge shifts to getting there from here. Although much effort focuses on the wholesale conversion of dietary patterns, the introduction or removal of highly nutritious foods can have direct health effects, and potentially reverberate through the diet as well, shifting the quality of the diet and related health effects. Studies demonstrating favorable effects of daily walnut ingestion in diabetes and insulin resistance are profiled as an illustration, and an ongoing study examining the implications of daily walnut ingestion on diet quality and various biometric variables is described. The line between dietary pattern and the epidemiology of diabetes is indelibly established; we must work to connect the dots between here and there. [ABSTRACT FROM AUTHOR]

Methods for translating the findings of controlled trials, such as the Diabetes Prevention Program, into real-world community application have not been clearly defined. A standardized research methodology for making and evaluating such a transition is needed. We introduce the multisite translational community trial (mTCT) as the research analog to the multisite randomized controlled trial. The mTCT is adapted to incorporate the principles and practices of community-based participatory research and the increased relevance and generalizability gained from diverse community settings. The mTCT is a tool designed to bridge the gap between what a clinical trial demonstrates can work in principle and what is needed to make it workable and effective in real-world settings. Its utility could be put to the test, in particular with practice-based research networks suchas the Prevention Research Centers. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of a nutrition education program designed to teach elementary school students and their parents, and to distinguish between more healthful and less healthful choices in diverse food categories. Three schools were assigned to receive the Nutrition Detectives™ program and 2 comparable schools served as controls. A total of 1180 second, third, and fourth grade elementary school students were included, with 628 students in the intervention and 552 in the control group. The program, delivered by physical education instructors over several sessions totaling less than 2 hours, taught the children how to read food labels and detect marketing deceptions, while learning to identify and choose healthful foods. Parents were introduced to the program through written materials sent home and at school functions. Assessments included a food label quiz, dietary pattern, and body mass index (BMI). Students in intervention schools showed a significant increase in nutrition label literacy (p < .01). Third grade students showed the most improvement, 23% (p < .01). The parents of intervention group students also showed a significant increase in nutrition label literacy by 8% (p < .01). Total caloric, sodium, and total sugar intake decreased nonsignificantly among students in the intervention group (p > .05). BMI did not change over the short duration of the study. Nutrition Detectives effectively enhances the ability of students and their parents to identify more nutritious food choices. Further evaluation of the program and its potential to influence dietary pattern, BMI, and health outcomes in students and their families is warranted. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effects of a nutrition education program designed to teach elementary school students and their parents, and to distinguish between more healthful and less healthful choices in diverse food categories. Three schools were assigned to receive the Nutrition Detectives™ program and 2 comparable schools served as controls. A total of 1180 second, third, and fourth grade elementary school students were included, with 628 students in the intervention and 552 in the control group. The program, delivered by physical education instructors over several sessions totaling less than 2 hours, taught the children how to read food labels and detect marketing deceptions, while learning to identify and choose healthful foods. Parents were introduced to the program through written materials sent home and at school functions. Assessments included a food label quiz, dietary pattern, and body mass index (BMI). Students in intervention schools showed a significant increase in nutrition label literacy (p < .01). Third grade students showed the most improvement, 23% (p < .01). The parents of intervention group students also showed a significant increase in nutrition label literacy by 8% (p < .01). Total caloric, sodium, and total sugar intake decreased nonsignificantly among students in the intervention group (p > .05). BMI did not change over the short duration of the study. Nutrition Detectives effectively enhances the ability of students and their parents to identify more nutritious food choices. Further evaluation of the program and its potential to influence dietary pattern, BMI, and health outcomes in students and their families is warranted. [ABSTRACT FROM AUTHOR]

An interview with David L. Katz, director and founder of Yale University's Prevention Research Center and the Integrative Medicine Center at Griffin Hospital in Derby, Connecticut, is presented. He asserts that increasing rate of women suffering from chronic diseases will face hindrances in coping their conditions. He notes the need for effective teamwork even at the primary care setting. He views that physicians have not been taught to approach patient care outside the conventional box.

Purpose. Consumer understanding of nutrition information is key to making dietary choices consistent with guidelines. The development of an objective, science-based, and univ. sally applicable system of nutrition guidance would he of considerable Potential value to the public health. Design. A multidisciplinary expert panel was convened to develop the Overall Nutritional Quality Index (ONQI). Dietary guidelines, existing nutritional scoring systems, and other pertinent scientific literature were reviewed. An algorithm based on the overall nutritional quality of food was developed and subjected to consumer research and validation testing. Results. The ONQI algorithm incorporates over 30 entries representing both micronutrient and macronutrient properties of foods, as well as weighting coefficients representing epidemiologic associations between nutrients and health outcomes. The basic entry in the algorithm is a weighted trajectory score, which compares nutrient concentration in a food to the recommended concentration of a given nutrient in a healthful diet. In content validity testing, ONQI rankings and expert panel rankings correlated highly (R = .92; p < .001). In regression analysis, aggregated ONQI scores for total diet corresponded well with the Healthy Eating Index (p < .001) in the National Health and Nutrient Examination Survey 2003-2006 cohort (n = 15,900). Consumer research indicated strong appeal to consumers of the ONQI system in general, and the scores on a 1 to 100 scale specifically. A system for acquiring nutrient data, meeting U.S. Food and Drug Administration and U.S. Department of Agriculture standards, has been established so that virtually any food, beverage, meal, or recipe can be scored. Conclusions. The ONQI is a sophisticated nutrition guidance system developed by a multidisciplinary group independently of all food industry interests with excellent initial performance in both consumer research and validation testing. Combined with a consumer education program, the ONQI has considerable potential to improve dietary pattewis, and consequently the public health. Prospective. Study of effects on dietary patterns and health outcomes is warranted. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Systematic reviews point to inconclusive evidence that counselling patients in a primary care setting is effective in increasing adults’ physical activity (PA) levels. This study evaluates the impact of an innovative physician counselling programme on physicians’ PA counselling behaviour and their patients’ PA levels. Methods A controlled educational study conducted at six Yale School of Medicine hospitals. Sixty-five internal medicine residents and 316 primary care patients were randomized to intervention or control groups. Intervention physicians participated in five interactive sessions outlining details of the Pressure System Model, while control physicians received usual residency training. Intervention and control patients’ PA levels and residents counselling behaviour were assessed using a validated questionnaire and compared pre- and post intervention. Data analysis was performed using paired t-tests and repeated measuresanova. Results At 6-month follow-up intervention, patients’ PA levels increased significantly from baseline (1.77 ± 0.84; P = 0.0376). A similar pattern was observed after 12 months (1.94 ± 0.98; P = 0.0486). Control patients’ PA did not change significantly from baseline at 6 or 12 months (0.35 ± 1.00; P = 0.7224 and 0.99 ± 1.52; P = 0.5160, respectively). At 12 months, intervention residents provided PA counselling 1.5 times more than they did at baseline ( P < 0.05) compared with no significant changes in the control group. Conclusions The present study has shown that providing residents with a practical tool, enabling them to deal with patients’ barriers and previous failure in behavioural change, is efficacious in increasing PA levels of adult patients. [ABSTRACT FROM AUTHOR]

COVID-19, inevitably, has co-opted this - the first spread by I True Health Initiative i under the "Knowing Well, Being Well" banner - as it has nearly all else related to living in this moment. Accessed May 7, 2020. https://gothamist.com/news/new-york-antibody-test-results-coronavirus 5 Shakiba M, Hashemi Nazari SS, Mehrabian F, Rezvani SM, Ghasempour Z, Heidarzadeh A. Seroprevalence of COVID-19 Virus Infection in Guilan Province, Iran. [Extracted from the article]

In response to an accelerating obesity pandemic, competing weight-loss diets have propagated; those touting carbohydrate restriction are currently most in vogue. Evidence that sustainable weight loss is enhanced by means other than caloric restriction, however, is lacking. Whereas short-term weight loss is consistently achieved by any dietary approach to the restriction of choice and thereby calories, lasting weight control is not. Competing dietary claims imply that fundamental knowledge of dietary pattern and human health is lacking; an extensive literature belies this notion. The same dietary and lifestyle pattern conducive to health promotion is consistently associated with weight control. A bird's eye view of the literature on diet and weight reveals a forest otherwise difficult to discern through the trees. Competing diet claims are diverting attention and resources from what is actually and urgently needed: a dedicated and concerted effort to make the basic dietary pattern known to support both health and weight control more accessible to all. [ABSTRACT FROM AUTHOR]

Although the CDC ACIP (Advisory Committee on Immunization Practices) recommends that appropriate inpatients receive pneumococcal and influenza vaccines, adult vaccination rates for these remain low. We therefore examined perihospitalization vaccination rates for high-risk pneumonia inpatients.A retrospective chart review of all pneumonia patients admitted to one community hospital from 6/1/95 to 5/31/96. Vaccination history, co-morbidity, mortality, and prior and subsequent pneumonia admissions were recorded. Primary care providers and nursing homes were contacted to complete and verify vaccine histories.For 173 total admissions (160 subjects), vaccine histories were documented in the hospital chart in less than 0.5% of patients. While 97% had indications for both vaccines at the time of admission, no vaccines were given in the hospital and less than 5% had documented vaccinations during the subsequent 3 years.Despite clear indications, few patients had documented vaccination at any time. These data lend urgency to the recommendation that pneumococcal and influenza vaccines should be routinely administered to pneumonia inpatients at discharge. Furthermore, they illustrate the need for an improved method for tracking individual adult vaccinations. [Copyright &y& Elsevier]

Background: Because of egg cholesterol content, reduction in egg consumption is generally recommended to reduce risk of cardiovascular disease. Recently, however, evidence has been accumulating to suggest that dietary cholesterol is less relevant to cardiovascular risk than dietary saturated fat. This randomized controlled crossover trial was conducted to determine the effects of egg ingestion on endothelial function, a reliable index of cardiovascular risk. Methods: Forty-nine healthy adults (mean age 56 years, 40% females) underwent a baseline brachial artery reactivity study (BARS), and were assigned to two eggs or oats daily for 6 weeks in random sequence with a 4-week washout. A BARS was done at the end of each treatment phase, measuring flow-mediated vasodilation (FMD) in the brachial artery using a high-frequency ultrasound. Results: FMD was stable in both egg and oat groups, and between-treatment differences were not significant (egg -0.96%, oatmeal -0.79%; p value >0.05). Six weeks of egg ingestion had no effect on total cholesterol (baseline: 203.8 mg/dl; post-treatment: 205.3) or LDL (baseline: 124.8 mg/dl; post-treatment: 129.1). In contrast, 6 weeks of oats lowered total cholesterol (to 194 mg/dl; p=0.0017) and LDL (to 116.6 mg/dl; p=0.012). There were no differences in body mass index (BMI), triglyceride, HDL or SBP levels between egg and oat treatment assignments. Conclusion: Short-term egg consumption does not adversely affect endothelial function in healthy adults, supporting the view that dietary cholesterol may be less detrimental to cardiovascular health than previously thought. [Copyright &y& Elsevier]

Focuses on the evidence base for complementary and alternative medicine (CAM). Evidence mapping with application to CAM; Alternative medicine benefits.

Background. Optimal behavioral interventions for sustainable weight loss are uncertain. We therefore conducted a study among overweight/obese women comparing conventional dietary counseling of individuals (counseling-based intervention) to a novel, group-based skill-building intervention.Methods. Eighty subjects were randomly assigned to either the counseling-based or to the skill-building intervention. Outcomes included weight loss, dietitian hours per group and per unit weight loss, and dollars spent per group and per unit weight lost.Results. Weight loss at 6 months (follow-up rate 61.3%) in the counseling-based group was 8.8 lb (P = 0.0001), and in the skill-building group was 3.8 lb (P = 0.01). A total of 160 dietitian hours were required for the counseling-based group, and 131 for the skilled-building group. The counseling-based group cost an average of $21 per pound lost, while the skill-building cost an average of $48 per pound lost (P = 0.16).Conclusions. At 6 months, individualized office-based counseling produced more weight loss than a skill-building approach and cost less than half as much per pound of weight loss. Longer-term follow-up is required to determine if, as hypothesized, the skill-building intervention produces more sustainable weight loss. [Copyright &y& Elsevier]

That sociopolitical trends, the long-neglected malady of systemic racial injustice, and the anxieties of a historic pandemic would converge to propagate discord and amplify native divisions was entirely unforeseen, and among the singular public health challenges of our time. That we are social animals all but connotes its own corollary: cohesion, cooperation and community nurture us; discord and division assault us. We Homo sapiens are social animals. [Extracted from the article]

Objectives. This study assessed hospital electronic patient information systems (EPIS) for inclusion of variables associated with avoidable and extended hospitalization (preventable inpatient time). Methods. We searched MEDLINE and HealthSTAR databases to identify predictors of preventable inpatient time. We then audited the admissions process and the handwritten medical record at 1 hospital, and the EPIS at all hospitals, affiliated with the Yale University School of Medicine for inclusion of the predictors. Results. Whereas the written medical record included all 58 predictors, the EPIS of the 10 hospitals surveyed included an average of only 38% of the predictors. Conclusions. The conventional approach to information gathering during hospital admission is highly inefficient. Revising EPIS to include predictors of preventable inpatient time could enhance efficiency and quality, while reducing costs, of hospital care. (Am J Public Health. 1999;89:1885-1889) [ABSTRACT FROM AUTHOR]

Previous studies have reported that patients with bulimia often display nonsuppressed response to the dexamethasone suppression test (DST), suggesting that bulimia may be associated with hypercortisolism. To further evaluate the hypothalamic-pictuitary-adrenal axis in bulimia, 24-hour urinary free cortisol (UFC) levels and response to the 1 mg dexamethasone suppression test (DST) were assessed in 7 normal-weight women with bulimia by DSM-III. All displayed normal UFC and nonsuppressed response to the DST. [ABSTRACT FROM AUTHOR]

The article focuses on the need for whole systems approach to evidence evaluation as per studies by the American College of Lifestyle Medicine (ACLM). Topics discussed include impact on mortality and morbidity, benefits of randomized control trials (RCT) and practise based evidence, and project Hierarchies of Evidence Applied to Lifestyle Medicine (HEALM).

The article focuses on the health controversies concerning the association of dietary fat intake with the risk of having cardiovascular disease. It states that the historical origin of the idea can be traced from the work of Ancel Benjamin Keys. It also mentions the increasing evidence of lauric acid as innocuous.

The article reports on a meta-analysis which reveals the significant benefit of omega-3 fatty acid supplementation in improving attention-deficit/hyperactivity disorder (ADHD) symptoms in children. It mentions that omega-3 supplementation improved hyperactivity and inattention but efficacy was modest compared with traditional ADHD pharmacotherapy. It concludes that omega-3 supplementation may be a treatment option to ADHD drugs or for families seeking nonpharmacologic treatment options.

Objectives: Cognitive difficulties or impairment may be an early step in the development of dementia. Several modifiable risk factors for cardiovascular disease (CVD) may also increase the risk of dementia. The objective of our study was to compare adults with subjective cognitive impairment (SCI), using the Behavioral Risk Factor Surveillance System (BRFSS) cognitive disability measure, with adults who reported CVD. Methods: We examined data on 3 key outcomes among 302 008 adult respondents aged ≥45 in the 2017 BRFSS: respondents with SCI only, respondents with CVD only, and respondents with both conditions. We compared measures of disability, quality of life, access to health care, and a composite measure of the following 7 risk factors: current smoking, diabetes, high cholesterol, hypertension, inadequate fruit and vegetable consumption, obesity, and sedentary lifestyle. We also estimated population-attributable risk (PAR). Results: Among respondents, 7.9% reported SCI only, 11.1% reported CVD only, and 3.2% reported both conditions, with differences by age and sex. Adults with SCI only were more likely than adults with CVD only to report other disability, worse access to health care, and poorer quality of life, even though adults with CVD were older. Compared with adults with neither condition, adults with any of the 3 outcomes were more likely to report having each of the 7 risk factors; we found a linear association with an increasing number of risk factors. Five or 6 risk factors contributed to PARs for each of the 3 key outcomes. PARs for SCI only were highest for ever smoking (17.2%) and sedentary lifestyle (12.8%), whereas for CVD only, PARs were highest for hypertension (35.5%) and high cholesterol (22.9%). Conclusion: Despite differences between adults with SCI and adults with CVD in several demographic and health-related measures, the overall similarity in PARs for SCI and CVD suggests potential benefits from using effective CVD interventions to address SCI. [ABSTRACT FROM AUTHOR]

Background: Diet quality photo navigation (DQPN) is a novel dietary intake assessment tool that was developed to help address limitations of traditional tools and to easily integrate into health care delivery systems. Prevailing practice is to validate new tools against approaches that are in wide use. Objective: This study aimed to assess 1) the validity of Diet ID in measuring diet quality, food group and nutrient intake against 2 traditional dietary assessment methods (i.e., food record [FR], food frequency questionnaire) and 2) the test reproducibility/reliability of Diet ID to obtain similar results with repeat assessments. Methods: Using a participant-sourcing platform for online research, we recruited 90 participants, 58 of whom completed DQPN, a 3-d FR (via the Automated Self-Administered 24-hour Dietary Assessment Tool), and a food frequency questionnaire (FFQ, via the Dietary History Questionnaire III). We estimated mean nutrient and food group intake with all 3 instruments and generated Pearson correlations between them. Results: Mean age (SD) of participants was 38 (11) y, and more than half were male (64%). The strongest correlations for DQPN when compared with the other 2 instruments were for diet quality, as measured by the Healthy Eating Index 2015; between DQPN and the FFQ, the correlation was 0.58 (P < 0.001), and between DQPN and the FR, the correlation was 0.56 (P < 0.001). Selected nutrients and food groups also showed moderate strength correlations. Test-retest reproducibility for measuring diet quality was evaluated for DQPN and showed a correlation of 0.70 (P < 0.0001). Conclusions: The current study offers evidence that DQPN is comparable to traditional dietary assessment tools for estimating overall diet quality. This performance, plus DQPN's ease-of-use and scalability, may recommend it in efforts to make dietary assessment a universal part of clinical care. [ABSTRACT FROM AUTHOR]