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Thứ Năm, 8 tháng 2, 2018

Eat Your Veggies and More Heart Healthy Tips From the Nutrition Twins

Nutrition TwinsBy Tammy Lakatos Shames and Elysse Lakatos, The Nutrition Twins, Special to Everyday HealthIf the thought of getting heart disease puts you a little on edge and gets your heart beating a little faster, we understand. After all, heart disease is the No.1 killer in the United States — and that’s enough to raise anyone’s blood pressure.But there’s great news — eating the right veggies may improve heart health by lowering cholesterol, reducing blood pressure and decreasing inflammation in the arteries. And more good news — by focusing on the foods that you should eat more of, you’ll automatically eat less of the bad stuff that could lead to heart disease, like butter, processed meats, fatty red meats, and baked goods that contain artery-clogging hydrogenated oils.A heart-healthy diet includes at least 2.5 cups of cooked veggies each day or 5 cups of raw, leafy veggies. Although this may sound like a lot, the key is to mix your veggies right into your meal so you’ll eat less of the heavy stuff without even realizing that you’re filling your stomach with heart-protective veggies and meeting your daily quota to boot. Our clients eat this way and find they easily eat more than the minimum veggie recommendations. Eat this way too and you’ll get plenty of protective nutrients.

Heart-Protective Nutrients

Potassium counterbalances sodium and the damage it causes by helping to reduce the risk of high blood pressure. Potassium also helps to flush sodium out of the body and keep your blood vessels more elastic and pliable.
  • Good sources are crimini mushrooms, spinach and swiss chard. These veggies are all great in omelets, sandwiches and soups.
  • Try this Super Easy Spinach Pomodoro. Defrost a box of frozen spinach, mix in 3/4 cup of marinara sauce and a few teaspoons of grated parmesan cheese — and voila!
Phytonutrients protect the heart, keep inflammation at bay, repair damaged cells, help build our immune systems, and act as antioxidants. Of course, this means they help protect the cardiovascular system, so we certainly heart our phytonutrients.
  • Most veggies are a good source. Variety is the key since each veggie contains different phytonutrients that can tackle different types of damage in our bodies. As healthy as broccoli is, don’t eat it only because you’re used to it. Get out there and experiment — add purple cabbage to add dimension to your salad, bell peppers to sweeten your panini and snow peas to add crunch to your tuna sandwich.
B Vitamins help lower homocysteine, an amino acid in the blood that may promote fatty deposits in blood cells.
  • Leafy greens are high in vitamin B. Aim to eat them daily. If you’re bored with the same mixed green salad, switch things up by choosing romaine lettuce, Boston red leaf, spinach leaves or arugula.
  • Trying to cut calories? Replace the bread on your sandwich or wrap (or even half of the bread) with several large leaves of your fave leafy greens. Lettuce wraps are delicious on tuna and egg salad.
Fiber lowers cholesterol levels. Although soluble fiber is more effective at lowering cholesterol (it pulls the bad cholesterol right out of your body!), both soluble fiber and insoluble fiber are good for your health, and most vegetables contain some of each.
  • Good sources are broccoli, Brussels sprouts, celery, carrots, cucumbers, beans, dry peas, artichokes, parsnips, sweet potatoes and turnips.
  • Added bonus: Double your fiber intake and you’ll actually absorb 90-130 fewer calories each day—that translates into an 8-10 pound weight loss over the next year!
And of Course, Garlic, which can lower triglycerides and total cholesterol by as much as 5 - 15 percent. But garlic’s biggest asset is its unique set of sulfur-containing compounds that protect blood cells and blood vessels from inflammatory and oxidative stress.
  • Tip: After chopping or crushing garlic, allow it to sit for 5 minutes before cooking it to so its phytonutrient alliin can convert to the health and heart superstar allicin.  Roast garlic with veggies or in a little olive oil and spread it on your bread in lieu of butter.
Tammy Lakatos Shames and Elysse Lakatos, The Nutrition Twins, are nationally recognized registered dietitians and personal trainers with 15 years experience helping clients boost their energy naturally, get healthier, happier and into tip-top shape. Their latest book, The Nutrition Twins’ Veggie Cure, was released in January 2014.

Thứ Tư, 7 tháng 2, 2018

Relaxation Techniques for Depression

 Diana  Rodriguez

Practicing relaxation techniques is a simple way to boost your emotional health. Learn how to relax, de-stress, and maybe even ease your depression.

People with depression often struggle with more emotional weight than depression alone. Depression and anxiety often go hand-in-hand, and stress can also challenge your emotional health. When anxiety and stress build up, they can affect your depression symptoms and make them more difficult to manage. Some simple relaxation techniques may help you escape your stress and anxiety, as well as better manage your depression.How Relaxation Helps DepressionCaring for all aspects of your emotional health is important for managing depression, and that means easing stress and anxiety, too. A daily dose of relaxation may be just what the doctor ordered."Relaxation can help just about anybody," says Jennifer L. Payne, MD, PhD, assistant professor and co-director of the Women's Mood Disorders Center at The Johns Hopkins Hospital in Baltimore.Anxiety, which is common in people who have depression, can make people feel tense. The anxiety can be severe, says Dr. Payne, and may even lead to panic attacks."Certainly when someone is depressed, much of their outlook is negative," adds Payne. "Relaxation techniques can help with that; it can bring people down a notch so that they're not so anxious or negative." Relaxation techniques such as meditation, massage, and exercise can also release endorphins, which are chemicals in the body that relieve pain and are thought to elevate your mood.Relaxation also benefits your physical health. "It's another tool to combat those physical effects of depression," Payne says.Relaxation techniques may even help prevent depression in some people. According to Payne, "Environmental stress can trigger depressive episodes, so if you have a genetic predisposition to depression, and you go through a stressful time, you are more likely to have a depressive episode. Learning how to control your stress levels may help prevent depressive episodes."Relaxation Techniques for DepressionWhich relaxation techniques will be most effective for improving emotional health depends on the person, says Payne. Some people find a massage or pedicure to be calming, while those activities could actually cause stress for someone who doesn't enjoy them. Your relaxation technique doesn't have to be complicated — anything that makes you unwind and feel good will benefit your emotional health.Here are some relaxation techniques known to help ease depression and anxiety. Try the ones that appeal to you, and discover which ones deliver the most stress relief.
  • Deep breathing. Deep, slow breathing can help you release anxiety and relax from head to toe. Try it at set times throughout the day or whenever you feel stress building. Combine deep breathing with meditation for even greater relaxation, stress relief, and focus.
  • Exercise. This is a great relaxation technique, says Payne, and it offers great physical health benefits, too. Yoga is a particularly beneficial therapy because it focuses on meditation, balance, deep breathing, and relaxation all at the same time.
  • Surround yourself with scents. Some people find certain pleasant aromas very relaxing. Known as aromatherapy, this technique can be as simple as lighting a candle scented with a favorite fragrance.
  • Take a vacation in your mind. Called visual or guided imagery, this relaxation technique uses your imagination to carry yourself away from daily stress. Picture yourself in a serene, peaceful place that makes you happy. Take time to experience all the sensations in your mind.
  • Warm up. Treat yourself to a long, luxurious soak in a bubble bath or lose yourself in the steam of a hot shower. Even sipping on a mug of hot coffee, tea, or cocoa can be soothing.
  • Scribble out your stress. If something's bothering you and you just need to get it off your chest, a diary or journal can be your best friend. Take a few moments each day — or any time you feel down or stressed — to write about your fears, concerns, or frustrations.
Everyone's idea of relaxation is different. It doesn't matter what you do to relieve stress as long as it helps you feel better. Make time each day for a short respite, something that you look forward to and that will leave you feeling more hopeful as you face the rest of your day.
 

Thứ Hai, 5 tháng 2, 2018

Nghề viết lách

Nghề viết lách

Thành phố càng về hướng trung tâm, dòng xe cộ càng đông đúc nối đuôi nhau kẻn xe inh ỏi. Khói bụi mịt mờ. (Nếu có một bộ óc tượng tưởng ai đó sẽ ví cảnh tượng này như một đàn kiến trên rừng Amazon )... phải mất đến hơn 45 phút tôi mới tìm được cái nhà sách cần tìm nằm trên đường Lê Lợi bởi đường xá dạo này thay đổi nhiều do những hướng phân luồng xe mới cộng với những hàng rào tôn lấn chiếm gần hết một đoạn đường khá dài trên con đường sầm uất này...do đang xây dựng một tuyến metro đi ra hướng thủ Đức 

Bước vào văn phòng của nhà sách. Tôi thấy một người đàn ông đã luống tuổi, đáng gầy gò, nét mặt đã hằn lên những dấu tích của thời gian. Đôi môi khô khốc còn đọng chút Bọt nơi khoé mép, ông đang hăng say nói về một tác phầm mà theo ông đã bỏ ra hơn 20 năm để viết. Tôi không muốn nghe lóm câu chuyện của ộng nhưng ông thấy tôi ngồi gần đấy nên muốn chia sẽ nỗi niềm cả với tôi. Ông nói, sách của ông chỉ bao gồm những kinh nghiệm sống , những phương pháp tập luyện và cách ăn uống khoa học để có được một cuộc sống tươi vui và khỏe mạnh. Nội dung sách của ông đã được đánh giá rất cao ở Thụy sỹ. Ông tự hào cho biết mình đá sống và làm việc ở Thủy sỹ hơn 40 năm ( ông chẳng nói ông làm nghề gì) nhưng nay ông đã về hưu, các đồng nghiệp của ông động viên ông nên viết một cuốn sách để lại cho hậu thế đặc biệt là dành cho quê hương nơi ông đã từng sống những ngày thơ ấu, đã từng trèo hái một thứ trái gì đó nơi làng quê ông như lời bài hát gì đó mà ông rất thích nhưng bỗng chốc ông không thể nhớ ra được. Tôi rất Thông cảm với cảm xúc mãnh liệt của ông lúc ấy và cũng cảm nhận được cái bóng xế chiều đang dần ập đến trong ông, có vẻ như ông nói trước quên sau, cứ nói đi nói lại những điều mà ông sợ như không còn dịp để nói. Cách nói ấy đã làm anh nhân viên tìm cách chấm dứt câu chuyện với ông một cách lịch sự bằng cách giới thiệu tôi với ông để ông tha hồ mà diễn đạt mà kể lễ nhưng trước khi để cho anh nhân viên đứng lên. Một lần nữa...
Ông hỏi: “tôi mưốn in quyển sách này ở Việt Nam cho rẻ để đáp ứng được như cầu muốn truyền lại chút kinh nghiệm sau 20 năm bốn ba nơi xứ người”
“ ông phải tìm đến một nhà xuất bản nào đó xin cấp phép cho nội dung quyển sách của ông, khi đã có phép của nhà xuất bản ông mới đem in được “ anh nhân viên giải thích vẻ hơi chút bực bội lộ rõ trên nụ cười gượng gạo
“ bên Thụy sỹ người ta đã đồng y xuất bản và phát hành quyển sách của tôi đến một triệu bản, mỗi bản tôi được một đô” ông lại tiếp tục trình bày “ ... nhưng tôi muốn mang về quê hương để giúp cho độc giả Việt Nam có được một quyến sách hay nhưng giá lại rẻ” ông lập lại cái điệp khúc ấy chán đến độ anh nhân viên quyết định đứng lên, không quên cái bắt tay lạnh nhạt cho phải phép

Tôi không biết ông làm nghề gì và nội dung quyển sách của ông viết về chủ đề gì nhưng rất Thông cảm với nỗi ưu tư và mơ ước thật đẹp của ông đang thai nghén cho một tác phẩm đầu tay, một đứa con tinh thần mà ông muốn sinh ra lần cuối ngoài những đứa con bằng xương bằng thịt của ông Tôi chợt nghĩ sao ông không xuất bản và phát hành ngay bên Thụy sỹ một công đôi việc ( vừa được tự do xuất bản lại vừa nhận được tiền bạc triệu)

Tôi lại nhớ lại những tháng ngày chạy đôn chạy đáo cho đứa con tinh thần của mình trào đời. Cái cảm giác thật vui và hạnh phúc biết bao... nhưng cái quá trình phát hành nó tưởng chừng như đơn giản lại hoá ra phức tạp hơn tôi tưởng.
Các công ty phát hành sách đều đồng ý giúp tôi quảng bá đứa con tinh thần của tôi
Nhưng họ bảo “ đứa con của tôi rất kén bạn đấy!!”
Tôi biết trước điều ấy...mà!!

Hôm ấy ngồi nghe câu chuyện của ông-một Việt kiều Thụy sỹ-không khỏi khơi lên những kỳ niệm của riêng mình , mới cảm nhận được những lời chia sẻ không hề sai của những “ bậc thầy” đi trước về cái nghề viết lách này. Cái nghề đã hút đi chất xám của người viết, rồi để cho bọn lái sách tha hoá kiếm lời vô tội vạ nhưng chắc hẳn 
Tiền bạc không thể bù cho những lời động viên của độc giả sẽ giúp cho người viết chút Hưng phấn tác dụng của những liều thuốc hồi sinh đề giúp họ mạnh dạn chấp nhận những tháng năm thai nghén dầy vò để tiếp tục hạ sinh ra những đứa con tinh thần mới nhưng phải thay đổi cách sinh khác cho phù hợp với lối sống công nghiệp digital ...đành chấp nhận lối ký sinh khác nhẹ nhàng và văn minh hơn , đơn giản chỉ để vơi đi chút nỗi niềm riêng

Thế mới biết người xưa thường nói nghề viết văn không đủ nuôi sống hay nói cách khác người viết thật sự đang phải trả cái nghiệp cầm bút của mình chấp nhận mọi gian khó để đổi lấy chút niềm vui cống hiến cho cuộc đời...

Xin chúc cho những ai đã từng viết sẽ mãi mãi có được niềm vui và sức khỏe để trả hết cho đời những gì mình đã nhận

                                   Saigon. Feb 6, 2018

                                            Paul Hunter

Thứ Sáu, 26 tháng 1, 2018

How about Liquid Biopsy for detecting Colon Cancer

Liquid Biopsy Shows Promise for Colon Cancer

High sensitivity, specificity for cancerous, precancerous lesions


  • by Senior Associate Editor, MedPage Today
  • This article is a collaboration between MedPage Today® and:
    Medpage Today

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
SAN FRANCISCO -- A liquid biopsy detected circulating tumor cells (CTCs) associated with colorectal cancer with overall accuracy approaching 90%, according to a study reported here.
The test's accuracy varied according to the stage of the disease, including 77% sensitivity for detection of precancerous lesions in the colon. The test had sensitivity exceeding 97%, reflecting a low probability of false-positive result.

If the results hold up in additional testing, the liquid biopsy might offer another option for colorectal cancer screening, Wen-Sy Tsai, MD, of Linkou Chang Gung Memorial Hospital in Taoyuan, Taiwan, reported at the Gastrointestinal Cancers Symposium.
"There is still some reticence among patients to use stool-based tests or have an invasive exam like colonoscopy to detect colorectal cancer," Tsai said in a statement. "Our results may point to a solution for people who are reluctant to get an initial screening colonoscopy or are not compliant in returning stool-based test kits that they get from their doctors."
Several recent studies showed that more than 80% of patients who are reluctant to undergo colonoscopy would find a blood test acceptable, said co-author Ashish Nimgaonkar, MD, of Johns Hopkins University in Baltimore. Other studies showed that affordability remains the biggest obstacle to colorectal cancer screening for most people; a liquid biopsy for CTCs might cost less than $100, he added.
Inconvenience, discomfort, and cost all contribute to Americans' reluctant to undergo colorectal cancer screening, agreed Nancy Baxter, MD, PhD, an American Society of Clinical Oncology expert in gastrointestinal cancers.
"Thought this research needs more investigation, a simple, accurate blood test could help increase screening rates, which could ultimately improve detection of colorectal cancers at earlier stages when treatment is most likely to be curative," said Baxter, of the University of Toronto and St. Michael's Hospital.

The study involved 620 adult Taiwanese patients with scheduled routine colonoscopy or colonoscopy for follow-up of confirmed colorectal cancer. Colonoscopy and biopsy confirmed that 111 of the patients had adenomatous polyps and 327 had colorectal cancer, ranging from early- to late-stage disease. The remaining 182 patients had no evidence of adenomas or colon cancer and served as a comparison group.
The liquid biopsy required each patients to provide 2 mL of blood, which was analyzed by a test with proven ability to identify a single CTC within 1 billion cells from an adenomatous polyp. Results were compared with the colonoscopy findings by reviewers who had no prior knowledge of the findings of either test.
Using colonoscopy findings as the definitive result, investigators found that the blood test had an overall accuracy of 88%. The test had a sensitivity of 84.0% among the 182 study participants without adenomas or colorectal cancer, 76.6% for participants with adenomatous polyps, and 86.9% for the patients with colorectal cancer. The test results yielded a specificity of 97.3% in the cancer-free group, the polyp group, and the patients with confirmed colorectal cancer.
"We believe our high specificity results are important because a high number of false-positive results would discourage many people who are considering getting screened for colorectal cancer from doing so," said Tsai.
Performance analysis showed the test had an area under the curve of 0.87 for the control group, 0.84 for the participants with polyps, and 0.88 for the patients with colorectal cancer.

Following approval of the Cologuard stool DNA test for colorectal cancer screening, gastroenterologists and colon cancer specialists noted the test's poor performance for detecting adenomatous polyps. In the randomized comparing against fecal immunochemical testing that supported the FDA application, the DNA test detected 92% of colon cancers versus 42% of adenomatous polyps. The study also yielded a 13% rate of false-positives for the DNA test.
Moreover, as one gastroenterologist noted in an opinion piece for MedPage Today, no currently available screening test will replace colonoscopy as the gold standard for diagnosis of colorectal cancer. Even if the initial results with the liquid biopsy hold up in additional testing, the CTC test colonoscopy will remain the standard for definitive diagnosis and to guide biopsy of a tumor or removal of a polyp detected by the liquid biopsy, Nimgaonkar noted.

Thứ Năm, 25 tháng 1, 2018

exercising with diabetes

Exercising With Diabetes: Is It Better to Eat Before or After Your Workout?

The great debate of whether to eat before working out is even more important if you have diabetes. Here’s your exercise nutrition game plan.





To maintain your blood sugar levels, plan what to eat before, during, and after a workout.
To maintain your blood sugar levels, plan what to eat before, during, and after a workout.
Alamy

Whether it’s best to eat before or after a workout has been debated for decades, and the decision becomes even more complicated if you have diabetes. “For someone with diabetes, they not only have to think about fuel for exercise, but they also have to think about glycemic control,” says Monet S. Bland, a clinical exercise physiologist and diabetes educator with Joslin Diabetes Center in Boston.
Exercise impacts your blood sugar, so you need to make sure your levels aren’t too high when you start exercising, but also not so low that they’ll plummet during your workout. So while a study published in November 2010 in the Journal of Physiology found that not eating before exercise helped people burn fat, people with diabetes need to maintain blood sugar levels, and should plan to eat before, after, and sometimes even during exercise, Bland says.
That’s the general recommendation, but it’s not a one-size-fits-all approach. You need to keep an eye on how your body responds, since “some people are more sensitive to the effects of exercise versus others,” Bland says. Not sure where to start? Bland recommends working with an endocrinologist or an exercise physiologist to establish blood glucose targets and an exercise plan that’s safe for you.
No matter what, you’ll want to check your blood sugar before working out so you know how to fuel up. Your goal is a level greater than 100 milligrams per deciliter (mg/dL) — but always skip the workout if your blood sugar is at or higher than 250 mg/dL and ketosis is present, or greater than 300 mg/dL without ketosis. Be sure to talk to your doctor about your blood glucose targets before and after exercise.
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The Best Pre-Workout Snacks

Your best bet is eating a balanced meal an hour to an hour and a half before your workout, says Lori Zanini, RD, CDE, creator of the seven-day diabetes meal plan. Shoot for 30 grams (g) of high fiber carbohydrates, 3 to 4 ounces (oz) of lean protein, 5 to 10 g of healthy fats, and two servings of nonstarchy vegetables (a serving is 1 cup of raw veggies or ½ cup of cooked veggies), Zanini says. A turkey sandwich on whole wheat bread with ¼ of an avocado, lettuce, tomato, and 1 cup of sugar snap peas on the side checks all the boxes.
If you’re short on time or knocking out your workout first thing in the morning, adjust your approach and grab a snack that combines protein with healthy carbohydrates (ideally 15 grams) 15 to 30 minutes before exercising, says Jessica Crandall, RDN, CDE, wellness center director at Denver Wellness and Nutrition in Englewood, Colorado. The carbs-plus-protein combo “helps you keep your blood sugar stable for a longer period of time,” she says. Try a hard-boiled egg and 1 cup berries, 1 cup of cottage cheese, and ½ cup of pineapple, or 1 to 2 tablespoons (tpsp) of peanut butter and an apple, Zanini says.

What to Reach for During Exercise

Depending on how long and how intense your workout is, your blood sugar can decrease as you’re exercising. Keep a snack with about 15 to 20 g of carbohydrates nearby — Crandall likes dried fruit because it’s easy to stash in a workout bag — and reach for it if hypoglycemia occurs, Bland says.

The Best Post-Workout Snacks

As you exercise, your body will use insulin more efficiently, which lowers your blood sugar for up to 24 hours, creating what’s known as the “lag effect.” “This puts an individual with diabetes at risk for hypoglycemia in the hours following exercise completion,” Bland says.
To counter it, reach for a snack within 15 minutes of your cooldown. The snack should have 15 g of carbohydrates, which is about what you’ll find in ½ cup of oatmeal, 1 cup of berries, or half of a medium-sized sweet potato, Zanini says. Crandall suggests adding protein, such as nuts, string cheese, or cottage cheese, to help support muscle mass.
Finally, sit down for a meal within an hour or two, Zanini says. Just be careful not to overdo it. According to the American Diabetes Association, you likely won’t need to add any extra carbs to your diet, unless you’re exercising for longer than an hour. It’s easy to adopt the “I just worked out, so I deserve this doughnut” reasoning, but going overboard could cancel out your exercise efforts.
Last Updated:7/20/2017