One of my patients – who had been struggling with obesity, uncontrolled diabetes and the cost of her medications – agreed in June 2019 to adopt a more whole-food plant-based diet.
Excited by the challenge, she did a remarkable job. She increased her fresh fruit and vegetable intake, stopped eating candy, cookies and cakes and cut down on foods from animal sources. Over six months, she lost 19 pounds and her HbA1c – a measure of her average blood sugar – dropped from 11.5% to 7.6%.
She was doing so well, I expected that her HbA1c would continue to drop and she would be one of our plant-based successes who had reversed diabetes.
Her three-month follow-up visit in March 2020 was canceled because of COVID-19 lockdowns. When I eventually saw her again in May 2021, she’d regained some of the weight and her HbA1c had climbed to 10.4%. She explained that her diabetes doctor and a diabetes nurse educator had told her that she was eating too much “sugar” on the plant-based diet.
She’d been advised to limit carbohydrates by cutting back on fruits and starchy vegetables and eating more fish and chicken. Sugar-free candy, cakes, cookies and artificial sweeteners were encouraged. In the face of conflicting medical advice, she fell back on conventional wisdom that “sugar” is bad and should be avoided whenever possible, especially if you have diabetes.
I’m a physician, board certified in preventive medicine with a lifestyle medicine clinic at Morehouse Healthcare in Atlanta. This emerging medical specialty focuses on helping patients make healthy lifestyle behavior modifications. Patients who adopt whole-food plant-based diets increase carbohydrate intake and often see reversal of chronic diseases including diabetes and hypertension. In my clinical experience, myths about “sugar” and carbohydrates are common among patients and health professionals.
Fruit vs. sugar
Your body runs on glucose. It is the simple sugar that cells use for energy.These molecules are the three kinds of simple sugars, found in starches, fruit and milk. Trinset/ iStock via Getty Images Plus
Glucose is a molecular building block of carbohydrates, one of the three essential macronutrients. The other two are fat and protein. Starches are long, branching chains of glucose.Chains of simple sugar molecules linked together form starches and other carbohydrates. Trinset/iStock via Getty Images Plus
Naturally occurring carbohydrates travel in nutrient-dense packages such as fruits, vegetables, whole grains, nuts and seeds.
Humans evolved to crave sweet tastes to get the nutrients needed to survive. A daily supply of vitamins, minerals and fiber is needed because our bodies cannot make them. The best source of these substances for our ancient ancestors was sweet, ripe, delicious fruit. In addition, fruits contain phytonutrients and antioxidants, chemicals produced only by plants. Phytonutrients such as ellagic acid in strawberries have cancer-fighting properties and promote heart health.
Refined sugars, on the other hand, are highly processed and stripped of all nutrients except calories. They’re a concentrated form of carbohydrates. The food industry produces refined sugars in many forms. The most common are sucrose crystals, which you’d recognize as table sugar, and high-fructose corn syrup, which is found in many processed foods and sweetened beverages.
If you continually satisfy your taste for sweet with foods that contain refined sugar – rather than the nutrient-rich fruits at the core of this craving passed on by evolution – you may not get all the nutrients you need. Over time, this deficit may create a vicious cycle of overeating that leads to obesity and obesity-related health problems. Women who eat the most fruit tend to have lower rates of obesity.
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Sugar toxicity
Refined sugars are not directly toxic to cells, but they can combine with proteins and fats in food and in the bloodstream to produce toxic substances such as advanced glycation end products (AGEs). High blood glucose levels may produce glycated low-density lipoproteins. High levels of these and other glucose-related toxic substances are associated with an increased risk of a wide range of chronic health problems, including cardiovascular disease and diabetes.
The disease most commonly associated with sugar is Type 2 diabetes. A surprising number of people, including health professionals, incorrectly believe that eating sugar causes Type 2 diabetes. This myth leads to a focus on lowering blood sugar and “counting carbs” while ignoring the real cause: progressive loss of pancreatic beta cell function. At diagnosis, a patient may have lost between 40% and 60% of their beta cells, which are responsible for producing insulin.
Insulin is a hormone that controls how much glucose is in the bloodstream by blocking glucose production in the liver and driving it into fat and muscle cells. Loss of beta cell function means not enough insulin gets produced, resulting in the high blood glucose levels characteristic of Type 2 diabetes.
People interested in losing weight and improving health often ask if they should do a “sugar detox.” In my opinion this is a waste of time, because it is not possible to eliminate sugar from the body. For instance, if you ate only baked chicken breasts, your liver would convert protein to glucose in a process called gluconeogenesis.
Eliminating foods sweetened with refined sugar is a worthy goal. But don’t think of it as a “detox” – it should be a permanent lifestyle change. The safest way to go on a refined sugar “detox” is to increase your intake of nutrient-dense fruits and vegetables. Once you eliminate refined sugar, you’ll likely find that your taste buds become more sensitive to – and appreciative of – the natural sweetness of fruits.
PFAS in pregnant women’s drinking water puts their babies at higher risk, study finds
A new study shows pregnant women exposed to PFAS-contaminated drinking water face higher risks of low birth weight, preterm birth, and infant mortality. Learn how PFAS, or “forever chemicals,” impact babies and what you can do to reduce exposure.
PFAS, or perfluoroalkyl and polyfluoroalkyl substances, have captured the attention of the public and regulators in recent years for good reason. These man-made compounds persist in the environment, accumulate in human bodies and may cause harm even at extremely low concentrations. Most current knowledge about the reproductive effects of PFAS comes from laboratory studies on animals such as rats, or from correlations between PFAS levels in human blood and health outcomes. Both approaches have important limitations. Rats and humans have different bodies, exposures and living conditions. And independent factors, such as kidney functioning, may in some cases be the true drivers of health problems. We wanted to learn about the effects of PFAS on real-world human lives in a way that comes as close as possible to a randomized experiment. Intentionally exposing people to PFAS would be unethical, but the environment gave us a natural experiment of its own. We looked at the locations of wells that supply New Hampshire residents with drinking water and how those locations related to birth outcomes. We collected data on all births in the state from 2010 to 2019 and zoomed in on the 11,539 births that occurred within 3.1 miles (5 kilometers) of a site known to be contaminated with PFAS and where the mothers were served by public water systems. Some contamination came from industries, other from landfills or firefighting activities.A conceptual illustration shows how PFAS can enter the soil and eventually reach groundwater, which flows downhill. Industries and airports are common sources of PFAS. The homes show upstream (left) and downstream (right) wells.Melina Lew PFAS from contaminated sites slowly migrate down through soil into groundwater, where they move downstream with the groundwater’s flow. This created a simple but powerful contrast: pregnant women whose homes received water from wells that were downstream, in groundwater terms, from the PFAS source were likely to have been exposed to PFAS from the contaminated site, but those who received water from wells that were upstream of those sites should not have been exposed. Using outside data on PFAS testing, we confirmed that PFAS levels were indeed greater in “downstream” wells than in “upstream” wells. The locations of utilities’ drinking water wells are sensitive data that are not publicly available, so the women likely would not have known whether they were exposed. Prior to the state beginning to test for PFAS in 2016, they may not have even known the nearby site had PFAS.
PFAS connections to the riskiest births
We found what we believe is clear evidence of harm from PFAS exposure. Women who received water from wells downstream of PFAS-contaminated sites had on average a 43% greater chance of having a low-weight baby, defined as under 5.5 pounds (2,500 grams) at birth, than those receiving water from upstream wells with no other PFAS sources nearby. Those downstream had a 20% greater chance of a preterm birth, defined as before 37 weeks, and a 191% greater chance of the infant not surviving its first year. Per 100,000 births, this works out to 2,639 additional low-weight births, 1,475 additional preterm births and 611 additional deaths in the first year of life. Looking at the cases with the lowest birth weights and earliest preterm births, we found that the women receiving water from wells downstream from PFAS sources had a 180% greater chance of a birth under 2.2 pounds (1,000 grams) and a 168% greater chance of a birth before 28 weeks than those with upstream wells. Per 100,000 births, that’s about 607 additional extremely low-weight births and 466 additional extremely preterm births.
PFAS contamination is costly
When considering regulations to control PFAS, it helps to express the benefits of PFAS cleanup in monetary terms to compare them to the costs of cleanup. Researchers use various methods to put a dollar value on the cost of low-weight and preterm births based on their higher medical bills, lower subsequent health and decreased lifetime earnings. We used the New Hampshire data and locations of PFAS-contaminated sites in 11 other states with detailed PFAS testing to estimate costs from PFAS exposure nationwide related to low birth weight, preterm births and infant mortality. The results are eye-opening. We estimate that the effects of PFAS on each year’s low-weight births cost society about US$7.8 billion over the lifetimes of those babies, with more babies born every year. We found the effects of PFAS on preterm births and infant mortality cost the U.S. about $5.6 billion over the lifetimes of those babies born each year, with some of these costs overlapping with the costs associated with low-weight births. An analysis produced for the American Water Works Association estimated that removing PFAS from drinking water to meet the EPA’s PFAS limits would cost utilities alone $3.8 billion on an annual basis. These costs could ultimately fall on water customers, but the broader public also bears much of the cost of harm to fetuses. We believe that just the reproductive health benefits of protecting water systems from PFAS contamination could justify the EPA’s rule.
Treating PFAS
There is still much to learn about the risks from PFAS and how to avoid harm. We studied the health effects of PFOA and PFOS, two “long-chain” species of PFAS that were the most widely used types in the U.S. They are no longer produced in the U.S., but they are still present in soil and groundwater. Future work could focus on newer, “short-chain” PFAS, which may have different health impacts.If the water utility isn’t filtering for PFAS, or if that information isn’t known, people can purchase home water system filters to remove PFAS before it reaches the faucet.Compassionate Eye Foundation/David Oxberry via Getty ImagesPFAS are in many types of products, and there are many routes for exposure, including through food. Effective treatment to remove PFAS from water is an area of ongoing research, but the long-chain PFAS we studied can be removed from water with activated carbon filters, either at the utility level or inside one’s home. Our results indicate that pregnant women have special reason to be concerned about exposure to long-chain PFAS through drinking water. If pregnant women suspect their drinking water may contain PFAS, we believe they should strongly consider installing water filters that can remove PFAS and then replacing those filters on a regular schedule. Derek Lemoine, Professor of Economics, University of Arizona; Ashley Langer, Professor of Economics, University of Arizona, and Bo Guo, Associate Professor of Hydrology, University of Arizona This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Empowering Seniors for Safer Online Experiences: 6 Practical Safety Tips for Caregivers and Families
Safety Tips for Caregivers: Empower seniors with essential online safety tips. Learn 6 practical strategies caregivers can use to help older adults navigate digital threats, scams, and security risks confidently.
Empowering Seniors for Safer Online Experiences: 6 Practical Safety Tips for Caregivers and Families
(Family Features) Today’s seniors aren’t shying away from a world that has become increasingly reliant on technology. Quite the opposite, in fact, as recent survey findings suggest adults ages 65 and older are more digitally active and self-assured than ever before. Nearly all seniors surveyed as part of the “Connecting the Digital Dots: Online Habits and Safety Concerns Across Three Generations” survey from Cox Mobile consider themselves digitally literate, using devices for shopping, banking, social media and entertainment. With older adults spending a significant amount of time connected to the digital world – 41% of those surveyed reported spending five or more hours online daily – they’re also more at-risk for scams, viruses like malware and data breaches. Even though 61% of seniors who encountered digital threats were able to mitigate the issues themselves, showing their growing digital capability, increased online engagement brings new challenges and responsibilities for caregivers, who often play a crucial role in supporting seniors’ digital journeys. To help support older loved ones’ safety and confidence as they navigate an evolving digital landscape, Cox Mobile, in partnership with Common Sense Media, offers educational materials on digital safety, smart device use and media literacy for all ages. In addition, these practical safety strategies can help empower seniors to make informed, safe choices online. Encourage Strong Passwords: Simple passwords, like number sequences, keyboard patterns or personal information – such as variations of your name, birthdate, address or names of pets or loved ones – are easily guessable and may lead to issues. While the survey found 70% of seniors already create strong, unique passwords, encourage them to avoid reusing passwords across sites. Recommend a password manager app to safely store passwords and eliminate the need to write them all down, which could lead to a breach if not stored properly. Promote Security Software: If devices aren’t protected, even the most careful users are susceptible to viruses. Though 63% of those surveyed have security software installed, it’s important to regularly make sure it’s up to date (or that automatic updates are enabled) and covers all devices, including laptops, tablets and smartphones. Enable Multi-Factor Authentication: A simple and effective way to stop most attempts at unauthorized account access, 60% of seniors are already using multi-factor authentication as an extra layer of protection. Some seniors, however, may need assistance setting up the safeguard, which typically sends a code to a phone number or email address as part of the login process, for online banking, email or social media accounts. Review Apps and Channels: Over time, it can be easy to accumulate apps on smartphones and tablets. While 51% of surveyed seniors remove unsafe apps, make it a habit to regularly check loved ones’ devices for unfamiliar or suspicious applications and delete them. Also keep an eye out for unauthorized charges, data sharing or browser extensions. Utilize Built-In Safety Features: Explore privacy controls on individual devices (and apps) and check with your loved ones’ internet service provider to ensure security features are being utilized like the 43% of those surveyed who are already taking advantage of their devices’ safety settings. Included privacy protections may include limiting data sharing, disabling location tracking, blocking pop-ups and restricting other unwanted communication. Discuss Online Safety Regularly: Because technology is ever-changing, it’s important for caregivers to talk with senior loved ones about online safety. Open, ongoing conversations, like those one-third of seniors are already having several times a week or even daily, can help build trust and awareness of current scams, suspicious texts or emails, commonly used apps and more. By fostering open dialogue, sharing practical safety strategies and leveraging trusted resources, caregivers can help their loved ones thrive and stay safe. Visit your local Cox Mobile store or go to CoxMobileSafety.com to find more tips, guides and full survey results. SOURCE:Cox Communications
How to keep dementia from robbing your loved ones of their sense of personhood – tips for caregivers
Learn evidence-based communication strategies to preserve your loved one’s sense of self through dementia’s progression. Discover how to adjust conversations for early, middle, and late-stage dementia while maintaining meaningful connection and dignity.
How to keep dementia from robbing your loved ones of their sense of personhood – tips for caregivers
R. Amanda Cooper, University of Connecticut Every three seconds, someone in the world develops dementia. There are over 6 million people living with dementia in the U.S. and 57 million globally. These figures will only increase in the coming years, as rates of dementia are predicted to double by 2060. If you don’t know someone affected by dementia, you probably will at some point. Dementia is incredibly difficult both for the person experiencing it and for their loved ones, not only because of the symptoms of the disease but also because of the social stigma associated with cognitive decline. Experiencing stigma makes it difficult for people with dementia to ask for help, increases anxietyand depression, and ultimately leads to social isolation. Dementia-related stigma is perpetuated through media messages that portray people with dementia as mindless and incapable, as well as through daily interactions in which others dismiss and dehumanize the person living with dementia. These forms of invalidation – usually unintentional – accelerate and intensify the loss of self-worth and identity that dementia patients are already experiencing. Fortunately, educating and spreading awareness can help reduce behaviors that propagate stigma and dehumanizing treatment of people with dementia. As a social scientist and researcher in interpersonal communication and family caregiving, I explore the social and relational side of dementia. Through my work with these patients and families, I’ve learned that reducing stigma and supporting self-worth for people who have dementia is often done through daily conversations.People living with dementia can continue to have fulfilling interactions when caregivers carry out person-centered care.Jessie Casson/DigitalVision via Getty Images
How is dementia defined?
Dementia is an umbrella term that refers to a family of cognitive conditions involving memory loss, difficulty thinking or processing information, changes in ability to communicate and challenges with managing daily tasks. The most common form of dementia is Alzheimer’s disease, but there are several other forms of dementia that can severely affect a person’s quality of life and that of their loved ones. Most forms of dementia are progressive, meaning that the symptoms of the disease get steadily worse over time. A person with dementia can live with the disease for several years, and their symptoms will shift as the disease progresses. People in the early stages of dementia, including mild cognitive impairment, continue to engage socially and participate in many of the activities they have always done. In the middle stage of the disease, people often need more help from others to complete daily tasks and may have more difficulty holding conversations. In the late stage, people with dementia are dependent on others and often lose the ability to communicate verbally. Despite the cognitive declines that come with dementia, people living with dementia can maintain many of their former abilities as the disease progresses. Even in the late stages, research shows that people with dementia can understand tone of voice and nonverbal communication such as body language, facial expressions and gentle touch. This makes it clear that people with dementia can continue having meaningful social connections and a sense of self-worth even as their disease progresses.Engaging in meaningful activities that are appropriate to the person’s stage of dementia can help foster a sense of self.Jessie Casson/DigitalVision
Focusing care around the person
In the 1990s, psychologist Tom Kitwood, who studied dementia patients in long-term care settings, introduced the notion of “personhood.” Personhood is a recognition of a person’s unique experiences and individual worth. He had observed that residents with dementia were sometimes treated as objects rather than people and were dismissed as being “no longer there” mentally. In response, Kitwood advocated for a new model of person-centered care. In contrast to the medical model of care that was standard at the time, person-centered care aims to provide people with dementia comfort, attachment, inclusion, occupation and identity. Comfort includes both physical and psychological comfort, ensuring that the person with dementia feels safe and is as pain-free as possible. Attachment and inclusion have to do with supporting a person with dementia’s closest relationships and making sure they feel included in social activities. Occupation is about giving the person meaningful activities that are suited to their abilities, while identity is about preserving their unique sense of self. According to Kitwood, each of these elements of personhood can be upheld or threatened through a person’s interactions with others. I find Kitwood’s work particularly important because it suggests that communication is at the heart of personhood.
Communicating to support personhood
So how can family members and friends communicate with their loved one with dementia to help preserve their sense of self? Researchers have identified several evidence-based communication strategies that support person-centered care both in long-term care settings and within the family. These include:
Using simple prompts to help the person successfully engage in conversation.This can be done through repeating or rephrasing questions, paraphrasing the person’s responses, pausing to give the person time to think, and providing simple prompts to help the person remember.
Creating and maintaining connection.In families, this is done by giving a hug or kiss or saying “I love you”; doing activities together such as playing simple games, making art or playing music; and joking around and laughing together.
Communication shifts as the disease progresses
Supporting personhood requires adjusting to the communication abilities of the person with dementia. Some communication strategies are helpful in one stage of the disease but not in others. In a recent study, my team and I found that asking the person with dementia to recall the past was affirming for those who were early in the disease and who could still recall the past. But for people who were in later stages of the disease, asking them “Do you remember?” was received more like a test of memory and led to frustration or confusion. Similarly, we found that suggesting words to prompt recall was helpful later in the disease but demeaning for people who were in earlier stages of the disease who could still find their words without help. Providing more help in conversation than is needed can lead people with dementia to withdraw, whereas appropriately adjusting to a person’s communication abilities can empower them to continue to engage socially. Ultimately, supporting a person with dementia’s sense of self and self-worth in conversations is about finding a communication sweet spot – in other words, matching your approach to their current capabilities. Changing your default approach to conversations can be challenging, but making simple communication changes can make all the difference. Meaningful conversations are the key to helping your loved one live their days to the fullest, with a sense of personal worth and a feeling of meaningful connection with others. R. Amanda Cooper, Assistant Professor of Communication, University of Connecticut This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Promote Security Software: If devices aren’t protected, even the most careful users are susceptible to viruses. Though 63% of those surveyed have security software installed, it’s important to regularly make sure it’s up to date (or that automatic updates are enabled) and covers all devices, including laptops, tablets and smartphones. Enable Multi-Factor Authentication: A simple and effective way to stop most attempts at unauthorized account access, 60% of seniors are already using multi-factor authentication as an extra layer of protection. Some seniors, however, may need assistance setting up the safeguard, which typically sends a code to a phone number or email address as part of the login process, for online banking, email or social media accounts. Review Apps and Channels: Over time, it can be easy to accumulate apps on smartphones and tablets. While 51% of surveyed seniors remove unsafe apps, make it a habit to regularly check loved ones’ devices for unfamiliar or suspicious applications and delete them. Also keep an eye out for unauthorized charges, data sharing or browser extensions. Utilize Built-In Safety Features: Explore privacy controls on individual devices (and apps) and check with your loved ones’ internet service provider to ensure security features are being utilized like the 43% of those surveyed who are already taking advantage of their devices’ safety settings. Included privacy protections may include limiting data sharing, disabling location tracking, blocking pop-ups and restricting other unwanted communication. Discuss Online Safety Regularly: Because technology is ever-changing, it’s important for caregivers to talk with senior loved ones about online safety. Open, ongoing conversations, like those one-third of seniors are already having several times a week or even daily, can help build trust and awareness of current scams, suspicious texts or emails, commonly used apps and more. By fostering open dialogue, sharing practical safety strategies and leveraging trusted resources, caregivers can help their loved ones thrive and stay safe. Visit your local Cox Mobile store or go to 
