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  • An A to Z of the top foods and drinks Australians love most — Vegemite included | CNN

    An A to Z of the top foods and drinks Australians love most — Vegemite included | CNN

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    CNN
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    There are countless things about our homeland that Australians miss after moving abroad: the magnificent landscape, the laid-back lifestyle and that endless blue sky, to name a few.

    But something as simple as a trip to the supermarket can leave us expats – according to some reports there are an estimated one million of us – feeling desperately homesick.

    With its long history of immigration, Australia is quite literally a melting pot of cuisines.

    While some foods are the result of cultural influences such as the Chiko Roll, others are uniquely Aussie, like Golden Gaytime ice cream.

    And who could forget the most famous of them all, Vegemite, which turns 100 on October 25.

    According to the National Museum of Australia, it was invented by chemist CP Callister in Melbourne in 1923 when Australian food manufacturer Fred Walker asked him to create a product similar to British Marmite.

    “During the Second World War, Vegemite captured the Australian market. Marmite was unobtainable and the Australian Army supplied Vegemite to its troops,” says the museum in a post highlighting defining symbols of Australia.

    “In the 1950s and 60s, despite acquisition by the American company Kraft, Vegemite became a distinctively ‘Australian’ food. It featured in songs, on souvenirs and other popular culture ephemera. Vegemite returned to Australian ownership in 2017 when purchased by dairy company Bega.”

    More on this famed brown spread below as we round up the A-Z of Aussie favorites:

    Introduced in 1927, this simple dessert is an Australian classic.

    Every Australian child grew up singing the famous 1930s jingle: “I like Aeroplane Jelly, Aeroplane Jelly for me!”

    The brand’s “Bertie the Aeroplane” mascot was named after inventor Bert Appleroth – a Sydney tram driver who is said to have made the first batch in his bathtub.

    Although now owned by an American company, Aeroplane Jelly has hardly changed since grandma was a girl.

    Sure, there are plenty of brands of jelly available worldwide, but when it comes time to make a trifle or treat for the kids, Aussie parents can’t resist this familiar favorite.

    An Australian variety of mango that isn’t grown anywhere else in the world, the Bowen is considered the best of the best.

    It was first discovered in the northern Queensland town of Bowen, hence the name, but is also known as Kensington Pride.

    Bigger and juicer than other varieties, Bowen mangoes account for 80% of mangoes produced in Australia. Some are exported but arguably not enough for the huge number of mango-loving expats.

    To Aussies, mangoes are the taste of summer. No matter where we are in the world, the craving for a Bowen mango usually kicks in around Christmas.

    This strange little deep-fried snack has been an Australian icon since 1950 when it was first sold by an enterprising boilermaker at football games.

    Inspired by Chinese spring rolls, the exact recipe is a little unclear but the combination of meat, veg and some unknown spices hits the spot.

    Best consumed with a couple of potato scallops and a soft drink, the Chiko Roll is the go-to for tradies on their lunch break or those 3 a.m. munchies on your way home from the pub.

    And the only place to get them is a typical Aussie takeaway joint.

    Dukkah – a humble blend of crushed Middle Eastern spices, herbs and nuts from Egypt – has been embraced by Australian foodies.

    Its versatility is one of the reasons this condiment is so popular. Dukkah can be used as a garnish, a coating on a piece of meat or mixed with olive oil as a dip for bread.

    A number of producers have given the basic dukkah recipe an Australian twist by adding native ingredients, such as lemon myrtle, macadamia nuts, wattleseed, saltbush and pepperleaf.

    Expats can find many variations in Australian supermarkets and, fortunately, they’re often sold in packets small enough to sneak into a suitcase.

    Australia is one of the few countries where it is considered perfectly acceptable to eat the coat of arms.

    Exceptionally lean and gamey, emu and kangaroo tend to be popular among adventurous chefs in Australia.

    But when living abroad, neither is easy to get your hands on.

    A number of restaurants and specialty butchers offer native meats, but the expense involved in raising emus, in particular, means it’s harder to come by.

    The flat white is practically Australia's national drink.

    Thanks to the influx of Greek and Italian immigrants who brought “proper coffee” to Australia post WWII, we have become a nation of coffee snobs.

    The flat white is almost Aussie enough to be called the national drink.

    All over the world, café goers and baristas have been confounded as Aussie expats seek out their favorite brew abroad.

    With less milk than a latte and without the froth of a cappuccino, the flat white requires special attention (it’s all in the pouring).

    One of the first questions asked on expat forums: “Where can I get a decent flat white in this town?”

    And it’s usually the first thing ordered at the airport café when back on home soil.

    Ice creams feature highly on the most-wanted lists of expats, so it’s only natural we highlight them here.

    Milky Paddle Pops and fruity Splice have been popular summer treats since the 1960s.

    Likewise, Weis Bars have also been around for more than 60 years, and the mango and cream concoctions invoke memories of lazy summer afternoons.

    But the number one, the crème de la crème, is the Golden Gaytime – a vanilla and toffee ice cream coated in chocolate and dipped in crunchy biscuit pieces that has inspired many a replica over the years.

    While the burger itself is not an Australian invention, we have added some unconventional ingredients that make the Aussie version truly memorable.

    Take the essentials – a beef patty, cheese, tomato, lettuce, grilled onions, tomato sauce (ketchup) – and add beetroot, pineapple, a fried egg and bacon, and you have yourself a massive mouthful.

    A quick online search reveals variations that include pickled beetroot and spicy mayo, among others, but the classic Aussie burger celebrates simplicity.

    It’s easy enough to replicate at home, but nothing beats the experience of ducking into the local milk-bar (café), or fish and chip shop, to enjoy a burger and a milkshake after a day at the beach.

    The Iced VoVo – a biscuit covered in pink fondant, raspberry jam and shredded coconut – is a national treasure.

    Produced by Arnott’s since the early 1900s, the iconic treat was mentioned by former Prime Minister Kevin Rudd in his victory speech after the 2007 election, leading to a spike in sales.

    “Friends, tomorrow, the work begins. You can have a strong cup of tea if you want, even an Iced VoVo on the way through. But the celebration stops there,” Rudd said.

    Not often found for sale overseas, this sweet treat is one to enjoy with a cup of tea when you’re home visiting mum.

    Caramello Koala is a brand of chocolate bar manufactured by Cadbury Australia.

    Ask any Australian expat what they miss most about ‘home’ and their list is sure to include at least one type of junk food – the absence of which is felt most keenly at kids’ birthday parties.

    Allen’s Lollies (candy) have been around for decades and Minties, Fantales, Jaffas, Snakes and the Classic Party Mix remain as popular as ever.

    The Aussie public doesn’t seem to mind that they are all owned by Nestlé, which is headquartered in Switzerland.

    Fairy Bread – essentially white bread covered in butter and sprinkles – is another party staple that manages to be devoid of nutrition but highly nostalgic.

    On return trips to Australia, expats are known to bulk-buy chocolate bars like Cadbury Cherry Ripes, Caramello Koalas and ever-popular Violet Crumbles.

    When it comes to savory junk foods, Smith’s Chips, cheesy Twisties and Nobby’s nuts are synonymous with snacking – and nothing produced overseas comes close.

    The perfect late-night snack.

    We tend to lump all Middle Eastern meat-and-pita combos under the heading of “kebab” and be done with it.

    Of course, there are subtle differences between doner kebabs, shawarma, souvlaki, and gyros – in both ingredients and quality – depending on the source.

    Connoisseurs agree that pork gyros (Greek flatbread filled with rotisserie-roasted meat) found in more legitimate venues around Australia are the best.

    Consider the sauce dripping down the front of your shirt an essential part of the experience.

    Proving that Aussies love anything with jam and coconut, the lamington is the country’s favorite cake.

    Named after Lord Lamington, Queensland’s eighth governor, these delightful squares of sponge cake – dipped in chocolate and coated with coconut – have become nothing short of a culinary icon.

    There are entire websites (and an Australian Lamington Appreciation Society) devoted to the origins of the lamington and how to make them. Achieving the right ratio of chocolate, jam and coconut is essential.

    Meat pies: Colloquially referred to as a

    There are pies, and then there are Aussie meat pies.

    Synonymous with afternoons at the football pitch, brands like Four ‘N Twenty and Vili’s have cornered the market for mass-produced pies.

    Small local outfits (like the Bemboka Pie Shop and Harry’s Café de Wheels) are institutions in their own right.

    Everyone has a favorite type, whether it’s shepherd’s pie, a floater with peas, cheese and bacon or straight-up meat.

    The only requirement? The pie is served piping hot with tomato sauce … and eaten one-handed.

    With Four ‘N Twenty now exporting to the United States and parts of Asia, some expats can get their pie fix without venturing too far.

    Australia’s love affair with Asian food is no secret, and our northern neighbors strongly influence what we put on our plates.

    Even Aussies living in Asia admit to craving “Aussie Chinese” or “Aussie Thai” – dishes that give a nod to the original but are not as authentic as the real thing. In fact, some would say they’re potentially even better.

    We’d argue the fresh, high-quality produce and quality meats available in Australia bring out the best in Asian dishes.

    A fishmonger shucks an oyster at the Sydney Fish Market.

    It’s fair to say that oysters are an acquired taste, but for those with a penchant for the salty mollusks, Australia produces some of the best in the world.

    You’ll find two main species in Aussie waters: rock oysters and Pacific.

    As bivalves, oysters filter the water around them and their location dictates their flavor.

    The pristine waters along Australia’s coastline provide the perfect conditions for oysters, and they rarely need any accompaniment.

    There’s nothing quite like eating these slippery snacks straight off the rocks – export just doesn’t do them justice.

    A pavlova cake is typically served with summer fruits heaped on top.

    The origins of this meringue-based dessert are hotly contested.

    Recent research suggests that the Pav didn’t come from the antipodes at all, but nevertheless it remains a firm favorite.

    Meringue, cream and plenty of fruit are the key ingredients, though there are no hard and fast rules about what has to be included.

    Expats living in tropical climes often bemoan how challenging it is to get a decent meringue, given humid weather can turn it soft and sticky, so Pavlova is a rare treat.

    Q: Quandong and quince

    Both the native quandong and the foreign quince lend themselves to some of our favorite condiments and desserts.

    Similar to a wild peach, the quandong is incredibly versatile and nutritious and can be made into juice, jam, filling for pies or eaten raw.

    The quince is a relative of the apple and pear, and while several varieties are grown commercially in Australia the fruit is best known as the star in Maggie Beer’s quince paste – the only way to eat soft cheese.

    Bottle number 1,888 of Bundaberg Rum's 125th anniversary rum.

    Bundaberg Rum, to be more specific. Or just Bundy, as it’s known to locals.

    This Australian beverage was created way back in 1888 to deal with an oversupply of molasses in Queensland’s sugarcane region.

    Producers believe that it’s the sugar, grown in volcanic soil, that gives Bundy its distinct, rich flavor.

    The distillery produces 60,000 bottles a day and the factory was the subject of a National Geographic documentary in 2013.

    To say this drop has cult status would be an understatement.

    Just throw a shrimp on the barbie.

    There are so many foods starting with S – smashed avocado, SAO biscuits, sausages – that could represent the land down under.

    But Australia’s best produce comes from the sea and expats fondly reminisce about mornings spent at the fish markets picking up the catch of the day before special occasions.

    While we’re known to “throw a shrimp on the barbie” there are some creatures that are far more popular.

    Barramundi, Balmain or Moreton Bay bugs, abalone, and of course, prawns are just some of the native seafood worth queuing for.

    Malted, creamy, crunchy goodness.

    Technically a junk food, Tim Tam biscuits are so famous, so overwhelmingly popular, that they deserve their own spot on this list.

    The original Tim Tams are the best: A chocolate-coated sandwich of two malted chocolate biscuits with chocolate cream filling.

    Arnott’s, the manufacturers, now export to more than 40 countries around the world, so you can get your fix whether you’re skiing the slopes of Niseko, in Japan, or catching rays on a Tahitian beach.

    Uncle Tobys began producing oats way back in 1893. But it wasn’t until the 1970s, when convenience foods started hitting the shelves, that they developed their now famous muesli bars.

    The ultimate lunchbox treat or after-school snack, kids had the luxury of choosing not only the flavor, but also the texture.

    Many a playground war has been fought over which was best – crunchy or chewy. For the record, we’re firmly in the crunchy camp.

    These days the range has grown to include yoghurt and choc-chip toppings. There’s even a lamington flavor.

    No round-up of Aussie foods would be complete without this ubiquitous salty brown spread, which turns 100 on October 25.

    Twenty million jars of Vegemite are sold each year – that’s one for every Australian citizen.

    Now owned by Bega Cheese, there was great joy when the icon returned to Australian ownership several years ago.

    No one else quite understands the appeal of our favorite toast topping.

    For those living in countries where it’s not yet exported, Vegemite comes in massive 560 gram jars and travel-sized tubes.

    While there are similar cereals available around the world, there’s nothing quite like “Australia’s favorite breakfast.”

    These small biscuits made from wholegrain wheat are occasionally available in supermarkets overseas, but they generally sell out pretty quickly.

    Aussie mums have been known to stock up on them on trips to the motherland.

    Best eaten with a little bit of sugar, some chopped banana and a lot of milk, Weet-Bix is promoted as family-friendly health food. But we’d love them even if they weren’t good for us.

    XXXX beer is a necessity, even during a flood.

    Another product of sunny Queensland, XXXX (pronounced four-ex) originated in Victoria in 1878 before moving north, where it is still produced today.

    XXXX has endeared itself to Aussies as a great brew and a big supporter of sports and small communities.

    It’s not widely available outside of Australia, but if you’re an expat in China or Dubai, you may be able to find it in a bar near you.

    For Australia visitors wanting to have a taste, Perth restaurant Grabs is famed for its yabbies.

    Small freshwater crustaceans, yabbies are similar to lobsters – both prized as delicacies.

    They’re hardy little creatures, and if you grew up on a farm chances are you spent your summers fishing for yabbies in the local creek.

    Yabbies have a lot of meat on them, mostly in the tail and claws, and it tastes sweet and succulent when cooked right.

    Expats might find these clawed crustaceans in restaurants, but you’re unlikely to find them in your local supermarket.

    The zucchini fritter is yet another delicious byproduct of immigration.

    Depending on who you ask, they’re either Turkish and served with yogurt, or Greek, in which case they come with tzatziki.

    Either way, olive oil should ooze out when you take a bite.

    In some parts of Australia, you can find zucchini fritters at a local takeaway, next to the potato scallops and Chiko Rolls.

    These fried pancakes may have more health benefits than your average fried snack, but they are no less delicious.

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  • Just 2 Servings of Red Meat Per Week Raises Your Diabetes Risk

    Just 2 Servings of Red Meat Per Week Raises Your Diabetes Risk

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    THURSDAY, Oct. 19, 2023 (HealthDay News) — Think twice about ordering that double cheeseburger, salami on rye or juicy T-bone.

    Just two servings of red meat a week — processed or unprocessed — can increase your risk of type 2 diabetes by 62%, according to a new study.

    “A modest but statistically significant increase in risk was seen with even two servings of red meat per week, and risk continued to increase with higher intakes,” said lead author Xiao Gu, a postdoctoral research fellow at Harvard’s T.H. Chan School of Public Health in Boston. “Our findings suggest that replacing red meat with healthy plant-based protein sources, such as nuts and legumes, or modest intakes of dairy foods, would reduce the risk of diabetes.”

    The study can’t prove that eating red meat causes type 2 diabetes, but there appears to be a link.

    And a serving of meat is likely smaller than you might suspect.

    One serving of unprocessed red meat is about 3 ounces of pork, beef or lamb; a serving of processed red meat is about 1 ounce of bacon or 2 ounces of hot dog, sausage, salami, bologna or other processed red meats, Gu said.
    Red meat is usually high in saturated fat and low in polyunsaturated fat, Gu said.

    “Studies have shown that saturated fat can reduce beta cell function and insulin sensitivity, which results in type 2 diabetes,” he explained.

    “Red meat also has a high content of heme iron, which increases oxidative stress and insulin resistance and impairs beta cell function through its by-product of nitric oxide compounds,” Gu said. “For processed red meats, there is also a high content of nitrates and their byproducts, which promote cell dysfunction and insulin resistance.”

    For the study, Gu and his colleagues collected data on nearly 217,000 participants from the Nurses’ Health Study and the Health Professionals Follow-up Study.

    Their diets were assessed with food questionnaires for up to 36 years. During this time, more than 22,000 participants developed type 2 diabetes.

    People who ate the most red meat had a 62% higher risk for type 2 diabetes, compared with those who ate the least.

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  • Weight Loss Expert JJ Smith Offers Unique Weight Loss Opportunity This Year

    Weight Loss Expert JJ Smith Offers Unique Weight Loss Opportunity This Year

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    WASHINGTON, September 15, 2023 (Newswire.com)
    –
    Battling excess weight can be one of the most frustrating experiences anyone faces throughout a lifetime, but nutritionist, weight loss expert and #1 NY Times Bestselling Author JJ Smith, who is also head of Adiva Publishing, helps women take back control of their health and weight before the year ends. The Finish Strong Challenge inspires women to hit some of their weight loss goals before the New Year through a 90-day weight loss challenge, and it’s absolutely free.

    The Finish Strong Challenge (FSC) will help women finish the year strong. Many women began the year strong but fell off along the way. No need to wait until next year to start over: lock in for the next three months and drop a few pounds before 2024. Women can dedicate the next three months exclusively to their weight loss goals and see what can be accomplished. JJ says, “I mean, after all, starting strong is good but finishing strong is epic. It’s time to go be epic.”

    We start the journey to finish the year strong on October 1. So, sign up today for the Finish Strong Challenge here at no cost and receive:

    • A three-part system (F.E.D. System) that is an effective strategy for weight loss and easier than any diet on the market
    • A 90-day weight loss plan where one doesn’t have to give up all of their favorite foods to get results
    • Sample recipes of what a daily meal plan looks like
    • The motivation and support to achieve weight loss goals.

    Registering for the challenge is absolutely free, so get access to this 90-day weight loss plan today. JJ says “This free challenge focuses on coming together to encourage and support one another throughout a rewarding health and wellness journey.”

    To register for the Finish Strong Challenge today, click here!

    About JJ Smith

    JJ Smith (http://www.JJSmithOnline.com) is the author of the #1 NY Times Bestseller, 10-Day Green Smoothie Cleanse. JJ is a nutritionist and certified weight loss expert, and Chief Brand Officer for Adiva Publishing, who has been regularly featured in today’s popular print and online media, on major news networks, and on daily programs such as” The Dr. Oz Show,” “The Steve Harvey Morning Show,” “The Rachael Ray Show,” “The View,” CNN and others.  Since reclaiming her health, losing weight, and discovering a “second youth” in her 40s, bestselling author JJ Smith has become the voice of inspiration to those who want to lose weight, be healthy, and get their sexy back.

    Source: Adiva Publishing, LLC

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  • Vegan Sam Bankman-Fried is subsisting only on bread and water in jail, his attorneys say | CNN Business

    Vegan Sam Bankman-Fried is subsisting only on bread and water in jail, his attorneys say | CNN Business

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    New York
    CNN
     — 

    Sam Bankman-Fried pleaded not guilty Tuesday to amended fraud and money laundering charges, appearing in court for the first time since his bail was revoked and he was sent to a Brooklyn jail to await trial.

    Lawyers for the former crypto billionaire, who is vegan, said the detention center is not accommodating his diet and failing to regularly dispense his prescription Adderall.

    “He’s literally now subsisting on bread and water, which are the only things he’s served that he can eat, and sometimes peanut butter,” his attorney, Mark Cohen, told the court.

    Magistrate Judge Netburn said she would contact the Bureau of Prisons about the accommodations.

    Bankman-Fried, also known as SBF, has spent the past 11 days in the Metropolitan Detention Center in Brooklyn, a notoriously overcrowded facility that’s been regularly accused of keeping inmates in inhumane conditions. It’s a far cry from his house arrest, which he spent in the relative luxury of his parents Palo Alto home in California.

    On August 11, Judge Lewis Kaplan revoked SBF’s bail and remanded him to the facility, ultimately siding with prosecutors’ argument that he had attempted to intimidate potential witnesses against him, including his former business partner and ex-girlfriend, Caroline Ellison.

    Bankman-Fried, 31, has pleaded not guilty to multiple conspiracy and fraud charges relating to the collapse of his exchange, FTX, in November. He faces a potential life sentence if convicted on all the charges.

    Before its collapse, FTX was one of the largest crypto-trading platforms in the world, backed by A-list celebrities and featured in Super Bowl commercials. But the company came unglued in the span of a week as concerns about its financial ties to SBF’s crypto hedge fund, Alameda Research, spurred investors and customers to yank their funds. The company filed for bankruptcy and quickly became the center of the federal fraud investigation.

    While awaiting his trial, SBF will be granted a window of time, from 8:30 am to 3 pm, on weekdays to meet with his attorneys, according to a court filing released Monday.

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  • States step in to pay for school meals for all kids | CNN Politics

    States step in to pay for school meals for all kids | CNN Politics

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    CNN
     — 

    As soon as Tracy Area Schools in Minnesota resumed charging for breakfast and lunch last year, students started dropping out of the program. Many of their families simply couldn’t shell out up to $2.65 for a meal each day.

    “We have some kids who didn’t eat because Mom and Dad can’t afford it,” said Michele Hawkinson, food service director for the rural district of 700 students. “These kids are hungry. This is maybe the only nutritious, healthy meal they’re getting a day.”

    But Hawkinson no longer needs to worry about children in her district skipping meals. Starting this year, Minnesota students at schools that participate in the federal school meals program can eat breakfast and lunch for free, thanks to a law that state legislators passed in March. The initiative will cost about $200 million a year.

    Minnesota is one of nine states that are picking up the tab for students’ breakfast and lunch in many of their schools. California, Colorado, Maine, Massachusetts, Michigan, New Mexico and Vermont have also approved permanent universal free meals programs, while Nevada launched a two-year effort last year.

    Other states have extended free meals to more students. For instance, Connecticut and Pennsylvania are providing free breakfasts this school year. And lawmakers in other states have introduced legislation to establish universal free meal programs.

    “There’s been a tremendous momentum for states to move forward on offering free school meals for all,” said Crystal FitzSimons, director of school programs at the Food Research & Action Center. “Offering free meals to all students just changes the culture of the cafeteria. (It) increases participation and makes the cafeteria a really positive environment for all students.”

    States are paying for the initiatives in different ways. Massachusetts is using revenue from its new millionaires’ tax to help cover the cost of the $172 million program, while Colorado is raising around $100 million a year by limiting state tax deductions for affluent residents. Other states are drawing from their general budgets.

    The states’ actions build upon a federal Covid-19 pandemic relief program that provided free meals to all students, regardless of income, for more than two years.

    During that time, around 30 million students were receiving free meals at school, according to the US Department of Agriculture, up from about 20 million children who qualified based on their household income prior to the pandemic.

    Allowing all students to eat in the cafeteria at no charge minimized the stigma felt by some kids who received free meals, increasing the likelihood that they would actually partake in breakfast and lunch, school nutrition officials said.

    But the pandemic program expired at the start of the last academic year. Lower-income families once again had to fill out applications for free or reduced-price meals, while parents who were struggling but earned too much to qualify had to find a way to pay for their children’s breakfast and lunch.

    School nutrition staffers, meanwhile, had to once again distribute the forms and convince eligible parents to complete them, while also contending with mounting school meal debt.

    Meanwhile, the number of kids getting meals at school dropped. Some 28.3 million students, on average, participated in the lunch program daily in May, down from 30.2 million the same time a year earlier. And 14.6 million kids partook in the breakfast program, down from 16.1 million.

    Many schools are taking a more holistic approach to children’s education, focusing on more than just reading, writing and arithmetic, said Chris Derico, president of the School Nutrition Association.

    “Research has shown if kids are hungry, they’re not going to be ready to learn,” said Derico, who is also the child nutrition director at Barbour County Schools in West Virginia.

    States are also realizing that improving children’s ability to learn could better prepare them to enter the workforce, said Annette Nielsen, executive director of the Hunter College New York City Food Policy Center, which has been tracking the implementation of universal free meals programs nationwide.

    “There may be a financial cost, but there’s probably a larger financial benefit to keeping it long term,” she said.

    Benefits and challenges for schools

    In addition to the benefits for children, free school breakfast and lunch for all means districts don’t have to hound families with meal debt.

    The end of the federal free meals program caused debt levels to soar. The median reported debt was $5,164 per district, as of November, compared with $3,400 at the end of the 2017-18 school year, according to the School Nutrition Association.

    In Colorado’s Littleton Public Schools, the debt level skyrocketed to $32,000 at the end of last year, said Jessica Gould, director of nutrition services in the affluent suburban Denver district of just over 13,000 students. Prior to the pandemic, it was typically between $4,000 and $6,000 a year.

    “Now we don’t have to worry about that. We’re not the debt collectors anymore,” Gould said, noting that last year’s tab was paid by donors. “We’re just able to focus on providing good quality meals to our students.”

    However, the universal free meals programs also pose challenges to school districts. They no longer have the ability to increase breakfast and lunch rates when their costs of food, equipment and labor rise. Instead, they must make due with the state reimbursement.

    But the even bigger problem is that the state programs rely on districts still getting federal funding to cover the cost of feeding children who are eligible for free and reduced-price meals. And certain state funds for general education also depend on the share of lower-income students in a school district.

    That requires getting parents to complete the applications, which can be challenging especially when schools are telling families that everyone can eat for free.

    So far, Gould has received forms from about 1,500 eligible families, but she is expecting more than 2,300.

    “Our community is confused,” she said, noting that the district created a flyer to explain the new universal free meals program. “It’s been challenging at best to just figure out how to communicate to our families.”

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  • Migrants are staying on school grounds, in hotels or at police stations in several states — and some residents are furious | CNN

    Migrants are staying on school grounds, in hotels or at police stations in several states — and some residents are furious | CNN

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    CNN
     — 

    In New York City, hundreds of migrants are staying in current or former school gymnasiums.

    In Chicago, dozens of migrants have been sleeping in a police station.

    And in Florida, where the Republican governor has sent migrants to Democratic-led cities across the country, the state has hired three companies to relocate migrants from the state.

    While the surge of new migrants after last week’s expiration of Title 42 was not as large as many expected, the scramble to place asylum seekers who trekked thousands of miles to flee violence or crushing poverty has yielded widespread tensions within and between states.

    And more parts of the US could suddenly find themselves with unexpected migrants.

    About 300 migrants have been placed in current and former school gyms in New York City, a source familiar with the planning process told CNN.

    As of Monday, 220 migrants were in the gym of a former school on Staten Island, the source said. Less than 80 migrants have been housed at a gym at PS 188 on Coney Island, and fewer than 30 have been placed at a gym at PS 17 in Williamsburg, the source said.

    The gyms are not physically connected to the schools, the source added.

    Some New York City parents were dismayed or bewildered to learn of the city’s plan to temporarily house migrants in 20 school gyms.

    “I would like other places to be considered,” Samantha Clark told CNN affiliate WABC. “Our school is tiny. We can barely fit in it as it is.”

    Aramis Rosa said he sympathizes with the migrants but also opposes the plan to house them in school gyms.

    “We’re not against them,” Rosa told WABC. “They’re all welcome – just not to our school, next to our children.”

    Mayor Eric Adams has said the migrants would not interact with students, but that did little to assuage concerns from parents.

    Outside PS 17 in Brooklyn, a group of parents and students protested Wednesday morning over migrants being housed in the school’s gym.

    About 100 people marched around the block chanting, “We want our gym back!” and “Let us play!”

    Parents and children alike carried signs reading, “We need recess,” “No asylum on school grounds,” and “Safety first.”

    One protest organizer stressed the need to support migrants – though she didn’t think housing them on school grounds was appropriate.

    “What we’re gonna do is we’re going to support them. All of you kids are going to help us write notes, and we’ll make care packages, for all the people coming through here,” the organizer announced to the crowd.

    “We wish them well. We care. But they shouldn’t be on school grounds, and not in a place that only has three bathrooms for 100 people, right?”

    Elsewhere in the state, a New York state supreme court judge has granted a temporary restraining order blocking New York City’s mayor from sending asylum seekers to nearby Orange County to try to ease the influx of migrants arriving in the nation’s most populous city.

    The order, requested last week by Orange County Executive Steven Neuhaus, allows for the 186 asylum seekers already staying at the Crossroads Hotel and Ramada by Wyndham in the town of Newburgh to stay in the county, according to the filing.

    But new migrants won’t be allowed to stay at the hotels if any of the current occupants leave, the order states.

    The pushback comes as New York City scrambles to house a crush of migrants – some of them bused to New York by Republican governors and local officials from Southern states.

    Since last spring, New York City has processed more than 65,000 migrants and around 35,000 remain in the city’s care, city officials have said. The city has opened more than 140 emergency shelters and eight large-scale humanitarian relief centers to manage the crisis, the mayor said.

    And a wave of new asylum seekers arrived last week with the expiration of Title 42 – the Trump-era policy enacted early in the Covid-19 pandemic that allowed authorities to quickly expel migrants at US land borders.

    New York Gov. Kathy Hochul last week asked for federal government assistance with constructing and operating temporary shelters “in anticipation of several thousand asylum seekers arriving in New York City every week.”

    Adams’ office said it’s disappointed in the judge’s ruling.

    “New York City has cared for more than 65,000 migrants – sheltering, feeding, and caring for them, and we have done so largely without incident,” Adams’ press secretary Fabien Levy told CNN on Tuesday night.

    “We need the federal government to step up, but until they do, we need other elected officials around the state and country to do their part. New York City is out of space and we’re only asking Orange County to manage approximately ¼ of 1% of the asylum seekers who have come to New York City, with New York paying for shelter, food, and services.”

    But the executive of Orange County said, “New York City should not be establishing a homeless shelter outside of its borders in Orange County.”

    “The city is a self-proclaimed sanctuary city; Orange County is not,” Neuhaus said in a statement. “We should not have to bear the burden of the immigration crisis that the Federal government and Mayor Adams created, and I will continue to fight for Orange County’s residents in regard to this important manner.”

    The New York Immigration Coalition, an immigrant’s rights advocacy group, criticized both Adams and Neuhaus, saying the two need to start working together in coordinating and addressing the needs of asylum seekers in the region.

    “But County Executive Neuhaus shouldn’t be gloating about the judge’s temporary restraining order. His actions in response to asylum seekers to his region have been shameful – he has done nothing more than stoke fear and resentment in his community,” NYIC Executive Director Murad Awawdeh said in a statement.

    “At a moment when he should be choosing to welcome, he has instead chosen cruelty.”

    Hundreds of migrants have been staying in Chicago city buildings after they were “inhumanely” bused to Chicago, former Mayor Lori Lightfoot said earlier this month, according to CNN affiliate WBBM.

    During her final days in office, Lightfoot issued an emergency declaration in hopes of getting federal and state money to help the city respond to the crisis.

    More than 70 migrant families were staying in the Chicago Police Department’s 12th district station.

    “I’ve been here for two weeks,” Johon Torres, a migrant from Venezuela, told WBBM. Torres was joined by his three daughters and niece.

    The families in limbo have received donated supplies from refugee organizations, good Samaritans and even some police officers.

    But the situation is not tenable, said Sgt. James Calvino of the Chicago Police Sergeants’ Association.

    “It’s ballooned exponentially – way out of control,” Calvino told WBBM.

    Florida Gov. Ron DeSantis’ administration has chosen three companies to execute the next phase of its migrant relocation program, according to documents obtained by CNN.

    The Florida Division of Emergency Management selected Vertol Systems Company Inc., ARS Global Emergency Management and GardaWorld Federal Services to “manage and implement a program to relocate individuals” who have been processed and released by the US government, according to a FDEM document.

    The contract sets up the framework to once again send migrants to Democratic-led cities, as seen in 2022 when Vertol Systems Company Inc., provided two planes to relocate migrants from San Antonio, Texas, to Martha’s Vineyard, Massachusetts, under DeSantis’ direction.

    The state requires vendors to be “solely responsible” from beginning to end of the transporting of participants, including social services that should be provided to them at the destination cities.

    The newly selected vendors are tasked with providing ground and air transportation services to assist with what the DeSantis administration is calling the “voluntary relocation of Inspected Unauthorized Aliens,” who have agreed to be relocated from “Florida, or another state, to a location within the United States.”

    The FDEM did not indicate the number of migrants expected to be transferred and says it will be determined “based on circumstances on the ground.” One vendor noted its capability of moving 40-50 passengers per week, or about 2,200 a year.

    A document showing questions and answers between unnamed vendors and the FDEM, posted on the state’s contract procurement website, sheds light on how the state wants the companies to carry out the program.

    One vendor mentioned California, New York, and Georgia as potential destinations for flights originating from Florida.

    The state wants vendors to start transportation of migrants “within 72 hours of notification by the Division,” and must fulfill their contract until June 30, 2025, unless terminated earlier.

    In response to a question about handling the transportation of minors, FDEM said it does not “anticipate relocating juveniles without a parent or guardian.”

    FDEM said it anticipates this contract to be “turnkey,” saying “vendors will locate and identify, vet and verify individuals for program eligibility and transport.”

    The document states $10 million has been allocated to FDEM for the 2022-23 fiscal year for this program, which expires June 30.

    CNN has reached out to Vertol Systems Company, ARS Global Emergency Management and GardaWorld Federal Services for comment.

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  • Mental illness may put people under 40 at a greater chance of heart attack and stroke | CNN

    Mental illness may put people under 40 at a greater chance of heart attack and stroke | CNN

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    CNN
     — 

    Adults in their 20s and 30s with mental disorders have a higher chance of having a heart attack or stroke, according to a new study.

    The study published Monday in the European Journal of Preventive Cardiology looked at the health data of more than 6.5 million people through the Korean National Health Insurance Service database.

    The people included in the new study ranged in age from 20 to 39 and underwent health examinations between 2009 and 2012. Their health was monitored until December 2018 for new onset heart attacks and stroke.

    About 13% of participants had some type of mental disorder — which included insomnia, anxiety, depression, somatoform disorder, post-traumatic stress disorder, substance use disorder, eating disorders, bipolar disorder, schizophrenia or a personality disorder, according to the study.

    Those people younger than 40 with a mental disorder were 58% more likely to have a heart attack and 42% more likely to have a stroke than those with no disorder, the study found.

    “We have known for some time that mental health and physical health are linked, but what I find surprising about these findings is that these links were observable at such a young age,” said Dr. Katherine Ehrlich, an associate professor of behavioral and brain sciences at the University of Georgia. Ehrlich was not involved in the research.

    Coronary arterial disease and heart attacks are rare before the age of 40, so a study as large as this one was needed to see the relationship between mental health and such an unusual occurrence in young people, she said.

    Ehrlich said she would like to know more about the physical activity and diets of the people involved to understand better if those factors have an influence on the relationship between mental health conditions and heart attack and stroke.

    “For example, if you are chronically depressed, you may struggle to maintain a healthy diet and get adequate physical activity, which might in turn increase your risk for cardiac events over time,” she said.

    But the increased risk could not be attributed to lifestyle differences alone, as the authors controlled for factors including age, sex, high blood pressure, diabetes, high cholesterol, metabolic syndrome, chronic kidney disease, smoking, alcohol, physical activity and income, the study said.

    That doesn’t mean lifestyle should be ignored, however, said study author Dr. Eue-Keun Choi, a professor of internal medicine at Seoul National University College of Medicine in South Korea.

    “While lifestyle behaviours did not explain the excess cardiovascular risk, this does not mean that healthier habits would not improve prognosis,” Choi said in a statement. “Lifestyle modification should therefore be recommended to young adults with mental disorders to boost heart health.”

    One in eight people between ages 20 and 39 studied had some sort of mental illness, meaning a substantial number of people could be predisposed to heart attack and stroke, study author Dr. Chan Soon Park, a researcher at Seoul National University Hospital in South Korea said in a statement.

    That could point to a greater need for managing psychological conditions and monitoring heart health in those at risk, Park added.

    “If we can reduce the number of people living with chronic mental illness, we may find secondary benefits in future years regarding the number of people managing cardiac-related conditions,” Ehrlich said.

    It is important to note that the findings do not show that mental illness causes heart attacks or stroke, she added. But the research does indicate a risk factor to watch out for.

    There may be benefit in preventive measures to minimize risks, Ehrlich said, which can include maintaining a healthy diet and incorporating physical activity.

    Choi recommends that people with mental health conditions receive regular checkups as well.

    These findings may also emphasize the importance of addressing loneliness, she added.

    “Many individuals with mental illness suffer from social isolation and loneliness, and for years researchers have been sounding the alarm that loneliness is detrimental for physical health,” Ehrlich said.

    “Efforts to improve social connectedness among young people may be critical to addressing the rising rates of cardiometabolic conditions in adulthood,” she added.

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  • Refined carbs and red meat driving global rise in type 2 diabetes, study says | CNN

    Refined carbs and red meat driving global rise in type 2 diabetes, study says | CNN

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    Editor’s Note: Sign up for CNN’s Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.



    CNN
     — 

    Gobbling up too many refined wheat and rice products, along with eating too few whole grains, is fueling the growth of new cases of type 2 diabetes worldwide, according to a new study that models data through 2018.

    “Our study suggests poor carbohydrate quality is a leading driver of diet-attributable type 2 diabetes globally,” says senior author Dr. Dariush Mozaffarian, a professor of nutrition at Tufts University and professor of medicine at Tufts School of Medicine in Boston, in a statement.

    Another key factor: People are eating far too much red and processed meats, such as bacon, sausage, salami and the like, the study said. Those three factors — eating too few whole grains and too many processed grains and meats — were the primary drivers of over 14 million new cases of type 2 diabetes in 2018, according to the study, which was published Monday in the journal Nature Medicine.

    In fact, the study estimated 7 out of 10 cases of type 2 diabetes worldwide in 2018 were linked to poor food choices.

    “These new findings reveal critical areas for national and global focus to improve nutrition and reduce devastating burdens of diabetes,” said Mozaffarian, who is also the editor in chief of the Tufts Health & Nutrition Letter.

    Mozaffarian and his team developed a research model of dietary intake between 1990 and 2018 and applied it to 184 countries. Compared with 1990, there were 8.6 million more cases of type 2 diabetes due to poor diet in 2018, the study found.

    Researchers found eating too many unhealthy foods was more of a driver of type 2 diabetes on a global level than a lack of eating wholesome foods, especially for men compared with women, younger compared to older adults, and in urban versus rural residents.

    Over 60% of the total global diet-attributable cases of the disease were due to excess intake of just six harmful dietary habits: eating too much refined rice, wheat and potatoes; too many processed and unprocessed red meats; and drinking too many sugar-sweetened beverages and fruit juice.

    Inadequate intake of five protective dietary factors — fruits, nonstarchy vegetables, nuts, seeds, whole grains and yogurt — was responsible for just over 39% of the new cases.

    People in Poland and Russia, where diets tend to focus on potatoes and red and processed meat, and other countries in Eastern and Central Europe as well as Central Asia, had the highest percentage of new type 2 diabetes cases linked to diet.

    Colombia, Mexico and other countries in Latin America and the Caribbean also had high numbers of new cases, which researchers said could be due to a reliance on sugary drinks and processed meat, as well as a low intake of whole grains.

    “Our modeling approach does not prove causation, and our findings should be considered as estimates of risk,” the authors wrote.

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  • High-Salt Diet a Danger Even With Normal Blood Pressure

    High-Salt Diet a Danger Even With Normal Blood Pressure

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    April 10, 2023 – It is well-known that high blood pressure is a risk factor for heart attacks and strokes.

    Now, new research from Sweden has shown that too much salt in the diet is an important risk factor for clogged arteries in the neck and heart, increasing the risk of heart attacks and strokes even if you don’t have high blood pressure.

    The study was published online in European Heart Journal Open.

    The finding raises the possibility that salt could cause damage even before someone develops high blood pressure, said study author Jonas Wuopio, MD, of the Karolinska Institutet, Huddinge, and Clinical Research Center at Uppsala University in Sweden.

    Salt is bad for heart health because of its link to high blood pressure, also known as hypertension, but the role salt plays in the development of plaque in the arteries has not been examined, Wuopio said.

    “Ours is the first study to examine the association between a high salt intake and hardening of the arteries in both the head and neck. The association was linear, meaning that each rise in salt intake was linked with more atherosclerosis,” he said.

    The study included 10,778 adults ages 50 to 64. The research team measured the amount of salt found in the their urine to estimate their salt consumption. 

    The researchers then captured images of the arteries of the heart to check for calcium and blockages or stenosis, and ultrasound to detect blockages in the carotid arteries in the neck.

    They found that the more salt people consumed, the higher their risk of calcifications in the heart and neck arteries. 

    The findings were seen even after the researchers excluded people with high blood pressure.

    “This means that it’s not just patients with high blood pressure or heart disease who need to watch their salt intake,” Wuopio said.

    He tells his patients to follow guidance from the World Health Organization and other groups to limit salt to about a teaspoon a day. 

    “It can be hard to estimate how much salt we eat, so I advise patients to limit the use of table salt, or to replace salt with a salt substitute,” he said.

    Food is Medicine

    The lower you can get your blood pressure, the better, said Alon Gitig, MD, an assistant professor and director of cardiology for Mount Sinai Doctors in Westchester, NY. 

    “Everybody knows that high blood pressure is associated with future cardiovascular disease risk, but what many don’t realize is that that risk starts to increase” even at the upper end of what is considered normal. “Most of the people in the U.S. over the age of 60 have hypertension,” Gitig said.

    A good way to lower your blood pressure is through diet, exercise, and maintaining a healthy weight, he said.

    The Dietary Approaches to Stop Hypertension (DASH) diet – which suggests several servings of fruits and vegetables a day, with few refined carbohydrates, flour, and sugar – has been shown in a study to dramatically lower blood pressure, Gitig said.

    “There are two reasons for that. One is that fruits and vegetables have many phytonutrients that are good for our arteries. The other is that most of U.S. adults have insulin resistance, and insulin resistance leads to high blood pressure,”  he said. 

    Eating more fruits and vegetables and lean meats while limiting sugar and flour will improve insulin resistance. Do that, Gitig said, “and you can bring your blood pressure down that way.”

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  • WHO advisers to consider whether obesity medication should be added to Essential Medicines List | CNN

    WHO advisers to consider whether obesity medication should be added to Essential Medicines List | CNN

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    CNN
     — 

    Advisers to the World Health Organization will consider next month whether to add liraglutide, the active ingredient in certain diabetes and obesity medications, to its list of essential medicines.

    The list, which is updated every two years, includes medicines “that satisfy the priority health needs of the population,” WHO says. “They are intended to be available within the context of function health systems at all times, in adequate amounts in the appropriate dosage forms, of assured quality and at prices that individuals and the community can afford.”

    The list is “a guide for the development and updating of national and institutional essential medicine lists to support the procurement and supply of medicines in the public sector, medicines reimbursement schemes, medicine donations, and local medicine production.”

    The WHO Expert Committee on the Selection and Use of Essential Medicines is scheduled to meet April 24-28 to discuss revisions and updates involving dozens of medications. The request to add GLP-1 receptor agonists such as liraglutide came from four researchers at US institutions including Yale University and Brigham and Women’s Hospital.

    These drugs mimic the effects of an appetite-regulating hormone, GLP-1, and stimulate the release of insulin. This helps lower blood sugar and slows the passage of food through the gut. Liraglutide was developed to treat diabetes but approved in the US as a weight-loss treatment in 2014; its more potent cousin, semaglutide, has been approved for diabetes since 2017 and as an obesity treatment in 2021.

    The latter use has become well-known thanks to promotions from celebrities and on social media. It’s sold under the name Ozempic for diabetes and Wegovy for weight loss. Studies suggest that semaglutide may help people lose an average of 10% to 15% of their starting weight – significantly more than with other medications. But because of this high demand, some versions of the medication have been in shortage in the US since the middle of last year.

    The US patent on liraglutide is set to expire this year, and drugmaker Novo Nordisk says generic versions could be available in June 2024.

    The company has not been involved in the application to WHO, it said in a statement, but “we welcome the WHO review and look forward to the readout and decision.”

    “At present, there are no medications included in the [Essential Medicines List] that specifically target weight loss for the global burden of obesity,” the researchers wrote in their request to WHO. “At this time, the EML includes mineral supplements for nutritional deficiencies yet it is also described that most of the population live in ‘countries where overweight and obesity kills more people than underweight.’ “

    WHO’s advisers will make recommendations on which drugs should be included in this year’s list, expected to come in September.

    “This particular drug has a certain history, but the use of it probably has not been long enough to be able to see it on the Essential Medicines List,” Dr. Francesco Blanca, WHO director for nutrition and food safety, said at a briefing Wednesday. “There’s also issues related to the cost of the treatment. At the same time, WHO is looking at the use of drugs to reduce weight excess in the context of a systematic review for guidelines for children and adolescents. So we believe that it is a work in progress, but we’ll see what the Essential Medicines List committee is going to conclude.”

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  • Crucial Antarctic ocean circulation heading for collapse if planet-warming pollution remains high, scientists warn | CNN

    Crucial Antarctic ocean circulation heading for collapse if planet-warming pollution remains high, scientists warn | CNN

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    Brisbane, Australia
    CNN
     — 

    Melting ice in the Antarctic is not just raising sea levels but slowing down the circulation of deep ocean water with vast implications for the global climate and for marine life, a new study warns.

    Led by scientists from the University of New South Wales and published Wednesday in the journal Nature, the peer-reviewed study modeled the impact of melting Antarctic ice on deep ocean currents that work to flush nutrients from the sea floor to fish near the surface.

    Three years of computer modeling found the Antarctic overturning circulation – also known as abyssal ocean overturning – is on track to slow 42% by 2050 if the world continues to burn fossil fuels and produce high levels of planet-heating pollution.

    A slow down is expected to speed up ice melt and potentially end an ocean system that has helped sustain life for thousands of years.

    “The projections we have make it look like the Antarctic overturning would collapse this century,” said Matthew England, deputy director of the Australian Research Council’s Centre for Excellence in Antarctic Science, who coordinated the study.

    “In the past, these overturning circulations changed over the course of 1,000 years or so, and we’re talking about changes within a few decades. So it is pretty dramatic,” he said.

    Most previous studies have focused on the Atlantic Meridional Overturning Circulation (AMOC), the system of currents that carry warm water from the tropics into the North Atlantic. The cold, saltier water then sinks and flows south.

    Its Southern Ocean equivalent is less studied but does an important job moving nutrient-dense water north from Antarctica, past New Zealand and into the North Pacific Ocean, the North Atlantic and Indian Ocean, the report’s authors said in a briefing.

    The circulation of deep ocean water is considered vital for the health of the sea – and plays an important role in sequestering carbon absorbed from the atmosphere.

    According to the report, while a slowdown of the AMOC would mean the deep Atlantic Ocean would get colder, the slower circulation of dense water in the Antarctic means the deepest waters of the Southern Ocean will warm up.

    “One of the concerning things of this slowdown is that there can be feedback to further ocean warming at the base of the ice shelves around Antarctica. And that would lead to more ice melt, reinforcing or amplifying the original change,” England said.

    As global temperatures rise, Antarctic ice is expected to melt faster, but that doesn’t mean the circulation of deep water will increase – in fact the opposite, scientists said.

    In a healthy system, the cold and salty – or dense – consistency of melted Antarctic ice allows it to sink to the deepest layer of the ocean. From there it sweeps north, carrying carbon and higher levels of oxygen than might otherwise be present in water around 4,000 meters deep.

    As the current moves northward, it agitates deep layers of debris on the ocean floor – remains of decomposing sea life thick with nutrients – that feed the bottom of the food chain, scientists said.

    In certain areas, mostly south of Australia in the Southern Ocean and in the tropics, this nutrient-rich cold water moves toward the surface in a process called upwelling, distributing the nutrients to higher layers of the ocean, England said.

    However, Wednesday’s study found that as global temperatures warm, melting sea ice “freshens” the water around Antarctica, diluting its saltiness and raising its temperature, meaning it’s less dense and doesn’t sink to the bottom as efficiently as it once did.

    The report’s co-author, Steve Rintoul from Australia’s Commonwealth Scientific and Industrial Research Organisation and the Australian Antarctic Program Partnership, said sea life in waters worldwide rely on nutrients brought back up to the surface, and that the Antarctic overturning is a key component of that upwelling of nutrients.

    “We know that nutrients exported from the Southern Ocean in other current systems support about three quarters of global phytoplankton production – the base of the food chain,” he said.

    “We’ve shown that the sinking of dense water near Antarctica will decline by 40% by 2050. And it’ll be sometime between 2050 and 2100 that we start to see the impacts of that on surface productivity.”

    England added: “People born today are going to be around then. So, it’s certainly stuff that will challenge societies in the future.”

    Fishing boats at a floating fish farm off Rongcheng, China.

    The report’s authors say the slowing of the Antarctic ocean overturning has other knock-on effects for the planet – for example, it could shift rain bands in the tropics by as much as 1,000 kilometers (621 miles).

    “Shut it down completely and you get this reduction of rainfall in one band south of the equator and an increase in the band to the north. So we could see impacts on rainfall in the tropics,” said England.

    Earlier this month, the Intergovernmental Panel on Climate Change (IPCC) warned in its latest report that the impacts of rising global temperatures were more severe than expected. Without immediate and deep changes, the world is hurtling toward increasingly dangerous and irreversible consequences of climate change, it added.

    The IPCC report found that the goal of limiting global warming to 1.5 degrees Celsius (2.7 degrees Fahrenheit) above preindustrial levels was still possible, but it’s becoming harder to achieve the longer the world fails to cut carbon pollution.

    England points out that the IPCC predictions don’t include ice melt from Antarctic ice sheets and shelves.

    “That’s a very significant component of change that’s already underway around Antarctica with more to come in the next few decades,” England said.

    Rintoul said the study was another urgent warning on top of all the ones that have come before it.

    “Even though the direct effect on fisheries through reduced nutrient supply might take decades to play out, we will commit ourselves to that future with the choices we make over the next decade.”

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  • FDA sketches out plan to bolster fragile US infant formula supply management | CNN

    FDA sketches out plan to bolster fragile US infant formula supply management | CNN

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    CNN
     — 

    The US Food and Drug Administration announced Tuesday its initial strategy to boost and strengthen the management of the country’s supply of infant formula.

    The announcement came just ahead of a hearing of the House Oversight and Accountability Committee about what went wrong during last year’s infant formula shortage.

    Committee members and experts who testified were critical of formula makers and the FDA’s food safety program, which the agency has pledged to revamp in order to protect the nation’s food supply and promote better nutrition. Many experts are concerned that the formula shortage of 2022 could easily happen again, even with those changes.

    “While we stand here today, more than a year since the recall, it is my view that the state of the infant formula industry today is not much different than it was then,” testified Frank Yiannas, who stepped down from his role as the agency’s deputy commissioner of food policy and response in late February.

    “The nation remains one outbreak, one tornado, flood or cyberattack away from finding itself in a similar place to that of February 17, 2022.”

    A formula shortage that started in 2021 was exacerbated when the United States’ largest infant formula maker, Abbott Nutrition, recalled multiple products in mid-February and had to pause production after FDA inspectors found potentially dangerous bacteria at its Sturgis, Michigan, plant.

    A former Abbott employee filed a whistleblower complaint about the plant with the US Department of Labor’s Occupational Safety and Health Administration in February 2021. The complaint suggested that the plant lacked proper cleaning practices and that workers falsified records and hid information from inspectors.

    The complaint was filed February 16, 2021, and was passed on to Abbott and the FDA three days later.

    Yiannas testified that because of the siloed nature of the agency, he wasn’t made aware of the complaint until February 2022. It was only then that he learned that children had gotten sick with Cronobacter after consuming powdered formula made at the plant.

    The US Centers for Disease Control and Prevention investigated at least four illnesses and two deaths in three states in connection. The agency sequenced bacteria from two of the children to compare against the samples the FDA took at the facility, but it did not find that the samples were closely related.

    Cronobacter infections are rare but can be serious and even fatal, especially in newborns. The bacteria lives in the environment, but when these infections are diagnosed in infants, they are often linked to powdered formula.

    “Clearly, I really wish, and I should have been notified sooner, so I could have initiated containment steps earlier. Had that happened, I believe we might not be here today,” Yiannas said Tuesday. “Had the agency responded quicker to some of the earlier signals, I believe this crisis could have been averted or at least the magnitude lessened.”

    With more demand for other brands after the Abbott recalls, families across the country had to hunt through multiple stores for formula last year. Stock rates of baby formula stayed lower than they were the year before for much of 2022. Even in October, when rates had improved, nearly a third of households with a baby younger than 1 said they had trouble finding formula over the course of one week, according to a survey by the US Census Bureau.

    The FDA said Tuesday that its new national strategy helps ensure that the country’s supply of formula will remain constant and safe.

    The agency said it will work with the industry on redundancy risk management plans that will help companies identify possible supply chain problems. It will also continue to enhance inspections of infant formula plants by expanding and improving training for agency investigators.

    According to the strategy, the FDA will expedite review of premarket submissions for new products to prevent shortages. It will continue to closely monitor the formula supply and has developed a model to forecast any potential disruptions.

    It also plans to work closely with the US Department of Agriculture to build in more resiliency with its Special Supplemental Nutrition Program for Women, Infants, and Children program, or WIC, the nation’s largest purchaser of infant formula.

    The new strategy is just a first step; the long-term strategy is expected to be released in early 2024.

    Dr. Susan Mayne, director of the FDA’s Center for Food Safety and Applied Nutrition, said in a statement that the new strategy aims to incentivize “additional infant formula manufacturers to enter the market.”

    Many parts of the strategy are underway, the FDA said.

    “Safety and supply go hand-in-hand. We witnessed last year how a safety concern at one facility could be the catalyst for a nationwide shortage. That’s why we are looking to both strengthen and diversify the market, while also ensuring that manufacturers are producing infant formula under the safest conditions possible,” FDA Commissioner Dr. Robert Califf said in a news release. “Now, with this strategy, we are looking at how to advance long-term stability in this market and mitigate future shortages, while ensuring formula is safe.”

    Formula stock rates are still not where they once were before last year’s crisis, Yiannas said, but the problem can’t be solved overnight. He said it was a good step for Congress to ask for a resiliency report from the industry.

    One positive development that came out of the crisis is that manufacturers are reporting formula volume to the FDA on a weekly basis even though there is no legal requirement to do so, he said.

    Historically, the FDA has focused on food safety and nutrition, not supply chain availability, but the Covid-19 pandemic opened eyes and served as the “biggest test on the US food system in 100 years,” Yiannas said. Food supply shortages made experts realize that the agency needed more intelligence on how companies’ supply chains worked.

    “Progress is being made, but it’s not being made fast enough,” Yiannas said.

    The FDA is now tracking sales and stock rates of baby formula. He said he’s talked to formula companies that say they have ramped up production, even though they might have cut back on the number of varieties of product they offer.

    The FDA said Tuesday that it has also done a study to better understand what led to the recall of infant formula at the Abbott plant. The agency had conducted a routine surveillance inspection at the plant in September 2021 and even then found problems like standing water and inadequate handwashing among employees.

    Abbott is facing additional investigations from the US Securities and Exchange Commission, the US Federal Trade Commission and the US Department of Justice as well as lawsuits from customers.

    Yiannas told the House committee Tuesday that one strategy to head off similar shutdowns would be to require manufacturers to report Cronobacter bacteria found in its products. Currently, only the Abbott plant in Michigan is required to report the bacteria as part of the consent decree that allowed it to reopen.

    The FDA said in November that it would like Cronobacter infections added to the CDC’s list of national notifiable diseases, which would require doctors to report cases to public health officials so the CDC and the FDA could keep better track of infections. Only two states have such a reporting requirement now.

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  • Chris Martin No Longer Eats Dinner

    Chris Martin No Longer Eats Dinner

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    Chris Martin has cut back from three square meals a day to one at the advice of The Boss.

    A week after his ex-wife Gwyneth Paltrow shared her controversial broth-based diet, the musician revealed his own complicated eating schedule on the Conan O’Brien Needs a Friend podcast published Monday, confessing that he doesn’t “actually have dinner anymore.” Martin explained, “I stop eating at 4, and I learned that from having lunch with Bruce Springsteen.” He added that he, “was lucky enough to go over there to lunch the day after [Coldplay] played Philadelphia last year,” noting that even before implementing Springsteen’s routine he already “was on a really strict diet anyway.” But when he sat down to eat with the legendary singer, Martin realized that the 73-year-old looked “more in shape” than him at the time. When Springsteen’s wife Patti Scialfa revealed that it’s because her husband “only eat[s] one meal a day,” Martin thought, “Well, there you go. That’s my next challenge.” He then joked that Springsteen’s one meal a day is comprised of a “flank of buffalo with a steroid sauce.”

    In 2021, Springsteen spoke with Tim McGraw in an interview for Apple Music, during which he was also asked about how he stays in top physical condition. “The biggest thing is diet, diet, diet,” the “Born in the U.S.A.” musician explained. “I don’t eat too much, and I don’t eat bad food, except for every once in a while when I want to have some fun for myself. So I think anybody that’s trying to get in shape, exercise is always important of course, but diet is 90 percent of the game.”

    And last week, Paltrow admitted that she is also a big fan of intermittent fasting, taking long stretches between eating and waiting until 12 p.m. to have her first meal of the day. On the March 13 episode of the Art of Being Well podcast, she said, “I have bone broth for [lunch] a lot of the days. Then for dinner I try to eat according to paleo, so lots of vegetables.” During the conversation, the Goop founder was also hooked up to an IV drip which she claims made her “feel so good.” Clips from that conversation went viral on TikTok and soon after stars like Tess Holliday and Meghan McCain accused the actor of disordered eating. But in an Instagram Story on Friday, Paltrow addressed some of those concerns, explaining that her diet choices are due to “very high levels of inflammation” caused by her battle with long COVID-19. “I have been really working to really focus on foods that aren’t inflammatory,” she explained. The former actor also noted that her eating habits are not “meant to be advice for anyone else” as they are “based on [her] medical results and extensive testing.”

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  • Pandemic lowered US step count and Americans haven’t bounced back, study says | CNN

    Pandemic lowered US step count and Americans haven’t bounced back, study says | CNN

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    Editor’s Note: Sign up for CNN’s Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts.



    CNN
     — 

    Americans took fewer steps during the height of the Covid-19 pandemic, and they still haven’t gotten their mojo back, a new study found.

    “On average, people are taking about 600 fewer steps per day than before the pandemic began,” said study author Dr. Evan Brittain, associate professor of cardiovascular medicine at Vanderbilt University Medical Center in Nashville.

    “To me, the main message is really a public health message — raising awareness that Covid-19 appears to have had a lasting impact on people’s behavioral choices when it comes to activity,” he said.

    The study used data from the National Institutes of Health’s All of Us Research Program, which is focused on identifying ways to develop individualized health care. Many of the 6,000 participants in the program wore activity trackers for at least 10 hours a day over multiple years and allowed researchers access to their electronic health records.

    Brittain and his colleagues have used the ensuing data before, publishing a study in October 2022 that found overweight people could lower their risk of obesity by 64% by increasing their steps taken from about 6,000 to 11,000 per day.

    In the new study, published Monday in JAMA Network Open, researchers compared steps taken by nearly 5,500 people who wore the program’s activity trackers. Most were White women, with an average age of 53.

    Step counts collected between January 1, 2018, and January 31, 2020, were considered pre-Covid. Steps tracked after that date until the end of 2021, which is when the study ended, were considered post-Covid.

    Results showed no difference in identified step activity based on sex, obesity, diabetes and other illnesses or conditions such as coronary artery disease, hypertension or cancer.

    People who took the fewest steps were socioeconomically disadvantaged, under psychological stress and not vaccinated, the study said.

    Age made a difference as well, but in an unexpected manner: People over 60 were not impacted by the pandemic, the study found — they continued to keep their steps up.

    Oddly, it was younger people between 18 and 30 whose step counts were most impacted, Brittain said. “In fact, we found every 10-year decrease in age was associated with a 243 step reduction per day.”

    “If this persists over time, it could certainly raise the risk of cardiovascular disease, obesity, hypertension, diabetes and other conditions strongly linked to being sedentary,” Brittian said. “However, it’s too soon to know whether this trend will last.”

    Why would a younger generations lose steps while older people did not?

    “I think it’s difficult to interpret because it’s only 600 steps, which you could argue is what some people would get simply walking into work and through their day,” said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health, a hospital in Denver, who was not involved in the research. “I think the question is who is more likely to work from home?”

    Younger generations make up the majority of workers in technology, software and other professions that are able to work from anywhere, “whereas older people may have less of those jobs,” Freeman said.

    Whatever the reason, the study data shows that people were not moving as much during the pandemic as they used to. That is worrisome, Freeman added.

    “If this trend remains, we should really be cognizant that if you’re going to work from home, use either a standing, treadmill or bike desk,” he said, adding that managers of remote employees should “insist people take periodic breaks for people to do exercise, which also is proven to improve mental clarity and acuity,” he said.

    Health professionals should always be talking to their patients about activity levels, but “the impact of Covid-19 might make those kinds of messages all the more important to discuss with patients,” Brittain said.

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  • There’s a new Reese’s in town, hold the dairy | CNN Business

    There’s a new Reese’s in town, hold the dairy | CNN Business

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    New York
    CNN
     — 

    Vegan Reese’s are happening.

    Hershey, which makes Reese’s along with Hershey bars, Kisses and other chocolates and candies, announced two new dairy-free products on Tuesday: Reese’s plant-based peanut butter cups, and a vegan chocolate Hershey bar with almonds and sea salt, each made with oats instead of dairy and designed to taste like milk chocolate. The new Reese’s variety will be available nationally this month, and the new Hershey bar is arriving in April.

    The company is the latest to introduce a vegan chocolate in hopes that it will attract more customers. But Hershey is a little late to the game.

    Nestlé

    (NSRGY)     introduced KitKat V, a vegan version of the chocolate bar, in 2021. Mondelez

    (MDLZ)     acquired Hu, a company which makes vegan chocolate, that year, as well. Hershey also initiated a test of a version of its product in 2021.

    In prepared remarks discussing the company’s fourth-quarter results, CEO Michele Buck said that “better for you,” which includes plant-based items, presented an opportunity for the company and will “receive greater levels of support this year.”

    “We are excited to introduce these delicious, plant-based options,” Teal Liu, brand manager of Better For You at Hershey

    (HSY)    , said in a statement announcing the launch Tuesday, adding that the new products offer more options for “chocolate lovers looking for plant-based alternatives.”

    By focusing on vegan alternatives to milk chocolate, specifically, Hershey may have a better chance of setting its products apart from others in the market.

    “As the vegan chocolate space gets more crowded, claims beyond plant-based may be necessary,” Kelsey Olsen, consumer insights analyst for food & drink at market research firm MIntel, told CNN in an email. “While many plant-based items previously launched have been dark chocolate varieties, brands should explore the areas of plant-based milk chocolate and white chocolate.”

    Touting oat as an ingredient could also help.

    Confectioners “can take advantage of oat milk’s unique properties to appeal to a larger consumer base, whether vegan or not,” Olsen said.

    Chocolate as a category has been resilient in the past few years, with people reaching for treats during the stress of the early pandemic and seeing it as a relatively affordable splurge even as prices rise.

    But it’s not clear that an oat-based chocolate will do the trick. “The majority of consumers are not focused on added [better for you] components to chocolate,” Olsen noted in a Mintel report last year.

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  • Top Risk Factor to Good Health Is Probably Not What You Think

    Top Risk Factor to Good Health Is Probably Not What You Think

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    March 7, 2023 — If you think the biggest risk factor to good health is smoking or genetics, think again. 

    According to Stephen Kopecky, MD, a preventive cardiologist at the Mayo Clinic, “nutrition is now the number one cause of early death and early disease in our country and the world.” Moreover, he says that while having genes for disease will increase your risk by 30% to 40%, having a bad lifestyle for disease will increase your risk by 300% to 400%.

    About 20 years ago, Kopecky says, the cause of death worldwide changed from infection to non-infection (like non-communicable diseases). “In those last 20 years, that’s grown in terms of what kills us and what gets us sick,” he says. “The three big non-communicable diseases are heart disease, cancer, and rapidly rising is Alzheimer’s. But there’s also diabetes, obesity, and high blood pressure — all those things are also related to diet.”

    Forty-eight-year-old James, of Fredericksburg, VA, knows this all too well. James asked that his last name not be printed, to protect his privacy. For the last 30 years, he’s been managing type 1 diabetes and complications of insulin resistance, along with high blood pressure, high cholesterol, thyroid disease, and low testosterone. As a former Division 1 college athlete, James exercised regularly and ate what he believed to be a responsible diet.

    “Those weirdos in the gym at 5 a.m. who eat chicken salads for every lunch? Yeah, that’s me,” says James. 

    But he went from a playing weight of 202 pounds to 320 pounds, despite continuing to lift weights and do cardiovascular exercise at least 5 days a week. “Whenever I went to the doctor and stepped on the scale, I got skeptical looks when I made claims of ‘exercising and eating right.’ In all honesty, I thought I was,” says James, noting he followed a low-carb, high-protein diet. “But I didn’t count calories or consider the impact of fat on my already insulin-resistant body,” he says.

    After visiting many health professionals, James finally found success with Nancy Farrell Allen, a registered dietitian nutritionist.

    Previous doctors applauded his diet, but Allen explained that his insulin resistance was linked to the amount of fat James consumed. “The more fat in my system, the more insulin I needed to inject,” he says. “The more insulin I injected, the more weight I’d gain. The more weight I’d gain, the more insulin I’d inject, continuing this regrettable cycle.” 

    Allen suggested he shift his diet to a more balanced approach, with a strict eye on fat. “She completely changed my way of thinking about food, broke my belief that all carbs are bad, helped me identify my daily caloric needs, and focused me on eating a balanced diet enriched with fiber,” says James, who then lost 45 pounds in 3 months. “I found myself having more energy, sleeping better, focusing better, and taking less insulin than I had in nearly 20 years,” he says. 

    Another patient, Sheila Jalili of Miami, took a proactive approach to her health when she turned 40, getting some tests and lab work done for a baseline comparison. “My BMI was around 20, I exercise every day, and I don’t have any diseases in my family,” Jalili says, noting everything checked out fine. 

    She continued her annual checkups and tests, noticing her triglycerides and cholesterol numbers increasing. When her cholesterol reached alarming levels and her triglycerides skyrocketed to 1,230, she met with Kopecky, the Mayo Clinic cardiologist, who prescribed fish oil and asked about her diet. Jalili started tracking what she ate and did an exhaustive review of her fridge contents, noting the sodium levels, cholesterol levels, and fat levels in the foods. 

    To her surprise, she discovered she ate a lot of unhealthy carbs and fats. “I went into overload. I changed everything. I did so much research,” she says. After 42 days of eating extremely healthy, she dropped her total cholesterol by about 100, halved her HDL, and reduced her triglycerides from 1,238 to 176.

    A bad lifestyle often starts with what you eat — and what you don’t. Even if you think you’re eating healthy, you might want to revisit your diet. In particular, reconsider ultra-processed foods (like doughnuts, hot dogs, and fast-food burgers). Though convenient and affordable, they’re inflammatory and, over time, can cause many health issues.

    “It bothers our tissues, our heart, our arteries, our brains, our pancreas, our liver, and our lungs, and that leads to disease,” Kopecky says. “It could be in the brain with Alzheimer’s, the heart with coronary artery disease, or cancers elsewhere.”

    Ideally, you’d immediately overhaul an unhealthy diet. But that’s not a reality for most people. Making sweeping changes all at once can feel overwhelming. Take small steps instead.

    Baby-Step Your Way to a Healthier Diet

    Before making any dietary changes, Selvi Rajagopal, MD, MPH, advises having a conversation with your health care provider to figure out your specific health status. Rajagopal, assistant professor of medicine at Johns Hopkins University, says that, generally speaking, everyone will benefit from eating a balanced, healthy diet filled with a variety of nutrient-rich foods. 

    That includes fruits, vegetables, whole grains, lean protein, low-fat/fat-free dairy, and healthy fats. However, talking with your doctor can help you identify any specific nutrient deficiencies, health issues, and lifestyle factors that need to be addressed. Then you can devise a healthy eating plan that works specifically for your needs.

    Revamp how you organize your refrigerator. Most refrigerators put two opaque drawers labeled “Fruits” and “Vegetables” at the bottom, where you’re least likely to see them. Kopecky advises moving your produce to eye level and put the less-healthy options in those bottom drawers. “When we open the fridge, that’s what we see, and that’s what we tend to eat,” he says.

    Change your perspective. “There isn’t one healthy weight or one healthy size,” says Rajagopal. Don’t aim for a number on the scale or a certain BMI or certain clothing size. Every body is different, not only in shape and size, but in health risk factors. Also, many people feel really overwhelmed trying to “be healthy.” Rajagopal says, “Healthy is just trying to do something to improve your health, and that improvement can be really small.”

    Understand how to read food labels. Allen takes every patient to the grocery store to read and understand food labeling and to highlight different foods. She shares the guidelines below with her patients. 

    • Fat: Low-fat foods contain 3 grams of fat or less per serving.
    • Sugar: Four grams equal 1 teaspoon. When a serving of sugar lists 12 grams of sugar in a 2/3-cup serving, that means it contains roughly 3teaspoonsof sugar.
    • Fiber: A naturally high-fiber food can contain about 5 grams of fiber per serving. 
    • Sodium: A low-sodium food contains less than or equal to 140 milligrams of sodium per serving. 
    • Protein: Seven grams of protein equal about 1 ounce of protein. 

    This approach is particularly important as the FDA is exploring a change in which foods can be labeled as healthy. The agency in September unveiled a proposed rule to try and counter the fact that, as the agency claims, more than 80% of people in the U.S. aren’t eating enough vegetables, fruit, and dairy. And most people consume too much added sugars, saturated fat, and sodium.

    Under the proposed rule, in order to be labeled “healthy” on food packaging, products must contain “a certain meaningful amount” of food from at least one of the food groups or subgroups (e.g., fruit, vegetable, dairy, etc.) recommended by the agency’s dietary guidelines.

    They must also stick to specific limits for certain nutrients, such as saturated fat, sodium, and added sugars. 

    Breakfast cereals, for example, would need to contain 0.75 ounces of whole grains and contain no more than 1 gram of saturated fat, 230 milligrams of sodium, and 2.5 grams of added sugars to qualify, the agency said.

    Don’t fear carbs or fat! Your body needs both to survive, as carbs help fuel your body and fat helps your body absorb fat-soluble nutrients like vitamins A, D, and E. But not all carbs or fats are equal. Choose complex carbohydrates found naturally in plant-based foods (like fruits, vegetables, and whole grains) over simple carbohydrates often found in processed foods (like white bread, enriched pasta, and white rice). 

    Similarly, strive to include healthy, unsaturated fats (including polyunsaturated and monounsaturated fats) found in foods such as fatty fish, vegetable oils, avocadoes, and some seeds and nuts. Avoid foods with unhealthy saturated and trans fats found primarily in animal products (such as meat, eggs, high-fat dairy) and highly processed foods (frozen pizza and microwave popcorn). “Having a baseline understanding of what this means makes you a much savvier consumer,” says Rajagopal, who suggests going to the U.S. Department of Agriculture’s website to learn about these food components. 

    Adopt healthier cooking methods. Maybe you’re buying healthy foods but preparing them in unhealthy ways. That lean, skinless chicken breast just got a lot less healthy once you breaded it, deep-fried it, and smothered it with cheese. Allen suggests lighter, leaner techniques such as baking, roasting, grilling, and steaming. “Frying, sautéing, breading, au gratin, buttery, and Alfredo all add additional calories to burn off,” says Allen.

    Start small. Eliminate the all-or-nothing thinking, such as, “I want to cut out all sugar” or “I want to cook all my meals at home.” 

    If you’ve been eating sugar your whole life or eating dinner out 5 nights a week, eliminating this bad habit at once is a huge undertaking. Instead, start small. For instance, reduce one sugary food item you frequently eat. 

    “Maybe it’s soda,” says Rajagopal. “Maybe you go from four cans of soda a day to two cans. Make one change and see how it goes for a week or two.” 

    Ditto for cooking — aim to add one more home-cooked meal a week rather than trying to cook at home 7 days a week. She also advises bringing in an accountability buddy to help you stay on track. 

    Take one bite. “If you take a bite of a ground meat or sausage and replace that with a bite of something that’s a little healthier — like black beans or a vegetable — then, after doing this for a couple of years, that actually reduces your risk of heart attack and reduces your risk in the long-term of cancers and Alzheimer’s,” advises Kopecky. “Literally one bite difference.”

    By making small, consistent changes, they can have a big impact over time. Pick one tip that resonates most, implement it, and stick to it until it becomes second nature. Once mastered, move on to another tip, building on that foundation of success.

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  • Bempedoic acid improved heart health in patients who can’t tolerate statins, study finds | CNN

    Bempedoic acid improved heart health in patients who can’t tolerate statins, study finds | CNN

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    CNN
     — 

    Bempedoic acid may be an alternative for people who need to lower their cholesterol but can’t or won’t take statins, according to a large study published Saturday in the New England Journal of Medicine.

    Statins are the most commonly prescribed cholesterol-lowering drugs that help lower what’s known as the “bad” cholesterol, or low-density lipoprotein (LDL) cholesterol in the blood; more than 90% of adults who take a cholesterol-lowering medicine use a statin, according to the US Centers for Disease Control and Prevention.

    Statins are considered safe and effective, but there are millions of people who cannot or will not take them. For some people it causes intense muscle pain. Past research has shown anywhere between 7% and 29% of patients who need to lower cholesterol do not tolerate statins, according Dr. Steven Nissen, a cardiologist and researcher at the Cleveland Clinic and co-author of the new study.

    “I see heart patients that come in with terrible histories, multiple myocardial infarction, sometimes bypass surgery, many stents and they say, ‘Doctor, I’ve tried multiple statins, but whenever I take a statin, my muscles hurt, or they’re weak. I can’t walk upstairs. I just can’t tolerate these drugs,’ ” Nissen said. “We do need alternatives for these patients.”

    Doctors have a few options, including ezetimibe and a monoclonal antibody called a proprotein convertase subtilisin/kexin type 9, or PCSK9 inhibitors for short.

    Bempedoic acid, sold under the name Nexletol, was designed specifically to treat statin-intolerant patients. The FDA approved it for this purpose in 2020, but the effects of the drug on heart health had not been fully assessed until this large trial. The new study was funded in part by Esperion Therapeutics, the maker of Nexletol.

    For the study, which was presented Saturday at the American College of Cardiology’s Annual Scientific Session with the World Congress of Cardiology, Nissen and his colleagues enrolled 13,970 patients from 32 countries.

    All of the patients were statin intolerant, typically due to musculoskeletal adverse effects. Patients had to sign an agreement that they couldn’t tolerate statins “even though I know they would reduce my risk of a heart attack or stroke or death,” and providers signed a similar statement.

    The patients were then randomized into two groups. One was treated with bempedoic acid, the other was given a placebo, which does nothing. Researchers then followed up with those patients for up to nearly five years. The number of men and women in the trial were mostly evenly divided, and most participants, some 91%, were White, and 17% were Hispanic or Latino.

    The drug works in a similar way that statins do, by drawing cholesterol out of a waxy substance called plaque that can build up in the walls of the arteries and interfere with the blood flow to the heart. If there is too much plaque buildup, it can lead to a heart attack or stroke.

    But bempedoic acid is only activated in the liver, unlike a statin, so it is unlikely to cause muscle aches, Nissen said.

    In the trial, investigators found that bempedoic acid was well-tolerated and the percent reduction in the “bad” cholesterol was greater with bempedoic acid than placebo by 21.7%.

    The risk of cardiovascular events – including death, stroke, heart attack and coronary revascularization, a procedure or surgery to improve blood flow to the heart – was 13% lower with bempedoic acid than with placebo over a median of 3.4 years.

    “The drug worked in primary and secondary prevention patients – that is, patients that had had event and patients who were very high risk for a first event. There were a lot of diabetics. These were very high risk people,” Nissen said. “So the drug met its expectations and probably did a lot better than a lot of people thought it would do.”

    In the group that took bempedoic acid, there were a few more cases of gout and gallstones, compared with people who took a placebo.

    “The number is small, and weighing that against a heart attack, I think most people would say, ‘OK I’d rather have a little gout attack,’ ” Nissen said.

    Bempedoic acid had no observed effect on mortality, but that may be because the observation period was too short to tell if it had that kind of impact. Earlier trials on statins showed the same; it was only after there were multiple studies on statins that scientists were able to show an impact on mortality.

    Dr. Howard Weintraub, a cardiologist at NYU Langone Health who did not work on this study, said that while he knows some people will not consider a medication successful unless it reduces mortality, he thinks that is short-sighted.

    “I think there’s more to doing medicine then counting body bags,” Weintraub said.”Preventing things that can be life changing, crippling, and certainly change your quality of life forever going forward, and your cost of doing things going forward, I think is a good thing.”

    He was pleased to see the results of this trial, especially since the people in this study are often what he called “forgotten individuals” – the millions who could benefit from lowering their cholesterol, but can’t take statins.

    “It’s not like their LDL was 180 or 190 or 230, their LDL was 139. This is about average in our country,” Weintraub said. He said often doctors will just tell those patients to watch their diet, but he thinks this suggests they would benefit from medication.

    “Both groups primary and secondary prevention got benefit, which I think is impressive with the modest amount of LDL reduction,” Weintraub said.

    There are some limitations to this trial. It was narrowly focused on patients with a known statin intolerance. Nissen said the trial was not designed to determine whether bempedoic acid could be an alternative to statins.

    “Statins are the gold standard. They are the cornerstone. The purpose of this study was not to replace statins, but to allow an alternative therapy for people who simply cannot take them,” Nissen said.

    Bempedoic acid is a much more expensive drug than a statin. There are generic versions of statins and some cost only a few dollars. Bempedoic acid, on the other hand, has no generic alternative and a 30-day supply can cost more than $400, according to GoodRx.

    “I think what insurance companies need to recognize that even though this drug is going to cost more than statins, having a heart attack or a stroke or needing a stent is expensive. A 23% reduction in (myocardial infarctions) is a considerable reduction,” Weintraub said.

    In an editorial in the New England Journal of Medicine that accompanied the study, Dr. John H. Alexander, who works in the division of cardiology at Duke Clinical Research Institute, Duke Health, Durham said that doctors should take these results into consideration when treating patients with high cholesterol who can’t take statins.

    “The benefits of bempedoic acid are now clearer, and it is now our responsibility to translate this information into better primary and secondary prevention for more at-risk patients, who will, as a result, benefit from fewer cardiovascular events,” Alexander wrote.

    Dr. Manesh Patel, a cardiologist and volunteer with the American Heart Association who was not a part of the study, said that providers are already prescribing bempedoic acid for some patients, but with this new research, he thinks they will quickly be used with more statin-intolerant patients.

    “We continue to see that if we can lower your LDL significantly, we improve people’s cardiovascular health. And so we need as many different arrows in our quiver to try to get that done,” Patel said.

    Heart disease is the No. 1 killer for men and women in the world. One person dies every 34 seconds in the US from cardiovascular disease, according to the CDC. About 697,000 people in the US died from heart disease in 2020 alone – about the same number as the population of Oklahoma City.

    “Given the number of people that are eligible for statins, which are tens of millions of patients already, the number of people who cannot tolerate statins is in the millions,” Nissen said. “This is a big public health problem and I think we’ve come up with something that directly addresses this.”

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  • NFL star Aaron Rodgers went to a darkness retreat to contemplate his future. What is that and how does it work? | CNN

    NFL star Aaron Rodgers went to a darkness retreat to contemplate his future. What is that and how does it work? | CNN

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    CNN
     — 

    For four days this week, home for Green Bay Packers quarterback Aaron Rodgers was a pitch-black room. There were no phones, no television, no lights or distractions. Just Rodgers, alone with his thoughts, in a cabin built specifically for prolonged isolation in the dark.

    When the four-time NFL MVP announced plans earlier this month to contemplate his NFL future in isolation at a “darkness retreat,” many were left scratching their heads.

    “It’s just sitting in isolation, meditation, dealing with your thoughts,” Rodgers said earlier this month. “We rarely even turn our phone off or put the blinds down to sleep in darkness. I’m really looking forward to it.”

    Rodgers is no stranger to alternative therapies. He credits psychedelics like psilocybin and ayahuasca for helping to alleviate his fear of death and deepening a sense of self-love. The football star said he has done “many meditation and yoga retreats” in the past and defended his decision to try darkness therapy as one of several practices “that have stimulated my mind and helped me get in a better headspace and have a greater peace in my life.”

    But what exactly happens in a darkness retreat? And is it just another new-age fad or perhaps something that could benefit the rest of us?

    A darkness retreat is exactly what it sounds like: a prolonged stay in a space completely devoid of light. One of the centers offering the practice is Sky Cave Retreats, nestled in the Cascade-Siskiyou wilderness, in Southern Oregon, near Klamath Falls.

    “The reasons for doing this range from people wanting to know themselves more, to people who want to rest, reset and relax, to those who want to explore consciousness and deepen their meditation practice,” said Scott Berman, who owns Sky Cave Retreats along with his wife Jill, adding the darkness helps illuminate what really matters by stripping away the constant bombardment of sensory input and stimulation many people experience in their hectic modern lives.

    “When someone goes into the darkness, all these things that were important to them like money, fame, power, status, being worthy – they all become insignificant and meaningless in the dark,” Berman said. “In the dark, all you have is the present moment which reveals what is truly meaningful – whether it’s love, forgiveness, peace – and it begins to transform you as you truly authentically touch what is most important to you.”

    The center currently operates three stand-alone cabins built specifically for prolonged isolation in the dark – earth-sheltered caves, which on the outside are somewhat reminiscent of a Hobbit home. Each space contains a bed, a toilet, sink and a bathtub, as well as a low table for eating and a carpeted area for yoga and meditation. Participants can leave at any time – the doors are never locked – and there is a light switch for emergencies which is protected by a childproof guard so it isn’t flipped on by accident.

    The cost includes three meals a day, which Berman delivers personally all at once in the evening (through a lightproof double-sided food box) to minimize the disturbance. This is when participants have an opportunity for a conversation, which could be 10 seconds or 30 minutes, according to Berman, depending on the person’s needs.

    Participants typically spend three to four days in the darkness at a cost of $250 a night and are encouraged to take an extra day before and after to integrate the experience.

    Each space contains a bed, a toilet, sink and a bathtub, as well as a low table for eating and a carpeted area for yoga and meditation.

    Burak Dalcik, a 27-year-old salesman from Arlington, Virginia, said the four days he spent in the dark at Sky Caves Retreats in January gave him clarity about his priorities. He found he no longer labeled experiences as positive or negative, but rather allowed them to come and to go, which led to less stress and anxiety at work and in his personal life. He also said he started calling his mom, who lives back in Turkey, more frequently.

    “It just really trims all the unnecessary fat and allows you to focus on some of the most important things and really allows you to understand who you are,” said Dalcik. “There’s nothing New Age about this – it boils down to can you just sit by yourself with yourself? And if you can’t, you should probably get pretty curious about why.”

    Berman cautions the retreat isn’t for everyone, nor should it be seen as a quick fix to one’s troubles.

    “It’s not like this magical, mind-blowing, amazing experience – it can be extremely difficult and uncomfortable,” Berman said. “But in the darkness, discomfort is the door to transformation. There’s an acceptance and a profound love that people start to experience when they’re no longer resisting that part of themselves.”

    For now, there is limited research on how darkness retreats impact the human brain and body. Some centers claim the experience can help heal traumas or activate the pineal glad, another claim is darkness therapy increases melatonin production in the brain.

    “That’s totally false,” said Dr. David Blask, the head of the Laboratory of Chrono-Neuroendocrine Oncology at Tulane University School of Medicine. “There may be some psychological benefits that people derive from a darkness retreat that they feel are important for them, but certainly not from a strict endocrine neuroendocrine or biochemical physiological standpoint.”

    Dr. Marek Malůš, a psychologist at the University of Ostrava in the Czech Republic who has been studying darkness therapies since 2010, sees the technique as a promising therapeutic tool.

    “Your thoughts, memories, emotions, inner world and mental processes become much more balanced and integrated,” Malůš said.

    While he and his colleagues are working to secure funding for additional studies, Malůš said preliminary research showed just four days in a darkness chamber was enough to help increase mindfulness and self-esteem, lower symptoms of depression and anxiety, while improving parasympathetic nervous system functions, which helps with stress management and lowering burnout symptoms. Subjects reported feeling the benefits three weeks after the experience.

    Berman said he hopes to see more scientific research into the benefits of darkness retreats, but cautions against anyone seeking to use the retreat for some sort of natural high.

    “If somebody’s coming here because they want to have a so-called DMT experience, you’ve come into the wrong place,” he said. “But there is a lot of benefit in not looking outside of ourselves for confirmation of our worth and using the darkness to illuminate our true nature.”

    For those who aren’t able to commit the time or money for a darkness retreat but want a taste of some of the benefits, Berman suggests starting small at home.

    “It’s about becoming accustomed to authentically slowing down, putting the phone away, turning out the lights, closing the blinds and just resting,” he said. “Not to get somewhere, not to heal but just to be curious about what’s actually happening within yourself.”

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  • Strengthen your core with exercises you can do at home using only a paper plate | CNN

    Strengthen your core with exercises you can do at home using only a paper plate | CNN

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    Editor’s Note: Dana Santas, known as the “Mobility Maker,” is a certified strength and conditioning specialist and mind-body coach in professional sports, and is the author of the book “Practical Solutions for Back Pain Relief.”



    CNN
     — 

    With spring still nearly a month away, the continued wintry weather and shorter days with less sunlight could be taking a toll on your motivation to get out and exercise. Understandably, you may be inclined to skip the gym in favor of staying cozy inside. But don’t let the winter blues keep you from moving your body!

    By getting creative, you can get the exercise you need at home not only to boost your physical health but also to increase the feel-good brain chemicals serotonin, dopamine and noradrenaline to help you beat those doldrums.

    There are lots of ways you can work out in the comfort of your home quickly and simply — without expensive gym equipment. With a little ingenuity, broom handles, backpacks and other everyday household items can serve as useful tools during your workout. If you have access to stairs, there are numerous exercises you can do using just two stairs. Even a paper plate can be used for exercise.

    That’s right, just a single paper plate can provide all the means necessary for a surprisingly challenging total-body workout that strengthens your core and improves your balance. It may sound far-fetched, so I’ve outlined the exercises below and included an instruction video at the top of this article so you can try it for yourself.

    Important note: Before beginning any new exercise program, consult your doctor. Stop immediately if you experience pain.

    Perform eight to 10 repetitions of each exercise on each side of your body while maintaining a focus on good form and being able to breathe well. The instability of the paper plate is what creates the challenge. In each exercise, the side of your body that’s not using the paper plate is the stabilizing side, so that side will feel the burn of working harder to maintain balance.

    If you struggle with strength or balance limitations, start off by practicing the movements using the suggested modifications for each exercise.

    Place one foot on the paper plate and slide that leg back into a lunge position, bending your knee to gently tap it on the floor, if possible. The forward leg should also bend into a lunge position with your knee aligned above your ankle.

    Use the strength of your core and stabilizing front leg to return to standing. That’s one rep. Go through all reps on one side and then repeat on the other side.

    How to modify: Decrease how far back you slide and place a hand on a wall if balance is an issue.

    From a standing position, put one foot on the paper plate and perform a slide-out lateral lunge by sliding your foot out to the side while taking a half-squat position with your opposite leg. Keep your chest up, trying not to lean forward too much.

    As you perform a slide-out lateral lunge, focus on the standing leg that's stabilizing your movements and keep your chest high.

    Use the strength of your core and stabilizing leg to return to standing. Go through all reps on one side and then repeat on the other side.

    How to modify: If you aren’t strong enough to hold the half-squat position, you can put a chair under your hip to sit back on as you slide out your opposite leg. Place a hand on a wall if you need help with balance.

    From a plank position on the floor with your feet positioned a little wider than hip distance apart to help with counterbalance, place one of your hands on the paper plate. Maintaining a strong core and neutral spine, make circles with the plate on the floor.

    From a plank position, use the plate to make circles on the floor while keeping a strong core and neutral spine.

    Go as wide as your shoulder mobility will allow while still being able to stabilize. After making four circles in one direction, go in the other direction for another four circles. Switch to the other side and repeat the pattern of four circles in each direction.

    How to modify: If you feel your back arching, lower to your knees to make it a bit easier to engage your core and keep a neutral spine.

    From a plank position with your feet a little wider as noted above, place the toes of one foot on the paper plate. Just like you did with the shoulder circles, use your hip mobility to draw circles with your foot.

    Use your hip mobility to draw circles with your foot — just as you did with the shoulder circles.

    Make four circles in one direction and four in the other direction, then repeat with the other leg.

    How to modify: You can lower to the knee of your stabilizing leg if you have difficulty maintaining a neutral spine. If you struggle to make a circular motion, try a mountain climber forward-back motion instead.

    Try a mountain climber forward-back motion if you have trouble making a circular motion.

    Depending on your current fitness level and how you feel while doing these exercises, do the four exercises sequentially through three to five rounds. You might be surprised by how exhausted you can get using just a paper plate! Be sure to take short breaks in between rounds to drink some water and catch your breath.

    To help you overcome the winter blues and strengthen your body — especially your core, I recommend doing this workout a few times per week. Once spring arrives, look for more opportunities to exercise outside.

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  • I tried Microsoft’s new AI-powered Bing. Here’s what it’s like | CNN Business

    I tried Microsoft’s new AI-powered Bing. Here’s what it’s like | CNN Business

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    Seattle
    CNN Business
     — 

    Microsoft’s Bing search engine has never made much of a dent in Google’s dominance in the more than 13 years since it launched. Now the company is hoping some buzzy artificial intelligence can win converts.

    Microsoft on Tuesday announced an updated version of Bing designed to combine the fun and convenience of OpenAI’s viral ChatGPT tool with the information from a search engine.

    Beyond providing a list of relevant links like traditional search engines, the new Bing also creates written summaries of the search results, chats with users to answer additional questions about their query and can write emails or other compositions based on the results. With the new Bing, for example, users can create trip itineraries, compile weekly meal plans and ask the chatbot questions when shopping for a new TV.

    This is the new era of search that Microsoft

    (MSFT)     — which is investing billions of dollars in OpenAI — envisions, one where users are accompanied by a sort of “co-pilot” around the web to help them better synthesize information. The company is betting on the new technology to drive users to Bing, which had for years been an also-ran to Google Search. Microsoft

    (MSFT)     also announced an updated version of its Edge web browser with the new Bing capabilities built in.

    The event comes as the race to develop and deploy AI technology heats up in the tech sector. Google on Monday unveiled a new chatbot tool dubbed “Bard” in an apparent bid to keep pace with Microsoft and the success of ChatGPT. Baidu, the Chinese search engine, also said this week it plans to launch its own ChatGPT-style service.

    The updated Bing and Edge launched to the public on a limited basis on Tuesday, and are set to roll out to millions of people for unlimited search queries in the coming weeks. I took Bing for a spin at a press event at Microsoft’s Redmond, Washington, headquarters Tuesday.

    The tool provides the sort of immediate gratification we now expect from the internet — rather than clicking through a bunch of links to suss out the answer to a question, the new Bing will do that work for you. But it’s still early days for the technology, which Microsoft says is still evolving.

    The homepage of the new Bing feels familiar: you can type a query into the search bar and it returns a list of links, images and other results like a typical search engine. But on the left side of the page are written summaries of the results, complete with annotations and links to the original information sources. The search field allows up to 2,000 characters, so users can type the way they’d talk, rather than having to think of the few correct search terms to use.

    Users can also click over to a “chat” page on Bing, where a chatbot can answer additional questions about their queries.

    I asked Bing to write me a five-day vegetarian meal plan. It returned a list of vegetarian meals for breakfast, lunch and dinner for Monday through Friday, such as oatmeal with fresh berries and lentil curry. I then asked it to write me a grocery list based on that meal plan, and it returned a list of all the items I’d need to buy organized by grocery store section.

    Based on my request, the Bing chatbot also wrote me an email that I could send to my partner with that grocery list, complete with a “Hi Babe” greeting and “XOXO” closing. It’s not exactly how I’d normally write, but it could save me time by giving me a draft to edit and then copy and paste into an email, rather than having to start from scratch.

    The generated portions of Bing have personality. When you ask the chatbot a question, it responds conversationally and sometimes with emojis, letting you know it’s happy to help or that it hopes you have fun on the trip you’re planning.

    With the new Edge browser, I asked the tool to summarize one of my articles, and then turn that into a social media post the length of a short paragraph with a “casual” tone that I could share on Twitter or LinkedIn.

    The new Bing is built in partnership with OpenAI — the company behind ChatGPT in which Microsoft has invested billions — on a more advanced version of the technology underlying the viral chatbot tool. Still, the new Bing has some of the quirks that the public version of ChatGPT is known for. For example, the same query may return different responses each time it’s run; this is in part just how the tool works, and in part because it’s pulling the most updated search results each time it runs.

    It also didn’t cooperate with some of my requests. After the first time it created a meal plan, grocery list and email with the list, I ran the same requests two more times. But the second and third time, it wouldn’t write the email, instead saying something like, “sorry, I can’t do that, but you can do it yourself using the information I provided!” The tool is also sensitive to the wording used in queries — a request to “create a vegetarian meal plan” provided information about how to start eating healthier, whereas “create a 5-day vegetarian meal plan” provided a detailed list of meals to eat each day.

    Even next-gen search technology isn’t immune to basic flubs. I can imagine using the tool ahead of an upcoming local election, to learn about who is running for office in my area, what their positions are and how and when to vote. But when I asked the chatbot, “when is the next election in Kings County, NY?” it returned information about the November election last year.

    The new Bing may also present some of the same concerns as ChatGPT, including for educators. I asked Bing’s chatbot to write me a 300-word essay about the major themes of the book “Pride and Prejudice” and, within less than a minute, it had pumped out 364 words on three major themes in the novel (although some of the text sounded a bit repetitive or wonky). Per my request, it then revised the essay as if it was written by a fifth grader.

    The chatbot tool has feedback buttons so users can indicate whether its answers were helpful or not, and users can also chat directly with the tool to tell it when answers were incorrect or unhelpful, the company says.

    “We know we won’t be able to answer every question every single time, … We also know we’ll make our share of mistakes, so we’ve added a quick feedback button at the top of every search, so you can give us feedback and we can learn,” Yusuf Mehdi, Microsoft’s vice president and consumer chief marketing officer, said in a presentation.

    With some controversial search topics, it appears the new Bing chatbot simply refuses to engage. For example, I asked it, “Can you tell me why vaccines cause autism?” to see how it would react to a common medical misinformation claim, and it responded: “My apologies, I don’t know how to discuss this topic. You can try learning more about it on bing.com.” The same query on the main search page returned more standard search results, such as links to the CDC and the Wikipedia page for autism.

    Likewise, it would not return a chatbot request for how to build a pipe bomb, instead saying in its answer, “Building a pipe bomb is a dangerous and illegal activity that can cause serious harm to yourself and others. Please do not attempt to do so.” However, one of the links provided in the annotation of its answer brought me to a YouTube video with apparent instructions for building a pipe bomb.

    Microsoft says it has developed the tool in keeping with its existing responsible AI principles, and made efforts to avoid its potential misuse. Executives said the new Bing is trained in part by sample conversations mimicking bad actors who might want to exploit the tool.

    “With a technology this powerful I also know that we have an even greater responsibility to make sure that it’s developed, deployed and used properly,” said responsible AI lead Sarah Bird.

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