Nuts: Roasted chestnuts are a great suggestion. And nuts too as long as not salted are a good snack.

If youve had a big lunch, whats a better alternative to a turkey sandwich supper?

Give your body time to rest and recover. What I find is that its not the meal itself that is usually the biggest problem, its the cravings it creates following the meal. So opt for a lighter meal. Maybe soup, scrambled eggs with spinach and avocado, or some smoked salmon, poached eggs and asparagus, which is enough to keep you satiated but not to trigger the cravings at the next meal.

Lastly, if you fall off the diet wagon over the festive period, knowing that you can climb back on it is the most important thing. Dont beat yourself up and find the balance between indulging and overindulging. To get back on track, I would suggest:

1. Set fresh goals for 2020

2. Clean out the pantry

3. Get on top of your social calendar

4.Adopt a Mediterranean style of eating

Visit link:
How to have a merry 5:2 Christmas - the dos and don'ts of festive fasting - The Telegraph

Not all fat is created equally and as opposed to subcutaneous fat, which describes the fat you can pinch, visceral fat lies deep under the surface, near vital organs such as the liver, stomach and intestines. A build-up of visceral fat therefore poses grave health risks, leading to chronic complications such as type 2 diabetes and cardiovascular disease.

READ MORE:Best supplements for weight loss: Expert recommends key nutrient to help you lose weight

Luckily, making positive changes to your diet can help to curb visceral fat, keeping the associated health risks at bay.

One simple dietary tweak shown to reduce the harmful belly fat is to take probiotics - live bacteria that can boost your gut and digestive health.

Probiotics can be taken in supplement form and studies investigating the link between probiotic consumption and visceral fat loss suggest that probiotics may reduce dietary fat absorption in the gut, causing the body to expel more of it out.

In addition, probiotics may help promote higher levels of GLP-1, a fullness hormone, and ANGPTL4, a protein that may help reduce fat storage

Studies have revealed that consuming a particular strain of probiotic supplement may help to reduce belly fat.

Evidence links a certain strain of probiotic bacteria from the Lactobacillus family, such as Lactobacillus fermentum, Lactobacillus amylovorus, and especially Lactobacillus gasseri to visceral fat loss.

For example, a study in 210 healthy Japanese adults investigated the effects of taking Lactobacillus gasseri over a 12-week period.

It found that people who took Lactobacillus gasseri lost 8.5 percent visceral fat.

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However, as soon as participants stopped taking the probiotic, they gained all of the visceral fat back within a month.

Exercise also plays a key role in reducing visceral fat and certain exercises have proven to be more beneficial than others in reducing the harmful belly fat.

Harvard Health recommends engaging in regular moderate-intensity physical activity at least 30 minutes per day (and perhaps up to 60 minutes per day) to control weight and lose belly fat.

Extensive evidence supports this claim, showing that aerobic exercise can help you lose visceral fat, even without dieting

For example, an analysis of 15 studies in 852 people compared how well different types of exercise reduced visceral fat without dieting.

They found that moderate and high-intensity aerobic exercises were most effective at reducing visceral fat without dieting.

Aerobic exercise is any form of exercise that gets your heart pumping and makes you breathe faster, such as walking, bicycling or swimming.

Strength training (exercising with weights) may also help fight abdominal fat, according to Harvard Health.

Diet also plays a key role in reducing visceral fat, with numerous studies promoting a low-carb diet to combat the harmful belly fat.

In an eight-week study including 69 overweight men and women, scientists found that people who followed a low-carb diet lost 10 percent more visceral fat and 4.4 percent more total fat than those on a low-fat diet.

Furthermore, the ketogenic diet, which drastically reduce carb intake and replaces it with fat, may also help reduce visceral fat.

A study including 28 overweight and obese adults found that those who followed a ketogenic diet lost more fat, especially visceral fat, than people following a low-fat diet.

See more here:
How to get rid of visceral fat: Best supplement to reduce the harmful belly fat - Express

While there are plenty of fad weight loss diets available on the Internet for free chances are that most of these diet plans will not be able to help you achieve your target weight loss goal. Why? Well, most fad diets are time bound eating practices, which essentially suggest starving yourself or cutting down a major chunk of healthy food from your life in order to lose weight.

Reads kind of nutty right? It indeed does. Not only is this approach to weight loss extremely unhealthy, it is also unreliable as once you stop following it, youll regain all the weight youve lost in a matter of days/months. So, what can one do to lose weight in a sustainable manner? To take a page from 22-year-old Sumeet Manohares book, you can first: not starve yourself and second: not put a timeline on your weight loss journey.

Sumeet tells us that it took him 3 years to trim from a whopping 106 kgs to 78 kgs. Being obese never felt good to me. I always imagined myself as a really fit and confident person, who could wear fit clothes. So, in 2015 I decided to join the gym, he says.

But during my transformation journey, I lost hope so many times! Until, I came across a friend's Super Fat to Super Fit transformation. At that time, I had given up on my own journey but after looking at her before and after pictures, and also just talking to her about the whole process, I was motivated to get back to the gym and try once again, he adds.

By 2018, Id lost 28 kgs and heres the real deal, I didn't lose any weight by following a strict diet, starving myself or by taking any fat burners. My weight loss journey has been a slow yet effective ride. Below is the weight loss routine that helped him lose 28 kgs.

I joined a gym in May 2015 and started working out. It was disheartening to find out that I couldn't even do a single push-up. I had to do it by resting my knees on the floor. In fact, initially, I struggled with many simple exercises.

As I got comfortable with exercising, I started making changes in my diet as well. I reduced eating junk food though I never ate excess of it and also made these changes:

- Walk for 20 minutes after dinner or perform Vajrasana after eating (it aids faster digestion)

- I stopped sitting and watching TV as soon as I finished eating as well

He also charted a new diet plan for himself, minus the junk food.

My diet was and still is centered around homemade Indian food. I have never consumed any kind of supplements.

Early Morning: Warm Water with Lemon juice

**Breakfast: Oatmeal (Oats + Milk + Apple/Banana + Homemade Peanut Butter) / Poha / Upma with Oats / Oats Apple/Banana Pancakes / Omelette

Lunch: Vegetables with 2 Rotis, Daal & Salad

Evening Pre-Workout: Chana Chaat (Homemade) / Any Fruit / Brown Bread with Peanut Butter

Post-Workout: 2 or 3 Egg Whites

Dinner: Vegetables + 2 Rotis, Salad and Daal / Rice with veggies or Biryani.

Snacks (through the day): Nuts / Peanuts / Homemade Peanut butter (Without Sugar)

During the initial period, I followed a basic workout routine which was mostly just cardio.

I did Cardio which included Treadmill, Cross trainer, Cycling for 15 min each. And other exercises such as Push ups, Body Weight Squats, Skipping, Bending with Stick, etc.

ALSO READ: The best cardio machine for every type of workout

After a month of doing only cardio, my trainer included weight training in my workout schedule. This was the routine that I followed:

Monday - Chest & Shoulders

Tuesday - Biceps & Triceps with Cardio

Wednesday - Legs & Back

Thursday - Chest & Shoulders

Friday - Biceps & Triceps with Cardio

Saturday - Legs & Back

Even though this was an effective workout routine, I couldn't lose much weight. I was hardly consistent at gym and skipped twice or thrice a week. Also, I believe that my mind was not at peace at that phase. I left the gym multiple times and lost all hopes to get in shape. It was in July 2017 when I decided to give one more try. However, this time even my parents thought that gym isn't the right option for me as they saw my progress over the years. But, I was pretty sure that I'm gonna prove everyone wrong this time.

In 2017, I started following the below Full Body Exercise regime. And I exercised twice a day for three months, at home in the morning and at the gym in the evening (not advisable to everyone).

Morning - Exercises for Abs which included overall core strength exercises (With the help of an Android app)

Evening - Gym

Monday - Chest, Shoulders and Biceps

Tuesday - Cardio and Full Body Exercises

Wednesday - Legs and Back

Three sets of each exercise with 12-15 reps.

1. Plate & Dumbbell (12 3)

2. Burpees (12 3)

3. Superman + Burpees (12 3)

4. Jumping Jack (30 2)

5. Skipping (100+)

Stay consistent. This is the only advice or tip I could give to anyone trying to get fit by losing weight or even gaining it. Do not just focus on losing weight. Do not check weigh scale every single day instead focus on your workout. Because once you start loving and enjoying working out, you won't need to check your weight. You could feel being healthy, light and much happier than before. Also, don't join gym just because I or someone else did. Do what you really enjoy doing. Go run, do Yoga, play a sport or whatever activity that you enjoy.

Disclaimer: The diet and workout routines shared by the respondents may or may not be approved by diet and fitness experts. GQ India doesn't encourage or endorse the weight loss tips & tricks shared by the person in the article. Please consult an authorised medical professional before following any specific diet or workout routine mentioned above.

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See the original post:
How to lose weight like this guy who lost 28 kgs with a unique approach to weight loss instead of dieting - GQ India - What a man's got to do

(CBS4) Who is the most popular doctor in America? Why, Dr. Google of course.

In 2019, more than 93 million of us turned to the good doctor for medical advice and information.

So, what did we want to know?

This week, Google shared the ten health questions people searched for the most from January 2019 to early December 2019.

Now comes the tricky part. Dr. Google can be a fine source of health care information, but you still need to be careful youre not referred to a quack. Avoid sites that want personal information, want to sell you something, or offers a magic remedy. And by all means, EXTREME black box warnings about going to a chat room, or a social media group for info or advice.

Here are a few of my favorite health sites for patients:

my.clevelandclinic.org/health

hopkinsmedicine.org/patient_care/

mayoclinic.org/symptom-checker/

nationaljewish.org/health-insights(Especially good for asthma and other respiratory conditions.)

There are many, many more great sites. Ask your doctor for a recommendation. A nurse line is an added resource for advice.

And dont forget, when it comes to Dr. Google, a second opinion is always a good idea.

Originally posted here:
The Top 10 Health Questions We Asked Dr. Google In 2019 - CBS Denver

Opinion As an NHS dietitian, I know this is not a healthy approach to food

Thursday, 12th December 2019, 12:09 pm

Updated Thursday, 12th December 2019, 1:50 pm

Nutrition is not as simple as calorie content. Oversimplifying it is dangerous

Food is so much more than its calorie content. It should be enjoyed, balanced and taste good.

Labelling food with how much walking or running it equates to, as proposed on Wednesday, will further damage society's relationship with food, demonising calories and promoting compensatory exercise. All, while not taking into account the calories required for our bodies to survive.

Calories are a measure of the energy our bodies need to function. It is wrong and potentially damaging to imply that each calorie consumed needs to be "burnt off". We use 60 to 75 per cent of our daily calories at rest, known as our basal metabolic rate. This can vary hugely from person to person and is affected by a multitude of factors including body composition, gender and health.

Exercise is framed here as a punishment for eating (Photo: Henning Kaiser/DPA/AFP/Getty)

We need these calories to perform basic functions like breathing, digestion, and temperature regulation. Being encouraged to use every calorie consumed - which I believe this physical activity calorie equivalent (PACE) food labelling would insinuate - is wrong and dangerous.

Beat, the eating disorders charity, estimates 1.25 million people in the UK have an eating disorder. Exercise is a common compensatory behaviour seen in patients with eating disorders and this proposal has the potential to trigger and hinder their recovery. I would even go as far to say that this calorie demonising labelling could increase the prevalence of disorders such as orthorexia - an unhealthy obsession with eating "pure food".

As an NHS dietitian, I consider having a healthy relationship with food to be the most important element of a balanced diet. A low-calorie diet does not equal a healthy or balanced one and focussing purely on the calorie content of food disregards its value from other important nutrients including protein, fibre, healthy fats, vitamins and minerals.

I spend most of my time helping patients find ways to increase the nutritional value of their diet, often by choosing calorie-dense foods to help ensure they are getting enough energy for their body to efficiently function and recover. A healthy diet is not one size fits all and PACE labelling could increase feelings of guilt and punishment around foods high in calories.

Read More

The study behind this labelling recommendation found that when foods were displayed with exercise, fewer calories were selected when compared to comparative food labelling methods. There are many flaws to the practical application of this studies results.

The study did not look at long term results of this labelling method, consider the effect of PACE labelling on the participants relationship with food, assess if this had any effect on physical activity level, or measure participant weight changes. So it seems like a stretch to imply that this labelling method can improve health.

Exercise is framed here as a punishment for eating. We all know exercising is beneficial for health, it should be something that we enjoy and encouraged for all its great benefits for physical and mental health, not something to make up for food consumption or to shrink our bodies.

It is also misleading as an 18-year-old girl will not use the same amount of calories running for 20 minutes as a 50-year-old 100kg man. Furthermore, the PACE labelling method completely excludes anyone unable to walk or run. If this method was to be widely used it discriminates against anyone with mobility problems.

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Obesity is a complex issue affected by an individuals socioeconomic status, food environment, genetics, and education.

Ultimately, increased numbers of specialist health professionals, including psychologists and dietitians, and improved access to these services by the patients are whats required to support this issue.

Eloise Garbutt is an NHS dietitian.

See the article here:
Labelling food with exercise to 'burn it off' could increase obesity and eating disorders - inews

Edith Cowan University researchers have found that a chronic disease affecting up to 80 per cent of overweight people may be causing an iron deficiency that simply leaves them too tired to get off the couch.

Fatty liver disease affects about one in three Australians and is often associated with being overweight or obese. If left untreated, it can lead to liver cirrhosis, liver cancer and increase the risk of a heart attack.

But the remedy to lose weight through diet or exercise is often difficult to achieve for affected individuals.

In other words, it may not be laziness but lack of iron which is important for energy production that is stopping people with non-alcoholic liver disease from addressing their condition.

This research indicates that people with the condition may be physiologically incapable of exercise due to iron not being available for the body to use normally, which is very similar to the effects observed in people who have a true iron deficiency.

The new research, under the direction of lead researcher Professor John Olynyk, will help guide future treatment for people with non-alcoholic fatty liver disease.

The body is like a car

ECU researchers measured the cardiovascular fitness of 848 17-year-old West Australians enrolled in the well known Raine Study and found that those with non-alcoholic fatty liver disease had lower physical work capacity independent of their weight.,

This reduced physical work capacity was also strongly related to parameters suggesting that iron is not being made available to the body for normal metabolism.

Professor John Olynyk said the study showed that people with non-alcoholic-fatty-liver disease had lower cardiovascular fitness, which was likely caused by a functional iron deficiency.

We know that an iron deficiency can cause lethargy and fatigue, making it harder for people to exercise, he said.

What is likely happening is that non-alcoholic fatty liver disease is impeding the bodys ability to provide adequate iron into the blood to fuel processes such as energy and blood cell production.

To use an analogy, if you imagine the body as a car and iron as its fuel, what is likely happening is that there is plenty of iron, or fuel in the tank, but the non-alcoholic fatty liver disease has caused the fuel line to shrink, so theres not enough fuel can get to the engine.

Diet before exercise

Professor Olynyk said the findings were useful for guiding the treatment of non-alcoholic fatty liver disease.

The main treatment is lifestyle change aimed at reducing weight, primarily achieved through exercise and a modified diet, he said.

In particular, there is evidence published by other investigators in the field that the Mediterranean diet can reduce the severity of non-alcoholic fatty liver disease. This is because it is high in foods like fruit and vegetables and whole grains, which have anti-inflammatory properties.

This research shows that it may be more effective to first focus on new ways to improve the availability of iron to the body, enabling diet and physical activity to have better and more sustained effects on weight and the severity of their non-alcoholic fatty liver disease.

Read the original here:
Diet, Not Exercise, May Be Key to Addressing Our Biggest Cause of Liver Disease - Global Health News Wire

The year is drawing to a close, and with that comes a wrap ofthe fitness and diet choices that ruled the web and influenced our health decisions for 12 months. To find out which workouts and diets shined bright in 2019, Google studied an aggregation of trillions of searches on its platform and combined it with data from Google Trends. The result? The top trending searches that had a high spike in traffic over a sustained period in 2019.

Popular favorites like the keto ultra diet and plank exercises made Googles Year in Search report along with newer breakout trends like the Dr. Sebi diet. Whether weight loss is at the top of your 2020 goals or youre exercising for the first time, check out the popular workout and diet searches from 2019.

Working Out While Traveling: How You Can Do a Total-Body Workout in Your Hotel Room

Workouts that saw a spike in 2019 were medicine ball workouts, flat stomach workouts, mirror workouts, the Bikini Body Guide workout andbody groove workouts a workout routine that relies on dance moves to help exercisers burn off calories.Bungee workouts, plank exercises and themanduu exercisea concept that uses electrical muscle stimulation (EMS) for a custom exercise experience also topped the list.Theone punch man workout, an anime-inspired workout, was also among the most searched work out terms.

A few diet regimens also saw a search increasein 2019. The intermittent fasting diet, 1200 calories diet, keto ultra diet and the GOLO diet were all common searches. The Dubrow diet, Sirtfood diet, endomorph diet,Dr. Sebi diet, Noom diet and the no carbs no sugar diet were also included in Google's list. Before embarking on any popular diet though you should be warned,many popular diets with have hidden side effects.

Read more from the original source:
The Top Trending Diet and Exercise Searches of 2019 - Yahoo Lifestyle

Andre Drummond is a lot of man: 610 and 279 pounds, to be more precise. Those measurements guarantee that the 26-year-old Detroit Pistons center isnt going to blend in with the masses while walking down the street, playing Top Golf, or bowling (the latter two are some of his favorite off-the-court activities), but hes mostly cool with that. Case and point: His Today With Dre series on Overtime, in which he allowed cameras to document the full extent of his comings and goings, including his musical-minded pursuits. The series shows hes a defensive menace whos just as unfazed by an incoming dunk attempt as he is the prospect of spitting bars at a venue. My music is a little bit of everythingR&B, hip-hop, EDM, he says. I have a bunch of songs that Ill get out sooner or later.

Like his Overtime series, Drummonds admitted beer-a-day habit has also piqued the Internets interest of late. But I wanted to find out what really gives him his pre-game fuel, so we chatted prior to him catching a flight to Chicago. Given Drummonds stature, you wouldnt be off-base assuming he eats enough to feed a family of four at every meal. As it turns out, however, the current league-leader in rebounds is only swallowing up boards at a proficient rate.

GQ: Youve been in the NBA for eight seasons now. Whats the best piece of advice youve been given about staying healthy since you started?

Andre Drummond: Its all about icing, stretching, the things you eat, the time you go to sleep, and the pregame preparation. I like to eat a lot of fruit and starchy things to give myself more energy before games. But its the off-the-court things, like how Im taking care of my body, that are most important.

What time do you usually get up in the morning?

Im up around 8 or 8:30. But if were talking about the morning after a game, then Im up much later, like 12ish. I try to get eight or nine hours of sleep a night, and if I dont, Ill make sure to take a nap.

Whats your breakfast routine?

I work directly with my personal chef on my breakfast and making sure I have enough fats and proteins to perform without overindulging. In the morning, Ill drink some water, and then its usually an omelet with some potatoes and veggies. Ill go for any vegetables except zucchini, really. I hate that stuff. Ive also cut out red meat and processed foods, which means that I dont eat steak or anything crazy like that. I feel a lot better since Ive done that. My diet is now a lot of fish and leafy green vegetables, except I dont like tilapia.

Are you a coffee person?

I drink coffee a lot before my games. I take it with cream and sugar.

Okay, so after the coffee, what happens?

Well my meals and overall food intake are pretty low, because I dont want to eat too heavy. Some days its just a bunch of fruit, plus the omelet with potatoes and veggies in it. Ill maybe have a cup of tea. I also take fish oil and vitamin D supplements. The natural sugar in the fruit plus some coffee before go-time acts as a natural pre-workout. I also usually drink Essentia Water and my chef makes his amazing homemade peanut butter chocolate chip protein bars. That's pretty much it. The last thing I want is to feel like Im weighed down on the court.

It sounds like youre not too big on lunches.

It really just depends on the day. Same for if I eat after the game, which depends on whether my adrenaline is still pumping. I definitely wont eat right away when were done playing. Usually my post-game meal is something like pasta to get the carbs back that Im missing. Over the past year, I completed a few physical tests to figure out what works best for my body, and I got leaner and stronger in the process. Ive tried a ton of different diets, but this has been one of my best seasons yet.

Has anyone ever told you that youre not eating enough?

I know what works for my body. I have a chef and we have a team nutritionist who helps us figure things out. When I wake up in the morning, the food stuff is all done. I just go down to the kitchen and grab it.

I read recently that you drink a beer every day. Whats the deal with that?

I went through a phase where I did that to make sure that I was getting in the calories I needed. If I drink a beer, its usually a Miller Lite or Corona. Sometimes, that one beer would get me to the right place, and especially in the summer, its nice. Now its not always the same routine.

You mentioned drinking water in the morning. How much are you consuming throughout the day?

I probably drink about a gallon-and-a-half a day. Im the guy thats carrying a jug with me everywhere I go.

This interview has been edited and condensed for clarity.

Real-Life Diet is a series in which GQ talks to athletes, celebrities, and everyone in between about their diets and exercise routines: what's worked, what hasn't, and where they're still improving. Keep in mind, what works for them might not necessarily be healthy for you.

The Real-Life Diet of Gunnar Peterson, Trainer to the Los Angeles Lakers and Other Assorted Stars

Peterson wakes up at 3:45 a.m. so he can squeeze in his own workout before training clients like the Kardashians and Kate Beckinsale.

Originally Appeared on GQ

See more here:
The Real-Life Diet of Andre Drummond, Whose Offseason Routine Featured a Beer a Day - Yahoo Lifestyle

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How a decade of major discoveries has dramatically changed how we think about conception.

On July 24, 2003, Robert G. Edwards, a physiologist who pioneered the in vitro fertilization technique, made the following remark: I wanted to find out exactly who was in charge, whether it was God himself or whether it was scientists in the laboratory, adding, It was us.

Since the first I.V.F. baby was born in 1978 25 years before Dr. Edwards made that statement and 32 years before he would win the Nobel Prize in Medicine for developing the technique the seemingly supernatural ability to unite sperm and eggs outside the body and implant them directly into the womb has been heralded as the most remarkable achievement in fertility to date. Its allowed millions of babies to be born that otherwise would not have been born; I think its been revolutionary, said Dr. Mindy Christianson, M.D., medical director of the Johns Hopkins Fertility Center.

Now, as this decade comes to a close, what kinds of major advancements in fertility science have we seen since 2010? While were still a far cry from a future in which a woman can analyze her egg reserve with the tap of a smartphone, or in which a man can get a running tally of his sperm count with the flick of a smartwatch, the past 10 years have been no less remarkable than decades past. Here are some of the biggest breakthroughs in fertility since 2010.

Scientists have been able to easily freeze embryos and sperm for decades, but it wasnt until 2012 that egg freezing went from an experimental procedure to a promising insurance policy for thousands of women in the United States, including cancer patients, single women and those who want or need to delay having children. The ability to successfully freeze eggs over the last 10 years has been one of the bigger, if not the biggest, achievement, Dr. Christianson said.

This is largely because of the development of a flash-freezing technique called vitrification. Previously, human eggs which are the largest cells in the human body and hold a lot of water were challenging to freeze because ice crystals would develop and damage the cell. But with vitrification, experts can freeze the cells so quickly that ice crystals dont have a chance to form.

[Wait, is that another ad for egg freezing?]

I.V.F. is expensive, not to mention emotionally and physically taxing. Its important, then, that providers select the best and most competent embryos from the petri dish in the lab to implant into the womb. While experts have for more than 10 years been able to scan the genetic material of these rudimentary cells for signs that they might fail to implant or result in miscarriage or birth defects, genetic testing of embryos has become more mainstream, affordable and reliable in the past decade.

When I was still in training seven or eight years ago, Dr. Christianson said, it was cost-prohibitive for most patients to do genetic testing of their embryos. Today, she said, companies charge per embryo, making it much more affordable.

Another advancement that has allowed providers to select the most robust embryos to implant: the ability to grow them in the lab until they reach what is called the blastocyst stage (which occurs five or six days after fertilization). If an embryo is healthy enough to survive until this stage outside the body, the thinking goes, it has a higher chance of sticking around after implantation. Such advances in selecting the best embryos have also allowed providers to transfer just one, rather than multiple, embryos into the womb at a time, reducing the risk of twins or more and thereby reducing risk in the pregnancy.

With the right embryo, most women will have a very high chance of live birth, and were able to decrease that risk of multiples, Dr. Christianson said. So I think thats one of the revolutionary breakthroughs.

[Read more about I.V.F. and what it costs.]

Before the 2010s, the only parenting options for women who didnt have a uterus or who couldnt carry a pregnancy were adoption or surrogacy. But in 2013, doctors in Sweden made history after a 35-year-old patient, who had had a uterus from a 61-year-old woman transplanted, gave birth to a healthy boy. In 2016, doctors in Brazil advanced the technique even further, announcing that a 32-year-old woman had given birth with a uterus that had been transplanted from a deceased donor.

While these breakthroughs are huge for reproductive science, Dr. Christianson said, uterine transplants are also expensive. Its the only transplant we know of that is for a one-time use to make a baby and then you dont need the transplant anymore, she said. So while this procedure is revolutionary for the right type of patient, it most likely wont become mainstream.

One of the biggest achievements for male infertility, said Dr. Peter Schlegel, M.D., urologist in chief at New York-Presbyterian Hospital/Weill Cornell Medical Center and president of the American Society for Reproductive Medicine, has been in the treatment of those with severe infertility. Particularly in men who produce little to no sperm, he said, or who had previously been rendered sterile because of treatments like chemotherapy.

A technique called micro-TESE which was developed in the late 1990s, improved in the 2000s and more popularized in the past decade, Dr. Schlegel said involves identifying areas of the testicle that have the best sperm production and microsurgically removing those sperm for use with assisted reproductive technologies like I.V.F.

A lot of those men are now considered treatable, Dr. Schlegel said, whereas before, our understanding of how and whether you could treat them was pretty limited.

[What to know about male infertility.]

Intrauterine devices have had a decidedly rocky past. The first known IUD-like device for humans, developed in 1909, reportedly involved inserting a ring made of silkworm gut seriously into the uterus. Since then, IUDs have advanced from silkworm rings wrapped entirely in silver (which, surprise, turned womens gums blackish-blue) to countless variations of loops, coils and plastic Ts. In the 1970s, the Dalkon Shield IUD was infamously pulled from the market after its poor design increased womens risk of infection and infertility. But in the late 1980s and early 2000s, the IUD regained popularity with the Food and Drug Administrations approval of the copper ParaGard and levonorgestrel-releasing Mirena.

It wasnt until 12 years later, in 2013, that the F.D.A. approved the next IUD, the Skyla, which is a low-dose hormonal option. In 2015 and 2016, the agency approved even lower-dose options the Liletta and the Kyleena. These IUDS have really revolutionized contraception because theyre highly effective and they are very well tolerated, Dr. Christianson said.

They are also valuable therapies for women with certain conditions, like heavy uterine bleeding, which in the past was mainly treated by performing a hysterectomy. Less women are undergoing hysterectomies because their symptoms can be treated with an IUD, Dr. Christianson said.

For women who cant freeze their eggs, like prepubescent girls or women who suddenly need cancer treatment, ovarian tissue freezing has offered a chance for them to preserve their ovaries for later reimplantation and use. The procedure has been available for about 20 years, Dr. Christianson said, but within the past 10 years, there have been several advances in the technique and more live births as a result.

Because most people who have frozen ovarian tissue havent needed to use it yet, the procedure is still considered experimental. Hopefully at some point the experimental label will be lifted, Dr. Christianson said.

Its perhaps not surprising that diet, sleep and exercise play a role in fertility. And while scientists are still in the early stages of sussing out how the food we eat and the sleep and exercise we get translate to prolificacy, recent albeit limited evidence is offering more clues.

A 2018 review from scientists from Harvard University, for instance, found that folic acid, vitamin B-12, omega-3 fatty acids and a Mediterranean diet were linked with better fertility in women, while unhealthy diets, like those high in trans fats, red and processed meats, added sugars and sugar-sweetened beverages, were associated with worse fertility. In men, similarly, researchers have found that those who follow healthy diets tend to have better fertility, while those with diets high in saturated and trans fats are worse off.

There is also budding evidence about how exercise and sleep affect virility in men, Dr. Schlegel said and some of the results seem counterintuitive. Moderate exercise, for instance, seems to be beneficial, but when those men exercise more vigorously such as by cycling for more than five hours per week, he said their sperm counts can be reduced by nearly half. Men who get six to eight hours of sleep per night tend to have better sperm production and fertility than those who get more or less, Dr. Schlegel said.

While many of these studies are promising, most are based on observational data, Dr. Schlegel said, so its not yet clear why researchers are seeing such associations, or whether changes to diet, sleep and exercise can really alter your fertility in the first place.

[Does stress actually affect fertility?]

For the bulk of the past century, fertile and pregnant women have been excluded from most clinical trials over fears of potential harms to future or current pregnancies. But as a result, there is a huge gap in knowledge about how safe and effective certain drugs are for women in general (case in point, the thalidomide debacle of the 1950s and 1960s).

More recently, there has been a major push for better representation of women in medical research.

For womens health in general, I think that this is a breakthrough, Dr. Christianson said. When we look at cardiology studies and other types of studies, a lot of times theres been more men than women. So I think focusing studies on women has been revolutionary for womens health.

While the textbook signs and symptoms of pre-eclampsia have been well understood high blood pressure, protein in the urine, swelling, headache, trouble breathing and more scientists still dont understand what causes the condition, and diagnosing it and predicting those who will develop it are challenging. Similarly, the most effective treatment for pre-eclampsia is also the least satisfying one delivery.

But research in recent years has helped improve our understanding of how the condition progresses in the body, said Dr. Ananth Karumanchi, M.D., a professor of medicine at Cedars-Sinai Medical Center in Los Angeles. And that research has led to development of the first blood test which has been widely used abroad that can accurately diagnose the condition in women who have pre-eclampsia. While the test has not yet been approved in the United States, Dr. Karumanchi said that its development was a big deal because it might lead to new therapies for pre-eclampsia within the next decade.

The definition of pre-eclampsia was revised in 2014, based on new evidence, to capture women who have the condition but who dont have only the classic signs, like high blood pressure and protein in their urine. Now, for instance, it is well understood that some women may have only organ problems, such as with their liver or kidneys, before high blood pressure and protein in the urine set in.

New research has also offered clues on how women who are high risk might thwart the condition completely. A double-blind, placebo-controlled trial published in 2017, for example, found that taking 150 milligrams of aspirin daily from 11 to 14 weeks of pregnancy through the 36th week could reduce the chances of developing pre-eclampsia. Though because high doses of aspirin can also be associated with certain risks to a pregnancy, like pregnancy loss or certain birth defects, you should never start taking it without consulting your doctor.

In the past, a cervical cancer diagnosis might have meant the end of your ability to conceive, because standard treatment was to remove all or part of the uterus. But recent advances in fertility-conserving surgeries have given cancer patients more options. A procedure called a trachelectomy, for instance, which has been around for decades but has become more commonly used in recent years, allows doctors to remove only the cervix in patients who have cervical cancer. And as a result, shes able to preserve her uterus for future pregnancy, Dr. Christianson said.

Similarly, there has been a push in recent years to treat endometrial cancer more conservatively, Dr. Christianson said, by trying hormonal therapies before removing the uterus.

Julia Calderone is a senior staff editor for NYT Parenting. Follow her @juliacalderone.

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10 Years of Fertility Advances - NYT Parenting - NYT Parenting

Nearly a fifth of the nations youngestuninsured children live in Texas, a stark reminder that the state has some of the most restrictive policies in the nation governing healthcare benefits for its most vulnerable residents.

More than 8% of Texan children under the age of 6 are not insured, according to a report released Wednesday by Georgetown University researchers. Thats almost double the national rate.

The report is not surprising. A similar report, released in October, found that Texas had the highest uninsured rate in the nation among all children up to age 18.

Still, Elisabeth Wright Burak, one of the report's authors, called the study's results very sobering, citing the recent reversal in a decade-long trend of falling uninsured rates.

Texas' increasing rate of uninsured small children mirrors a national trend, which has policy experts like Burak worried. The last few years have been a period of strong economic expansion, when more people would typically seek health insurance.

But since 2016, Texas' uninsured rate among young children increased by a percentage point.

They already have a lot of uninsured kids, and theyre going in the wrong direction, Burak said, referring to states like Texas during a webcast announcing the report.Medicaid enrollment has been linked to a variety of better outcomes later in life, from financial security to college completion, she added.

Only Alaska has a higher uninsured rate among children under age 6, a consequence of that states large population of indigenous people, who are far more likely to be uninsured. Texas problem, however, can be traced directly to decisions by state policymakers.

Whether children are insured depends on their parents. Those who can't afford it often obtain coverage through government programs like Medicaid and Children's Health Insurance Program, and participation by parents in these programs has been linked to a variety of better outcomes for their children later in life, from financial security to college completion, Burak said.

Texas is one of 14 states where policymakers have elected to not accept federal funding to expand Medicaid coverage to more low-income families. Young children are more likely to be covered in states that have adopted the Medicaid expansion,Burakadded.

The crisis disproportionately impacts Hispanic families. Nearly 15% of Hispanic minors in Texas are uninsured, according to a separate report by the Georgetown researchers.

The Trump administration recently published changes to the "public charge" rule this year, which would allow immigration officials to consider enrollment in Medicaid when reviewing applications for green cards. The changes were blocked by federal judges after several states filed suit, but two of those injunctions have been lifted in recent weeks, paving the way for an eventual implementation of the rule change.

Around a quarter of Texas children have at least one parent who is not a citizen, according to theCenter for Public Policy Priorities, an Austin-based policy institute. The latest numbers on low insurance rates among Hispanic children reinforce reports of the impending rule's "chilling effect." Immigrants, reports say, are forgoing lawful benefits out of fear of later being denied citizenship.

The state has put up other roadblocks as well. According to research by the center, participation in the state's Medicaid and CHIP programs has dropped in recent years, a result of cuts in outreach funding and new rules that add extensive red tape to the programs' enrollment process.

The cost of paying for care of the uninsured ultimately falls on taxpayers. In 2018 alone, the Parkland Health and Hospital System gave out more than $1 billion in un-reimbursed care. A third of its budget comes from local property taxes.

The hospital stations social workers and financial counselors in its maternity wards to assist uninsured mothers in accessing benefits, saidBart Ensley, the hospital's director of patient access.

"We try to do what we can to help," he said.The hospital is expanding pediatric care to community clinics across the Dallas area to make follow-up appointments more convenient.

David Murphy, a researcher at the think tank Child Trends, explained to the Observer earlier this year how a lack of health insurance can create mounting problems for young kids, from irregular visits to the pediatrician to missed immunizations.

When children don't have that regular check-in with a pediatrician or family practice provider, issues around sleep, diet, exercise those kinds of things that are really important to stay healthy and to do well in school those can suffer, he said.

Lucas Manfield is an editorial fellow at the Observer. He's a former software developer and a recent graduate of Columbia Journalism School.

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More and More Very Young Children Across the Nation Lack Health Insurance. Guess How Texas Fares. - Dallas Observer