It's Valentine's Day, and love is in the air. But so are big stock gains, with the benchmark S&P 500 and technology-heavy Nasdaq Composite hitting all-time record highs earlier this week.

A number of top money managers have said that you shouldn't fall in love with your investments, but that's a pretty hard suggestion to follow when there are so many great businesses you can own a piece of and call your very own for a long time. Below, you'll find seven stock market sweethearts that offer a combination of competitive advantages, superior branding, and long-term growth opportunities that'll have you swooning.

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Amazon (NASDAQ:AMZN) is pretty much at its all-time high -- and so what? Not only is Amazon responsible for close to 40% of the United States' e-commerce retail sales, according to eMarketer, but its cloud services business, Amazon Web Services (AWS), is growing at a significantly faster pace than its retail operations.

Why's this important? AWS generates substantially juicier margins than traditional retail sales, meaning that as AWS becomes a greater percentage of total sales for Amazon, the company's cash flow and profitability should soar.

According to Wall Street estimates, Amazon's cash flow per share is expected to nearly double between 2019 and 2022, placing the company at a significant discount to its average price-to-cash-flow ratio over the past five years. Assuming Amazon continues to dominate with its cloud offerings, considerable upside remains for its share price.

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Like Amazon, robotic-assisted surgical system developer Intuitive Surgical (NASDAQ:ISRG) is a company that just continues to grow stronger over time. Although Intuitive Surgical earns quite a bit of revenue from the sale of its pricey da Vinci surgical systems ($0.5 million to $2.5 million per machine), these systems are costly to build and therefore result in only modest margins.

Rather, this company generates the bulk of its profits from selling instruments with each procedure, as well as servicing its systems. As more da Vinci systems are installed, these higher-margin revenue streams become a larger percentage of total sales. Translation: Operating margins should increase over time.

What's more, Intuitive Surgical is just scraping the tip of the iceberg on soft-tissue surgeries with da Vinci. Aside from prime market share in gynecology and urology procedures, there's a long-term opportunity to grow its market share in colorectal, thoracic, and general soft-tissue surgeries. In short, this is a razor-and-blade business model with an extremely long growth runway.

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Cannabis hasn't exactly been a top-performing investment over the past 10-plus months, but that hasn't stopped marijuana real estate investment trust (REIT) Innovative Industrial Properties (NYSE:IIPR) from thriving. This REIT, which acquires medical marijuana growing and processing sites then leases them out for long periods of time, currently owns 49 properties in 15 states.

These assets have a weighted-average lease length of 15.6 years, with its $538 million in invested assets yielding an average of 13.2%. In other words, Innovative Industrial Properties should have a complete payback on its invested capital in just about 5.5 years.

Furthermore, the only high-yielding cannabis stock continues to benefit from vertically integrated multistate operators in the U.S. having limited access to financing. As long as cannabis banking reform is swept under the rug or kicked down the road on Capitol Hill, Innovative Industrial Properties' key advantage remains in place.

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While there's no denying that AT&T (NYSE:T) isn't the telecom growth giant it once was, there's also no overlooking its rock-solid business model or longer-term growth drivers. For instance, the rollout of 5G networks, while initially costly for the company, should lead to a steady wave of smartphone upgrades. Increased data usage is great for AT&T and its bread-and-butter wireless division, since data is where its juiciest margins lie.

Furthermore, AT&T is a content giant that should be able to utilize its purchase of Time Warner to its advantage. The addition of TNT, TBS, and CNN provides a lure to new consumers, especially streaming customers, while bolstering AT&T's ad-pricing power.

Sporting a 36-year streak of increasing its dividend, AT&T and its 5.4% yield are about as safe as it gets on the income front.

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It's pretty incredible how quickly Bank of America (NYSE:BAC) has transformed since the Great Recession. A number of settlements tied to the mortgage meltdown are now firmly in the rearview mirror, and BofA has done a bang-up job of reducing noninterest expenses to improve profitability. This has been accomplished by closing some of its physical branches and focusing on the next generation of consumers via digital banking and mobile apps.

Bank of America is also expected to benefit from the long-term normalization of interest rates. There's not a money-center bank that's more sensitive to interest rates than BofA. If interest rates wind up nearing their historic average, it should lead to billions in added net interest income for Bank of America. Following a $37 billion capital-return plan, announced in June 2019, BofA's capital returns could be robust if the fed funds rate finds its way back to 3%.

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Maybe it's apropos that a list of stock market sweethearts includes social-media giant Pinterest (NYSE:PINS), which is all about sharing your interests and things you like/love with the world. Last year, Pinterest saw its sales rise 51% to $1.14 billion, with global monthly active users (MAUs) rising 26% in the fourth quarter to 335 million from the year-ago quarter.

The Pinterest story is really all about international growth. In 2019, U.S. MAUs increased by only 8%, with the bulk of the gains coming from international markets, with MAUs up 35%. What's more, average revenue per user (ARPU) in foreign markets is really beginning to take off.

ARPU more than doubled on a full-year basis to $0.54 from $0.25. Pinterests' global ARPU level is still way behind rival Facebook, but it clearly demonstrates that advertisers are willing to pay up for eyeballs on Pinterest's platform, which, in turn, suggests that the company's ad-pricing power is improving.

With a turn to recurring profitability expected in 2020, Pinterest looks to be a solid candidate to "pin" to your portfolio.

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Historically, there's just never a bad time to buy into payment-processing giant Visa (NYSE:V). Visa is a dominant force in the U.S. that's responsible for more than half of the country's network purchase volume. It's also laying the groundwork to be a major payment-processing provider in markets well outside the United States. The 2016 purchase of Visa Europe significantly increased its global merchant network, and the company has the ability to continue growing its overseas market share as underbanked regions of the world, such as the Middle East and Africa, improve banking and credit access.

The beauty of Visa's operating model is that it's not a lender. Sure, this doesn't allow the company to double dip like some of its peers and earn interest while also lending money. However, it also protects Visa from credit delinquencies when U.S. or global economic growth contracts. This sole focus on being a payment facilitator and payment innovator is what allows Visa to charge higher.

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7 Stock Market Sweethearts You'll Want to Call Your Own - Motley Fool

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Much has been spoken of Henry Cavills punishing diet and exercise regimes, unsurprisingly for someone synonymous with Superman, with real-life comic-book good looks. Since taking on the role of genetically enhanced monster slayer Geralt of Rivia, The Witcher workout (involving daily fasting, cardio and weights session) has become a big search term, while his intense dehydration diet employed for shirtless scenes went viral. But behind the cape or leather armour donned for his characters, the British actor has some relatable rituals that non-superstars (or superheroes) can easily employ.

Cavill confirms there's a lot of gym work in his weekly schedule. When hes shooting a movie or series, to make sure that I can survive it, he trains twice a day.

Yes, its definitely for aesthetic reasons, he admits, but its also for the ability to actually manage an arduous shoot for seven to eight months or whatever it may be. Working 14-hour days does take its toll.

Regardless, his ethos is about trying to stay as healthy as possible. That means clean eating, too.

The most important thing for diet is knowledge and preparation, he tells us. And its very difficult for us as people who are busy running around doing our jobs to gain all that knowledge. His solution? If you can find a person or company who can do the knowledge part for you, so you know what your goals are, they can at least give you the information so you can do food prep, for example. This is is enormously helpful, Cavill says, allowing you to be in control of your nutrition.

I have found food prep to be a massive saving grace for me, time-wise and health-wise

I have found food prep to be a massive saving grace for me, time-wise and health-wise, because then I know what Im having and when. Therefore, he can eat as cleanly as possible when working, and then once a week Ill have a meal that I really want to have and thatll be off-diet.

Cavill will suffer for his art, but he knows its just that. On The Graham Norton Show he recently revealed how he would limit his water intake when filming for The Witcher. On the first day youll have a litre and a half, and the second day half a litre, and then the third day, no water, and youll shoot on the fourth [day], he explained.

Will this be a repeat performance? When it comes to shirtless stuff I would absolutely do it again, he says. But I do not recommend it: its not healthy. It doesnt feel good but it does look good! He tells us he only does the the light version of it, (apparently bodybuilders go hard). But for me, if it sells a character to an audience then yes absolutely Ill do it, but if its going to be a risk to my health, then no.

The actor knows that he has a professional trainer observing him, making sure that Im okay and that I have all the right things going into my system. For us mere mortals, its the opposite of what hed recommend.

Dehydration diets aside, Cavill is water obsessed. I was looking to start my own water [brand], he tells us, I was researching various springs around the UK; I wanted it to be environmentally responsible and ethical. He then met David and Bonita Spencer-Percival, founders of No1 Botanicals, who extract the compounds out of herbs and make pure botanical drinks with them.

Cavills now partnered with the couple, enabling him to drink a lot of the No1 Rosemary Water. It completely replaces my regular water intake, he reveals. I love the stuff. The only time I dont [drink it] is when Im in the gym because then I have electrolytes.

This completely replaces my regular water intake

To grasp the botanical science behind it, Cavill made a short documentary in Acciaroli, Italy, to see why the villagers are living long, happy, healthy lives. Indeed, they consume heaps of rosemary, but he assures us theres heavyweight science beneath the romantic concept.

Indeed, Cavill feels it himself. I realised quite quickly that my body was craving it. It really wanted it, and I started to feel better when I was drinking it. I noticed a massive difference when I was working on The Witcher - in prep when I had a window to do all my work for the day I was drinking this stuff and instantly felt sharper. The brain just started firing and it really, really helped.

The tangible health benefits of ancient herbal wisdom is becoming apparent to Cavill.

While he wasnt conscious to include herbs in his diet before, now that Im learning about super herbs, and they are important to include he feels. Especially if you want to live your life to the fullest; if you want to take full advantage of everything the body and mind is keyed to do. So, we can all play Superman?

Its as simple that, he adds. If you start putting this stuff in your body, it works better and more efficiently.

Does warm lemon water have any health benefits?

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What we can all learn from Henry Cavill's health and wellbeing rituals - harpersbazaar.com

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The amount of carbohydrates available on campus has an effect on a students lifestyle and diet, according to students and exercise and sports science professor on campus. They said a balanced diet of refined and unrefined carbohydrates is important for a healthy lifestyle. In reality, they added anyone can eat whatever they want if they exercise accordingly.

Joel Reece is a BYUHawaii assistant professor in Exercise and Sports Science. Reece said he believes the presence of carbohydrates on campus is not great. He said, I think carbohydrates are a good thing for us. Often times, carbohydrates are looked at as being bad, but carbohydrates are the thing that provides energy for us.

Our body wants us to use carbohydrates as energy before any other macronutrients. Carbohydrates are one essential macronutrient that we can use for energy our body can use for energy I think maybe the misconception about carbohydrates is like a simple carbohydrate versus a complex carbohydrate or carbohydrates from whole grains versus refined.

Reece added, Maybe there are too many refined carbohydrates on campus.

Tale of two carbohydrates

The healthy balance between refined and simplified carbohydrates can affect a healthy diet, said Reece. According to medicalnewstoday.com, Unprocessed carbs contain fiber, vitamins, and minerals. However, processing them removes nutrients and results in refined carbs, which people sometimes refer to as empty carbs or empty calories.

Refined carbs provide very few vitamins and minerals. The body processes refined carbs quickly, so they do not provide lasting energy, and they can cause a persons blood sugar to spike.

According to Reece, refined carbohydrates, when eaten, could be either used as energy or later stored, but too much refined carbohydrates cannot be converted into energy and instead converts into fat stored in the body.

Although carbohydrates turn into sugar once consumed, sophomore Jeffery Tang, a biology major from California, said he doesnt think food plays a huge role in fat. He said people can eat whatever they want as long as they have the right amount of exercise. Tang said he was able to eat whatever he wanted due to balancing both calorie intake and exercise.

He shared from personal experience. I used to have to eat 8,000 calories a day to maintain my body weight. If I started not eating 8,000 calories then I would lose weight. Thats why with [the] right amount of exercise, you can eat any amount of food you want.

Brec Jorgenson, an undecided freshmen from Utah, said, I think that carbs are a good thing on campus. Carbs should be an important part of a students diet, but not overdone.

Jorgenson shared he thinks its not necessary to withdraw carbohydrates from a diet, but instead, its better to limit the amount of refined carbohydrates in a diet. The best thing to do is to balance both types of carbohydrates and exercise.

I believe that students put in enough time [studying and staying active] that carbs will help them keep going. I do believe that loading up on carbs and not adding exercise into someones weekly schedule will not be helpful in the long run.

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Joel Reece encourages students to know their eating habits and avoid excessive refined carbohydrates - Ke Alakai

Authors: Ksenia Power, M.S., Sara Kovacs, Ph.D., Lois Butcher-Poffley, Ph.D., Jingwei Wu, Ph.D., and David Sarwer, Ph.D.

Corresponding Author: Ksenia Power, PhD Candidate 1800 N. Broad Street, Pearson Hall, 242 Philadelphia PA, 19122 tug82764@temple.edu 267-766-8938

Ksenia Power is a Doctoral Candidate and an Instructor of Record in the Department of Kinesiology at Temple University, majoring in Psychology of Human Movement. She is also a Volunteer Assistant Womens Tennis Coach at Temple University.

ABSTRACT

Over the last three decades, a large body of research has examined the issue of eating disorders, both formal diagnoses and subclinical features, as well as compensatory behaviors in National Collegiate Athletic Association (NCAA) athletes. In general, this literature suggests that large numbers of student-athletes engage in disordered eating and compensatory behaviors; smaller percentages have symptoms that reach the threshold of formal diagnoses. Increased symptoms are associated with reduced athletic and academic performance, both of which may impact psychosocial functioning later in adulthood. Unfortunately, a number of methodological shortcomings across this body of research (e.g., studies with insufficient sample sizes, inappropriate comparison groups, and suboptimal or biased psychometric measures) limit the confidence that can be placed in these findings, underscoring the need for a new generation of studies. This paper provides an overview of this literature, focusing on issues of gender differences, sport type, and age. It also highlights the relationship between disordered eating and compulsive exercise, a compensatory behavior that is highly prevalent among collegiate athletes. The health and athletic performance consequences of eating disorders in conjunction with compulsive exercise are also discussed. In addition, a focus on more recently recognized eating disorders, such as binge eating disorder and the night eating syndrome is underscored. Future work in this area needs to include the most methodologically rigorous measures available in order to aid most appropriately coaches and athletic trainers in promptly identifying at-risk athletes and to inform future prevention and treatment efforts.

Key words: eating disorder, disordered eating, compulsive exercise

INTRODUCTION

Over the past decade, a number of studies have examined the symptoms of disordered eating among National Collegiate Athletic Association (NCAA) athletes (9,12,13,24,30). Up to 84% of collegiate athletesreported engaging in maladaptive eating and weight control behaviors, such as binge eating, excessive exercise, strict dieting, fasting, self-induced vomiting, and the use of weight loss supplements (12,13,24). Subclinical symptoms or those that reach diagnostic criteria may contribute to poor physical and mental health, as well as suboptimal athletic and academic performance (29).

The substantial physical demands of being a student-athlete are believed to contribute to the development of eating pathology and compensatory behaviors (32). In season, student-athletes are restricted to 20 hours of weekly on-and-off the court/field physical workload, including the time spent in competition (1).However, the 20-hour rule if frequently violated, which results in excessive hours of physical activity and subsequent overtraining (39). For instance, Division I football, baseball, and basketball players reported the highest weekly in-season athletic commitments, averaging nearly 40 hours per week (39). In all other sports, the weekly times spent in training and competition averaged 32 hours (39). The combination of disordered eating and physical overtraining may further produce significant health impairments, such as low energy availability, muscle weakness, acquisition of overuse injuries, mineral bone deficiency, cardiac complications, impaired immune function, malnutrition, dehydration, fatigue, amenorrhea, and osteoporosis (5,15). Some of these conditions are sustained after the athlete has moved on from organized competition (29,44). Physical overtraining and inadequate nutrition can also negatively impact an athletes mood, contributing to poor academic and athletic performance (29,44,45).

Some collegiate athletes suffering from disordered eating are known to engage in compulsive exercise as a strategy to compensate for excessive caloric intake (33). Compulsive exercise, beyond sport-required training, places student-athletes at a high-risk for physical overtraining, overuse injuries, and subsequent diminished performance (12, 53). In addition, this compensatory behavior often occurs as a symptom of eating psychopathology (21, 33). Particularly worrisome is the finding that maladaptive eating with simultaneous engagement in compulsive exercise can often remain undetected in athletes and contribute to the progression of an eating disorder (36, 45). Like subclinical eating disorders, formal eating disorders can endure into adulthood and have a continued, negative impact on physical and psychosocial health (56). Unfortunately, most of these athletes experience eating disorder symptoms in isolation, as these behaviors often are missed by the coaching and athletic training staff (62,63). Thus, further studies are necessary for identifying eating disordered athletes (9,25,29).

Disordered Eating Symptoms and Eating Disorder Diagnoses

According to the Diagnostic and Statistical Manual (DSM-V) of the American Psychiatric Association (2013), eating disorders are characterized by severe alterations in an individuals eating habits that are linked to physiological changes.Individuals with eating disorders become pre-occupied with food, body weight, and physical appearance. Common eating disorders that occur in collegiate athletes are Anorexia Nervosa (AN) and Bulimia Nervosa (BN) (4,10,12, 24, 42). For instance, in a mixed-sport sample of Division I collegiate athletes, 5.1% of all women scored in the clinical range for either Anorexia Nervosa or Bulimia Nervosa (49). Similar rates of clinical eating disorders were reported in a sample of 414 NCAA Division I athletes (6.3%), with Bulimia Nervosa being the most frequent one (4).

According to the American Psychiatric Association (2013), Anorexia Nervosa (AN)is characterized by persistent restriction of caloric intake, resulting in significantly low body weight (below the minimal norm considering an individuals age, height, weight, and developmental trajectory). It also manifests through an intense fear of gaining weight and severe disturbances in ones perceptions of his or her own body weight and shape (i.e., refusal to recognize the seriousness of ones low body weight). Bulimia Nervosa (BN) is characterized by the following symptoms: (a) recurrent episodes of binge eating; (b) recurrent engagement in detrimental compensatory behaviors in order to prevent weight gain; (c) the binge eating and compensatory behaviors must occur at least once a week for three consecutive months; and (d) an individuals body and shape become vital parts in his or her self-evaluation (3). Binge Eating Disorder (BED)includes the following symptoms: (a) recurrent engagement in episodes of binge eating; (b) occurrence of binge eating episodes, on average, at least once a week for three consecutive months; (c) manifestation of distress related to binge eating; and (d) disassociation with the recurrent use of compensatory behaviors as in Bulimia Nervosa or Anorexia Nervosa (3). Other Specified Feeding or Eating Disorder (OSFED) can be applied to cases, when a person engages in eating behaviors that cause clinically significant distress or impaired functioning, but does not meet full criteria for an eating disorder (3). Lastly, Night Eating Syndrome is characterized by recurring episodes of eating after awakening from sleep or by immoderate food consumption following the evening meal (3).

The Prevalence of Eating Disorders in Athletes

Although disordered eating and exercise behaviors have been highlighted as significant issues among collegiate athletes, the percentage of athletes who meet full diagnostic criteria for clinical or subclinical eating disorders vary greatly, from 1.1% to 49.2% across studies (4,10,12,24,30,42). For instance, Greenleaf et al. (2009) found that, in a group of female collegiate athletes, 2% met the criteria for an eating disorder diagnosis and another 25.5% exhibited subclinical symptoms of an eating disorder (e.g., binge eating, self-induced vomiting, and excessive dieting). Similarly, in Petrie et al.s (2008) study, 19.2% of collegiate athletes reported maladaptive eating behaviors. Sanford-Martens et al. (2005) detected slightly lower rates of subclinical eating problems (14.5%).

In Anderson and Petries (2012) study among female collegiate athletes, 26.8% of women reported disordered eating behaviors. Approximately 40% of the athletes engaged in at least two hours of daily physical activity, suggesting that many may be using this high level of activity as a compensatory strategy in response to binge eating. Up to 28% of athletes reported dieting or fasting at least two times over the past year (4). Kato and colleagues (2011) reported the highest rates of disordered eating in a sample of NCAA Division I and III athletes, ranging from 40.4% to 49.2%. In addition, 30.7% of all athletes reported body dissatisfaction, weight preoccupation, and bulimic tendencies. Wide-ranging rates of clinical and subclinical eating disorders in collegiate athletes call for additional research on eating disorders and associated symptoms, including compulsive exercise (9,29). Although previous studies provided useful prevalence data (4,12,24,30,42), new studies could potentially yield more accurate and consistent results of unhealthy eating and weight control behaviors in collegiate athletes.

Health Consequences of Eating Disorders

While each eating disorder has its distinct signs, symptoms, and health effects, the most frequent signs and symptoms of disordered eating and compensatory behaviors include: sudden weight loss, gain, or fluctuation; hypothermia (i.e., a dangerously low body temperature); and fatigue (29). Oral and dental problems caused by pathogenic weight control behaviors are dental erosion or caries, perimolysis (i.e., a dental condition linked to frequent regurgitation), and recurrent sore throats (64). Dermatological issues, such as hair loss, brittle nails, skin discoloration, and poor skin healing; also arise in individuals suffering from an eating disorder (54). Disordered eating behaviors also severely affect an individuals endocrine system by resulting in irregular menstrual cycles or a complete absence of menstruation (i.e., amenorrhea), which could potentially lead to infertility (55). Furthermore, prolonged misuse of laxatives, diuretics, enemas, and diet pills, as well as self-induced vomiting lead to various gastrointestinal problems, such as abdominal pain, early satiety and delayed gastric emptying, constipation, hematemesis (i.e., the vomiting of blood), and hemorrhoids (40). The resulting damages of disordered eating on the cardiorespiratory system include, but are not limited to, chest pains, hypotension (i.e., low blood pressure), arrhythmia (i.e., irregular heart beat), bradycardia (i.e., an extremely low heart rate), and shortness of breath (11).

Another consequence of maladaptive eating and compensatory behaviors is the Female Athlete Triad, which is characterized by energy deficiency, menstrual irregularities, and low bone mass that occur as a consequence of malnutrition and disordered eating (40). Low bone mineral density can result in injuries, stress fractures, and potential osteoporosis (55). This may be especially hazardous for competitive athletes who are generally at higher risks for overuse injuries due to their continuous engagement in high amounts of intense physical training (61). For instance, disordered eating, amenorrhea, and low bone mineral density were associated with musculoskeletal injuries in interscholastic female athletes (46). Finally, neuropsychiatric symptoms, including memory loss or lack of concentration, insomnia, increased anxiety, depression, seizures, obsessive-compulsive behavior, and suicidal ideation can be seen in persons with eating disorders (50). Up to a third of athletes at-risk for an eating disorder tend to engage in multiple pathogenic behaviors, as opposed to a single behavior such as restrictive eating (41).

Consequences of Eating Disorders on Athletic Performance

Disordered eating can have an effect on athletic performance (18). In aesthetic (e.g., gymnastics, swimming, diving), endurance (e.g., cross-country), and weight-classsports (e.g., wrestling, rowing), it is believed that leanness leads to enhanced performance (9). However, many athletes achieve low weight through disordered eating and compensatory behaviors, which can significantly decrease athletic performance (18,29). Specifically, long-term disordered eating impairs the main components of muscular fitness (i.e., aerobic fitness, musculoskeletal fitness, motor fitness, and flexibility), thus resulting in poor athletic performance (18). In addition, the health consequences of restricted caloric intake, such as loss of fat, lean body mass, electrolyte imbalances, and dehydration, can contribute to diminished performance (29). In a study among junior elite female swimmers, Van Heest and colleagues (2014) found that female athletes who restricted caloric intake and increased energy expenditure in training frequently suffered from ovarian suppression (i.e., lack of estrogen production). Female athletes who trained in the presence of low energy availability and ovarian suppression exhibited significant declines in their swim velocity (59).

A similar study of high school athletes found a negative relationship between disordered eating and athletic performance (56). Among a large sample of high school athletes, 35.4% were found to suffer from disordered eating, 18.8% reported menstrual irregularities, while 65.6% reported suffering a sports-related musculoskeletal injury during the ongoing season. Athletes exhibiting disordered eating behaviors were twice as likely to sustain a sports-related injury during a competitive season, as compared to the athletes reporting healthy eating behaviors. Moreover, the inability to train and compete due to an injury further results in decreased athlete performance upon the athletes return to play (56).

In addition to physical consequences on sport performance, disordered eating may contribute to other psychosocial issues (18). In particular, obsessive concern about weight and body image, as well as continuous eating restriction have been associated with mood disorders, which may impact athletic but also academic performance (27). Furthermore, overvaluation of shape, weight and eating control, anxiety, and depression that often coexist in athletes at-risk for an eating disorder, are capable of decreasing athletes motivation to train and compete. The resulting poor performance may further increase the pressure experienced by athletes to train more intensely and adhere to even more rigid dieting for weight loss (18). Disordered eating behaviors in competitive athletes may not only severely undermine an athletes health, but may also produce deterioration in sport performance (18).

Eating Disorders by Gender

A number of studies have found higher rates of maladaptive eating habits in female athletes compared to male athletes (9,10,24,31). For example, in a sample of 800 NCAA Division I student-athletes, 19% of women and 12% of men reported unhealthy eating habits (10). Krebs et al. (2019) also found a higher rate of eating disorders in collegiate female athletes than males. Specifically, three times as many female distance runners screened positively for an eating disorder as compared to male (46% and 14%, respectively). In another study, 26% of student-athletes scored in the clinical range for an eating disorder, with five times more females (84%) than males (16%) reporting disordered eating behaviors (37).

The main explanation for this tendency is that female athletes are more subjected to socio-cultural pressure to diet and be thin, while male athletes tend to be more concerned with physical fitness and masculinity (51). Thus, fewer male athletes contemplate dieting as compared to female athletes, which represents a risk factor for the development of eating disordered in females (51). Nevertheless, disordered eating has been significantly increasing among male athletes (22,12,42,52). For instance, certain male athletes, specifically wrestlers, rowers, and long-distance runners, are more likely to engage in pathogenic weight control behaviors than female athletes in general due to an increased focus on physical appearance and weight (22,26).

Hinton and colleagues (2004) examined dietary intake and eating behaviors in 345 NCAA Division I student-athletes. They found that more male athletes than female athletes exhibited having inadequate nutrient intake. Specifically, only 10% of male athletes, as compared to 19% of female athletes, consumed the recommended minimum of carbohydrates per each kilogram of their body weight, while 19% of males and 32% of females consumed the minimum recommended amount of protein. Moreover, male athletes were more likely to exceed the Dietary Guidelines for fat, saturated fat, sodium, and cholesterol intakes, as compared to female athletes (26).

In contrast to female athletes, who indicated restricting their nutrient intakes for weight gain prevention, male athletes reported using dietary supplements (other than vitamins) for weight reduction (26). Also, approximately 6% of male athletes indicated restricting their fluid intake. These findings can potentially be understood in the context of mens preoccupation with muscularity, resulting in a focus on diet, nutritional supplements, and excessive exercise (10). Hinton et al.s (2004) study findings suggest that male athletes, just as female athletes, undergo psychological problems of body dissatisfaction and low self-esteem, which leads to the onset of eating pathologies. In regards to sport-specific factors, male athletes are equally pressured to diet and exercise compulsively in order to maintain low body weight and produce successful athletic results (14).

In summary, a substantial body of literature shows that rates of eating disorders and disordered eating symptoms among collegiate athletes range widely, 0-19% in male athletes and 6-45% in female athletes (9,29,31,34). While the occurrence of clinical eating disorders is more prevalent in female athletes than male athletes, male athletes, in sports such as wrestling, rowing, and cross country, are at greater risk for pathological weight control behaviors (26,49,52). Such findings highlight inconsistencies in the eating disorder area and emphasize the need for additional research on the prevalence of eating disorders among both male and female athletes.

Eating Disorders by Sport

A number of studies have determined that the sport type in which an athlete participates can serve as a risk-factor for the development of disordered eating (4,22,48,52). In eating disorder research, sports have been categorized according to the level of pressure an athlete faces to maintain a low body weight for aesthetic reasons and/or performance enhancement (14). Across several studies (4,22,29,42),the following categories have been described: aesthetic or lean sports (e.g., gymnastics, figure skating, swimming, diving, track and field), endurance sports (e.g., cross country, cycling), technical sports (e.g., tennis, golf, baseball, softball), ball game sports (e.g., soccer, volleyball, basketball, football), weight-class sports (e.g., wrestling, rowing), and anti-gravitational sports (e.g., skiing, pole vault jumping).

Higher rates of eating disorders in aesthetic, endurance, and weight-class sports have been consistently reported (9,29,57). For example, Thiemann et al. (2015) found a greater frequency of maladaptive eating in aesthetic sports (17%) than in ball-game sports (3%). In Sundgot-Borgen and Torstveits (2004) study on elite athletes, 42% of women in aesthetic sports had subclinical and clinical eating disorders (e.g., gymnastics, figure skating, diving), 24% in endurance sports (e.g., long-distance running, cycling, swimming), 17% in technical sports (e.g., golf, tennis), and 16% in ball game sports (e.g., soccer, volleyball, basketball). Among male athletes, 9% of eating disorders were seen in men participating in endurance sports and 5% in ball-game sports (52). There are three possible explanations of higher rates of eating disorders in aesthetic, endurance, and weight-class sports. First, in endurance sports, such as cross-country, weight higher than an athletes optimum performance weight is linked to decreased performance (14). Second, in weight category sports, such as wrestling, athletes are pressured to meet a specific weight requirement just to qualify for a competition (9). Third, in aesthetic sports, such as gymnastics, athletes physical appearance is a part of an aesthetic evaluation, which pressures athletes to attain a certain body composition (14).

While the prevalence of disordered eating in sports that emphasize leanness is high, the reported rates of eating disorders vary by sport (48,53,57). For instance, in a sample of 414 NCAA Division I female athletes competing in gymnastics and swimming/diving, 108 (26%) scored in the subclinical range for an eating disorder (4). In addition, 26 athletes (6.1% of gymnasts and 6.7% of swimmers/divers) were classified as having an eating disorder. Out of 26 athletes in the eating disorder group, 20 athletes were identified as having subthreshold Bulimia Nervosa, 4 with Non-bingeing Bulimia, and 2 with Binge Eating Disorder (4).

In contrast to Anderson and Petries (2012) findings, Carter and Rudd (2005) detected lower rates of disordered eating considering the sport type. In a mixed-gender sample of 800 NCAA Division I athletes, Carter and Rudd (2005) found 9.2% of non-lean sport athletes and 17.5% of lean-sport athletes exhibiting subclinical features for an eating disorder. Additionally, 6.1% of athletes in lean sports suffered from chronic dieting, as compared to 2.5% of athletes in non-lean sports. Such high rates of disordered eating in gymnasts and swimmers/divers support the notion that athletes competing in lean and aesthetic sports are pressured to possess ideal body weight for reaching optimal performance. Thus, lean- and aesthetic-sport athletes are exposed to higher risks for developing an eating disorder than athletes competing in sports that do not overly emphasize body weight and physical appearance (4,10). Furthermore, Glazer (2008) found that athletes participating in lean sports averaged significantly higher on the Eating Attitudes Test (EAT) and the Social Physique Anxiety Scale (SPAS), suggesting greater disordered eating and physique anxiety, as compared to athletes participating in non-physique-salient sports. Glazers (2008) findings support the notion of increased prevalence of eating disorders in sports that emphasize leanness (e.g., gymnastics, long distance running). Participation in non physique-salient sports (e.g., basketball, softball, soccer) may be a protective factor for the development of disordered eating (22).

Although some studies have linked the sport team classification to disordered eating levels (4,10,48), other studies found no support for this relationship (24,42,49). For example, despite the high frequency of pathogenic eating in a sample of collegiate athletes (19.2%), no association was found between sport team classification and eating disorder status in Petrie et al.s (2008) study. Similarly, Greenleaf et al. (2009) found no differences in the frequency of maladaptive eating behaviors across sport type. These results corroborated previous findings from Sanford-Martens and colleagues (2005) study, which also found no differences in eating disorder symptoms across sport types. These findings suggest that sport type may not be an influential factor in the development of maladaptive eating habits in competitive athletes (49).

To conclude, some studies suggested that lean-sport athletes (such as gymnasts, runners, swimmers, cyclists, and wrestlers) are more prone to developing an eating disorder than non-lean sport athletes, who do not overly emphasize body weight and physical appearance as part of their sport (4,10). However, other studies failed to establish the relationship between athletes sport classification and their propensity for unhealthy eating behaviors (24, 42). This observation calls for the need to broaden researchers perspectives on identification of at-risk athletes (9). Future studies may provide a clearer pattern between the sport type and disordered eating in collegiate athletes.

Eating Disorders and Age

While a great number of studies on the prevalence of eating disorders among athletes have reported their ages as a demographic variable (22,34,36,47,52), only a few studies assessed the direct link between disordered eating and college athletes age (23,24,42). For instance, in Petrie et al.s (2008) study, disordered eating group status (symptomatic vs. asymptomatic) was not related to age, indicating that symptomatic athletes may be found among all different ages (42). Similarly, Greenleaf et al. (2009) found no differences in athletes eating disorder status (i.e., symptomatic vs. eating disordered) based on their age. These findings suggest that the age variable may not be an influential factor on collegiate athletes disordered eating symptomology (24). Similarly, in a sample of 290 elite athletes between 14 and 30 years of age, Gomes et al. (2011) assessed the relationship between unhealthy eating behaviors and age. No association was found between athletes age and each subscale of the Eating Disorder Examination Questionnaire (EDE-Q, 20). Thus, the findings indicate that athletes across different ages may be equally at-risk for developing maladaptive eating habits (23, 42).

Pettersen et al. (2016) further examined the prevalence of disordered eating in 225 Norwegian athletes in the age groups of 17, 18, and 19+ years old. In total, 18.7% of the athletes exhibited symptoms of disordered eating. Age was not a significant predictor of athletes maladaptive eating patterns. As Pettersen et al. (2016) explain, the peak risk for the development of an eating disorder occurs between childhood and early adolescence. However, the majority of the sample athletes were in their later adolescence and early adulthood, which may explain why age was unrelated to disordered eating symptoms. Specifically, adult athletes have acquired higher levels of confidence and self-esteem than athletes in their early adolescence, which could serve as a protective mechanism against the development of eating pathologies (43).

In summary, some studies suggest that the prevalence of maladaptive eating behaviors (e.g., fasting, self-induced vomiting, using laxatives and diuretics, binging followed by exercise, etc.) is higher in the college-aged athletes, as compared to competitive adolescent athletes (29, 30, 43). Nevertheless, a substantial body of literature indicates that competitive adolescent athletes experience severe eating disorder symptoms as do collegiate athletes (9, 29, 43). Additionally, the studies focusing specifically on the impact of age, failed to establish a significant association between age and athletes eating disorder status (24, 42 ,43). Thus, additional studies are necessary to establish a clearer association between athletes age and pathogenic eating.

CONCLUSIONS

Collegiate student-athletes represent a unique population of young adults who, because of the demands on their time associated with their sport, may be at particular risk for disordered eating and compulsive exercise (32). Specifically, many collegiate athletes appear to use excessive exercise as a compensatory behavior to control their body weight (4, 12, 36, 42, 48). Compulsive exercise, in combination with the sport-required training, place student-athletes at a high-risk for overuse injuries, and physical exhaustion, which can further impede athletic performance (12, 53). Therefore, there is a need to further examine disordered eating and compulsive exercise patterns among collegiate student-athletes in order to draw athletic staffs, coaches, and athletes attention to the deleterious health effects of these disordered behaviors.

APPLICATIONS IN SPORT

The roles of athletic trainers, administration, and coaches are paramount in recognizing detrimental eating and exercise patterns in athletes and providing them with the necessary professional assistance (14). First, expanding athletes knowledge about proper nutrition habits, maladaptive eating behaviors and their health consequences, and learning how to address the issue of disordered eating, are pivotal steps in primary prevention (40). There is a need to inform athletes that dietary restriction and purging behaviors for attainment of the desired body weight may lead to decreased athletic performance and adverse health consequences. Structured educational programs have shown to reduce the impact of risk factors of disordered eating (6, 17, 19). For instance, Becker et al. (2012) observed a significant reduction in bulimic symptoms just after 1 year following a peer-led educational intervention for athletes. In addition, the researchers found an increase in the number of athletes seeking medical assistance due to the concern that they may suffer from the Female Athlete Triad symptoms (6). Through educational programs, athletes, parents, and coaches can also learn that menstrual dysfunction occurs as a result of low energy availability due to deliberate dietary restriction, rather than a positive adaptation to high-intensity sport participation (17).

Changing perspectives on competitive sport participation for athletes and coaches could be another strategy for eating disorder prevention. Specifically, the way in which athletes evaluate their maladaptive eating and exercise habits can foster maintenance of an eating disorder (44,58). For instance, Thompson and Sherman (2010) found that athletes tend to underreport their eating disorder symptoms due to the misconception that dietary restriction and excessive exercise will result in enhanced sport performance. Athletes and coaches often reinforce maladaptive behaviors (i.e., dietary restriction, excessive exercise) because they believe that certain aspects of sport participation, such as mental toughness and continuous engagement in intense training, are pivotal in reaching optimal performance (44). As a result, athletes may perceive compulsive exercise as a demonstration of high commitment to their sport, rather than a symptom of an eating disorder (16,28). In addition, athletes and coaches falsely believe that weight loss achieved through food restriction and excessive exercise will imminently lead to increased performance (16). Thus, due to perfectionistic and result-oriented views of athletic participation, eating disorder symptoms are often overlooked and underreported (28). Consequently, an emphasis of educational programs should be placed on prompt recognition of maladaptive eating and exercise habits to prevent the development of a clinical eating disorder.

Furthermore, despite the availability of various eating disorder prevention strategies, Vaughan et al. (2004) found that only 1 in 4 (27%) of athletic trainers feel confident in identifying an athlete with an eating disorder. In addition, only 38% of athletic trainers feel confident in asking an athlete about disordered eating behavior (60). Although educational programs and counseling services have been created for collegiate student-athletes, proactive steps on behalf of the university athletic staff are necessary for early identification and prevention of eating disorders (8,35). Prompt detection of unhealthy eating behaviors through screening protocols has been associated with more effective treatment outcomes (8,57).

For instance, the Preparticipation Physical Examination (PPE) monograph, created by the American Medical Society for Sports Medicine (AMSSM) and the American College of Sports Medicine (ACSM), can serve as an effective screening tool for identification of disordered eating behaviors in athletes (7). This instrument assesses whether athletes suffer from body weight pre-occupation, restrict their caloric intake, use nutritional supplements for weight loss, and undergo pressure to lose weight by outside sources (7). The Female Athlete Triad Coalition developed an 11-question screening tool that could be successfully employed as a part of the Pre-participation Physical Examination (17). This measure evaluates a female athletes pre-occupation with body weight, dietary restriction, menstrual dysfunction, bone injuries, and low bone mineral density. Consequently, simultaneous use of these screening tools could play a key role in identifying at-risk athletes and providing immediate treatment prior to competitive season. By utilizing screening protocols, coaches and athletic trainers can ensure that student-athletes have rewarding collegiate experiences. In addition, this method can protect athletes against the development of eating disorders that otherwise may endure into adulthood, impacting their physical and psychosocial health long-term (18,27).

Directions for Future Research

Further studies investigating the patterns of disordered eating in conjunction with compulsive exercise in collegiate athletes are necessary for several reasons. First, it is pivotal to provide athletes, coaches, athletic trainers, and athletic administrators with accurate information about the severity of maladaptive eating and exercise in collegiate athletes. Second, various socio-cultural and sport-specific pressures have been identified as potential risk factors for the onset of eating disorders in athletes, which allows researchers to examine the links between these risk factors and the development of disordered eating behaviors (14,18,51). While numerous studies have investigated these issues in great depth, wide gaps still exist in the literature due to inconsistent prevalence rates of eating disorders based on athletes gender, age, and sport type (9,29). In addition, certain studies yielded contradictory results and failed to establish the relationships among athletes sport classification, age, and their propensity for unhealthy eating behaviors (23,24,42).

To date, there is a scarcity of literature focusing on more recently recognized eating disorders, such as Binge Eating Disorder and the Night Eating Syndrome (4,12). Studies investigating the prevalence of clinical eating disorders in collegiate athletes reported rare instances of BED and the NES, ranging from 0 to 0.5% (4,10,12,24,42). The low rates of BEDs can be explained by the difficulty to disassociate the recurrent use of compensatory behaviors, which are distinct symptoms of AN and BN only (3). In the majority of clinical cases, athletes disordered eating occurs in conjunction with pathogenic weight control behaviors (12), which results in higher rates of AN and BN, and significantly lower rates of BED diagnoses.

In addition, a great number of studies in eating disorder research used the Questionnaire for Eating Disorder Diagnoses (Q-EDD; 38) due to its high psychometric properties (4,10,12,24,42,49). Based on the DSM-IV (2) diagnostic criteria for eating disorders, the Q-EDD mainly assesses the symptoms of AN, BN, and BED, thus omitting questions related to the symptoms of the NES, an eating disorder that was later added the DSM-V (3). Consequently, questions exploring the NED symptoms, such as the frequency of recurring episodes of eating after awakening from sleep and the episodes of immoderate food consumption following the evening meal, should be added to the more recent eating disorder measures.

Considering limitations of the previously discussed studies of eating disorders in athletes, the following methodological recommendations could help future researchers to gain a better understanding of the nature and distribution of eating disorders. First, samples should include a large number of NCAA athletes to provide more reliable and valid results, and to ensure generalizability of the study findings. Second, athlete samples representative of each sport should be selected for accurate and valid comparisons by sport type. One way to achieve this goal is to categorize sports by their types (e.g., lean vs. non-lean, weight-class vs. non-weight-class) and recruit approximately an equal number of athletes for each sport category.

In regards to gender comparison, sufficient samples of both female and male athletes competing at the collegiate level need to be recruited to more accurately address the issue of gender differences in eating disorders. Although male athletes generally have a lower prevalence of eating disorders than female athletes, an increasingly large body of literature indicates that disordered eating among male athletes is on the rise (12,22,42,52). Moreover, male athletes in certain sports are more likely to engage in compensatory behaviors than female athletes (26). This conclusion could not be drawn if the study focused solely on one gender. Thus, excluding one gender from the investigation may result in biased reporting of the disordered eating problem and inaccurate conclusions about its prevalence rates across both genders.

Lastly, the conditions under which athletes report their eating behaviors must be assessed prior to data collection. Athletes tend to underreport their maladaptive eating and compulsive exercise habits due to the fear that their eating disorder may be discovered by their coaches and potentially affect their athletic careers (52). Consequently, athletes must be provided with confidentiality and a pressure-free environment in which they can answer instrument questions candidly. In addition, researchers need to choose appropriate measures that have been previously validated in athlete samples to successfully discriminate between eating disordered and healthy athletes.

ACKNOWLEDGMENTS

None

REFERENCES

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Disordered Eating and Compulsive Exercise in Collegiate Athletes: Applications for Sport and Research - United States Sports Academy Sports Journal

The ketogenic diet - or 'keto' for short - is a high fat, low carb, restrictive eating plan that promises to help you lose weight.

It has also been deemed effective in treating epilepsy, but has been widely criticised by nutritionists for being restrictive and extreme.

Now a study published in Frontiers in Endocrinology, warns of another concern - keto may have an unexpected side effect of weakening athletes' bones during intense training.

Researchers from the Australian Institute of Sport and Australian Catholic University looked at 30 elite race walkers (25 male and five female) over three and a half weeks of intense athletic training.

About half of the group were assigned to a low carb, high fat ketogenic diet, getting between 75 and 80 per cent of their daily calories from fat. The other half stuck to a high carb diet. Both groups consumed the same amount of calories, relative to their body weight, and both groups ate a moderate amount of protein.

The team found that the athletes on the keto diet showed greater signs of bone breakdown than they had at the start of the study. Athletes on a high carb diet, however, showed no significant difference, according to the test results.

After reintroducing carbs into their diet, the keto athletes saw some improvement in their bone health, but they weren't back to full strength, the researchers found.

These results suggest that the ketogenic diet somehow sped up the breakdown of athletes' bones during intense exercise, and inhibited recovery, although it's not exactly clear how.

The new findings come alongside other criticisms of the diet, with experts suggesting that keto is only safe and effective over a short period of time.

Some experts have even warned that a longterm keto diet can damage the heart muscle.

"We believe that the keto diet may affect bone metabolism due to the downstream effects of low-carbohydrate availability on certain hormones, along with other factors," said Louise Burke, lead author of the study and head of sports nutrition at the Australian Institute of Sport in Canberra

It is not clear from this study how the keto diet will affect bone health over a longer period of time and whether athletes may be able to adapt the diet to reduce symptoms.

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Following a keto diet could weaken your bones and increase your risk of injury - Luton Today

Start (Dec. 31): 447 lbs.

Two weeks ago: 433 lbs.

This week: 437 lbs.

Total lost in 2020: 10 lbs.

Shortly after writing these words two weeks ago, I began to struggle: Although I have not yet struggled with any major issues so far this year, I know that eventually life will knock me down again, and Ill have to work hard to get back up.

Yup, I got knocked down, and now Im back up again.

It all started with my new work schedule and a special project that required a lot of long days, extra attention to detail and creativity. Needless to say, it took a lot of energy out of me, and when I dont have the energy, I dont have the will power to behave. Ill start making excuses as to why I cant exercise and justifications as to why its OK to eat that junk food or drink that beer.

When things get busy at work, sometimes the dishes dont get done in a timely manner, and after a long day, the last thing I want to do is wash dishes so I can cook a healthy meal. I end up choosing the quicker option of picking up food, such as frozen pizza, that I can just pop in the oven. The next day, its something else, then something else, and before I know it, Im out of control.

A little extra sleep helps. So does exercise, especially when you are forced to get the exercise.

After the snowstorm last Friday, for example, I had to shovel about 18 inches of snow out of the driveway so we could get the cars out. On Friday night, I moved all the snow from my wifes side of the driveway to my side of the driveway in front, behind and on top of my 2012 Ford Focus. You couldnt see my car at all.

On Saturday, I was busy announcing the Gala Parade in front of the town hall for the Saranac Lake Winter Carnival and was too tired afterward to shovel.

On Sunday, I spent three hours shoveling my car out, taking breaks by sitting on the front steps of my house and listening to the blue jays make all kinds of noise. It had warmed up, too, so it was pleasant. I actually enjoyed it. It was meditative, if that makes any sense. I was at peace while I was out there. It helped me recharge and get back on track.

Even with two weeks of questionable behavior eating junk food, meat and drinking a six pack of beer Im still 10 pounds down for the year.

I have a feeling my struggles will continue in the coming months, as I feel cabin fever setting in, and spring isnt coming anytime soon. Thats usual this time of year. With almost four months of winter weather, its getting me down, and I feel the need more than ever to reach for comfort food.

In April 2014, when I was down 60 pounds on the first round of the Lake Placid Diet, I wrote about cabin fever and how I was self-medicating:

I keep placing sunshine on my daily list of positives when the sun is out. Even then, I continue to find myself in a dark place this time of year.

With the long winter almost over, tax day reminds me of finances, which always give me stress, especially after learning last week that its going to cost $700 to fix my car. I hate money problems.

I also hate this time of year. Ive been suffering from cabin fever for almost three months, and its getting worse. There is no spring break in my world, so theres no hope Ill get better any time soon. My spirits could be lifted if I took a small break, but where would I go? I cant afford to travel. And spring break in the Adirondacks doesnt cure cabin fever, not with fresh snow on the ground this week. So Im stuck with the urge to self-medicate with food.

I go through short periods of depression once in awhile. Thats normal, isnt it? I even find myself enjoying the melancholy. Its a good time to reflect on whats important in life. But the depression is always deeper in March and April.

Before starting this column, I shut the blinds in my office, closed the door and turned off all the lights except for a warm antique desk lamp my mother gave me. Its just me, the light, and the computer, and Im doing what I like best writing. Its therapeutic.

Foods always been my answer to depression, not alcohol, illegal drugs, medication, therapy or religion. I keep rubbing my eyes, searching for answers and not finding any. I just find more questions and the uneasy craving for food, knowing all the time that stuffing my gut wont solve a thing.

Still, it makes me feel better in the short term. Over and over, one day after another, giving myself a high with food, kept me going for years. But its an addiction I want to break, one that the Lake Placid Diet was designed for.

I spent years looking forward to dinner as the highlight of my day, and on weekends, it would be breakfast, lunch and dinner. I would just eat and eat and eat. It was a time to enjoy food behind closed doors, leaving the stresses of everyday life for a short time while I indulged in the guilty pleasures on my plate, feeding myself well past the feeling of being full. I dont drink a lot of alcohol, and I dont smoke or do drugs. Food is my addiction.

I cant promise that when I see you next Ill be out of this funk, but I will promise to try not to self-medicate with food. And Ill still be seeking that sunshine until I finally feel better.

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Gearing up for my annual battle with cabin fever - Lake Placid Diet by Andy Flynn - LakePlacidNews.com | News and information on the Lake Placid and...

The disruption to shift workers natural bodily rhythms may play a part in their increased risk of disease, according to a new study.

Every human body runs on a 24-hour clock. This system, known as the circadian rhythm, uses factors such as daylight to determine when a person sleeps and wake.

It also has an effect on bodily functions such as metabolism and cognition. However, in the modern age, technology and varying working hours can disrupt this delicate balance.

Conflict between a persons natural bodily rhythm and the way they live can have a number of detrimental effects, including hormonal changes.

These alterations can lead to metabolic syndrome. This is a condition that increases a persons risk of stroke, type 2 diabetes, and heart disease.

Night shift workers, who make up almost around a fifth of the United States workforce, are more likely to experience these effects than others. Not only are they more likely to develop sleep disorders, they are also at a higher risk of cardiovascular disease and type 2 diabetes than other workers.

Also, people who work irregular or rotating shifts may face an even greater risk of sleep problems and metabolic syndrome.

Previously, researchers believed that the lifestyle habits that tend to go hand-in-hand with shift work was responsible for this increased risk. However, no solid evidence exists to back up this belief.

Researchers are therefore beginning to dig deeper into the relationship between shift patterns and metabolic syndrome.

A new review in the Journal of the American Osteopathic Association did exactly that, focusing on the circadian rhythm.

Examining a number of studies and clinical trials from 2018, the review authors used the findings to propose ways of reducing the circadian impact of shift work, such as optimizing sleep and diet.

Its true that getting enough sleep, eating right, and exercising are critical to everyones health, says lead study author Kshma Kulkarni, from the Touro University College of Osteopathic Medicine in California.

However, the nature of shift work is so disorienting and discordant with those principles, we really need to help people in those jobs strategize ways to get what they need.

It is not only individual workers who can help. Employers and healthcare professionals also have a responsibility to make changes.

Good quality sleep is one of the simplest ways to prevent detrimental health effects. Shift workers themselves should try to sleep for 78 hours at the same time every day, suggests Kulkarni.

In order to aid the bodys natural cycle, workers should try to sleep in the evening, or as close to the evening as possible. They can take naps earlier on, and these should last between 20 and 120 minutes.

Moving away from rotating shift patterns is one way employers can help in this area. Kulkarni also suggests that employers should ensure that shifts begin before midnight and last for no longer than 11 hours.

Nutrition is another element to tackle. Research has shown that shift workers tend to miss meals and opt for sugary snacks instead.

Eating three meals per day is vital, says Kulkarni. These meals, along with any snacks a person has, should include a good amount of protein and vegetables.

Consuming more calories earlier in a persons day is also a beneficial step to take. Employers should therefore try to schedule breaks earlier in a shift and offer more healthful snack options.

Shift workers should also try to take exercise levels into account. Kulkarni recommends working out around the same time each day, at least 5 hours before bedtime.

It may be best to prioritize aerobic exercise, such as running and dancing, as this may boost the quality of a persons sleep.

These three factors are not the only lifestyle choices that may benefit shift workers.

Sufficient light exposure may also help. Certain light sources can alter a persons circadian rhythm to their advantage.

Night workers should try to increase their exposure to light before shifts and throughout. Installing high intensity lights in workplaces can also help employees feel more awake.

It is also important to avoid blue light 23 hours before going to sleep.

Kulkarni and colleagues also believe that medical treatment is of interest.

Medications that help control the sleep cycle, such as certain benzodiazepines and antidepressants, may benefit people at risk of metabolic syndrome.

Similarly, a physical technique called osteopathic manipulative treatment can reduce the amount of time shift workers spend trying to fall asleep.

It is critical we address the health issues facing people in this line of work, Kulkarni explains, particularly because the strength of our economy and safety of our society depend heavily on night shift workers.

To prevent metabolic syndrome, healthcare professionals should check workers especially those in sectors including hospitality and the emergency services for signs of a disrupted circadian rhythm.

With early detection, a person can successfully implement lifestyle modifications and treatment regimens.

However, further research is necessary to determine the most effective strategies.

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Using the bodys natural cycle to improve shift workers health - Medical News Today

Its been said that a thousand-mile journey begins with one step. Similarly, a journey to a healthier you begins with just one consultation.

There are an endless number of reasons why our health starts to slip away from us as we get older. A demanding career, family commitments, age and injury all these things can impact our ability to adhere to a program focussed on healthy living.

But the good news is that there are people here to help.

Live Well Exercise Clinic is a state-of-the-art exercise facility that provides professional fitness training and healthy lifestyle coaching to members of any age, shape or size. By using exercise as medicine, the expertly trained and educated staff at Live Well coach members on developing healthy habits that lead to sustained lifestyle change and improved quality of life.

Live Well Exercise Clinic in Lynn Valley has been open just over a year now and has already helped dozens of clients on their journey to find their way back to a healthier self.

Take Live Well member Tanja for example. Fed up with the constant guessing game of which diet and which gym would serve her best, Tanja decided to seek professional help to finally find a long-term solution to her health concerns.

Like many others, I have been yo-yo dieting for the majority of my adult life and stuck on the weight loss and weight gain cycle for years. I have tried every diet program and joined just about every gym, says Tanja.

Thats when she found Live Well.

Live Well fosters a friendly and welcoming community, and this motivates me to keep coming to exercise classes. Sessions are structured so that there is a different educational and inspirational component with each visit. Also, if something is not quite working for me, staff is always on hand to answer my questions and help me adjust my own personal program to suit my needs, says Tanja.

I have learned to incorporate (and even enjoy) regular exercise in my life again. Along with gaining more muscle strength and stamina, I also noticed that after a few months of doing the Live Well program I had less knee and joint pain! I feel physically stronger and more confident, and I am enjoying exercising my body and treating it well.

Unlike Tanja, Live Well member Tory had apprehensions about exercising for years due to her fear of injury, anxiety and lack of preparedness but after years of stagnant living she soon found that she couldnt delay her health journey any longer.

I spent years trying to get fit and lose weight, trying all sorts of things but nothing worked until Live Well. My balance was bad, my strength was minimal and I was scared. My whole life Ive taken horrible falls, many with serious injury, says Tory.

Since Ive been with Live Well, I have not fallen at all. The trainers are so amazing, if something doesnt work for you or you feel unwell they find an exercise you can do. Everyone has a different program with exercises just for them. There is no competition, the gym feels more like a sanctuary than a gym.

Some members have found inspiration to seek out and sustain healthier habits together like married Live Well couple Irene and Lloyd.

Lloyd and I both realized we needed to have some structured exercises as we age and we wanted it to be in a safe and supervised environment so that we could maintain and build strength, flexibility and stamina, said Irene.

Lloyd saw an ad for Live Well, looked into it and suggested we go. It has been a very positive and enjoyable experience. The groups are small, the exercises are designed for each individual and we work and advance at our own pace. It isnt a competitive environment and everyone in each session is at a different level.

Whatever the reason for seeking out Live Well, each member is able to find the safe and secure environment that they need to flourish. With just one consultation, the journey to a healthier you begins. Come visit us today and let us show you the path to a lifestyle youll be happy to have.

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Start your Health Journey with Live Well Exercise Clinic - North Shore News

Cramps are involuntary, localized muscle contractions that are often painful. Leg cramps typically affect the calf muscle, though they can occur in other parts of your leg as well (1).

These contractions commonly occur at night and can last seconds to minutes. Most leg cramps are over in less than a few minutes (1).

Although their exact cause isnt always clear, multiple factors, including pregnancy, medical treatments, insufficient blood flow, and the use of certain drugs, may increase your risk.

The keto diet may make you more susceptible to leg cramps for several reasons (2).

A potential cause of leg cramps is an electrolyte imbalance.

Electrolytes are minerals that are essential for critical functions in your body, such as cell communication. They include sodium, magnesium, chloride, potassium, calcium, phosphate, and bicarbonates (3).

If your levels become depleted, your nerve cells may become more sensitive. In turn, this leads to pressure on nerve endings, which may cause muscle spasms (4).

When adapting to the keto diet, your body may lose more electrolytes through urination in response to decreased levels of blood sugar and the hormone insulin (5).

This loss is typically greatest during the first 14 days of transitioning to keto, so muscle cramps related to electrolyte imbalance may be worse during this period (5).

People transitioning to the keto diet often urinate more due to factors like reduced insulin levels and increased sodium excretion. In turn, increased urination can lead to dehydration, another potential cause of leg cramps (1, 5).

Dehydration is one of the most common keto side effects and may thus increase your risk of leg cramps (6, 7, 8).

All the same, evidence is mixed and more studies are needed (9).

Several other factors may also cause leg cramps.

For example, certain medications, such as diuretics, asthma drugs, and statins, are associated with an increased risk of these pains (10).

Additionally, sedentary habits, old age, strenuous physical activity, and medical conditions like liver and kidney failure are associated with leg cramps (11, 12).

People on the keto diet may experience leg cramps due to dehydration and electrolyte imbalances. Other causes of leg cramps include sedentary habits and certain medications.

Aside from leg cramps, other symptoms associated with the keto diet include headaches, constipation, and fatigue collectively known as the keto flu.

These symptoms may likewise be caused or worsened by dehydration and electrolyte imbalances, making prevention all the more important.

The best way to prevent and treat leg cramps on keto is to ensure that youre eating nutritious foods, supplementing if necessary, and staying properly hydrated. Here are a few tips:

If you have persistent or extreme leg cramps, you should visit a health professional to ensure that youre not experiencing symptoms of a more serious medical condition.

Staying hydrated, consuming plenty of electrolytes, and engaging in gentle physical activity may help reduce your chances of leg cramps on keto.

While many people swear by the keto diet, transitioning to a very low carb, high fat diet can lead to uncomfortable symptoms, including leg cramps.

Nonetheless, making a few simple changes to your diet and lifestyle, such as staying hydrated, eating plenty of electrolyte-rich foods, and engaging in gentle activity, may help treat and prevent keto-associated leg cramps.

If youre experiencing leg cramps, try out a few of the tips listed above but remember to visit your healthcare provider if your cramps are persistent or extreme.

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By Swati Srivastava | 02/14/2020

According to Nursing Assoc. Prof. Samuel Green, mindfulness is defined as being present in any situation.

With classes, extra-curricular activities and limited budget, it can be hard for students to always maintain healthy lifestyles. Many students try to eat a balanced diet, exercise and meditate or practice self-care. At times, it may be difficult to establish a routine, but various communities and programs on and near Grounds can help them keep up with their goals.

Many choose to practice mindfulness, which is the act of focusing attention on the present moment while acknowledging thoughts and emotions that arise. Mindfulness has been shown to help reduce stress and boost overall mood and health. Mindfulness practices are taught in various University classes as well as drop-in classes from organizations such as the Contemplative Sciences Center and the Mindfulness Center.

Jon Kabat-Zinn, American professor emeritus of medicine at the University of Massachusetts Medical School, was a key figure in the development of mindfulness practice in the United States. Hypothesizing that mindfulness may help patients experiencing chronic pain, Kabat-Zinn created the eight-week Mindfulness-Based Stress Reduction program in 1979. It went on to become the precedent for mindfulness programs and classes throughout the country.

According to Nursing Assoc. Prof. Samuel Green, mindfulness is defined as being aware in any situation.

The point is to be present with whatever comes up, [whether it is] pleasant, unpleasant or neutral, Green said. As a result of doing that over and over and over again, the mind becomes less reactive.

Studies have further shown mindfulness helps those who are suffering from chronic pain, including people who rely on opioids as painkillers.

Green and John Schorling, director of the Universitys Mindfulness Center and professor in the University School of Medicine, explained that the exact mechanism by which mindfulness provides physiological benefits is not yet well understood. But researchers have been able to conclude that it helps reduce levels of stress hormones such as cortisol and adrenaline. This reduction can lead to benefits, including better immune system function and decreased inflammation.

Schorling also mentioned that mindfulness has been shown to decrease the feeling of burn-out in healthcare providers. In addition to MBSR classes, the Mindfulness Center also offers a class specifically designed for the University Health Systems employees. Although it is based on MBSR, the Mindfulness for Health System Employees class focuses on teaching employees to balance self-care with patient care via mindfulness, Schorling explained.

We often use the airline analogy in case of a drop in cabin pressure, put your own oxygen mask on first before helping others, Schorling said in an email to The Cavalier Daily.

Although the Mindfulness Center is open to the greater Charlottesville community, the classes require a fee and are not aimed at students, Green explained. Instead, for University students he teaches a class in the School of Nursing. Green said that students often say they wished they had taken the class earlier and explained how it helps them.

Students who are pretty good about doing the daily practice, after three or four weeks, find that they're getting that 20 minutes back in the rest of the day because they're more focused, and they get work done faster and better, Green said.

Diane Whaley, education professor and director of lifetime physical activity program, explained that the kinesiology department also offers many mindfulness, meditation and yoga classes for University students. Due to the increasing popularity of these classes, the department also offers a yoga class KINE 1410 with one section reserved exclusively for first-year students.

These kinesiology classes, as well as Greens class, are all one credit and are graded as credit or no-credit rather than being assessed using the letter-grade scale. The classes have a strict attendance policy, as they involve practicing mindfulness in person.

Whaley highly encourages students to try these classes.

"I think one of the misconceptions is that it's hard to do or you have to spend a lot of time doing it and that's just not true," she said. The first important step in alleviating stress is recognizing it, and mindfulness gives us that break to take a step back and say, what am I worried about?

In addition to academic classes offered by the University, students can attend drop-in classes at the Contemplative Sciences Center. Leslie Hubbard, program director for student engagement and contemplative instruction at the Center, explained that its vision is to promote student flourishing in other words, help students reach their full potential and wellbeing.

Robin Albertson-Wren, an instructor at the Contemplative Sciences Center, encourages students to attend drop-in meditation and mindfulness classes offered at Clemons Library. Students can enjoy these classes for free, and Albertson-Wren noted that most of the classes are conveniently located in Clemons.

Whaley, Green and Schorling echoed the sentiment of taking a class to help students keep up with mindfulness practices and integrate them into their schedules.

Albertson-Wren also suggested using daily concrete tasks, such as picking up keys or walking through a certain door, as times to pause slightly and take a few deep breaths.

Lastly, Whaley emphasized the importance of college students taking time now to prioritize self-care practices.

It's really important, I think, to establish these habits now before you get into your careers, because if you're thinking you're going to balance your work-life ten years down the road, that's very difficult to do, Whaley said.

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Various classes offer students and community opportunities to practice mindfulness - University of Virginia The Cavalier Daily