Dear Dr. Roach: In a recent column, you said, ''I don't find simply telling people to eat less and move more to always be an effective therapy.'' What do you suggest to patients wanting to lose weight? C.N.

Dear C.N.: The vast majority of patients I see who are overweight know they are overweight, and have tried unsuccessfully to lose weight. Often, they have tried multiple different types of diets, sometimes having success in the short term but then having gained it back. ''Eat less, move more,'' while correct, doesn't address the issues that are important for many people.

Although some of my colleagues will disagree with me, I look at the issue differently. I recommend that people choose a healthy diet. There are many healthy diets, and people can choose what they like, but I recommend plenty of vegetables, some fruits, and good-quality protein sources such as legumes or nuts and lean meats or fatty fish for those who eat them; processed foods, especially starches and processed meats, should be avoided. Along with these dietary changes, which are modest for many people, I advise increasing exercise, from wherever the person starts (within reason). My rationale is that ''losing weight'' often seems unattainable to people; however, eating better and exercising more feel like they are within one's control. There is no doubt that people will be healthier with a better diet and with more exercise.

It is true that over a long time, most people who make those dietary and exercise changes will lose weight. But the primary goal is to improve health, even if the weight doesn't come down.

Some people, especially those with medical problems due to their weight, need more-intensive intervention, and I am fortunate to have colleagues in weight management, both medical and surgical, for those who need it.

Dear Dr. Roach: I went gluten-free four years ago for ''health'' reasons. I had no irritable bowel issues or celiac disease. After this amount of time, is it OK to reintroduce wheat and gluten? Does going gluten-free when you do not have celiac disease cause you to become more gluten-sensitive because its reintroduction would be like a foreign substance to your system? I fear I may have caused myself to become gluten-sensitive by avoiding it when I didn't have to. Can you please advise? L.

Dear L.: If you had no gluten sensitivity and no celiac disease, then you should have no issues with going back on a diet containing gluten, as far as I have been able to tell from my reading and my understanding of the condition. However, some people with celiac disease have extremely mild symptoms it could be just some abdominal discomfort after eating, or fatigue symptoms felt by nearly everyone from time to time. Nonetheless, making the diagnosis of celiac disease is important, even in people with minimal or no symptoms. People with celiac disease are more likely to develop autoimmune disorders and some cancers, because of possible nutritional deficiencies, and dietary intervention is critical in the case of women who might become pregnant.

If you truly had no symptoms at all before you went gluten-free, and still don't once you restart, I don't think any testing is necessary. However, if you notice symptoms, then a blood antibody test while on a diet containing gluten can establish the diagnosis.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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Choose a better diet and exercise regimen for health - Sarasota Herald-Tribune

If you're constantly judging your diet, exercise regime and lifestyle by labelling things as 'good' and 'bad', you need to stop. Now.

Photo: Lyndi Cohen/ Supplied

This article initially appeared on lyndicohen.com and has been republished here with permission.

All-or-nothing thinking is also known as black-or-white thinking and it's when things are viewed as 'all good' or 'all bad.'

All-or-nothing thinking often means that anything less than 'perfect' is perceived as a failure.

Having these incredibly unattainable standards sets you up to feel like a failure, and you start to tell yourself things like "nothing I ever do is good enough", "if I just weighed less, then..." or "everyone is prettier and thinner than me".

All-or-nothing thinking keeps you stuck, unhealthy and unbalanced. You become unable to eat anything in moderation and are constantly yo-yo-ing from one extreme to another, flipping from restriction to binge eating or inactivity to over-doing at the gym. From feeling motivated and excited to feeling like it's not even worth trying.

But you are not the problem. All-or-nothing thinking is the problem, and it's holding you back.

Why? Well, first of all, you don't need to change yourself. You are enough just the way you are.

You just need to stop thinking it's 'all-or-nothing'.

The first steps to letting go of the all or nothing approach is to realise when you're doing it. Awareness is key. Take this short test to help you work out if you are a black or white thinker:

Is an 'all or nothing' approach to food holding you back from being healthy?

If you can relate to one or more of the following, you probably have an all-or-nothing approach and can benefit from making a mindset shift.

If any of these sound familiar, you need to let go of this approach, and start thinking of your health in holistic terms. These are some of the strategies that helped me...

1. Notice when you're stuck in this thinking pattern

The first step is to become aware of when you're using an 'all-or-nothing' approach. Often, using words like 'always', 'never' or 'nothing' will give you a clue that you're stuck in the cycle.

Try this instead: Count your success! At the end of each day, take two minutes to note the things you did well that day. Just before turning off the lights to sleep, I tell my partner the things I am grateful for about myself that day. This is important for me as my normal default is to run through all my flaws and faults. I don't talk about the things I didn't do well enough, only the things I am proud of doing or grateful to have learned.

2. Give yourself permission to enjoy food throughout the week

If you spend Monday to Friday being incredibly 'good' (or strict), then when it gets to the weekend, you're going to feel like you deserve a treat for your hard work. When you're feeling deprived, one cheat meal will often turn into a cheat weekend.

Try this instead: Give yourself permission to enjoy treats during the week. I personally like to have a couple of squares of chocolate every day. If I'm at a birthday party and there is cake, I'll have it if I feel like it and often I'll share. Say to yourself: "I am allowed it if I want, but do I really feel like it?"

3. Food is neither good or bad, so adjust your language

I get that you've been taught to think that there are 'good foods' or 'bad foods'. There aren't. Enjoying a piece of cake is not bad and salad is not good. Having cake and feeling guilty about it defeats the purpose. All food can be enjoyed in moderation at some time.

Try this instead: Don't refer to food as 'good' or 'bad'. Become aware of your language. You'll notice just how common, socially acceptable it is to label food as good/bad (black/white). Just because everyone else refers to food as good or bad doesn't mean you have to. Your thinking will change when your language does - and your behaviour will change with it.

4. Find the silver lining and practice being an anti-perfectionist

Good enough really is good enough. Something is better than nothing. Any small effort is worthy of being recognised and applauded.

Try this instead: Add the word 'but' to negative statements. For example, "I didn't get to exercise today BUT I did get to bed an hour earlier tonight and my body needs rest" or "I overate at dinner tonight BUT I understand why that happened" or "I ate chocolate today BUT I really enjoyed it" or "I didn't eat enough vegetables today BUT I did have two pieces of fruit". When I'm feeling less than perfect, I'll repeat to myself "I accept myself and accept others". It helps me let go of my need to be perfect and my expectation that everyone else must be perfect, too.

Dancer Amrita Hepi takes you through a stretching routine you can do in the office

Lyndi Cohen is an accredited practising dietitian and the founder of the Keep It Real healthy eating program. For more from Lyndi, head to http://www.lyndicohen.com and keepitreal.lyndicohen.com.

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This expert says you need to let go of your 'all or nothing approach' - Body and Soul

Is the 80/20 rule true when it comes to weight loss?

We know that in order to lose weight, its important to watch what you eat and engage in moderate exercise regularly.

But which is more effective at helping you get the body you want diet or exercise?

According to some personal trainers and nutrition experts, the answer is diet. In fact, they believe that 80 per cent of weight loss is the result of making healthy changes to your diet, while the remaining 20 per cent is due to being physically active.

This 80/20 rule, as its commonly called, is indeed accurate, and one that most nutritionists recommend, says Ardyce Yik, a registered naturopath at the Integrated Medicine Institute in Central, Hong Kong.

The key to weight loss is achieving a negative calorie balance, which means taking in fewer calories than you burn.

Decreasing the number of calories you consume is so much more effective than exercising, because it takes a tremendous amount of physical activity to create a calorie deficit, Yik adds.

But I exercise a lot, more than the average person, at least four times a week, you say.

Unfortunately, that doesnt give you a free pass to indulge in a high-calorie diet.

Studies show that exercise alone has a negligible impact on weight loss, Yik explains.

For example, youd need to burn 3,500 calories to lose just 500g of fat. If you relied on exercise alone to lose weight, you would essentially need to run more than 10km each day to lose one pound a week, without increasing your caloric intake.

This is why the 80/20 rule makes sense its easier to cut calories than it is to burn the same amount of calories through exercise.

However, Yik adds that this is a general rule, and one that may work better for some people more than others, since everyone is different.

Monitor your diet but also commit to exercise if you really want to lose weight.

She says that whats more important is to commit to both a healthy diet and regular, moderate exercise if youre looking to shift extra pounds.

Diet and exercise are equally important for weight loss.

Although cutting calories from your diet is easier and more practical than exercising a lot, bear in mind that when you start eating less, your metabolism starts to slow down and your body will resist weight loss. Exercise can counteract this.

I usually recommend a combination of cardiovascular and strength-training exercises about 30 minutes of moderate cardiovascular exercise, four or five times a week, plus two or three strength-training sessions per week.

As for your diet, you should look to slash about 500 calories a day to lose 500g of fat per week.

I always recommend a healthful and varied diet based on whole, unprocessed foods, says Yik.

Ideally, your meals should consist of lean protein, colourful vegetables, whole grains, nuts and seeds.

If you find that decreasing your caloric intake and exercising regularly isnt helping you achieve your weight loss goals, then you should speak to a nutritionist, dietitian or doctor to investigate and address the underlying causes of your inability to lose weight. South China Morning Post/Sasha Gonzales

Read more here:
The secret to weight loss is 80% diet, 20% exercise is this true? - Star2.com

NBR Radio has teamed up with Spotify to bring Sunday Business to its podcast platform. You can also listen to the full episode free on SoundCloudhere.

A Stanford University psychology professor, Carol Dweck, is this week'sfeatured guest on NBR Sunday Business with Andrew Patterson.

Her research into what has become known as growth mindset has been something of a revolution in the area of personal development, affecting not only business but also education.

Simply put, individuals who believe their talents can be developed through hard work, good strategies, and input from others have a growth mindset. They tend to achieve more than those who adopt a fixed mindset believing their talents are innate gifts. This is because the former worry less about looking smart and they put more energy into learning.

Professor Dweckdiscusses the impact of her research and the potential to measure the mindset of entire countries in the future.

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CAROL DWECK on revolutionising personal development - The National Business Review

England manager Gareth Southgate says he is hopeful Nathaniel Chalobah's "personal development" will benefit from joining Watford.

News of the Hornets' move for the England Under-21 international surprised many given his 13 years at Stamford Bridge, and his growing reputation despite remaining on the fringes of the Blues' squad.

But Southgate was impressed with the 22-year-old's desire to prove himself despite a new contract offer from Antonio Conte, and is hopeful the move will prove fruitful.

Chalobah partnered fellow Watford new-boy Will Hughes during the Under-21s' run to the semi-finals in this year's European Championships, with both already tipped for a senior squad call-up should they enjoy profitable seasons.

Southgate said: "I think that with Nathaniel, its always going to be harder to break into the top six than further down the league because the level of player needed is high and the opportunity to get in the best from around the world is there.

"I think if Nathaniel had stayed at Chelsea this year he might have got more matches and progressed.

"But hes taken the decision to look elsewhere and maybe get a guarantee of more games and, hopefully, for his personal development thatll prove to be the right decision."

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England manager Gareth Southgate hopes Watford move helps Nathaniel Chalobah's "personal development" - Watford Observer

MORE than 50 people came together last week to celebrate the personal achievements made by young people in a Thornbury youth club over the past year.

The Krunch South West summer party, which was held at Turnberries Community Centre, saw the club members come together with their families to enjoy a fun-filled evening, with plenty of games, an inflatable assault course, and barbecue.

Presentations of certificates and other awards were also made to several people in the club, having worked hard towards qualifications and accreditation to show their progress, with some having struggled in the school environment in the past.

I am really proud of these wonderful young people, said Krunch project manager Penny Baker.

We have had a really successful year, with the group taking big steps and accomplishing a lot.

People are often quick to point out the negatives of youth in the town, but they rarely see the positives.

But the work that goes on behind the scenes here is something they do not see.

The party made for a really great evening, and this event was a wonderful way to celebrate those milestones.

Having joined the club for a picture on the inflatables in her full mayoral robes, Cllr Helen Harrison said how delighted she was to present certificates at the party, but that she found it a little nerve-wracking to wait at the bottom of the slide for everyone to join her.

The visit to Krunch was really good, she said. It was lovely to hand out the certificates to young people who have overcome a lot of obstacles and demonstrate some amazing personal development.

It was also a great opportunity to thank Penny and the team at Krunch for the amazing things they do week-in-week-out for the young people at the club.

"They offer a very important service to our community and I am honoured to have been invited to join in with their celebrations.

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Young people in Thornbury celebrate a year of personal development at Krunch summer party - South Cotswolds Gazette

England manager Gareth Southgate is hopeful Nathaniel Chalobah's decision to leave Chelsea for regular game time will pay off.

Chalobah completed a permanent move to Watford for a fee in the region of 5million after making just 15 appearance for the Blues last term.

As a former England Under-21 manager, Southgate knows how difficult it is for young players to force their way into the first team at club level.

He urged them to rise to the challenge and is confident that, over time, the senior England side will feel the benefits. Southgate said: Weve really improved the games programme and experiences for the young players and also due to a lot of the work going on in the clubs, we are starting to see a better, more rounded type of player coming through. Its not just about what were doing just as England, but also the work thats going on in clubs. To have a successful national team, those things have to be aligned.

"Moving forward (it will have an impact) on the senior squad. How quickly that will happen depends on those players getting an opportunity at their clubs and being able to stake a claim at a higher level. Obviously to impact the senior team, those boys will need to be playing Premier League football and doing well.

Thats the challenge for them, they cant just say were World Cup winners now, everythings going to fall into place. We wouldnt hesitate to involve them in that (the senior team), and as weve shown already, were quite prepared to put young players in.

The lack of first-team football is why Chalobah, Englands most capped player at youth level with 97 appearances, left Chelsea for Watford this month. The England Under-21 midfielder spent six spells on loan while at the club, including one at Watford. I think that with Nathaniel, its always going to be harder to break into the top six than further down the League because the level of player needed is high and the opportunity to get in the best from around the world is there, said Southgate. I think if Nathaniel had stayed at Chelsea this year he might have got more matches and progressed. But hes taken the decision to look elsewhere and maybe get a guarantee of more games and, hopefully, for his personal development thatll prove to be the right decision.

Nathan Ake, the 22-year-old Holland defender, and Dominic Solanke, player of the tournament at the Under-20 World Cup, are other young players to have left the Blues this summer. Chelsea have won the FA Youth Cup for the past four years but John Terry is the last Academy graduate to establish himself in the first team. Englands age-group teams have benefited from Chelseas youth talent and Southgate said: The success of our junior teams this year, theres a big debt to what Neil Bath (head of youth development) has done at Chelsea.

Gareth Southgate was speaking at an FA Lidl Skills coaching day. The programme aims to give children and families better access to football.

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Nathaniel Chalobah's decision to quit Chelsea could accelerate his personal development, says Gareth Southgate - Evening Standard

Online Education is one of the most necessary yet undermined topics in the field of education. Online education is the process of attending college through internet. It basically means that a student can sit in his computer and earn college equivalent degree without even leaving their room. As marvelous as it sounds, online education courses are far from being taken in by the students. The traditional belief of education by person to person interaction seems to be one of many problems.

The world population is ever increasing, while schools and colleges are getting crowded. The concept of mass education compromises the quality of education. Students also travel to their respective colleges in their vehicles. The gasoline demands are forever increasing and with the growing population, it is set to get even higher than ever.

In such a scenario, online education courses serve as an efficient and easy way of minimizing such problems. Colleges are expensive as they have to encompass a large housing space for their dorms and classrooms. As a result, more barren land is created by demolishing forests which inevitably points toward the danger of global warming, climate change and many other problems. Online education courses also provide a solution to this problem. When students use such courses, there is no need to create huge housing spaces for college and dorms. Hence a large portion of the forest can remain unharmed.

Online education courses can also limit the flow of immigrant students who leave their country for education. As the colleges are less crowded, teachers will have a less student to deal with, enabling them to pay much closer attention to details, ensuring a higher quality of education. It can also help financially backward students to attend courses of their choice. As they can just stay at home and get education, the cost of travelling and accommodation can be saved.

However, online education courses also have disadvantages. For instance, the only medium to attain online courses is computer and internet, and youll have nothing in your hands if these mediums somehow get disrupted. Online education can also be annoying for some who do not want to sit on their computers for hours and take lessons.Digital divide, lack of computer education and other factors can also make online education inaccessible. Meanwhile, electronic devices can also be distracting for some. Students might move on to playing online games or watching videos when they are studying online.

Although the concept of online education courses is promising, its implementation is complicated. Such courses can save time, money and fuel. But it is not a realistic idea for underdeveloped countries. People have yet to understand that education can also be completed beyond the four-walled classrooms.

Originally posted here:
Online Education A broader solution - Republica

I like nothing better than getting things wrong. When we are wrong, we learn something.

So I interested to read a NYTimes piece on 7/10/17 on e-commerce, the tech sector, and job creation.

For a while now Ive thought that the growth of online shopping is killing retail jobs, and that this trend would inevitably result in overall job losses as less the role of sales people and cashiers is eliminated.

But maybe Ive been wrong.

And if online shopping is really a jobs engine, couldnt online learning also be a job creator for educators?

The Times article summarizes research from Michael Mandel, chief economic strategist at the Progressive Policy Institute, that makes the case that online shopping has created more jobs than it has displaced in bricks-and-mortar retail stores.

According to Mandel, in the decade between 2007 to 2017 the e-commerce industry created 397,000 jobs in the United States. This compares to loss of 76,000 jobs in the traditional retail industry. Even better, the jobs created in e-commerce fulfillment - such as warehouse jobs - pay on average 30 percent more than retail positions.

The article is quick to point out that Mandels findings are controversial. It is difficult to assign job creation directly to the growth of e-commerce, as it is not always clear what tasks employees of Amazon or Google or other tech companies are assigned. Nor is it certain that warehouse job creation will not plateau, as productivity around online shipping grows as the sector grows, and as warehouses themselves become more automated.

Might online education be operating in some similar ways as online shopping?

How many good jobs in education have been created by the growth in online learning?

From 2002 to 2014 the number of students who took at least one online course rose from 1.6 million to 5.8 million. The bulk of all online learning programs are concentrated in non-profit institutions, accounting for over 2 million of the total 2.8 million enrolled in online only programs. From 2012 to 2014 the percentage of 4-year schools offering online degree programs rose from 46 percent to 59 percent.

Has anyone counted the number of jobs, and what types of jobs, that the growth in online education has created?

Conventional wisdom would hold that online learning has the potential to displace full-time residential faculty with contingent online instructors. But is this really true?

Many schools that I know of draw their online faculty from the same pool of full-time and tenure-track/tenured faculty as their residential programs - as well as from the same pool of part-time and adjunct faculty teaching in-person. If anything, Ive seen online learning offer more opportunities for teaching gigs for all higher ed teachers.

Has anyone been able to count the number of instructional design and other non-faculty educator jobs that have been created by the growth of online education? Quality online programs require a team approach to course development. Faculty (subject matter experts) are paired with experts in learning design and technology.

The indirect impact of online learning on higher education employment may also be under-appreciated. Id like to see some national level data on the revenue impact of online programs on the budgets of non-profit institutions. How much cross-subsidization of residential programs is occurring from online units? How many higher ed jobs have been saved or created by profitable online units?

Where would one start in unpacking the higher education employment impact of online education?

Can we interest Michael Mandel and the Progressive Policy Institute in taking up this question?

Is this a question that WCET, OLC, EDUCAUSE, or the National Council for Online Education could answer?

When have you been wrong lately?

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Is Online Education a Jobs Engine? - Inside Higher Ed (blog)

How long is your commute?

Do you think that educators involved in online education think differently about commuting - including telecommuting?

Might the growing reach and acceptance of distance learning change how we think about commuting?

Ive been thinking about the relationship between commuting and online education after reading anarticle in this past Sundays NYTimes on extreme commuting.

According to the Times, the number of people who commute two hours or more (each way) to work is increasing. While solid data on the growth of extreme commuting is lacking, the consensus is that the trend towards long-distance commutes is accelerating.

Reasons for the growth in extreme commuting include:

Am I missing any of the reasons for the growth in extreme commuting?

In reading the Times article, my response was 'this is crazy'. A 4+ hour commute - even one by train that allows an extension of the workday into commuting time - just seems insane.

How much of my reaction against extreme commuting is driven by my experience with online education?

The one big thing that Ive learned in two decades of work in online education is that online education is really good. Done well, and for the right students and the right programs, online education is just as good as face-to-face.

How many jobs are there that truly require everyone to be in the same physical place at the same time?

Yes, I want the person who cuts my hair to be in the office when I go for a haircut. I suppose that there are some jobs that require physical proximity, such as most health care providers and firefighters and cops and other first responders. Construction workers cant work remotely. Nor can mechanics. Who else?

And yes, all the educators and staff who make residential colleges go need to come to campus - at least most days. Professors need to teach residential courses in classrooms. Researchers who work in labs need to come to the lab. The academic library would be a shell of itself without the presence of academic librarians. All the people who make the physical plant of the campus run need to come to campus to do so.

For most of the work that most workers do, however, Id venture that telecommuting would be just fine.

What weve learned from online education is that with a combination of thought, investment, and a willingness to make data-driven continuous improvements - that distance is not a barrier to quality.

Weve learned through online education that distance need not impede collaboration, community building, or the development of relationships.

The most important element in teaching an online class is developing a sense of presence. The best online courses are set-up so that there is a density of interactions. And the best online faculty prioritize rapid feedback, clear communication expectations, and the use of different platforms and tools for rich interactions.

This prioritization of presence and collaboration in online learning would translate well into the world of work. The biggest obstacle for telecommuting would be, Id guess, a concern about all those hallway conversations and micro-interactions that might be missed if people were not in the same physical space.

This concern, however, is a solved problem in online learning. We know how to build community, presence, and collaboration online - and we can take our methods and tools to goal of improving the productivity of telecommuting.

Have we done enough to take what weve learned in online education to improving telecommuting?

Should the champions of online learning also be advocating for telecommuting?

It seems strange that as we get more experience and comfort with distance education that extreme commuting should also be increasing.

Maybe some workers have jobs that truly require face-to-face in office time. I doubt, however, that the majority of extreme commuters are employed in such jobs.

Are online learning people also natural champions of telecommuting?

How do you see the relationship between online learning and extreme commuting?

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Extreme Commuting and Online Education - Inside Higher Ed (blog)