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#1 Killer in the United States

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While heart disease is still the number-one killer in the United States, it’s also no longer a guaranteed death sentence, thanks to newer medications, improved surgical techniques, and better understanding of the disease.

Society as a whole has also gotten better at preventing heart disease. A 2018 study in the journal Circulation found that the overall rate of heart disease in the U.S. had declined 38% since 1990. Other developed countries have seen even greater reductions.

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But these improvements haven’t benefited everyone equally—and one new study shows a troubling trend among young people, and young women, in particular. When researchers looked at hospitalization rates for heart attacks between 1995 and 2014, they found that those numbers had steadily increased among people ages 35 to 54. More specifically, hospitalization rates remained relatively stable among men in this age group but increased significantly (from about 21% to 31%) among women.

The findings, published last month in Circulation, aren’t the first to suggest that young women are being left behind when it comes to advancements in heart disease treatment and prevention. Now, doctors are trying to figure out why.

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For Young Women Disturbing Heart Trends 

Scientists can’t say for sure what’s causing an increase in heart disease among young women, but they do have some ideas. Last month’s study found that not only had hospitalization rates for heart attacks increased among young people since 1995, but that hypertension and diabetes rates had increased as well. The young women in the study were also more likely to be black than the young men, suggesting that heart disease is hitting young black women especially hard.

The study didn’t look at patients’ body mass indexes, but co-author Melissa Caughey, PhD, a research instructor at UNC School of Medicine, notes that hypertension and diabetes tend to be associated with obesity.

“We know that there’s an obesity epidemic going on in the United States, and we know that women—especially black women—tend to have higher obesity rates than men,” Caughey tells Health. “It may be that these are actionable areas where physicians could do better to manage risk factors in these high-risk patients.”

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Another interesting finding was that, compared to the young men in the study, the young women were less likely to have previously been treated for conditions like high blood pressure, high cholesterol, or stroke. This suggests that women are being under-treated for heart disease risk factors, wrote Viola Vaccarino, MD, PhD, an epidemiologist at Emory University, in a commentary published along with the study. Prevention guidelines may also underestimate risk among this age group, she added.

“Notably, there was no indication that the sex-related treatment gap improved between 1995 and 2014; if anything, there was a tendency for the disparities to worsen over time,” wrote Dr. Vaccarino.

Another challenge is that women tend to experience heart attacks differently than men—so they, and their doctors, may not even recognize it when it’s happening, and their treatment may suffer as a result.

Traditionally, a heart attack is described as the man clutching his chest and suddenly falling out of his chair,” says David Goff, MD, director of Cardiovascular Sciences at the National Heart, Lung, and Blood Institute. “But heart attacks are seldom that dramatic, especially for women.” Women are more likely to report back pain, nausea, sweating, lightheadedness, or dizziness, Dr. Goff tells Health, rather than chest pains.

“When women present with these symptoms, the sad reality is that too often, the health care system doesn’t think about heart attacks first,” he says. “Women might be told that it’s anxiety or it’s gastroesophageal reflux or some other problem, because physicians still don’t know to look for heart problems.”

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Things to be Changed

The new Circulation study did find some promising trends. Young women in the study were less likely to smoke than their male counterparts and were more likely to have health insurance. Indeed, says Dr. Goff, the decline in smoking rates over the last 50 years has been a big part of the overall decline in heart disease across all age groups.

Caughey stresses that the overall risk of heart disease for young women “remains quite low,” and that it increases significantly after menopause. “I don’t think this is anything for young women to panic over, but I do think it’s a warning sign that maybe women of this generation are not as healthy as those of previous generations were.”

Dr. Goff paints a slightly more concerning picture. “One out of four women in our country will die of heart disease, and 60% will have a major cardiovascular event before they die,” he says. “This means that none of us can really ignore our heart health—whether you’re older and overweight or you’re young and lean and otherwise healthy.

Young women can improve their lifestyle and decrease their risk for heart disease by getting more physical activity, eating a healthier diet, and avoiding both first- and secondhand smoke, says Caughey. “And even if you’re already doing that, you should still know your numbers and check in every year or so with your doctor,” she adds.

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Ultimately, experts say, doctors need to watch young women for symptoms of heart disease, so they can be diagnosed and treated before their conditions worsen. Doctors also need to pay attention to risk factors that could make young women more vulnerable to heart attacks and other forms of heart disease in the future.

For example, Dr. Vaccarino wrote, young women who have heart attacks are more likely than men to have depression or post-traumatic stress disorder, to report high levels of stress and more life adversities, and to fall into lower education and income brackets. Female-specific conditions like polycystic ovary syndrome (PCOS), premature menopause, or a history of preeclampsia may also play a role in heart disease risk.

“Younger adults, and women in particular, have been inadequately studied in cardiovascular research,” Dr. Vaccarino wrote. “It is now time to pay attention to this group to optimize prevention strategies and promote cardiovascular health among women.”

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Keto Diet : Risk of Health

don’t know about its long-term effects on the

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It’s easy to see why a diet that promises quick results—and that technically allows you to still enjoy foods like burgers and cheese—would be so tempting. But before you try it, it’s important to realize that keto can also have its downsides and that there’s a lot health experts still don’t know about its long-term effects on the body.

Following the keto diet for an extended period of time can be difficult, and even some of its top proponents warn against sticking to its strict guidelines (like cutting back carbohydrates to 50 grams a day or less) for more than 30 to 90 days. Other researchers warn that sticking to the diet long-term could even be dangerous. Here are a few reasons why.

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Limiting carbs to 50 grams a day or less likely means you’re cutting out unhealthy foods like white bread and refined sugar. But it also means you may have to cut back on fruits and certain vegetables, which are also sources of carbohydrates.

That’s a concern, says Annette Frain, RD, program director with the Weight Management Center at Wake Forest Baptist Health, especially if someone is spending more than a few weeks on this type of diet. “Fruits and vegetables are good for us; they’re high in antioxidants and full of vitamins and minerals,” she says. “If you eliminate those, you aren’t getting those nutrients over time.”

It may also be hard to get enough fiber while you’re cutting back so severely on carbohydrates, since whole grains are one of the biggest sources of this important nutrient. That can lead to digestion problems (ranging from constipation to diarrhea), bloating and weight gain, and even elevated cholesterol and blood pressure.

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here’s no shortage of athletes who have jumped on the keto bandwagon, but some researchers worry that they could actually be sabotaging their strength and fitness. In a recent study in the Journal of Sports Medicine and Physical Fitness, researchers found that participants performed worse on high-intensity cycling and running tasks after four days on a ketogenic diet compared to those who’d spent four days on a high-carb diet.

 The body is in a more acidic state when it’s in ketosis, lead researcher Edward Weiss, PhD, associate professor of nutrition and dietetics at Saint Louis University, previously told Health, which may limit its ability to perform at peak levels.

Sure, keto can help athletes lose weight, which can be helpful for speed and endurance. “But I’m very concerned that people are attributing the benefits of weight loss to something specific in the ketogenic diet,” Weiss said. “In reality, the benefits of weight loss could be at least partially canceled out by reductions in performance.”

Because the keto diet is so strict, many variations of the diet recommend incorporating several stages. The first stage, usually the first one to three months, is extremely low-carb and allows for very few “cheat days,” if any at all. It also requires keeping close track of your carbohydrate and fat consumption to ensure your body is entering ketosis.

But then, people may transition to a more relaxed form of keto that allows for more carbohydrates or less monitoring—sometimes known as lazy keto, keto cycling, or “maintenance mode,” as Jenna Jameson has called it. The problem here, says Frain, is that weight re-gain is almost inevitable.

“Keto can be a great jump-start to weight loss, but the reality is that most people can’t adhere to it for very long,” says Frain. “Often, people are going into ketosis and losing weight, then coming out and gaining it back and falling into this yo-yo pattern, and that’s not what we want.” In addition to being extremely frustrating, she says, these types of weight fluctuations are also linked to a higher risk of early death.

The type of weight you gain back is important as well. If you lost weight when you first started on keto, you likely lost some muscle mass along with fat tissue, says Kristen Kizer, RD, a nutritionist at Houston Methodist Medical Center. Now, since you’re following a high-fat diet, you will probably gain back more fat and less lean muscle—which not only looks and feels different on the body, but also burns calories at a slower rate. This can affect your metabolism and make it more difficult to lose weight again in the future.

Enjoying a “cheat day” in the short-term on the ketogenic diet can also have long-term consequences, say researchers from the University of British Columbia. In a recent study published in Nutrients, they found that indulging in a high-sugar treat (like a large bottle of soda) while on a high-fat, low-carb diet can actually damage blood vessels.

“My concern is that many of the people going on a keto diet—whether it’s to lose weight, to treat type 2 diabetes, or some other health reason—may be undoing some of the positive impacts on their blood vessels if they suddenly blast them with glucose,” said senior author Jonathan Little, associate professor in the School of Health and Exercise Sciences, in a press release. “Our data suggests a ketogenic diet is not something you do for six days a week and take Saturday off.”

Health experts worry about how a long-term keto-style diet can affect the heart and arteries. A not-yet-published study, presented at the American College of Cardiology’s annual Scientific Session, found that people on low-carb diets are more likely to develop atrial fibrillation (AFib) compared to those who eat moderate amounts of carbohydrates. AFib is the most common heart rhythm disorder and raises the risk of stroke and heart failure.

It’s not just the heart they’re worried about either. Research presented earlier this year at the European Society of Cardiology Congress found that people who followed low-carb, high-fat diets had an increased risk of dying from cancer and all other causes during the study period. And a recent study in the Lancetalso found that low-carb dieters who consumed large amounts of meat and dairy had a higher risk of early death compared to those who consumed carbs in moderation or who consumed mostly plant-based protein.

Most of this research, it’s worth pointing out, is still observational—meaning that it’s only been able to find associations with certain health outcomes and not cause-and-effect relationships. Frain says that, overall, there’s not enough long-term research to know exactly what the ketogenic diet does to the body over an extended period of time—or why it seems to affect some people differently than others.

But she advises anyone who’s thinking about trying keto to strive for balance, not for extremes. “It’s important to look at what you’re missing in a diet and what is really sustainable for you,” she says. “You want to make sure you have satisfaction and satiety from the foods you’re eating and that you feel good and are getting great nutrition from a variety of foods. That’s what will help you keep it up and keep the weight off.”

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Take a Walk After Eat : A Case Study

At the end of a long day, it’s tempting to dive into your social feeds or Netflix queue the minute you’ve finished eating. But back before screens bogarted all our free time, an after-dinner stroll was a popular activity and one associated with improved health and digestion. “Italians have been walking after meals for centuries,” says Loretta DiPietro, a professor of exercise science at George Washington University’s Milken Institute School of Public Health, “so it must be good.”

Research backs this up. One small study co-authored by DiPietro found that when older adults at risk for type-2 diabetes walked on a treadmill for 15 minutes after a meal, they had smaller blood sugar spikes in the hours afterwards. In fact, the researchers found that these short post-meal walks were even more effective at lowering blood sugar after dinner than a single 45-minute walk taken at mid-morning or late in the afternoon.

The human digestive system converts food into the sugar glucose, which is one of the body’s primary energy sources—so after a meal, glucose floods a person’s bloodstream. Hormones like insulin help pull that glucose into cells, either to be used immediately or stored away for later use. But for people with diabetes and impaired insulin activity, too much glucose can remain in the blood, which can cause or contribute to heart disease, stroke, kidney disease and other health problems.

Insulin secretion in response to a meal tends to wane later in the day, and this is especially so in older people,” DiPietro says. She points out that many of us eat our largest meal of the day in the evening, and we also tend to sit around afterward. As a result, “blood glucose levels will rise very high and will stay elevated for hours,” she says.

What good does walking do? “The muscles we use to walk use glucose as energy, drawing it out of circulation and therefore reducing how much is floating around,” says Andrew Reynolds, a postdoctoral research fellow at the University of Otago in New Zealand.

Reynolds coauthored a 2016 study of people with type-2 diabetes and found that just 10 minutes of walking after a meal helped control their blood sugar levels. “We saw the biggest differences with walking after dinner time,” compared to other times of the day, Reynolds says. Like DiPietro, he says many people just sit around in the evenings, and this may be especially bad because the body’s ability to manage blood sugar at that time of day is weakest. “Getting up and moving around at that time was very effective,” he says.

Along with combatting surges in blood sugar, a little post-meal movement may also aid digestion. “Exercise stimulates peristalsis, which is the process of moving digested food through the GI tract,” says Sheri Colberg-Ochs, a diabetes and exercise researcher at Old Dominion University. Her research has found that a post-meal walk is much more effective than a pre-meal walk for controlling blood sugar.

More research has found that walking helps speed up the time it takes food to move from the stomach into the small intestines. This could help improve satiety after eating. There’s also evidence that links this type of faster digestion with lower rates of heartburn and other reflux symptoms.

Walking isn’t the only type of post-meal exercise that provides these benefits. “Whether it is resistance exercise or aerobic exercise, both have a similar impact on lowering blood glucose levels,” says Jill Kanaley, a professor of nutrition and exercise physiology at the University of Missouri. One small study by Kanaley and others found that for people with obesity and type-2 diabetes, doing a weight training session with leg presses, calf raises, chest flies and back extensions 45 minutes after dinner lowered their triglycerides and blood sugar for a short time—and improved their wellbeing.

But more isn’t necessarily better when it comes to post-eating exercise. There’s some evidence that vigorous forms of training may delay digestion after a meal. “Exercising muscles pull more of the blood flow their way during activity, and the GI tract gets relatively less,” Colberg-Ochs says. “That actually slows down the digestion of food in your stomach during the activity.” Most of the research on post-meal physical activity suggests that moderate intensities—think fast walking or biking—are best. “Anything but really intense exercise would probably work equally well,” she adds.

As far as timing goes, try to move your body within an hour of eating—and the sooner the better. Colberg-Ochs says glucose tends to peak 72 minutes after food intake, so you’d want to get moving well before then.

Even if you can only fit in a quick 10-minute walk, it’ll be worth it. Apart from the perks mentioned here, more research has linked short bouts of walking with benefits like lower blood pressure and a reduced risk for depression.

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Great Source of Protein in USA

There’s no question that plant-based diets are on the rise: Between 2000 and 2017, dairy consumption fell 24%. And market research firm Mintel reports that plant “milk” sales (such as almond, coconut, and oat milks) rose more than 60% between 2012 and 2017. Thirty-six percent of consumers and 60% of millennials buy plant-based “meats.” And two-thirds of Americans surveyed say they have reduced their meat consumption in at least one category over the previous three years—mostly red and processed meat.

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There are many reasons for a shift toward plant-based eating. Whole-food, plant-based diets are associated with lower body weight and a reduced risk of several chronic conditions, including heart disease, the nation’s top killer of both men and women, as well as cancer, type 2 diabetes, high blood pressure, and cognitive decline.

Some people also have concerns about the treatment of animals for food production, and the impact on the environment. A recent Harvard report, The EAT-Lancet Commission on Food, Planet, Health, states, “Food is the single strongest lever to optimize human health and environmental sustainability,” and calls for a primarily plant-based diet.

There is no one definition of a plant-based diet, but most experts agree that it means primarily eating plants, although small or occasional amounts of any type of animal protein many be included. However, two specific versions of a plant-based diet are well defined: vegetarianism and veganism. So what’s the difference between them?

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What’s a vegetarian?

Vegetarianism generally means that no meat, poultry, or seafood is consumed. Eggsand/or dairy are typically included in a vegetarian diet.

People who eat eggs as their only animal protein are called ovo-vegetarians. Those who allow dairy in their diet are lacto-vegetarians, and people who eat both eggs and dairy are deemed lacto-ovo-vegetarians. Pescatarian is a title for people who do eat fish and seafood but no meat or poultry, although they are generally not considered to be part of the core vegetarian community.

What’s a vegan?

Veganism excludes all animal foods, meaning no meat, poultry, seafood, eggs, dairy, or any ingredients derived from animal sources, including honey and gelatin. Veganism generally extends to a lifestyle that involves not using any materials derived from animals, including leather, fur, wool, and silk. Household products, such as cosmetics and soaps are also excluded if they are made with or tested on animals.

Nutritionally speaking, omitting more animal foods can make it challenging to meet the needs for certain nutrients, such as vitamins D and B12, iron, zinc, and calcium. However, it is possible to obtain all of the necessary nutrients on a vegan diet if you are knowledgeable about which plant foods contain key nutrients and how to supplement properly if needed. If you are vegan or are thinking of going vegan, consult with an RD who specializes in vegan diets or, at the very least, refer to a book like Becoming Vegan, written by two RDs.

When it comes to health protection, the quality of any plant-based diet is king. One recent study, published in The Journal of Nutrition, followed over 800 people who were vegans, lacto-ovo vegetarians, semi-vegetarians, and non-vegetarians. Researchers found that vegans had higher levels of healthy fats, antioxidants, and anti-inflammatory compounds in their bodies than non-vegetarians, likely because they consume more produce and other whole, plant-based foods.

How to get more plants in your diet

While vegetarianism and veganism are two pillars of plant-based eating, many consumers are creating new categories, like chegans (vegans who sometimes “cheat” with an animal-based food).

Regardless of what you call your personal style of eating, prioritize nutrient-rich, whole-plant foods. Aim for about five cups of veggies and two cups of fruit daily, along with pulses (the edible seeds of certain plants in the legume family) such as beans, lentils, peas, and chickpeas; whole grains, like quinoa and brown or wild rice; and a variety of nuts and seeds. Vegan goodies, like coconut milk ice cream, and vegan cupcakes are fine as occasional treats, but they shouldn’t be mainstays.

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Type 2 Diabetes- What to Do ?

Losing weight with diabetes

When you have type 2 diabetes, losing just 5% of your weight can improve blood sugar, blood pressure, and cholesterol. However, as if dropping pounds isn’t tough enough, diabetes can make it even more difficult. Many people who begin taking insulin to control their blood sugar see the scale tick up, and other diabetes drugs, including sulfonylureas, thiazolidinediones, and meglitinides, have also been associated with weight gain. (Although some, like metformin, may help you lose weight.) What’s more, hormonal changes that occur in your late 30s and early 40s add to insulin resistance, which is when your body fails to use insulin efficiently, says Betul Hatipoglu, MD, an endocrinologist at Cleveland Clinic. “Metabolism slows down and the risk of gaining weight increases, especially around the midsection,” she says. Here, top experts give their best advice to make losing weight with diabetes a little easier.

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Move as much as you can

The best way to overcome insulin resistance is with exercise, says Dr. Hatipoglu. “Exercise improves the body’s insulin resistance and helps get rid of the fat,” she says. In fact, exercise can be as powerful as medication at lowering your blood sugar. Take every opportunity to get up and walk around during the day and avoid sitting for long periods of time. Some simple lifestyle tweaks: take the stairs instead of the elevator; get off one stop early if you use public transportation or park at the back of the lot if you drive; and walk over to your coworker’s desk to ask a question instead of shooting an email or instant message. Aim for a total of 30 minutes of moderate-intensity activity a day.

Take breakfast

Including breakfast in the daily routine is a common denominator for successful weight loss and maintenance, says Rene Ficek, RD, lead nutrition expert at Seattle Sutton’s Healthy Eating and a Certified Diabetes Educator. “This may work because breakfast suppresses midmorning hunger, produces better blood glucose and elevates basal metabolic rate,” she explains. An Israeli study showed one-third of people with diabetes who ate a big breakfast that included protein and fat were able to reduce their diabetes medication and lower their blood sugar levels compared with only 17% of those eating a smaller breakfast. Eating breakfast also typically results in fewer episodes of imbalanced, impulsive, or excessive eating later in the day increases fiber intake from veggies and whole grains; reduces dietary fat intake; and encourages improved health consciousness.

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Check body weight frequently

In addition to a reduced-calorie diet, frequent weighing is an integral part of successful weight loss, says Ficek. “Monitoring weight on a regular basis is a form of accountability and self-monitoring, and consistent self-monitoring is associated with improved weight loss.” Ficek recommends weighing yourself one to two times a week. Be consistent with the time of day and weigh yourself with the same clothes—don’t wear your shoes one day and leave them off the next.

Plan before dining out

It happens: A big project keeps you at the office late, and you have nothing to eat waiting for you at home. Instead of pulling into a drive-thru and asking for the first thing that looks good to you, have a list of healthy options saved in a note on your smartphone so you know exactly what to order, suggests Weisenberger. All major fast food chains have nutrition information available on their websites. Find out which options have an amount of carbs and calories that your nutritionist could give a thumbs up. Good bets: healthy salads with nuts (skip sugary dressings!), half sandwiches or breadless options with vegetables, lettuce wraps, asking for mustard instead of mayo, and fruit parfaits.

Make your own flavored water

Slashing empty calories from sugary sodas and juices is a no-brainer when you have type 2 diabetes. But if you can’t stand the idea of drinking plain water, skip diet drinks (they aren’t any better for you than the sugary stuff) and make your own flavored H2O, says Weisenberger. “Flavor your water with fruit, vegetables, and herbs.” Try cucumber and mint, peach and basil, lemon slices, and strawberry, lime and rosemary. Before adding the herbs, crush them lightly in your hand to release their flavors, she suggests.

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The Benefits of HMR Diet

The Benefits of HMR Diet

Introduction

There are countless weight-loss plans to choose from, but the simple truth is this: What works for one person just may not click for another. Some people need a plan with lots of choices and variety, or one that allows them to cook. Others prefer an ultra-streamlined approach, in which all of the food is provided and options are minimized.

If you’re in the latter group, one program to consider is HMR, which stands for Health Management Resources. Here’s how to follow HMR, the number of calories and types of foods you’re allowed, and my thoughts as a registered dietitian nutritionist as to whether it’s safe, healthy, and can result in long-term weight loss.

Following Rules

 News and Reports ranked HMR the number one diet for fast weight loss. The company’s simple 3+2+5 Healthy Solutions plan includes 3 shakes per day and 2 pre-made meals (which you purchase from HMR) and 5 daily servings of fruits and vegetables that you supply yourself.

The structured approach also recommends daily tracking using the HMR app, and incorporating physical activity, such as a few daily walks. Participants typically lose 23 pounds on average within 12 weeks. The company also offers an even lower calorie medically supervised option, which can result in significantly greater weight loss for obese people. (More on this below.)

The plan provides roughly 1,200 calories a day, and a starter kit that contains three weeks worth of meals costs about $300. However, this phase is designed to last until you hit your goal, which may take much longer. The program also includes support, via the app, and weekly group phone sessions led by a “health coach” who offers cheerleading and problem solving.

The goal is to transition to a maintenance plan, which reduces the reliance on HMR foods and teaches healthy lifestyle skills, including meal planning and prep, plus how to navigate social situations while you’re trying to lose weight.

Benefits

In all of my years counseling clients, I have learned that it’s important to know your personality in order to determine if any particular approach is doable and sustainable for you. Both ultimately determine a successful (or disastrous) outcome, as well how you’ll feel emotionally as you’re shedding pounds.

For example, if fewer choices make you feel restricted and trigger cravings, a plan like HMR isn’t the best choice. But if you’re the type of person who thrives on structure and repetition, and you feel freed by not having to make decisions about what and how much to eat, an approach like this may work well. And if you need to see some quick weight loss in order to build momentum and boost your motivation to transition to a longer term healthy eating pattern, a ready-to-eat approach may fit.

Know About

There are few things I don’t like about HMR, however. My number one issue is the ingredients. The shakes contain the artificial sweetener saccharin and artificial flavor, and they are dairy and egg-based. I did not see an option for those with dairy or egg allergies or sensitivities on the HMR site.

Also, the entrees are shelf stable (not frozen) and highly processed. While some are better than others, I did spot ingredients like carrageenan, which has been linked to inflammation, as well as preservatives and soy, another common allergen.

My other red flag concerns long-term results. While I appreciate the fact that the program emphasizes produce from day one, supplies group support, and teaches lifestyle changes, I’ve seen people use these types of programs as quick fixes before rebounding right back to old habits. There doesn’t seem to be solid data on how HMR participants do at keeping weight off for good.

One study, which looked at the very low calorie diet (VLCD) HMR option, was unable to determine outcomes past one year. Researchers also noted some risks associated with very VLCD approaches, including constipation and gallstones. The latter may be three times more common in VLCDs compared to more traditional low calorie approaches.

Finally, HMR or any plan like it is challenging when socializing. Dining out is pretty much off limits in phase one, and getting through holidays and special occasions can be difficult—not just for the dieter but also for friends and family.

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It’s Not Keto,But This Is The Best Diets of 2019 According to Experts

It’s Not Keto,But This Is The Best Diets of 2019 According to Experts

The 2019 rankings include 41 of today’s most popular diets. New to the list this year is the Nordic Diet, a plant-heavy eating plan that incorporates Scandinavian traditions and ranked 9th best overall. Here’s how the rest of the rankings shook out this year, and what experts have to say about the good, the bad, and the trendy. (Here’s a hint: They’re still not crazy about keto.)

Best overall diets

For the last eight years, the DASH Diet (which stands for Dietary Approach to Stopping Hypertension) has been ranked the best overall diet by U.S. News. Last year it tied for first with the Mediterranean Diet, and this year it’s been bumped to No. 2 for the first time.

U.S. News’s panel of experts noted that the Mediterranean Diet earned this year’s top spot because research suggests it can help improve longevity and ward off chronic disease. The Mediterranean Diet was also ranked No. 1 in several other categories: Easiest Diet to Follow, Best Diet for Healthy Living, and Best Diet for Diabetes. It also tied with the Ornish Diet for Best Diet for Heart Health.

“The Mediterranean Diet has been studied extensively, so that’s a big part of it,” says panelist David Katz, MD, director of the Yale-Griffin Prevention Research Center. But the diet—which emphasizes fruits, vegetables, whole grains, and lean protein—also gets top billing because it’s practical, he adds.

“This is a traditional diet of a large region of the world where people happily go to enjoy the food,” Dr. Katz tells Health. “This is very manageable; it’s not suffering, it’s not excluding things—it’s something that people and families really can do.”

The DASH Diet, now in second place, is also an excellent choice for health-conscious Americans, says Dr. Katz. Although it was designed to help lower blood pressure, the diet has also been shown to help people lower their cholesterol and lose weight, among other health benefits.

Coming in third this year is the Flexitarian Diet, which involves following a mostly vegetarian regimen and incorporating more non-meat proteins like beans, peas, and eggs. Weight Watchers—the highest ranked commercial diet—takes the fourth spot, tied with the MIND Diet, a Mediterranean-DASH hybrid plan that aims to stave off cognitive decline.

New kid on the block: What is the Nordic Diet?

U.S. News’s expert panel decided to include the Nordic Diet (also known as the New Nordic Diet) in this year’s rankings after it received considerable attention in the last year. There’s no one official Nordic Diet, but the 2017 book The Nordic Way is a good example of the diet’s basic guidelines.

Essentially, the Nordic Diet is based on 10 core concepts: eating more fruits and vegetables every day; eating more whole grains; eating more seafood; choosing high-quality meat, but less meat overall; seeking out food from wild landscapes; using organic produce whenever possible; avoiding food additives; basing more meals on seasonal produce; consuming more home-cooked food; and producing less waste.

In other words, the Nordic Diet focuses on locally sourced ingredients, avoids processed foods, and embraces “a return to relaxed meals with friends and family,” according to U.S. News’s description. These are similarities it shares with the Mediterranean Diet, Dr. Katz points out.

“In all of these places around the world where people derive the greatest benefit from their diets, people aren’t waiting around for anyone to tell them what to eat on January 1,” he says. “Even though we have new diets to evaluate every year, the ones that rank the highest are generally the oldest, most traditional ones.”

Where does the ketogenic diet rank?

One of the buzziest trends in the weight-loss world has been the ketogenic diet, a low-carb, high-fat regimen that promises fast results. People on the “keto” diet cut back on bread and sugar so that their body enters ketosis, a state in which it burns fat rather than carbohydrates.

But health experts are wary about the keto diet, and U.S. News’s rankings reflect that skepticism. For the second year, keto is at the bottom of the best diet rankings (tied with the Whole30 Diet at No. 38 out of 41), with an overall score of just 2.1 out of 5 and a “healthy” score of just 1.8 out of 5.

We have basically no evidence that this diet is consistent with human health over time,” says Dr. Katz. (Its heavy emphasis on animal protein isn’t ecologically sustainable, either, he adds.) “All of the evidence we have points toward a plant-predominant diet with an emphasis on vegetables, whole grains, fruits, nuts, and seeds—all of the very things that the ketogenic diet avoids.”

The keto diet did jump considerably in one specific category, however: This year it tied with several other diets for No. 2 in Best Fast Weight-Loss Diets (after the HMR Diet, a commercial plan that replaces most meals with pre-packaged nutrition bars and shakes), up from No. 13 last year. “Yes, you can do this for quick weight loss,” says Dr. Katz, “but I wouldn’t recommend it.”

How the rankings are calculated

U.S. News’s Best Diets rankings are put together by a panel of nutritionists, dietary consultants, and doctors specializing in diabetes, heart health, and weight loss. Each member of the panel scored all 41 diets in seven different areas, including how easy they are to follow, how well they protect against chronic disease, and how likely it is that followers will actually lose weight and keep it off.

The rankings rely heavily on peer-reviewed clinical trials, a practice that provides both strengths and weaknesses, says Dr. Katz. On one hand, it’s good to have evidence-based data, he says—but it also means that lesser-known, non-commercialized diets may not get the attention they deserve.

For example, Weight Watchers has consistently ranked toward the top of the U.S. News list. “That may be well deserved,” says Dr. Katz, “but they have also been around longer and have more money to afford more studies, which gives them an advantage.”

Despite their limitations, these rankings are important, says Dr. Katz—especially because more than 45 million Americans embark on diets every year, and many of them are overwhelmed by constantly changing messages in the media.

“There is a range of diets here, which should be an invitation for people to go shopping among these diets, which are approved by experts, and find one that works well for themselves and their families,” he says. “The idea that there are so many variations on healthy eating is a really good thing.”

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Want to Lose Belly Fat Try these Simple Ways

 Want to Lose Belly Fat

Try these Simple Ways

Excess weight in your midsection can be annoying—not only because it’s so darn tough to ditch, but because it also has an impact on your overall health. Extra belly fat ups your risk of issues such as heart disease and diabetes, and, according to certified strength and condition specialist Michele Olson, PhD, life is filled with sneaky little saboteurs that make putting on the pounds in this area way too easy.

“Due to changes in hormones, daily stresses, lack of sleep, coupled with possibly pregnancies, the fat women gain is often stored increasingly in the belly area,” explains Olson, also a senior clinical professor at Huntington College in Montgomery, Alabama.

And while you can’t exactly spot reduce, you can make lifestyle changes that can help you lose belly fat—and fast. Here, healthy-living pros offer their best science-backed strategies for winning the battle of the bulge.

Clean up your diet

If you’ve heard it once, you’ve heard it a million times: Abs are made in the kitchen. Unfortunately, if you regularly eat ultra-processed foods (think chips, store-bought baked goods, and candy), you won’t be able to see yours. “These foods are produced using sweeteners like high fructose corn syrup, which in high amounts has been shown to promote visceral fat accumulation in the liver, leading to weight gain, inflammation, and related diseases,” explains Rachel Fine, RD, owner of To The Points Nutrition.

Instead, opt for eats that have healthy amounts of soluble fiber such as oatmeal, sweet potatoes, avocado, and citrus fruits. Research reveals that an increase in these foods is linked to a decrease in visceral—aka belly—fat.

Slow down on spirits

Reducing alcohol intake can also help, says Fine. Alcohol contains about seven calories per gram—”just under fat, which equates to nine calories per gram.” And because alcohol is absorbed quickly, “when over-consumed, alcohol metabolism impairs metabolism of other macro nutrients, such as carbs and fat, promoting…fat storage rather than breakdown,” she says.

While you’re rethinking your drinks, limit your consumption of carbonated beverages as well, advises Vanessa Volitional, RD, a New York City-based registered dietitian, noting that those fizzy drinks, though yummy, can cause belly bloat. (Sorry LaCroix!)

Instead, stick to water, which Emily Incledon, RD says can act as an appetite suppressant, as well as help flush out your body to decrease the feeling of being bloated.

Make sure you exercise

Great news: Working out is good for more than just adding years to your life, boosting your brain health, and reducing stress levels—it can also help you rein in your gut. In fact, research in the journal Cell Metabolism reveals that exercise specifically helps reduce visceral fat.

The key to losing belly fat with exercise, though, is making sure your sweat session is intense. You’ll want to be working at 85% of your max heart rate at least, says Olson. “The higher your heart rate, the higher the release of epinephrine into the bloodstream and cells,” she explains. “A positive side effect of epinephrine is that it also activates greater release of abdominal fat into the bloodstream to be used for energy.”

So what type of exercise is best when it comes to burning belly fat? Olson recommends intense weight training, Tabatha interval training, sprint-style cardio, and kettle bell exercises. Of course, a little ab work won’t hurt either—especially moves (like dead bug) that target the transverse abdominal, the deep core muscles that act like a girdle for the waist, cinching you in all over.

Don’t skimp on sleep

Falling short on zzz’s is also a surefire way to put your waistline in jeopardy. That’s because sleep deprivation knocks your hunger hormones out of whack, leading to an increase in ghrelin, which stimulates appetite, and a decrease in lepton, which signals when you are satiated. What’s more, research has shown that when you aren’t well-rested, you’re also more likely to reach for junk food (hello Ben & Jerry’s!)—and it may even become harder for you to build muscle mass.

To help keep belly fat in check, aim to cuddle with your pillow for at least seven to eight hours each night. And if possible, hit the hay at the same time each night—one study found that women who did so and clocked around eight hours of sleep per night had lower body fat.

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The DASH Diet Is Great For Weight Loss, But No One Following It,Case Study….

The DASH Diet Is Great For Weight Loss, But  No One Following It,Case Study….

Dash Diet Hypertension

The DASH diet often flies under the radar, especially when compared to buzzy diets such as the Keto diet, but it’s one of the most widely-respected diets out there. U.S. News & World Report has named it the “Best Diet Overall” for eight consecutive years in its annual diet rankings, and it’s recommended by the American Heart Association, who used it to develop their 2010 Dietary Guidelines.

With virtually no food groups as off-limits, DASH offers much more flexibility than other popular diet plans. It can also aid in weight loss and weight maintenance, given its emphasis on overall health. With all its praiseworthy qualities, you’d think everyone would be following a DASH diet plan. But here’s the surprising truth—less than 2 percent of the population actually follows the DASH diet.

How could this be? Let’s take a closer look at the DASH diet to find out for ourselves.

What Is the DASH Diet?

DASH stands for “Dietary Approaches to Stop Hypertension.” The diet was developed out of a study by the National Institutes of Health after researchers noticed that vegetarians tended to have lower rates of high blood pressure. Understanding that sodium intake affected blood pressure, researchers also believed that these levels may also be impacted by other nutrients in plant-based diets.

Enter the DASH diet. When individuals followed this eating plan, researchers saw dramatic reductions in blood pressure levels. Today, the eating plan is recommended for preventing and treating hypertension and heart disease—and it has been linked to decreased bone deterioration, improved insulin sensitivity, and possible risk reduction for some cancers.How to Follow a DASH Diet Plan:

keto-diet-vs-atkins-diet

The DASH diet plan focus on increasing vegetables, fruits, whole grains, and legumes; choosing lean meats, low-fat dairy, nuts and healthy fats; and limiting added sugars, trans fats, added salt, and processed foods. Serving sizes from each food group are based on individual calorie needs (see below for a 1600-calorie plan), and you’ll likely find that the plan looks pretty close to the MyPlate plan, as well as another consistently rated “top diet,” the Mediterranean Diet. Here’s a breakdown of the recommended nutrients in a typical day and week on the DASH diet:

Nutrients Per Day:

  • Grains: 6 servings
  • Vegetables: 3-4 servings
  • Fruits: 4 servings
  • Low-Fat or Fat-Free Dairy: 2-3 servings
  • Lean Meat, Poultry, or Fish: 4 ounces or less
  • Fat/oils: 2 servings
  • Sodium: 2300 mg or less

Nutrients Per Week:

  • Nuts, seeds, and legumes: 3-4 times per week
  • Sweets and added sugars: 3 servings or less

The secret to DASH’s success is its emphasis on increasing vegetables, fruits, and whole foods that are naturally low in sodium and high in potassium. While most know that reducing sodium is essential, many don’t realize that getting adequate potassium intake is just as key for regulating blood pressure.

When foods are processed, their potassium levels actually decrease. So, choosing whole or minimally processed foods can improve blood pressure regulation from both a sodium and a potassium perspective. In addition, you’ll usually decrease your intake of saturated fat, added sugars, and overall calories—all of which can help you lose weight, and keep it off for good.

So—Why Does DASH Have So Few Followers?

DASH’s lack of followers seems to come down to misconceptions that people have about it. Here are some common perceptions about the DASH diet, including what is—and what isn’t—true.

The DASH diet was created when researchers were looking for ways to effectively reduce hypertension, but this was over 20 years ago! Though it’s still often marketed as a treatment for high blood pressure, the DASH eating plan is really an ideal way to eat for overall health, weight maintenance, and chronic disease prevention. In fact, studies suggest that DASH lowers risk for heart disease, type 2 diabetes and metabolic syndrome, and some cancers.

Also, people with high blood pressure aren’t the only ones who need to worry about sodium intake. Data suggests that 90 percent of Americans exceed sodium’s max limit (3500mg) daily. Regularly going over this amount takes a toll on your body—even healthy bodies—over time.

Sodium reduction is part of the DASH equation, but it’s not the only focus. Eating by DASH recommendations also increases your intake of potassium, calcium, magnesium and fiber—all nutrients that play a role in cardiovascular health, as well as the prevention of other chronic diseases. It’s thought to be the combination of increasing your intake of these nutrients and decreasing your intake of added sugar, salt, sodium and unhealthy fats that leads to lower blood pressure and a laundry list of other long-term health benefits.

Also, reducing sodium doesn’t restrict you to boring, bland food, nor does it mean you have to toss out the salt shaker. Yes, reducing the amount of salt you use and choosing lower-sodium products are key, but opting for fresh foods or whole foods instead of boxed, canned, and ready-to-heat items makes a big enough impact. Experiment with spices and herbs, and use a little salt to enhance flavor. Salt should never be the sole flavoring or seasoning in any in dish.

Many equate healthy eating, particularly lower-sodium eating such as DASH, with the idea that all meals have to be cooked from scratch. This is overwhelming for many (myself included), but there are plenty of tricks and tips to help you. First, understand that “whole foods” doesn’t exclusively mean fresh produce. Take advantage of time-saving, minimally processed foods like unseasoned frozen vegetables and no-salt-added canned veggies.

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A Nutritionist Explains Can It Help You Lose Weight


A Nutritionist Explains

Can It Help You Lose Weight

small food meal HIIT high intensity workout frequent frequency meal diet nutrition learning portion

If you’ve tried to lose weight on the ketogenic diet or another low-carb plan and found it too difficult to all but abstain from bread, whole grains, and other carbohydrates, then you might be in need of a little TLC—the TLC diet, that is.

planetary diet vegetarian pescatarian red meat fruits vegetables health healthy digestion planet earth sustainable

TLC stands for Therapeutic Lifestyle Changes. Created by the National Institutes of Health, the plan focuses on helping people make heart-healthy food choices. It encouraging followers to get 50%-60% of their daily calories from carbs, 24%-35% from fat, and 15% from protein. The plan debuted in 2002 and was updated in 2013, and earlier this month it landed on the list of best-ranked diets by U.S. News and World Report.

Here’s how to follow it, what the pros and cons are, and how to know if TLC is right for you.

What is the TLC diet?

Designed as a way to manage cholesterol, TLC may also help you lose weight and lower your risk of other chronic illnesses. Following the diet means keeping track of the percentage of macronutrients you take in daily. No food group is banned, but you might have to whip out a calculator to make sure you’re consuming the right balance of carbs, protein, and fats. The breakdown of what to eat goes like this: 

25–35% of your daily calories should come from fat. As for types of fat, less than 7% of your daily calories should come from saturated fat. Up to 10% of your daily calories should be from polyunsaturated fat, and about 20% of your total calories should come from monounsaturated fat.

50–60% of your daily calories should come from carbohydrates, with 20–30 grams per day of dietary fiber. 

Approximately 15% of your daily calories should come from protein.

Less than 200 mg a day of cholesterol is allowed. Sweets and desserts are okay too, but definitely in moderation.

As for calories, only consume enough to reach or maintain a healthy weight.

TLC also advises at least 30 minutes of a moderate intensity physical activity, such as brisk walking, on most, and preferably all, days of the week.

Pros and cons of the TLC diet

The plan offers a few key pros. Because it recommends 20-30 grams of fiber daily, whole foods that are high in healthy carbohydrates like vegetables, fruit, pulses, nuts, and whole grains are encouraged. This also fits with the 200 mg per day limit on cholesterol, as dietary cholesterol is not found in plant-based foods. And the allowance of up to 20% of calories from monounsaturated fat makes the TLC diet avocado- and olive oil–friendly, giving it some alignment with the highly regarded Mediterranean diet.

There are a handful of cons however. The high percentage of calories from carbs and modest allotment of protein may be slightly off base for some. In my practice, I often cap carbs at 40% of calories for less active people, or those with lower energy needs, including older adults. And my active clients typically require a higher protein intake, depending on their training regime and goals.

In addition, the 200 mg cholesterol limit now appears to be unnecessary. You may have heard that the 2015 Dietary Guidelines scientific advisory panel deemed cholesterol (from food) “not a nutrient of concern for over consumption.” That designation was based on a growing consensus that cholesterol intake has little effect on cholesterol in the bloodstream. In addition, some high-cholesterol foods, like whole eggs, can contain health-protective nutrients, including anti-inflammatory vitamin D and omega-3 fatty acids. 

The other challenging aspect of TLC is translating the numbers into practical everyday meals. The 85-page TLC explainer from the National Institutes of Health offers suggested daily servings from various food groups, answers questions about sodium, omega-3 fatty acids, and alcohol, and provides tips for seasoning food, snacking, dining out, exercise, and weight loss. But you’ll have to look further for sample menus and recipes. 

Plus, many of the food suggestions are outdated, in my opinion. These include eating lower-fat hot dogs, using margarine, and opting for Jello as dessert, to name a few. In the face of today’s clean eating mantra and advice to slash sugar, I believe TLC could use another update.

If you decide to give TLC a try, consider modernizing the plan with a focus on whole foods, which further supports anti-inflammation and weight loss. And if you need help personalizing the plan based on things like food allergies or intolerance’s, or you want to adapt it to meet the needs of your very active lifestyle, consider meeting with a registered dietitian nutritionist.

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You Lose Weight Fast But Is It Safe?

You Lose Weight Fast But Is It Safe? 

There are countless weight-loss plans to choose from, but the simple truth is this: What works for one person just may not click for another. Some people need a plan with lots of choices and variety, or one that allows them to cook. Others prefer an ultra-streamlined approach, in which all of the food is provided and options are minimized.

If you’re in the latter group, one program to consider is HMR, which stands for Health Management Resources. Here’s how to follow HMR, the number of calories and types of foods you’re allowed, and my thoughts as a registered dietitian nutritionist as to whether it’s safe, healthy, and can result in long-term weight loss.

How to follow the HMR diet

U.S. News and World Report ranked HMR the number one diet for fast weight loss. The company’s simple 3+2+5 Healthy Solutions plan includes 3 shakes per day and 2 pre-made meals (which you purchase from HMR) and 5 daily servings of fruits and vegetables that you supply yourself.

The structured approach also recommends daily tracking using the HMR app, and incorporating physical activity, such as a few daily walks. Participants typically lose 23 pounds on average within 12 weeks. The company also offers an even lower calorie medically supervised option, which can result in significantly greater weight loss for obese people. (More on this below.)

The plan provides roughly 1,200 calories a day, and a starter kit that contains three weeks worth of meals costs about $300. However, this phase is designed to last until you hit your goal, which may take much longer. The program also includes support, via the app, and weekly group phone sessions led by a “health coach” who offers cheerleading and problem solving.

The goal is to transition to a maintenance plan, which reduces the reliance on HMR foods and teaches healthy lifestyle skills, including meal planning and prep, plus how to navigate social situations while you’re trying to lose weight.

The benefits of HMR

In all of my years counseling clients, I have learned that it’s important to know your personality in order to determine if any particular approach is doable and sustainable for you. Both ultimately determine a successful (or disastrous) outcome, as well how you’ll feel emotionally as you’re shedding pounds.

For example, if fewer choices make you feel restricted and trigger cravings, a plan like HMR isn’t the best choice. But if you’re the type of person who thrives on structure and repetition, and you feel freed by not having to make decisions about what and how much to eat, an approach like this may work well. And if you need to see some quick weight loss in order to build momentum and boost your motivation to transition to a longer term healthy eating pattern, a ready-to-eat approach may fit.

Drawbacks to know about

There are few things I don’t like about HMR, however. My number one issue is the ingredients. The shakes contain the artificial sweetener saccharin and artificial flavor, and they are dairy and egg-based. I did not see an option for those with dairy or egg allergies or sensitivities on the HMR site.

Also, the entrees are shelf stable (not frozen) and highly processed. While some are better than others, I did spot ingredients like carrageenan, which has been linked to inflammation, as well as preservatives and soy, another common allergen.

My other red flag concerns long-term results. While I appreciate the fact that the program emphasizes produce from day one, supplies group support, and teaches lifestyle changes, I’ve seen people use these types of programs as quick fixes before rebounding right back to old habits. There doesn’t seem to be solid data on how HMR participants do at keeping weight off for good.

One study, which looked at the very low calorie diet (VLCD) HMR option, was unable to determine outcomes past one year. Researchers also noted some risks associated with very VLCD approaches, including constipation and gallstones. The latter may be three times more common in VLCDs compared to more traditional low calorie approaches.

Finally, HMR or any plan like it is challenging when socializing. Dining out is pretty much off limits in phase one, and getting through holidays and special occasions can be difficult—not just for the dieter but also for friends and family.

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Amazon Shoppers Are Convinced This

Amazon Shoppers Are Convinced This

We just found the swimsuit of your dreams.

We’re calling it now—what the viral Orolay “Amazon coat” was to winter, this popular Tempt Me one-piece swimsuit will be to summer.

While there are tons of cute swimsuits in a range of styles on Amazon, this $26 to $27 ruched one-piece bathing suit stands out from the rest for its universally flattering design and affordable price point, according to Amazon shoppers. Over 1,200 reviewers gave it a five-star rating, praising its simple but very stylish silhouette.

Shoppers love the inexpensive suit, which comes in nine colors, for its comfortable feel, supportive bust, interesting mesh V-shaped neckline, and its flattering ruching across the stomach. And owners all agree about one thing in particular—the piece’s unique look strikes the perfect balance of being subtly sexy without being too revealing.

“Wow. I have never found a suit that provides so much coverage and is still perfectly flattering,” one Amazon reviewer wrote. “I don’t usually write clothing reviews however, if I can help just one woman find her perfect suit and feel great then it is entirely worth it. If you’re thinking about this swimsuit, do it and you will not regret it!”“I will be buying another one. Not kidding,” another chimed in. “It makes me feel sexy and comfortable and covered up [without] feeling too naked! This swimsuit is definitely worth more than they are charging!”

Owners even argue it’s better than any high-end suit you’ll find in a department store. “Loved it,” one owner wrote. “It was tight enough to give some shaping support and covered in all the right places. Much better quality and fit than more expensive suits that I’ve bought at popular brick and mortar retail stores!”

Reviewers also appreciate the range of sizes offered (extra small through 16 plus) and its thoughtful design that beautifully complements all shapes and figures. Women with everything from small to large busts, short to long torsos, and a variety of swimwear concerns say it fits them perfectly. Just like the pair of jeans from The Sisterhood of the Traveling Pants, this stylish bathing suit seems to work for everyone.

What’s more, the suit features removable cups to ensure you’re supported, plus just a touch of stretch to ensure you’re comfortable for long days at the beach and pool.

As summer approaches, now’s the perfect time to replace that tired, go-to suit that’s seen better days. And since it comes with Prime shipping, you can order it and have it at your door in just two days, making it the perfect piece to throw in your suitcase at the last minute. Thousands of Amazon shoppers can’t be wrong, right?

www.topshops.biz

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How This Woman Lost 80 Lbs. with Small Changes

Randi Vasquez was “always pretty chubby” growing up, but it never affected her confidence.

“I was always feeling myself,” the 27-year-old tells PEOPLE. “I wasn’t scared to wear a two-piece bathing suit or trendy outfits. I wasn’t always the happiest about my image, but I didn’t let that hold me back.”

But after she graduated from college, Vasquez found herself in “a post-grad slump.”

“I couldn’t find the job that I wanted, and I had trouble adapting,” she says.

Living in Chattanooga, Tenn., she and her friends would go for hours-long, mimosa-filled brunches every weekend and dine on fried chicken and waffles. And her other meals were just as caloric — Vasquez relied on fast food and remembers one day when she and her roommate ate at the southern burger joint Krystal’s three times.

“I was getting heavier and heavier,” she says. “I started to notice that my confidence was going down, and I wasn’t motivated to do anything. It started to click that if I didn’t change my life that it would just get worse and worse.”

“I remember one proposal session on a mountain and I had to run up and down this trail,” she says. “I couldn’t keep up with the couple and I remember that day was a big moment because I felt so out of shape. I was so embarrassed because I was so exhausted.”

Vasquez decided to start trying to lose weight, but with small changes. She joined her local YMCA in the fall of 2014 and found a body pump class that she loved.

“I went twice a week — I became obsessed with it. Within five or six months I lost 18 to 20 lbs. just by going to the gym,” she says.

In March 2015, a friend introduced her to Kayla Itsines’ popular BBG plan, and she got a Fitbit Surge later that year to monitor her heart rate and figure out how to push herself during workouts.

“Within a few weeks my body started to change and that helped me stay motivated,” she says.

Vasquez also started cooking more of her meals and going for healthier options. She stuck to a low-carb diet as much as possible, but didn’t cut out fast food completely — “I didn’t want to restrict too many things,” she says. One of the biggest moments in her weight loss journey came when Itsines shared one of Vasquez’s progress photos on Instagram.

“That was one of the best moments for me, because it helped me break down a wall I had up,” she says. “Before I was heavy and I didn’t want anyone to know that I had gained weight after college and that I was struggling, but having that out in the world tore that wall down. It helped me share my story and meet other people like me who were tackling their weight problems.”

And slowly but surely, the weight started coming off.

“Year after year, month after month, I made small little goals and just kept going,” she says. “I hit 80 lbs. down in fall 2017. That was such a big moment for me. That was my original weight loss goal. I had these jars with marbles in them, and every time I lost a pound I would move a marble to the other jar. When I hit 80 lbs. down and moved that last marble it was such an amazing moment.”

In the year-and-a-half since, Vasquez has worked on maintaining her weight loss with a few ups and downs — she opened up to her now-72,800 Instagram followers in January that she was “constantly yo-yoing” in weight during 2018 and wanted to find a better balance. And in the months since, she accomplished one of her bucket list goals: running a half marathon.

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Because She Lost 350 Lbs

Getting Skin Removal Surgery on Her Legs

Because She  Lost 350 Lbs

After losing 350 lbs., the first thing Jacqueline Adan wanted gone were the layers of loose skin now covering her legs.

“They’re my biggest insecurity,” the 32-year-old tells PEOPLE. “I always struggled with loving my legs, and the size of them.”

And they were also a source of bullying — Adan, a Montessori preschool teacher — went viral in 2017 after she shared a photo of herself on the beach, post-weight loss, and said that a couple nearby started pointing and laughing at her legs.

But when she started the long and painful process of skin removal surgery in 2016, her doctor said that she would have to be patient.

“He said that we’re putting my body back together like a puzzle, and we can’t start with the legs,” Adan explains. “We started with my stomach, because it was the largest area, and then we did the upper part of my stomach and my arms.”

The surgeries and the lengthy, difficult recoveries that followed took three years, and during that time her legs struggled to hold up the excess skin around them.

“The pain in my legs from the loose skin keeps getting worse, because they’re just so heavy,” she says. “I was going to physical therapy because my knees and my hips couldn’t keep carrying that weight, and there’s nothing I can do until I get the skin removed. They started putting me in compression garments to hold the skin, but then all the loose skin got pulled to the top. All the leg skin is sitting at the top of my hips. I just need it removed.”

On March 21, Adan is finally getting her wish. After a consult with her doctor last week, they determined that she’s ready for skin removal surgery on her legs. Over the 7-hour surgery, Adan’s doctor will cut from the groin area down to the backs of her knees to take off pounds of excess skin.

But as excited as she is for the surgery to finally happen, Adan struggled with her mindset after their consult.

“I started getting really hard on myself and angry because I have to get this surgery, and asking myself why I let myself get to 500 lbs., and all that negative talk started coming in,” she says. “I started getting annoyed with myself that I have to go through another intense surgery that I could have avoided if I didn’t get myself to 500 lbs. But I can’t change the past. I have to focus on right now and getting mentally prepared so I can deal with it in the best way possible. Going into these surgeries with a positive mindset is so important because it helps you heal faster.”

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