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To Eat or Not to Eat? The Skinny on Intermittent Fasting Diets are a dime a dozen, so it’s easy to lose sight of the important questions like how does the diet work, or what are the benefits and risks associated with it? The latest nutrition trend is intermittent fasting. This type of diet is very popular among athletes, but many weight-loss seekers also tout it as the ultimate slim-down method. So we decided to take a closer look at this kind of fasting and share with you what we found. A young woman who is preparing a salad. What is intermittent fasting? As the name suggests, intermittent fasting is an eating pattern that cycles between periods of fasting and eating. Strictly speaking, it is not a diet but more of an “eating schedule.” You are not told what to eat, but you do have to stick to specific times. There are several methods of intermittent fasting. The most popular ones are 16/8 method: This is known as the Leangains method. Here, you have a feeding window of eight hours and a fasting period of 16 hours. Put simply, the normal fasting period while you sleep is simply extended by a few hours. You can skip breakfast, for instance, and consume your first meal at noon and keep eating up to eight o’clock in the evening. 5:2 diet: The idea is that for two days a week you reduce your calorie intake to a maximum of 500 to 600 calories per day. The days do not have to be back-to-back. The other five days you can eat what you want within reason. Eat Stop Eat: This type of intermittent fasting alternates between fasting and non-fasting days. You eat what you want for 24 hours and then take a complete break from food on the following day. You repeat this pattern once or twice a week. Calorie-free beverages are allowed, as they are in the other methods as well. It also changes your hormonal balance But intermittent fasting does far more than just restrict your calorie intake. It also changes the hormones in your body so they can make better use of your fat stores. The following changes take place: Intermittent fasting improves your insulin sensitivity, especially in combination with exercise. This is very important for people struggling with their weight because low insulin levels in the blood are associated with better fat burning. The opposite of this is insulin resistance. Studies have shown that increased body weight can interfere with insulin’s ability to reduce blood sugar levels, resulting in more insulin being released. This in turn promotes the storage of fat. The secretion of human growth hormone (HGH) increases, speeding up protein synthesis and making fat available as an energy source. This means, in simple terms, that you burn fat and pack on muscle faster. This is why HGH is often taken in large quantities by the bodybuilding community as a doping agent. Furthermore, according to research, fasting activates autophagy, which removes damaged cells, contributes to cell renewal and generally supports your body’s regenerative processes. A bowl with greek salad next to a measuring tape. You will lose weight if you do it right If you skip meals and create a calorie deficit, you will lose weight. That is, unless you compensate for the fasting periods with foods that are packed with fat and sugar. It can happen: This type of eating pattern does not tell you what foods you should or shouldn’t eat. Studies have found that intermittent fasting (if done properly) can be just as effective at preventing Type 2 diabetes as a daily reduction in calories. Plus, your body can learn to process the foods consumed during the feeding window better and more efficiently. Additional research has shown that a combination of the 16/8 method and strength training (with your own body weight, as well as free weights) can reduce more body fat than strength training alone. This also means that it is particularly effective when combined with regular workouts. Note: This type of dieting is not necessarily suitable for people with diabetes, high blood pressure or pregnant & breastfeeding women. You should check with your doctor before changing your eating pattern. Don’t forget about the social aspect So, fasting can be an effective weight loss method, but have you ever considered the social aspect? Picture this: Friends have invited you to a birthday brunch on Sunday. The breakfast buffet is replete with delicious muesli, fresh fruit, yogurt, scrambled eggs, vegetables, salmon… Your friends dig right into their sumptuous breakfast. And you? You sit next to them and sip on your water. After all, it is only ten o’clock in the morning and you can’t eat your first meal until noon. Plus, you have dinner plans that same evening at 7 pm – with an eight-hour window, you have to make the most of it. If you plan your fasting window cleverly, you can still enjoy meals together with your friends and family. But, generally speaking, this type of eating pattern doesn’t leave much room for spontaneity and flexibility. A family who are sitting at a table filled with good food in the garden. What can you do when hunger strikes? Many people who try intermittent fasting complain about hunger pains, fatigue, exhaustion and cravings, which makes sense considering that you skip meals. But others say that the hunger goes away once you have withstood the first “critical” phase (about two days). If your hunger gets too bad in between, you can try drinking some green tea or black coffee to help you get by until your next meal. Bottom line: Intermittent fasting is definitely not for everyone, but it can be a good method for reducing body fat. You should definitely watch what foods you eat during the feeding window, so don’t just stuff yourself with burgers, fries and pizza. The focus here, as elsewhere, should be on eating a healthy, balanced diet.
COPD-OSA Overlap Syndrome The recognition of co-existing OSA in COPD patients has important clinical relevance as the management of patients with overlap syndrome is different from COPDalone, and the survival of overlap patients not treated with nocturnal positive airway pressure is significantly inferior to those overlap patients appropriately treated.
Can I prevent a chest infection? There are measures you can take to help prevent chest infection and to stop the spread of it to others. You can pass a chest infection on to others through coughing and sneezing. So if you have a chest infection, it's important to cover your mouth when you cough or sneeze and to wash your hands regularly. Throw away used tissues immediately. Immunisation against the pneumococcus germ (bacterium) - the most common cause of bacterial pneumonia - and the annual flu (influenza) virus immunisation are advised if you are at increased risk of developing these infections
Comprehensive and Individualized Patient Care in Idiopathic Pulmonary Fibrosis: Refining Approaches to Diagnosis, Prognosis, and Treatment Implement multidisciplinary clinical and imaging approaches to achieve more timely and accurate diagnosis of IPF • Develop IPF treatment strategies based on key guideline recommendations and examine the supporting clinical trial data • Describe key elements of an individualized approach to IPF treatment that involves shared decision-making Standard immunosuppressive therapy is no longer indicated, whereas pirfenidone, nintedanib, and antacid therapy are all conditionally recommended for use. Individualizing treatment is important in light of potential improved adherence to both drug therapy and health behaviors. An early referral to an interstitial lung disease center offers the advantages of comprehensive diagnostic and disease-management expertise, potential enrollment in a clinical trial, and evaluation for transplantation.
Reduced COPD exacerbation risk correlates with improved FEV1: A meta-regression analysis. A significant correlation between increased FEV1 and lower COPD exacerbation risk suggests airway patency is an important mechanism responsible for this effect
Obstructive sleep apnea (OSA) is a heterogeneous disorder. If left untreated, OSA has major health, safety and economic consequences. In addition to varying levels of impairment in pharyngeal anatomy (narrow/collapsible airway), non-anatomical ‘phenotypic traits’ are also important contributors to OSA for most patients. However, the majority of existing therapies only target the anatomical cause (e.g. continuous positive airway pressure [CPAP], oral appliances, weight loss, positional therapy, and upper airway surgery). These are typically administered as monotherapy according to a trial and error management approach in which the majority of patients are first prescribed CPAP. Despite its high effectiveness, CPAP adherence remains unacceptably low and second-line therapies have variable and unpredictable efficacies. Recent advances in knowledge of the multiple causes of OSA using respiratory phenotyping techniques have identified new targets or ‘treatable traits’ to direct therapy. Identification of the traits and development of therapies that selectively target one or more of the treatable traits has the potential to personalize the management of this chronic health condition to optimize patient outcomes according to precision medicine principles.
Practical Recommendations for COPD: Evidence-Based Care The treatment of patients with chronic obstructive pulmonary disease (COPD) depends on symptoms and history of exacerbation. These elements define the treatment strategies within the Global Initiative for Chronic Obstructive Lung Disease (GOLD) Guidelines' ABCD assessment tool • Although not taken into account in the ABCD tool, spirometry remains important for the diagnosis and assessment of airflow limitation. Bronchodilators are first-line treatment, either as a single or dual bronchodilator treatment. • The recently available combination of a long-acting beta agonist (LABA) and a long-acting muscarinic receptor antagonist (LAMA) into a single inhaler has demonstrated improvement in lung function, either in combination or with monotherapy. In the SPARK study evaluating indacaterol/glycopyrrolate vs glycopyrronium and tiotropium (LABA/LAMA vs LAMA alone) for the prevention of exacerbation in patients with COPD, the combination therapy was superior to a single bronchodilator as measured by the reduction of exacerbations. • LABA/LAMA was also shown to be superior in the ILLUMINATE study, which compared the patient-reported outcomes and the transition dyspnea index (TDI) for patients on LABA/LAMA with patients on LABA/ICS (inhaled corticosteroid). Data from multiple studies show that ICS-containing regimens can also effectively reduce exacerbation rates. Data from post-hoc analyses of clinical trials suggest that patients with high levels of blood eosinophils may respond better to ICS therapy, whereas patients with very low levels of eosinophils may not respond. ICS therapy is associated with serious side effects, such as pneumonia. In the WISDOM trial, patients who discontinued ICS experienced approximately 40 mL in forced expiratory volume over 1 second (FEV1), indicating that ICS should be withdrawn very carefully in some patients. As exacerbations are more frequent and often more severe in winter months, it is recommended to not withdraw steroids during that period Current evidence suggests that the combination of LABA/LAMA with ICS into a single inhaler will improve lung function, exacerbations, and symptoms Other treatment options besides triple therapy exist for patients who still experience exacerbations after LABA/LAMA treatment. • Roflumilast may be considered in patients with chronic bronchitis. • The use of long-term macrolides is possible in a particular profile subset of patients who have frequent exacerbations with bronchiectasis, bronchial colonization, and frequent bacterial infections.
Ref: RMCR_2017_75_R1 Title: Xanthomatous pleuritis Journal: Respiratory Medicine Case Reports Dear Dr. singh, I am pleased to inform you that your revised paper has been accepted for publication. The letter outlining your specific response to the reviewer’s comments is very important and when well done and very clear, can speed the acceptance of your revision. . Now that your manuscript has been accepted for publication it will proceed to copy-editing and production. Thank you for submitting your work to Respiratory Medicine Case Reports. We hope you consider us again for future submissions. Kind regards, Professor Barbara Yawn, MD MSc Editor-in-Chief Respiratory Medicine Case Reports