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Healthwatch
How And Why To Fit More Fiber And Fermented Food Into Your Meals
~5.0 mins read
Fiber and fermented foods aid the gut microbiome, contributing to better health and mood.
A bowl of whole-grain muesli, yogurt, red watermelon, and yellow mango with two little side bowls of nuts and fruit; concept is fiber and fermented foods
An F may mean failure in school, but the letter earns high marks in your diet. The two biggest dietary Fs — fiber and fermented foods — are top priorities to help maintain healthy digestion, and they potentially offer much more. How can you fit these nutrients into meals? Can this help your overall health as well as gut health?

Fiber, fermented foods, and the gut microbiome

The gut microbiome is a composed of bacteria, viruses, fungi, and other microorganisms living in the colon (large intestine). What you eat, the air you breathe, where you live, and many other factors affect the makeup of the gut microbiome. Some experts think of it as a hidden organ because it has a role in many important functions of the body — for example, helping the immune system function optimally, reducing chronic inflammation, keeping intestinal cells healthy, and providing some essential micronutrients that may not be included in a regular diet.
Your gut communicates with your brain through pathways in the gut-brain axis. Changes in the gut microbiome have been linked with mood and mental health disorders, such as depression and anxiety. However, it's not yet clear that these changes directly cause these types of problems.
We do know that a healthy diet low in processed foods is key to a healthy gut microbiome. And increasing evidence suggests that fiber and fermented foods can play important parts here.

Fiber 101

Fiber's main job is to make digestion smoother by softening and adding bulk to stool, making it pass quickly through the intestines.
But fiber has other benefits for your microbiome and overall health. A high-fiber diet helps keep body weight under control and lowers LDL (bad) cholesterol levels. Research has found that eating enough fiber reduces the risk of heart disease, type 2 diabetes, and some cancers.

What to know about fiber

There are two types of fiber: insoluble (which helps you feel full and encourages regular bowel movements) and soluble (which helps lower cholesterol and blood sugar). However, recent research suggests people should focus on the total amount of fiber in their diet, rather than type of fiber.
If you're trying to add more foods with fiber to your diet, make sure you ease into new fiber-rich habits and drink plenty of water. Your digestive system must adapt slowly to avoid gas, bloating, diarrhea, and stomach cramps caused by eating too much too soon. Your body will gradually adjust to increasing fiber after a week or so.

How much fiber do you need?

The fiber formula is 14 grams for every 1,000 calories consumed. Your specific calorie intake can vary depending on your activity levels.
"But instead of tracking daily fiber, focus on adding more servings of fiber-rich foods to your diet," says Eric Rimm, professor of epidemiology and nutrition at Harvard's T.H. Chan School of Public Health.

Which foods are high in fiber?

Fruits, vegetables, legumes, nuts, seeds, and whole grains are all high in fiber. The Dietary Guidelines for Americans has a comprehensive list of fiber-rich foods and their calorie counts.
What about over-the-counter fiber supplements that come in capsules, powders that you mix with water, and chewable tablets? "If you have trouble eating enough fiber-rich foods, then these occasionally can be used, and there is no evidence they are harmful," says Rimm. "But they should not serve as your primary source of dietary fiber."

Fermented foods 101

Fermented foods contain both prebiotics — ingredients that create healthy changes in the microbiome — and beneficial live bacteria called probiotics. Both prebiotics and probiotics help maintain a healthy gut microbiome.

What to know about fermented foods

Besides helping with digestion and absorbing vital nutrients from food, a healthy gut supports your immune system to help fight infections and protect against inflammation. Some research suggests that certain probiotics help relieve symptoms of gut-related conditions like inflammatory bowel disease and irritable bowel syndrome, though not all experts agree with this.
Many foods that are fermented undergo lacto-fermentation, in which natural bacteria feed on the sugar and starch in the food, creating lactic acid. Not only does this process remove simple sugars, it creates various species of good bacteria, such as Lactobacillus or Bifidobacterium. (Keep in mind that some foods undergo steps that remove probiotics and other healthful microbes, as with beer or wine, or make them inactive, like baking and canning.)
The exact amounts and specific strains of bacteria in fermented foods vary depending on how they are made. In addition to probiotics, fermented foods may contain other valuable nutrients like enzymes, B vitamins, and omega-3 fatty acids.

How often should you eat fermented foods?

There is no recommended daily allowance for prebiotics or probiotics, so it is impossible to know precisely which fermented foods or quantities are best. The general guideline is to add more to your daily diet.

Which fermented foods should you choose?

Fermented foods have a range of tastes and textures because of the particular bacteria they produce during fermentation or that are added to foods. Yogurt is one of the most popular fermented foods (look for the words "live and active cultures" on the label). Still, many options are available if you are not a yogurt fan or want to expand your fermented choices. Kimchi, sauerkraut, kombucha, and pickles are a few examples.
As with fiber, probiotics are also marketed as over-the-counter supplements. However, like all dietary supplements, they do not require FDA approval, so there is no guarantee that the types of bacteria listed on a label can provide the promised benefits — or are even in the bottle. "Therefore, it is best to get your probiotics from fermented foods," says Rimm.
To learn more about the value of fiber, fermented foods, and a healthy gut microbiome, listen to this episode of the Food, We Need to Talk podcast, "Understanding the Microbiome."

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Healthwatch
What Can Magnesium Do For You And How Much Do You Need?
~5.7 mins read
This forgotten mineral is having a moment.
Green leafy spinach, yellow bananas in a net bag, avocado half, nuts, dried apricots and other foods containing magnesium
In the world of nutrients, minerals, vitamins, and supplements, magnesium seems to be having a moment. Perhaps it’s long overdue: in many ways, magnesium has been overlooked, underappreciated, or even forgotten. That may be ending.
But why is magnesium getting so much attention lately? Are claims about its benefits true? Are you getting enough magnesium, or should you join the rising number of people who take magnesium supplements every day? If you have these questions, this post is for you.

What is magnesium?

Magnesium is a mineral the human body needs to function properly. It’s especially important for a healthy cardiovascular system, nerves, muscles, and bones. It helps regulate the body’s calcium and blood sugar levels, and it’s vital for the body’s production of protein. And that’s just the short list: more than 300 chemical reactions in the body rely, at least in part, on magnesium.

Are you getting enough magnesium?

Most of us don’t need to fret over how much magnesium we’re getting. The recommended daily amount of magnesium — 320 milligrams (mg) a day for women and 420 mg a day for men — isn’t difficult to take in through a healthy diet.
But getting extra magnesium is important for people with magnesium deficiency, and those who have complications of pregnancy known as preeclampsia and eclampsia.
More limited evidence suggests that extra magnesium could also be helpful for people with:
  • cardiovascular disease, including high blood pressure or coronary artery disease
  • insomnia
  • migraines
  • anxiety
  • diabetes and diabetic neuropathy
  • muscle soreness after exercise
  • constipation.
  • There are even studies suggesting that magnesium supplements might help with brain health and smoking cessation.
    Many studies of the potential benefits of magnesium are quite small, and some have inconsistent results. Despite the shaky evidence for many claims, this large and expanding list of proposed health benefits is one reason magnesium supplements have been increasingly popular in recent years.

    Is there a test to check magnesium levels?

    A blood test can measure whether you’re getting enough magnesium. The normal range for blood magnesium is 1.7 to 2.2 milligrams per deciliter (mg/dL).
    In general, the body does a great job of regulating the blood levels of magnesium. If levels rise, the kidney dumps excess magnesium into the urine; if levels fall, the kidneys hold onto more magnesium, bones release the mineral into the circulation, and the intestinal absorption of magnesium from the diet increases.

    What are the symptoms of low magnesium?

    The symptoms of too little magnesium (hypomagnesemia) include nausea, fatigue, and reduced appetite. Of course, these symptoms can be due to many other conditions, such as a stomach bug or medication side effects.
    When severe, low magnesium may cause numbness in the arms and legs, muscle cramps, and an abnormal heart rhythm.
    Some common causes of magnesium deficiency are:
  • malnutrition (or simply choosing a diet that’s low in magnesium)
  • gastrointestinal conditions (such as Crohn’s disease) that cause vomiting, diarrhea, or poor absorption of magnesium
  • kidney disease, some types of which cause excess loss of magnesium in the urine
  • medications like diuretics or certain types of chemotherapy
  • alcohol use disorder, because alcohol can boost the loss of magnesium in the urine.
  • Studies also suggest that magnesium deficiency is common among adults over age 70. The reasons include low intake of magnesium, poor absorption in the digestive tract, use of certain medicines, and kidney disease.

    What are the symptoms of too much magnesium?

    The symptoms of too much magnesium (hypermagnesemia) include nausea, headache, muscle weakness, and trouble breathing.
    Hypermagnesemia is quite rare. Most people with higher-than-normal blood levels of magnesium have kidney failure. Others may be taking too much magnesium in supplements or taking certain medicines (such as magnesium-containing laxatives).

    Which foods are good sources of magnesium?

    Magnesium-rich foods like green, leafy vegetables (such as spinach), beans, nuts, and whole grains will help you get there. Pumpkin seeds, soy milk, bananas, and dark chocolate (in moderation!) are also good sources.
    Eating one serving of spinach, an ounce of almonds, and a banana provides 190 mg of magnesium. That’s nearly 60% of the daily recommendation for women and 45% for men. Fortunately, magnesium is found in many healthy foods, so a good diet (such as the Mediterranean diet) will usually provide all the magnesium that you need.

    Should you take a magnesium supplement?

    Unless you have a diagnosed or suspected magnesium deficiency, or a condition with clear evidence of benefit such as preeclampsia or Crohn’s disease, there’s no compelling reason to routinely take a magnesium supplement.
    For some conditions, such as insomnia or migraine headaches, a magnesium supplement may be worth a try. But it’s a good idea to run this by your doctor first. All supplements come with a risk of side effects. In the case of magnesium, this includes nausea and diarrhea. Magnesium supplements can also interact with other medicines and supplements you’re taking.

    Which type of magnesium is best?

    Magnesium found in foods is usually the best choice. When needed, magnesium supplements are available in several different forms, including:
  • magnesium citrate, which is often taken as a laxative for gut health
  • magnesium glycinate, which is commonly promoted for improved sleep and reduced anxiety
  • magnesium oxide, which tends to be taken for constipation or indigestion.
  • All of these can provide extra magnesium. So the choice mostly comes down the reason you’re taking it, whether you experience side effects, cost, and personal preference.
    Daily supplements of less than 350 mg usually are considered safe. But when people have certain health conditions such as kidney disease, it can be tricky to get the right amount of magnesium, and monitoring blood levels is important.
    It’s safest to check with your doctor if you’re wondering whether to start taking a magnesium supplement, or unsure which one or how much to take.

    The bottom line

    Most people are fine without paying too much attention to their magnesium status. If you have concerns about whether you’re getting enough magnesium and whether you should take a supplement, ask your doctor about it. But don’t be surprised if you get some familiar advice: Choose a healthy, well-balanced diet. Your body will take care of the rest.

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    Healthwatch
    Less Butter, More Plant Oils, Longer Life?
    ~3.1 mins read
    Stepping up plant oils while pulling back on butter in our diet may help lengthen lives.
    Bottles of all shapes and sizes filled with healthy plant oils posed on a reflective countertop
    Not such good news for butter lovers like myself: seesawing research on how healthy or unhealthy butter might be received a firm push from a recent Harvard study published in JAMA Internal Medicine. Drawing on decades of data gathered through long-term observational studies, the researchers investigated whether butter and plant oils affect mortality.
    One basic takeaway? "A higher intake of butter increases mortality risk, while a higher intake of plant-based oil will lower it," says Yu Zhang, lead author of the study. And importantly, choosing to substitute certain plant oils for butter might help people live longer.

    What did the study find about butter versus plant oils?

    The researchers divided participants into four groups based on how much butter and plant oils they reported using on dietary questionnaires. They compared deaths among those consuming the highest amounts of butter or plant oils with those consuming the least, over a period of up to 33 years.
    Plant oils won out handily. A 15% higher risk of death was seen among those who ate the most butter compared with those who ate the least. A 16% lower risk of death was seen among those who consumed the highest amount of plant oils compared with those who consumed the least.
    Higher butter intake also raised risk for cancer deaths. And higher plant oil intake cut the risk for dying from cancer or cardiovascular disease like stroke or heart attack.
    While the study looked at five plant oils, only soybean, canola, and olive oil were linked with survival benefits. Swapping out a small amount of butter in the daily diet — about 10 grams, which is slightly less than a tablespoon — for an equivalent amount of those plant-based oils was linked with fewer total deaths and fewer cancer deaths, according to a modeling analysis.

    How could substituting plant oils for butter improve health?

    "Butter has almost no essential fatty acids and a modest amount of trans fat — the worst type of fat for cardiovascular disease," Dr. Walter C. Willett, professor of epidemiology and nutrition at the Harvard T.H. Chan School of Public Health and professor of medicine at Harvard Medical School, noted by email.
    By contrast, the plant oils highlighted in this study are rich in antioxidants, essential fatty acids, and unsaturated fats, which research has linked to healthier levels of cholesterol and triglycerides and lower insulin resistance.
    Especially when substituted for a saturated fat like butter, plant oils also may help lower chronic inflammation within the body. Making such substitutions aligns with American Heart Association recommendations and current Dietary Guidelines for Americans for healthful eating that lower risk for chronic disease.
    And for the butter lovers? "A little butter occasionally for its flavor would not be a problem," says Dr. Willett. "But for better health, use liquid plant oils whenever possible instead of butter for cooking and at the table." Try sampling a variety of plant oils, like different olive oils, mustard oil, and sesame oil, to learn which ones you enjoy for different purposes, he suggests. Additionally, a blend or mix of butter with oils — or sometimes a bit of butter on its own — can satisfy taste buds.

    What about study limitations and strengths?

    The study crunched data collected through a questionnaire answered every four years by more than 221,000 adults participating in the Nurses' Health Study, Nurses' Health Study II, and Health Professionals Follow-Up Study. As is true of all observational studies, this type of research can't prove cause and effect, although it adds to the body of evidence. Because most participants were white health care professionals, the findings may not apply to a wider population.
    The researchers adjusted for many variables that can affect health, including age, physical activity, smoking status, and family history of illnesses like cancer and diabetes. The size of the study, the length of follow-up, and multiple adjustments like these are all strengths.

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    Healthwatch
    Wildfires: How To Cope When Smoke Affects Air Quality And Health
    ~3.5 mins read
    Smoke from regional wildfires endangers health even for those not directly in the path of fire.
    Billowing clouds of smoke from a forest fire roll over a hill and approach a city
    As wildfires become more frequent due to climate change and drier conditions, more of us and more of our communities are at risk for harm. Here is information to help you prepare and protect yourself and your family.

    How does wildfire smoke affect air quality?

    Wildfire smoke contributes greatly to poor air quality. Just like pollution from burning coal, oil, and gas, wildfires create hazardous gases and tiny particles of varying sizes that are harmful to breathe. Wildfire smoke also contains other toxins that come from burning buildings and chemical storage.
    Smoke carried by weather patterns and jet streams can cross state and national boundaries, traveling to distant regions.

    How does wildfire smoke affect our health?

    The small particles in wildfire smoke –– known as particulate matter, or PM10, PM2.5, PM0.1 –– are the most worrisome to our health. When we breathe them in, these particles can travel deep into the lungs and sometimes into the bloodstream.
    The health effects of wildfire smoke include eye and skin irritation, coughing, wheezing, and difficulty breathing. Other possible serious health effects include heart failure, heart attacks, and strokes.

    Who needs to be especially careful?

    Those most at risk from wildfire smoke include children, older adults, outdoor workers, and anyone who is pregnant or who has heart or lung conditions.
    If you have a chronic health condition, talk to your doctor about how the smoke might affect you. Find out what symptoms should prompt medical attention or adjustment of your medications. This is especially important if you have lung problems or heart problems.

    What can you do to prepare for wildfire emergencies?

    If you live in an area threatened by wildfires, or where heat and dry conditions make them more likely to occur:
  • Create an evacuation plan for your family before a wildfire occurs.
  • Make sure that you have several days on hand of medications, water, and food that doesn’t need to be cooked. This will help if you need to leave suddenly due to a wildfire or another natural disaster.
  • Regularly check this fire and smoke map, which shows current wildfire conditions and has links to state advisories.
  • Follow alerts from local officials if you are in the region of an active fire.
  • What steps can you take to lower health risks during poor air quality days?

    These six tips can help you stay healthy during wildfire smoke advisories and at other times when air quality is poor:
  • Stay aware of air quality.AirNow.gov shares real-time air quality risk category for your area accompanied by activity guidance. When recommended, stay indoors, close doors, windows, and any outdoor air intake vents.
  • Consider buying an air purifier. This is also important even when there are no regional wildfires if you live in a building that is in poor condition. The EPA recommends avoiding air cleaners that generate ozone, which is also a pollutant.
  • Understand your HVAC system if you have one. The quality and cleanliness of your filters counts, so choose high-efficiency filters if possible, and replace these as needed. It’s also important to know if your system has outdoor air intake vents.
  • Avoid creating indoor pollution. That means no smoking, no vacuuming, and no burning of products like candles or incense. Avoid frying foods or using gas stoves, especially if your stove is not well ventilated.
  • Make a “clean room.” Choose a room with fewer doors and windows. Run an air purifier that is the appropriate size for this room, especially if you are not using central AC to keep cool.
  • Minimize outdoor time and wear a mask outside. Again, ensuring that you have several days of medications and food that doesn’t need to be cooked will help. If you must go outdoors, minimize time and level of activity. A well-fitted N95 or KN95 mask or P100 respirator can help keep you from breathing in small particles floating in smoky air.

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