The greatest scam in the history of modern medicine – Prof Noakes on Keys’ Cholesterol Con – BizNews

For approximately 70 years, the world has been conned into believing that Ancel Keys’ hypotheses were scientific fact. After a relentless crusade starting in the 1940s, Keys established his twin hypotheses relating to the relationship between diet, cholesterol, and coronary heart disease as the globally dominant nutritional paradigm which still stands to this day. In Part 2 of Professor Noakes’ ‘Ancel Keys’ Cholesterol Con’ series, Noakes details how scientific events starting in 1910 laid the groundwork upon which Keys ‘produced the greatest scam in the history of modern medicine”. – Nadya Swart

Ancel Keys’ Cholesterol Con Part 2.

By Prof Tim Noakes

The sequence of events that produced the greatest scam in the history of modern medicine.

Table 1 describes the sequence of 70 events that I will argue were critical in directing an unquestioning global acceptance of Keys’ unproven hypotheses and then its subsequent disproof. In that table I simply outline each event in its barest detail. In the coming sequence of columns I expose the meaning of each scientific event and how the most damaging of the scientific findings were skillfully managed by a core of like-thinking scientists to ensure that the real truth could not emerge.   

The ideas and arguments I present are not original in that I am not their original source. Rather they have been covered in compelling detail in the four iconic books (1-4), and in a number of others that confine themselves to what has become known as the Cholesterol Scam or the Cholesterol Con (5-9). That list is not all-inclusive. 

Re-reading Smith and Pinckney, Moore, Taubes and Teicholz’s books brings home to me just how brilliantly exceptional they are. If this series drives yet more to read any or all of those books, the series will have been successful. So my goal here is perhaps twofold. First to introduce and direct the diligent reader to the original sources of all this material. And second, to bring a comprehensive focus on the full nature of the ingenious scam to which we have all been exposed – at great cost. Included is my interpretation of the reasons why that scam has succeeded. So far. Perhaps my real hope is that by once more re-telling the story of how this scam unfolded over the past century, we may come a little closer to the day when the medical and nutrition professions will be forced to admit that, yes, they finally acknowledge what is now obvious. 

That this has been the greatest scam in the history of modern medicine. Who knows? One day they might even apologise.

cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol
cholesterol

Conclusion: 

On the basis of all this information it is extremely difficult, in fact impossible, to make any credible case to support Keys’ Twin Hypotheses. In the following 11 columns I provide the details behind each of these 70 events before providing a final summary of exactly what this multi-billion dollar research effort, the goal of which was to provide support for Keys’ Twin Hypotheses, did actually reveal.

It’s finally time to expose this evidence more widely, but especially to the medical and nutrition/dietetics professions, so that in 2020 we can give humans the appropriate dietary advice that will return us all to a state of optimum metabolic health.

References:

  1. Moore TJ. Heart Failure: A Critical Inquiry into American Medicine and the Revolution in Heart Care. New York, NY: Simon and Schuster, 1989. [Also Moore TJ. The cholesterol myth. The Atlantic. 1989;264(September):37].
  2. Smith RL, Pinckney ER. The Cholesterol Conspiracy. Warren H Green Inc; St Louis MI, 1991.
  3. Taubes G. Good calories bad calories. Fats, carbs, and the controversial science of diet and health. Anchor Books, New York, NY. 2008.
  4. Teicholz N. The Big Fat Surprise. Why butter, meat and cheese belong in a heathy diet. Simon and Schuster, New York, NY. 2014. 
  5. Ravnskov U. The Cholesterol Myths. Exposing the fallacy that saturated fat and cholesterol cause heart disease. New Trends Publishing, Washington, DC. 2000.
  6. Colpo A. The Great Cholesterol Con.  LULU publishers, 2007. 
  7. Kendrick M. The Great Cholesterol Con. The truth about what really causes heart disease and how to avoid it. John Blake, London, UK. 2007.
  8. Ravnskov U. Fat and cholesterol are good for you. GB Publishing, Sweden. 2009.
  9. Rosch PJ. Fat and cholesterol don’t cause heart attacks. And statins are not the solution. Columbia Publishing, UK. 2016.
  10. Keys A. Prediction and possible prevention of coronary disease. Am J Publ Health 1953;43:1399-1407.
  11. Page IH, Stare FJ, Corcoran AC, et al. Atherosclerosis and the fat content of the diet. Circulation 1957;16:163-178.
  12. Ahrens EH, Hirsch J, Insull W, et al. Dietary control of serum lipids in relation to atherosclerosis. JAMA 1957;164:1905-1911.
  13. Albrink MJ, Man EB. Serum triglycerides in coronary artery disease. Arch Intern Med 1959;103: 4-8. 
  14. Central Committee for Medical and Community Program of the American Heart Association. Dietary Fat and Its Relation to Heart Attacks and Strokes. JAMA 1961;175:389-391. 
  15. McGandy RB, Hegsted DM, Stare FJ. Dietary fats, carbohydrates and atherosclerotic vascular disease. NEJM 1967;277:186-192; (concluded) NEJM 1967;277:242-247
  16. Adeva-Andany MM, Martinez-Rodriquez J, Gonzalez-Lucan M et al. Insulin resistance is a cardiovascular risk factor in humans. Diab Metab Syndr:Clin Res Rev 2019;13:1449-1455.
  17. Anon. Toward Healthful Diets. Food and Nutrition Board, National Research Council, National Academy of Sciences, Washington DC: 1980. 
  18. Steinberg D. An interpretive history of the cholesterol controversy, part IV: The 1984 Coronary Primary Prevention Trial ends it – almost. J Lipid Res 2006;47:1-14.
  19. Kannel WB, Castelli WP, Gordon T. Cholesterol in the prediction of atherosclerotic disease: New perspectives based on the Framingham Study. Ann Intern Med 1979;90:85-91.
  20. Ramsden CE, Zamora D, Leelarthaepin B, et al. Use of dietary linoleic acid for secondary prevention of coronary heart disease and death. Evaluation of recovered data from the Sydney Diet Heart Study and updated meta-analysis. BMJ 2013 Feb 4;346:e8707.
  21. Ramsden CE, Zamora D, Majchrzak-Hong S, et al. Re-evaluation of the traditional diet-heart hypothesis: analysis of recovered data from Minnesota Coronary Experiment (1968-73). BMJ 2016;353:i1246.
  22. Grasgruber P, Sebera M, Hrazdira E, et al. Food consumption and the actual statistics of cardiovascular diseases: an epidemiological comparison of 42 European countries. Food Nutr Res 2016;60:394
  23. Dehghan M, Mente A, Zhang X, et al. Association of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study. Lancet 2017;390:2050-2062; Mente A, Dehghan M, Rangarajan S, et al. Association of dietary nutrients with blood lipids and blood pressure in 18 countries: a cross-sectional analysis from the PURE study. Lancet 2017;390:774-787; Miller V, Mente A, Dehghan M, et al. Fruit, vegetable, and legume intake, and cardiovascular disease and deaths in 18 countries (PURE): a prospective cohort study. Lancet 2017;390:2037-2049; Dehghan M, Mente A, Rangarajan S, et al. Association of dairy intake with cardiovascular disease and mortality in 21 countries from five countries (PURE): a prospective cohort study. Lancet 2018;392:2288-2297.
  24. Ioannidis JPA. We need more randomized trials in nutrition – preferably large, long-term, and with negative results. Am J Clin Nutr 2016;103:1385-1386.

Read Also:

(Visited 337 times, 337 visits today)

Health experts urge public to quit smoking, invest in healthy lifestyle – GMA News Online

Health experts urged the public to quit smoking and invest in a healthy lifestyle to prevent cardiovascular diseases (CVDs).

In a statement, the Philippine Heart Association (PHA) said that at least 345 Filipinos die daily due to heart diseases.

The PHA said among the causes of heart diseases were unhealthy health habits such as smoking and vaping, lack of exercise, and an unhealthy lifestyle.

“Three decades ago, CVDs were more common in people aged 50 and above but nowadays, patients in their 30s suffer from a premature heart attack,” PHA Director Dr. Luigi Pierre Segundo said on Thursday – World Heart Day.

Segundo advised Filipinos to invest in their health to prevent these heart diseases.

PHA Secretary Dr. Rodney Jimenez echoed Segundo’s call, urging smokers to quit as the habit would harm not just the lungs and heart but also other body organs.

“We will constantly urge you to quit smoking or vaping or perish the thought of trying it because it is not just hazardous to the lungs and heart but to other body organs,” Jimenez said.

Pulmonologist Dr. Jonray Magallanes, on the other hand, said that smoking can also put other people at risk from heart attacks.

“Smoking does not damage the lungs alone but causes cancer, stroke, heart attack, and heart failure. And did you know that a smoker also puts his housemates at risk because they get to inhale the fumes,” Magallanes said.

“The primary smoker inhales the bigger particles of fumes while the people exposed to him/her who get to inhale the smaller particles can suffer from a heart attack,” he added.

Segundo also said eating food containing trans fat contributes to the leading cause of death in the country which is a heart attack.

“The bad news is that industrially-produced trans fat has no known benefits. But it is still used in the Philippines and many other countries in cakes and fried foods, repackaged snacks, certain cooking oils and fats that are used at home in restos or street food,” he said.

“Trans fat, or to be more specific the industrially processed trans fatty acids, are partially hydrogenated fats that are usually from vegetable oil to make the food stable and have no health benefits. They contribute to the top cause of death in the Philippines: heart attack,” he added.

Meanwhile, the imposition of taxes on sin products has helped the Department of Health (DOH) in its bid to control lifestyle risk factors among the population, according to DOH officer in charge Dr. Maria Rosario Vergeire.

Citing the data from the Department of Science and Technology-Food and Nutrition Research Institute (DOST-FNRI), Vergeire said the Sin Tax helped reduce the smoking prevalence in the country from 31% in 2008 to 20% in 2019.

“Malaking bagay po yun dahil yun ang titignan para makita yung risk ng population at saka yung burden sa population cause we know that this kind of lifestyle will lead to diseases eventually, the non communicable diseases, and will be an economic burden also to the country,” Vergeire said. — DVM, GMA News

Repurposing existing drugs to fight new COVID-19 variants – MSUToday

Finding new ways to treat the novel coronavirus and its ever-changing variants has been a challenge for researchers, especially when the traditional drug development and discovery process can take years. A Michigan State University researcher and his team are taking a hi-tech approach to determine whether drugs already on the market can pull double duty in treating new COVID variants.

“The COVID-19 virus is a challenge because it continues to evolve,” said Bin Chen, an associate professor in the College of Human Medicine. “By using artificial intelligence and really large data sets, we can repurpose old drugs for new uses.”

Chen built an international team of researchers with expertise on topics ranging from biology to computer science to tackle this challenge. First, Chen and his team turned to publicly available databases to mine for the unique coronavirus gene expression signatures from 1,700 host transcriptomic profiles that came from patient tissues, cell cultures and mouse models. These signatures revealed the biology shared by COVID-19 and its variants.

With the virus’s signature and knowing which genes need to be suppressed and which genes need to be activated, the team was able to use a computer program to screen a drug library consisting of FDA-approved or investigational drugs to find candidates that could correct the expression of signature genes and further inhibit the coronavirus from replicating. Chen and his team discovered one novel candidate, IMD-0354, a drug that passed phase I clinical trials for the treatment of atopic dermatitis. A group in Korea later observed that it was 90-fold more effective against six COVID-19 variants than remdesivir, the first drug approved to treat COVID-19. The team further found that IMD-0354 inhibited the virus from copying itself by boosting the immune response pathways in the host cells. Based on the information learned, the researchers studied a prodrug of IMD-0354 called IMD-1041. A prodrug is an inactive substance that is metabolized within the body to create an active drug.

“IMD-1041 is even more promising as it is orally available and has been investigated for chronic obstructive pulmonary disease, a group of lung diseases that block airflow and make it difficult to breathe,” Chen said. “Because the structure of IMD-1041 is undisclosed, we are developing a new artificial intelligence platform to design novel compounds that hopefully could be tested and evaluated in more advanced animal models.”

The research was published in the journal iScience.

This project was led by two senior postdoctoral scholars in the Chen lab: Jing Xing, who recently became a young investigator at the Chinese Academy of Sciences, and Rama Shankar, with the support from researchers from Institut Pasteur Korea, Shanghai Institute of Materia Medica, University of Texas Medical Branch, Spectrum Health in Grand Rapids and Stanford University.

A healthy lifestyle is positively associated with mental health and well-being and core markers in ageing – BMC Medicine – BMC Medicine

  • World Health Organization. Healthy living: what is a healthy lifestyle? Copenhagen: WHO Regional Office for Europe; 1999.

    Google Scholar 

  • World Health Organization. Tackling NCDs: ‘best buys’ and other recommended interventions for the prevention and control of noncommunicable diseases. Geneva: World Health Organization; 2017.

    Google Scholar 

  • World Health Organization. WHO global report on trends in prevalence of tobacco smoking 2000–2025. 3rd ed. Geneva: World Health Organisation; 2019.

    Google Scholar 

  • World Health Organization. 2021 Physical Activity Factsheets for the European Union Member States in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2021.

    Google Scholar 

  • Eurostat. Database on health determinants 2021 [Available from: https://ec.europa.eu/eurostat/web/health/data/database?node_code=hlth_det.

  • Whitman IR, Agarwal V, Nah G, Dukes JW, Vittinghoff E, Dewland TA, et al. Alcohol abuse and cardiac disease. J Am Coll Cardiol. 2017;69(1):13–24. https://doi.org/10.1016/j.jacc.2016.10.048.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019;92:98–107. https://doi.org/10.1016/j.metabol.2018.10.011.

    CAS  Article  PubMed  Google Scholar 

  • Freisling H, Viallon V, Lennon H, Bagnardi V, Ricci C, Butterworth AS, et al. Lifestyle factors and risk of multimorbidity of cancer and cardiometabolic diseases: a multinational cohort study. BMC Med. 2020;18(1):5. https://doi.org/10.1186/s12916-019-1474-7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Liu Y, Pleasants RA, Croft JB, Wheaton AG, Heidari K, Malarcher AM, et al. Smoking duration, respiratory symptoms, and COPD in adults aged ≥ 45 years with a smoking history. Int J Chron Obstruct Pulmon Dis. 2015;10:1409. https://doi.org/10.2147/COPD.S82259.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Kirsch Micheletti J, Bláfoss R, Sundstrup E, Bay H, Pastre CM, Andersen LL. Association between lifestyle and musculoskeletal pain: cross-sectional study among 10,000 adults from the general working population. BMC Musculoskelet Disord. 2019;20(1):609. https://doi.org/10.1186/s12891-019-3002-5.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Bowe AK, Owens M, Codd MB, Lawlor BA, Glynn RW. Physical activity and mental health in an Irish population. Ir J Med Sci. 2019;188(2):625–31. https://doi.org/10.1007/s11845-018-1863-5.

    Article  PubMed  Google Scholar 

  • Richardson S, McNeill A, Brose LS. Smoking and quitting behaviours by mental health conditions in Great Britain (1993–2014). Addict Behav. 2019;90:14–9. https://doi.org/10.1016/j.addbeh.2018.10.011.

    Article  PubMed  PubMed Central  Google Scholar 

  • Levy MZ, Allsopp RC, Futcher AB, Greider CW, Harley CB. Telomere end-replication problem and cell aging. J Mol Biol. 1992;225(4):951–60. https://doi.org/10.1016/0022-2836(92)90096-3.

    CAS  Article  PubMed  Google Scholar 

  • Shaughnessy DT, McAllister K, Worth L, Haugen AC, Meyer JN, Domann FE, et al. Mitochondria, energetics, epigenetics, and cellular responses to stress. Environ Health Perspect. 2014;122(12):1271–8. https://doi.org/10.1289/ehp.1408418.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Cui Y, Gao YT, Cai Q, Qu S, Cai H, Li HL, et al. Associations of leukocyte telomere length with body anthropometric indices and weight change in Chinese women. Obesity. 2013;21(12):2582–8. https://doi.org/10.1002/oby.20321.

    Article  PubMed  Google Scholar 

  • Crous-Bou M, Fung TT, Prescott J, Julin B, Du M, Sun Q, et al. Mediterranean diet and telomere length in Nurses’ Health Study: population based cohort study. BMJ. 2014;349:g6674. https://doi.org/10.1136/bmj.g6674.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Janssen BG, Gyselaers W, Byun H-M, Roels HA, Cuypers A, Baccarelli AA, et al. Placental mitochondrial DNA and CYP1A1 gene methylation as molecular signatures for tobacco smoke exposure in pregnant women and the relevance for birth weight. J Transl Med. 2017;15(1):5. https://doi.org/10.1186/s12967-016-1113-4.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Navarro-Mateu F, Husky M, Cayuela-Fuentes P, Álvarez FJ, Roca-Vega A, Rubio-Aparicio M, et al. The association of telomere length with substance use disorders: a systematic review and meta-analysis of observational studies. Addiction. 2020;116(8):1954–72. https://doi.org/10.1111/add.15312.

    Article  PubMed  Google Scholar 

  • Pyle A, Anugrha H, Kurzawa-Akanbi M, Yarnall A, Burn D, Hudson G. Reduced mitochondrial DNA copy number is a biomarker of Parkinson’s disease. Neurobiol Aging. 2016;38:216.e7-.e10. https://doi.org/10.1016/j.neurobiolaging.2015.10.033.

    CAS  Article  Google Scholar 

  • Ashar FN, Zhang Y, Longchamps RJ, Lane J, Moes A, Grove ML, et al. Association of mitochondrial DNA copy number with cardiovascular disease. JAMA Cardiol. 2017;2(11):1247–55. https://doi.org/10.1001/jamacardio.2017.3683.

    Article  PubMed  PubMed Central  Google Scholar 

  • Chen S, Lin J, Matsuguchi T, Blackburn E, Yeh F, Best LG, et al. Short leukocyte telomere length predicts incidence and progression of carotid atherosclerosis in American Indians: the Strong Heart Family Study. Aging. 2014;6(5):414–27. https://doi.org/10.18632/aging.100671.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Mons U, Müezzinler A, Schöttker B, Dieffenbach AK, Butterbach K, Schick M, et al. Leukocyte telomere length and all-cause, cardiovascular disease, and cancer mortality: results from individual-participant-data meta-analysis of 2 large prospective cohort studies. Am J Epidemiol. 2017;185(12):1317–26. https://doi.org/10.1093/aje/kww210.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lindqvist D, Epel ES, Mellon SH, Penninx BW, Révész D, Verhoeven JE, et al. Psychiatric disorders and leukocyte telomere length: underlying mechanisms linking mental illness with cellular aging. Neurosci Biobehav Rev. 2015;55:333–64. https://doi.org/10.1016/j.neubiorev.2015.05.007.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Noble N, Paul C, Turon H, Oldmeadow C. Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity (‘SNAP’) health risk factors. Prev Med. 2015;81:16–41. https://doi.org/10.1016/j.ypmed.2015.07.003.

    Article  PubMed  Google Scholar 

  • Poortinga W. The prevalence and clustering of four major lifestyle risk factors in an English adult population. Prev Med. 2007;44(2):124–8. https://doi.org/10.1016/j.ypmed.2006.10.006.

    Article  PubMed  Google Scholar 

  • Demarest S, Van der Heyden J, Charafeddine R, Drieskens S, Gisle L, Tafforeau J. Methodological basics and evolution of the Belgian Health Interview Survey 1997–2008. Arch Public Health. 2013;71(1):24. https://doi.org/10.1186/0778-7367-71-24.

    Article  PubMed  PubMed Central  Google Scholar 

  • Goldberg DP. User’s guide to the General Health Questionnaire. Windsor: NFER-Nelson; 1988.

    Google Scholar 

  • Ware JE Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33. https://doi.org/10.1097/00005650-199603000-00003.

    Article  PubMed  Google Scholar 

  • Cantril H. Pattern of human concerns. New Brunswick: Rutgers University Press; 1965.

    Google Scholar 

  • Kroenke K, Spitzer RL, Williams JB, Löwe B. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry. 2010;32(4):345–59. https://doi.org/10.1016/j.genhosppsych.2010.03.006.

    Article  PubMed  Google Scholar 

  • Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Med Care. 2008;46(3):266–74. https://doi.org/10.1097/MLR.0b013e318160d093.

    Article  PubMed  Google Scholar 

  • Gisle L, Drieskens S, Demarest S, Van der Heyden J. Enquête de santé 2018: Santé mentale. Bruxelles: Sciensano; 2018. (https://www.enquetesante.be. Available from. Numéro de rapport: D/2020/14.440/3).

    Google Scholar 

  • Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care. 1992;30(6):473–83.

    Article  Google Scholar 

  • Braunholtz S, Davidson S, Myant K, O’Connor R. Well? What do you think?: the Third National Scottish Survey of Public Attitudes to Mental Health, Mental Wellbeing and Mental Health Problems. Scotland: Scottish Government Edinburgh; 2007.

    Google Scholar 

  • Van Lente E, Barry MM, Molcho M, Morgan K, Watson D, Harrington J, et al. Measuring population mental health and social well-being. Int J Public Health. 2012;57(2):421–30. https://doi.org/10.1007/s00038-011-0317-x.

    Article  PubMed  Google Scholar 

  • de Bruin A, Picavet HSJ, Nossikov A. Health interview surveys: towards international harmonization of methods and instruments. Copenhagen: World Health Organization. Regional Office for Europe; 1996.

    Google Scholar 

  • Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–13.

    CAS  Article  Google Scholar 

  • Superior Health Council. Dietary guidelines for the Belgian adult population. Report 9284. Brussels: Superior Health Council; 2019.

    Google Scholar 

  • World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: World Health Organization; 2020.

    Google Scholar 

  • World Health Organization. HEARTS Technical package for cardiovascular disease management in primary health care: healthy-lifestyle counselling. Geneva: World Health Organization; 2018.

    Google Scholar 

  • World Health Organization. Country profiles on nutrition, physical activity and obesity in the 28 European Union Member States of the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2013.

    Google Scholar 

  • Bhaskaran K, dos-Santos-Silva I, Leon DA, Douglas IJ, Smeeth L. Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3.6 million adults in the UK. Lancet Diabetes Endocrinol. 2018;6(12):944–53. https://doi.org/10.1016/S2213-8587(18)30288-2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Benetou V, Kanellopoulou A, Kanavou E, Fotiou A, Stavrou M, Richardson C, et al. Diet-related behaviors and diet quality among school-aged adolescents living in Greece. Nutrients. 2020;12(12):3804. https://doi.org/10.3390/nu12123804.

    Article  PubMed Central  Google Scholar 

  • Martens DS, Plusquin M, Gyselaers W, De Vivo I, Nawrot TS. Maternal pre-pregnancy body mass index and newborn telomere length. BMC Med. 2016;14(1):148. https://doi.org/10.1186/s12916-016-0689-0.

    Article  PubMed  PubMed Central  Google Scholar 

  • Janssen BG, Munters E, Pieters N, Smeets K, Cox B, Cuypers A, et al. Placental mitochondrial DNA content and particulate air pollution during in utero life. Environ Health Perspect. 2012;120(9):1346–52. https://doi.org/10.1289/ehp.1104458.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Jacka FN, O’Neil A, Opie R, Itsiopoulos C, Cotton S, Mohebbi M, et al. A randomised controlled trial of dietary improvement for adults with major depression (the ‘SMILES’ trial). BMC Med. 2017;15(1):23. https://doi.org/10.1186/s12916-017-0791-y.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pavkovic B, Zaric M, Markovic M, Klacar M, Huljic A, Caricic A. Double screening for dual disorder, alcoholism and depression. Psychiatry Res. 2018;270:483–9. https://doi.org/10.1016/j.psychres.2018.10.013.

    Article  PubMed  Google Scholar 

  • De Wit LM, Van Straten A, Van Herten M, Penninx BW, Cuijpers P. Depression and body mass index, a u-shaped association. BMC Public Health. 2009;9:14. https://doi.org/10.1186/1471-2458-9-14.

    Article  PubMed  PubMed Central  Google Scholar 

  • Meader N, King K, Moe-Byrne T, Wright K, Graham H, Petticrew M, et al. A systematic review on the clustering and co-occurrence of multiple risk behaviours. BMC Public Health. 2016;16:657. https://doi.org/10.1186/s12889-016-3373-6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Saneei P, Esmaillzadeh A, Hassanzadeh Keshteli A, Reza Roohafza H, Afshar H, Feizi A, et al. Combined healthy lifestyle is inversely associated with psychological disorders among adults. PLoS ONE. 2016;11(1):e0146888. https://doi.org/10.1371/journal.pone.0146888.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Bonnet F, Irving K, Terra J-L, Nony P, Berthezène F, Moulin P. Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis. 2005;178(2):339–44. https://doi.org/10.1016/j.atherosclerosis.2004.08.035.

    CAS  Article  PubMed  Google Scholar 

  • Loprinzi PD, Mahoney S. Concurrent occurrence of multiple positive lifestyle behaviors and depression among adults in the United States. J Affect Disord. 2014;165:126–30. https://doi.org/10.1016/j.jad.2014.04.073.

    Article  PubMed  Google Scholar 

  • Yang H, Gao J, Wang T, Yang L, Liu Y, Shen Y, et al. Association between adverse mental health and an unhealthy lifestyle in rural-to-urban migrant workers in Shanghai. J Formos Med Assoc. 2017;116(2):90–8. https://doi.org/10.1016/j.jfma.2016.03.004.

    Article  PubMed  Google Scholar 

  • Oftedal S, Kolt GS, Holliday EG, Stamatakis E, Vandelanotte C, Brown WJ, et al. Associations of health-behavior patterns, mental health and self-rated health. Prev Med. 2019;118:295–303. https://doi.org/10.1016/j.ypmed.2018.11.017.

    Article  PubMed  Google Scholar 

  • Conry MC, Morgan K, Curry P, McGee H, Harrington J, Ward M, et al. The clustering of health behaviours in Ireland and their relationship with mental health, self-rated health and quality of life. BMC Public Health. 2011;11(1):692. https://doi.org/10.1186/1471-2458-11-692.

    Article  PubMed  PubMed Central  Google Scholar 

  • Buttery AK, Mensink GB, Busch MA. Healthy behaviours and mental health: findings from the German Health Update (GEDA). The European Journal of Public Health. 2015;25(2):219–25. https://doi.org/10.1093/eurpub/cku094.

    Article  PubMed  Google Scholar 

  • Ahmed NJ, Husen AZ, Khoshnaw N, Getta HA, Hussein ZS, Yassin AK, et al. The effects of smoking on IgE, oxidative stress and haemoglobin concentration. Asian Pac J Cancer Prev. 2020;21(4):1069–72. https://doi.org/10.31557/APJCP.2020.21.4.1069.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Langley MR, Yoon H, Kim HN, Choi C-I, Simon W, Kleppe L, et al. High fat diet consumption results in mitochondrial dysfunction, oxidative stress, and oligodendrocyte loss in the central nervous system. Biochim Biophys Acta Mol Basis Dis. 2020;1866(3):165630. https://doi.org/10.1016/j.bbadis.2019.165630.

    CAS  Article  PubMed  Google Scholar 

  • Tan HK, Yates E, Lilly K, Dhanda AD. Oxidative stress in alcohol-related liver disease. World J Hepatol. 2020;12(7):332–49. https://doi.org/10.4254/wjh.v12.i7.332.

    Article  PubMed  PubMed Central  Google Scholar 

  • Martens DS, Nawrot TS. Air pollution stress and the aging phenotype: the telomere connection. Curr Environ Health Rep. 2016;3(3):258–69. https://doi.org/10.1007/s40572-016-0098-8.

    CAS  Article  PubMed  Google Scholar 

  • Martens DS, Van Der Stukken C, Derom C, Thiery E, Bijnens EM, Nawrot TS. Newborn telomere length predicts later life telomere length: tracking telomere length from birth to child- and adulthood. EBioMedicine. 2021;63:103164. https://doi.org/10.1016/j.ebiom.2020.103164.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Hang D, Nan H, Kværner AS, De Vivo I, Chan AT, Hu Z, et al. Longitudinal associations of lifetime adiposity with leukocyte telomere length and mitochondrial DNA copy number. Eur J Epidemiol. 2018;33(5):485–95. https://doi.org/10.1007/s10654-018-0382-z.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Gu Y, Honig LS, Schupf N, Lee JH, Luchsinger JA, Stern Y, et al. Mediterranean diet and leukocyte telomere length in a multi-ethnic elderly population. Age. 2015;37(2):24. https://doi.org/10.1007/s11357-015-9758-0.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Sellami M, Al-Muraikhy S, Al-Jaber H, Al-Amri H, Al-Mansoori L, Mazloum NA, et al. Age and sport intensity-dependent changes in cytokines and telomere length in elite athletes. Antioxidants. 2021;10(7):1035. https://doi.org/10.3390/antiox10071035.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Savela S, Saijonmaa O, Strandberg TE, Koistinen P, Strandberg AY, Tilvis RS, et al. Physical activity in midlife and telomere length measured in old age. Exp Gerontol. 2013;48(1):81–4. https://doi.org/10.1016/j.exger.2012.02.003.

    CAS  Article  PubMed  Google Scholar 

  • Mirabello L, Huang WY, Wong JY, Chatterjee N, Reding D, David Crawford E, et al. The association between leukocyte telomere length and cigarette smoking, dietary and physical variables, and risk of prostate cancer. Aging Cell. 2009;8(4):405–13. https://doi.org/10.1111/j.1474-9726.2009.00485.x.

    CAS  Article  PubMed  Google Scholar 

  • Sun Q, Shi L, Prescott J, Chiuve SE, Hu FB, De Vivo I, et al. Healthy lifestyle and leukocyte telomere length in US women. PLoS ONE. 2012;7(5):e38374. https://doi.org/10.1371/journal.pone.0038374.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Sindi S, Solomon A, Kåreholt I, Hovatta I, Antikainen R, Hänninen T, et al. Telomere length change in a multidomain lifestyle intervention to prevent cognitive decline: a randomized clinical trial. J Gerontol A. 2021;76(3):491–8. https://doi.org/10.1093/gerona/glaa279.

    Article  Google Scholar 

  • Paltoglou G, Raftopoulou C, Nicolaides NC, Genitsaridi SM, Karampatsou SI, Papadopoulou M, et al. A comprehensive, multidisciplinary, personalized, lifestyle intervention program is associated with increased leukocyte telomere length in children and adolescents with overweight and obesity. Nutrients. 2021;13(8):2682. https://doi.org/10.3390/nu13082682.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Chakravarty EF, Hubert HB, Krishnan E, Bruce BB, Lingala VB, Fries JF. Lifestyle risk factors predict disability and death in healthy aging adults. Am J Med. 2012;125(2):190–7. https://doi.org/10.1016/j.amjmed.2011.08.006.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bosnes I, Nordahl HM, Stordal E, Bosnes O, Myklebust TÅ, Almkvist O. Lifestyle predictors of successful aging: a 20-year prospective HUNT study. PLoS ONE. 2019;14(7):e0219200. https://doi.org/10.1371/journal.pone.0219200.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Epel ES, Prather AA. Stress, telomeres, and psychopathology: toward a deeper understanding of a triad of early aging. Annu Rev Clin Psychol. 2018;14:371–97. https://doi.org/10.1146/annurev-clinpsy-032816-045054.

    Article  PubMed  PubMed Central  Google Scholar 

  • Verhoeven JE, Révész D, Epel ES, Lin J, Wolkowitz OM, Penninx BW. Major depressive disorder and accelerated cellular aging: results from a large psychiatric cohort study. Mol Psychiatry. 2014;19(8):895–901. https://doi.org/10.1038/mp.2013.151.

    CAS  Article  PubMed  Google Scholar 

  • Han LK, Verhoeven JE, Tyrka AR, Penninx BW, Wolkowitz OM, Månsson KN, et al. Accelerating research on biological aging and mental health: current challenges and future directions. Psychoneuroendocrinology. 2019;106:293–311. https://doi.org/10.1016/j.psyneuen.2019.04.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kim MY, Lee JW, Kang HC, Kim E, Lee DC. Leukocyte mitochondrial DNA (mtDNA) content is associated with depression in old women. Arch Gerontol Geriatr. 2011;53(2):e218–21. https://doi.org/10.1016/j.archger.2010.11.019.

    CAS  Article  PubMed  Google Scholar 

  • Mengel-From J, Thinggaard M, Dalgard C, Kyvik KO, Christensen K, Christiansen L. Mitochondrial DNA copy number in peripheral blood cells declines with age and is associated with general health among elderly. Hum Genet. 2014;133(9):1149–59. https://doi.org/10.1007/s00439-014-1458-9.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Otsuka I, Izumi T, Boku S, Kimura A, Zhang Y, Mouri K, et al. Aberrant telomere length and mitochondrial DNA copy number in suicide completers. Sci Rep. 2017;7(1):3176.

    Article  Google Scholar 

  • Chung JK, Lee SY, Park M, Joo E-J, Kim SA. Investigation of mitochondrial DNA copy number in patients with major depressive disorder. Psychiatry Res. 2019;282:112616. https://doi.org/10.1016/j.psychres.2019.112616.

    CAS  Article  PubMed  Google Scholar 

  • Takahashi PY, Jenkins GD, Welkie BP, McDonnell SK, Evans JM, Cerhan JR, et al. Association of mitochondrial DNA copy number with self-rated health status. Appl Clin Genet. 2018;11:121–7. https://doi.org/10.2147/TACG.S167640.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Vyas CM, Ogata S, Reynolds CF 3rd, Mischoulon D, Chang G, Cook NR, et al. Lifestyle and behavioral factors and mitochondrial DNA copy number in a diverse cohort of mid-life and older adults. PLoS ONE. 2020;15(8):e0237235. https://doi.org/10.1371/journal.pone.0237235.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Verhoeven JE, Révész D, van Oppen P, Epel ES, Wolkowitz OM, Penninx BW. Anxiety disorders and accelerated cellular ageing. Br J Psychiatry. 2015;206(5):371–8. https://doi.org/10.1192/bjp.bp.114.151027.

    Article  PubMed  Google Scholar 

  • Pisanu C, Vitali E, Meloni A, Congiu D, Severino G, Ardau R, et al. Investigating the role of leukocyte telomere length in treatment-resistant depression and in response to electroconvulsive therapy. J Pers Med. 2021;11(11):1100. https://doi.org/10.3390/jpm11111100.

    Article  PubMed  PubMed Central  Google Scholar 

  • da Silva RS, de Moraes LS, da Rocha CAM, Ferreira-Fernandes H, Yoshioka FKN, Rey JA, et al. Telomere length and telomerase activity of leukocytes as biomarkers of selective serotonin reuptake inhibitor responses in patients with major depressive disorder. Psychiatr Genet. 2022;32(1):34–6. https://doi.org/10.1097/ypg.0000000000000305.

    Article  PubMed  Google Scholar 

  • Aas M, Elvsåshagen T, Westlye LT, Kaufmann T, Athanasiu L, Djurovic S, et al. Telomere length is associated with childhood trauma in patients with severe mental disorders. Transl Psychiatry. 2019;9(1):97. https://doi.org/10.1038/s41398-019-0432-7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Birkenæs V, Elvsåshagen T, Westlye LT, Høegh MC, Haram M, Werner MCF, et al. Telomeres are shorter and associated with number of suicide attempts in affective disorders. J Affect Disord. 2021;295:1032–9. https://doi.org/10.1016/j.jad.2021.08.135.

    CAS  Article  PubMed  Google Scholar 

  • Phillips AC, Robertson T, Carroll D, Der G, Shiels PG, McGlynn L, et al. Do symptoms of depression predict telomere length? Evidence from the West of Scotland Twenty-07 Study. Psychosom Med. 2013;75(3):288–96. https://doi.org/10.1097/PSY.0b013e318289e6b5.

    Article  PubMed  Google Scholar 

  • Incollingo Rodriguez AC, Polcari JJ, Nephew BC, Harris R, Zhang C, Murgatroyd C, et al. Acculturative stress, telomere length, and postpartum depression in Latinx mothers. J Psychiatr Res. 2022;147:301–6. https://doi.org/10.1016/j.jpsychires.2022.01.063.

    Article  PubMed  Google Scholar 

  • Darrow SM, Verhoeven JE, Révész D, Lindqvist D, Penninx BW, Delucchi KL, et al. The association between psychiatric disorders and telomere length: a meta-analysis involving 14,827 persons. Psychosom Med. 2016;78(7):776–87. https://doi.org/10.1097/PSY.0000000000000356.

    Article  PubMed  PubMed Central  Google Scholar 

  • Simon NM, Walton ZE, Bui E, Prescott J, Hoge E, Keshaviah A, et al. Telomere length and telomerase in a well-characterized sample of individuals with major depressive disorder compared to controls. Psychoneuroendocrinology. 2015;58:9–22. https://doi.org/10.1016/j.psyneuen.2015.04.004.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Schaakxs R, Verhoeven JE, Voshaar RCO, Comijs HC, Penninx BW. Leukocyte telomere length and late-life depression. Am J Geriatr Psychiatry. 2015;23(4):423–32. https://doi.org/10.1016/j.jagp.2014.06.003.

    Article  PubMed  Google Scholar 

  • de Baumont AC, Hoffmann MS, Bortoluzzi A, Fries GR, Lavandoski P, Grun LK, et al. Telomere length and epigenetic age acceleration in adolescents with anxiety disorders. Sci Rep. 2021;11(1):7716. https://doi.org/10.1038/s41598-021-87045-w.

    CAS  Article  Google Scholar 

  • Schutte NS, Malouff JM. The association between depression and leukocyte telomere length: a meta-analysis. Depress Anxiety. 2015;32(4):229–38. https://doi.org/10.1002/da.22351.

    CAS  Article  PubMed  Google Scholar 

  • Drieskens S, Demarest S, Bel S, De Ridder K, Tafforeau J. Correction of self-reported BMI based on objective measurements: a Belgian experience. Archives of Public Health. 2018;76:10. https://doi.org/10.1186/s13690-018-0255-7.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  • Gorber SC, Schofield-Hurwitz S, Hardt J, Levasseur G, Tremblay M. The accuracy of self-reported smoking: a systematic review of the relationship between self-reported and cotinine-assessed smoking status. Nicotine Tob Res. 2009;11(1):12–24. https://doi.org/10.1093/ntr/ntn010.

    Article  Google Scholar 

  • Knez J, Winckelmans E, Plusquin M, Thijs L, Cauwenberghs N, Gu Y, et al. Correlates of peripheral blood mitochondrial DNA content in a general population. Am J Epidemiol. 2016;183(2):138–46. https://doi.org/10.1093/aje/kwv175.

    Article  PubMed  Google Scholar 

  • Taking a Holistic Approach Might Be Key to Managing High Cholesterol – Everyday Health

    Nyarumba Nota loves good food.

    When he and his wife, Christine, met in Anguilla, an island in the Eastern Caribbean, in 2008, they often went out to eat, filling their plates with delicious barbecued meats, fritters and patties, and fried fish. When the couple moved to New York, in 2010, where Christine grew up, home-cooked meals consisted of restaurant-style burgers, steaks, and pizza.

    The couple ate the same foods on a daily basis. They both also smoked cigarettes — at his peak, Nota smoked a pack a day — and got the same limited amounts of exercise. But when they went for their first physicals in years, shortly after they moved to Westchester, New York, their cholesterol levels were starkly different.

    Nota’s routine total cholesterol screening was 872 mg/dL, well above the high range of 240 mg/dL or more for men older than 20, according to the guidelines from the American College of Cardiology.

    “The doctors didn’t understand why I was still alive with such a reading — it would make sense that my arteries would be completely clogged,” says Nota, who was 42 at the time of that first cholesterol screening.

    Even though Black Americans are slightly less likely to have high cholesterol than white Americans, according to the Centers for Disease Control and Prevention, and Black men and Hispanic women have the lowest rates of high cholesterol in the country, at about 9.2 percent, they still have a high risk of heart disease.

    Nota also had an extensive family history of heart disease and high cholesterol — also known as familial hypercholesterolemia. Both of his parents died of heart disease, and one of his sisters had been taking statins to manage her high cholesterol for years before Nota was diagnosed with the same condition.

    According to Anjori Dunbar, MD, director of the preventive cardiology program at Lenox Hill Hospital in New York, high cholesterol is complex.

    “We think that for everyone, part of the cholesterol story has to do with family history and the other part has to do with lifestyle factors,” Dr. Dunbar says, noting that while there are some genetic factors healthcare providers can test for, doctors don’t yet know all of the genes that will put someone at a higher risk of high cholesterol, meaning they can’t yet test for all of them.

    “Just because someone doesn’t test for one of these genetic factors doesn’t mean that they don’t have a genetic component to their high cholesterol,” Dunbar adds. Nota, who is now 56, likely falls into that category.

    Nota’s primary care physician referred him to a local cardiologist who started him on statin medications. The doctor briefly mentioned the lifestyle changes he should also make — a diet with less saturated fat, salt, and red meat; quitting smoking; exercising more — but did not advise him on how he could integrate such changes into his life. Instead, the emphasis was on medication.

    The statins made Nota’s muscles ache, especially in his chest. That pain would radiate down his arms and make it difficult for him to do much of anything. When he brought this up at follow-up appointments, the doctor would prescribe him another brand of statin — but they all caused the same muscle pain and weakness. According to the Mayo Clinic, that is one of the most common side effects of taking statins.

    “Because I wasn’t tolerating statins, I wasn’t exactly compliant with taking the medication. I would take it on and off; this went on for about five years,” Nota says.

    Finally, after years of trying different statins, Nota’s local cardiologist referred him to a clinical cardiologist at Lenox Hill Hospital in New York, a 50-minute drive from his home in Westchester. That referral changed his life.

    Tackling High Cholesterol Takes Teamwork

    Eugenia Gianos, MD, identified Nota’s risk factors and broke them down in sequence in terms of how they’d tackle them together. First, they would treat his high blood pressure and high blood sugar, both which raise a person’s risk of heart disease, while also addressing his diet, smoking, and lack of physical activity, which all contribute to high cholesterol.

    When Dr. Gianos first met Nota, she remembers that almost none of his risk factors were managed.

    “He had major obstacles to overcome,” she says, noting that the key to his success was his willingness to work as a team, both with his healthcare providers and his wife.

    Gianos says Nota’s story is a great example of how she strives to partner with patients to reduce certain risk factors for heart disease, one step at a time.

    According to Dunbar, a colleague of Gianos, it’s critical to look at a patient’s risk factors in totality. If a person’s cholesterol is high because of what they eat, but they’re only treating it with medication, they aren’t addressing a key culprit — their diet, she says. “Alternatively, if a genetic component is at play and the focus is just on lifestyle changes, we’re missing the use of medication.”

    What Nota remembers most about his first meeting with Gianos is the way she went into detail describing how inflammation in his body was causing his high cholesterol — and how they would reduce it holistically. They’d lower his LDL (“bad”) cholesterol and raise his HDL (“good”) cholesterol, all with the goal of reducing his risk of heart disease.

    “The doctor-patient relationship is extremely important because if we as doctors cannot connect with patients, we can’t make a meaningful impact on their lives,” says Dunbar.

    First, they had to get Nota’s high blood pressure and high blood sugar under control, while also giving his kitchen a complete overhaul. That meant replacing vegetable oils with olive oil; ditching steaks for fresh fish, lean chicken, and veggie burgers; and switching from dairy milk to almond milk.

    “Burger and steak night were swapped for tuna steaks and swordfish,” Nota says, noting that these items would never have been in his previous diet.

    The next step was quitting smoking, which Nota and his wife did together. One morning, he suddenly decided it was time.

    “I remember crumbling half a pack of cigarettes that I had and throwing them out, and that was it,” he says.

    Nota and his wife also took up hiking in upstate New York. When they moved in with her mother to help take care of her at the end of her life, Nota and his wife got a treadmill, so that they could keep up with their daily exercise routine.

    “It literally takes a proverbial village to take on this condition,” says Nota, saying that his wife played a pivotal role in keeping him on track.

    The final step was finding a medication that worked for him. With his family history, lifestyle changes alone wouldn’t be enough to keep his cholesterol levels down.

    Gianos tried two more medications before finding one that did not give Nota muscle pain. The medication, a monoclonal antibody called evolocumab (Repatha), is a biweekly injection that helps lower LDL cholesterol in people whose cholesterol cannot be managed with lifestyle changes alone — mostly those with a family history of the condition.

    Nota, who is a lawyer by profession, also took a part-time job unloading groceries at a local store, which allows him to put in 6,000 to 8,000 steps during a single shift. “Why pay the gym to get fit when you can get paid to work and get fit?” he says.

    Five years after his first appointment with Gianos, Nota has never been healthier. His blood pressure, blood sugar, and LDL cholesterol are all now within healthy ranges. He’s still working to bring up his HDL cholesterol level, but he knows that he will be able to do it with the same commitment and support he’s had in the past few years.

    “I found a doctor who has such a deep knowledge of the subject. She is so meticulous, thorough, and empathetic,” says Nota. “I’m someone who doesn’t like taking medication in general, but she found a way of connecting with me that I thought was very special,” he says. “I credit her with saving my life.”

    Bodybuilding Competition: The Posing Rounds – Muscle & Fitness

    Way back in the day, some bodybuilding contests were conducted by having all the competitors and the judges in the same room within a few feet of each other, which gave the judges a chance to look over all the bodybuilders, move them around, make comparisons and eventually decide what order they should place. (The first Ms. Olympia in 1980 was done like this.) There are certain advantages to this method. But it doesn’t allow for an audience to participate. It doesn’t create a “show” to which you can sell tickets.

    Olympia Pre Judge 1980-Dobbins
    In 1980, the first Ms. Olympia prejudging was done up close where the judges could move athletes around in comparisons and decide what order competitors should place. Bill Dobbins

    So, in time we had the evolution of today’s “round” system. It involves having competitors present themselves in different ways for the scrutiny of the officials. These are

    1. The “Symmetry” Round.
    2. The Compulsory Round.
    3. The Free Posing Round.
    4. The Posedown.

    These rounds are one thing on paper, according to the rules, but are often quite different in actuality.

    THE SYMMETRY ROUND

    For example, the symmetry or “standing relaxed” round is supposed to involve competitors standing as if “at attention” and facing in four directions to give the judge a look at the overall shape and proportions of their physiques. It is not supposed to be about flexing and showing your muscularity. But starting in the 1990s, bodybuilders began twisting severely from the waist, flexing their triceps in the side poses and flaring out their lats in the back view. For some, the effort was so great they had trouble simply getting through the round. I remember watching IFBB Pro Paul Dillett compete in the Olympia and his efforts appeared so intense and exhausting, that I did not think he was going to make it.

    So, obviously, the symmetry round has become just another muscle-posing round, and it is not about symmetry. This has been tolerated for so long now that it seems unlikely the federations are going to step in to change things back to what the rules originally required. So, bodybuilders

    with obviously great symmetry are disadvantaged when this round is done this way, and those with less symmetry can disguise their weaknesses.

    Symmetry Round-Dobbins
    Rather than standing “at attention,” bodybuilders nowadays twist and flex, making it difficult to judge them based on “symmetry.” Bill Dobbins

    THE COMPULSORY ROUND

    There is little controversy regarding the compulsory posing round. This involves a series of poses designed to show a competitor’s strengths and weaknesses to the judges in as straightforward a way as possible. So, bodybuilders do a biceps pose from the front and back, a side chest and triceps pose, lat spreads from the front and back and an abdominal and thighs pose. The competitors each do these poses on their own and then in comparison to others. And this is very important. As you get to higher and higher levels in bodybuilding, virtually all the competitors are amazing genetic geniuses and, compared to any other human beings, truly amazing. When they first come out on stage and are seen as individuals, they mostly all look like winners. But human perception is largely based on comparison and contrast.

    If I were to give you a 25-gram weight to hold and asked you to estimate its weight, it would be tough to come close. But if you hold a 24-gram weight in one hand and a 25-gram weight in the other, you can immediately tell the difference. That is the power of comparison. Along the same lines, you take a bodybuilder you thought was terrific and stand him or her next to another in the lineup, and small differences immediately become apparent.

    ABS and Thighs-Dobbins
    The abdominal and thighs pose is one of the standard compulsories. Bill Dobbins

    Plus, there is the fact that our perception of something takes place in “layers.” The brain does a quick scan of what we are looking at, then uses succeeding scans to acquire more information and register more details. This is an unconscious process that takes place automatically. Except that it would be more difficult to create a show to which you can sell tickets, it would probably be best not to score by round but simply let the judges continue to look at bodybuilders posing over an hour or two to give their brains time to accumulate the maximum amount of information. In most cases, who is best or better would become painfully obvious with no conscious effort required.

    Lat Spread-Dobbins
    The Lat Spread pose is one of the basic compulsories. Bill Dobbins

    THE INDIVIDUAL POSING ROUND

    In any event, the compulsory round involves the judges saying, “show me your physique in a way that gives me all the information I am looking for, with no way of disguising your weaknesses.” Then comes the round of individual posing, in which the competitors put together a routine as a way of showing off their physiques in a way that calls attention to their strengths and away from their weaknesses. Ideally, this round is a way for competitors to change the minds of judges, “my physique is actually better than you first thought.”

    Some competitors concentrate on movement in their routines, even to the point of dancing, or showing themselves as “robots” or doing the “moonwalk.” But the question should always be, “Is this routine going to make the judges score the athlete higher than they would have otherwise?” Some contests have “best poser” awards, but the winner of this is rarely the winner of the contest.

    Most Muscular-Dobbins
    THE MOST MUSCULAR POSE – Variations of the “most muscular” pose are not part of the compulsories but judges can request this pose during the comparisons. However, this is something that happens in bodybuilding for men, but not for women. Bill Dobbins

    Many simply rely on free posing routines that are basically just more versions of the compulsory poses, which the judges have already seen. Bodybuilders with truly outstanding physiques frequently need to do nothing more than just keep hitting the same basic poses to remind judges how good they are.

    THE POSEDOWN

    The posedown round, in which the bodybuilders all just mill around on stage, hitting whatever poses they can and creating comparisons with their rivals, is very exciting. It would be great if this had some actual impact on the scoring, but this rarely seems the fact. Usually, the pose down takes place while the judging scores are being tabulated.

    The posedown allows competitors to seek out a rival and try to show the judges who is superior. But this can have the opposite effect. I once saw a bodybuilder race across the stage to pose his legs up against those of Tom Platz, who had the most incredible legs in the sport. I would have called this action a moment of insanity.

    Posedown-Dobbins
    The posedown is frequently very exciting but rarely figures into the scoring. Bill Dobbins

    Maybe there could be a posedown round during prejudging as well as the evening finals. This could actually have some impact on the scores. But as it is, the posedown is mostly just for show.

    The one absolute necessity to make these posing rounds work is accurate and unbiased judging. In the past, this has often been problematic, with officials allowing political, economic, or even sexual biases to cloud their judgment. Thankfully, this has not been any kind of major consideration in the recent past. Judging bodybuilding is always going to involve a balance of the objective and the subjective. Two judges may see the same kind of development of a physique, but one prefers it while the other doesn’t or, at least, not as much. There are so many elements to a competition physique, including such things as mass, muscularity, symmetry, and definition – and another that Is aesthetic beauty – that it is inevitable that two judges will develop different opinions when it comes to scoring. But not “too different,” or the federations will not consider that judge really qualified.

    For judging to work, there must be at least a consensus as to what the contest is about and what everybody is there for. So, differences in judgment and perception must be within certain limits to be accepted as quality judging.

    Showoff-Dobbins
    Lee Labrada’s signature pose allowed him to best show off the best qualities of his physique. Bill Dobbins

    Addressing the anxiety crisis | News – UC Riverside

    More than 40 million adults in the United States have an anxiety disorder. Not surprisingly, the COVID-19 pandemic exacerbated the mental health crisis the country faces. Indeed, just last week, a panel of medical experts recommended for the first time that doctors screen all adult patients under 65 for anxiety; a similar recommendation for children and teenagers was issued earlier this year. 

    Below, experts in the Department of Psychiatry and Neuroscience at the School of Medicine at the University of California, Riverside, answer questions about mental health issues since the pandemic as they pertain to adults, children, and students.

    Dr. Christopher G. Fichtner, clinical professor and interim chair 
    Q: How has anxiety changed among adults since the pandemic? What are you seeing more of? Less of?
    Christopher Fichtner
    Christopher Fichtner.

    With the pandemic there have been some patients who were having anxiety at work and were relieved to switch to remote work, which was actually helpful for them. On the other hand, there have been individuals who were not necessarily struggling with work-related anxiety but who, nonetheless, were happy to have the opportunity to work from home. Some of these individuals have found themselves becoming more socially avoidant, not eager to return to work in person because the thought now makes them anxious; but others feel isolated, miss the interpersonal contact and are anxious or eager to reconnect. That may vary based on the individual’s home circumstance — for example, whether they live alone or with others. We do see some patients who, having been spending much more time at home, have developed new symptoms of social anxiety or even panic attacks when they return to work on-site and are commuting. 

    In general, patients who were anxious before the pandemic have been more anxious during the pandemic for a number of reasons, including the threat of illness, the stress of its impact on friends and family, and changes in routines at home involving children, school and daycare. Dr. Kimberley Lakes in our department here at UCR recently published an article in JAMA Pediatrics in which she and her colleagues analyzed data on children’s activity levels, showing the kids had become significantly less active — and, in fact, less active than they need to be for optimum health and well-being. 

    While many have appreciated the opportunity to work from home, we have also been reminded that it is important to stay connected, and that missing the opportunity to connect can also be a source of anxiety.

    Dr. Takesha J. Cooper, associate professor of psychiatry
    Q: What are some new anxieties you have seen in children and teenagers since the start of the pandemic?
    Takesha Cooper
    Takesha Cooper.

    I have seen an increase in social anxiety disorder, generalized anxiety disorder, and panic disorder. With school closures, children had fewer opportunities to socialize and interact with their peers. Many children turned to social media, but we know this is not a substitute for healthy in-person peer-to-peer interaction. Once schools re-opened, many children struggled with navigating and reestablishing relationships with their peers, and symptoms that accompanied this were irritability, excessive worries that are difficult to control, poor sleep, and panic attacks — all of which are symptoms of anxiety disorders. We also noticed increase in depression as many children worried about family finances and loved ones becoming sick or even dying.

    Q: How can children and teenagers (and their parents) best manage these new anxieties?

    Parents can spend time talking with their children about their child’s worries to better understand what their child is going through. Parents can model calmness and encourage coping skills, such as abdominal breathing, going for a calming walk, and ensuring the child is getting adequate sleep. Providing structure to the child’s day can also help provide predictability which can be helpful for children and teens. If excessive worries do not improve, parents should seek expert help in the form of a therapist or child and adolescent psychiatrist who can incorporate psychoeducation and cognitive behavioral therapy, or CBT. CBT is an evidence-based therapy that helps a child understand the connection between their thoughts, feelings, and behaviors. This helps children challenge their worry thoughts, which helps them develop more balanced thinking, thereby reducing anxiety. For severe anxiety, children often benefit from a combination of therapy and medication.

    Dr. Toshia Ann Yamaguchi, director of student health and wellness at UCR Health and health sciences assistant clinical professor
    Q: How has the pandemic affected student mental health?
    Toshia Yamaguchi
    Toshia Yamaguchi.

    The pandemic disrupted college students’ college experience, their home life, their families, their support networks, their finances, and their plans for the future. Specifically, American college students have attributed to the pandemic disruption to sleep and eating patterns, increased social isolation, and concerns about academic performance. In a spring 2020 survey, 20% of college students reported their mental health had worsened significantly, 48% reported financial concerns, 80% reported difficulty concentrating. In a follow-up fall 2020 survey, 89% of college students reported that they were experiencing stress or anxiety, 25% reported increased depression during the pandemic.

    Q: What sorts of mental health issues have come up that you didn’t see as much before?

    Mostly I’m seeing standard cases at my clinic for undergraduate, graduate, and professional students, but one thing that is new is patients reporting new problems with either concentration or fatigue, despite lack of any other physical or psychiatric symptom. These may reflect neuropsychiatric symptoms of long Covid. More research is needed. Among my child patients, I’m seeing more patients presenting with concerns and symptoms, even substance addictions, informed by TikTok. Unfortunately, it is largely misinformation.

    Q: What general advice do you have for students to best manage anxieties resulting from the pandemic?

    First, I want to impart that as the data above depicts, struggling in college is commonplace. It is a new environment to navigate, full of its own unique experiences, stressors, resources, and limitations. To further complicate things, the internal world of the young adult is underpinned by ongoing neuropsychological changes. Therefore, naturally, exploration and adaptation are often required for success in this new developmental chapter. There are a number of things students can try to help support their mental health. The key is to have both an open mind and persistence when trying to find a strategy that works for you; many strategies require a dedicated trial period before one starts to notice results. 

    Q: What are some recommendations you can share?

    Here are some tried and true recommendations:

    • While following safety guidelines, I recommend students spend time with family and friends. This targets the isolation that commonly triggers psychological distress.
    • Students commonly report to me that implementing an exercise routine helps them to feel better.
    • Forest bathing is a Japanese practice of restoring wellness through the sensory experience of being in nature. Try hiking, going to the beach, or even taking a walk outside your home.
    • Prioritize your sleep. A regular sleep routine has mental and physical health benefits. Try bedtime yoga on YouTube and sleep podcasts. Try blue-light-blocking glasses.
    • Meditation and mindfulness apps and YouTube channels are ubiquitous. Try Calm or Headspace. The U.S. Dept. of Veterans Affairs YouTube channel has a #LiveWholeHealth playlist teaching and practicing various mindful techniques.
    • Workbooks are helpful resources to approach therapy in the comfort of your home and at your own pace. I recommend “The Mindful Self-Compassion Workbook” by Kristen Neff and Christopher Germer. Self-compassion therapy is a more contemporary therapy modality that offers evidence-based practices. “Mind Over Mood” by Dennis Greenberger and Christine A. Padesky and “Feeling Good” by David D. Burns are CBT classics that therapists swear by. They truly stand the test of time.
    • Decreasing your use or even achieving sobriety from alcohol, cannabis, nicotine, and/or caffeine can produce notable differences in one’s mental health. As I always like to say, the desired neuropsychological effects we are chasing when using these substances are produced by the presence and activity of these substances in our brain. The substances are, therefore, present and available to act on the brain in a way that produces the negative neuropsychological effects associated with these substances.
    • Visit your primary care physician regularly for annual exams and to address any medical concerns. The health of the body and mind are strongly related. Sometimes mental health issues stem from underlying medical conditions.
    • Look into mental health support resources. 
    • Reach out to professors, teaching assistants, and other campus resources if you’re struggling in class. Academic difficulty is both a trigger for and a symptom of psychological distress among college students. 

    Gestational diabetes: A healthy lifestyle reduces type 2 diabetes risk – Medical News Today

    Two females performing jumping exercises up a flight of outdoors stairsShare on Pinterest
    A recent study suggests that people who’ve had gestational diabetes may be able to reduce their risk for type 2 diabetes with healthy lifestyle practices. Jovo Jovanovic/Stocksy
    • Gestational diabetes is diabetes that develops during pregnancy.
    • People who’ve been diagnosed with gestational diabetes have a greater risk of developing type 2 diabetes later in life.
    • A recent study shows that for women who have had gestational diabetes, adopting certain lifestyle practices is associated with a 90% reduced risk of developing type 2 diabetes.
    • The results held true even among women who were obese or had a higher genetic risk for developing type 2 diabetes.

    Pregnancy can bring with it a number of unique challenges and health concerns.

    Pregnant people and their fetuses require various forms of monitoring throughout pregnancy to ensure healthy pregnancies and deliveries. One condition women are monitored for is gestational diabetes, a type of diabetes that develops during pregnancy. People who have gestational diabetes are more likely to develop type 2 diabetes later in life.

    A​ recent study published in BMJ looked at modifiable risk factors for type 2 diabetes among women with a history of gestational diabetes.

    The researchers found that the risk for developing type 2 diabetes decreased in women who adopted certain healthy lifestyle practices.

    This risk assessment held true even among women who were obese or had a higher genetic risk for developing type 2 diabetes.

    Gestational diabetes is diabetes that develops explicitly during pregnancy. Gestational diabetes can be caused by existing insulin resistance and increased insulin resistance linked to hormonal changes and fat gain during pregnancy.

    A​bout 6-9% of women develop gestational diabetes during pregnancy. Doctors in the U.S. may recommend testing for gestational diabetes about 6 months into the pregnancy because this is when gestational diabetes is most likely to develop.

    After the pregnancy is over, blood sugar levels typically return to a healthy range. However, for those who have had gestational diabetes, there is a greater risk of developing type 2 diabetes later in life.

    Dr. Wiyatta Freeman, an obstetrics and gynecology specialist at UT Physicians Women’s Center and Memorial Hermann Southeast Hospital in Houston, Texas, not involved in the study, told MNT that a history of gestational diabetes “is predictive of an increased risk of developing type 2 diabetes, metabolic syndrome, cardiovascular disease (CVD), and even type 1 diabetes.”

    Therefore, individuals who’ve had gestational diabetes should schedule regular follow-ups with their physician to screen for the development of type 2 diabetes and other chronic conditions.

    Dr. Kay Lovig, an endocrinologist with White Plains Hospital Physicians Associates in New York, not involved in the study, explained to Medical News Today:

    “Gestational diabetes is diabetes that occurs during pregnancy. During pregnancy, hormones that are made by the placenta result in insulin resistance in everyone. Insulin resistance means that your body does not respond as efficiently to the insulin you are producing in order to have a normal blood sugar…People who develop gestational diabetes have an increase in insulin resistance as compared to someone who does not develop gestational diabetes. Therefore, those who experience gestational diabetes are at a higher lifetime risk of developing type 2 diabetes, which is also a result of insulin resistance.”

    Researchers are still looking into how to best reduce the risk for type 2 diabetes among those who have had gestational diabetes.

    T​his particular study looked at five modifiable risk factors among women who had a history of gestational diabetes:

    1. not being overweight or obese
    2. eating a high quality diet
    3. exercising regularly
    4. drinking moderate amounts of alcohol
    5. not smoking

    The study included over 4,000 participants from the Nurses’ Health Study II. Researchers followed up with participants for an average of almost 28 years. During this follow-up timeframe, 924 participants developed type 2 diabetes.

    T​hey found that participants with optimal levels in all five categories had over 90% less risk of developing type 2 diabetes.

    They found that “each additional optimal modifiable factor was associated with an incrementally lower risk of type 2 diabetes.”

    The risk association held true, even among women who were overweight or obese or had a greater genetic risk for developing type 2 diabetes.

    Sherry Roberts, registered dietitian nutritionist and certified diabetes care and education specialist, who was not involved in the research, shared her thoughts on the study to MNT:

    “I feel that the study was well done and thorough as it followed nurses that had gestational diabetes for nearly 28 years. It looked at the modifiable risk factors of not being overweight or obese, high-quality diet, regular exercise, moderate alcohol consumption, and no smoking. The overall results indicate that the women that were able to maintain optimal levels of the modifications have a lower risk for developing diabetes. The clinical implications for this study provide additional support for the importance of maintaining healthy habits in order to prevent type 2 diabetes. It also demonstrates how important it is to offer prevention programs and support to those trying to prevent type 2 diabetes.”

    The study did have some limitations. For example, it was an observational study, so the results cannot determine the cause. Researchers relied on participant self-reporting, increasing a certain risk for error.

    The authors excluded non-white participants who were likely to have been mostly of European ancestry, which can limit how applicable the data is to other ethnic groups. It also indicates the need for more diverse cohorts for longitudinal studies in the future.

    The study also specifically looked at physical activity based on leisure time activities. The researchers note that further data could look at how other physical activities, such as work-related activity, could be investigated more in the future.

    They also did not have data on the severity of participants’ gestational diabetes or their baseline for blood sugar control.

    Finally, based on the data collection methods and the participants, the full benefit of these healthy lifestyle choices may be underestimated. Overall, the results demonstrate the importance of maintaining a healthy lifestyle, particularly among those with a higher risk of developing type 2 diabetes.

    Roberts noted the following areas for continued research:

    “Additional research should be done for women with gestational diabetes that do not have a healthcare background and are part of the general population. Similar research should also be done on the children that were born to mothers with gestational diabetes.”

    Viral TikTok Bodybuilding Cinderella Story Has The Internet Jacked Up – OutKick

    Montreal college student Zach Charlesworth is officially a TikTok viral star thanks to his weekend stunt at a bodybuilding competition.

    There was Zach on stage amongst giants of Canadian bodybuilding at the Montreal Summum Classic posing next to raw-egg consuming beasts who eat weights and slam GNC smoothies for a living. And then there’s Zach, who doesn’t skip calf day.

    “My friend told me we were going swimming,” Zach wrote on TikTok to set up the goof.

    And then we see a viral video that has already racked up an astounding 23.7 million views on the social media platform where stunts like this are rewarded with followers and the promises of riches from brands that want to connect with content geniuses.

    Let’s get to the open Class B action from Montreal:

    @zachairious

    ♬ Cbat – Hudson Mohawke

    How about the balls on young Zach?

    Yes, he finished last because the judges didn’t have the balls to slide him into the 8th spot and turn this viral bit into a massive controversy within the bodybuilding world like it deserves to be. Instead, they stood by their bodybuilding integrity and scored Zach in last place.

    To put this competition into perspective, Zach was up against the likes of professional bodybuilder Eric Rice, a trained tricep assassin who specializes in Instagram pose-downs.

    Speaking of pose-downs and pose-offs, Zach was pitted against pro Rinaldo Denis as judges got a good look at what each was working with in the lat department.

    Zach poses against Rinaldo Denis / TikTok

    Now it’s back to the drawing board for Zach as he tries to find a path up the Canadian bodybuilding leaderboard. At least he has the tan part down.

    Zach Charlesworth bodybuilding Montreal TikTok viral video
    The judges at the 2022 Montreal Summum Bodybuilding Classic were very tough on college student Zach Charlesworth, who clearly won the calf competition. / Canadian Physique Alliance

    Your 2022 Montreal Summum Classic Open Class B winner Eric Rice!

    What to Know About Anxiety, Signs to Be Aware of and How to Cope – CNET

    Anxiety is the most common mental illness in the US — an estimated 40 million adults report having anxiety every year. Anxiety is something each of us experience differently. It’s a normal, human emotion. But for some people, anxiety can become a serious problem and difficult to manage. Understanding what anxiety is and how it affects us is important in coming up with an effective way to cope when it starts taking over your life. Here’s what you need to know about anxiety disorders.

    What is anxiety?

    Anxiety is defined as fear or worry about the future and its symptoms can range from mild to severe. Experiencing some level of anxiety is a normal part of life. However, when anxiety becomes so heightened that it keeps us from normal daily activities or interrupts our ability to enjoy our lives, it can become an anxiety disorder. Even if your anxiety isn’t at the level of being diagnosed, there are many ways to alter your daily habits to decrease stress in your life. 

    What are the causes and risk factors for anxiety? 

    It’s not easy to pinpoint what causes anxiety since it can arise from a combination of sources. Here are some of the risk factors that may make anxiety and associated disorders more likely:

    • Environmental factors: If you live in a chaotic or highly demanding environment, stressors can enhance anxiety.
    • Medical factors: Studies have linked certain medical conditions with anxiety due to increased hormones — like cortisol. 
    • Daily stressor: If you are constantly in a stressful environment, anxiety can be a natural response. 
    • Genetics: It is possible that genetic factors can pass along a propensity to anxiety.
    • Drug or alcohol use: Certain drugs and excessive alcohol use can prompt more anxiety than is typical in those who do not use those substances.
    • Personalities: Some level of forward-thinking, fearfulness, and mental tension can be part of one’s personality and the way you approach the world, which is formed by a complex variety of factors.

    What are the signs of anxiety?

    Common symptoms of anxiety as listed in the Diagnostic and Statistical Manual Edition 5 include: 

    • Feeling restless, “keyed up,” or otherwise “on edge”
    • Constant feeling of fatigue
    • Irritability
    • Difficulty concentrating or your mind going blank
    • Trouble falling or staying asleep
    • Muscle tension

    Generally, a diagnosis is more likely if three or more of these are present for more than half the days for six months or more. You can still experience anxiety for less time, with fewer symptoms, or less frequently, but the persistence and variety of symptoms is what indicates a diagnosis. 

    Young woman in front of computer feeling stressed
    Carol Yepes/Getty Images

    What are the different types of anxiety? 

    Anxiety experiences are categorized by the way they manifest, including symptoms in the moment and the triggers that produce the anxiety. While generalized anxiety disorder is one of the most commonly diagnosed disorders, it is possible to experience a combination of various types of anxiety

    Generalized anxiety disorder

    The DSM-5 characterizes generalized anxiety disorder as “Excessive anxiety and worry (apprehensive expectation), occurring more days than not for at least six months, about a number of events or activities (such as work or school performance).” It is the most broad diagnosis, and usually is indicated when a person is not worried about a single event more than others. Instead, those who experience GAD have dread, worry or tension associated with many aspects of life. 

    Panic disorder

    While GAD may involve lower-intensity symptoms frequently, panic disorder is associated with sudden-onset, high-intensity symptoms which together mark a “panic attack” or anxiety attack. They can include intense fear, increased heart rate, chest pain, nausea, dizziness, a feeling of being crazy or of not being real. Having an isolated panic attack isn’t usually considered a panic disorder. 

    Separation anxiety disorder

    While some separation anxiety is expected at certain ages and stages of life, a separation anxiety disorder may be present if a person feels excessive fear at being outside their home or away from their close relationships, such as parents or other family members. People with separation anxiety often worry that something bad may happen when separated from those they are attached to.

    Social anxiety disorder

    Social anxiety disorder involves excessive or limiting amounts of stress and fear in social situations. People with social anxiety often worry excessively about being watche or judged by others. For some, social anxiety can interfere with daily tasks, going to work or school and socializing with others.

    Phobia disorders

    Phobias are intense fears that go beyond a general distaste or worry about something. Phobias become disorders when they involve triggers that cannot be avoided while participating in everyday life. The trigger must arouse such intense fear that the person either cannot function normally in its presence or must avoid it at all costs, even if it creates great hardship and inconvenience. Common types of phobias include:

    • Animals — like spiders, frogs, snakes and dogs
    • Heights
    • Flying
    • Blood
    • Getting injections
    Woman looking at a spider in fear
    Ezra Bailey/Getty Images

    Agoraphobia

    Agoraphobia is just one of a variety of phobias or fears that have escalated to the point where it affects your life in a negative way. While some phobia-level fears can simply be avoided in most circumstances, such as a person with a severe fear of snakes, agoraphobia is associated with tight or crowded spaces, being in public or being outside your home on your own. Because regular life requires that we frequently encounter these circumstances, agoraphobia can interrupt life and make it hard to get the work, socialization, and errands done that are necessary. 

    How is anxiety treated?

    Treatment for anxiety tends to vary based on severity as well as what’s helped a person in the past. Your mental health professional may recommend psychotherapy, medication or a combination of both, and it may take a couple different trials to find what works best for you. 

    Psychotherapy 

    There are many types of psychotherapy that can bring relief to individuals with anxiety, but because each therapist takes their own approach to a given form of therapy, the results may vary. For instance, a common therapeutic approach, Cognitive-Behavioral Therapy, has been studied and found to have a 51% “remission rate” for anxiety patients, though this number may not show the full amount of patients who received some benefit from the experience. Therapy can be conducted in-person or using one of a variety of online services that are now available.

    The key to exploring psychotherapy for anxiety is to try a different therapist or therapeutic approach if your current one isn’t helping you to alleviate your anxiety. 

    Medication

    The most common class of anxiety medications used to treat anxiety disorders are known as SSRIs, or selective serotonin reuptake inhibitors, which are also used to treat depression and anxiety. Common names of medicines include Prozac, Zoloft, and Lexapro. Other medications, such as beta blockers, tranquilizers, and even certain antihistamines such as Hydroxyzine may be prescribed. Other remedies, like CBD, aren’t medical solutions but have anecdotally helped people manage their anxiety.

    Talk to your psychiatrist about the rationale for prescribing a certain anxiety medication, and also stay in contact about any side effects you experience. 

    Close up of white and colores pills in the palm of a hand.
    Aleksandr Zubkov/Getty Images

    How to deal with anxiety

    Because many people experience anxiety as part of daily life, a good way to start your path to lower anxiety is to try some lifestyle changes that are considered helpful. Learning how to calm anxiety can be the start of learning how to get rid of anxiety in your own life and circumstances. Diagnosis and treatment are still options, but many people experience better results when they combine lifestyle changes with any of the above treatments. 

    • Use relaxation techniques: Deep breathing techniques, meditation and mindfulness exercises are all designed to help people focus on the present moment and let go of forward-thinking worry, fear or strain. Incorporating relaxation one or more times a day can help you calm anxiety. If you need guidance, there are a variety of mental health apps that can help you establish a daily practice.
    • Try and manage stress: In many cases, stressful circumstances prompt anxiety, including chaotic home situations, unreasonable workplace expectations and relationship strain. While some stressful circumstances cannot change quickly, a valuable goal is to put a plan in place for reducing the stressors themselves, where possible. 
    • Cut your caffeine intake: Many people observe that reducing their caffeine intake by replacing some caffeinated beverages with uncaffeinated ones prompts less anxious thinking. If you choose this path, don’t immediately cut your caffeine dramatically, but rather slowly reduce your caffeine intake each day so that your body has time to adjust. 
    • Make sure you have support: Asking family and friends for help, such as for regular social time or for help caring for children or relatives, can strengthen your bond and help you feel less alone in busy or overwhelming circumstances. 
    • Eat right and exercise regularly: Increasing foods like vegetables, fruit, lean proteins and whole grains has been shown to offer a range of health benefits, including reduction of stress and anxiety. Exercising vigorously multiple times a week is also associated with helping bodies process anxiety, leaving the person with the ability to process stress in a healthy way afterward. 
    • Make sure you’re getting enough sleep: Interrupted or short sleep doesn’t allow our bodies to recover from the anxiety of previous days. If there are ways to add more sleep or longer lengths of sleep to your lifestyle, trying that could improve your anxiety. 

    When and how to get help for your anxiety 

    A basic level of anxiety comes from a healthy place, helping us to plan ahead and avoid dangers. However, when your anxiety doesn’t serve you but instead overwhelms your ability to calm yourself effectively, it’s worth talking to a mental health professional to learn more about how your particular anxiety symptoms compare with the diagnostic categories they have. Talking to someone helps us feel less alone in our journey toward greater mental health, whether it results in a diagnosis or simply helps us get new techniques for coping with our anxiety symptoms. 

    Mental health resources

    More help for managing anxiety

    The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.