Can Gluten-Free Foods Fuel Your Kids?

When it comes to food trends, “gluten-free” (GF) is at the top of the heap. Some people claim that the meal plan has helped them lose weight, have more energy, and just feel better. But is it better fuel for your kids?

Unless your child has a specific medical reason to avoid gluten, there’s little proof that a GF meal plan is better than the healthy, balanced foods that all kids need. Before you start planning GF meals, it’s important to understand the basics of this approach to eating.

What It Means to Go Gluten-Free
Gluten is a protein found in some grains. If your child goes on a GF diet, they’ll avoid all food and drinks that have:

Wheat
Rye
Barley
Triticale (a cross between wheat and barley)
Instead, they’ll focus on foods that are naturally gluten-free. These include fruits, vegetables, meat, poultry, fish, beans, legumes, and most dairy products.

Some grains and starches are OK on a gluten-free diet, like:
Buckwheat
Corn and cornmeal
Rice
Soy
Quinoa
Tapioca
Special GF flours are also made from many of these grains.

Is a Gluten-Free Diet a Healthy Choice for Kids?
The only people who need to stick to a gluten-free diet are those with celiac disease, a condition in which gluten can damage the small intestine. Kids who are allergic to gluten, like those who have a wheat allergy, should avoid it, too.

For everyone else, gluten is not unhealthy. Avoiding it won’t make your kids “feel better” or have more energy. In fact, trying to cut it out of your child’s diet may make it harder for him to get enough key nutrients, like iron, zinc, calcium, vitamin B, and folate. Plus, since so many grains are off-limits, a GF diet can mean he’ll have a tough time getting enough fiber.

It’s still the overall quality of the foods your child eats that makes the biggest difference in how he feels. Focus on helping him choose a variety of whole, healthy foods and cutting out processed ones. (Packages of gluten-free cookies or potato chips aren’t any healthier than the regular kinds.)

Artificial pancreas effectively controls type 1 diabetes in children age 6 and up

A clinical trial at four pediatric diabetes centers in the United States has found that a new artificial pancreas system — which automatically monitors and regulates blood glucose levels — is safe and effective at managing blood glucose levels in children as young as age six with type 1 diabetes. The trial was funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. Results from the trial were published August 26 in the New England Journal of Medicine.

“Fewer than 1 in 5 children with type 1 diabetes are able to successfully keep their blood glucose in a healthy range with current treatment, which may have serious consequences on their long-term health and quality of life,” said Guillermo Arreaza-Rubín, M.D., director of NIDDK’s Diabetes Technology Program and project scientist for the study. “Earlier research showed that the system tested in this study was safe and effective for people ages 14 and older. This trial now shows us this system works in a real-world setting with younger children.”

The artificial pancreas, also known as closed-loop control, is an “all-in-one” diabetes management system that tracks blood glucose levels using a continuous glucose monitor (CGM) and automatically delivers the insulin when needed using an insulin pump. The system replaces reliance on testing by fingerstick or CGM with delivery of insulin by multiple daily injections or a pump controlled by the patient or caregiver.

The study enrolled 101 children between ages 6 and 13 and assigned them to either the experimental group, which used the new artificial pancreas system or to the control group which used a standard CGM and separate insulin pump. Check-ins and data collection were conducted every other week for four months.

Study participants were instructed to continue about their daily lives so that the researchers could best understand how the system works in the typical routines of the children.

The study found that youth using the artificial pancreas system had 7% improvement in keeping blood glucose in range during the daytime, and a 26% improvement in nighttime control compared to the control group. Nighttime control is of particular importance for people with type 1 diabetes, as severe, unchecked hypoglycemia can lead to seizure, coma or even death. The overall time-in-range goal for the artificial pancreas reflected a nearly 11% improvement, which translated to 2.6 more hours per day in range.

“The improvement in blood glucose control in this study was impressive, especially during the overnight hours, letting parents and caregivers sleep better at night knowing their kids are safer,” said protocol chair R. Paul Wadwa, M.D., professor of pediatrics at the Barbara Davis Center for Childhood Diabetes at the University of Colorado, Aurora (CU). “Artificial pancreas technology can mean fewer times children and their families have to stop everything to take care of their diabetes. Instead, kids can focus on being kids.”

Sixteen adverse events, all classified as minor, occurred in the artificial pancreas group during the study, with most due to problems with the insulin pump equipment. Three events occurred in the control group. No cases of severe hypoglycemia or diabetic ketoacidosis occurred during the study.

“For decades, NIDDK has funded research and technology development to create a user-friendly automated device that could ease the constant burden of type 1 diabetes, from the finger sticks and insulin injections, to the insulin dose calculations and constant monitoring while improving diabetes control outcomes and preventing both short- and long-term complications of the disease,” said Arreaza-Rubín.

“The artificial pancreas is a culmination of these years of effort, and it’s exciting to see how this technology may benefit children with type 1 diabetes and their families, and hopefully benefit everyone with diabetes in the future.”

The artificial pancreas technology used in this study, the Control-IQ system, has an insulin pump that is programmed with advanced control algorithms based on a mathematical model using the person’s glucose monitoring information to automatically adjust the insulin dose. This technology was derived from a system originally developed at the University of Virginia (UVA), Charlottesville, with funding support from NIDDK.

This four-month study was part of a series of trials conducted in the International Diabetes Closed-Loop (iDCL) Study. In addition to CU and UVA, study sites included Stanford University School of Medicine, Palo Alto, California; and Yale University School of Medicine, New Haven, Connecticut. Jaeb Center for Health Research served as the data coordinating center.

Based on data from the iDCL trials, Tandem Diabetes Care has received clearance from the U.S. Food and Drug Administration for use of the Control-IQ system in children as young as age six years.

“As we continue to search for a cure for type 1 diabetes, making artificial pancreas technology that is safe and effective, such as the technology used in this study, available to children with type 1 diabetes is a major step in improving the quality of life and disease management in these youth,” said NIDDK Director Dr. Griffin P. Rodgers.

The iDCL Study is one of four major research efforts funded by NIDDK through the Special Statutory Funding Program for Type 1 Diabetes to test and refine advanced artificial pancreas systems. The studies, with additional results forthcoming, are looking at factors including safety, efficacy, user-friendliness, physical and emotional health of participants, and cost.

This study was funded by NIDDK and Tandem Diabetes, Inc. Tandem provided the experimental closed-loop systems used in the trial, system-related supplies including the Dexcom CGM and Roche glucometer, and technical expertise.

Drug Might Relieve Low Back Pain in Whole New Way

A new nonopioid pain reliever could be welcome news for people who have difficult-to-treat back pain.

Tanezumab is what’s called a monoclonal antibody. And it might offer extended relief from chronic lower back pain, a large, new study finds. However, a serious side effect remains a concern.

Tanezumab works differently from other treatments, as it blocks nerve growth factor, a protein that causes pain, researchers say.

“It appears that we are on the cusp of developing new drugs, which treat chronic pain by turning down the sensitivity of the nervous system, which is a whole new way of approaching the problem of chronic pain,” said lead researcher Dr. John Markman. He’s a professor of neurosurgery and neurology at the University of Rochester School of Medicine in New York.

“This is very important because we haven’t really had drugs with a new way of affecting chronic pain developed in maybe 100 years,” Markman said.

This phase 3 trial was funded by drugmakers Pfizer and Eli Lilly and Co. Twelve-hundred patients were randomly assigned to one of two doses of tanezumab or placebo. Another 600 patients received the opioid tramadol.

The higher dose of tanezumab reduced pain and also improved function, the researchers said.

Currently, opioid painkillers or nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are the only medications for chronic lower back pain. But opioids can be addictive, and NSAIDs can cause serious gastrointestinal bleeding.

If these drugs don’t work, the alternative is spinal fusion surgery, and that’s not always effective, Markman said.

Tanezumab is given by injection about every two months. It has none of the side effects of opioids or NSAIDs.

It does, however, have one very serious side effect that affects up to more than 2% of patients. The drug has been linked to joint deterioration that may require joint replacement.

This concern is the major focus of the U.S. Food and Drug Administration’s current review of the drug as a treatment for chronic pain from severe osteoarthritis, Markman said.

China coronavirus vaccine may be ready for public in November: official

Coronavirus vaccines being developed in China may be ready for use by the general public as early as November, an official with the Chinese Center for Disease Control and Prevention (CDC) said.

China has four COVID-19 vaccines in the final stage of clinical trials. At least three of those have already been offered to essential workers under an emergency use programme launched in July.

Phase 3 clinical trials were proceeding smoothly and the vaccines could be ready for the general public in November or December, CDC chief biosafety expert Guizhen Wu said in an interview with state TV late on Monday.

Wu, who said she has experienced no abnormal symptoms in recent months after taking an experimental vaccine herself in April, did not specify which vaccines she was referring to.

A unit of state pharmaceutical giant China National Pharmaceutical Group (Sinopharm) and U.S.-listed Sinovac Biotech SVA.O are developing the three vaccines under the state’s emergency use programme. A fourth COVID-19 vaccine being developed by CanSino Biologics 6185.HK was approved for use by the Chinese military in June.

Sinopharm said in July that its vaccine could be ready for public use by the end of this year after the conclusion of Phase 3 trials.

Global vaccine makers are racing to develop an effective vaccine against the virus which has killed more than 925,000 people. Leading Western vaccine makers pledged earlier this month to uphold scientific study standards and reject any political pressure to rush the process.

High-Protein Diet for Weight Loss

Going on a high-protein diet may help you tame your hunger, which could help you lose weight.

You can try it by adding some extra protein to your meals. Give yourself a week, boosting protein gradually.

Remember, calories still count. You’ll want to make good choices when you pick your protein.

If you plan to add a lot of protein to your diet, or if you have liver or kidney disease, check with your doctor first.

The Best Protein Sources
Choose protein sources that are nutrient-rich and lower in saturated fat and calories, such as:

Lean meats
Seafood
Beans
Soy
Low-fat dairy
Eggs
Nuts and seeds
It’s a good idea to change up your protein foods. For instance, you could have salmon or other fish that’s rich in omega-3s, beans or lentils that give you fiber as well as protein, walnuts on your salad, or almonds on your oatmeal.

How much protein are you getting? Here’s how many grams of protein are in these foods:

1/2 cup low-fat cottage cheese: 14g

3 ounces tofu, firm: 9g

1/2 cup cooked lentils: 9g

2 tablespoons natural-style peanut butter (7g) or almond butter (6.7g)

3 oz skinless chicken breast: 26g

3 oz fish fillet (depending on type of fish): 17-20g

1 ounce provolone cheese: 7g

1/2 cup cooked kidney beans: 7.7g

1 ounce almonds: 6g

1 large egg: 6g

4 ounces low-fat plain yogurt: 6g

4 ounces soy milk: 5g

4 ounces low-fat milk: 4g

Carbs and Fats
While you’re adding protein to your diet, you should also stock up on “smart carbs” such as:

Fruits
Vegetables
Whole grains
Beans and legumes (both also have protein)
Low-fat milk and yogurt (both have protein)
Also try healthy fats such as:

Nuts and natural-style nut butters
Seeds
Olives
Extra virgin olive oil and canola oil
Fish
Avocados
To help manage your appetite, it also helps to split your daily calories into four or five smaller meals or snacks.

Balance Training

How It Works
Though it might not cross your mind, you need good balance to do just about everything, including walking, getting out of a chair, and leaning over to tie your shoes. Strong muscles and being able to keep yourself steady make all the difference in those and many other things you do every day.

Balance training involves doing exercises that strengthen the muscles that help keep you upright, including your legs and core. These kinds of exercises can improve stability and help prevent falls.

Doing balance exercises can be intense, like some very challenging yoga poses. Others are as simple as standing on one leg for a few seconds. Or you can use equipment that forces your body to stabilize itself, like a Bosu half-circle stability ball or a balance board you use along with a video game.

Examples of balance exercises include:

Standing with your weight on one leg and raising the other leg to the side or behind you
Putting your heel right in front of your toe, like walking a tightrope
Standing up and sitting down from a chair without using your hands
Walking while alternating knee lifts with each step
Doing tai chi or yoga
Using equipment, like a Bosu, which has an inflatable dome on top of a circular platform, which challenges your balance
Over time, you can improve your balance with these exercises by:

Holding the position for a longer amount of time
Adding movement to a pose
Closing your eyes
Letting go of your chair or other support
You can do balance exercises as often as you’d like, even every day. Add in two days a week of strength training, which also helps improve your balance by working the muscles that keep you stable.

Intensity Level: Moderate
To balance train, you don’t have to run, jump, or do any other high-impact or high-intensity exercises. Usually balance training involves slow, methodical movements.

Areas It Targets
Core: Yes. You need strong core muscles for good balance. Many stability exercises will work your abs and other core muscles.

Arms: No. Most balance exercises are about balancing on your feet. So unless you’re doing moves that involve your arms, or you’re holding weights, they don’t work your arms.

Legs: Yes. Exercises in which you balance on one leg and then squat or bend forward also work the leg muscles.

Glutes: Yes. The same balance exercises that work the legs also tone the glutes.

Back: Yes. Your core muscles include some of your back muscles.

Type
Flexibility: No. Balance training is more about strengthening muscles and improving stability than gaining flexibility.

Aerobic: It can be, but often is not. It depends on how intense the activity is. If you’re moving fast, then it may be aerobic. Slower balance exercises do not make you breathe faster or make your heart pump harder.

Strength: Yes. Many of these exercises will work your muscles, especially the muscles of your legs and core. Some moves may also use your chest and shoulder muscles, like the plank position in yoga.

Sport: No. Balance training involves a series of exercises. It is not a sport.

Low-Impact: Yes. There is no impact involved in doing balance exercises.

What Else Should I Know?
Cost. No. You can do balance exercises on your own, with nothing more than a chair. There is a cost if you want to take a tai chi or yoga class, or buy a stability ball, video, or other piece of equipment.

Good for beginners? Yes. Balance training is good for people of any age and fitness level. It’s recommended for older adults to help prevent falls.

Outdoors. Yes. You can do balance exercises anywhere: in your backyard, on a beach, in a park.

At home. Yes. You can do these exercises at home.

Equipment required? No. You only need your own body to do balance exercises: for example, by standing on one leg. Or you can buy a piece of equipment like a Bosu ball to challenge your balance even more.

What Dr. Michael Smith Says:
The beauty of balance training is that anyone can, and should, do it. Balance training improves the health, balance, and performance of everyone from beginners to advanced athletes, young and not-so-young.

If you’re new to exercise, it’s a great place to start. Focusing on your core and balance improves overall strength and gets your body ready for more advanced exercise. Start off easy. You may find that you need to hold onto a chair aft first. That’s absolutely fine.

If you’re an advanced exerciser, you’ll likely find you still need to start with somewhat simple moves if balance isn’t your thing. Then push yourself to perform more complex moves that both challenge your muscular strength and your aerobic stamina. If you think balance exercises are easy, you haven’t tried yoga’s warrior III pose.

Is It Good for Me If I Have a Health Condition?

If you have back pain, balance training is one of the best ways to strengthen your core and prevent back pain. If you’re recovering from a back injury, get your doctor’s OK and then start balancing. It’ll help prevent more problems in the future.

When you strengthen muscles, it also helps arthritis by giving more support to painful joints. You may need to adjust or avoid certain moves to decrease pressure on your knees. For example, a balance move that involves a lunge may be more than your knees can handle. Good news is there are many exercises to choose from.

If you have diabetes, high blood pressure, high cholesterol, or even heart disease, exercise is a must to help you get control of your condition. Balance training is an excellent place to start. The first step of resistance training should focus on core and balance exercises, according to the American Council on Exercise. As you get stronger and become able to perform more intense exercises, balance training can give you an aerobic workout that even helps control blood sugar, cholesterol, and blood pressure along with other aerobic exercise.

If you’re pregnant, choose your balance exercises carefully. Women can and should exercise during pregnancy. The main concern with exercise during pregnancy is falling, so moves that make you unstable are not a good choice. Choose balance moves that either keep both feet on the floor or that you do on all fours, like plank (you may need to support your body with one knee on the ground). As with any exercise, if you did it before pregnancy, you’re likely OK doing it after pregnancy. It’s always good to check with your doctor to be sure.

8 At-Home Back Exercises for a Stronger Upper Body

Most people head into a workout focusing on the areas we consider the most noticeable—butt, stomach, legs, etc. But here’s a secret: Strong upper-body muscles (and back muscles, specifically) are not only key for an overall defined look, but they’re your best defense against pain, injury, and poor posture for years to come.

Try these eight back exercises at home or at the gym to sculpt a strong, sexy back, and shoulders all at once.

How it works: Three or four days a week, do 1 set of each of these exercises for back fat, with little or no rest in between moves. After the last exercise, rest 1 to 2 minutes and repeat the full circuit 2 more times (3 times total).

You’ll need: A pair of light-weight dumbbells and a pair of medium-weight dumbbells

T-Raises

This at-home back exercise proves that you don’t need huge weights to make some huge strength gains.

Grab a pair of light-weight dumbbells and stand with feet hip-width apart.
Take a slight bend in knees as you shift hips back and lower torso until it’s parallel to the floor.
Bring weights together and turn palms to face forward.
Keeping arms straight, lift weights up to shoulder height then lower back down. (Make sure to keep core and glutes engaged the entire time.)
Do 15 reps.

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Remedies for Nausea and Vomiting

Nausea and Vomiting: What’s Wrong?

Your child’s nausea has turned to vomiting, and you want to help him fast. Luckily, bouts of vomiting in kids aren’t usually harmful, and they pass quickly. Common causes are stomach viruses and sometimes food poisoning. Check in with your doctor if your child is less than 12 weeks old, acts sick, or if you are worried.

Signs of Dehydration

One of the best things you can do is watch for dehydration. Kids get dehydrated more quickly than adults. Watch your child for: acting tired or cranky, dry mouth, fewer tears when crying, cool skin, sunken-looking eyes, not urinating as often as normal, and when he does go, not peeing very much or urine that is darker yellow.

Treating Dehydration

To prevent and relieve dehydration, try to get your child to drink in very small amounts. Even if vomiting continues, she’s still absorbing some of what you give her. Try ice chips, sips of water, sports drinks, or oral rehydration solutions like CeraLyte, Enfalyte, or Pedialyte. After she vomits, start with a small amount: a few tablespoons every few minutes. Over time, give her more as she is able to hold it down. Make sure she urinates regularly.

What About Flat Soda?

For many years, parents used flat lemon/lime soda and ginger ale to help kids replace fluids, and many doctors still recommend those. But research has begun to show that oral rehydration solutions are better for kids. These drinks offer the right amounts of sugar and salt. An alternative can be a sports drink mixed with an equal amount of water.

Liquid Diet

When it’s been several hours since your child last vomited, you can begin a clear liquid diet beyond just water, electrolyte drinks, or oral rehydration solutions. Stick with liquids you can see through. They are easier to digest, yet they offer nutrients to give your child energy. Think clear broth, cranberry juice, apple juice. Popsicles and Jell-O can work well, too.

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Masks and Summer Heat: Expert Tips

Dr. Teresa Murray Amato rode the subway into Manhattan from Queens the other day and found that summertime and face masks aren’t an easy fit.

“It was a warm day. I definitely felt it was a little hot,” said Amato, director of emergency medicine at Long Island Jewish Forest Hills in Queens, N.Y.

Despite her discomfort, Amato resisted the urge to remove her mask — and she recommends that you do the same.

COVID-19 continues to spread even in the humid heat of summer, so it’s important to keep wearing masks and maintaining social distancing to prevent transmission, said Dr. Waleed Javaid, director of infection prevention and control at Mount Sinai Downtown in New York City.

At least 10 states — Alabama, Arkansas, California, Florida, Nevada, North Carolina, Oklahoma, South Carolina, Tennessee and Texas — reached record levels of hospitalized COVID-19 patients on Sunday, the Washington Post has reported.

This was the risk of reopening, but public health officials have said it’s worth it if people wear masks.

Evidence has shown that masks can reduce transmission of the new coronavirus, if everyone wears one, Amato said.

Summer heat may make your mask feel stifling, but you should keep wearing it if you’re near other people or in enclosed spaces, she said.

“Even though we know it’s going to be a little uncomfortable, I really think the benefits outweigh the discomfort of being a little warm while wearing your mask,” Amato said.

Keeping both your mouth and nose covered is important. Folks struggling with their mask in the heat might try switching to a lightweight one that’s more breathable.

At this point, surgical masks are in good enough supply that people who are uncomfortable with a cloth face covering might consider buying a box, Amato said. Even grocery stores are carrying them now.

“A light surgical mask probably does the trick with the least amount of discomfort,” she said.

Sweat is another problem. If your mask becomes damp with sweat, its ability to screen out coronavirus is diminished, Amato and Javaid said.

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Cancer Drug Might Help Curb Severe COVID-19

Could a cancer drug spare hospital patients from the ravages of severe COVID-19?

Yale doctors think it can after giving the medication, known as tocilizumab, to severely ill patients back in March.

How does tocilizumab work? It has a long history of dampening the life-threatening immune system reactions cancer patients often experience while undergoing treatment. Since the same kind of dangerous response develops in many COVID-19 cases, the researchers thought the drug might make a difference for the sickest patients.

The result — while preliminary — appears to be a dramatically lower death rate among patients placed on mechanical ventilators.

How much lower? Among the first 239 COVID-19 patients treated at Yale New Haven Hospital, in Connecticut, during the early weeks of the pandemic, 153 were treated with tocilizumab, including all 48 patients who had been placed on ventilators. “Instead of survival rates of 10% to 50% reported elsewhere, it was 75% in [ventilated] patients treated with tocilizumab,” said study author Dr. Christina Price, Yale’s chief of clinical allergy and clinical immunology.

In addition, among those seriously ill patients who ultimately survived COVID-19, tocilizumab appears to have significantly shortened overall ventilation time. While hospitals around the country were having to keep patients hooked up for between 12 to 14 days, ventilations at Yale typically lasted only about five days.

How tocilizumab works against COVID-19

What accounts for its apparent success against COVID-19?

It all originates in the threat posed by a deadly immune system phenomenon known as “cytokine release syndrome” (CRS), an out-of-control inflammatory response that the virus triggers in some patients.

CRS is “when the body’s response to fighting the virus goes so unchecked it ends up being harmful, damaging the liver, the kidney, the lungs. You need an immune response. You can’t totally shut it down completely. But you can’t let it get out of control, which is what can happen to cancer patients undergoing treatment. And to COVID patients,” Price said.

The problem? “There were no [U.S. Food and Drug Administration]-approved medications for COVID in March,” she stressed.

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