Stress is a normal psychological and physical reaction to the demands of life. A small amount of stress can be good, motivating you to perform well. But many challenges daily, such as sitting in traffic, meeting deadlines and paying bills, can push you beyond your ability to cope.

Your brain comes hard-wired with an alarm system for your protection. When your brain perceives a threat, it signals your body to release a burst of hormones that increase your heart rate and raise your blood pressure. This “fight-or-flight” response fuels you to deal with the threat.

Once the threat is gone, your body is meant to return to a normal, relaxed state. Unfortunately, the nonstop complications of modern life and its demands and expectations mean that some people’s alarm systems rarely shut off.

Stress management gives you a range of tools to reset and to recalibrate your alarm system. It can help your mind and body adapt (resilience). Without it, your body might always be on high alert. Over time, chronic stress can lead to serious health problems.

Don’t wait until stress damages your health, relationships or quality of life. Start practicing stress management techniques today.

Stress symptoms: Effects on your body and behavior

Stress symptoms may be affecting your health, even though you might not realize it. You may think illness is to blame for that irritating headache, your frequent insomnia or your decreased productivity at work. But stress may actually be the cause.

Common effects of stress

Indeed, stress symptoms can affect your body, your thoughts and feelings, and your behavior. Being able to recognize common stress symptoms can help you manage them. Stress that’s left unchecked can contribute to many health problems, such as high blood pressure, heart disease, obesity and diabetes.

Common effects of stress

On your body	On your mood	On your behavior
Headache	Anxiety	Overeating or undereating
Muscle tension or pain	Restlessness	Angry outbursts
Chest pain	Lack of motivation or focus	Drug or alcohol misuse
Fatigue	Feeling overwhelmed	Tobacco use
Change in sex drive	Irritability or anger	Social withdrawal
Stomach upset	Sadness or depression	Exercising less often
Sleep problems

Act to manage stress

If you have stress symptoms, taking steps to manage your stress can have many health benefits. Explore stress management strategies, such as:

• Getting regular physical activity
• Practicing relaxation techniques, such as deep breathing, meditation, yoga, tai chi or massage
• Keeping a sense of humor
• Spending time with family and friends
• Setting aside time for hobbies, such as reading a book or listening to music

Aim to find active ways to manage your stress. Inactive ways to manage stress — such as watching television, surfing the internet or playing video games — may seem relaxing, but they may increase your stress over the long term.

And be sure to get plenty of sleep and eat a healthy, balanced diet. Avoid tobacco use, excess caffeine and alcohol, and the use of illegal substances.

When to seek help

If you’re not sure if stress is the cause or if you’ve taken steps to control your stress but your symptoms continue, see your doctor. Your healthcare provider may want to check for other potential causes. Or consider seeing a professional counselor or therapist, who can help you identify sources of your stress and learn new coping tools.

Also, get emergency help immediately if you have chest pain, especially if you also have shortness of breath, jaw or back pain, pain radiating into your shoulder and arm, sweating, dizziness, or nausea. These may be warning signs of a heart attack and not simply stress symptoms.

1. Skipping breakfast aids weigh loss

The common adage that breakfast is the most important meal of the day may or may not be true, but it seems unlikely that skipping the morning meal aids weight loss.

The rationale behind this strategy is that missing one meal a day leads to a lower overall intake of calories. However, the story is not so straightforward.

One study, published in 2010, analyzed food intake information from 2,184 people aged 9–15 years. Twenty years later, the researchers asked for the same information again.

They compared data from people who had skipped breakfast during childhood and adulthood with data from those who had never skipped breakfast or had done so only in adulthood.

Compared with the other groups, the participants who skipped breakfast during both childhood and adulthood tended to have larger waist circumferences, higher fasting insulin levels, and higher total cholesterol levels.

Sometimes, people who skip breakfast eat more during the rest of the day to counteract the deficit. But one 2013 study

found that missing breakfast does not lead to eating more at lunch. The authors conclude that “Skipping breakfast may be an effective means to reduce daily energy intake in some adults.”

However, these researchers only monitored the participants’ food intake at lunch, not dinner. And the study only included 24 participants, so we should be wary of drawing solid conclusions from the findings.

A much larger 2007 study, which involved more than 25,000 adolescents, looked for links between skipping breakfast and having overweight. The researchers also assessed the roles of alcohol intake and levels of inactivity.

The scientists found that skipping breakfast had a stronger association with overweight than either alcohol consumption or levels of inactivity.

A 2020 systematic review and meta-analysis that appears in the journal Obesity Research & Clinical Practice concurs. After analyzing the results of 45 previous studies, the authors concluded:

“Skipping breakfast is associated with overweight/obesity, and skipping breakfast increases the risk of overweight/obesity.”

2. ‘Fat-burning’ foods can aid weight loss

Certain foods are referred to as “fat-burning.” This sounds too good to be true, and it probably is.
Some people claim that foods such pineapple, ginger, onions, avocados, asparagus, celery, chilies, broccoli, green tea, and garlic speed up the body’s metabolism, thereby helping the body burn fat.

There is little scientific evidence, however, that these foods can help reduce weight.

3. Weight loss supplements can help

Proponents of certain supplements claim that they, too, help the body burn fat. In reality, these are generally ineffective, dangerous, or both. The Food and Drug Administration (FDA) report that they have “found hundreds of products that are marketed as dietary supplements but actually contain hidden active ingredients contained in prescription drugs, unsafe ingredients in drugs that have been removed from the market, or compounds that have not been adequately studied in humans.”

Jason Humbert, a senior regulatory manager at the FDA, adds:

“We’ve also found weight loss products marketed as supplements that contain dangerous concoctions of hidden ingredients, including active ingredients contained in approved seizure medications, blood pressure medications, and antidepressants.”

4. Low fat foods aid weight loss

Of course, reduced fat or low fat foods are likely to contain less fat. However, these products sometimes compensate with added sugar or salt. Checking labeling is key.

Also, it is worth noting that “reduced fat” does not necessarily mean “low fat,” but simply that the fat content of a product is lower than the full-fat version.

5. Thou shalt not snack

People may believe that snacking is a cardinal sin of dieting. In some cases, though, snacking can help people manage their caloric intake more effectively. It is not so much snacking itself, but what one snacks upon that that counts.

Snacking may be more complex than it first appears. While some snack on celery and others on cookies, some people might snack because they are hungry and others because they are bored.

Having a piece of fruit or some low fat yogurt between meals, for instance, might reduce food cravings, keeping a person from overeating at mealtimes or resorting to more energy-dense snacks.

Some research has shown that people with obesity are more likely to snack than people without the condition. In this case, switching from unhealthful to healthful snacks may aid in weight loss, if this is a goal.

In general, snacking is multifaceted — it may support or hinder weight loss efforts, and in some cases it may have little effect. Older research, from 2007, investigated the role of snacking in weight loss. In the yearlong study, the researchers asked one group of participants to have three meals a day, without snacking. A second group was asked to have three meals and three snacks daily. Individuals in both groups consumed equivalent amounts of energy each day.

At the end of the study, the authors found no difference in weight loss between the two groups; snacking, it seems, neither helped nor hindered.

Another study, from 2011, investigated the “relationship between eating frequency and weight loss maintenance.” The researchers recruited participants who had previously had overweight or obesity but who had since maintained healthy weights.

They compared these individuals’ eating patterns with those of people with obesity and people with healthy weights who had never had overweight.

The team found that participants with healthy weights ate more snacks than those who had lost weight — and that people with overweight ate the fewest snacks.

Overall, the authors concluded that “Eating frequency, particularly in regard to a pattern of three meals and two snacks per day, may be important in weight loss maintenance.”

6. No treats allowed

This follows on from the myth above. Of course, limiting sugary, high fat treats is important, but cutting them out entirely is unnecessary and could be counterproductive.

As the British Heart Foundation explain:

“Depriving yourself of all the foods you enjoy won’t work. You’ll eventually give into temptation and abandon your efforts. There’s no harm in allowing yourself a treat now and again.”

7. Some sugars are worse than others

There is a rumor that minimally processed sugars, such as those in maple syrup or honey, are more healthful than white sugar. In reality, our bodies process sugar in the same way — regardless of its source. The gut reduces all sugars into monosaccharides.

Rather than looking at sugar processing, it is more important to note the amount of sugar in any food. All types of sugar provide around 4 calories per gram.

8. Cut out all sugar

Following on from the myth above, we know that all sugar is high in calories. However, a person looking to lose weight does not need to mercilessly cut sugar from their diet.

As with all things, moderation is key. It may instead be a good idea to avoid products with added sugar.

9. Artificial sweeteners are healthful

To lower their sugar intakes, many people opt for low- or no-calorie sweeteners, such as aspartame. This may reduce the number of calories consumed, but some studies have linked artificial, or nonnutritive, sweeteners to weight gain.

A systematic review and meta-analysis published in 2017 analyzed 37 existing studies involving a total of 406,910 participants to investigate the impact of sweeteners on cardiometabolic health.

According to the researchers, “Observational data suggest that routine intake of nonnutritive sweeteners may be associated with increased BMI [body mass index] and cardiometabolic risk.”

However, not all studies have reached this conclusion. Researchers and health experts continue to discuss the effects of nonnutritive sweeteners on weight loss and metabolic health.

10. You can target fat in specific areas

Some people are particularly keen to lose fat from certain areas, such as the thighs or abdomen. In reality, this targeting is not possible. All bodies respond differently to weight loss, and we cannot choose which bits of fat will go first.

However, if weight loss is paired with exercises to tone a particular area, it can give the impression of more region-specific weight loss.

11. This fad diet is excellent

Vast legions of diets have become fashionable only to fade into obscurity, making room for more. As the Centers for Disease Control and Prevention (CDC)

explain in a nutshell:

“[Fad] diets limit your nutritional intake, can be unhealthy, and tend to fail in the long run.”

The take-home

Overall, losing weight can be challenging. Our bodies evolved during leaner times, so they are primed to take on energy and store it. However, many of us live in a world where calories are readily available, and our bodies still store this energy as if it’s going out of fashion.

In general, reducing the caloric intake and exercising is the most reliable approach to weight loss. With that said, people with chronic diseases, including diabetes and obesity, should speak with their doctors before beginning a new weight loss regime.

It is also worth remembering that if anything seems too good to be true, it probably is — any “weight loss miracle” is unlikely to be miraculous. Most foods are not inherently unhealthful, but it is a good idea to consume high-sugar and high-fat foods sparingly.

For anyone embarking on a healthful weight loss program this year, good luck. 

A study found hitting the 8,000-step goal just one to two days per week is still associated with a significant reduction in all-cause and cardiovascular mortality. Third Eye Images/Getty Images

• Current research suggests that walking 8,000 brisk steps or more per day may be the sweet spot for receiving the health benefits walking provides.
• People who have trouble finding time to walk each day of the week will be encouraged by a new study that demonstrates walking just one to two days is still associated with a significant reduction in all-cause and cardiovascular mortality.
• The study’s authors found that each additional day walked confers greater benefits.

Briskly walking 8,000 or more steps each day of the week is associated with a significant decrease in all-cause and cardiovascular mortality. A new study finds, however, that people taking just 8,000 steps one or two days a week are also less likely to die over a 10-year follow-up period.

The study published in JAMA Network Open found that over a decade of follow-up, people 20 years or older who took 8,000 or more steps on one or two days a week were 14.9% less likely to die compared to people who were sedentary.

The risk of death dropped as the number of days involved increased. For example, exercising from three to seven days a week was associated with a 16.5% reduction in all-cause and cardiovascular deaths.

The same pattern held true for people meeting step goals of 6,000 to 10,000 steps.

Previous research found that mortality risk decreases up to 10,000 steps per day for people younger than 60 and 8,000 for people older than 60.

‘Weekend warrior’ style of exercising

The study’s findings pertain to both “weekend warriors,” people who confine their exercise to non-work days, and to people who steal a few hours to walk during the week.

The study cites recent data showing the average American takes just 4,800 steps a day, too few to provide much of a health benefit.

“Brisk walking” is defined as walking three miles an hour. If you can speak song lyrics but not sing them, you are walking briskly.

The current study compared data from the U.S. 2005 and 2006 National Health and Nutrition Examination Survey with the National Death Index up to the year 2019. It incorporated accelerometer data from 3,101 participants 20 years or older and was a nationally representative sample. It included a similar number of women and men, and 50.9% were White, 21.5% Black, 23.7% Hispanic, and 3.9% other race and ethnicity.

The participants most likely to walk 8,000 or more steps every day were more likely to be young, male, Hispanic, insured, and married. They were also typically never-smokers and were less likely to be obese or have comorbidities.

A daily challenge of walking 8,000 steps

For many people, walking 8,000 steps each day requires a significant commitment of time. 8,000 steps are about four miles, which, walking at three miles per hour, comes to a total of about an hour and 20 minutes every day. Steps can be taken simultaneously or in shorter periods of brisk walking.

The study was led by Dr. Kosuke Inoue of Kyoto University in Japan, collaborating with researchers from UCLA in California. Dr. Inoue explained why the study was undertaken:

“We started this study to answer the question one of my patients asked during an outpatient clinic: ‘It is hard for me to keep sufficient steps every day. Is it okay to focus on walking only during the weekend?’”

Steps studies often consider the value of a week’s worth of various step goals, and Dr. Inoue saw a lack of evidence regarding the possible benefits of walking just a few days a week.

“Given that a lack of time is one of the major barriers to exercise in modern society,” said Dr. Inoue, “our findings provide useful information to recommend walking even for a couple of days per week to reduce mortality risk.”

“This is one of the first studies to use direct measures of daily steps using a wearable accelerometer over a 10-year followup period,” said Dr. Paul Arciero, a professor in the Health and Human Physiological Sciences Department at Skidmore College, who was not involved in the study.

How walking benefits overall health

Walking is viewed as a simple, low impact means of making a person’s life less sedentary. A sedentary lifestyle has been linked to an increased risk of all-cause and cardiovascular mortality.

“Further, a sedentary lifestyle drastically increases the risk of cardiometabolic disease such as abdominal obesity, hypertension (high blood pressure), type 2 diabetes, stroke, heart disease, and certain inflammatory conditions and cancers,” said Dr. Arciero.

According to Harvard Medical School, taking one’s steps has additional, less-obvious benefits. Walking offsets the effect of weight-promoting genes, reduces breast cancer risk, and boosts one’s immune system. It can also lessen arthritis-based joint pain, and even a 15-minute walk can curb a craving for chocolate, both generally and in response to stress.

Dealing with limited time for walking

The study’s findings should provide valuable information for clinicians and health professionals, said Dr. Inoue. He suggested a reader’s takeaway should be that for people who have difficulties engaging in regular exercise, “achieving recommended daily steps only a couple of days per week can have meaningful health benefits.”

Describing the study’s conclusions as “encouraging,” Dr. Arciero suggested the study may help people who don’t have enough time to walk 8,000 steps a day overcome feelings that walking less is pointless.

“We now have scientific evidence that proves this mindset is not true, and even a couple of days is beneficial!” said Dr. Arciero.

He said the study underscores the value of increasing one’s daily step count:

“Always a good reminder that any amount of walking, even one to two days per week, is still better than no walking.”

• Peptides are smaller versions of proteins that have a range of purposes, such as the potential to reduce the signs of aging, relieve inflammation, or promote muscle growth.
• In 2015, researchers discovered a type of peptide called PEPITEM, and recognized its function in the adiponectin-PEPITEM pathway, which regulates the onset and severity of autoimmune or chronic inflammatory conditions.
• Now, new research in animal models reveals that this peptide has the potential to offer a groundbreaking solution for many diseases.
• The peptide may decrease the chances of developing type 2 diabetes and other conditions associated with obesity, such as fatty liver disease, the study indicates.

Obesity leads to significant changes in adipose (fat) tissue metabolism, harms the pancreas, impairs insulin sensitivity, and eventually causes hyperglycemia (high blood sugar), which is the foundation of type 2 diabetes.

Additionally, it triggers a low-grade inflammatory reaction throughout the body, which promotes the infiltration of white blood cells into numerous tissues, including fat deposits located deep within the body that surround organs, such as the liver and gut — called visceral adipose tissue — and the peritoneal cavity, a delicate membrane that encloses the gut.

According to a new study, published in Clinical and Experimental Immunology, the adiponectin-PEPITEM pathway provides a link between obesity, the accompanying low-grade inflammatory response, and modifications in the pancreas that occur prior to the onset of diabetes.

Using a mouse model of obesity, the researchers administered the peptide PEPITEM using a slow-release pump, to see if it could prevent or perhaps even reverse the impacts of a high-fat diet on the pancreas.

The researchers found that administering PEPITEM to mice that were following a high-fat diet resulted in a significant reduction in the enlargement of insulin-producing cells in the pancreas and the number of white blood cells in the visceral adipose tissue and peritoneal cavity when compared to the control group.

Scale of problem in diabetes

Diabetes is a non-communicable disease (NCD) where the amount of glucose in the blood is too high. Type 1 diabetes is an autoimmune disease whereby the body is unable to produce any insulin, and Type 2 diabetes develops when the body stops producing enough insulin or the body’s cells stop reacting to insulin produced.

Type 2 diabetes is associated with lifestyle factors – being overweight or obese is the major modifiable risk factor for Type 2 diabetes. The onset of Type 2 diabetes can be delayed or prevented through support to change behaviour around lifestyle choices. Type 1 diabetes is not related to lifestyle issues, and at this point cannot be prevented.

Risk factors for Type 2 diabetes

The obesogenic environment and associated lifestyle risk factors

The increasingly obesogenic environment we live in makes it harder for individuals to avoid unhealthy lifestyle choices. The obesogenic environment can be considered to be at the root of the prevention challenge in Type 2 diabetes.

From childhood, people are exposed to ultra-processed, energy-dense, nutrient-poor foods, which are cheap and readily available. Opportunities for physical activity, both in and out of school and the workplace, have been reduced and more time is spent on screen-based and sedentary leisure activities. As a result, high proportions of children and adults have increasingly been defaulting to unhealthy lifestyle choices including unhealthy diets, low levels of physical activity, and sedentary behaviour. These all give rise to higher risk of Type 2 diabetes:

• overweight or obesity with a body mass index (BMI) of 25 or more
• a large waist circumference – more than 80cm or 31.5 inches in women and 94cm or 37 inches in men

How do I know if I have flu?

Your respiratory illness might be influenza (flu) if you have fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and/or fatigue. Some people may have vomiting and diarrhea, though this is more common in children. People may be sick with flu and have respiratory symptoms without a fever. Flu viruses usually cause the most illness during the colder months of the year. However, flu can also occur outside of the typical flu season. In addition, other viruses can also cause respiratory illness similar to flu. So, it is impossible to tell for sure if you have flu based on symptoms alone. If your doctor needs to know for sure whether you are sick with flu, there are laboratory tests that can be done.

What kinds of flu tests are there?

A number of tests are available to detect flu viruses in respiratory specimens. The most common are called “rapid influenza diagnostic tests (RIDTs).” RIDTs work by detecting the parts of the virus (antigens) that stimulate an immune response. These tests can provide results within approximately 10-15 minutes but may not be as accurate as other flu tests. Therefore, you could still have flu, even though your rapid test result is negative. Other flu tests called “rapid molecular assays” detect genetic material of the flu virus. Rapid molecular assays produce results in 15-20 minutes and are more accurate than RIDTs.

In addition to RIDTs and rapid molecular assays, there are several more accurate flu tests available that must be performed in specialized laboratories, such as hospital and public health laboratories. These tests include reverse transcription polymerase chain reaction (RT-PCR), viral culture, and immunofluorescence assays. All of these tests require that a health care provider swipe the inside of your nose or the back of your throat with a swab and then send the swab for testing. Results may take one to several hours.

How well can rapid tests detect flu?

During a flu outbreak, a positive rapid flu test is likely to indicate flu virus infection. However, rapid tests vary in their ability to detect flu viruses, depending on the type of rapid test used, and on the type of flu viruses circulating. Also, rapid tests appear to be better at detecting flu in children than in adults. This variation in ability to detect viruses can result in some people who are infected with flu having a negative rapid test result. This situation is called a false negative test result. Despite a negative rapid test result, your health care provider may diagnose you with flu based on your symptoms and their clinical judgment.

Will my health care provider test me for flu if I have flu-like symptoms?

While your doctor may test you for flu, not everyone who goes to the doctor with flu-like symptoms will be tested. After evaluating you, your doctor may choose to diagnose you with flu without the need for testing based on your symptoms and his or her own clinical judgement.

Difference Between Flu and COVID-19

Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same. Some PCR tests can differentiate between flu and COVID-19 at the same time. If one of these tests is not available, many testing locations provide flu and COVID-19 tests separately. Talk to a healthcare provider about getting tested for both flu and COVID-19 if you have symptoms.

Can I have flu and COVID-19 at the same time?

Yes. It is possible to have flu as well as other respiratory illnesses including COVID-19 at the same time. Health experts are still studying how common this can be.

Is there a test that can detect both flu and COVID-19?

Yes. There is a test that will check for seasonal flu type A and B viruses and SARS-CoV-2, the virus that causes COVID-19. This test is being used by U.S. public health laboratories for surveillance purposes. Testing for these viruses at the same time will give public health officials important information about how flu and COVID-19 are spreading and what prevention steps should be taken. The test will also help public health laboratories save time and testing materials, and possibly to return test results faster.

The Food and Drug Administration (FDA) has given CDC an Emergency Use Authorization for this new test. Initial test kits were sent to public health laboratories in early August 2020. CDC will continue to manufacture and distribute these kits.