Resistance training: here’s why it’s so effective for weight loss

Weight lifting, also known as resistance training, has been practised for centuries as a way of building muscular strength. Research shows that resistance training, whether done via body weight, resistance bands or machines, dumbbells or free weights, not only helps us build strength, but also improves muscle size and can help counteract age-related muscle loss.

More recently it’s become popular among those looking to lose weight. While exercises such as running and cycling are indeed effective for reducing body fat, these activities can simultaneously decrease muscle size, leading to weaker muscles and greater perceived weight loss, as muscle is more dense than fat. But unlike endurance exercises, evidence shows resistance training not only has beneficial effects on reducing body fat, it also increases muscle size and strength.

The ‘after-burn effect’

When we exercise, our muscles need more energy than they do when resting. This energy comes from our muscles’ ability to break down fat and carbohydrate (stored within the muscle, liver and fat tissue) with the help of oxygen. So during exercise, we breathe faster and our heart works harder to pump more oxygen, fat, and carbohydrate to our exercising muscles.

What is less obvious, however, is that after we’ve finished exercising, oxygen uptake actually remains elevated in order to restore muscles to their resting state by breaking down stored fat and carbohydrates. This phenomenon is called excess post-exercise oxygen consumption (EPOC) – though more commonly known as the “after-burn effect”. It describes how long oxygen uptake remains elevated after exercise in order to help the muscles recover.

The extent and duration of the after-burn effect is determined by the type, length, and intensity of exercise, as well as fitness level and diet. Longer-lasting exercise that uses multiple large muscles, performed to or near fatigue, results in higher and longer-lasting after-burn.

High-intensity interval training (HIIT) and high intensity resistance training are most effective at elevating both short and long-term after-burn. The reason HIIT-type exercises are thought to be more effective than steady-state endurance exercise is because of the increased fatigue associated with HIIT. This fatigue leads to more oxygen and energy required over a prolonged period to repair damaged muscle and replenish depleted energy stores. As such, resistance exercise is an effective way to lose excess fat due to the high calorie cost of the actual training session, and the “after-burn effect”.

Long-term fat loss

Resistance training can also be effective for long-term weight control, too. This is because muscle size plays a major role in determining resting metabolic rate (RMR), which is how many calories your body requires to function at rest. Resting metabolic rate accounts for 60-75% of total energy expenditure in non-exercising people, and fat is the body’s preferred energy source at rest.

Increasing muscle size through resistance training increases RMR, thereby increasing or sustaining fat loss over time. A review of 18 studies found that resistance training was effective at increasing resting metabolic rate, whereas aerobic exercise and combined aerobic and resistance exercise were not as effective. However, it’s also important to control calorie intake in order to lose fat and sustain fat loss.

Resistance training exercises should engage the largest muscle groups, use whole body exercises performed standing and should involve two or more joints. All of these make the body work harder, thereby increasing the amount of muscle and therefore RMR. An effective resistance training programme should combine intensity, volume (number of exercises and sets), and progression (increasing both as you get stronger). The intensity should be high enough that you feel challenged during your workout.

The most effective way of doing this is using the repetition maximum method. For the purpose of fat loss, this should be performing between six and ten repetitions of an exercise with a resistance that results in fatigue, so that you cannot comfortably do another full repetition after the last one. Three to four sets, two or three times a week for each muscle group is recommended.

The repetition maximum method also ensures progression, because the stronger you get, the more you will need to increase resistance or load to cause fatigue by the tenth repetition. Progression can be achieved by increasing the resistance or intensity so that fatigue occurs after performing fewer repetitions, say eight or six.

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Why absence could make your heart go longer

Why absence could make your heart go longer: As Britain sees a gradual shift towards so-called remote medicine, we take a look at the inventions that are changing the face of cardiac care

  • Britain is seeing a gradual shift towards so-called remote medicine for patients
  • Complex tests now performed without patient needing to step outside house   
  • However there may be caveats if the device needs to be surgically implanted

A doctor monitoring your health without even setting eyes on you used to be the stuff of science fiction.

But thanks to modern technology, Britain is seeing a gradual shift towards so-called remote medicine, where patients are supervised round the clock by high-tech implants or devices while at home.

Complex tests and check-ups that once required bulky hospital equipment are now performed without the patient needing to step outside their front door — with the results transmitted via smartphone technology straight to their doctor’s computer.

There may be caveats if the device needs to be surgically implanted, as this carries a chance, albeit low, of triggering life-threatening infections.

A 2015 study suggested that faulty heart implants could be responsible for up to 2,000 deaths a year in the UK, although this has been strongly disputed by the British Heart Foundation. (Stock image)

Some implantable devices have also been known to go wrong. 

A 2015 study suggested that faulty heart implants — including pacemakers — could be responsible for up to 2,000 deaths a year in the UK, although this has been strongly disputed by the British Heart Foundation, which insists the devices have a good safety record.

Martin Cowie, a professor of cardiology at Imperial College London, says remote monitoring will transform patient care.

‘The pandemic has highlighted how convenient it is, and now it’s here to stay,’ he adds.

Here, we take a look at the inventions that are changing the face of cardiac care, one of the areas where this advance has been the most rapid.


A high-tech pendant could make it easier to diagnose atrial fibrillation (AF), an irregular or ‘fluttering’ heartbeat, which affects around a million people in the UK.

Often triggered by high blood pressure, AF causes the heart’s electrical activity to go haywire, increasing the risk of a stroke. But patients can go days or weeks without an abnormal rhythm, making the condition hard to spot during a brief hospital visit.

The pendant, which is the brainchild of scientists at the University of Eastern Finland, is only the size of a 5p piece and can carry out pared down electrocardiograms (ECGs) — the measure of the heart’s electrical activity which is used in hospitals to diagnose AF.

Worn on a discreet silver chain, it contains an electrode, a recording device and a computer chip, which are all wirelessly connected to an app on the patient’s smartphone.

Pressed firmly against the chest for 30 seconds, it instantly transmits a read-out of the heart’s electrical activity via the app to the patient’s cardiologist. Readings should be taken several times a day.

Results of a study of 145 adults, presented at a European cardiology congress in May, showed that the gadget was as good at diagnosing AF as hospital-based ECGs. Larger trials are now planned.

‘I use devices like this a lot,’ says Richard Schilling, a professor of cardiology at Barts Health NHS Trust in London. ‘This kind of patient-performed ECG has transformed the diagnosis of some conditions.’


Getting a heart check usually means doctors attaching equipment to the outside of your body.

Now, an implant that does the tests from the inside — without the need for a medic even to be present — is undergoing trials at Queen Elizabeth Hospital in Birmingham and London’s Hammersmith Hospital.

The V-lap microcomputer monitors patients with heart failure, which is where the heart, weakened after a heart attack or by a condition such as untreated high blood pressure, is unable to pump sufficient blood around the body to deliver the oxygen vital organs need. 

Treatment for the 1.3 million Britons with heart failure usually starts with drugs to lower blood pressure and reduce water retention, a common symptom.

This new implant, which is inserted into the left atrium — one of the heart’s two upper chambers — during an hour-long keyhole operation, senses changes in blood pressure which are a sign of further deterioration of the organ.

Transmitted to a patient’s cardiologist twice a day, the data can give several weeks’ notice that heart function is deteriorating — enough time to increase drug dosage and stave off greater damage.

Professor Francisco Leyva-Leon, a cardiologist trialling the implant in Birmingham, says: ‘The benefits could be huge. In my hospital alone we admit more than 1,000 patients a year with heart failure.’


Home blood pressure monitoring is nothing new. But devices are fairly cumbersome, involving wearing a ‘sleeve’ that wraps round the upper arm, just like the one in a GP surgery.

That could be about to change, thanks to Japanese scientists working out how to shrink the key components of the equipment into a wristwatch.

HeartGuide, which can also be used as a normal watch, has a built-in cuff under the strap that inflates around the wrist when the patient presses the watch face.

Daily readings are beamed wirelessly to a smartphone app that shares the data with doctors, who then decide if the patient’s medication needs altering — without needing a consultation.

However, at around £500, it’s not a cheap option.

‘This smart watch is an interesting idea,’ says Professor Martin Cowie. ‘But it is important to remember blood pressure goes up and down in response to activity or sleep. The patient would need to take a large number of readings.’


Pacemakers have been around for more than half a century, but a new generation of miniature implants are capable of much more than just regulating the heart — they can also communicate with doctors remotely.

Alternative remedies

The aloe vera plant is often found in tropical climates

Pharmacist Gemma Fromage reveals the unexpected uses for everyday products. 

This week: Aloe vera for acid reflux.

The use of aloe vera, a plant often found in tropical climates, dates back to Ancient Egyptian times.

It is well known as a home remedy for scrapes and burns due to its anti-inflammatory properties.

The juice, derived from the inner lining of its leaves, has also been found to soothe acid reflux. A study in the Journal of Traditional Chinese Medicine showed purified aloe vera juice improved reflux symptoms as well as, and in some cases better than, traditional medications — possibly because it reduces acid production.

Pregnant women and those with diabetes are advised against taking aloe vera juice, as it may cause uterine contractions and affect blood sugar levels. 

Anyone using prescribed medicines for reflux should also consult their doctor before stopping their treatment regimen in favour of aloe vera, or adding the juice to it.


Pacemakers are matchbox-sized gadgets used to treat a range of conditions that affect the heart —from children born with cardiac defects to adults with AF. Implanted in the chest, they send electrical pulses to the heart to keep it beating regularly.

Older devices store readings on built-in microchips which can only be accessed by visiting a hospital up to four times a year to have them downloaded. But now doctors can gather the data without the patient needing to leave their home.

Modern pacemakers have a transmitter that ‘talks’ to a mobile-phone sized monitor. It uses an internet connection to send encrypted data straight to the doctor’s computer.

‘We already use remote monitoring for thousands of pacemaker patients,’ says Professor Francisco Leyva-Leon.

‘It means we can screen them on a regular basis and only need to call them in for a consultation if there is a potential problem.’


A stick-on chest patch called Zio that you can even wear in the shower is increasingly being used to diagnose irregular heart rhythms without going to hospital.

The matchbox-sized patch has built-in electrodes and a recording device to pick up the heart’s electrical activity as the patient goes about their day.

Made from waterproof plastic, the patient wears it on their upper chest for up to two weeks to record their heart’s activity, before sending it back to the supplier, Surrey-based firm iRhythm.

The company uses the results to compile a report for the patient’s doctor.

A 2019 study at King’s College Hospital in London found the Zio patch was almost eight times more effective than current portable monitors at detecting heart rhythm problems.

The cost to the NHS is £800 per patch, including the analysis and the report provided for GPs.

‘Devices like the Zio skin patch are easier to wear than monitors during exercise and may even perform better,’ says Dr Sarah Clarke, a cardiologist at the Royal Papworth Hospital in Cambridge.

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Why we must decolonise mental health

In 2017, the UN Special Rapporteur Dr. Dainius Pūras noted that mental healthcare services around the world were in a crisis and rightly called for a ‘revolution’ in mental healthcare. He identified problems of power asymmetries, an over-reliance on psychotropic drugs, and a system that revolves around profits for experts and the pharmaceutical industry. These issues have culminated in a coercive and largely biomedical approach to mental health.

Chief Ombudsman Peter Boshier’s report on the breaching of human rights in mental health facilities highlights the serious failings of this approach. Of particular concern is the use of exclusion zones for accommodating residents.

Similar issues were also highlighted in “He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction” in 2018, which reiterated that the system is under pressure and unsustainable in its current form. This earlier report found the system was also less equitable for Māori, who were more likely to experience compulsory treatment and seclusion, and that the current system reinforced trauma because Māori felt culturally alienated. After nearly four decades of deinstitutionalisation, human rights violations continue in our mental health system.

The issue here is that while Aotearoa New Zealand deinstitutionalised mental health, it failed to decolonise it. To begin the decolonisation process an acknowledgement of historical trauma in the mental health system needs to be incorporated. Unless this trauma is recognised, new approaches that are holistic, rights-based and kaupapa Māori-centred cannot be developed.

Indigenous forms of mental health care also need to be mainstreamed rather than presented as alternative approaches. During colonial times, indigenous knowledge and treatment approaches across Britain’s colonies were labelled as superstitious and local practitioners were accused of quackery.

The establishment of asylums in the 19th century led to the marginalisation of local practitioners like the tohunga,and also to the spread of a narrative that indigenous approaches were superstitious. Tohunga were referred to as ‘quacks’ and accused of ‘degenerating into tricky humbugs’. Doctors even urged the government to put an end to the tohunga. This disruption of indigenous mental health care is another form of historical trauma that eventually led to the sidelining of traditional approaches.

A purely biomedical psychiatric approach excludes social and cultural narratives that are crucial in the healing process, and interdisciplinary voices are essential to further the process of decolonisation.

The example of recent stories about Māori finally experiencing healing through using mātauranga Māori services after years in the mental health system highlight the importance of these other voices, and should influence our research into new approaches to mental healthcare.

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Why is wildfire smoke so bad for your lungs?

If I dare to give the coronavirus credit for anything, I would say it has made people more conscious of the air they breathe.

A friend texted me this week after going for a jog in the foothills near Boise, Idaho, writing: “My lungs are burning … explain what’s happening!!!”

A wildfire was burning to the east of town — one of dozens of fires that were sending smoke and ash through communities in hot, dry western states. As an environmental toxicologist, I research how air pollution, particularly wood smoke, impacts human health and disease.

I gave my friend the short answer: The state had issued a yellow, or moderate, air quality index warning due in part to wildfires. The high temperature for the day was expected to reach 100 degrees Fahrenheit, and it was already approaching 90. That combination of high temperatures and elevated levels of particles from a fire can affect even healthy lungs. For someone with lung damage or respiratory illness, moderate levels of smoke particulate can exacerbate respiratory problems.

That’s only the start of the story of how wildfire smoke affects humans who breathe it. The rest, and how to stay healthy, is important to understand as the western wildfire season picks up.

What’s in wildfire smoke?

What exactly is in a wildfire’s smoke depends on a few key things: what’s burning — grass, brush or trees; the temperature — is it flaming or just smoldering; and the distance between the person breathing the smoke and the fire producing it.

The distance affects the ability of smoke to “age,” meaning to be acted upon by the sun and other chemicals in the air as it travels. Aging can make it more toxic. Importantly, large particles like what most people think of as ash do not typically travel that far from the fire, but small particles, or aerosols, can travel across continents.

Smoke from wildfires contains thousands of individual compounds, including carbon monoxide, volatile organic compounds (VOCs), carbon dioxide, hydrocarbons and nitrogen oxides. The most prevalent pollutant by mass is particulate matter less than 2.5 micrometers in diameter, roughly 50 times smaller than a grain of sand. Its prevalence is one reason health authorities issue air quality warnings using PM2.5 as the metric.

What does that smoke do to human bodies?

There is another reason PM2.5 is used to make health recommendations: It defines the cutoff for particles that can travel deep into the lungs and cause the most damage.

The human body is equipped with natural defense mechanisms against particles bigger than PM2.5. As I tell my students, if you have ever coughed up phlegm or blown your nose after being around a campfire and discovered black or brown mucus in the tissue, you have witnessed these mechanisms firsthand.

The really small particles bypass these defenses and disturb the air sacks where oxygen crosses over into the blood. Fortunately, we have specialized immune cells present in the air sacks called macrophages. It’s their job to seek out foreign material and remove or destroy it. However, studies have shown that repeated exposure to elevated levels of wood smoke can suppress macrophages, leading to increases in lung inflammation.

What does that mean for COVID-19 symptoms?

Dose, frequency and duration are important when it comes to smoke exposure. Short-term exposure can irritate the eyes and throat. Long-term exposure to wildfire smoke over days or weeks, or breathing in heavy smoke, can raise the risk of lung damage and may also contribute to cardiovascular problems. Considering that it is the macrophage’s job to remove foreign material — including smoke particles and pathogens — it is reasonable to make a connection between smoke exposure and risk of viral infection.

Recent evidence suggests that long-term exposure to PM2.5 may make the coronavirus more deadly. A nationwide study found that even a small increase in PM2.5 from one U.S. county to the next was associated with a large increase in the death rate from COVID-19.

What can you do to stay healthy?

The advice I gave my friend who had been running while smoke was in the air applies to just about anyone downwind from a wildfire.

Stay informed about air quality by identifying local resources for air quality alerts, information about active fires, and recommendations for better health practices.

If possible, avoid being outside or doing strenuous activity, like running or cycling, when there is an air quality warning for your area.

Be aware that not all face masks protect against smoke particles. In the context of COVID-19, the best data currently suggests that a cloth mask benefits public health, especially for those around the mask wearer, but also to some extent for the person wearing the mask. However, most cloth masks will not capture small wood smoke particles. That requires an N95 mask in conjunction with fit testing for the mask and training in how to wear it. Without a proper fit, N95s do not work as well.

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Establish a clean space. Some communities in western states have offered “clean spaces” programs that help people take refuge in buildings with clean air and air conditioning. However, during the pandemic, being in an enclosed space with others can create other health risks. At home, a person can create clean and cool spaces using a window air conditioner and a portable air purifier.

The EPA also advises people to avoid anything that contributes to indoor air pollutants. That includes vacuuming that can stir up pollutants, as well as burning candles, firing up gas stoves and smoking.

This article was originally published at The Conversation. The publication contributed the article to Live Science’s Expert Voices: Op-Ed & Insights.

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Gigi Hadid Reveals a Bit of Her Bump & Why You Won't See More

During her pregnancy, Gigi Hadid is learning one of the first harsh rules about motherhood: Some people will care more about your child more than they do about all the other amazing things you create. Case in point, in preparing to promote Gigi Journal Part II, an art book she created with V Magazine, she wound up receiving tons of fan questions about showing off her baby bump, yet again.

“I’m so grateful for the positive comments and the questions and wanting just to know that we’re all good and safe and everything’s going great and I love you guys,” Hadid said on Wednesday in a long Instagram Live post to unveil the book.

“Obviously, I think a lot of people are confused why I’m not sharing more, but I’m pregnant through a pandemic,” she explained. “Obviously, my pregnancy is not the most important thing going on in the world. That’s a reason that I felt that it’s not really something that I need to share apart from with my family and friends. Obviously, a lot of people have lost lives due to coronavirus that was in the beginning of quarantine and still happening. And then we moved obviously into the reemergence of the [Black Lives Matter] movement, and I thought that our presence on social media should be used for that.”

This is a very mature, selfless way of explaining Hadid’s lack of pregnancy updates. Mine would have been more like, “I’ll post if I want to, so mind your own business,” only with more expletives. (Reason #798 Hadid is a social media star and I am not.)

But beyond the fact that the world is on fire and there are more important things to discuss than the shape of one model’s belly, Hadid also does want to maintain a bit of privacy during this very special time.

“I have been taking a lot of pictures of my bump and sending it to friends and family,” she said. “And it’s been really cute and exciting, and I’m trying to document it well because I’ve heard a lot of people say, make sure you don’t miss it. And I will be sharing stuff like that in the future. I just am not rushed to do it, and I feel like right now, I just want to experience it.”

Hadid spends her entire life presenting an image of herself for public consumption, so it’s pretty understanding if she wants a break from all that.

“I just don’t want to worry about waking up every day during my pregnancy and worry about having to like look cute or post something,” she went on.

We’ll always have the Bella twins for pregnancy bump pics.

Still, she made one tiny concession for curious fans who just want to see evidence of the life growing inside her. After she had previously explained about not looking pregnant on Instagram videos taking from the front, she discussed her love of loose, linen clothing, particularly the set from Holiday she was wearing. Then she unbuttoned the bottom of her shirt.

“OK, there’s my belly, y’all,” she said, revealing the top of her bump and leaving the rest out of view of the camera. “It’s there. It’s just that from the front, it’s different. … I’m taking my time with sharing my pregnancy, and you guys will see it when you see it.”

With that, she continued on with her original purpose, to show off Gigi’s Journal. Because, for real, can we please let a mom-to-be also have her career?

If Gigi and Zayn don’t have a name picked out yet, maybe they can get inspo from these wacky celebrity baby names.

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Why people of color are suffering more from COVID-19

The statistics are shocking. As of mid-June, Black Americans have been hospitalized or died from COVID-19 at a rate about five times that of white Americans, according to the U.S. Centers for Disease Control. Other people of color have experienced much higher hospitalization and death rates than whites as well.

A recent report indicated that if people of color had experienced the same mortality rate as whites, as of late May, more than 14,000 Black Americans would still be alive, along with 1,200 Latino Americans and 400 indigenous Americans.

Tufts experts in public health and community health said they are not surprised by these numbers. “Even prior to the COVID-19 pandemic, we were already in a public health crisis,” said Adolfo Cuevas, an assistant professor of community health in the School of Arts and Sciences. “More than half of Black individuals have a chronic health condition” such as diabetes or high blood pressure, he said, which predisposes people to suffer from the COVID-19 virus. “The racial difference is striking already.”

Ndidiamaka Amutah-Onukagha, an associate professor of public health at the School of Medicine, said, “I think the mortality and morbidity that we’re seeing in COVID-19 is directly related to decades of systemic racism and the impact of racism on communities of color. Racism plays out in the rationing of equipment for people who are testing positive for COVID and even in back room decisions about who is eligible to get tests.”

A number of factors contribute to the health disparities highlighted by COVID-19. Black Americans are more likely to be essential workers, who must work and interact with other people—delivery drivers, grocery store employees, transit workers. They also are disproportionately low-wage workers, unable to afford to not work, said Amutah-Onukagha.

“They don’t have the luxury of working from home and shifting their livelihood to a virtual environment,” she said. “They are still going to have to deal with people face to face.”

Blacks also shoulder a higher burden of chronic disease, with up to 40 percent higher rates of high blood pressure and up to 60 percent higher rates of diabetes than white Americans, she said. Both conditions are increase risk for serious illness from COVID-19, according to the CDC.

Cuevas, whose research focuses on obesity, noted that about 40 percent of individuals nationally has the condition, a risk factor for increasing complications from the coronavirus. But about half of Black Americans have obesity compared to about 40 percent of whites. “So, the racial difference was already alarming,” he said. “What COVID-19 basically has done is exacerbate these racial disparities even more.”

Stress is a risk factor, too. “We know that when you put people in racially charged situations, their blood pressure goes up and their cortisol levels goes up,” said Amutah-Onukagha, who has done research on maternal health among women of color. Cortisol is the body’s main stress hormone, and heightened levels of it increase the frequency of preterm birth, low birth weight, and infants and mothers dying, she said.

The body’s physiologic response to stress “is really having an impact front and center for African Americans,” said Amutah-Onukagha.

Cuevas, who trained as a psychologist, agreed that stress has a physical and emotional effect. “Racial and ethnic minorities report experiencing a wide range of stressors day-to-day—financial strain, relationship problems, discrimination,” he said. “That accumulates over time to adversely affect both the mental and physical health of the individual.”

Add that to the lack of access to health care and to healthy foods and vegetables—and living in communities that are high in environmental toxins and pollutants—”it becomes a really bad soup that contributes to high rates of all these diseases,” he said.

Living conditions matter, too. “Black and brown populations, who have already been suffering from chronic conditions, live in areas that do not facilitate social distancing,” said Cuevas. That in turn causes the virus to spread at a quicker rate and suffer disproportionately from the virus.

Many of the current living conditions arose out of discriminatory policies from the past, Cuevas said. He pointed to government-supported neighborhood redlining from the 1930s to the 1960s—a practice that kept Black communities from building wealth

“Even after the 1960s laws prohibiting redlining, the effects of these practices persist,” he said. “The systematic denial of services limited people’s opportunities to get decent jobs and education, which some scholars suggest led to an overrepresentation of Black people in poverty and working menial labor jobs, which are two factors preventing many from staying at home.”

Likewise, it’s more difficult for people to practice social distancing in these neighborhoods, because residents tend to live in small apartments and with a sizable number of other individuals, he said. “Once you place more of the historical perspective into it, all of these health disparities make a lot more sense.”

Overcoming all these systemic deficits, which lead to health disparities that are especially vivid with the COVID-19 pandemic, is vital—and difficult, Amutah-Onukagha and Cuevas said.

“There is an opportunity here for community health scientists and elected officials to really change the social and public health landscape of the United States,” Cuevas said. “There needs to be real radical change to actualize equal opportunity for all. As community health scientists and elected officials, we must continue to highlight and address the social determinants of health disparities. As citizens, we must engage in local civic and political action to achieve equity near us.”

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Jon Gosselin: Why I Didn't Spend 4th of July With Son Collin

Celebrating apart. Jon Gosselin explained why he didn’t spend the 4th of July with his son Collin.

“Happy Fourth of July to every one!!!” the Jon & Kate Plus 8 alum, 43, captioned a Saturday, July 4, Instagram selfie with his girlfriend, Colleen Conrad, and daughter Hannah. “Sorry for the late post!!! Collin had other plans with his friends this weekend, that’s why he is not in the picture (shame I have to explain all that, but I just did)!!!!”

Conrad posted pictures on her own account, writing, “Happy 4th of July!! Missing Collin who dissed us for his friends.”

Jon welcomed Hannah, Collin and their sextuplet siblings Aaden, Joel, Leah and Alexis in 2004 with his now-ex-wife, Kate Gosselin. The former couple are also the parents of twins Madelyn and Cara, 19.

Following their split, Jon and the Kate Plus Date star, 45, were granted shared physical custody of their kids. Hannah moved in with the prep cook in 2018, and he was given sole custody of Collin the following year.

In May, Collin gushed about his relationship with his dad’s girlfriend in honor of Mother’s Day.

“I don’t think mother can describe all the things Colleen has done for me,” Collin wrote via Instagram at the time. “Yes a mother clothes her children and cooks for them but it’s the best feeling when your mother or mother figure is one of your best friends and always has your back, the one who always shares that laugh of the humor only you guys get.”

He went on to write, “I could call it Mother’s Day, but it’s more than that, Colleen, you are so much more than a mother to me, you are one of my guidelines and one of my guiding lights. Thank you doesn’t say enough, I love you so much and you’ve done so much for me that claims you my strong, happy, loving and awesome mother figure, you’re irreplaceable. Thank you so much Colleen love you so much!!!”

Keep scrolling to see pictures of Jon with Hannah and Conrad on the 4th of July.

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Coronavirus: scientists uncover why some people lose their sense of smell

From the first reports coming out of Wuhan, Iran and later Italy, we knew that losing your sense of smell (anosmia) was a significant symptom of the disease. Now, after months of reports, both anecdotal and more rigorous clinical findings, we think we have a model for how this virus may cause smell loss.

One of the most common causes of smell loss is a viral infection, such as the common cold, sinus or other upper respiratory tract infections. Those coronaviruses that don’t cause deadly diseases, such as COVID-19, SARS and Mers, are one of the causes of the common cold and have been known to cause smell loss. In most of these cases, sense of smell returns when symptoms clear, as smell loss is simply the result of a blocked nose, which prevents aroma molecules reaching olfactory receptors in the nose. In some cases, smell loss can persist for months and years.

For the novel coronavirus (SARS-CoV-2), however, the pattern of smell loss is different. Many people with COVID-19 reported a sudden loss of sense of smell and then a sudden and full return to a normal sense of smell in a week or two.

Interestingly, many of these people said their nose was clear, so smell loss cannot be attributed to a blocked nose. For others, smell loss was prolonged and several weeks later they still had no sense of smell. Any theory of anosmia in COVID-19 has to account for both of these patterns.

This sudden return of a normal sense of smell suggests an obstructive smell loss in which the aroma molecules cannot reach the receptors in the nose (the same type of loss one gets with a clothes peg on the nose).

Now that we have CT scans of the noses and sinuses of people with COVID-19 smell loss, we can see that the part of the nose that does the smelling, the olfactory cleft, is blocked with swollen soft tissue and mucus—known as a cleft syndrome. The rest of the nose and sinuses look normal and patients have no problem breathing through their nose.

We know that the way SARS-CoV-2 infects the body is by attaching to ACE2 receptors on the surface of cells that line the upper respiratory tract. A protein called TMPRSS2 then helps the virus invade the cell. Once inside the cell, the virus can replicate, triggering the immune system’s inflammatory response. This is the starting point for the havoc and destruction that this virus causes once in the body.

Initially, we thought that the virus might be infecting and destroying the olfactory neurons. These are the cells that transmit the signal from the aroma molecule in your nose to the area in the brain where these signals get interpreted as “smell”.

However, an international collaboration showed recently that the ACE2 proteins the virus needs to invade the cells were not found on the olfactory neurons. But they were found on cells called “sustentacular cells”, which support the olfactory neurons.

We expect that these support cells are likely to be the ones that are damaged by the virus, and the immune response would cause swelling of the area but leave the olfactory neurons intact. When the immune system has dealt with the virus, the swelling subsides and the aroma molecules have a clear route to their undamaged receptors and the sense of smell returns to normal.

So why does smell not return in some cases? This is more theoretical but follows from what we know about inflammation in other systems. Inflammation is the body’s response to damage and results in the release of chemicals that destroy the tissues involved.

When this inflammation is severe, other nearby cells start to be damaged or destroyed by this “splash damage”. We believe that accounts for the second stage, where the olfactory neurons are damaged.

Recovery of smell is much slower because the olfactory neurons need time to regenerate from the supply of stem cells within the lining of the nose. Initial recovery is often associated with distortion of the sense of smell known as parosmia, where things don’t smell like they used to. For many parosmics, for instance, the smell of coffee is often described as burnt, chemical, dirty and reminiscent of sewage.

Physiotherapy for the nose

Olfaction has been called the Cinderella of the senses because of its neglect by scientific research. But it has come to the forefront in this pandemic. The silver lining is that we will learn a lot about how viruses are involved in smell loss from this. But what hope is there for people with a loss of smell now?

The good news is that the olfactory neurons can regenerate. They’re regrowing in almost all of us, all of the time. We can harness that regeneration and guide it with “physiotherapy for the nose”: smell training.

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Why COVID-19 poses greater risks for men than women

While it’s not exactly clear why, the finding itself is certain: Men are suffering worse fates than women when it comes to COVID-19, regardless of geography or age. A variety of data from outbreaks across the world has established this fact, and experts like Johns Hopkins biologist Sabra Klein are trying to understand more.

Last month, Klein contributed to a viewpoint in the Journal of Critical Investigations calling for broader study of how biological sex differences between men and women affect outcomes with COVID-19—which she and colleagues believe should be a significant consideration for developing effective treatments and vaccines.

Earlier this week, Klein joined fellow Johns Hopkins University researchers in for a webinar exploring sex and gender dimensions of coronavirus. That talk was hosted by two research units Klein co-chairs, the Center for Women’s Health, Sex, and Gender and a specialized center under the National Institutes of Health that studies sex and age differences in influenza immunity.

The Hub reached out to Klein for more insights on what the scientific community knows so far about the different outcomes between men and women who contract COVID-19.

What is the evidence showing different outcomes for men and women who contract COVID-19?

Around the world, on every continent, we’re observing that men are significantly more likely to be hospitalized with severe COVID-19, and men are also significantly more likely to die from COVID-19. Some studies are showing the risks are twofold for men. Women are contracting the virus at same rates as men, but they are more likely to recover.

Because these findings are cutting across social and cultural boundaries, that strongly suggests the biological difference between males and females is contributing. That likely doesn’t tell the full story, however—social and lifestyle factors may certainly be influencing the trends, but we need to understand more.

What might be the possible explanations for the discrepancy?

I am hypothesizing that because women typically have a more rapid and robust immune response to viruses than men, this may be one factor contributing to female-biased protection against SARS-CoV-2, the virus that causes COVID-19. There are data from early outbreaks in Wuhan, China, for example, that show women clear the virus more quickly than men.

A sex difference in immune responses that control and clear SARS-CoV-2 suggests there there’s a difference between sexes affecting immunity. We have data for other viruses illustrating that sex differences in immunity are caused by genetic as well as hormonal differences between women and men. For example, in females, hormones such as estrogen and progesterone may be protective against the virus, and it’s possible testosterone does the opposite for men.

Scientists are also looking into the role of the ACE-2 receptor, which is found on the cells lining the lung and airways and is used by the SARS-CoV-2 virus to enter cells. From what we know about this receptor, from other conditions such as hypertension and kidney disease, ACE-2 expression is greater in males than in females. We also know from work in the kidneys that estrogen downregulates the expression of ACE-2,which could be a plausible biological explanation for reduced severity of the virus in women.

How is the factor of age overlapping with all of this?

It turns out the male bias severity is happening across a diverse range of ages. A very large JAMA study on cases in New York City, for example, looked at ages 30 through 90, and found that males were significantly more likely to be hospitalized or die regardless of age. Another study in The Lancet examining ages 20 upwards in European countries also shows this trend across ages. What we’re seeing in ages 60 years and older is that this is where we find the most severe outcomes of death.

You said that social and cultural factors may also be playing a role.

My colleague Rosemary Morgan, in international health, is studying this; she specializes in gender-associated factors that impact health and disease, including COVID-19. We know that biological differences are only part of the story of what make men and women different. It also has to do with our behavior and even the social and cultural norms that define our roles and responsibilities. For example, females may be more likely to be frontline workers, which could create more risks for exposure. In terms of lifestyle, men tend to be more likely to be smokers, which is a risk factor, and they’re less likely to seek out medical care when there’s a problem. And with COVID-19, if men are less likely to engage in behaviors like mask-wearing and hand-washing, that may increase risks.

There are also underlying conditions such as hypertension, heart disease, and diabetes, which men are statistically more likely to have and some of which can be attributed to lifestyle factors, that also amplify risks with COVID-19.

What are the implications of all of this for treatment and vaccines?

As my colleagues and I wrote in the Journal of Critical Investigations, we need to be ensuring a large prism of men and women take part in the numerous clinical trials for vaccines and we need to be able compare outcome data between men and women. Formulating vaccines should take into account the differences.

Vaccines are just one arm of how we’re addressing protections from COVID-19, however. Another is therapeutics. We have data from the past showing more adverse reactions for women than men with antiviral drugs, and it’s important to be aware of that. We don’t want the reaction to the drug to be worse than the condition it’s trying to treat.

What are you researching right now related to this issue?

I’m one of the partners working with Hopkins immunologist Arturo Casadevall on the promising treatment of convalescent plasma, which uses antibodies of recovered COVID-19 patients to boost immunity in others. Personally, that’s giving me lots of fabulous serological data to use to characterize differences between men and women in antibody responses to SARS-CoV-2.

My colleague Sean Leng at the School of Medicine and I have also won a grant to study differences in immune responses to the virus in older adults, the people who are most at risks of severe outcomes.

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Why I Decided to Become a Breast Milk Donor

My third daughter was born with a pre-existing medical condition that precluded our establishing a conventional breastfeeding relationship. Honestly, I was devastated. After successfully breastfeeding my two older daughters, each for 18 months, I was determined to make breastfeeding an option for my youngest child as well — no matter how deep in the distant future that might be. Cora was hospitalized for the first two weeks of her life, after having undergone open-heart surgery when she was just two days old. The myriad of scrub-clad doctors and nurses hovering over her around the clock caused me to question my entire role in Cora’s care. What was my job as mom to a newborn patient?

In the end, I survived what could have been a disastrous newborn period with a wildly important job: I became a breast milk donor. 

The moment my milk came in, I knew I wouldn’t let my liquid gold go to waste. “Breast milk has well-recognized nutritional benefits for infants,” pediatrician Dr. Claudia M. Gold told SheKnows. “It contains antibodies and other substances that help babies fight infections. For mothers, breastfeeding releases the hormone oxytocin, which produces feelings of contentment and helps the uterus return to pre-pregnancy size,” she explained. Understanding this mutually beneficial relationship was key in my decision to share the proverbial wealth. Before Cora’s first surgery, the hospital’s lactation consultant helped me to hand-express colostrum from each of my swollen breasts which — when swabbed directly into the baby’s mouth — was key in colonizing her gut with good bacteria prior to surgery. And then I made fast friends with a hospital-grade breast pump. 

“The mothers who do tend to donate are overproducers,” Kim Barbas, the Director of Lactation Support at Boston Children’s Hospital, told SheKnows. “They have all of this milk, from hours and hours of pumping for their baby, and they don’t want to see it discarded,” she explained of a driving factor in mother’s choosing to become breast milk donors. And then there are practical reasons — chief among them lack of freezer space — that make becoming a donor a logical choice. In my case, I fully intended to put my ounces upon ounces of pumped milk to use feeding my own infant. It was, at the time, the easiest (and most practical) way for me to be an active participant in Cora’s “team;” 8-10 times a day, while Cora remained in the hospital, I pumped at her bedside. Of all the jobs that needed to be done, this was the single one only I could do. And so I pumped, for what felt like hours upon end, dreaming of nourishing my child once she was on the road to recovery.

Today, donor milk is a standard of care at many hospitals — including Boston Children’s Hospital — even in the cardiac unit (where my daughter was a patient as a newborn). “We can keep babies exclusively human-milk fed until mom’s milk is available,” Barbas explains of the rise in donor milk use among at-risk populations. The practice, called “bridging,” allows everyone space to get acclimated to their respective “new normal”; by the time the baby is ready to eat again, post-op, mom’s milk is ready and she likely has a good supply. Again, the benefits are two-fold: “First, we’re realizing that these kids eat better post-op if they suckled on something pre-op,” Barbas explains. “And if that [child’s] mom turns around and has extra milk, she will often donate to continue that cycle,” said Barbas of a practice that benefits all who participate. 

Once we got home from the hospital, my freezer drawer filled at an alarming rate — and then Cora was diagnosed with a cow’s milk protein intolerance rendering hundreds of ounces of frozen breastmilk useless to her (as my diet was full of dairy). A quick Google search revealed that the Mothers’ Milk Bank Northeast, in Newton Upper Falls (just two hours from my home in western Massachusetts) was not yet accepting donor milk. The Mothers’ Milk Bank Austin (yes, Texas!) was accepting donor milk, and the staff there helped me navigate the three-step application process: I filled out a series of informational forms; I completed a ten-minute phone screening; and I complied with a simple blood test (for which the organization paid).

Within three weeks, I was approved as a donor. In a matter of about a month, I sent 234 ounces of breastmilk to Austin via FedEx (and dry ice). In the same amount of time, I eliminated all traces of cow’s milk from my diet leaving me with a ready milk supply to feed my growing baby. Looking back, it was a win-win situation: becoming a donor allowed me to remain an integral part of my own child’s care; pay it forward to another mother/child in need; and maintain a healthy milk supply to make breastfeeding an option for me and Cora going forward. Not to mention the modicum of control it offered me during a time when my life felt like it was spiraling out of control. 

“You are the only one who can make milk that is ideally suited to your baby,” Barbas reminds the mothers she meets, for many of whom pumping is their life-line to that baby. For me, becoming a breastmilk donor was a way of normalizing my maternal experience and paying it forward. It’s what Barbas calls a new mother’s “superpower” which, looking back, I’m so thankful to have shared. 

Want more honest breastfeeding stories? Celebrity moms get real about breastfeeding, pumping and more, here.

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