Showing posts with label need. Show all posts
Showing posts with label need. Show all posts

Need a Weekly Meal Planner a Grocery List or Price Books We Have 36 of ‘em

Wednesday, May 21, 2014

As with war, politics, and solving a Scooby Doo mystery, when it comes to saving cash and eating well, nothing is more important than having a plan. Grocery lists keep you from blowing dough on extraneous stuff. Price books give you the best possible food costs. Menu planners ensure you’re not scrambling to put dinner on the table, thus preventing dangerous bouts of crazy.

My own time-tested system combines a half-baked price book, hastily scrawled grocery lists, and yelling, “HON?! What are you in the mood for?” It works for now, but I’m thinking of going the pen-and-paper route. It’s working for Leigh, after all.

Fortunately, there are gazillions of downloadable menu planners, grocery lists, and price books all over the web. Unfortunately, many aren’t free, and involve some kind of weird sign-up or registration. Unless it’s for health insurance or Idol voting (Bowersox 4-evs), I hate doing that.

So, for your organizing pleasure, here are 36 free templates that’ll get you cooking. To know:
  • There are no memberships or sign-ups required.
  • All files are printable images, PDFs, or Excel spreadsheets.
  • To make sure the sites were kosher, I downloaded/opened at least one form from each page. My computer has not virusized yet. (KNOCK ON WOOD.) Still, use at your own risk.
  • Again: free.
If you’re craving more than a basic Word document, starred (*) entries go beyond the usual cells and tables. Their artsy graphic designs are Etsy worthy, and will look particularly cute hanging on your fridge.

Readers, if you know of any good templates/spreadsheets/whatever I missed, add ‘em in the comment section. Prettified ones will receive extra bonus points. (Meaning: a quiet “yay” in my small Brooklyn apartment.)

MULTIPLE RESOURCES
These websites include many different kinds of templates.

Better Budgeting
Basic weekly menu planner and weekly dinner planner, along with a grocery list organized by aisle.

Free Printable Grocery List
Dozens of grocery lists and menu planners, both blank and with pre-formatted checklists. Some have cute (but minimal) designs. Click on the sidebar and start printin’.

I’m an Organizing Junkie
Grocery list and weekly menu planner/grocery list combo. Formatted in boxes. A twist!

Keep and Share
Nice compilation of grocery lists for diet restrictions, including gluten-free, kosher, diabetic, lactose-free. Includes a pair of massive two-pagers, as well.

Mom’s Budget
Weekly and monthly meal planners, price logs, pantry inventories, and grocery lists in blue, green, orange, pink, and purple.

Money Saving Mom
Fourteen free downloads, including weekly, bi-weekly, and monthly menu planners as well as a master prep, ingredient, and shopping lists.


COMBINATIONS
Each of these single documents will do double-duty as say, a menu planner AND grocery list.

*A Feathered Nest
Menu planner/grocery list combo that’s super cute without being twee.

About.com
Weekly menu planner and shopping list.

*Carina Gardner
Anthropologie-esque weekly menu planner with a grocery list on the bottom. Nice! (Its the one pictured at the top.)

*Design Sponge
A weekly menu planner/grocery list combo, as well as blank and checklist-style grocery lists. Cute!

Organized Home
Weekly menu planner and shopping list

*The Project Girl
Menu planner and shopping list, with the best design out of everything here. Very pretty!

Saving Your Cents
Weekly menu planner and shopping list. Simple and clean. Use #1. (The others are already on this list.)


PRICE BOOKS
Excel documents unless otherwise noted.

Cheap Cooking
You have to do a little deleting here, but it should work otherwise.

It’s Your Money
A larger file requiring unzipping.

No Credit Needed
Uncomplicated and easy to figure out. My favorite of these options.

Organized Home
This one’s not an Excel spreadsheet. It’s a fill-in-the-blank-with-your-own-pen-style price book.


MENU PLANNERS

Busy Bee Lifestyle
Weekly planner with separate columns for kids and adults. With a picture of a bee! (Note: I like bees.)

*Disney Family Fun
Dinner planner only, but with a cute, kid-oriented design.

*From the Kitchen of…
Super fun weekly planner. Be aware that it’s a big file, and has to be unzipped. I don’t know why, but it reminds me a little of a Lynda Barry cartoon.

Home Life Weekly
Rainbow colored weekly planner.

The Home School Mom
Has one with a weekly activity planner on the side, and one without. Pretty basic.

Main Street Mom
Super, super basic design. But effective.

Meal Planning Mommies
Weekly plan with “I’m a meal planning mommy!” written across the top. Helpful if you forget who you are, not helpful if youre male.

Organized Home
Weekly menu planner made especially for notebooks.

*Petit Elefant
This one involves some re-sizing, but has a totally cute format and design.

Unclutterer
Available in spreadsheet or PDF form. Clean and efficient.

Vertex 42
Basic weekly, bi-weekly, and monthly menu planners in both portrait and landscape print styles.


GROCERY LISTS

Excel Template
Three printable spreadsheets of varying sizes, for general-to-specific shopping.

Mom Ready
Simple and straightforward checklist for your weekly trip.

Painted Gold
Simple blank list organized by department.

Pike’s Pickles
PDF files with both a blank list and formatted checklist.

Split Coast Stampers
Another checklist-style Excel spreadsheet. Also in PDF format if you scroll down a little further

Squawkfox
Landscape-style one-page checklist with many attractive boxes. Pretty thorough.

The Ultimatest Grocery List
Huge single-page checklist, with a massive bonus list for vegetarians! Maybe the best option if you’re looking for this kind of thing.

Vertex 42
Blank template organized by category. Handy.

Readers, whatchoo got? The comments are open!

~~~
If you like this article, you might also enjoy:
  • Cheap Healthy Good’s Ultimate Guide to Kitchen Equipment
  • Information Central: 32 Free Food Charts, Checklists, and Wallet-Sized Guides
  • Pantry of the Gods
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You Must Need To Know About Cancer

Tuesday, April 15, 2014

You Must Need To Know About Cancer

Cancer has affected a lot of population in this world. They can be of numerous different kinds. In the recent days, with the immense progression of health science and continuous studies conducted on this health issues, some kind of cancerous disease treatment has been competently discovered and it has become a relief for men and women, but when cancer is noticed in the early phases it is easy to save life of a person, the remedy can prove to be the most effective. Regrettably, in most cases, the symptoms of the infection emerge at a very sophisticated stage which can be said has very late to treat and people can die when the infection appears to have disperse to other part of body. The oncologists identify and work on treating cancer problem, and on the cornerstone of that, they recommend the most perfect and apt remedy productive for the patient. With these different treatment choices, the disease will not be completely healed, but the disperse of the infection can be prevented and we can avoid the death of precious people in our life.

Different Forms of Cancers: 
There are distinct kinds of cancers and many of them are treatable. Although, among some of the most common types of cancers, breast cancer is one of them and many women are prone to this diseases. This cancer can furthermore be afresh noticed in several phases, and founded on the status the doctor determines the perfect Breast cancerous disease treatment. In some cases, the cancerous disease cells are discovered to be rather sensitive to the hormones and keep on multiplying, and in such a case, the medical practitioner works out a distinct kind of treatment that might verify to be productive and reduce the cancer tumor. 

Surgery And Chemotherapy: 
Most women proceed for surgery as part of breast cancer disease treatment generally known as mastectomy, whereby it is believed to absolutely cure the cancerous disease but women have to get rid of breast. On the other hand, the medical practitioners furthermore often suggest going for chemotreatment or hormone treatment largely founded on the stage of the cancerous disease, as well it also help in preserving health. Emission is furthermore advised to be an effective form of remedy option by means of which the persevering can get respite from the condition. Women health are being affected by cancer day by day and they need to address this problem at earliest.

Getting A Second Opinion:
If you happen to proceed through breast cancer, first step will be to contact a medical profession on your part to consult regarding the perfect breast cancerous disease treatments that are available and productive for you. Apart from that, if you want, you can furthermore go for other choices of treatment for cancer. It is always better to consult more than one doctor. There is not anything to be worried about, because this pattern of cancer can be cured, and you can also be able to keep it in control and live a long life without any worries and stress and enjoy a life with family. Make certain that you do not hold up in getting the right remedy for treatment, as wrong method to cure cancer can make it worse. Make proper investigation about doctors and facilities before you enter them.
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I Dont Need a Better Style of Eating What I need is a Style of Not Eating

Friday, April 4, 2014

In his PDF book, "Eat Stop Eat" Brad Pilon makes the following statement:

"While you may find this guideline overly simplistic at first, the truth is there is NO normal or perfect way to eat for weight loss. This is the great fallacy behind most diet books. The fact is, and always will be, it is calorie restriction that causes weight loss."

I am amazed that this statement is so amazing to me. I hope you are getting the double whammy that is in that statement. It does not say you have to count calories, he says you have to restrict them... in other words: eat less. I know. I know. Whats so unusual about that? Everybody knows that! If you want to lose weight you have to eat less. Point made. Point taken. Lose the food, lose the weight.

I have spent so much time trying to figure out what to eat to lose weight that this simple truth somehow whizzed right over my head. Brads statement brought it down in front of my eyes. I dont like to think of myself as "simple minded" but, darn, maybe I am. I worked hard to find a style of eating that would help me lose weight and what I really needed was a style of not eating. Oh my.

The "double" part is that eating "low carb" or "low fat" or "high protein" is not the point. The point is less food. What my mother used to say. All this time, Ive been avoiding it, but it turns out she was right. It is the one thing that works. Just eat smaller portions. It is not even important how much smaller, just smaller than what youve been eating. You dont need "guidelines" from someone else. Just make your portions smaller than what you usually eat. Start where you are and trim a little off the contents of the plate. Drink plenty of water, too.

Surprise. You dont need to fill up all the spaces in your stomach. Once it becomes a habit, it will not seem unusual or strange to you.

I think the thing I feared was not having food to eat. Or eating less. Or being deprived. Somehow. I know... I feared "hunger." Is that possible? Yes, I think it is. I feared being hungry. I dont know why... and Im not even interested in finding out why. Im just glad that Ive already discovered that "hunger" is nothing to fear!! That is the major lesson I learned from fasting. It is not the overpowering, all consuming, scary thing that I seemed to think it was. Hunger. Wow.  Starvation? Yes, that should be feared and worked against. But, simple ordinary every day hunger? What is there to fear in that. It is almost silly. Funny.

I worked so hard to avoid the fact of simply eating less that I went round in circles over and over again. I did not think I could control the quantity of food that I eat in a session, so avoided attempting something at which I believed I would fail. I believed I could not simply eat smaller portions and be satisfied. I was used to dealing with the eating machine which is the antithesis of portion control. The eating machine is portion out of control.

But Ive been fasting for 24 hour periods for a while now so I know I can do it and love it. Not that every time I try it, it is successful. Just today I was going to do a spur of the moment fast, but I petered out later and ate. But ESE is flexible and I know I can do it tomorrow and if I prepare for it, I will do it.

Fasting has shown me there is a different way to approach food and eating. You do know those are two different things. Food. And eating. Food is simply a substance. Eating is an act that is performed. If you want to lose weight, you have to eat less.



The other day I had gotten out one of my mothers old dessert dishes (picture above). I dont remember what for. But as I walked across the floor I stopped and looked at the size of this tiny dish that had the name "dessert dish." It fit in the palm of my hand. I thought about the gargantuan bowls of ice cream I used to eat when I was a kid. I remember my Dad teasing that I would "make a good step mother" because I served everyone large portions. They never used them. And here in my hand was this tiny little cut glass dessert dish. If every dessert I had would fit in that small dish, I would probably be thin.

It is almost as if the size of the bowl creates the size of the person.

I was recently watching episodes of the BBC program call "Supersize vs. Super Skinny" where one humongous person and one tiny person swapped meals for a certain amount of time in what they call their feeding clinic. They have to sit across the table from one another, after preparing a meal from a day in their own food diary, and then when they sit down to eat, they trade meals. The big person eats the small persons meal and the small person eats the big persons meal for a few days in a row. 

They are both flabbergasted at what the other one eats and they have conversations about this experiment as they do it. Often the big person quickly eats the little persons meal and then sits and watches the tiny person struggle to eat their gigantic portions of food which they almost never finish. Each one feels responsible for the other ones discomfort. When they see how the other person has to struggle to do what they do on a regular basis, they begin to realize what they have been doing to themselves. The big person realizes just how unrealistically large their portions are. The thin person realizes that the tiny meals they eat are not enough for an adult to live on.

The supersize person gets a trip to America that the skinny person does not get. They go to visit a person who can be as much as a couple hundred pounds larger than they are for the purpose of seeing, for themselves, what the effects of continuing to pack on the pounds does to a human body. The people they visit often have many ailments and they often are not doing anything to curb their appetites and lose weight, although not all of them are like that. They suffer from immobility, pain, seeping legs, high blood pressure, diabetes, sleep apnea and all kinds of weight related problems. They often need help, just to go to the bathroom. This is the "wake up" call for the English participant. They get to be up close and personal with what it really means to continue doing what they are doing. It works. They get it.
 
From having watched many episodes this feeding clinic exercise seems to help the overly slim or super skinny person get in touch with their hunger, which for whatever reason, got turned off sometime in the past. When they return to the show about 8 weeks later they look more normal sized and not so skinny, even though they worked hard, ate lots, and put on about 3 pounds they look like theyve put on 15 or 20. The fat person also looks different. They often lose quite a bit of weight and feel very good about themselves and they look good too.  But... a year later the formerly super skinny person now looks like a normal human being, the fat person looks like a smaller fat person. Sometimes the "one year later" show has three of the participants back and very often it is two of the ormed super skinnies, and one of the somewhat smaller fat people. Makes me wonder if the fatties got lost somewhere, or put their weight back on again, so they are not on the show. They never say anything like that. You just never see them again.

All of these prove that we have perceptions about food and eating that show up as body size. Sometimes they are easy to change and sometimes they are not. I find that the twice weekly fasting has taught me some things about me that I did not know before. For one thing, I can now skip a meal and not have a cow. In fact, it really is rather simple and very easy to skip a meal, or two, or three in a row, and not die. It does not make me sick. I dont get light headed. I dont feel faint. I dont get tired. In fact, just the opposite happens. I feel lighter on my feet, awake and alert and, dare I say it: happy. I still know where my next meal is coming from. Im not starving. I dont go into starvation mode and my metabolism is not harmed in any way. Studies on fasting prove this is true. (You can read about it in ESE.)

You wont go into starvation mode until about 72 hours of not eating. The body also knows how to maintain your metabolism. If it is not getting food to run on, it uses the storage of fat. A fat belly really is like a pantry for the body to feed itself, but if you keep eating continually, it never gets the opportunity to use up the one year supply of food on your back. This makes it very hard to lose weight and very easy to pack on more pounds. It is not the style of eating that needs to be changed. It is the style of not eating!!

Short, 24-hour fasts for one, two, or even three days in a week gives your body the chance to go into fat burning mode. In between you can eat what you normally eat but in a responsible manner. Brad suggests that you eat more fruit and vegetables, which will replace a lot of processed foods. If you are conscious enough to be eating more fruit and veggies you probably are already not eating as much sugar and starchy foods. Brad says that the key to making this work for you is "self control." You cannot eat like a sumo wrestler and expect to look like a super model. On the days you eat, eat sensibly. Eat enough. And then move on.

So the new thing for me in this is the dessert dish. Now I know what size a dessert should be for a normal sized human being. With the combination of 24 hour fasts, and in between, sensible eating, I should be able to speed up the weight loss thingy. 

Wonder what people will think when I bring my dessert dish with me as a reminder for myself that I can have dessert as long as it fits in my dessert dish? I picture holding it up and saying (more to myself than to anyone else), "As long as it fits in here, I can eat it. If it does not fit in here, then I dont eat it."

I guess Ill find out.

Be back soon,

Marcia



 



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Seven Things You Need to Know About 2011 Health Care Spending

Friday, February 28, 2014

If youre interested in learning more about the latest U.S. health care cost trends, everything you need to know is in this article in the January 2013 issue of Health Affairs.

Or you could rely on the Disease Management Care Blog to point out the articles 7 most important points.  Use them to impress your colleagues and stymie your foes:

1) The data only go up to 2011; well have to wait another year before well know about 2012.

2) 2011 health care spending, as a percent of gross domestic product, remained at 17.9%.  The overall economy was slow and that took its toll on the health care sector.

3) That comes out to $2.7 trillion or $8,680 in health care spending per person.

4) While the percent remained stable, the economy experienced modest growth in 2011. The health care sector, thanks to an overall growth rate of 3.9%, kept pace. Prices for services grew less than the demand for services.  As we grow older, demand is likely to grow.

5) Medicare and private insurance grew faster than the economy, which was offset by Medicaid cost cutting by the states.

6) If the past is any guide, when the U. S. economy rebounds, health care spending is likely to accelerate and resume its march toward becoming 20% of GDP.

7) The relative stabilization of 2011 health care costs is independent of the Affordable Care Act.  Many of its important provisions (such as the mandate) dont kick in until 2014.
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Why You Dont Need to Worry About Saturated Fat

Sunday, February 23, 2014

Ohh saturated fat, where do I even begin?  Youve been vilified for decades by the likes of the USDA, the American Heart Association, and the Academy of Nutrition and Dietetics (formerly the American Dietetic Association... new name, same haters).  Foods high in saturated fat will clog our arteries and kill us, they say.  In fact, in the newest version of the Dietary Guidelines for Americans, the USDA has taken the war on saturated fats to a new level with the creation of a new category known as "SoFAS".  While that may look like it was typed by a 14-year-old girl on Twitter, it is in fact an acronym for "solid fats and added sugars", and the guidelines recommend we avoid them like the plague.  With the creation of this new category, traditional sources of saturated fat like grass-fed butter and coconut oil are now considered equal to processed junk like Crisco and candy corn.  Seriously.  This is what our government is telling us.

But why?  Why do they think saturated fat is going to clog our arteries and kill us?  There are three parts to this hypothesis, and they go like this...
  1. Saturated fat in the diet increases the cholesterol levels in your blood
  2. High cholesterol in the blood is associated with heart disease
  3. So, high saturated fat intake leads to heart disease
Sounds good right?  Not quite.  This is the circa-1990, total-cholesterol-is-everything, eat-more-low-fat-cookies-and-throw-out-the-yolk theory of heart disease.  I hate that theory of heart disease.  In this article, Ill attempt to disprove the first and third parts of this:  whether or not saturated fat leads to high cholesterol and/or heart disease.  Ill ignore the second part, because its a little off-topic and it becomes irrelevant with the collapse of the first part.  Plus Ive covered the cholesterol thing in the past (1, 2, 3).  Here we go...


Does eating saturated fat give you high cholesterol?
Most clinical trials are in agreement on this one.  When participants are asked to eat more saturated fat, their cholesterol typically goes up.  But these studies have one key limitation:  their short duration.  The typical clinical trial showing the saturated fat and blood cholesterol connection is only 2-13 weeks long (4).  What happens in the long-term?  While we dont have any controlled, clinical trials of this length, there has been plenty of prospective, observational research conducted.  And even though research of this type usually takes a backseat to the more controlled trials, it comes in particularly handy here.  Dr. Stephen Guyenet recently conducted a review of this type of research on his blog, Whole Health Source, citing eight such prospective studies (5).  Of the eight, only one showed a connection between saturated fat intake and blood cholesterol, and that one connection was a weak one.  In other words, people in the real world who eat a high saturated fat diet generally have the same cholesterol levels as those who eat a low saturated fat diet.  This is clearly at odds with the clinical evidence showing that saturated fat causes a spike in blood cholesterol.

The likely truth is that saturated fat intake does increase blood cholesterol in the short term, but that this effect fades over time.  Long term research indicates a minor increase at best, and quite possibly no relationship at all.  This is consistent with what has been observed in several other animal species as well; why would humans be any different (6)?  Yet the idea that saturated fat increases cholesterol is so engrained in the scientific community and the media that youre likely to get some weird looks at the very suggestion that its not true.  I know I have.  But that doesnt make me wrong.  Im sticking to my guns.  I do believe, however, that even though saturated fat doesnt ultimately affect total cholesterol, it alters the balance of HDL and LDL, as well as modulates LDL particle size.  But thats more detail than I care to go into right now.  Perhaps another time.

Does eating saturated fat increase your risk for heart disease?
Proponents of the aforementioned hypothesis will tell you that since saturated fat increases blood cholesterol, and high cholesterol leads to heart disease, then saturated fat obviously leads to heart disease.  As weve seen already, the first part of that statement isnt true.  And if youve read my past articles on cholesterol, then you know that the second part isnt quite right either.  So that brings us to the third and final part (which ends up being sort of redundant since it crumbles by default along with the first two, but I will ask the question anyway; perhaps youre not fully convinced).  Does saturated fat consumption increase your risk for heart disease?

No it does not.  As my proof, I offer you a pair of well-done meta-analyses.  A meta-analysis, for those of you who dont know, is a type of scientific study.  Essentially, it is a study of studies.  In other words, it looks at the data from several existing papers and pools them together to find the bigger picture.  It is significantly more informative than any single study because it takes an (ideally) unbiased look at the data as a whole.  My first meta-analysis was performed by Dr. Ronald Krauss and company.  They took a look at 21 prospective epidemiological studies that had looked at this saturated fat and heart disease thing before (7).  Out of the 347,747 subjects in all 21 studies combined, 11,006 of them developed coronary heart disease (CHD) or stroke.  And I quote, "Intake of saturated fat was not associated with an increased risk of CHD, stroke, or CVD (cardiovascular disease)."  I think that speaks for itself.  On to my second meta-analysis.  This one, which I think Ive mentioned like ten times on this blog, was done by Dr. Dariush Mozaffarian and colleagues at Harvard (8).  Although their study specifically targeted red meat and its relation to heart disease, stroke, and diabetes, it also has key implications for saturated fat consumption.  Out of the 20 studies they chose to look at, consisting of 1,218,380 participants, they found a very significant link between processed red meats and chronic disease.  There was no link, however, between unprocessed red meat and chronic disease, and this was irrespective of saturated fat content of the meat.  So, to clarify my point, processed meats like the low-in-fat deli turkey were associated with higher rates of heart disease, stroke, and diabetes.  But unprocessed meats like a not-low-in-fat rib-eye steak showed no connection. So then, the summation of a combined 41 studies, and 1,566,127 participants (FYI: thats more than the population of eleven U.S. states), shows no connection between saturated fat intake and heart disease. 

Oh, and theres another piece of evidence that Ive written about in the past.  Its a completely observational look at saturated fat and heart disease in countries across Europe (9).  It turns out, the seven European countries that eat the most saturated fat all have lower rates of heart disease than all seven of the countries that eat the least saturated fat.  Sounds ass-backwards right?  But its real.  Check it out.

Of course, no blog post of mine would ever be complete without the evolutionary biology view.  The most up-to-date research on the diets of our hunter-gatherer ancestors, which constituted our diet as humans for over 99% of our existence, shows that we consumed 10-15% of our calories from saturated fat (10).  Anything outside of that range would be considered to be the exception rather than the rule, and is likely to be discordant with the human genome.  In contrast, the current USDA recommendations say to keep our intake of saturated fat below 10% of total calories.  So Im not saying you should base your diet on lard, but should you make a conscious effort to avoid saturated fat?  Absolutely not.  Incidentally, if you choose to eat real foods, like meat, fish, eggs, fruits, veggies, dairy, and potatoes, youll likely end up with a saturated fat intake right around that 10-15% range.


And after all that, I must admit... I dont really like discussing saturated fat like this, as if its all the same stuff.  There are all different kinds:  youve got beef fat, grass-fed beef fat, pork fat, chicken fat, milk fat, grass-fed milk fat, egg fat, coconut fat... hell, theres even saturated fat in vegetables, albeit in very small amounts.  There are at least eight important saturated fatty acids found in food, and each of these food sources offers them in a varying proportions.  Its almost useless, in my opinion, to assess saturated fat as a whole like I did in this article; Id much rather look at one type at a time in a food-based fashion.  We eat foods.  We dont eat all saturated fats equally, and we dont eat individual fatty acids either.  It only makes sense to study them the way we eat them.  Next time on the blog, Ill do exactly that and focus on dairy fat.  I know youre looking for a reason to spoon-feed yourself butter, so stay tuned!
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Electronic Health Record EHR Robots and The Need for a Legal Framework

Tuesday, February 11, 2014

Hal of 2001: A Space Odyssey
The Economists recent scrutiny of battlefield and automotive robotics prompted the Disease Management Care Blog to ponder the parallels of "robot-like" health care. 

Sounds too weird, you say?  Alarmist?  Silly?  Read on.

Consider the following scenario:

After checking in with her primary care provider, a check of Mrs. Smiths (not her real name) diabetes revealed her blood sugar was not in the generally recommended A1c range of 6.5-7% (see page 16).  She was free of low blood sugar spells and was otherwise healthy. The electronic health record (EHR) decision support protocols (like "Diabetes Wizard") prompted the care manager to OK a standard increase in Mrs. Smiths insulin dose ("Share the Care"). This was not only consistent with good clinical practice, the decision promised a pay-for-performance payday for the docs employer and fewer costly complications for the health insurer.
 
Several days later, her fatal car accident was ascribed to low blood sugar.  It turns out that the science of blood sugar control is still evolving, because tight diabetes control isnt necessary associated with better outcomes. In response, the Smith family lawyered-up.

The Economist article asks about the legal dilemmas inherent in robotic decision logic.  Can battlefield drones be adequately programmed to protect civilians?  Can driverless cars intentionally run over a dog if it means avoiding a child? Short of banning these automatons entirely, its obvious, says The Economist, that were going to have to develop a legal framework to deal with them: 

"...laws are needed to determine whether the designer, the programmer, the manufacturer or the operator is at fault if an autonomous drone strike goes wrong or a driverless car has an accident."

The DMCB agrees and suggests that this sensible recommendation be extended to the health care arena. EHR clinical programming may only imperfectly reconcile maximum near-term safety with longer term outcomes and fail to discern the subtleties that favor one treatment over another.

While white-coated plastic and metal cybertrons arent taking care of diabetic Mrs. Smiths (yet), machine logic reminiscent of "Hal 9000" of 2001: A Space Odyssey already is. Instead of an unblinking red orb, there are on-screen decision-support icons. Instead of a disembodied voice, there are clinical pathways (for example, see page 8). And instead of having control over vacuum locks that exit to space, these computer entities are using logic trees to direct, prompt and recommend that doctors and their team-nurses to chose treatment "A" over treatment "B."  If you think that the DMCB is being alarmist, consider that decision support, at last count, is involved in 17% of all outpatient visits in the U.S.  Thats a lot of legal exposure.

Thats why reasonable laws are needed here too, since its unclear how physicians, care managers, decision support programmers, EHR manufacturers (even with their notorious hold harmless clauses), physician clinics and health insurers would share in the culpability for allegedly awry decision-making.  Since, in the current U.S. tort system, all could be named in a suit, the risk is arguably intolerable. Just ask any physician, whose dread of being sued has already resulted in billions of unnecessary costs. 

Allowing that dysfunction to creep into computer-based clinical decision will increase costs there too, add uncertainty and slow adoption. 

The Economist has it right.

Image from Wikipedia
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5 Foods healthy does not need to be consumed

5 Foods healthy does not need to be consumed - Nutrition experts always recommend that we eat foods high in nutrients. But apparently there are foods that have frills word healthy which actually does not need to be enjoyed. What is it? Listen more, as reported by Live Science below.

Peanut butter without the fat

You know, actually fat peanut butter actually contains nutrients your body needs. So eat peanut butter without the fat precisely the same by removing nutrients from the origin.

Vitamin drinks

Now it is prevalent products were given drinking water containing flavorings and she says vitamin is beneficial for the body. When in fact these drinks actually contain a lot of sugar which is not healthy. It is better to get vitamins from foods such as fresh fruits and vegetables.

Energy bar

Biscuits, snack, or energy foods have a high reputation because it is known to stimulate the growth of muscle to burn fat and lose weight. In fact, energy bars also contain high sugar. If you want a healthy snack, better enjoy the fruits alone.

Multi grain foods

Many people are fooled by the frills multi or different kinds of wheat seeds contained in a product, such as bread, crackers, and cereal. Though different from the multi-grain whole wheat. If whole grains are associated with numerous health benefits, multi-grain just does not mean anything.

Baked chips

Just because there is no word fried in product chips or crackers crispy, does not mean these foods include healthy. Because of salt, oil, and it is high in cholesterol and can still give risk to health.

That food with frills healthy that it does not need to be consumed. You also should understand food labels properly before purchasing.
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Saturday Throwback 100 Thanksgiving Recipes and Links the Only Turkey Day Post Youll Ever Need

Saturday, February 8, 2014

 Every Saturday, we post an article from the CHG archives. This originally appeared in November 2008, and was updated in 2009.

Thanksgiving is upon us, and I don’t know about you, but I’ve read approximately 40,000,000 blog posts and magazine articles dealing with next Thursdays dinner. And that’s just this morning.

Yeah, Turkey Day can overwhelming, and with so many experts on the subject, sometimes it’s difficult to find information on any single aspect the holiday. And that’s where CHG comes in. What follows are more than 100 links, organized by the following subjects:
  • Appetizers
  • Turkey
  • Sides
  • Stuffing
  • Pies & Desserts
  • Drinks
  • General Menu Planning
  • Affordable Thanksgivings
  • Healthy Thanksgivings
  • Vegetarian Thanksgivings
  • Seating & Tablesetting
  • Troubleshooting
  • Leftovers
  • CHG Recipes
With the exception of the CHG section, each link contains several recipes and/or tips about preparing for the day. Sources include All Recipes, Being Frugal, Bon Appetit, Chow, Cooking Light, Culinate, Epicurious, Fine Cooking, Food and Wine, Food Network, Frugal Upstate, The Kitchn, Martha Stewart/Everyday Food, Money Saving Mom, O Magazine, Real Simple, Saveur, Serious Eats, and Squawkfox.

(It should be noted that Cooks Illustrated has a gloriously extensive Thanksgiving guide, as well, but it’s a subscription site, so you can’t get to it without being a member. HOWEVER, they’re offering a 14-day free trial membership for prospective customers. Check out the sign-up sheet here.)

Readers, if you have any ideas, I’d love to see them in the comments section. In the meantime, hope this helps and happy Thanksgiving!

APPETIZERS

Food Network: Thanksgiving Appetizers
Tips, tricks, techniques, and 100 appetizer recipes.

The Kitchn: Holiday Appetizers from The Kitchn
“Are you thinking about your Thanksgiving meal yet? We are! Well be pulling together some of our favorite Thanksgiving and holiday recipes from the archives this week, and were starting with appetizers.”


TURKEY

All Recipes: How to Cook a Turkey

Bon Appetit: Best Turkeys Slideshow
“Salted, brined, stuffed, or simply roasted, any of these eighteen turkeys will make a perfect centerpiece for your Thanksgiving meal.”

Bon Appetit: Turkey Buying Guide
Including posts called At the Market, Home from the Market, Turkey Prep, In the Oven, and Out of the Oven.

Chow: How to Carve a Turkey with Mark Dommen (video)
“Hacking is for hacks.”

Cooking Light: All About Turkey

Cooking Light: Turkey School

Culinate: How to Brine and Roast a Turkey
“Whether your turkey this Thanksgiving season is small (8 pounds) or enormous (20 pounds), there are plenty of ways to take it from raw to succulent.”

Epicurious: Turkey 101
“Confused about natural versus organic? Wondering whether to try brining? Our complete guide demystifies the process to help you roast the perfect bird”

Fine Cooking: How to Cook a Turkey
“The essential Thanksgiving guide.”

Food Network: Turkey
Tips, tricks, techniques, and 100 turkey recipes.

Gourmet: Expert Advice - Let’s Talk Turkey
“Of all the dishes that make up the Thanksgiving feast, the big bird demands the most attention. But how best to achieve turkey perfection—golden-brown skin with moist, tender white and dark meat? We roasted our way through more than 40 turkeys and found a method that’s so free of fuss and gets results so delicious, we can’t quite believe it ourselves.”

Real Simple: How to Carve a Turkey

Real Simple: What You Need to Know Before Roasting a Turkey

Serious Eats: How to Read Turkey Labels

Serious Eats: Turkey Recipes

Serious Eats: Turkey Talk
Discussions with Ruth Reichl of Gourmet, Barbara Fairchild of Bon Appetit, and Christopher Kimball of Cooks Illustrated.


SIDES

All Recipes: Thanksgiving Side Dishes

Bon Appetit: Thanksgiving Potatoes Slideshow
“One of these easy, homey potato recipes is sure to earn a permanent spot on your holiday table.”

Bon Appetit: Thanksgiving Sides Slideshow
25 Thanksgiving sides.

Cooking Light: Lighten Up - Holiday Classics

Fine Cooking: Vegetable Sides

Food and Wine: Thanksgiving Vegetables
“15 Thanksgiving side dishes, like roasted vegetables with pine-nut pesto.”

Food Network: Thanksgiving Side Dishes
“Make your Thanksgiving feast memorable with spectacular side dishes. The hardest part about these recipes will be figuring out which ones to make.”

Martha Stewart: Thanksgiving Sides
“For many, the real star of a Thanksgiving dinner is the assemblage of side dishes, not the turkey. To help you put together a showstopping selection for your table, we’ve rounded up our favorites.”

Serious Eats: Side Dish Recipes


STUFFING

All Recipes: Get Stuffed
“Options for preparing flavorful and interesting stuffings are virtually endless. From the recipes below, try anything from a traditional style to a southern cornbread dressing. Add richly flavored meats, or get creative this holiday by incorporating fruits or herbs. Whatever your desire, youll find a recipe to satisfy any dressing or stuffing craving.”

Bon Appetit: Thanksgiving Stuffing Slideshow
15 stuffing recipes.

Fine Cooking: Stuffing and Dressing

Food Network: Thanksgiving Stuffing & Dressing
Tips, tricks, techniques, and 51 stuffing recipes.

The Kitchn: Recipe Roundup - Thanksgiving Stuffing
“According to a survey we took last year, stuffing is by far your favorite Thanksgiving side dish. But when it comes to what type of stuffing, theres a lot of variation out there: cornbread, herb, oyster, sausage, apple, chestnut... We put together a list of 14 recipes to get you started.”

Serious Eats: Store-Bought Stuffing Mix Showdown
‘After the jump, the results of the Serious Eats taste test of eight packaged stuffing mixes, along with some suggestions on jazzing up your store-bought stuffing.”

Serious Eats: Stuffing and Dressing Recipes


PIE & DESSERTS

All Recipes: Pies & Desserts
Millions of Turkey Day suggestions.

Bon Appetit: Top 20 Thanksgiving Desserts
“Pies, crisps, tarts, and cheesecake: luscious ways to finish the feast.”

Culinate: Pumpkin pies - Three recipes for Thanksgiving

Fine Cooking: Pies and Tarts

Food Network: Thanksgiving Desserts
100 Thanksgiving Dessert Recipes.

Gourmet: Twelve Thanksgiving Pies
‘No matter how much turkey you’ve eaten, there’s always room for at least a sliver of pie—and these delicious options may have you going back for seconds.”

The Kitchn: Best Pie Bakeoff
“Have you ever made a pie? We were intimidated by pies for a long time, but now theyre one of our favorite desserts. We hope to make some converts, discover new recipes, and find the truly best versions of classic pies.

Martha Stewart: Holiday Pies
“We’ve rounded up our favorite pies – both the tried-and-true holiday staples as well as some modern variations that, for us, have become classics in their own right.”

Real Simple: Four Foolproof Thanksgiving Pie Recipes

Serious Eats: Dessert Recipes


DRINKS

Bon Appetit: Red, White, and Relax
We have some practical advice about what to drink with Thanksgiving dinner: Serve a few crowd-pleasing American wines.

The Kitchn: Thanksgiving Wine

O Magazine: Cocktails, Anyone?
Steamy Passion. Pink Halo. Dark and Stormy. No, were not talking romance novels, but the glorious technicolor cocktail. In a flute or on the rocks. With a twist or with a shout. Bottoms up, darling.

Serious Eats: Thanksgiving Wine, a Guide for Hosts and Guests
“Every year, Im struck all over again by how completely stressed out people get about what wine they should pour to go with the turkey. It is worth mentioning at the outset that traditional Thanksgiving fare goes with pretty much everything—sparkling wines, rosés, whites, and even reds.”


GENERAL MENU PLANNING

All Recipes: Thanksgiving Menus
Includes Make-Ahead, Stress-Free, Traditional, Small-Scale, and Last-Minute Menus.

Bon Appetit: Top 20 Thanksgiving Menus
“Traditional, modern, big, small, or somewhere in between, theres a menu here for Turkey Day your way.” Including menus for: Country Style, Heritage Feast, Vegetarian Feast, A Little Bit Fancy, A Small Gathering, Healthy Thanksgiving, Southern Comforts, Great for a Crowd, A Make-it Buy-it, Green Party, The Weekenders, Small and Sophisticated, Italian-Infused, Big Thanksgiving, New American Feast, Quick Dinner, (Meat)less is More, The Smaller Thanksgiving, Pilgrims Progress, Crowd-Pleasing Turkey Day.

Cooking Light: Ultimate Holiday Cookbook

Culinate: Classic Thanksgiving - All the turkey-day basics
“Here’s our roundup of the classic Thanksgiving basics, by dish. Pick a few to try and assemble your own turkey-day menu.”

Epicurious: A First-Timer’s Feast
“An indispensable Thanksgiving guide for the novice, with recipes and tips even an expert will love.”

Epicurious: The Ultimate Thanksgiving Guide
“Make Turkey Day easy and stress-free with our delicious recipes and menus, entertaining tips from the pros, tools, and how-to videos.” Master page includes menus for: An Inexpensive Feast, Thanksgiving in an Hour, A Global Menu, plus options for large group, small group, formal, casual, traditional, modern, regional, global flavors, quick and easy, healthy, and vegetarian diners.

Food and Wine: Three Amazing Thanksgiving Menus
“Tina Ujlaki, F&W’s executive food editor, put together these three incredible web-exclusive menus. She created a classic menu (pumpkin soup, bread stuffing with sausage and a deep-dish apple pie), an elegant menu (sparkling punch, a gorgonzola terrine and a chocolate macadamia tart) and an easy ethnic menu with flavors from around the world. All of them center around a turkey, and include drinks, appetizers, soup, sides and desserts.”

Food and Wine: Ultimate Thanksgiving Guide
“With F&W’s amazing recipes, practical tips, festive menus and wine recommendations, this ultimate Thanksgiving guide is the perfect resource to help you welcome family and friends to the table this year.”

Food Network: Thanksgiving Menus
Classic Thanksgiving, Thanksgiving with a Twist, and Thanksgiving Made Easy.

Gourmet: Five All-American Thanksgiving Menus
Inspired by this country’s diverse culinary traditions, these classic Thanksgiving meals represent regions from New England to the West Coast, the North to the Deep South.

Martha Stewart: Thanksgiving Menus
Master page includes menus for: Easy Thanksgiving Dinner, Thanksgiving with Italian Flavors, An Effortless Thanksgiving, A Holiday Buffet for Everyone, Thanksgiving: An All-Day Affair, A Classic Thanksgiving Menu, No-Fuss Thanksgiving, Thanksgiving Made Easy, Thanksgiving 1-2-3, A Hill Country Thanksgiving, A Southern-Style Feast, A Down Home Thanksgiving.

Martha Stewart: Martha’s Ultimate Thanksgiving

O Magazine: Os All-Time Favorite Thanksgiving Menus
“Looking to do something a little different this Thanksgiving? Let us help! O turns to an all-star cast of chefs for their most delectable holiday menus.” Page includes: Thanksgiving Miracle, Colin Cowie’s Incredible Thanksgiving Feast, Gobble Gobble: A Light Thanksgiving Menu, Dinner for 20 With the Greatest of Ease, Duck! Here Comes Thanksgiving, The Party Season Starts Here, Holiday Recipe Kit.

Real Simple: 50+ Thanksgiving Recipes

Real Simple: The Best Thanksgiving Shortcuts
“Make these six tasty convenience products part of your holiday arsenal.”

Real Simple: Your Stress-Free Thanksgiving Menu
“These recipes cover all the bases, from turkey to pie (heres hoping you have room for it).”

Saveur: The Ultimate Thanksgiving Guide

Serious Eats: Thanksgiving Menus
Classic, Easy, and Healthy Thanksgiving Menus.


AFFORDABLE THANKSGIVINGS

Being Frugal: A Memorable, Yet Frugal, Thanksgiving
“I love hosting Thanksgiving dinner, but if I don’t watch it, the expenses quickly add up. Here are some tips for a frugal, relaxed, and memorable Thanksgiving.”

Epicurious: A Potluck Planner
“Giving or going to a Thanksgiving dinner? Youll give thanks for these tips from this pro.”

Money Saving Mom: Thanksgiving on a Budget
Erin from 5DollarDinners and I will be teaming up to share some of our favorite frugal Thanksgiving recipes. Whether youre an experienced cook or a novice in the kitchen, we hope that our recipes, tips, and photo tutorials will inspire you to pull off your own "Thanksgiving on a Budget.”


HEALTHY THANKSGIVINGS

All Recipes: Healthy Thanksgiving Recipes
“Thanksgiving dinner is all about feasting and family, but it doesnt have to weigh you down.”

Bon Appetit: A Healthy Thanksgiving Menu for 6

Epicurious: Thanksgiving Menus
Includes A Healthy Thanksgiving Menu, Light Thanksgiving for Four, Light Maryland Thanksgiving, and A Turkey-less Thanksgiving.

Serious Eats: Healthy Thanksgiving Menu

Squawkfox: Recipes - Healthy Thanksgiving Dinner Menu Ideas


VEGETARIAN THANKSGIVINGS

Bon Appetit: Vegetarian Thanksgiving for 8
“This delicious meat-less meal includes a cornucopia of side dishes and a spicy fruit crisp dessert.”

Cooking Light: Vegetarian Thanksgiving

Gourmet: A Vegetarian Thanksgiving
“With these rich and hearty meatless menus, you won’t even miss the big bird.”

Epicurious: Vegetarian Thanksgiving Menus
Includes Autumns Savory Vegetarian Supper For Eight, Harvests Home, The Vegetarians Dilemma, Vegetarian Thanksgiving Feast, Rustic French Vegetarian Thanksgiving, Vegetarian Mexican Buffet, Thanks For the Memory, Vegetarian Mediterranean Thanksgiving Menu, A Peaceable Feast, and Green Party. (Some may be repeated in the Gourmet & Bon Appetit posts.)


SEATING & TABLESETTING

Epicurious: A Feast for the Eyes
“Easy do-it-yourself centerpieces, place cards, and napkin holders to complete your Thanksgiving table.”

Food and Wine: Set a Beautiful Holiday Table
Eight ideas for Turkey Day place settings.

Martha Stewart: Thanksgiving Table Settings

Real Simple: 60-Second Centerpieces

Real Simple: Dinner Party Seating Strategies


TROUBLESHOOTING

All Recipes: Thanksgiving Disaster-Savers
“Its 3 p.m. on Thanksgiving and youve got a house full of guests. Whats the worst thing that could happen?”

All Recipes: Pie Troubleshooting Guide
“Unworkable dough? Soggy crust? Learn how to prevent common pie problems.”

Food Network: Thanksgiving SOS
A series of troubleshooting videos.

Real Simple: How to Fix 10 Common Thanksgiving Problems

Real Simple: 10 Tricks to a Trouble-Free Thanksgiving


LEFTOVERS

All Recipes: Turkey Leftovers

Bon Appetit: Thanksgiving Leftovers Slideshow
“Leftover turkey goes upscale—and global—in these recipes for the day after the Thanksgiving feast. Plus, recipes for leftover cranberry sauce and potatoes.”

Cooking Light: Tomorrow’s Turkey

Fine Cooking: Leftovers

Real Simple: 10 Ideas for Leftover Turkey


CHEAP HEALTHY GOOD RECIPES

Baked Apples
Broccoli With Parmesan and Lemon
Cranberry Relish With Grapefruit and Mint
Garlicky Broccoli Rabe
Honey-Glazed Roasted Carrots
Maple Walnut Apple Crisp
Mashed Potatoes With Leeks and Sour Cream
Mostly Vegan Pumpkin Pie
Peach-Blueberry Cobbler
Roasted Brussels Sprouts
Roasted Root Vegetables
Spiced Slow Cooker Applesauce
Stewed Pears
Wild Berry Betty

Readers – ideas? I’d love to hear.
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Everything You Need to Know About Health Care Reform Thanks to a 25 Minute Video Courtesy of Managed Care Magazine

Tuesday, January 28, 2014

Thanks to Managed Care Magazine, the Disease Management Care Blog can post this interesting 25 minute interview with Princeton healthcare economist Uwe Reindardt.  Suitable for desk-bound meal-break viewing by overachieving DMCB readers, the modest and insightful Dr. Reindardt gets it mostly right:

No, the slowdown in the U.S. rate of health care costs cannot be ascribed to passage of the Affordable Care Act.  It started wayyyy before Obamacare was passed and is more likely due to the economic slowdown and increased consumer cost-sharing.

Accountable Care Organizations remain an "iffy" experimental proposition because they "dont go all the way like Kaiser."

Republican proposals to let health insurers sell their products across state lines are hardly a health orm panacea, because prices (and theore premiums) are not a function of where the insurer is domiciled, but where the care is rendered.  Texas insurers would still have to pay New York prices.

Americans use fewer pills, occupy less bed-days and see fewer doctors, but we pay more because providers can charge more.  Despite being relatively small vs. the behemoths like Aetna and Cigna, regional hospitals have considerable market power that translates into take-it-or-leave it local single seller monopsonies.   Europeans, in contrast, have lower prices because their system is dominated by single purchaser monopolies.

Were headed toward a three-tier system comprised of 1) the indigent safety-net public programs, 2) the middle class "erence pricing" "networks" where consumers pay the difference if they want to buy up and 3) "boutique" health care for the 5%.

Theres reason to be optimistic about the next five years thanks to a sluggish labor market (making it easier to impose networks and even more cost sharing) and innovation (computational capacity is putting meaningful quality measurement within reach, while techy gizmos are making self-care simultaneously cheap and fun). 

Plus, theres reason to be of good cheer.  Compared to the U.S. education and the legal systems, health care is far more efficient and consumer-friendly.  Stop beating up on yourselves.

(The DMCB didnt quite agree with Dr. Reinhardts views on worksite wellness.  He finds the notion counterintuitive and intrusive, perring that insurers own wellness.  He neglects to mention that the employers who invest heavily in wellness are typically self-insured and that employers have an arguable stake in improving the quality of their human capital.)



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Food and The Need to Feel Different

Monday, January 13, 2014

Hi,

I was going over some of the posts that I printed out in order to use them for support and motivation and got to thinking again.

I had asked myself the question, "What are you looking for when you eat?" and had come up with a really revealing post (link to post) but as I began to re-read it I cut the question down to, "What are you looking for?" and realized I am looking for a feeling.

That feeling of peace which I have only experienced through the Spirit of God.

Psalm 16:11
Thou wilt shew me the path of life: in thy presence is fulness of joy; at thy right hand there are pleasures for evermore.

I really do find the most joy in speaking with God, worshiping Him, reading His Word and writing Bible study/commentaries. When I am doing that, I feel complete and full. God is amazing.

So why would I look for that in food?

John 6:27
Labour not for the meat which perisheth, but for that meat which endureth unto everlasting life, which the Son of man shall give unto you: for him hath God the Father sealed.
Of course, it is "D." Biochemical triggers and the need to feel different.
The above is a quote from "The Anatomy of A Food Addiction" which I had been reading for a while. Link: (to the book).

I think I know how to handle the biochemical triggers which I consider to be carb cravings. I know she is talking about something more scientific but I happen to know, very well, that when I start eating too many carbs, too often, the eating machine starts to be in full swing. The biochemical triggers are real. My personal solution is the 3-day carb fast which really does set me right again.

The one thing that is really hard for me to control is that "need to feel different" which is why I go to carbs in the first place. I have not really investigated that before. Ive become a little more aware of it, but have not really looked at what is going on there.

Im thinking that that may be the place where I need to use the process of writing down my thoughts and then analyzing them, then providing a positive replacement for them which I was reminded of at Victory Steps. Link: (to the web site)

Im feeling a little fearful of this one. Its like I want to "not" investigate this, so prayer is needed. I will go to God with this one. 

As I was about to end this post, I got interrupted by the dryer finishing so I went and hung up the clothes and left the folding of the socks for a little later this evening. That was just enough distance for me to come back and resume my sharing.

This seems like a really core issue so I really do want to wait and go to God first on this one. I know that He will show me what I need. I dont have to do this alone.

I also know that just being aware of this is a good thing.

I am fasting today and have about an hour or so before I will have my meal. 

I also believe in "holding the question" -- which means I dont want the slick fast answers -- I want to look at the question, "What feeling are you looking for?"
One statement that I got from the Victory Steps, "Emotional Eating" program that I listened to is this:

"There are foods that we are consuming for entertainment – and not just for entertainment but as a substitute for prayer, for communication with other Christians, and as a substitute for God’s love and His Holy Spirit. Any time we use something physical like food or drugs or alcohol or shopping or sex – something physical to fulfill an emotional or spiritual need we will always fall short and frustrate ourselves. Because it is like drinking water from a glass with a giant hole in the bottom. " 
From: (Overcoming Emotional Eating and Negative Thinking, By: Bonnie MeChelle)

I wonder where all this will take me. Im feeling positive about this, now. Thank you Lord!

Be back soon, Lord willing,

Marcia






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7 Things You Need to Know about Proper Stretching Techniques

Sunday, January 12, 2014

Always warm up first."To improve range of motion and avoid injury, you do need to stretch, but dont ever do it when muscles are cold," warns orthopaedic surgeon William Levine, MD, director of sports medicine at Columbia University Medical Center in New York City. "Always start with some mild aerobic warm-ups to get blood to the tissue before doing any stretching."

Holcomb recommends brisk walking or slow jogging for about five minutes, rather than stretching before exercise. "Warming up increases blood flow, which increases the temperature in the muscle, which makes the collagen fibers more elastic like a rubber band," he explains.

After warming up, do dynamic (not static) stretches. Dynamic stretching means slow, controlled movements rather than remaining still and holding a stretch. They may include simple movements like arm circles and hip rotations, flowing movements as in yoga, or walking or jogging exercises like those mentioned below. While studies have not clearly proven this, increasing numbers of experts agree that dynamic stretching is the best stretching routine before a workout or competition. Levine warns, however, that proper technique is key. "Poor technique that is not anatomically correct puts you at higher risk for injury."


Holcomb recommends three all-purpose dynamic stretches for your lower body:

    * Goose-step march: Slowly lift your leg straight out in front of you, alternating as you walk with your normal stride length. While others may think youre doing a Monty Python skit, it is an effective hamstring stretch.
    * Knee lifts: As youre jogging or walking, bring knees up toward your chest. For a variation, as your right knee comes up, twist the lifted leg gently to the left and your upper body gently to the right for a spinal twist. Repeat on each side as you jog or walk (warning: you may be mistaken for a Rockette).
    * Butt-kick: As you jog or walk, bend one knee and lift it behind you as if you were trying to kick yourself in the butt. Its not punishment; it stretches the quadriceps.

Do several repetitions of 30 seconds each at your own pace. The point is to do the movements in a controlled way. Stop if you get tired so you still have energy for your workout.

Consider yoga. "Isnt it interesting that this new research is figuring out what yoga teachers have known for thousands of years?" says Mary Pullig Schatz, MD, a retired surgical pathologist, yoga expert, and author of Back Care Basics. If youre familiar with yoga basics, she suggests, you can use those moves as dynamic stretches before, say, a run or a long bike ride. Try two minutes of sun salutations to stretch multiple parts of the body. Or make downward-facing dog dynamic by pedaling your feel or lifting alternate legs.

"Improving your flexibility allows you to put your body in good ergonomic alignment," Schatz says. "Yoga can help you combine flexibility and strength, breathe properly, reduce head, neck, and back pain, and put the body back in balance."

After your workout or competition, then do static stretches. "Too many people do static stretching before and then nothing after," says Holcomb. "Thats the most common mistake I see." This is where youll lengthen muscles and improve your flexibility. Hold static stretches for about 30 seconds.

Learn warm-ups and stretches particular to your sport. Levines team takes care of 29 varsity teams, so hes seen every kind of sports injury there is.

"For example, football linemen are vulnerable to shoulder tears," he says. "Runners may suffer knee problems and shin splints. For golfers, the lower back is often the hot spot."

New research shows its a good move to learn stretching routines customized for your sport and to help prevent the injuries most common to it. The Santa Monica Orthopedic and Sports Medicine Research Foundation in California studied women soccer players who are subject to ACL tears and created a program called Prevent Injury and Enhance Performance (PEP). The program (which can be downloaded at http://www.aclprevent.com/pepprogram.htm) includes a warm-up and stretches (as well as strengthening and agility exercises) specifically designed to prevent ACL injuries.

 Never stretch to the point of pain. Forget the phrase "no pain, no gain. "You do not want pain when youre doing dynamic stretching," says Holcomb. "It should be gentle to start and then progress." When youre doing your static stretching afterward, you should go to the point of slight discomfort and intensity, he says, to improve your flexibility. But if youre making a face, your muscle is contracting to protect itself, which is counterproductive.

Stretch to de-stress. These are stressed-out times, and stretching can help. "As you know, your mind affects your body, and your body affects your mind," says Dean Ornish, MD, founder of the Preventive Medicine Research Institute in Sausalito, Calif., and author of The Spectrum. "During times of emotional stress, the muscles in your body contract. This is an adaptive response to acute stress, as it fortifies your body armor so that in times of danger, if you get hit, for example, your muscles help to protect you.

"However, in times of chronic stress, these same mechanisms that have evolved to protect us can create problems -- chronically tensed muscles, especially those in the back and neck, predispose to chronic pain or injury. Thus, stress management techniques can help prevent this. Also, gentle stretching of chronically tensed muscles provide relaxation to the mind as well as the body."
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