The surprise is not that someone is finally trying to launch a healthier alternative, but that it has taken so long – though pop-up healthy fast food vans have been trialled in London before, a new outlet, Chicken Town, is the first bricks-and-mortar shop to take on the challenge.
It will open in Tottenham, north London, in September, ready for the new school year. According to the not-for-profit community organisation behind the project, Create, there are 30 fast-food outlets within a mile of the site, so it will have to work hard for its business. Importantly, prices will be on a par with competitors, with a junior special priced at just £2, subsidised by the more grown-up trade the team hope to attract in the evenings.
What is on offer, however, is very different: the chicken, for example, will be free-range, and steamed before frying to cut down its time in the oil, meaning it will have only 30% of the fat and calories of the ordinary high-street variety.
Fried chicken can be made less fattening by steaming before frying. Photograph: Alamy
Interestingly, product developer William Leigh, who founded upmarket chicken joint Wishbone before selling it on to the Meatailer group last year, tells me that this is a fairly common cooking method. Spicy buffalo wings are traditionally pre-steamed to speed up delivery times at busy bars, while Korean-American chef David Chang of the achingly hip Momofuku empire argues that the process amplifies the natural flavour of his famous fried chicken (not something, perhaps, that might be desirable at your average chicken cottage).
Back in Tottenham, it is not just the meat that will be healthier. The fries will be made from sweet potatoes, which contain more fibre and vitamins – and fewer calories – than the ordinary white variety, and the menu, which is being developed by an executive chef with Michelin-starred experience, will also feature alternative sides such as greens, coleslaw and roasted corn.
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How to make fried chicken with a third of the calories.
A new community-run shop is to open later this year offering customers a wholesome version of the fast-food classic. And it’s hoped it will help cut obesity in the after-school market
Fish oil is now the third most widely used dietary supplement in the United States, after vitamins and minerals, according to a recent report from the National Institutes of Health. At least 10 percent of Americans take fish oil regularly, most believing that the omega-3 fatty acids in the supplements will protect their cardiovascular health.
But there is one big problem: The vast majority of clinical trials involving fish oil have found no evidence that it lowers the risk of heart attack and stroke.
From 2005 to 2012, at least two dozen rigorous studies of fish oil were published in leading medical journals, most of which looked at whether fish oil could prevent cardiovascular events in high-risk populations. These were people who had a history of heart disease or strong risk factors for it, like high cholesterol, hypertension or Type 2 diabetes.
All but two of these studies found that compared with a placebo, fish oil showed no benefit.
And yet during this time, sales of fish oil more than doubled, not just in the United States but worldwide, said Andrew Grey, an associate professor of medicine at the University of Auckland in New Zealand and the author of a 2014 study on fish oil in JAMA Internal Medicine.
“There’s a major disconnect,” Dr. Grey said. “The sales are going up despite the progressive accumulation of trials that show no effect.”
In theory at least, there are good reasons that fish oil should improve cardiovascular health. Most fish oil supplements are rich in two omega-3 fatty acids — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — that can have a blood-thinning effect, much like aspirin, that may reduce the likelihood of clots. Omega-3s can also reduce inflammation, which plays a role in atherosclerosis. And the Food and Drug Administration has approved at least three prescription types of fish oil — Vascepa, Lovaza and a generic form — for the treatment of very high triglycerides, a risk factor for heart disease.
But these properties of omega-3 fatty acids have not translated into notable benefits in most large clinical trials.
Some of the earliest enthusiasm for fish oil goes back to research carried out in the 1970s by the Danish scientists Dr. Hans Olaf Bang and Dr. Jorn Dyerberg, who determined that Inuits living in northern Greenland had remarkably low rates of cardiovascular disease, which they attributed to an omega-3-rich diet consisting mainly of fish, seal and whale blubber. Dr. George Fodor, a cardiologist at the University of Ottawa, outlined flaws in much of this early research, and he concluded that the rate of heart disease among the Inuit was vastly underestimated. But the halo effect around fish oils persists.
The case for fish oil was bolstered by several studies from the 1990s, including an Italian study that found that heart attack survivors who were treated with a gram of fish oil daily had a drop in mortality, compared with patients taking vitamin E. These findings prompted groups like the American Heart Association to endorse fish oil about a decade ago as a way for heart patients to get more omega-3s in their diets.
“But since then, there has been a spate of studies showing no benefit,” said Dr. James Stein, the director of preventive cardiology at University of Wisconsin Hospital and Clinics. Among them was a clinical trial of 12,000 people, published in The New England Journal of Medicine in 2013, that found that a gram of fish oil daily did not reduce the rate of death from heart attacks and strokes in people with evidence of atherosclerosis.
“I think that the era of fish oil as medication could be considered over now,” said the study’s lead author, Dr. Gianni Tognoni of the Institute for Pharmacological Research in Milan.
Dr. Stein said the early fish oil studies took place in an era when cardiovascular disease was treated very differently than it is today, with far less use of statins, beta blockers, blood thinners and other intensive therapies. So the effect of fish oil, even if it were minor, he said, would have been more noticeable.
“The standard of care is so good today that adding something as small as a fish oil capsule doesn’t move the needle of difference,” he said. “It’s hard to improve it with an intervention that’s not very strong.”
Dr. Stein also cautions that fish oil can be hazardous when combined with aspirin or other blood thinners. “Very frequently we find people taking aspirin or a ‘super aspirin’ and they’re taking fish oil, too, and they’re bruising very easily and having nosebleeds,” he said. “And then when we stop the fish oil, it gets better.”
Like many cardiologists, Dr. Stein encourages his patients to avoid fish oil supplements and focus instead on eating fatty fish at least twice a week, in line with federal guidelines on safe fish intake, because fish contains a variety of healthful nutrients other than just EPA and DHA. “We don’t recommend fish oil unless someone gets absolutely no fish in their diets,” Dr. Stein said.
But some experts say the case for fish oil remains open. Dr. JoAnn Manson, the chief of preventive medicine at Brigham and Women’s Hospital in Boston, said the large clinical trials of fish oil focused only on people who already had heart disease or were at very high risk. Fish oil has also been promoted for the prevention of a variety of other conditions, including cancer, Alzheimer’s and depression.
Dr. Manson is leading a five-year clinical trial, called the Vital study, of 26,000 people who are more representative of the general population. Set to be completed next year, it will determine whether fish oil and vitamin D, separately or combined, have any effect on the long-term prevention of heart disease, Type 2 diabetes, and other diseases in people who do not have many strong risk factors.
Dr. Manson says that although she recommends eating fatty fish first, she usually does not stop people from taking fish oil, in part because it does not seem to have major side effects in generally healthy people.
“But I do think people should realize that the jury is still out,” she said, “and that they may be spending a lot of money on these supplements without getting any benefit.”
Parsing Ronald Reagan’s Words for Early Signs of Alzheimer’s
By LAWRENCE K. ALTMAN, M.D.MARCH 30, 2015
WASHINGTON — Even beforeRonald Reagan became the oldest elected president, his mental state was a political issue. His adversaries often suggested his penchant for contradictory statements, forgetting names and seeming absent-mindedness could be linked to dementia.
Now a clever new analysis has found that during his two terms in office, subtle changes in Mr. Reagan’s speaking patterns linked to the onset of dementia were apparent years before doctors diagnosed hisAlzheimer’s disease in 1994.
The findings, published in The Journal of Alzheimer’s Disease by researchers at Arizona State University, do not prove that Mr. Reagan exhibited signs of dementia that would have adversely affected his judgment and ability to make decisions in office.
But the research does suggest that alterations in speech one day might be used to predict development of Alzheimer’s and other neurological conditions years before symptoms are clinically perceptible.
Detection of dementia at the earliest stages has become a high priority. Many experts now believe that yet-to-be-developed treatments are likely to be effective at preventing or slowing progression of dementia only if it is found before it significantly damages the brain.
The “highly innovative” methods used by the researchers may eventually help “to further clarify the extent to which spoken-word changes are associated with normal aging or predictive of subsequent progression to the clinical stages of Alzheimer’s disease,” said Dr. Eric Reiman, the director of the Banner Alzheimer’s Institute in Phoenix, who was not involved in the new study.
Visar Berisha and Julie Liss, professors of speech and hearing science at the university, compared transcripts of all 46 news conferences that Mr. Reagan held to the 101 sessions President George H. W. Bush held in his term.
The researchers assessed changes in the presidents’ speech patterns with a new algorithm based on a technique used by others to analyze changes in writing by novelists.
In an interview, Dr. Berisha said he did not set out to study Mr. Reagan, but found he was the only individual with progressive dementia for whom long-term transcript information is publicly available. He chose Mr. Bush because he was most comparable in age to Mr. Reagan at the start of their presidencies, and both men served during roughly the same decade.
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Visar Berisha, above, and Julie Liss of Arizona State University compared transcripts of the news conferences that Ronald Reagan held as president to those of George H.W. Bush.CreditNick Cote for The New York Times
Age and era are important issues for comparison because they can influence language measures. Mr. Reagan was 69 when he became president, and Mr. Bush was 64. Mr. Reagan died at 93 in 2004.
The researchers found no changes in the speaking patterns of Mr. Bush, who is not known to have developed Alzheimer’s. But in Mr. Reagan’s speech, two measures — use of repetitive words, and substituting nonspecific terms like “thing” for specific nouns — increased toward the end of Mr. Reagan’s presidency, compared with its start. A third measure, his use of unique words, declined.
The researchers’ methodology was not designed to determine whether the changes were present in Mr. Reagan’s rare early news conferences, Dr. Berisha said. Other factors — like a deliberate decision to reduce the complexity of his speaking style, or the injury, surgery and anesthesia from the assassination attempt made on him in 1981 — could account for the language changes they found, Dr. Berisha said.
In 1984, Mr. Reagan’s poor performance in his first presidential debate with Vice President Walter Mondale renewed questions about his mental capacity. A study published in 1988 suggested that Mr. Reagan had some cognitive impairment during his debates with President Jimmy Carter and Mr. Mondale, but the authors said that their findings were insufficient to conclude that the changes affected Mr. Reagan’s policy judgments and ability to make decisions.
The new research is part of a larger effort to develop objective tests that would serve as bellwethers for Alzheimer’s and other neurological diseases, Dr. Berisha said.
While the new study is “very clever,” said Dr. Richard Caselli, an Alzheimer’s expert at the Mayo Clinic in Scottsdale, Ariz., further research involving larger numbers of individuals is necessary to prove the methods actually predict dementia.
Imperceptible cognitive decline often predates by many years the precipitous downturn that occurs once compensatory strategies, like relying on well-rehearsed phrases and simple words, fail and an individual can no longer mask his cognitive deficit.
Dr. Berisha wanted to determine whether natural language processing and algorithms could be used to detect any such changes in news conferences, because spontaneous responses to questions require greater cognitive effort than a rehearsed speech does.
Sharing thoughts and ideas through spoken communication is a fragile process. Even the simplest verbal response requires a complex sequence of events. The brain must recall the words to best convey a message, put them in proper sequence, and then signal the muscles required to produce speech.
The slightest damage to brain areas that orchestrate these events can produce speech difficulties.
Earlier studies have shown that certain linguistic biomarkers change with disease progression. Spoken vocabulary size declines, for instance, and use of indefinite nouns increases.
Studies of a small group of American nuns have shown a strong relationship between the complexity of the language the women used in handwritten autobiographical essays when they were young and their cognitive health many decades later.
Canadian researchers have reported that analyses of syntax in novels by Iris Murdoch and Agatha Christie indicated early signs of dementia (Ms. Murdoch died of Alzheimer’s; Ms. Christie is suspected to have had it.) The same analysis applied to the healthy P. D. James, who died at 94 last year, did not find signs of dementia.
Dr. Berisha said his team intended to conduct similar analyses of transcripts of other presidents, as well as news conference transcripts of National Football League players known to have sustained head trauma.
He and his team also hope to devise a study in which the conversations between physicians and patients are recorded at each visit and later analyzed to determine if speech and language changes can predict the appearance of dementia.
If the day comes when such tests to detect the earliest stages of Alzheimer’s and other neurological diseases become widely established, a question will arise about their use to screen candidates for the White House and other public offices.
There are people in this country eating too much red meat. They should cut back. There are people eating too many carbs. They should cut back on those. There are also people eating too much fat, and the same advice applies to them, too.
What’s getting harder to justify, though, is a focus on any one nutrient as a culprit for everyone.
I’ve written Upshot articles on how the strong warnings againstsalt and cholesterol are not well supported by evidence. But it’s possible that no food has been attacked as widely or as loudly in the past few decades as red meat.
As with other bad guys in the food wars, the warnings against red meat are louder and more forceful than they need to be.
Americans are more overweight and obese than they pretty much have ever been. There’s also no question that we are eating more meat than in previous eras. But we’ve actually been reducing our red meat consumption for the last decade or so. This hasn’t resulted in a huge decrease in obesity rates or deaths from cardiovascular disease.
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It’s possible that no food has been attacked as widely or as loudly in the past few decades as red meat.CreditJustin Maxon/The New York TImes
This is the real problem: We eat more calories than we need. But in much of our discussion about diet, we seek a singular nutritional guilty party. We also tend to cast everyone in the same light as “eating too much.”
I have seen many people point to a study from last year that found that increased protein intake was associated with large increases in mortality rates from all diseases, with high increases in the chance of death from cancer or diabetes. A close examination of the manuscript, though, tells a different story.
This was a cohort study of people followed through the National Health and Nutrition Examination Survey, or Nhanes. It found that there were no associations between protein consumption and death from all causes or cardiovascular disease or cancer individually when all participants over age 50 were considered. It did detect a statistically significant association between the consumption of protein and diabetes mortality, but the researchers cautioned that the number of people in the analysis was so small that any results should be taken with caution.
The scary findings from two paragraphs up are from a subanalysis that looked at people only 50 to 65. But if you look at people over 65, the opposite was true. High protein was associated with lower levels of all-cause and cancer-specific mortality. If you truly believe that this study proves what people say, then we should advise people over the age of 65 to eat more meat. No one advises that.
Further, this study defined people in the “high protein” group as those eating 20 percent or more of their calories from protein. When the Department of Agriculture recommends that Americans get 10 to 35 percent of their calories from protein, 20 percent should not be considered high.
If I wanted to cherry-pick studies myself, I might point you to this 2013 study that used the same Nhanes data to conclude that meat consumption is not associated with mortality at all.
Let’s avoid cherry-picking, though. A 2013 meta-analysis of meat-diet studies, including those above, found that people in the highest consumption group of all red meat had a 29 percent relative increase in all-cause mortality compared with those in the lowest consumption group. But most of this was driven by processed red meats, like bacon, sausage or salami.
Epidemiologic evidence can take us only so far. As I’ve written before, those types of studies can be flawed. Nothing illustrates this better than a classic 2012 systematic review that pretty much showed that everything we eat is associated with both higher and lower rates of cancer.
We really do need randomized controlled trials to answer these questions. They do exist, but with respect to effects on lipid levels such as cholesterol andtriglycerides. A meta-analysis examining eight trials found that beef versus poultry and fish consumption didn’t change cholesterol or triglyceride levels significantly.
All of this misses the bigger point, though. It’s important to understand what “too much” really is. People in the highest consumption group of red meat had one to two servings a day. The people in the lowest group had about two servings per week. If you’re eating multiple servings of red meat a day, then, yes, you might want to cut back. I would wager that most people reading this aren’t eating that much. If you eat a couple of servings a week, then you’re most likely doing fine.
All the warnings appear to have made a difference in our eating habits. Americans are eating less red meat today than any time since the 1970s. Doctors’ recommendations haven’t been ignored. We’re also doing a bit better in our consumption of vegetables. Our consumption ofcarbohydrates, like grains and sugar, however, has been on the rise. This is, in part, a result of our obsession with avoiding fats and red meat.
Over the last few decades, Americans have changed their eating habits. The consumption of red meat has decreased as the consumption of grains has sharply increased.
Consumption per capita, in ounces per day. Sweeteners include sugar, corn sweeteners, honey and syrup. Other meat includes poultry, fish and shellfish.
6
4
2
0
Red meat
Grains
Vegetables
Other meat
Sweeteners
1970
1975
1980
1985
1990
1995
2000
2005
2012
We’re eating too many calories, but not necessarily in the same way. Reducing what we’re eating too much of in a balanced manner would seem like the most sensible approach.
Last fall, a meta-analysis of brand-name diet programs was published in the Journal of the American Medical Association. The study compared the results from both the individual diets themselves and three classes, which included low-carbohydrate (like Atkins), moderate macronutrient (Weight Watchers) and low-fat (Ornish). All of the diets led to reduced caloric intake, and all of them led to weight loss at six months and, to a lesser extent, at 12 months. There was no clear winner, nor any clear loser.
Where does that leave us? It’s hard to find a take-home message better than this: The best diet is the one that you’re likely to keep. What isn’t helpful is picking a nutritional culprit of bad health and proclaiming that everyone else is eating wrong. There’s remarkably little evidence that that’s true anytime anyone does it.
對於是否正在與其他受調查零售商-——沃爾格林(Walgreens)、沃爾瑪(Wal-Mart)和塔吉特(Target)——會談，以便達成類似的協議，紐約州總檢察長埃里克·T·施耐德曼(Eric T. Schneiderman) 不予置評。但是，在一份聲明中，施耐德曼說，他曾敦促零售商“以及所有草本保健品生產商像GNC一樣和我的辦公室合作，增加透明度，保障顧客的健康。”
Brice Robin, the Marseilles prosecutor investigating the recent Germanwings crash in the Alps, said that Andreas Lubitz, a 28-year-old German, had taken control of the plane and locked the pilot out of the plane’s cockpit after he momentarily stepped outside. Voice recordings revealed that the pilot then made increasingly frantic attempts to get back into the cockpit during the plane’s descent. The desperate cries of the passengers, who had become aware of the danger, could be heard in the final moments http://econ.st/1D1Ep0o
