STOP CALORIE COUNTING, START CARB SWITCHING

STUDIES SHOW YOU DON’T NEED TO COUNT CALORIES IF YOU FOCUS ON IMPROVING THE QUALITY OF THE CARBOHYDRATES YOU EAT. THERE IS A SIMPLE DIET SWAP TO HELP YOU LOSE WEIGHT AND LOWER HEALTH RISKS TOO.

or many people, figuring out the best diet for optimal health isn’t easy. But studies show that almost anyone can lose weight and improve their health by making one simple change to their diet.

The trick: Cut out processed carbs and replace them with high-quality carbs. These include fruits, vegetables, beans, lentils, quinoa and whole grains like brown rice, barley, farro and steel-cut oats.

According to a large and growing body of research, this one swap could help you lower your risk of cancer and Type 2 diabetes, reduce your likelihood of dying from heart disease or a stroke and help you shed pounds without counting calories.

While it sounds simple, for many people it will be a big change. These highquality carbs make up just 9 percent of all the calories that Americans consume.

For most people, processed, low-quality carbs are dietary staples. They make up

42 percent of all the calories that Americans consume. They include the packaged foods that dominate many supermarket shelves and household dinner tables, like white bread, pastries, pasta, bagels, chips, crackers and foods with added sugars, such as breakfast cereals, flavored yogurts, desserts, juices and soft drinks.

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Studies show that the fiber in these foods has multiple benefits. It promotes satiety, which helps you feel full. It nourishes the microbes that make up your gut microbiome, which can lower inflammation and protect against chronic diseases. And it improves your blood sugar control and cholesterol levels

A large meta-analysis in the Lancet examined the health effects of eating different types of carbs. The analysis, based on data collected from 4,635 people in 58 clinical trials, showed that adults who ate the highest levels of whole grains, vegetables and other fiber-rich carbs had a 15 to 31 percent reduction in diabetes, colorectal cancer and their risk of dying from a stroke or heart disease compared to people who ate the lowest amounts of these foods.

They also lost more weight — “despite not being told to eat less food or do more physical activity,” said Andrew Reynolds, a nutrition epidemiologist at Otago Medical School and co-author of the research.

Why are processed carbs so bad for are processed carbs so bad for processed so you? you? you? you?

On average, Americans eat five servings a day of foods with refined grains, like white bread and pasta, and just one serving a day of foods that are whole grain, like brown rice and barley, said Fang Fang Zhang, a nutrition epidemiologist at the Friedman School of Nutrition Science & Policy at Tufts University and author of a study in JAMA that examined the types of carbs and macronutrients that Americans consume.

In her research, Zhang found that Americans have been cutting back on their intake of sugary sodas and other foods with added sugar, thanks to growing public awareness about the damaging health effects of sugar.

But at the same time, we’ve been eating more and more foods with refined grains, in part because they are so ubiquitous.

“We are seeing an overall trend toward increased consumption of refined grains,” said Zhang. “With refined grains we are missing our target.”

These foods have been stripped of their fiber, vitamins and minerals and industrially converted into flour and sugar. This causes them to be rapidly absorbed by the body, prompting blood sugar and insulin levels to spike and activating reward regions in the brain, all of which can lead to cravings, overeating and a cascade of metabolic changes that lead to poor health.

Healthy carbs are those that haven’t been highly processed and stripped of their natural fiber. Fruits, vegetables, beans and whole grains are fiber-rich and full of health-promoting nutrients that help protect against heart disease and other leading causes of death.

If your goal is to lose weight and improve your metabolic health, you don’t need to count calories or go on a restrictive diet. Just start by cutting the empty carbs from your diet. Here’s how to do it:

Cut the white foods. Cut back on foods like cereal, pastries, white bread, white pasta, juices, sweetened beverages and other foods with added sugar.

ADD HIGHER QUALITY “NUTRIENT DENSE” FOODS BACK INTO YOUR DIET. THESE FOODS CARRY DIFFERENT LABELS THAT CAN HELP YOU IDENTIFY THEM. LOOK FOR DESCRIPTORS LIKE “MINIMALLY PROCESSED,” “SEASONAL,” “GRASS-FED,” “WHOLE GRAIN” AND “PASTURE-RAISED.”

Add healthy carbs. It’s simple. Eat more vegetables, whole grains, beans and lentils.

Add healthy fats and protein: After getting rid of those empty carbs, some people find that they feel better replacing them with foods higher in fat and protein, like nuts, seeds, avocado, eggs, poultry, yogurt and seafood.

Add healthy grains: Try replacing white and highly-processed carbs with whole grains, whole wheat breads, beans, peas, lentils, legumes, quinoa, fruits, vegetables and other unrefined carbs.

Add higher quality “nutrient dense” foods back into your diet. These foods carry different labels that can help you identify them. Look for descriptors like “minimally processed,” “seasonal,” “grass-fed,” “whole grain” and “pastureraised.”

It may be tough at first to cut back on some of your favorite refined carbs, but you won’t feel as hungry if you replace them with fiber-rich carbs and healthy fats.

In one randomized trial that was published in JAMA, overweight people who were counseled to cut back on added sugar, refined grains and highly processed foods for a year lost weight — without counting calories — and showed improvements in their blood sugar and blood pressure levels. This approach worked whether people followed a diet that was relatively low in fat or relatively low in carbs. The findings showed that for weight loss, diet quality trumped diet quantity, said Christopher Gardner, the director of nutrition studies at the Stanford Prevention Research Center, who has studied the effects of different diets on metabolic health and weight loss. If you want to eat a healthier diet, your first step, he said, should be “to get rid of the empty carb calories that just come with glucose and no fiber, vitamins or minerals.”

He recommends replacing those foods with what he calls a “foundational diet” rich in plant foods that are eaten by cultures around the world, like beans, nuts, seeds and vegetables.

In Latin American cuisine, red, black and pinto beans are staples. In the Middle East, people have been using chickpeas and sesame seeds to make hummus and other dishes for centuries. In India, red and yellow lentils can be found in delicious dal, soups and stews. And in the Mediterranean, many dishes incorporate things like fava beans, cannellini beans and split peas.

“Americans eat a shockingly low number of beans, nuts and seeds,” he said. “We should eat more like these other cultures around the world.” ou may know that being adequately hydrated is important for day-to-day bodily functions such as regulating temperature and maintaining skin health.

But drinking enough water is also associated with a significantly lower risk of developing chronic diseases, a lower risk of dying early or lower risk of being biologically older than your chronological age, according to a National Institutes of Health study published Monday in the journal eBioMedicine.

“The results suggest that proper hydration may slow down aging and prolong a disease-free life,” said study author Natalia Dmitrieva, a researcher in the Laboratory of Cardiovascular Regenerative Medicine at the National Heart, Lung and Blood Institute, a division of NIH, in a news release.

Learning what preventive measures can slow down the aging process is “a major challenge of preventive medicine,” the authors said in the study. That’s because an epidemic of “age-dependent chronic diseases” is emerging as the world’s population rapidly ages. And extending a healthy life span can help improve quality of life and decrease health care costs more than just treating diseases can.

The authors thought optimal hydration might slow down the aging process, based on previous similar research in mice. In those studies, lifelong water restriction increased the serum sodium of mice by 5 millimoles per liter and shortened their life span by six months, which equals about 15 years of human life, according to the new study. Serum sodium can be measured in the blood and increases when we drink less fluids.

Using health data collected over 30 years from 11,255 Black and White adults from the Atherosclerosis Risk in Communities study, or ARIC, the research team found adults with serum sodium levels at the higher end of the normal range — which is 135 to 146 milliequivalents per liter (mEq/L) — had worse health outcomes than those at the lower end of the range. Data collection began in 1987 when participants were in their 40s or 50s, and the average age of participants at the final assessment during the study period was 76.

Adults with levels above 142 mEq/L had a 10% to 15% higher chance of being biologically older than their chronological age compared with participants in the 137 to 142 mEq/L range. The participants with higher fasteraging risk also had a 64% higher risk for developing chronic diseases such as heart failure, stroke, atrial fibrillation, peripheral artery disease, chronic lung disease, diabetes and dementia.

And people with levels above 144 mEq/ L had a 50% higher risk of being biologically older and a 21% higher risk of dying early. Adults with serum sodium levels between 138 and 140 mEq/L, on the other hand, had the lowest risk of developing chronic disease. The study didn’t have information on how much water participants drank.

“This study adds observational evidence that reinforces the potential long-term benefits of improved hydration on reductions in long-term health outcomes, including mortality,” said Dr. Howard Sesso, an associate professor of medicine at Harvard Medical School and associate epidemiologist at Brigham and Women’s Hospital in Boston, via email. Sesso was not involved in the study. However, “it would have been nice to combine their definition of hydration, based on serum sodium levels only, with actual fluid intake data from the ARIC cohort,” Sesso added.

Biological age was determined by biomarkers that measure the performance of different organ systems and processes, including cardiovascular, renal (relating to the kidneys), respiratory, metabolic, immune and inflammatory biomarkers.

High serum sodium levels weren’t the only factor associated with disease, early death and faster aging risk — risk was also higher among people with low serum sodium levels.

This finding is consistent with previous reports of increased mortality and cardiovascular disease in people with low regular sodium levels, which has been attributed to diseases causing electrolyte issues, the authors said.

The study analyzed participants over a long period of time, but the findings don’t prove a causal relationship between serum sodium levels and these health outcomes, the authors said. Further studies are needed, they added, but the findings can help doctors identify and guide patients at risk.

“People whose serum sodium is 142 mEq/L or higher would benefit from evaluation of their fluid intake,” Dmitrieva said.

Sesso noted that the study did not strongly address accelerated aging, “which is a complicated concept that we are just starting to understand.”

“Two key reasons underlie this,” Sesso said. The study authors “relied on a combination of 15 measures for accelerated aging, but this is one of many definitions out there for which there is no consensus. Second, their data on hydration and accelerated aging were a ‘snapshot’ in time, so we have no way to understand cause and effect.”

Drink enough fluids every day enough fluids day Drink enough fluids every day enough fluids day

About half of people worldwide don’t meet recommendations for daily total water intake, according to several studies the authors of the new research cited.

“On the global level, this can have a big impact,” Dmitrieva said in a news release. “Decreased body water content is the most common factor that increases serum sodium, which is why the results suggest that staying well hydrated may slow down the aging process and prevent or delay chronic disease.”

Our serum sodium levels are influenced by liquid intake from water, other liquids, and fruits and vegetables with high water content.

“The most impressive finding is that this risk (for chronic diseases and aging) is apparent even in individuals who have serum sodium levels that are on the upper end of the ‘normal range,’” said

Dr. Richard Johnson, professor at the University of Colorado School of Medicine, via email. He was not involved in the study.

“This challenges the question of what is really normal, and supports the concept that as a population we are probably not drinking enough water.”

More than 50% of your body is made of water, which is also needed for multiple functions, including digesting food, creating hormones and neurotransmitters, and delivering oxygen throughout your body, according to the Cleveland Clinic.

The National Academy of Medicine (formerly known as the Institute of Medicine) recommends women consume 2.7 liters (91 ounces) of fluids daily, and that men have 3.7 liters (125 ounces) daily. This recommendation includes all fluids and water-rich foods such as fruits, vegetables and soups. Since the average water intake ratio of fluids to foods is around 80:20, that amounts to a daily amount of 9 cups for women and 12 ½ cups for men.

People with health conditions should talk with their doctor about how much fluid intake is right for them.

It's important to write down not only what your goals are, but also when, where and how you'll accomplish them.

“The goal is to ensure patients are taking in enough fluids, while assessing factors, like medications, that may lead to fluid loss,” said study coauthor Dr. Manfred Boehm, director of the Laboratory of Cardiovascular Regenerative Medicine, in a news release. “Doctors may also need to defer to a patient’s current treatment plan, such as limiting fluid intake for heart failure.”

If you’re having trouble staying hydrated, you might need help working the habit into your usual routine. Try leaving a glass of water at your bedside to drink when you wake up, or drink water while your morning coffee is brewing. Anchor your hydration habit to a location you’re in a few times per day, says behavioral science expert Dr. B.J. Fogg, founder and director of the Stanford University Behavior Design Lab. (Credt: CNN) espite volunteering and working out at the gym several days each week, socializing frequently with friends and family, reading all manner of books and doing daily crossword puzzles, 85-year-old Carol Siegler is restless.

“I’m bored. I feel like a Corvette being used as a grocery cart,” said Siegler, who lives in the Chicago suburb of Palatine.

Siegler is a cognitive “SuperAger,” possessing a brain as sharp as people 20 to 30 years younger. She is part of an elite group enrolled in the Northwestern SuperAging Research Program, which has been studying the elderly with superior memories for 14 years. The program is part of the Mesulam Center for Cognitive Neurology and Alzheimer’s Disease at Northwestern University Feinberg School of Medicine in Chicago.

“I’ve auditioned twice for ‘Jeopardy!’ and did well enough on it to be invited to the live auditions. Then Covid hit,” said Siegler.

“Who knows how well I would have done,” she added with a chuckle. “What I have told my children and anybody else who asked me: ‘I may know an awful lot about Beethoven and Liszt, but I know very little about Beyoncé and Lizzo.’”

To be a SuperAger, a term coined by the Northwestern researchers, a person must be over 80 and undergo extensive cognitive testing. Acceptance in the study only occurs if the person’s memory is as good or better than cognitively normal people in their 50s and 60s.

“SuperAgers are required to have outstanding episodic memory — the ability to recall everyday events and past personal experiences — but then SuperAgers just need to have at least average performance on the other cognitive tests,” said cognitive neuroscientist Emily Rogalski, a professor of psychiatry and behavioral sciences at Feinberg School of Medicine.

Only about 10% of people who apply to the program meet those criteria, said Rogalski, who developed the SuperAger project.

“It’s important to point out when we compare the SuperAgers to the average agers, they have similar levels of IQ, so the differences we’re seeing are not just due to intelligence,” she said.

Once accepted, colorful 3D scans are taken of the brain and cognitive testing and brain scans are repeated every year or so. Analysis of the data over the years have yielded fascinating results.

Bigger, tau-free neurons Bigger, tau-free neurons

Most people’s brains shrink as they grow older. In SuperAgers, however, studies have shown the cortex, responsible for thinking, decision-making and memory, remains much thicker and shrinks more slowly than those of people in their 50s and 60s.

A SuperAger’s brain, usually donated to the research program by participants after death, also has bigger, healthier cells in the entorhinal cortex. It’s “one of the first areas of the brain to get ‘hit’ by Alzheimer’s disease,” said Tamar Gefen, an assistant professor of psychiatry and behavioral sciences at Northwestern, in an email.

The entorhinal cortex has direct connections to another key memory center, the hippocampus, and “is essential for memory and learning,” said Gefen, the lead author of a November study comparing the brains of deceased SuperAgers with those of older and younger cognitively normal people and people diagnosed with early Alzheimer’s.

SuperAger brains had three times fewer tau tangles, or abnormal formations of protein within nerve cells, than the brains of cognitively healthy controls, the study also found. Tau tangles are a hallmark sign of Alzheimer’s and other dementias.

“We believe that larger neurons in the entorhinal cortex suggest that they are more ‘structurally sound’ and can perhaps withstand neurofibrillary tau tangle formation,” Gefen said.

Gefen also found the brains of SuperAgers had many more von economo neurons, a rare type of brain cell, which so far has been found in humans, great apes, elephants, whales, dolphins and songbirds. The corkscrewlike von economo neurons are thought to allow rapid communication across the brain. Another theory is that the neurons give humans and great apes an intuitive advantage in social situations.

The von economo neurons were found in the anterior cingulate cortex, which forms a collar in the front of the brain linking the cognitive, reasoning side with the emotional, feeling side. The anterior cingulate is thought to be important for regulating emotions and paying attention — another key to good memory. Taken together, these discoveries appear to point to a genetic link to becoming a SuperAger, Gefen said. However, she added: “The only way to confirm whether SuperAgers are born with larger entorhinal neurons would be to measure these neurons from birth until death. That obviously isn’t possible.”

Can environment play a role? environment play a SuperAgers share similar traits, said Rogalski, who is also the associate director of the Mesulam Center for Cognitive Neurology and Alzheimer Disease at Feinberg. These folks stay active physically. They tend to be positive. They challenge their brain every day, reading or learning something new — many continue to work into their 80s. SuperAgers are also social butterflies, surrounded by family and friends, and can often be found volunteering in the community.

“When we compare SuperAgers to normal agers we see that they tend to endorse more positive relations with others,” Rogalski said.

“This social connectedness may be a feature of SuperAgers that distinguishes them from those who are still doing well but who are what we would call an average or normal ager,” she said.

Looking back at her life, Carol Siegler recognizes many SuperAger traits. As a young child during the Great Depression, she taught herself to spell and play piano. She learned to read Hebrew at her grandfather’s knee, poring over his weekly Yiddish newspaper.

“I have a great memory. I’ve always had it,” Siegler said. “I was always the kid that you could say, ‘Hey, what’s Sofia’s phone number?’ and I would just know it off the top of my head.”

She graduated from high school at 16 and immediately went to college. Siegler got her pilot’s license at age 23 and later started a family business in her basement that grew to have 100 employees. At 82, she won the American Crossword Puzzle Tournament for her age group, which she said she entered “as a gag.” After seeing an advertisement for the SuperAger program on television, Siegler thought it too sounded like fun. Being chosen as a SuperAger was a thrill, Siegler said, but she is aware she was born lucky.

“Somebody with the same abilities or talents as a SuperAger who lived in a place where there was very little way to express them, might never know that he or she had them,” she said. “And that is a true shame.”