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Thursday 24 March 2016

Smoking Cessation Drugs

Prescription and over-the-counter drugs can help you quit smoking, but e-cigarettes may not be the best option.

Nicotine is a powerfully addictive drug, and is the main reason it can be so hard to quit smoking and using other tobacco products.

If you want to quit but are struggling with the effects of nicotinewithdrawal, you may find it helpful to use a nicotine replacement product (so-called nicotine replacement therapy, or NRT) or a prescription drug that doesn't contain nicotine.

Prescription Drugs to Help You Quit Smoking

There are a variety of doctor-prescribed drugs that can help you quit smoking.
The drugs may be used along with some NRT products.
Speak with your doctor to find the best choice for you.
The options approved by the Food and Drug Administration (FDA) include:

Bupropion

Bupropion (Wellbutrin, Zyban, or Aplenzin) does not contain nicotine.
Instead, it is a prescription antidepressant that reduces symptoms of nicotine withdrawal by acting on chemicals in your brain that help trigger nicotine cravings.
For the best results, you should start taking bupropion one to two weeks before you quit smoking.
Your doctor may have you keep taking it for a few weeks after you fully quit smoking.
The usual dosage is one or two 150 milligram (mg) tablets per day.
This drug should not be taken if you have or have ever had:
  • Seizures
  • Heavy alcohol use
  • Cirrhosis
  • Serious head injury
  • Bipolar disorder
  • Anorexia or bulimia
The most common side effects of bupropion include:
  • Dry mouth
  • Trouble sleeping
  • Tiredness
  • Irritability
  • Indigestion
  • Headaches

Varenicline

Varenicline (Chantix) was developed specifically to help people stop smoking; it works by interfering with nicotine receptors in the brain.
The drug does this in two ways: it lessens the pleasure you get from smoking, and it reduces the symptoms of nicotine withdrawal.Varenicline should be started a week before you quit smoking.
Studies have shown that varenicline can more than double your chances of quitting smoking, and may be more effective than bupropion in the short term.
Varenicline is taken over a 12-week period at increasingly higher dosages.
Be aware that varenicline carries an FDA-required black-box warning because of use of the drug has been linked to depression, suicide ideation, and suicide.
People taking varenicline should be monitored for any kind of psychiatric symptoms, such as agitation, hostility, depressed mood, changes in behavior or thinking, or suicidal thoughts or behavior.
The most common side effects of varenicline include:
  • Headaches
  • Changes in taste
  • Nausea
  • Vomiting
  • Trouble sleeping
  • Gas

Other Stop-Smoking Drugs

Other prescription drugs, such as nortriptyline (Pamelor) and clonidine (Catapres), are sometimes recommended for smokers who cannot use varenicline or bupropion.
Both of these are older drugs that may have significant side effects.
Talk to your doctor to decide if either of these are a good option for you when you're ready to stop smoking

Nicotine Replacement Therapy (NRT)

The Food and Drug Administration (FDA) has approved five types of over-the-counter nicotine replacement therapy (NRT) products.
These include nicotine gum, patches, lozenges, and inhalers.
You can use more than one type at a time, but if you do, speak with your doctor to make sure you're not getting too much nicotine at once.

E-Cigarettes

Electroniccigarettes, or e-cigarettes, let you inhale nicotine without the smoke.
These electronic devices discharge a nicotine mist without some of the chemicals found in tobacco. They are among the most popular quit-smoking products on the market, but their use remains controversial among health experts.
Some doctors are concerned that e-cigarettes may be a "gateway drug" to tobacco products, and they contain several chemical compounds (such as formaldehyde) that can cause cancer. 

Additionally, e-cigarettes are not regulated by the FDA, so the health risks associated with their use are not fully understood.

The Effects of Secondhand Smoke

All the cancer-causing ingredients in tobacco are also found in secondhand smoke


 Secondhand smoke — also called SHS, passive, or involuntary smoking — can increase your risk of heart disease, lung cancer, and other serious illnesses.

According to a 2014 Surgeon General's report, about 2.5 million Americans have died from the effects of secondhand smoke over the past 50 years.
If you're a smoker, the health of a loved one could be a primary motivating factor in your decision to quit smoking.

What Is Secondhand Smoke?

Cigarettes, pipes, and cigars emit two types of secondhand smoke: Sidestream smoke, which is the smoke from the lighted end, and mainstream smoke, the smoke exhaled by a smoker.
Of the two, sidestream smoke is the more dangerous; it contains higher concentrations of carcinogens, is more toxic, and has smaller particles that can penetrate deeper into your lungs than those in mainstream smoke.

What Are the Dangers of Secondhand Smoke?

Secondhand smoke has the same nicotine and harmful chemicals that smokers inhale into their lungs.
It contains more than 7,000 chemical compounds, of which more than 250 are known to be harmful, and at least 69 are known to cause cancer.
In the United States, the costs of extra medical care, illness, and death caused by SHS top $5.6 billion per year, reported a 2010 Surgeon General's report.
Each year, it's responsible for an estimated 46,000 deaths from heart disease and about 3,400 lung cancer deaths in adults who don't smoke.
Children are particularly susceptible to the effects of secondhand smoke. Every year, it causes: Severe asthma and asthma-related problems in up to 1 million asthmatic children.
  • Between 150,000 and 300,000 lower respiratory tract infections (bronchitis and pneumonia) in children younger than 18 months
  • Children to be put into intensive care when they have the flu
In addition, there is some evidence suggesting secondhand smoke might be linked to stroke,lymphoma, leukemia, and brain tumors in children.
It's also linked to cancers of the larynx (voice box), pharynx (throat), nasal sinuses, brain, bladder, rectum, stomach, and breast in adults.

Where Is Secondhand Smoke the Biggest Problem?

Secondhand smoke is the most common:
At home: If you're a smoker, the next best thing to quitting that you can do for your family is to keep your home smoke-free.
Spouses, children, and even pets are at risk from the danger of secondhand smoke.
If you live in an apartment building, know that smoke can travel through air ducts and walls, so try to opt for a smoke-free building if at all possible.
At work: Many cities and states have enacted smoke-free work policies, and with good reason: the Surgeon General has said that they are the only way to prevent SHS exposure at work. In the car: Even if you smoke with the windows rolled down, you are putting your passengers at risk for exposure to secondhand smoke. In fact, some cities and states have laws that ban smoking in the car if you have passengers under a certain age or weight.
In public: More and more public spaces are banning smoking, from parks and restaurants to malls and public transportation.
To date, 28 states and the District of Columbia have passed comprehensive smoke-free laws, including banning smoking in restaurants. Whenever you have a choice, always support a smoke-free business over one that is not

How to Quit Smoking------ Health Tips


Here's a simple step-by-step plan to help you stop smoking.



You decided to stop smoking? Great — it's one of the best things you can do for your health.
But quitting isn't easy. Nicotine — the addictive ingredient in tobacco — is as addictive as heroin or cocaine, according to the American Cancer Society.
In fact, the average person attempts to quit six times before succeeding.
Fortunately, there are steps you can take to set yourself up for success and kick the habit for good.
Set a date: Pick a day and time in the near future that you expect to be relatively stress-free so you can prepare to quit smoking.
Quitting when you have a big project due at work, or even when you have something happy on your calendar like a birthday party (if you tend to light up when you are drinking or socializing), can be more challenging.
Write down your reasons: Consider why you want to stop smoking and jot the reasons down. You can refer to them once you quit when you get a craving. A few universal benefits:
  • My risk of cancer, Heart attacks , chronic lung disease, stroke, cataracts, and other diseases will drop.
  • My blood pressure will go down.
  • I'll look better. My skin will be more hydrated and less wrinkled, my teeth will look less yellow and my fingers won't be stained with nicotine.
  • I'll save money.
  • My hair, clothes, car, and home won't reek of smoke.
  • I'll have more energy.
  • I'll set a better example for my kids, friends, and family.
  • I'll live longer.
Get your friends and family on board: The more support you have, the more likely you are to quit smoking.
Ask your loved ones to help keep you distracted by taking walks or playing games, and bear with you if you become cranky or irritable as you experience nicotine withdrawal.
Tell any smokers not to smoke around you, or better yet, ask your smoking buddies to quit with you.
Identify your triggers: You'll be most tempted to smoke during the same times you do now. Knowing your habits and what situations may set off a craving will help you plan ahead for distractions.
For example, you may typically smoke while driving, drinking, or after dinner, or it may be that you reach for a cigarette when you're feeling stressed, lonely, or depressed.
Create healthy distractions to head off potential smoking triggers. If you smoke while you drive, keep a pack of gum on hand, or if you smoke after dinner, plan to take a walk or chat on the phone with a friend.
Anticipate cravings: It's expected that you'll experience nicotine cravings as your body begins to go through withdrawal.
The good news is that cravings aren't endless. They generally last for five minutes and no longer than 10.
When cravings strike, focus on something else: Drink a glass of water, review your list of reasons for quitting, take deep breaths, play with your cat or dog — do whatever it takes until the craving subsides.
Distract yourself: Keep celery stalks, carrot sticks, nuts, or gum handy to give your mouth something to do when cravings occur.
And finding some way to occupy your hands — knitting, woodworking, cooking, yoga, or yard work — will help keep your mind off smoking.
Expect to feel a little off: Nicotine withdrawal can make you feel anxious, cranky, sad, and even make it hard for you to fall asleep.
It helps to know that all these feelings are a normal and temporary part of the process.
Throw out all your cigarettes: Yes, even that emergency one you stashed away.
If you don't have cigarettes on hand, it will make it that much easier to stay the course when a craving hits.
Reward yourself: With all the money you'll save by not buying tobacco, you can buy new clothes, splurge on dinner, or start a new hobby.
Some people keep their cigarette money in a jar, then reward themselves with a treat each week.
Talk to your doctor about cessation medications: If you're not sure you can go cold turkey, don't.
Speak with your doctor about over-the-counter (OTC) and stop-smoking medications that can make quitting easier.


Wednesday 23 March 2016

Simple tips for livening up your drinking water

Not everybody has a taste for water, but we all need it to ensure that our bodies continue functioning properly. If you want to drink more water, but aren't crazy about the taste (or lack thereof), here are some tips that can make it more enjoyable:

1. Add fresh fruit. Citrus fruits, such as lemons, limes, and oranges, are classic water enhancers, but other fruit flavors might also tempt your taste buds. Try crushing fresh raspberries or watermelon into your water, or adding strawberry slices. Cucumber and fresh mint are refreshing flavors as well — especially in summer.

2. Use juice. Any fruit juice can be a good base flavor for water, but tart juices, like cranberry, pomegranate, grape, and apple, are especially delicious. Go for juices that are all natural, with no added sugars. And remember: Fruits and their juices don't just taste good — they contain vitamins and antioxidants that can benefit your health too.

3. Make it bubbly. Many people prefer sparkling to still water. If plain old water isn't inspiring to you, try a naturally effervescent mineral water — which will give you the added benefit of minerals. Or try bubbly seltzer, a carbonated water. You can add fresh fruit or natural juice flavors to your seltzer, as suggested above, or look for naturally flavored seltzers at your local market. If you become a seltzer devotee, you might want to consider getting a seltzer maker for your home.

4. Get creative with ice. Some say that ice water tastes better than water served at room temperature. If that's so, flavored ice cubes may make an even better drink. Use some of the flavoring suggestions above and start experimenting with fresh fruit, mint, or cucumber ice cubes. Simply chop your additive of choice, add it to your ice cube tray along with water, then freeze. You may also consider juice, tea, or coffee cubes. If you want to be more creative, use ice cube trays that come in fun shapes, like stars, circles, or even fish.

5. Drink tea. Herbal, fruit, green, white, and red teas are generally considered to be better for you than black teas (or coffee, for that matter) because they contain little to no caffeine. And there are countless flavors of these teas to choose from. Start with the selection at your local market or health food store. If you're interested in pursuing more exotic flavors and sophisticated teas, start researching the vast array of specialty teas that come from all parts of the globe.

6. Try bouillons, broths, and consommés. If your palate leans toward the savory, you may pass on tea and start sipping one of these hot and savory liquids instead. Choose low-fat and low-sodium versions for maximum health benefits. Because soup is water-based, a cup of hot soup will count toward your daily fluid consumption.


7. Add fast flavor. If you're looking for a quick-and-easy flavor booster, you might also consider sugar-free drink mixes, and flavor cartridges that can be used with your faucet filter system.

The child years poverty linked to human brain changes related to depressive disorder

Children from poorer people are more likely to experience changes in human brain connectivity that put these people at higher risk of depression, compared with kids from more affluent households. This can be the conclusion of the new study by experts from the Washington University or college School of Medicine in St. Louis, MO.


Analysts determined brain changes amongst children from low-income people that were associated with
depression.
First study publisher Deanna M. Barch, PhD, chair with the Department of Psychological & Brain Savoir in Arts
& Savoir, and colleagues publish all their findings inside the North american Journal of Psychiatry.
The study builds on past research from the crew published last year, which will found that children brought up in poverty have lowered gray and white subject volumes inside the mind, compared with those increased in richer families.
In addition, they found that such brain changes had been connected to poorer academic accomplishment.
With this latest study, the team attempted to investigate if childhood poverty may as well cause brain changes
that influence mood and risk of depression, given that children raised in not as good families tend to become at
the upper chances of psychological illness and possess worse intellectual and educational outcomes.

Not as good preschool children at increased depression risk aged on the lookout for or 10

To reach their findings, Barch -- also the Gregory W. Couch professor of psychiatry at Washington's School of Medicine - and fellow workers enrolled 105 preschool kids aged 3-5.
The group calculated the poverty amounts of the children applying an income-to-needs ratio, which will makes
 up a family's size and yearly income. In present, the federal thankfully level in the usa is $24, two hundred and
 fifty 12 months for a family of four.

Between ages of 7-12, the kids underwent functional magnetic reverberation imaging (fMRI), which allowed the researchers to investigate the brain connections in the hippocampus - the place important for learning, recollection and stress regulation -- and the amygdala -- a region associated with stress and emotion.
In comparison with preschoolers from higher-income families, those from lower-income families demonstrated weaker contacts between the left hippocampus and the right outstanding frontal cortex, as very well as weaker connections among the right amygdala plus the right lingual gyrus.
The researchers found that these kinds of weakened brain connections amongst preschool children raised in
poverty were associated with greater likelihood of medical depression at the era of 9 or twelve.
"In this study, we all found which the way all those structures hook up with the rest of the mind within ways we could consider being less useful in regulating emotion and stress, " explains Barch.
What is more, the team found that the poorer children were for preschool age, a lot more likely they will were
to have weakened brain connections and despression symptoms at school age.

Early on intervention key for great emotional development

While the team's earlier research discovered that it could be possible to overcome some changes in brain
structure connected to low income - by increasing a child's home environment, to get example - no many
of these association was determined through this latest study.
Still, Barch stresses that this will not mean nothing can easily be done to inspire positive emotional development between children from poorer households:
"Poverty doesn't put a child on the predetermined flight, but it behooves all of us to remember that undesirable activities early in existence are influencing the creation and function of the brain. And if all of us hope to intervene, we all need to do that early in order that we can easily help shift children on to the best possible developing trajectories. "

Tuesday 22 March 2016

Kidney Diet and Disease





If your kidneys aren't working as they should, your doctor will likely prescribe a diet with specific daily amounts of protein, sodium and potassium. Keeping these nutrients in balance might help prevent kidney disease from getting worse.
Assuming you have kidney disease, you need a registered dietitian nutritionist on your health care team. An RDN will educate you on how to eat very well and manage this latest and very important part of your health plan.
You shall desire a meal plan that meets your individual needs. A registered dietitian nutritionist shall help you accomplish this by taking your food preferences, lifestyle and special needs into account.
Protein helps build, repair and maintain every cell within your body and works extremely well to provide energy if needed. Whenever your kidneys aren't working well, they can't handle as much health proteins. It is vital you eat enough carbohydrates and body fat to provide your body with the energy you need. The limited protein you eat will be utilized to build and mend your cells then. Your new diet will have to include the right balance of protein, carbohydrates and fat. Key sources of protein include meat, poultry, seafood, eggs, milk, nuts and beans. Breads, cereals, vegetables and seeds contain protein, too.
Sodium can raise your blood circulation pressure and make you retain fluids. For people with kidney disease, extra sodium and liquid can build up in your body, that may affect your heart and lungs. Your new diet can include a daily sodium limit. Your RDN will outline how best to stay within this limit. Sodium is found in salt and most processed foods. Make sure to examine labels for salt articles. Check labels of salt substitutes before using them also; many contain potassium which might must be limited.
Like sodium, potassium must stay well balanced in your body. If your kidneys aren't working well, potassium amounts in your bloodstream can rise. Large potassium amounts affect your heart and soul rhythm, so your new diet may include a potassium limit. Your RDN shall explain how to stay within your limit. Potassium is found in many fruits and vegetables, beans, dairy and nuts foods.
An RDN may also help you with other areas of your diet to make sure you get the nutrition you need. These include:
-           Total Calories. Calorie consumption is important in maintaining your weight in a healthy range.
-           Phosphorus. Poor kidney function could cause phosphorus levels to go up in your blood. For that reason, a lower phosphorus diet may be needed.
-           Calcium. A high phosphorus level within your body decreases the availability of calcium for your bones. Your diet shall need to offer the right harmony between phosphorus and calcium.
-           Vitamins and Minerals (especially B-complex, vitamin C, vitamin D, iron and zinc). Limiting certain food groupings to ease the workload on your kidneys could leave you lacking certain minerals and vitamins.



Sunday 20 March 2016

18 Keys to Healthy Weight Loss

Fad diets tend to have lots of very restrictive or complex rules, which give the impression that they carry scientific heft, when, in reality, the reason they often work (at least in the short term) is that they simply eliminate entire food groups, so you automatically cut out calories. Moreover, the rules are almost always hard to stick to and, when you stop, you regain the lost weight.
Rather than rely on such gimmicks, here we present 18 evidence-based keys for successful weight management. You don’t have to follow all of them, but the more of them you incorporate into your daily life, the more likely you will be successful at losing weight and—more important—keeping the weight off long term. Consider adding a new step or two every week or so, but keep in mind that not all these suggestions work for everyone. That is, you should pick and choose those that feel right for you to customize your own weight-control plan. Note also that this is not a “diet” per se and that there are no forbidden foods.

1. Start with a healthful diet.

That means a diet that's rich in vegetables, fruits, whole grains, and legumes and low in refined grains, sugary foods, and saturated and trans fats. You can include fish, poultry, and other lean meats, and dairy foods (low-fat or nonfat sources are preferable to save calories). Aim for 20 to 35 grams of fiber a day from plant foods, since fiber helps fill you up and slows absorption of carbohydrates. A good visual aid to use is the USDA’s my plat, which recommends filling half your plate with vegetables and fruits. Grains (preferably whole grains) and protein foods should each take up about a quarter of the plate.

2. Keep an eye on portions.

You can eat all the broccoli and spinach you want, but for higher-calorie foods, portion control is the key. Check serving sizes on food labels—some relatively small packages contain more than one serving, so you have to double or triple the calories, fat, and sugar if you plan to eat the whole thing. Popular “100-calorie” food packages do the portion controlling for you (though they won’t help much if you eat several packages at once.

3. Eat mindfully.

This involves increasing your awareness about when and how much to eat using internal (rather than visual or other external) cues to guide you. Eating mindfully means giving full attention to what you eat, savoring each bite, acknowledging what you like and don’t like, and not eating when distracted (such as while watching TV, working on the computer, or driving). Such an approach will help you eat less overall, while you enjoy your food more. Research suggests that the more mindful you are, the less likely you are to overeat in response to external cues, such as food ads, 24/7 food availability, and super-sized portions.

4. Eat slowly, chew well.

A component of mindful eating, this allows more time for satiety signals to reach the brain (it takes about 20 minutes), so slow eaters tend to feel more full and eat less. The process of chewing itself may also stimulate satiety signals. In addition, eating slowly makes you more aware of the smell, taste, and texture of the foods, which can lead to greater satisfaction with fewer calories. Keep in mind also that the most pleasure often comes from the first few bites of a food; after that, it’s the law of diminishing returns. Thus, you should focus on those first few tastes of chocolate, cake, or other indulgences, as this may be enough to satisfy. For gadget lovers, the HAPIfork  is an electronic fork that vibrates if you don’t pause long enough between bites.

5. Don’t rely on willpower.

Instead, control your “food environment” so that you don’t unconsciously overfill your plate and eat when you’re not hungry. That means, for example, not having junk foods at home or at least keeping them out of sight (such as on a top shelf or in the back of the fridge)—and changing your routines so you don’t regularly encounter temptations (such as avoiding the office pantry between meals if it has enticing foods and driving a route that doesn’t take you past your favorite food places). Usesmaller plates, bowls, cups, and utensils—you may even want to invest in portion-controlled plates (that delineate what reasonable serving sizes are) or portion-control devices (that allow you to measure your food directly on the plate); many different kinds are available online. Portion out snacks into small bowls or bags; don’t eat from large bags or boxes. You may not have control over everything in your food environment, but being aware of hidden food triggers and traps may be enough to keep you from overeating.

6. Identify emotional triggers that may be making you overeat.

For example, you may eat more when you are stressed, depressed, upset, angry, lonely, or even happy and excited. To distinguish between real hunger and emotional eating, rate your hunger/fullness levels before, during, and after eating on a scale of 1 to 10, with 1 being “beyond hungry” or “starving” (with associated headaches, lightheadedness, and weakness) and 10 being “beyond full” (as in after-Thanksgiving-meal stuffed). Ideally you should eat when you are at level 3 (hungry but not yet uncomfortable) and stop at level 7 .If you often eat for reasons other than hunger, find pleasurable non-food-related activities that you can do instead, such as going for a brisk walk or run.

7. Go for volume (low-energy-dense foods).

Eating foods low in energy density—that is, with fewer calories relative to their weight and volume—increases satiety, so you are likely to fill up on fewer calories. This well-tested concept was first developed by Barbara Rolls, PhD, at Pennsylvania State University in her well-regarded Volumetrics eating plan. In general, the best way to lower the energy density of your diet is to eat more foods that have a high water and high fiber content (notably fruits, vegetables, broth-based soups, and cooked whole grains) in place of low-moisture or high-fat foods (such as cheese, crackers, cookies, and fried potatoes). Incorporate more of these foods in recipes—add more vegetables to soups, stews, and pasta dishes, for example; fill sandwiches and wraps with lots of lettuce, chopped cucumbers, and grated carrots; top whole­ grain pizzas with more vegetables and less cheese. Snack on popcorn and grapes instead of raisins (for the same 120 calories, you can eat more than a cup of grapes compared to only 1/4 cup of raisins).

8. Get adequate protein (and include some with all meals).

There’s evidence that protein increases satiety more than carbohydrates do. Protein also helps limit muscle loss during weight loss. Look for sources of lean protein (such as beans and other legumes, white-meat poultry, and low-fat or nonfat dairy) or those also rich in healthy fats (such as fish, nuts, and soy foods). Some research suggests that distributing your protein throughout the day also helps in weight loss, rather than eating the bulk of it at, say, dinnertime. According to a 2015 paper in theAmerican Journal of Clinical Nutrition, higher-protein diets that include at least 25 grams of protein at each meal may reduce appetite and thus body weight, compared with lower-protein diets. However, people with or at high risk for kidney disease—and that includes many older people—should be careful not to consume excessive amounts of protein.

9. Eat regularly (don’t skip meals) and choose healthful low-calorie snacks.

Many people find that going longer than a few hours without food makes them more likely to overeat later (often on high-calorie treats). Find a meal-timing pattern that works best for you. If you eat between meals, plan ahead for healthful “mini-snacks” (100 to 200 calories), such as a small container of low-fat yogurt with a handful of berries; two tablespoons of hummus with a cup of baby carrots or sliced bell peppers; a slice of cheese or two thin slices of turkey on half a whole-grain pita; an ounce (small handful) of nuts; or a tablespoon of peanut butter and a banana.

10. Limit variety at meals.

Variety in your overall diet is important to ensure that you get a range of nutrients and other substances that contribute to good health. But having too many choices at once can lead to overconsumption (the “smorgasbord effect”) because foods with different flavors and sensory qualities whet the appetite, even if you are physically satiated—which is why there always seems to be “room for dessert.” It’s also easier to overfill your plate when you have a large number of choices. On the other hand, you’re likely to eat less if you have less variety, since foods similar in taste and texture dull the palate (a phenomenon called sensation-specific satiety). Be especially careful at all-you-can-eat buffets and parties. Scan the whole array of foods before making your selection, choose no more than three or four items that most appeal to you, and make only one trip. Using smaller plates also helps limit your choices.

11. Don’t drink your calories.

Beverages are not as satiating as solid foods, and people usually do not compensate for liquid calories by eating less food. It’s okay to drink milk but otherwise stick with water or other noncaloric beverages like tea and coffee (watch the cream and sugar). Choose whole fruits over juice. What about diet beverages? The jury is still out on whether they help with weight loss. The proposed 2015 U.S. Dietary Guidelines do not recommend sugar substitutes, citing a lack of evidence that they help in long-term weight loss. To liven up water, try a squeeze of lemon or lime or other fruit essence. If you drink alcoholic beverages, be aware of their calories (more than you may think) and that alcohol can have a disinhibiting effect on eating control.

12. Cook at home often.

That allows you to eat more whole foods and control how much oil, sugar, and other high-calorie ingredients you use. Studies have shown that people tend to eat more when they eat out—though you must still be careful to limit portion sizes at home. If cooking from recipes, look for healthy lower-calorie ones that include nutrition analyses, and stick to the serving sizes. Be aware also that just as restaurant portions have ballooned in recent years, recipe serving sizes have also been on the increase.

13. When eating out, follow these simple rules.

Take advantage of calorie listings on menus (or online beforehand) to find lower-calorie options, don’t order anything that’s been super-sized, and consider sharing entrĂ©es (or asking for half to be wrapped to take home before you start eating). Or have an appetizer or salad as your main dish. Reading over the whole menu before you order and asking questions of your server or the chef can help steer you toward more healthful, lower-calorie options. Request that dishes be prepared with no or minimal butter, oil, or other high-fat ingredients, and ask for salad dressings on the side so you can control how much you use. And be aware of the menu “tricks” that restaurants use to boost sales—often of cheaper and less-healthful foods.

14. Allow for (controlled) indulgences.

Most people find foods high in fat and sugar pleasurable, since they activate the body’s “reward system” (which releases chemicals in the nervous system relating to pleasure). Overly restricting such foods (or any other types of food you crave) can be counterproductive since it can increase your desire for them and lead to bingeing. An occasional treat is fine, as long as it doesn’t tip the scale with calories. You might, for instance, have a small daily treat or save up for some treats on weekends. On the other hand, some people can’t eat just a little and may be better off avoiding hard-to-resist foods altogether.

15. Keep a food diary.

Studies, including one in the Journal of the Academy of Nutrition and Dietetics, have found that dieters who regularly record what they eat lose more weight than those who don’t. It doesn’t matter how you do it—in a notebook, on the computer, or with an app on your phone—as long as you record your intake consistently and honestly (including even condiments and tastings you may take while cooking). This simple act makes you more accountable for what you eat and helps you see patterns in your eating habits that may be contributing to weight gain.

16. Get enough sleep.

An often overlooked factor in body weight may be your sleep habits. Though the optimal amount of sleep varies from person to person, too little sleep (fewer than six hours a night in one study) has been linked to weight gain because it may affect appetite hormones and lead to increased hunger and food intake, decreased calorie burning, and increased fat storage.

17. Consider weighing yourself regularly—at least once a week.

This increases self-awareness and can provide encouragement if the numbers are going in the right direction—or it can motivate you to get back on track if you detect an upward trend. A 2014 study in PLOS ONE of 40 overweight people found that more frequent self weigh-ins were associated with greater weight loss and that going more than a week without stepping on the scale was associated with weight gain. Regular self-weighing is a particularly effective strategy for maintaining long-term weight loss, according to the National Weight Control Registry, which tracks people who have successfully lost and kept weight off. Whether you weigh yourself and how frequently is a personal decision, however. Some people get discouraged by small fluctuations that occur over the course of a day or several days (which reflect normal shifts in fluid levels, rather than changes in body fat). Keep in mind also that weight is not everything: Another good—and sometimes better—gauge of weight-loss success is to measure your waist and other body areas, such as your hips and thighs.

18. Set realistic goals and have a realistic body image.

Just as weight tends to creep up over time, shedding excess pounds takes time. Don’t expect to be able to lose 10 pounds a week (any diet that says you can is counting on water losses, not fat loss). Small and steady losses—about one to two pounds a week—usually win the race in the long term. For most people, losing just 5 to 10 percent of body weight will provide health benefits. Also keep in mind that, depending on your body type and genetics, you may never be able to get back to your high school or college weight. And if you and your family members tend to have a certain body shape (like a pear, for example), weight loss will result in overall slimming but won’t reshape your body.