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Kate Scarlata is a world-renowned expert in GI nutrition. She’s a researcher, author, podcast host, and sought-after speaker, but the work she’s most proud of? The thousands of patients she’s helped throughout her decades-long career. Hear more about how she got started in GI nutrition, how the landscape has changed, and how her tenacity has helped bring nutrition to the forefront of patient care. Kate’s advice for the next generation of dietitians: “Educate yourself. Follow the science.” Tune in to this inspiring and empowering conversation to hear more of her career reflections from her incredible career and insights on where the profession is headed.
Hosted by Kristin Houts
Biography
Kate Scarlata MPH, RDN is a US-based gastroenterology specialized registered dietitian, researcher, writer and speaker with over 3 decades of clinical experience. Kate is a New York Times best-selling co-author of 21-Day Tummy Diet, co-author of The Low FODMAP Diet Step by Step and her latest book, Mind Your Gut, co-authored with GI psychologist Dr. Megan Riehl. Kate has made significant contributions to the field of GI nutrition. She is widely regarded for her insightful presentations at both national and international GI meetings.
In this episode, we discuss:
Kate’s personal experience that led to a career in GI nutrition
How empathy and empowerment impact patient care
The changing role of diet in the management of several GI conditions
What’s next in nutrition– and where dietitians need to be!
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Beginner-Friendly: A Guide to Help You Get Started
Whether you’re a newcomer to the world of personal finance, entrepreneurship, or simply a curious individual looking to improve your life, being a beginner can be daunting. There are so many options, ideas, and possibilities out there that it’s easy to feel overwhelmed. In this article, we’ll provide a comprehensive guide to help beginners get started on their journey, focusing on beginner-friendly resources, tips, and techniques.
Why Being a Beginner is Okay
Before we dive into the nitty-gritty, let’s address a common misconception: being a beginner is okay. In fact, being a beginner is an excellent starting point. Many successful individuals, including entrepreneurs and financial experts, began their journeys from scratch. The key is to take it one step at a time, ask questions, and be willing to learn.
Resources for Beginners
When starting out, it’s essential to have access to reliable and beginner-friendly resources. Here are some top recommendations:
Books
"Rich Dad Poor Dad" by Robert Kiyosaki – A classic book on personal finance and wealth creation
"The 4-Hour Work Week" by Timothy Ferriss – A motivational guide to creating a lifestyle of wealth and freedom
"The Lean Startup" by Eric Ries – A must-read for entrepreneurs and startup enthusiasts
"The Simple Path to Wealth" by JL Collins – A straightforward guide to investing and achieving financial independence
Online Courses and Tutorials
Coursera’s "Personal Finance" course by Wharton University
Udemy’s "Financial Freedom" course
Skillshare’s "Entrepreneurship" course
YouTube channels such as Dave Ramsey, GaryVee, and Graham Stephan
Mobile Apps
Mint – A free personal finance app for tracking expenses and managing budgets
Personal Capital – A financial management app for tracking investments and retirement accounts
Canva – A graphic design app for creating visual content
Todoist – A task management app for staying organized and focused
Online Communities and Forums
Reddit’s r/personalfinance and r/entrepreneur
Quora’s personal finance and entrepreneurship sections
Facebook groups such as "Personal Finance for Beginners" and "Entrepreneurs Unite"
Beginner-Friendly Tips and Techniques
Now that you have access to valuable resources, here are some beginner-friendly tips and techniques to help you get started:
Practice Mindset Shifts
Focus on progress, not perfection.
Embrace failure as a learning experience.
Stay positive and motivated by celebrating small wins.
Develop Good Habits
Start with small, achievable goals.
Track your progress and stay accountable.
Create a routine and stick to it.
Leverage Technology
Use apps and tools to streamline your financial management.
Automate your investments and savings.
Utilize virtual assistants for task management.
Overcoming Common Challenges
As a beginner, you’ll likely encounter common challenges such as procrastination, self-doubt, and feeling overwhelmed. Here are some strategies to overcome these hurdles:
Procrastination
Break down large tasks into smaller, manageable chunks.
Set timers and take regular breaks to maintain focus.
Reward yourself for meeting deadlines.
Self-Doubt
Focus on your strengths and abilities.
Seek feedback and guidance from others.
Celebrate your small wins to build confidence.
Feeling Overwhelmed
Prioritize your tasks and focus on one thing at a time.
Practice deep breathing and meditation to reduce stress.
Break your goals down into smaller, achievable steps.
Conclusion
Beginner-friendliness is all about embracing the process, taking it one step at a time, and being willing to learn. By accessing the right resources, following beginner-friendly tips and techniques, and overcoming common challenges, you’ll be well on your way to achieving your goals. Remember, being a beginner is okay, and it’s normal to feel uncertain or overwhelmed at first. With patience, persistence, and the right support, you can turn your ideas into reality.
FAQs
Q: What are the best beginner-friendly resources for personal finance?
A: Some of the best resources for beginners include "Rich Dad Poor Dad" by Robert Kiyosaki, the Coursera course "Personal Finance" by Wharton University, and the Mint personal finance app.
Q: How do I start investing as a beginner?
A: As a beginner, start by educating yourself on investing and setting clear financial goals. Use apps like Robinhood or Acorns to automate your investments, and consider consulting with a financial advisor.
Q: What are some effective ways to stay organized and focused?
A: Use task management apps like Todoist, set reminders, and prioritize your tasks to stay organized and focused. Additionally, practice time-blocking to create a schedule that works for you.
Q: How do I overcome self-doubt as a beginner?
A: Focus on your strengths and abilities, seek feedback and guidance from others, and celebrate your small wins to build confidence. Additionally, practice mindfulness and positive self-talk to overcome negative self-doubt.
Q: What are some beginner-friendly online communities for entrepreneurs?
A: Some popular online communities for entrepreneurs include Reddit’s r/entrepreneur, Quora’s entrepreneurship section, and Facebook groups like "Entrepreneurs Unite."
Presence is meditation in motion. It is the practice of bringing mindfulness into the activities of daily life. We can practice the art of being here, now, while waiting in a long grocery store line, changing a baby’s diaper, or sitting in traffic.
Presence involves a simple yet incredible shift—from the ordinary state of mind wandering to bringing our attention to the experience of what is happening right now. You can make this shift anytime, anywhere.
Why develop this habit? Spiritual leaders and philosophers have attempted to answer this question for thousands of years. And yet Ferris Bueller (the impetuous high school student from the classic 1986 film) might just have the best answer: “Life moves pretty fast,” he warned. “If you don’t stop and look around for a while, you might miss it.”
He’s right. Life without presence moves pretty fast. When we wake up, go to work, and do the other things we need to do, we often operate on autopilot; the days fly by, as do the weeks, months, and years. In fact, scientists have confirmed that this experience of time “flying by” increases with age. With each passing year, the novelty of life diminishes and our perception of time accelerates.
When we wake up, go to work, and do the other things we need to do, we often operate on autopilot; the days fly by, as do the weeks, months, and years.
This has led the mindfulness teacher Jon Kabat-Zinn to argue that if you really want to live a longer life, presence—not drugs, healthy eating, or any other strategy—is the best solution. You may not actually live longer in terms of calendar time, but your experience of life and your perception of time will expand. The days, months, and years can be richer, more meaningful, and more fully lived.
Appreciating the fall leaves, listening to the crunch under your feet as you walk on the winter snow, smelling the scents of flowers or fresh-cut grass, feeling the warmth of the summer sun—these simple acts of presence slow life down. They help us go through each day feeling more alive, awake, and content.
There are other benefits, too. Presence doesn’t simply change the quality of being. It can also transform the quality of what you do, leading to greater creative flow, enhanced relationships, and increased productivity at home and at work.
Through developing the habit of presence, we can get in touch with the fundamental wonder of what it is to be alive, and even the most ordinary moments become extraordinary.
How to Stay in the Present Moment
But it’s not that simple. There’s also something quite mysterious about this moment. It’s not like the past, which stretches infinitely behind us. It’s also not like the future, which stretches infinitely ahead. In fact, the moment you try to capture it, it’s gone. It becomes just another part of the past.
Philosophers have strived to define the present moment. While some have seen it as almost nonexistent—fleeting and infinitely thin—others saw it as having infinite depth.
In fact, the ancient Greeks identified three ways that opening to the present moment increases the depth of our experience and productive possibilities of each moment. First, when we fully experience what is here and now, we no longer postpone what we most want. We live our fullest life now. The philosopher Epicurus captures this ethos of urgency:
“We are only born once—twice is not allowed—and it is necessary that we shall be no more, for all eternity; and yet you, who are not master of tomorrow, you keep on putting off your joy?”
This is something many of us have experienced. Have you ever heard the shocking and sad news that someone close to you has died and then thought, Am I living life as fully and as presently possible? Death makes us acutely aware of our aliveness and the preciousness of each moment.
Second, attending to the present moment enables us to take advantage of the full range of possibilities that exist in each moment. This helps us adapt to even the most challenging situations. If you’re stuck at the airport with a long delay, you can let your mind swirl with thoughts about the past and future: I should have taken the earlier flight or I am going to be so late and tired. Or you can experience the power of the present moment and take advantage of the new possibilities available to you as a result of the delay: go for a brisk walk through the concourse, read for pleasure, eat a meal, or catch up with friends on the phone.
When we manage to enter the razor-thin moment of presence, something amazing happens: anxieties and resentments dissolve. We experience more ease, calm, and peace.
Being present opens up a third possibility: happiness and well-being. When we spend the day traveling through the past and future, we tend to get trapped in a host of negative emotions, from anxiety to irritation to resentment. The Epicurean school of ancient Greek thought used sayings like this: “Senseless people live in hope for the future, and since this cannot be certain, they are consumed by fear and anxiety.”
When we manage to enter the razor-thin moment of presence, something amazing happens: anxieties and resentments dissolve. We experience more ease, calm, and peace. In short, we experience more well-being. What is the present moment? This almost sounds like a trick question. Everyone knows that the present moment is what’s happening now. The wind in the trees, the touch of fabric against your skin, your dog brushing up against your leg.
The Science and Practice of Presence
The science on this is clear. Spending more time in the present moment leads to greater happiness. A Harvard University study conducted in 2010 by Matthew A. Killingsworth and Daniel T. Gilbert, for example, revealed that happiness is inversely related to mind wandering—the amount of time that we spend time traveling through thoughts about past and future.
Killingsworth and Gilbert discovered that most of us spend a lot of time mind wandering—distracted from the present moment. In fact, the average person spends 47 percent of the day mind wandering: thinking about something other than his or her present activity.
Their key insight, however, wasn’t just that our minds wander. It was the link between presence and happiness. Killingsworth concluded, “How often our minds leave the present and where they tend to go is a better predictor of our happiness than the activities in which we are engaged.” In other words, this landmark study shows that one of the keys to happiness lies in simply redirecting our attention from mind wandering and distraction to what’s happening right here, right now in the present moment.
A Practice to Shift Your Attention to the Present Moment
Notice—see if you can become aware—each time you step into the shower.
Shift your attention to the sights, sounds, and bodily sensations of the present moment. To do this, we recommend that you ground your feet and bring your attention to your breath. Use what we call the “4×4 breath” or the box breath—four counts in, four counts out, for four breaths. This move will help you begin building the habit of shifting your attention from mind wandering and stress to the present moment.
Rewire—encode this experience deep into your memory by savoring it for just 15 to 30 seconds.
Quick Tips
Do it every day: Practice presence every day and, if you forget to do it in the shower, practice presence during some other everyday life moment, such as walking up the stairs or starting your car.
How to remember to do it:The most difficult thing about building this habit is remembering. To help you remember, we have developed a low-tech but extremely effective method. Put a sticker at eye level on your shower door. If you don’t want to use a sticker (or don’t have a shower door), you could use a piece of masking tape with “Presence” written on it. After a month or so, once the habit is ingrained, you may find that you no longer need it.
How you know it’s working: After a couple of weeks or a month, you will likely start to notice that you no longer need to consciously remember to experience presence. It just starts to happen as you enter the shower. This is the magic moment of habit formation. It means that your brain has wired a new set of connections around this everyday activity.
If you want more: If you have mastered the habit in the shower, try adding an advanced cue: stairs. Every time you walk up or down a flight of stairs, see if you can be present. This is a perfect time to feel the sensations in your feet or to bring your attention to the sights and sounds that occur as you step. This additional cue will take you even deeper into the experience of presence.
Mindfulness teacher Jason Gant reflects on a heartfelt memory when he was able to lean on his deep practice and mindfully take action. Read More
Reclaim the first few moments of your day by dedicating some time to morning meditation or an empowering routine. To help you get started, we’ve gathered our best tips on how to ease your mind and body into a new day. Read More
Mindful Staff
April 28, 2021
Tita Angangco, cofounder of The Centre for Mindfulness Studies, shares a loving-kindness meditation that serves as an ignition to spark change. Read More
Obsessed with the pursuit of happiness? Be cautious — overthinking about it might affect happiness. While it is important to strive for happiness, constant obsession, overthinking, and concerns about one’s happiness can affect well-being, a study revealed.
People who value happiness highly are often found to be less happy. To understand why, researchers of the latest study looked at two aspects of valuing happiness. The first is how strongly someone views happiness as a key goal, which measures the aspiration to happiness. The second is how much they worry about their current happiness, which indicates concern about happiness.
The researchers then tested their hypothesis using three experiments conducted on a large sample size involving more than 1,800 participants. The sample involved participants from Yale University students, community members from Denver and Berkeley, California, and online studies with participants from the United States and Canada. They were assessed on their beliefs about happiness and tested for psychological well-being and depressive symptoms.
The results showed that unlike previously thought, the pursuit of happiness is generally harmless. However, being overly concerned about current happiness can lead to negative feelings about happiness, which can reduce overall life satisfaction, psychological well-being, and a greater chance of depressive symptoms.
“These findings suggest that highly valuing happiness is not inherently problematic; however, concern and judgment about one’s happiness can undermine it,” the researchers wrote in the study in the journal Emotion.
The researchers also noted that worrying about one’s happiness was linked to greater negativity about positive events.
“Thinking too much about one’s own level of happiness could be related to fears about not measuring up or not being as happy as other people. Having high expectations for one’s happiness can be detrimental because it makes it more difficult to achieve the level of happiness that we are expecting from a positive event,” lead researcher Felicia Zerwas said in a news release.
“There are plenty of societal pressures, at least within the United States, which encourage the fallacy that people must feel happy all of the time to achieve greater well-being. Overall, allowing yourself to experience your emotions, whether they are positive or negative, with an accepting attitude could be a useful tool for pursuing happiness and increasing well-being,” Zerwas said.
If you have a passion for cooking and dream of a culinary career, studying abroad can be a transformative experience. Beyond diverse cuisines and techniques, it offers a unique cultural immersion, enriching your culinary perspective. Here, we explore five of the best countries to study culinary arts abroad, each offering distinct advantages and opportunities for aspiring chefs.
Why Study Culinary Arts Abroad?
Studying culinary arts abroad offers numerous benefits that can significantly build your career. Firstly, it provides cultural immersion. You’ll experience diverse culinary traditions and techniques firsthand, expanding your repertoire and creativity in the kitchen. Additionally, studying abroad often means learning from world-renowned chefs and institutions, which can provide a competitive edge in the job market. According to a 2023 report by the World Association of Chefs’ Societies, chefs with international training are 30% more likely to secure top positions in the culinary industry.
1. France
Why Study in France?
France is often considered the culinary capital of the world, and for good reason. The country boasts a rich gastronomic heritage, with a focus on technique, precision, and artistry. French cuisine has influenced culinary traditions worldwide, making it an ideal place for aspiring chefs to improve their skills.
Top Culinary Schools
Le Cordon Bleu, Paris: Known for its rigorous training and prestigious reputation, Le Cordon Bleu offers a variety of programs in cuisine, pastry, and wine.
Ecole Ducasse: Founded by the legendary chef Alain Ducasse, this institution focuses on both culinary arts and entrepreneurship, preparing students for different career paths.
Programs and Opportunities
France offers a variety of programs ranging from short courses to full degrees in culinary arts. Many even include internships at top restaurants, giving you invaluable hands-on experience. According to a 2023 report by the French Ministry of Education, over 70% of culinary students in France find employment within six months of graduation.
Cultural Experience
Living in France allows you to immerse yourself in a culture that takes food seriously. From local markets to Michelin-starred restaurants, the culinary practice in France is broad and rich. This exposure helps you understand the importance of ingredients, techniques, and presentation in French cuisine.
2. Italy
Why Study in Italy?
Italy is another top destination for culinary arts education. Known for its regional diversity in cuisine, studying in Italy offers a comprehensive understanding of Italian culinary traditions. Cities like Florence, Rome, and Bologna are renowned for their culinary schools and thriving food culture.
Top Culinary Schools
ALMA – The International School of Italian Cuisine: Located in Parma, ALMA offers comprehensive programs that cover all aspects of Italian cuisine, from pasta making to wine pairing.
Italian culinary schools offer a range of programs, from short courses in pasta making to full degrees in culinary arts. According to a 2024 study by the Italian Ministry of Education, 65% of culinary graduates in Italy secure jobs within three months of completing their studies.
Cultural Experience
Italy’s culinary culture is deeply rooted in its history and traditions. Studying here allows you to experience the local food markets, vineyards, and traditional cooking methods. This cultural immersion is important for anyone looking to specialize in Italian cuisine.
3. Japan
Why Study in Japan?
Japan has a unique blend of traditional and modern culinary arts. Known for its precision and attention to detail, Japanese cuisine is a perfect study for those interested in mastering the art of sushi, ramen, and kaiseki.
Top Culinary Schools
Tokyo Sushi Academy: Specializing in sushi and Japanese cuisine, this academy offers intensive programs for beginners and experienced chefs.
Le Cordon Bleu Tokyo: This branch of the renowned French culinary school provides courses in both Japanese and French cuisine, offering a unique cross-cultural experience.
Programs and Opportunities
Japanese culinary schools offer specialized programs in various aspects of their cuisine. According to a 2023 report by the Japanese Ministry of Education, 80% of culinary students in Japan find employment within six months of graduation.
Cultural Experience
Studying in Japan provides an opportunity to immerse yourself in a culture that values precision and aesthetics in food preparation. From bustling fish markets to serene tea ceremonies, the cultural experience is enriching and educational.
4. Thailand
Why Study in Thailand?
Thailand is known for its colorful and flavorful cuisine. Studying here provides an opportunity to learn about the intricate balance of flavors and the use of fresh ingredients that define Thai cuisine.
Top Culinary Schools
Blue Elephant Cooking School: Located in Bangkok, this school offers a range of programs from short courses to professional chef training.
Le Cordon Bleu Dusit: This branch of the famous culinary school provides comprehensive programs in Thai and international cuisine.
Programs and Opportunities
Thai culinary schools offer a range of programs, from short courses in street food to full degrees in culinary arts. According to a 2024 study by the Thai Ministry of Education, 75% of culinary graduates in Thailand find employment within three months of completing their studies.
Cultural Experience
Living in Thailand allows you to experience the local food markets, street food culture, and traditional cooking methods. This cultural engagement is essential for anyone looking to specialize in Thai cuisine.
5. Spain
Why Study in Spain?
Spain provides a unique experience with its diverse regional cuisines. Known for its tapas, paella, and innovative culinary techniques, Spain is a great place to study culinary arts.
Top Culinary Schools
Basque Culinary Center: Located in San Sebastián, this prestigious institution offers undergraduate and postgraduate programs in culinary arts and gastronomy.
Le Cordon Bleu Madrid: This branch of the famous culinary school provides a range of programs in Spanish and international cuisine.
Programs and Opportunities
Spanish culinary schools offer a variety of programs, from short courses in tapas making to full degrees in culinary arts. According to a 2023 report by the Spanish Ministry of Education, 68% of culinary graduates in Spain secure jobs within six months of completing their studies.
Cultural Experience
Studying in Spain provides an opportunity to engulf yourself in a culture that values social dining and innovative culinary techniques. From local food markets to Michelin-starred restaurants, the culinary practice in Spain is diverse and exciting.
Conclusion
Choosing the right country to study culinary arts can significantly impact your career. Each of these countries offers unique opportunities to learn from the best, gain hands-on experience, and immerse yourself in rich culinary traditions. Whether you dream of mastering French pastries, perfecting Italian pasta, or exploring Japanese sushi, studying abroad can help you turn your passion into a rewarding career.
Explore these top culinary destinations, to develop your skills, gain invaluable experience, and launch a successful culinary career.
Pain that involves more than just one joint is called polyarticular joint pain. A joint may simply be painful (arthralgia) or may also be inflamed (arthritis).
True joint pain (arthralgia) may or not be accompanied by joint inflammation (arthritis). The most common symptom of joint inflammation is pain. Inflamed joints may also be warm and swollen, and less often the overlying skin may be red. Arthritis may involve only joints of the limbs or also joints of the central part of the skeleton, such as the spine or pelvis. Pain may occur only when a joint is moved or may be present at rest. Other symptoms, such as rash, fever, eye pain, or mouth sores, may be present depending on the cause of the joint pain.
Different disorders tend to affect different numbers of joints. Because of this, doctors consider different causes of pain when the pain affects one joint (see Joint Pain: Single Joint) than when it affects more than one joint. When multiple joints are involved, some disorders are more likely to affect the same joint on both sides of the body (for example, both knees or both hands) than other disorders. This is termed symmetric arthritis. Also, in some disorders, an attack of arthritis remains in the same joints throughout the attack. In other disorders, the arthritis moves from joint to joint (migratory arthritis).
Causes of Pain in Many Joints
In most cases, the cause of pain originating inside multiple joints is arthritis. Disorders that cause arthritis may differ from each other in certain tendencies, such as the following:
How many and which joints they usually involve
Whether the central part of the skeleton, such as the spine or pelvis, is typically involved
Whether arthritis is sudden (acute) or longstanding (chronic)
Acute arthritis affecting multiple joints is most often due to
Chronic arthritis affecting multiple joints is most often due to
Some chronic inflammatory disorders can affect the spine as well as the limb joints (called the peripheral joints). Some affect certain parts of the spine more frequently. For example, ankylosing spondylitis more commonly affects the lower (lumbar) part of the spine, whereas rheumatoid arthritis more typically affects the upper (cervical) part of the spine in the neck.
The most common disorders outside the joints that cause pain around the joints are
Bursitis and tendinitis often result from injury, usually affecting only one joint. However, certain disorders cause bursitis or tendinitis in many joints.
Evaluation of Pain in Many Joints
In evaluating joint pain, doctors first try to decide whether joint pain is caused by a disorder of the joints or a serious bodywide (systemic) illness. Serious bodywide disorders may need specific immediate treatment. The following information can help people decide when to see a doctor and know what to expect during the evaluation.
In people with pain in more than one joint, symptoms that should prompt rapid evaluation include
Joint swelling, warmth, and redness
New skin rashes, spots, purple blotches, or nail pitting
Sores in the mouth or nose or on the genitals
Chest pain, shortness of breath, or new or severe cough
Abdominal pain
Fever, sweats, weight loss, or chills
Eye redness or pain
People with warning signs should see a doctor right away. People without warning signs should call a doctor. The doctor decides how quickly they need to be seen based on the severity and location of pain, whether joints are swollen, whether the cause has been diagnosed previously, and other factors. Typically, a delay of several days or so is not harmful for people without warning signs.
Doctors first ask questions about the person’s symptoms and medical history. Then they do a physical examination. What doctors find during the history and physical examination often suggests a cause for joint pain and guides the tests that may need to be done (see table Some Causes and Features of Pain in More Than One Joint).
Doctors ask about pain severity, onset (sudden or gradual), how symptoms vary over time, and what increases or decreases pain (for example, rest or movement or time of day when the symptoms worsen or abate). They ask about joint stiffness and swelling, previously diagnosed joint disorders, and risk of exposure to sexually transmitted infections and Lyme disease.
Doctors then do a complete physical examination. They check all joints (including those of the spine) for swelling, redness, warmth, tenderness, and noises that are made when the joints are moved (called crepitus). The joints are moved through their full range of motion, first by the person without assistance (called active range of motion) and then by the doctor (called passive range of motion). This examination helps determine which structure is causing the pain and if inflammation is present. They also check the eyes, mouth, nose, and genital area for sores or other signs of inflammation. The skin is examined for rashes. Lymph nodes are felt and the lungs and heart examined. Doctors usually test function of the nervous system so that they can detect disorders of the muscles or nerves.
Some findings give helpful clues as to the cause. For example, if the tenderness is around the joint but not over the joint, bursitis or tendinitis is likely the cause. If tenderness is present in many areas besides the joints, fibromyalgia is possible. If the spine is tender as well as the joints, possible causes include osteoarthritis, reactive arthritis, ankylosing spondylitis, and psoriatic arthritis. Findings in the hand can help doctors differentiate between rheumatoid arthritis and osteoarthritis, two particularly common types of arthritis. For example, rheumatoid arthritis is more likely to involve the large knuckle joints (those that join the fingers with the hand) and wrist. Osteoarthritis is more likely to involve the finger joint near the fingernail. The wrist is unlikely to be affected in osteoarthritis, except at the base of the thumb.
The following tests are the most important overall:
If joints are swollen, doctors usually insert a needle into the joint to take a sample of the fluid in the joint for testing (a procedure called joint aspiration or arthrocentesis). Doctors numb the area before taking a sample, so people experience little or no pain during the procedure. Doctors generally do a culture on the fluid to see whether infection is present. They look under a microscope for crystals in the fluid, which indicate gout or related disorders. The numbers of white blood cells in the fluid indicate whether the joint is inflamed.
Doctors also often do blood tests for autoantibodies. Examples of such tests are antinuclear antibodies, anti–double-stranded DNA, anticyclic citrullinated peptide, and rheumatoid factor. Autoantibodies in the blood may indicate an autoimmune disorder such as rheumatoid arthritis or systemic lupus erythematosus.
The ESR is a test that measures the rate at which red blood cells settle to the bottom of a test tube containing a blood sample. Blood that settles quickly typically means that bodywide (systemic) inflammation is likely, but many factors can affect the ESR test including age and anemia, so the test is sometimes inaccurate. To help determine whether bodywide inflammation is present, doctors sometimes do another blood test called C-reactive protein (a protein that circulates in the blood and dramatically increases in level when there is inflammation).
Imaging tests are sometimes necessary, especially if there is a possibility of bone or joint tumors. X-rays are done first, but sometimes computed tomography (CT) or magnetic resonance imaging (MRI) is needed.
The underlying disorder is treated. For example, people with an autoimmune disorder (such as systemic lupus erythematosus) may need a drug that suppresses the immune system. People with a gonorrhea infection in the joint need antibiotics.
Symptoms can usually be relieved before the diagnosis is known. Inflammation can usually be relieved with nonsteroidal anti-inflammatory drugs (NSAIDs). Pain without inflammation is usually treated more safely with . Immobilizing the joint with a splint or sling can sometimes relieve pain. Applying heat (for example, with a heating pad) may decrease pain by relieving spasm in the muscles around joints (for example, after an injury). Applying cold (for example, with ice) may help relieve pain caused by joint inflammation. Heat or cold should be applied for at least 15 minutes at a time to allow deep penetration. The skin must be protected from extremes of heat and cold. For example, ice should be put in a plastic bag and wrapped in a towel.
After the acute pain and inflammation have lessened, physical therapy may be useful to regain or maintain range of motion and strengthen surrounding muscles. In people with chronic arthritis, continued physical activity is important to prevent permanent joint stiffness (contractures) and muscle loss (atrophy).
Essentials for Older People: Joint Pain
Osteoarthritis is the most common cause of multiple joint pains in older people.
Although more common among younger adults (those aged 30 to 40), rheumatoid arthritis can also begin later in life (after age 60).
People over age 55 who have hip and shoulder stiffness and pain that is usually worse in the morning may have polymyalgia rheumatica. Recognizing polymyalgia rheumatica is important because treating it can help prevent other problems.
Gout in older women tends to affect the distal interphalangeal (DIP) joints of the hands (the first knuckles from the tip of the fingers).
Key Points
Acute pain in multiple joints is most often due to inflammation, gout, or the beginning or flare up of a chronic joint disorder.
Chronic pain in multiple joints is usually due to osteoarthritis or an inflammatory disorder (such as rheumatoid arthritis) or, in children, juvenile idiopathic arthritis.
When significant fluid accumulates inside of a joint, a fluid sample usually must be withdrawn and tested.
Lifelong physical activity helps maintain range of motion in people with chronic arthritis.
There’s been a growing shift in the fitness, health, and wellness industry.
The promise of “immediate results” will probably never lose its sparkle.
But, as a good portion of our population (hi, Boomers!) moves into their “silver” years, conversations around optimizing lifespan (how long you live) and healthspan (how long you live with a high quality of life) are also on the rise.
People are more interested than ever in longevity, which, these days, means the combination of a long lifespan and a long healthspan. (Historically, longevity and lifespan were synonymous.)
Trending too is the concept of biological age—essentially, how “old” your cells are, determined by their health and functioning. (Compare this to chronological age, which just refers to how many years you’ve been on this planet.)
Increasingly, people want to improve their overall health—for the long haul.
Of course, the wellness market is responding to this trend with supplements, ultra-specific diet plans, I.V. therapy, cold plunges, and other fringe modalities that promise to reduce or slow biological aging.
While some of these therapies are questionable, the movement that inspired them is great; For many of us in the health and fitness industry, the shift toward holistic health and long-term wellbeing is a welcome one.
At PN, we’ve held and promoted this expanded view of health for a while now.
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We call it Deep Health
Deep Health is a “whole-person, whole-life” phenomenon that involves thriving in all dimensions of the human experience.
This framework of health includes six interdependent dimensions that influence and interact with each other.
These six dimensions are:
✅ Physical health
The one we all know best, and what people have historically thought of when thinking about health.
This is how your body feels, functions, and performs.
We measure physical health with blood work—such as your cholesterol and hormone levels and your blood pressure—as well as performance metrics like V02 max and demonstrations of strength, and subjective measures like energy and pain levels.
✅ Emotional health
This is about feeling a full range of emotions, but having more positive than negative feelings.
You can recognize, regulate, and appropriately express your emotions directly, maturely, and honestly. You have the resilience to recover from strong emotions, and calm yourself when you become stressed, anxious, or upset.
✅ Environmental health
This is about being and feeling safe and secure, as well as being and feeling supported by your everyday surroundings.
You have access to resources (health care, healthy food, clean air and water, nature) that support your goals and wellbeing.
✅ Mental or cognitive health
This is related to how well you think, learn, remember, and creatively problem-solve.
Your mind is sharp, and you’re able to be your most productive and do your best thinking.
This dimension also includes your mindset, capacity for insight, and your perspective and outlook on the world.
✅ Existential or purposeful health
Some might think of this as spiritual or soul health.
You have a deeper “why” or purpose for your life; you feel part of a “bigger picture.”
You have a strong sense of yourself and your intrinsic self-worth. You work to fulfill your purpose by choosing behaviors that align with your identity and values.
✅ Social or relational health
This is about connecting and interacting well with others.
You develop and maintain authentic, fulfilling relationships. You have a sense of belonging, and you feel respected, “seen,” valued, and supported by others.
If you have Deep Health, it’s almost a guarantee…
You’re experiencing a life well-lived. A vibrant, thriving life that’s healthy in every sense of the word.
Not surprisingly, such a life is also statistically more likely to last longer, with more of those years being enjoyable.
(For more on Deep Health, plus how you can use the concept to transform your own—or your clients’—health, read: The “Deep Health” coaching secret)
High-impact habits to boost Deep Health (and by extension healthspan, longevity, and biological age)
While there are many things that can impact healthspan, longevity, and biological age, the following will give you the best return on investment.
These aren’t always the “sexiest” actions, nor are they likely to sound “cutting edge” (partly because they’ve been tested by time and robustly proven by decades of research).
But—if you’re looking to maximize Deep Health for as long as possible—they’re the things worth spending your time on.
The most important thing is being active.
If there’s a “magical panacea” out there, it’s exercise.
Before you start beating yourself up for not being “a gym person”…
…Any activity helps…
…At any dose.
Whether you clean your yard, vacuum, play games with your pets or kids, or just do a little walking, tell yourself, “I’m doing great!”
Because you are. These activities make a positive, measurable difference.
If you want to level up, get in a mix of aerobic or cardiovascular exercise, strength training, and stability work (like yoga, tai chi, or balance-challenging exercises).
Again, these can be in whatever amounts you can, in ways you enjoy.
For quintuple stars, aim for at least 150 minutes per week of moderate aerobic exercise (or 75 minutes of intense aerobic exercise), plus two or more strength and stability training sessions per week. (If you do these activities with friends—bonus!—now you’re boosting social health too.)
In general, the more activity the better. (So long as you enjoy it—and your body is recovering adequately.)
A thoughtful diet—and a mindful approach to other substances—is big, too.
Rather than focus on food you “shouldn’t be eating,” center your attention on the abundance of foods that serve your health and wellbeing.
We’re talking:
Lean proteins (which can come from animals and/or plants, like fish, chicken, tofu, eggs, tempeh, Greek yogurt)
A rainbow of fruits and vegetables (fact: different colors provide different nutrients and benefits, so aim to eat all of the colors regularly)
Minimally-processed carbohydrates (whole grains, beans and lentils, starchy tubers like potatoes and sweet potatoes, and winter squash)
Healthy fats (from nuts, seeds, avocados, extra virgin olive oil, nut butters, and a little dark chocolate)
To stay hydrated, drink plenty of water. For variety, emphasize mostly zero-calorie drinks like unsweetened tea and coffee. (If you’re confused about how much fluid to drink every day, you’ll love the “pee chart” in this article: ‘How much water should I drink?’)
Avoid smoking or chewing tobacco, and if you drink alcohol, do so lightly to moderately.
And of course, getting quality sleep and regulating stress makes everything better.
Get enough quality sleep by prioritizing and protecting the time you rest.
Make your sleeping area as comfortable, quiet, and dark as possible. Figure out when you need to get to bed to get seven to eight hours of sleep, and ideally, start winding down with a relaxing bedtime ritual about half an hour to an hour before that time.
(Want to learn more about why sleep is so important—and how to get more of it? Check out our infographic: The power of sleep)
To build your emotional resilience and stress tolerance, incorporate soothing, self-regulating activities daily.
These activities are somewhat subjective (some people find it relaxing to sit and meditate, while others find it to be an opportunity for restless anxiety to boil over). However, “crowd favorites” include: breathing exercises, time in nature, various forms of self-expression (journaling, art, movement), or just a good soak in the tub.
One of the most important mindsets to adopt to help your mental and emotional health—although it can benefit all areas of life—is a growth mindset.
People with a growth mindset tend to view challenges and adversity as opportunities to grow, evolve, and learn. And turns out, this kind of perspective isn’t just good for your mental and emotional health, it boosts longevity, too.
Research shows that, compared to less optimistic individuals, those with a more positive attitude and a growth mindset about aging had a 43 percent lower risk of dying from any cause, and lived about 7.5 years longer.1 2
Lastly, don’t underestimate the power of finding your people—and a purpose.
Seeking and nurturing positive, supportive relationships is one of the best things you can do for your health.
And not just for your social health. Research shows that people who are satisfied with their relationships have better emotional health,3 cognitive health,4 and even physical health.5
In fact, one of the longest studies on human health—the Harvard Study of Adult Development, which tracked participants for nearly 80 years—showed that feeling happy and satisfied in one’s relationships was one of the best predictors of overall health, happiness, and longevity.6
Having a strong sense of purpose bolsters our health and longevity too.7 8
Interestingly, a sense of purpose seems to help people live longer, even when controlling for other markers of psychological well-being. So there’s something uniquely beneficial about having a strong purpose that’s different from, say, being happy.
A purpose can take time to uncover, but you can facilitate that discovery by devoting regular time to the “big questions” in life:
Who are you, really?
What do you want your life to be about?
How do you want to live?
More practically: What gets you out of bed in the morning? (Is it your family, or showing up for your clients? Or something else?)
But Deep Health isn’t just something you want to achieve—it also serves as a framework to help you make choices.
When you understand how Deep Health works, it can also help you answer the often vague and perplexing question, “How can I feel better?”
Knowing about your own Deep Health can tell you which area of your life to prioritize right now that will make the biggest impact on your overall health.
How to use Deep Health to help you prioritize next actions.
Depending on what’s going on in your life right now, you might get a Deep Health score that looks like this:
Or like this:
Or this:
Whatever your results (and no judgment on the numbers), the distribution of your score can tell you:
Where you’re currently thriving
Where you have the largest opportunities for growth and improvement
Where you might be able to make some easy improvements
Which dimensions, if you improve them, might best help you reach (and sustain) your goals
Your personalized assessment will make some suggestions. (The below is a sample screenshot.)
But of course, it’s entirely up to you where you decide to focus, and what actions you choose to take next—if any.
Let’s walk through an example
Let’s say you’ve recently become interested in optimizing health and longevity.
You’ve been listening to podcasts, you’ve read the articles about people “reversing” their biological age, and you feel fired up about it.
You haven’t felt so passionate or inspired about your health in a long time, and you’re excited to try some of the strategies recommended in those podcasts and articles. (You want to be 27 again! At least, your cells do.)
At the beginning of this journey, let’s imagine your Deep Health looks like this:
Kind of “so-so” all around. Definitely, there’s room for improvement.
Of course, in reality, there’s infinite pathways you could take. But let’s imagine two scenarios…
Scenario A: Biohack like a beast
After seeing your Deep Health score, you decide to simply tackle everything at once:
You subscribe to a longevity-boosting supplement program, that has you taking about 20 different tablets and powdered elixirs per day.
You start practicing 16:8 fasting (in each 24-hour cycle, you fast for 16 hours, and eat within an 8 hour window), eating only two meals per day.
You start eating fully plant-based, getting in tons of veggies, fruits, and legumes, and start tracking your macros meticulously.
You incorporate four 45-minute zone 2 cardio workouts a week (you heard that’s the amount needed to see significant benefit to your mitochondria).
You also add two 60-minute resistance training sessions a week.
You start taking cold plunges at the gym multiple times per week, and are even considering buying a cold plunge tank for your home.
For two weeks, you feel on top of the world.
Then, not so much. (You’ve actually grown to hate that green sludgy stuff you drink every morning.)
You continue to show up anyway with a gritty determination, and for months, follow your protocol as best as you can.
You forego social events, finding yourself grouchy and irritable. (When everyone else is munching on buttery canapés, you’re counting down the hours until your next feeding window.)
Every day feels like a Sisyphean effort, and you begin to wonder what the point of all of it is. You can’t imagine doing this for the rest of your life, which you’re (now ironically) trying to extend.
Eventually, all this white-knuckling in pursuit of optimal health starts to take a toll. On you, your marriage, your social life, and your mental and emotional wellbeing. And you want to know if all of this effort and suffering are worth it.
After several grueling months, you gather some data.
Your blood work looks awesome. You’re definitely leaner. And your biological age test tells you your rate of aging has slowed and your cells have gotten younger.
You’re… winning?
You decide to reassess your Deep Health, and it looks like this:
Your physical health has gone way up, but your emotional, social, mental, and existential health have all gone down. Overall, your Deep Health is somehow worse! (Argh!)
It becomes clear to you: While your “do all the things” protocol might help you live longer—it’s definitely not helping you live better.
Scenario B: Dig deep for Deep Health
In this scenario, you take a different approach.
Seeing your Deep Health starting point, you consider that list of “high impact habits” above.
You’re not sure which one to start with though, so you take some time to think about why you’re really interested in this whole longevity thing.
What’s your deeper purpose for wanting to live a longer, healthier life?
You think about your family, and tears come to your eyes when you conjure up the thought of your children having children, and imagining yourself tumbling around with a bunch of rambunctious grandkids. You want to be healthy, strong, and capable of playing with them.
This deep purpose aligns with your identity too. You’ve always been a “family guy,” and now you add a new layer on top of that: You decide to become the kind of person who makes their health and wellbeing a priority, so they can be there for their family for as long as possible.
With this new, revised identity and a clear purpose in mind, you begin to make some changes over time.
You focus on eating protein at most every meal, and up your fruit and vegetable game too.
You practice self-compassion when you can’t or just don’t get in as much protein or produce as you’d like. You also work on viewing your choices on a continuum—rather than simply “good” or “bad.” This flexibility helps you feel a sense of freedom in your diet, and feels a little more realistic, long-term.
Instead of going for the “perfect” four cardio sessions, you aim for two a week, for as long as you can fit in (which sometimes is only 20 minutes, but you do your best). Any extra sessions are a bonus.
You’re diligent with your resistance training, but you cap them at 30-45 minutes, twice per week (occasionally you only have 20 minutes for these sessions too, but you focus on consistency over perfection).
You begin going for outdoor walks after dinner with your partner—sometimes inviting a few neighborhood friends, too—and enjoy the deep yet fun conversations you have about work, family, and life (and, let’s be honest, some good neighborhood gossip).
After several satisfying months, you gather some data.
Your blood work has improved. You’ve leaned out a touch too. Your rate of aging has also slowed and your biological age has decreased, seemingly just as much as Scenario A.
But the biggest difference: You enjoyed this process.
You found it not only physically beneficial, but also socially enriching, mentally and emotionally enlightening, and deeply meaningful.
You reassess your Deep Health, and it looks like this:
Your physical health has gone up (though not quite as high as Scenario A), and so has your emotional, social, mental, and existential health. Your overall Deep Health is now undeniably, significantly up.
The funny thing: It didn’t even seem that hard.
Moreover, you feel more inspired and energized than ever to take even more steps to further invest in your health and wellbeing.
This is the power of Deep Health.
It’s not just about improving your biological age or increasing your healthspan (which mostly center on physical health metrics).
Striving for Deep Health means working to thrive in ALL areas of your life—not just the physical. Because no single aspect of your health functions alone.
With the push towards longevity and healthspan, and the focus on things like biological age and “biohacking” for optimal aging, it can be easy to forget that we already know the fundamentals of what it means to experience a life well lived.
The truth is, scientists don’t know everything that improves our biological age. Or even the best ways to measure it.
However, if you’re thriving in all dimensions of your health and wellbeing—in other words, achieving Deep Health—you can bet you’re doing all of the things that matter most in living a long, healthy, rewarding life.
You can help people build sustainable nutrition and lifestyle habits that will significantly improve their physical and mental health—while you make a great living doing what you love. We’ll show you how.
Yes, it’s hard to resist a bag of chips, but here’s a trick if you’re trying to cut calories- skip the dip. Researchers discovered that when consumers pair chips with dip, their caloric intake shot up by 77% compared to just eating chips alone.
Snacks make up about a quarter of the average person’s daily calorie intake, yet eating behavior around snacking remains surprisingly understudied.
John Hayes, professor of food science and director of the Penn State Sensory Evaluation Center, a corresponding author of the latest study emphasizes that understanding snacking behavior is essential for tackling issues of overeating and obesity.
To explore this, the research team investigated how adding a dip to a salty snack affected eating behavior and found some surprising results. When dips were served, people not only consumed more calories, but they also ate at a faster rate and took larger bites, according to the results published in Food Quality and Preference.
The study examined 46 adult participants during two visits to Penn State’s Sensory Evaluation Center, where they were served 70 grams of ranch-flavored chips, with or without a third of a cup of ranch dip. Participants were allowed to eat as much as they wanted, but their intake was carefully measured. Every session was video recorded and annotated for bite counts and active eating time.
Researchers then used this data to analyze “eating microstructure,” focusing on factors like eating rate and bite-size to understand how the addition of dip affected snacking behavior.
“On average per eating session, participants consumed 345 calories of chips and dip compared to 195 calories of chips alone,” the news release stated.
“The most striking finding of our study is that people didn’t eat fewer chips when dip was available — they ate the same amount of chips, plus the dip. This lack of compensation means that adding dip to chips can substantially increase overall energy intake without people realizing it,” Hayes said in a news release.
“This research opens up new avenues for exploring how the physical properties of foods can influence our eating behaviors and ultimately, our energy intake. If we can slow people down, we can influence energy consumption without giving up the pleasure from food,” Hayes added.
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