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25 Ways to Run Faster—Stat

Usain Bolt makes sprinting look easy. It’s almost as if he doesn’t have to try. But we’ll let you in on a little secret: Sure, Bolt is more of a natural runner than we are, but he still has to work at it in order to keep himself in top form. Even better news? There are tons of steps you can take to run faster, smoke the competition, and maybe even sent a new PR. 

1. Nail good form.

The key to running (at any speed) is to practice proper running technique. That means keeping your upper body tall yet relaxed, striking the ground with your mid-foot landing under your hip, and swinging your arms forward and back (not side to side!) at low 90-degree angles.

2. Count your steps.

Get familiar with stride turnover—the rate of steps you take while running, regardless of pace. The fastest, most efficient runners have a cadence of around 180 steps per minute and keep their feet close to the ground with light, short, and speedy steps. To find your magic number, run for one minute, count the number of times the right foot hits the ground, and multiply by two.

3. Try interval training.

Short on gym time? Try interval training. Alternate periods of high and low intensity while exercising to build speed and endurance—and burn major calories in less time too!

4. Don't forget to sprint.

There's a reason you see all those “real runners” doing short sprints before the big road race. Strides are a series of comfortable sprints (usually eight to 12, between 50 and 200 meters each) to improve acceleration technique.

5. Make the treadmill your friend.

The treadmill's belt assists with leg turnover, so it's actually easier to run faster. Plus, you have the power to push the pace right at your fingertips. Just make sure you get on the machine before turning up the dial.

6. Stretch daily.

The jury is still out on static stretches—it's unclear if they really prevent running injuries.  Stretching and injury prevention: an obscure relationship. Witvrouw E, Mahieu N, Danneels L. Sports medicine (Auckland, N.Z.), 2004, Dec.;34(7):0112-1642. But leaders of the pack know stretching daily (especially targeting those hip flexors) increases flexibility for better strides.

7. Switch up your pace.

Fartleks is a funny Swedish word (yes, our inner 10-year-old finds it hilarious) meaning “speed play.” Alternating jogs and sprints gradually builds up speed and endurance, plus you call the shots in determining when to switch it up.

8. Jump rope.

Take a lesson from boxers and add jump rope workouts to your routine. Boxers know that fast feet mean fast hands. But for runners, fast feet just equal fast feet.

9. Trade up for lighter shoes.

We're not saying you need to embrace barefoot running, but sneakers are getting lighter and lighter to mimic your foot's natural movement and improve your stride. Try a minimalist pair to see if less weight means more energy for faster feet.

10. Work out your core. 

Stronger core muscles (especially lower abs) allow runners to tap into more force out on the road. The best part? Just 15 minutes of core work a few days per week is enough to help you speed up. Does core strength training influence running kinetics, lower-extremity stability, and 5000-M performance in runners? Sato K, Mokha M. Journal of strength and conditioning research, 2009, May.;23(1):1533-4287.

11. Change how you breathe.

Learning how to breathe while running at faster speeds takes practice. Use both your nose and mouth while inhaling and exhaling to get the maximum amount of oxygen to the muscles. Also, try belly breathing—fill the stomach, not the chest, with air on each inhale.

12. Head for the hills.

Hill repeats are shown to improve speed, build muscle strength, and add a boost of confidence too.

13. Skip the sweets.

Junk food guarantees a sugar high and slows you down. Stick to whole grains and pasta before runs, which provide long-lasting energy—without the crash.

14. Play with resistance.

Try a running parachute for added resistance, or if your budget allows, see what it's like on the other edge of the resistance spectrum with an anti-gravity treadmill.

15. Lift weight.

Stronger, leaner muscles will help you get to the finish line faster. And while runners shouldn't take up bodybuilding, two short strength training sessions per week can go a long way in improving your speed.

16. Lose weight.

On the other hand, research shows that shedding the pounds (fat, not muscle) can help runners shave time off the clock—cutting an average of two seconds off your mile time for every pound you lose. Of course not everyone has the weight to lose, so remember to consult a physician before starting any weight-loss program.

17. Look ahead.

Looking down at your feet or turning your head to check out the competition can waste precious time. Instead, focus on what's directly in front of you—about 10 to 20 meters in the distance—and keep those eyes on the prize.

18. Go for a spin.

Indoor cycling gives your hips a workout while forcing your legs to get comfortable moving from slow leisurely rides to all-out sprints. The same goes for running. So hop on a bike and get ready for some cross-training.

19. Pay attention to your toes.

The whole body plays a role in speed—from your head to your toes! Try dorsiflexion (arching your toes up toward you shins) while running. That way less of your foot hits the ground for a quicker stride turnover.

20. Keep it steady.

Slow and steady may win the race, but fast and steady builds speed! A tempo run challenges runners to find a “comfortably hard” pace and hold it for a 20-minute period. Just don't burn out before the run is over like that silly little hare!

21. Drink coffee.

Turns out drinking caffeine before running gives you an extra jolt of speed. Even more good news? It's a totally legal performance enhancer.  Caffeine and sports performance. Burke LM. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme, 2009, Mar.;33(6):1715-5312.

22. Do mountain climbers.

The combo of moving your feet quickly while assuming a plank position will make you crazy fast. 

23. Try yoga.

Get a leg up on fellow runners by adding yoga to your training plan. The increased flexibility from runner-specific positions makes you faster and speeds up aids recovery.

24. Get enough shut-eye.

Studies show well-rested athletes have better reaction times and clock faster finishes.  The Effects of Sleep Extension on the Athletic Performance of Collegiate Basketball Players. Man C, Man K, et al. Sleep. 2011 Jul 1; 34(7): 943–950.  And think about it—the faster you run, the more time you have to kick back and relax!

25. Strip down.

When it's finally race day, take it off! The extra layers and fuel belts, that is. The less clothing and gear on your body, the faster your time—which is why the pros practically get right down to their skivvies to run.

Originally published January 2012. Updated February 2014 and April 2017.

Luxury retailer Jimmy Choo up for sale 

Luxury retailer Jimmy Choo is on the market.

>> Read more trending news 

The BBC reports the high-end shoe brand is seeking offers, but has not yet received any bids. 

Jimmy Choo believes a sale would “maximize ... value for its shareholders,” a company statement said Monday.

Right now, the British brand has a market value of nearly $900 million and operates more than 150 stores worldwide. 

According to Business Insider, its shares slumped last summer, but have since rebounded, increasing 35 percent over the last year.

JAB Holdings Inc., a long-term investment company, currently holds 68 percent of Jimmy Choo. While it is “supportive of the process,” it also said there is “no certainty that an offer will be made, nor as to the terms on which any offer will be made.”

JAB Holdings, which also holds ownership in Krispy Kreme and Caribou Coffee, purchased Panera Bread earlier this month.

>> Related: Krispy Kreme owner buys Panera Bread for $7 billion

Jimmy Choo was co-founded in 1996 by former “Vogue” editor Tamara Mellon and Choo, who once worked for Princess Diana.

The brand received global attention after its shoes appeared in films “Sex and the City” and “The Devil Wears Prada.”

A single pair of Jimmy Choo shoes can sell for more than $1,000.

Traditional retailers have faced recent tough times. Many iconic brands, from Bebe to Ralph Lauren, are closing stores and taking other drastic measures to stay afloat. Department stores, including Macy’sSears, and J.C. Penney, are shuttering mall locations nationwide. Billionaire investor Warren Buffett blamed the trend in part on the rise in popularity of e-commerce companies, such as Amazon.

>> Related: Wet Seal closing all stores

>> Related: Payless ShoeSource to close 400 stores, files for bankruptcy

3-Ingredient Breakfasts to Throw Together When You Have No Time

Whether you’re running out the door to work or just remembered you agreed to host Sunday brunch, odds are you need a ridiculously quick breakfast recipe. Calling for just three ingredients each, these nine sweet and savory breakfasts come together faster than you can make a stop at the bagel place—better yet, the ingredients are probably stuff you already have in the kitchen.

1. Three-Ingredient Pancakes You don’t have to save your pancake breakfast for the weekend. This pancake batter is just eggs, milk, and flour—we think that’s perfectly reasonable to mix up before work or on a Sunday morning. 2. Three-Ingredient Bacon and Egg Cups Make the cutest personal bacon and eggs for brunch: Crack an egg into each cup of a muffin tin lined with a strip of cooked bacon. Sprinkle with chives, then bake until eggs are cooked. 3. Three-Ingredient Acai Bowl This vibrant acai bowl looks intricate, but it’s actually ridiculously easy to make. Blend a frozen acai pack, a frozen banana, and a bit of nondairy milk or yogurt into a thick purple smoothie. Top with fruit and granola, or spoon it up as is. 4. Three-Ingredient Eggs and Sweet Potato Skillet Essentially a giant cheesy, eggy hash brown, this speedy vegetarian breakfast skillet is a morning dream, thanks to eggs, sweet potatoes, and a bit of sharp cheese. 5. Three-Ingredient Flourless Chocolate Muffins You don’t need to stop for a muffin to grab a quick breakfast. Mix nut butter, cocoa powder, and eggs, then pour into muffin tins. Stash a few in your purse for a hangry emergency. 6. Three-Ingredient Avocado Smoothie This creamy smoothie is packed with good-for-you fats, making it a perfect post-workout meal. Blend avocado, frozen banana, and milk until pale and smooth. Throw it in a jar and drink it on the go if you want. 7. Three-Ingredient Raspberry Chia Seed Pudding Stir chia seeds with a blended mixture of coconut milk and raspberries. Let it sit overnight, then wake up to the easiest (and prettiest) chia pudding breakfast around. 8. Three-Ingredient Breakfast Skillet A breakfast skillet is without a doubt the best meal to serve to a group of friends for brunch, made better only by a short ingredient list. Brown ground turkey in a pan, then add spicy salsa and crack in a bunch of eggs. Breakfast is served. 9. Three-Ingredient Strawberry Overnight Oats Blend frozen strawberries and milk into a thick mixture, then pour into a jar of oats. Stash in a jar overnight, then spoon up all that pink goodness tomorrow morning.

 

Win Tickets: Move - Beyond - Live Tour

Every morning this week we have your chance to win a pair of tickets to MOVE – BEYOND – LIVE ON TOUR May 11 at the Fox Theatre! 

Julianne and Derek Hough, are back and better than ever in 2017 with an all-new experience, MOVE – BEYOND – LIVE ON TOUR. Taking a cue from the elements, the show will feature inspiration pulled from earth, wind, fire and water. Get your tickets now at FoxTheatre.org 

Health Care In America: An Employment Bonanza And A Runaway-Cost Crisis

In many ways, the health care industry has been a great friend to the U.S. economy. Its plentiful jobs helped lift the country out of the Great Recession and, partly due to the Affordable Care Act, it now employs 1 in 9 Americans — up from 1 in 12 in 2000.

As President Donald Trump seeks to fulfill his campaign pledge to create millions more jobs, the industry would seem a promising place to turn. But the business mogul also campaigned to repeal Obamacare and lower health care costs — a potentially serious job killer. It’s a dilemma: One promise could run headlong into the other.

“The goal of increasing jobs in health care is incompatible with the goal of keeping health care affordable,” said Harvard University economist Katherine Baicker, who sees advantages in trimming the industry’s growth. “There’s a lot of evidence we can get more bang for our buck in health care. We should be aiming for a health care system that operates more efficiently and effectively. That might mean better outcomes for patients and fewer jobs.”

But the country has grown increasingly dependent on the health sector to power the economy — and it will be a tough habit to break. Thirty-five percent of the nation’s job growth has come from health care since the recession hit in late 2007, the single-biggest sector for job creation.

Hiring rose even more as coverage expanded in 2014 under the health law and new federal dollars flowed in. It gave hospitals, universities and companies even more reason to invest in new facilities and staff.  Training programs sprang up to fill the growing job pool. Cities welcomed the development — and the revenue. Simply put, rising health spending has been good for some economically distressed parts of the country, many of which voted for Trump last year.

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In Morgantown, W.Va., the West Virginia University health system just opened a 10-story medical tower and hired 2,000 employees last year. In Danville, Pa., the Geisinger Health System has added more than 2,200 workers since July and is trying to fill 2,000 more jobs across its 12 hospital campuses and a health plan. Out West, the University of the UCHealth system in Colorado expanded its Fort Collins hospital and is building three hospitals in the state.

In cities such as Pittsburgh, Cleveland and St. Louis, health care has replaced dying industries like coal and heavy manufacturing as a primary source of new jobs. “The industry accounts for a lot of good middle-class jobs and, in many communities, it’s the single-largest employer,” said Sam Glick, a partner at the Oliver Wyman consulting firm in San Francisco. “One of the hardest decisions for the new Trump administration is how far do they push on health care costs at the expense of jobs in health care.”

House Republicans, with backing from Trump, took the first swipe. Their American Health Care Act sought to roll back the current health law’s Medicaid expansion and cut federal subsidies for private health insurance. The GOP plan faltered in the House, but Republican lawmakers and the Trump administration are still trying to craft a replacement for Obamacare.

Neither the ACA nor the latest Republican attempt at an overhaul tackle what some industry experts and economists see as a serious underlying reason for high health care costs: a system bloated by redundancy, inefficiency and a growing number of jobs far removed from patient care.

Labor accounts for more than half of the $3.4 trillion spent on U.S. health care, and medical professionals from health aides to nurse practitioners are in high demand. But the sheer complexity of the system also has spawned jobs for legions of data-entry clerks, revenue-cycle analysts and medical billing coders who must decipher arcane rules to mine money from human ills.

For every physician, there are 16 other workers in U.S. health care. And half of those 16 are in administrative and other nonclinical roles, said Bob Kocher, a former Obama administration official who worked on the Affordable Care Act. He’s now a partner at the venture capital firm Venrock in Palo Alto, Calif.

“I find super-expensive drugs annoying and hospital market power is a big problem,” Kocher said. “But what’s driving our health insurance premiums is that we are paying the wages of a whole bunch of people who aren’t involved in the delivery of care. Hospitals keep raising their rates to pay for all of this labor.”

Take medical coders. Membership in the American Academy of Professional Coders has swelled to more than 165,000, up 10,000 in the past year alone. The average salary has risen to nearly $50,000, offering a path to the American Dream.

“The coding profession is a great opportunity for individuals seeking their first job, and it’s attractive to a lot of medical professionals burned out on patient care,” said Raemarie Jimenez, a vice president at the medical coding group. “There is a lot of opportunity once you’ve got a foot in the door.”

Some of these back-office workers wage battle every day in clinics and hospitals against an army of claims administrators filling up cubicles inside insurance companies. Overseeing it all are hundreds of corporate vice presidents drawing six-figure salaries.

Administrative costs in U.S. health care are the highest in the developed world, according to a January report from the Organization for Economic Cooperation and Development. More than 8 percent of U.S. health spending is tied up in administration while the average globally is 3 percent. America spent $631 for every man, woman and child on health insurance administration for 2012 compared with $54 in Japan.

America’s huge investment in health care and related jobs hasn’t always led to better results for patients, data show. But it has provided good-paying jobs, which is why the talk of deep cuts in federal health spending has many people concerned.

Linda Gonzalez, a 31-year-old mother of two, was among the thousands of enrollment counselors hired to help sign up Americans for health insurance as Obamacare rolled out in 2014. The college graduate makes more than $40,000 a year working at an AltaMed enrollment center, tucked between a Verizon Wireless store and a nail salon on a busy street in Los Angeles.

In her cramped cubicle, families pull up chairs and sort through pay stubs and tax returns, often relying on her to sort out enrollment glitches with Medicaid. As the sole breadwinner for her two children, ages 9 and 10, she counts on this job but isn’t sure how long it will last.

“A lot of people depend on this,” she said one recent weekday. “It’s something I do worry about.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Going For $1 An Ounce: The Burgeoning Trade In Mothers’ Milk

PALM SPRINGS, Calif. — Rebecca Soltes walked into a gaily decorated hospital meeting room, pushing her kids in a double stroller and carrying a soft-sided cooler filled with bags of frozen breast milk — 100 ounces of the stuff.

She dropped it on a table, and the roomful of lactation consultants and maternal health advocates from California’s Inland Empire erupted in applause.

She was donating the milk because she didn’t need it anymore. Her son, a young toddler, had recently graduated to solid food, but her freezer at home was still packed with pumped milk.

“I didn’t know what to do with it,” a harried-looking Soltes told two young staffers from the Mothers’ Milk Bank, a nonprofit group in San Jose, Calif., that provides breast milk for fragile infants in neonatal intensive care units (NICUs).

Increasing numbers of women who produce more breast milk than they need are handing it over — or selling it — for others to use. It’s a boon to fragile infants and mothers who can’t produce enough milk, but it also poses challenging ethical and public health questions.

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Physicians, regulators and others ask: Should sickly, premature babies get access to this milk before healthy ones? Should women be paid for their milk — even if it might lead some to deprive their own infants? Should greater safeguards be required to ensure the safety of the supply?

The Food and Drug Administration does not require testing for donated human milk. A handful of states, including California and New York, regulate milk banks the way they do tissue banks, enforcing some safety standards, and many nonprofit milk banks screen donors.

But the FDA has expressed concern about milk-trading websites, warning consumers that the milk offered there carries an increased risk of contamination by drugs or disease, including HIV. The agency further urges mothers not to feed their infants donated milk acquired from other individuals or over the internet, also because of such safety risks.

Some companies and medical experts wonder if even established milk banks — whose voluntary screening practices the FDA praised in 2010 — should be doing more to ensure safety. Dr. Jae Hong Kim, a neonatologist at UC-San Diego, said milk banks’ safety efforts have worked well thus far but are not error-free. “The challenge is, if you expand the operations, you increase your risk exposure,” he said.

Scott Elster, CEO of Prolacta Bioscience, a company that uses human milk to make fortifier products in its pharmaceutical-grade manufacturing facility, said he advocates a more rigorous level of screening.

“We believe that all human milk, whether it is distributed commercially, by a nonprofit or peer-to-peer network, should be tested for drugs of abuse, nicotine and other adulterants,” he said.

Milk Magic

As recently as the early 1970s, barely a fifth of American babies were breast-fed. Today, more than 80% get at least a taste of their mother’s milk, according to the federal Centers for Disease Control and Prevention. The health advantages are well-established, especially for premature infants.

“The first class I had on human milk I was blown away,” said Maryanne Perrin, a nutrition scientist at the University of North Carolina-Greensboro. “It’s Harry Potter meets Willy Wonka. It’s a magical food.”

[caption id="attachment_232054" align="alignright" width="370"] The Food and Drug Administration does not require testing for donated human milk. A handful of states, including California and New York, regulate milk banks as they do tissue banks. (Heidi de Marco/KHN)[/caption]

Some breast-feeding enthusiasts refer to human milk as “liquid gold.” At times, it seems as though everyone wants the stuff — from nonprofits like Mothers’ Milk Bank, to high-tech pharmaceutical companies that concentrate it into premium medical products, to your neighbor who might just want a bit more to supplement her baby’s diet.

Each year, new human milk banks open and new milk-focused companies are launched.

No one knows exactly how much of this excess milk is donated or sold, but the volume is increasing. Pauline Sakamoto, executive director of the Mothers’ Milk Bank and former president of the Human Milk Banking Association of North America, an association of nonprofit milk banks in the U.S. and Canada, said her organization’s affiliated banks distributed about 4.4 million ounces of human milk to hospitals last year, up from less than half that amount as recently as five years ago. When Sakamoto became president of  the organization in 2014, it had 18 milk banks. Now it has more than 30 open or planned.

To Profit Or Not To Profit?

The Mothers’ Milk Bank workers from San Jose traveled nearly 450 miles last year for donation drives in the southern part of the state, including the one at the Desert Regional Medical Center in Palm Springs where they applauded Soltes. The bank collects and pasteurizes donated human milk and provides it at cost to NICUs throughout California.

Over the week, workers planned to conduct risk screenings, including blood testing for HIV and other diseases, on mothers like Soltes. They also planned to ask the women’s doctors — and their babies’ doctors — to approve the donations. The team expected to collect 7,542 ounces of pumped breast milk — enough to provide more than 30,000 feedings for premature infants in NICUs.

“Right now, we have a consistent flow of milk coming in,” said Leah Carig, donor coordinator at the San Jose-based bank. “In the past, we’ve had to put out [e-mail] blasts” to increase supply.

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For-profit breast milk operations are expanding, too. Elster’s company, Prolacta Bioscience, stocks warehouse-like freezers full of human milk.

Based in City of Industry, Calif., it purchases the milk from women for $1 per ounce. The company uses it to make fortifiers that are added to a mother’s or donor’s milk to deliver extra calories, proteins and minerals to premature babies.

The products are expensive, at $200 to $300 for a one-day supply. But they win praise from NICU physicians like Kim, because they can replace fortifiers made of cow’s milk, which are known to increase the risk of necrotizing enterocolitis and sepsis.

Beyond the NICU and the gates of industry, informal internet-based sites, with names like Only the Breast and Eats on Feets, also appear to be booming. One report estimated that the number of online milk transactions in the U.S. soared from 22,000 in 2012 to 55,000 in 2015.

Some milk-sharing networks are run by mothers who sell their milk, while others give it away.

Mandy Lindberg, a board member of the Inland Empire Breastfeeding Coalition, has experience with both formal and informal donation networks. She said that women often opt to donate among themselves because they want to help friends or neighbors who don’t have enough milk for their babies.

“It’s nice to put a face with the name,” Lindberg said.

Research shows there’s some risk with milk that changes hands on informal sites, however. In 2015, a team of researchers who purchased breast milk on the open market reported in the journal Pediatrics that about 10 percent of samples contained cow’s milk, which could have been added by the sellers to increase volume and thus the size of the payment. The same team had reported in 2013 that milk purchased online was frequently contaminated by pathogenic bacteria.

Kim Updegrove, executive director of the nonprofit Mothers’ Milk Bank at Austin, in Texas, says the FDA should regulate informal milk-sharing, ideally requiring all milk to go through a milk bank focused on distributing it according to the greatest medical need. This, she believes, would help make the practice safer and ensure that the sickest babies were given priority.

Updegrove and others fear that if financial gain were to become the dominant factor in distribution of human milk, supplies could be siphoned away from the sickest NICU babies. Poor mothers might sell their milk instead of giving it to their own children, these critics said.

Women involved in sharing networks don’t always understand the mission and practices of nonprofit milk banks, Perrin reported with colleagues in a 2016 paper that appeared in the Journal of Human Lactation. Better education might encourage more to donate for NICU use, she suggested.

She said that when she started her research, she thought of human milk as a “scarce resource.” “But I’ve talked to women who have shared 9,600 ounces of milk. Some have freezers full,” she said. “I think it’s a distribution problem, and not a supply problem.”

The entire concept of breast milk banking — of any type — was new to Soltes. The La Quinta, Calif., mother said that when other members of her breast-feeding group had more milk than they could use, they didn’t know what to do with it. She learned about the milk drive by doing a Google search online.

“I just happened to find this event,” she said. “I thought, wow — I’d rather do this than throw it all out.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

A Spoonful Of Kids’ Medicine Makes The Profits Go Up

When prescribing medications, caring for children poses a particular challenge. They’re not just little adults. Their still-developing brains and bodies metabolize drugs differently, and what works for grown-ups can yield radically different — and sometimes dangerous — results in kids.

And now, even as high drug prices make headlines, the challenge of getting sick children the kind of medication they can take and tolerate — often by creating liquid formulations of drugs that are already on the market — is seen by some companies as a lucrative opportunity.

It is part of a pattern in which patent laws and government incentives — meant to encourage development of less-profitable drugs — enable some companies to get a leg up in the market and set high prices. The Best Pharmaceuticals for Children Act, for instance, allows for delaying the approval of competing generics if companies test their drugs in children. And the Pediatric Research Equity Act requires more companies to have pediatric-focused drugs clinically assessed in kids. These laws have spurred companies to do more in terms of testing and developing pediatric medicines. The companies can market the drugs without facing competition for a longer period of time. And as a result, the treatments cost exponentially more.

Critics say the higher price tags are out of line with the cost of developing kid-friendly remedies.

“The only R&D, if you will, that went into making these liquid is finding a solution to dissolve them in, and making sure it was stable and well-absorbed,” said Thomas Welch, who leads the pediatrics department at Upstate Medical University in Syracuse, N.Y. He co-authored a letter in the New England Journal of Medicine assessing the price increase for two of these drugs, which treat hypertension and heart conditions in children.

For Carissa Baker-Smith, a pediatric cardiologist at the University of Maryland, those drugs — Qbrelis, approved last July, and Epaned, approved in 2013 — could have been a godsend. They presented an alternative to their long-available generic adult versions, which, because of their strength, meant she usually referred her young patients to compounding pharmacies for liquid formulations, a step, she said, that requires “a bit of blind trust.”

At these pharmacies, licensed specialists use approved medications to create formulations for people whose needs are not met commercially.

On the plus side, these two drugs not only meet medical needs of Baker-Smith’s patients, but they went through the Food and Drug Administration’s rigorous approval process and are produced under the agency’s manufacturing-practice regulations, which do not apply to compounding pharmacies.

But their cost yields a different kind of angst.

Liquids pose “a financial burden to families,” Baker-Smith said. She added that parents frequently ask when their child is finally ready for the less pricey tablet.

“My patients need heart transplants, or have other issues,” she said. “That’s a huge cost.”

Seizing An Opportunity

How so? Qbrelis costs 775 times as much as the generic tablet, while Epaned is 21 times costlier than the off-brand, according to Welch’s letter.

Here’s another real-world comparison. If a compound pharmacy filled a prescription for a liquid formulation using the generic liquid Lisinopril — the active ingredient in Qbrelis — it would cost up to $20 a month. The patented liquid, though, could yield a monthly bill of $500 to $1,000, depending on how large a dose the child needs, estimated Erin Fox, an adjunct associate professor of pharmacotherapy at the University of Utah. For Epaned, a monthly regimen could cost $500 to $2,000; a compound pharmacy’s formulation of a comparable generic liquid would cost $20 to $80, she said.

The two drugs are both manufactured by Colorado-based Silvergate Pharmaceuticals. By creating liquid solutions of these drugs that can be dispensed in smaller doses, Silvergate was able to obtain patents for each. It controls the market on them until at least 2030, according to the FDA’s Orange Book, a comprehensive roster of drug approvals.

The company filed legal complaints when a rival — Bionpharma — sought to introduce a generic competitor to Epaned, saying it would infringe upon its patent. Representatives from Silvergate did not respond to multiple requests for comment.

In other circumstances, drugmakers could pursue even more market protections from the FDA. For instance, if the process of reformulating the drug involved clinical trials with children, manufacturers can win an additional six months of market exclusivity.

Additionally, two FDA guides are in the works recommending that doctors default to agency-approved drugs over similar compounded medicines, unless there is a particular chemical difference that makes the compound more effective. Cost isn’t a factor.

Together, experts say, those regulations can make it easier for companies looking to profit from limited investment or innovation.

“There’s . . . an increasing list of companies where it was only about gaming the rules, and not about anything that can be recognized as real pharmaceutical research,” said Jerry Avorn, a professor of medicine at Harvard Medical School who studies prescription drug policy. Silvergate, he added, appears to fit that mold.

A Safer Drug, But At A Price

Getting a compound drug can be logistically difficult for patients — not all pharmacies are certified to make them — and it assumes some trust, because the pharmacists involved aren’t held to the same manufacturing standards as for commercially available drugs. A 2012 fungal meningitis outbreak linked to the New England Compounding Center left 64 patients dead and raised consumer and regulatory concerns. Ultimately, the outbreak triggered heightened federal oversight of compounding.

Fox suggested that the value added by the new drugs — while meaningful — is counteracted when the price climbs.

“It’s better for patients if we’re using FDA-approved drugs,” Fox said. “But if no one can afford them, or if they raise prices so much other things are being impacted, then all the FDA approval in the world won’t improve access.”

These liquids do serve an important purpose, though — they’re lower-risk than compounds, and reformulating these drugs certainly requires work. But critics say the creativity involved in developing the drugs doesn’t justify its expense. And the generic enzyme inhibitors they use cost pennies. At stake for Baker-Smith’s patients is getting needed medical care, or going without.

“There are plenty of kids who can’t take a pill. For them,” she said, getting liquid drugs “is lifesaving.”

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

How to Meet Your Protein Needs without Meat

Eating a vegetarian diet can be very healthful and rewarding. However, most vegetarians—including soon-to-be vegetarians and their meat-eating loved ones—are concerned about getting adequate protein. Most people are accustomed to getting protein from meat, but what else contains protein? Aren't plant-based proteins "incomplete" or lower quality? Fortunately, with a bit of extra attention, you won't have any trouble meeting your protein needs just because you give up meat. There are so many protein-packed vegetarian options! Did you know that most foods, including vegetables, have some of the essential muscle-building nutrient? Without looking closely, it is easy to miss some great sources. (Who knew a cup of broccoli had 3 grams!) Nuts, seeds, soy products, cereal, eggs and dairy are all good meatless protein choices. These groups of food each contain different amino acids (the building blocks of proteins) and different levels of protein quality. There is no need to consume certain foods in special combinations as nutritionists once thought! When your diet includes a variety of each of these types of foods, you can rest assured that you're consuming all the amino acids you need for muscle growth and cell repair.  Pin this graphic for easy reference and scroll down for more details. Nuts Nuts provide a good dose of protein along with some heart-healthy fatty acids and antioxidants (vitamins A and E). They are also packed full of fiber. Take your pick! Many nuts have a significant source of protein ready to work for your body. Peanuts, almonds, pistachios, cashews, and pine nuts are among the highest in protein, while chestnuts and hazelnuts, although they do still have some protein, are the lowest. Think out of the box when you’re adding nuts to your diet. They can be grated, toasted, ground or eaten raw and are great when combined with salads, wraps, soups and stews and baked goods. But pay special attention to portion size! Nuts are a great source of many nutrients, but do come with a hefty dose of calories, thanks to the healthy fats they contain. A single serving is just 1 oz! Many nuts are best when stored in a refrigerator, which helps keep their fats from going rancid (for up to 6 months).   Nuts, 1/4 cup Protein Calories Fat Peanuts, raw 9 g 207 18 g Almonds, dry roasted 8 g 206 18 g Pistachios 6 g 171 14 g Hazelnuts 5 g 212 21 g Pine nuts 5 g 229 23 g Cashews, raw 5 g 197 16 g Walnuts 4 g 164 16 g Seeds Seeds are another great way to grab a few grams of protein and many other nutrients. Healthful unsaturated fats, as well as phytochemicals, make seeds a powerhouse for heart disease and cancer prevention. Just a quarter cup of pumpkin seeds (also called pepitas) has 8.5 grams of protein. Add this amount to a salad or eat them plain for a quick snack. Sunflower seeds are easy to add to pasta or salads, or sandwich wraps, while sesame seeds are easily ground and sprinkled onto steamed veggies for a protein dusting.   Seeds (1/4 cup) Protein Calories Fat Hemp seeds 15 g 232 18 g Pumpkin seeds, roasted 9 g 187 16 g Flaxseed 8 g 191 13 g Sunflower seeds, roasted 8 g 205 18 g Sesame seeds, roasted 6 g 206 18 g Legumes Dried peas, beans and lentils belong to a group of food known as "pulses" or "legumes." Aside from soybeans, these plants have a very similar nutrient content, which includes a good dose of protein. On average, they have about 15 grams of protein per cup, and tagging along with the essentials protein are fiber and iron. Adding beans, lentils and dried peas to your meals is a great way to replace meat (a beef burrito can easily become a black bean burrito, for example) while still getting your much needed protein. Add pulses to soups, salads, omelets, burritos, casseroles, pasta dishes, and more! Make bean dips (such as hummus, which is made from garbanzo beans, or black bean dip) to spread on sandwiches and use as protein-packed dips for veggies or snack foods.   Legumes, 1 cup cooked Protein Calories Fiber Soybeans 29 g 298 10 g Lentils 18 g 230 16 g Split peas 16 g 231 16 g Navy beans 16 g 258 12 g Garbanzo beans (chickpeas) 15 g 269 12 g Black beans 15 g 227 15 g Kidney beans 15 g 225 11 g Lima beans 15 g 216 13 g Pinto beans 14 g 234 15 g Soy Soybeans are a complete protein that is comparable in quality with animal proteins. Eating soybeans (and foods made from soybeans) has been growing trend in America for only five decades, but this protein-rich bean has been a staple in Asia for nearly 4,000 years! This plant powerhouse is used to create a variety of soy-based foods that are rich in protein: tofu, tempeh, textured vegetable protein (TVP, a convincing replacement for ground meat in recipes), soymilk and "meat analogs," such as vegetarian "chicken" or faux "ribs" are all becoming more popular as more Americans practice vegetarianism. To learn more about using tofu, read Tofu 101. To learn how soy may impact your health, click here.   Soy Foods Protein Calories Fat Soybeans, 1 cup cooked 29 g 298 10 g Tempeh, 4 oz cooked 21 g 223 13 g Edamame, 1 cup shelled 20 g 240 10 g TVP, 1/4 cup dry 12 g 80 0 g Soy nuts, 1/4 cup roasted 11 g 200 1 g Tofu, 4 oz raw 9 g 86 5 g Soy nut butter, 2 tablespoons 7 g 170 11 g Soymilk, 1 cup sweetened 7 g 100 0.5 g Soymilk, 1 cup unsweetened 7 g 80 0.5 g Grains In a culture that focuses largely on wheat, it's easy to overlook the many types of other grains available to us. Some of these grains are very high in protein and can be included in your diet for both whole-grain carbohydrates and muscle-building protein. Quinoa is unusually close to animal products in protein quality, making it an excellent grain to replace white rice or couscous. It can also be cooked and mixed with honey, berries and almonds in the morning for a protein-packed breakfast. Other grains high in protein include spelt, amaranth, oats and buckwheat. Choose whole-grain varieties of cereals, pastas, breads and rice for a more nutritious meal.   Grains Protein Calories Fiber Amaranth, 1 cup cooked 9 g 238 9 g Quinoa, 1 cup cooked 9 g 254 4 g Whole wheat pasta, 1 cup cooked 8 g 174 6 g Barley, 1 cup cooked 7 g 270 14 g Spelt, 4 oz cooked 6 g 144 4 g Oats, 1 cup cooked 6 g 147 4 g Bulgur, 1 cup cooked 6 g 151 8 g Buckwheat, 1 cup cooked 6 g 155 5 g Brown rice, 1 cup cooked 5 g 216 4 g Whole wheat bread, 1 slice 4 g 128 3 g Sprouted grain bread, 1 slice 4 g 80 3 g Dairy If you consume milk products, dairy is a great way to add some extra grams of protein to your day. Low-fat milk, cheese and yogurt are easily accessible, quick to pack and fun to incorporate into many meals and snacks. Whether you’re drinking a cup of skim milk with your dinner or grabbing some string cheese before you run errands, you can pack about 8 grams of protein into most servings of dairy. You’re also getting some bone-building calcium while you’re at it! Keep in mind that low-fat varieties of milk products are lower in calories and fat, but equal in calcium to the full-fat versions; low-fat varieties may also be higher in protein.   Dairy Protein Calories Fat Fat-free cottage cheese, 1 cup 31 g 160 1 g 2% cottage cheese, 1 cup 30 g 203 4 g 1% cottage cheese, 1 cup 28 g 163 2 g Fat-free plain yogurt, 1 cup 14 g 137 0 g Low-fat plain yogurt, 1 cup 13 g 155 4 g Parmesan cheese, 1 oz grated 12 g 129 9 g Whole milk yogurt, 1 cup 9 g 150 8 g Goat's milk, 1 cup 9 g 168 10 g 1% milk, 1 cup 8 g 102 2 g Swiss cheese, 1 oz 8 g 106 8 g 2% milk, 1 cup 8 g 121 7 g 3.25% (whole) milk, 1 cup 8 g 146 8 g Low-fat cheddar/Colby cheese, 1 oz 7 g 49 2 g Part-skim mozzarella cheese, 1 oz 7 g 72 5 g Provolone cheese, 1 oz 7 g 100 8 g Cheddar cheese, 1 oz 7 g 114 9 g Blue cheese, 1 oz 6 g 100 8 g American cheese, 1 oz 6 g 106 9 g Goat cheese, 1 oz 5 g 76 6 g Feta cheese, 1 oz 4 g 75 6 g Part-skim ricotta cheese, 1 oz 3 g 39 2 g Eggs Eggs contain the highest biologic value protein available. What this means is that an egg has a near perfect combination of amino acids within its shell; when assessing protein quality of all other foods (including meat), nutrition experts compare them to the egg. This doesn’t mean that all other sources of protein are less healthful or less important but does mean that an egg is an awesome way to get a few grams of protein. At 6 grams for one large egg, there are endless ways to add it to your diet. Salads, sandwiches, breakfasts or snack—an egg can fit in anytime!   Eggs Protein Calories Fat Egg, 1 boiled 6 g 68 5 g Egg white, 1 cooked 5 g 17 0 g Liquid egg substitute, 1.5 fl oz 5 g 23 0 g As you can see, protein is EVERYWHERE in our diet, and even without meat you can get enough every day; you just have to look in the right places! For more ideas for using these various plant-based proteins, check out our dailySpark series, Meat-Free Fridays for recipe and cooking ideas! Selected Sources Information Sheet: Protein from The Vegetarian Society (VegSoc.org) Various nutrient profiles from The World's Healthiest Foods (WHFoods.com) Want to learn more about going meatless? Check out SparkPeople's first e-book! It's packed with over 120 delicious meat-free recipes, plus tips and tricks for going meatless. Get it on Amazon for $2.99 and start cooking easy, wholesome veg-centric meals the whole family will love!Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=158

Best and Worst Salad Toppings

A few years back I typed up a list of New Year’s resolutions on a small piece of cardstock, laminated it, and put it in my wallet. On that list was the resolution to eat a salad every day, simply because eating salad always made me feel like I was doing something good for myself. After all, salad provides several vitamins and can fill you up while reducing your caloric intake. What could be healthier than a big, fresh salad? Unfortunately, many things, as I later found out. Salads can run the gamut of healthiness, depending on what is in them. Although that big bowl of greens may be packed full of antioxidants and fiber, it can also be laden with fat, cholesterol, and sodium—not to mention an overabundance of calories. Some restaurant salads can even contain more calories than a cheeseburger! Luckily, like most things in life, a salad is the outcome of several small decisions. To make sure you don't sabotage your healthy diet unintentionally, choose wisely the next time you order a salad from a restaurant or visit the salad bar. When dining out, don't be afraid to ask questions, make special requests (extra veggies, dressing on the side, light cheese) and ask about substitutions (like grilled chicken for breaded). Most restaurants will be happy to accommodate you as long as their kitchen is stocked with the ingredients you want. Here’s how to choose wisely next time you're making a salad at home or choosing one from a menu. Lettuce The foundation of most salads, lettuce adds substance, crunch, water, and fiber for very few calories—only about 10 per cup. But if you want all that and vitamins, too, toss out the iceberg and toss in the romaine, mixed baby greens and spinach. While iceberg lettuce is lower in nutrients (and still makes a decent choice if it's the only thing available), these other greens are rich in vitamins A, C and K, manganese, and folate. Protein Adding protein, such as lean meat, tofu, eggs or beans, will help bulk up your salad and keep you full longer. Unfortunately, many protein toppings are deep-fried, breaded and greasy, which adds unnecessary calories plus cholesterol, sodium and fat to your salad. Skimp on fattier toppings such as bacon and fried (breaded) chicken strips, and go for lean proteins instead. Grilled chicken, canned beans of all kinds, chickpeas, tofu, hardboiled eggs (especially whites), or water-packed tuna are leaner choices. Nuts and seeds are popular in salads, too, and while they’re a healthy source of good fats and some protein, they’re not exactly low-cal. If you choose to add them, watch your portions (1/2 ounce contains more than 80 calories). Cheese Restaurants know that people love cheese, so they tend to pile on multiple servings of it on their salads. It might be tasty, but it sends the calorie counts sky high! While cheese is a nutritious food that adds flavor, calcium, and protein to a salad, enjoy it in moderation due to its high fat content. Just a half-cup of cheddar cheese (the amount on many large restaurant salads) contains 18 grams of fat and 225 calories. To keep calories in check, use a single serving of cheese (approximately 2 tablespoons). Choose low-fat varieties as much as possible to save on saturated fat and calories. A smaller amount of a stronger-flavored cheese, such as Brie, feta, chevre, gorgonzola, sharp cheddar or bleu cheese will go a long way in helping you cut down on your portions. Pile on the Veggies Vegetables like bell peppers, grated carrots, sugar snap peas, and tomatoes provide flavor, fiber, and vitamins for few calories. Grated carrots, for example, have only 45 calories in a whole cup, and there are only about 20 calories in an entire red bell pepper. When building your best salad, use as many veggies as possible for extra filling power—and a nice crunch! Practice moderation when it comes to starchy vegetable toppings like corn and potatoes, which are higher in calories. And remember to go for a variety of colors to ensure you're getting several different nutrients and antioxidants in your salad bowl. Don't Forget the Fruit Don't leave fruit on the sidelines! Fresh, canned and dried fruits add a sweetness that can help temper the slightly bitter taste of greens and veggies. They also provide color and texture (not to mention nutrition) to your salad bowl. Chopped apples, pears, grapes, or mandarin oranges (canned in juice—not syrup—and drained) are excellent salad toppers. Chewy dried fruits (cranberries, raisins) work well, too, but they are also high in calories (so only use a sprinkle!). Avocados (and the guacamole made from them) are creamy and nutritious thanks to their heart-healthy fats, but they're also a concentrated sources of calories. Keep your use of avocado to a minimum if you're watching your weight. Crunchy Toppings Sesame sticks, crispy noodles and croutons are salty and crunchy but conceal lot of hidden fat. Better options include water chestnuts, apple slivers, a small serving of nuts, crumbled whole-grain crackers, and homemade croutons. To make your own low-fat croutons, just slice a large clove of garlic and rub it over both sides of a piece of whole-grain bread. Cut the bread into cubes and then brown it in the toaster or conventional oven. Dressing A very healthy salad could go very wrong with one too many shakes of oil or dressing. The main issue with dressing is its fat and sodium content—and the fact that people have trouble controlling their portions. Two tablespoons is an appropriate serving of dressing, but most restaurants serve much more than that, whether mixed in to your salad or served on the side. Those calories add up fast. When dining out, always ask for dressing on the side and dip your fork into the dressing before picking up your bite of salad. Caesar, ranch and other cream-based dressings (when not specified as low-fat) are calorie bombs worth avoiding. Look for dressings specified as "low-fat" that contain no more than 60 calories per serving. You can also add flavor for minimal calories by using salsa, vinegar or lemon juice. Salad may be the symbol of healthy eating, but not every salad is healthful—or diet-friendly. The healthfulness of your next salad depends on the simple choices you make when topping or dressing it. Perhaps my greatest discovery about salads was that because you can customize them so easily, you could make a huge main-course salad for a very small amount of calories. Pile in the lettuce and veggies, add a moderate amount of lean protein, sprinkling some cheese and a little something crunchy and measure a portion-controlled side of dressing, and you’ve got a dinner that won’t leave you feeling hungry.Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1388

Umami: What You've Been Missing!

You've slimmed down your recipes, made healthy food swaps, and integrated vegetables into your meals. But do you ever feel like your food is missing something? When you finish eating, do you ever wonder why a meal just didn't hit the spot? You're probably missing umami. You've probably heard of the four basic tastes: bitter, sour, sweet and salty. Well, "umami," which means "yummy" in Japanese, is another distinct taste. Commonly found in fermented or aged foods, umami (pronounced ooh-mah-mee) adds that "mouth feel" to food. It makes your food feel richer, more delicious and more decadent. A key component in Chinese and Japanese cuisine, umami is starting to gain importance in Western cooking. American cooking tends to rely on fat or salt to get that feeling, but there are other, healthier ways to give your food and meals a little more oomph. Ever notice how parmesan makes pasta taste so much better? Or how much tastier ketchup makes your burgers? The parmesan, the tomatoes, and the beef all contain umami. Think about Japanese miso soup or almost any Chinese food. They're delicious and satisfying, thanks to umami-rich seaweed, fish, and soy sauce. Many foods are considered to have umami, including familiar foods like pepperoni pizza and hamburgers! And many condiments that seem to add "empty" calories (ketchup, steak sauce and Worcestershire sauce) actually help food feel more satisfying when you eat it. Here's a list of some umami rich foods:

By adding more of these foods to your meals, you can boost your satisfaction and potentially eat fewer calories overall and avoid overeating. A little goes a long way, and many foods rich in umami should be used as seasonings rather than main ingredients because they can be high in sodium and fat. Try adding a pinch of Romano cheese to steamed veggies or adding asparagus or mushrooms to your salad. If you're feeling decadent, put a pinch of crumbled bacon or a couple of sun-dried tomatoes in an egg white omelet. That could be just what hits the spot! Article Source: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1348

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