Loneke Blackman Carr, University of Connecticut and Jameta Nicole Barlow, George Washington University

The popularity of weight loss drugs such as Ozempic and Mounjaro continue to reflect Americans’ desire to slim down. While these new drugs have offered a solution for people struggling with obesity, many eligible patients – especially Black adults – cannot afford the high price.

These drugs are also not a one-stop solution for better health, as healthy eating and regular exercise are also key to losing weight. But current weight loss interventions based on lifestyle changes largely fail to meet the needs of Black women.

As community health researchers, we wondered why scientists have been unable to craft a lifestyle-based weight loss solution that works for Black women.

So we reviewed 10 years of research on weight loss interventions based on lifestyle changes. We found that only a few studies focused on Black women, and those that did often resulted in only small amounts of weight loss and were inconsistent in how they approached weight loss. Why is that?

Missing the mark for Black women

Obesity increases the risk of developing weight-related conditions such as Type 2 diabetes, heart disease and some types of cancer. Nearly 60% of Black women in the U.S. are obese, placing them at greater risk of developing these conditions.

Lifestyle interventions focusing on healthy diet and increased physical activity are proven to help most people lose weight, typically resulting in a 5% to 10% weight reduction that also reduces the risk of chronic disease. However, these lifestyle interventions usually result in only a 2% to 3% weight loss in Black women.

Our review suggests that lifestyle-based weight loss has been stymied among Black women because they often aren’t included in this research. Because their lived experiences aren’t considered in these studies, these interventions might not meet their specific needs. Of the 138 studies we assessed, Black women made up at least half of the participants in only eight studies.

Research on why lifestyle interventions are often less effective for Black women is lacking. However, some studies highlight the effects of race and gender on their daily lives as potential factors.

The superwoman role

Black women exposed to the persistent stress of navigating everyday racism and sexism face the additional burden of what researchers call the superwoman role. Not only do Black women have to weather their own experiences of race- and gender-based inequalities, they’re also expected to be invulnerable, hyperindependent and suppress their emotions in order to seem strong to their family and community. Many minimize their vulnerabilities and overstress their capabilities in order to fulfill an overwhelming obligation to take care of other people.

Many famous names have spoken about the effects of being the strong superwoman. Actress Taraji P. Henson has pointed to how the need to display strength can lead to ignoring the physical and emotional needs of Black women.

Rapper Megan Thee Stallion spoke about the emotional toll of the superwoman role after being shot by rapper Tory Lanez. “As a Black woman … people expect me to take the punches, take the beating, take the lashings, and handle it with grace. But I’m human.”

The superwoman role levies a heavy tax on Black women, leaving little room to prioritize their health. To cope with the stress, some engage in emotional eating or binge eating. The constant demands of playing multiple caregiver roles can also disrupt physical activity.

Naturally, these challenges make it difficult to adopt healthier eating habits and a consistent exercise routine. Even when working toward weight loss, some Black women continue to gain weight.

Improving weight loss for Black women

Lifestyle interventions that fully integrate the lived experiences of Black women into treatment may be key to improving weight loss. We argue that Black Feminism and Womanism, which focus on the experiences of women of color, can guide researchers to rebuild and reframe weight loss interventions to be more effective for Black women.

Black Feminism and Womanism are approaches guiding Black women and girls to surviving and thriving, specifically by always considering the role that gender and race play in different issues. These frameworks focus on multiple areas of health and wellness, including physical, mental and emotional health, arguing that self-care and wellness practices are acts of social change.

Focusing on the full context of Black women’s lives can lead to better overall health. Obesity, specifically, is influenced by multiple factors, and treating obesity requires a focus on holistic health and well-being. This includes addressing Black women’s economic needs, incorporating faith practices central to Black life, attending to emotional and mental health, and building an environment that makes acquiring healthy food and engaging in daily exercise an easy choice.

Current weight loss interventions vary widely in which elements of Black women’s lives they focus on. For example, some emphasize spirituality, while others concentrate on emotional health. Approaches to weight loss that respond to individual needs and move away from one-size-fits-all will be critical to addressing the various aspects of Black women’s lives that affect their wellness.

If health care providers and researchers begin listening to and working with Black women to redesign weight loss interventions, they will likely find that their efforts at addressing obesity among Black women are more effective.

Loneke Blackman Carr, Assistant Professor of Community and Public Health Nutrition, University of Connecticut and Jameta Nicole Barlow, Associate Professor of Writing, Health Policy & Management and Women’s, Gender and Sexuality Studies,, George Washington University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Ian McDonough, Binghamton University, State University of New York and Michael Dulas, Binghamton University, State University of New York

Some 2.3 million of U.S. adults over 65 – more than 4% – have a diagnosis of dementia. But even without a diagnosis, a certain amount of cognitive decline is normal as age sets in.

And whether it’s due to fear of cognitive decline or noticing lapses in cognition when we are stressed, many of us have had moments when we thought we could use an extra cognitive boost.

The good news is research has shown that people can make changes throughout adulthood that can help prevent or delay cognitive decline and even reduce their risk of dementia. These include quitting smoking and properly managing blood pressure.

In addition to these lifestyle changes, many people are turning to brain-training games, which claim to optimize your brain’s efficiency and capacity at any age. The makers of brain-training apps and games claim their products can do everything from staving off cognitive decline to improving your IQ.

But so far these claims have been met with mixed evidence.

We are cognitive neuroscientists who focus on brain health across the adult lifespan. We study how the brain informs cognition and the ways we can use brain imaging to understand cognitive and brain-training interventions. We aim to understand how our brains change naturally over time as well as what we can do about it.

Ongoing research shows what actually happens to the brain when it is engaged in new learning, offering a window into how people can sustain their brain health and how brain-training games can play a role. We believe these studies offer some strategies to train your brain the right way.

Brain training fact vs. fiction

Brain training is a set of tasks, often computerized, based on well-known tests to measure a type of cognition, but in a gamified manner.

Most brain-training games were designed to help participants master one or more specific skills. One example is a game that shows you a letter and number combination, where sometimes you must quickly identify whether the letter is even or odd, while other times you must switch to deciding whether the letter is a consonant or vowel. The game may increase in difficulty by requiring you to accomplish the task within a set time limit.

Such games are designed to require a high level of attention, fast processing speed and a flexible mind to alternate between the rules, known as executive functioning.

But it turns out that the specific skills learned in these games often do not translate to more general, real-world applications. Whether brain games meet their end goal of lasting cognitive improvement across a number of areas is still highly debated among psychologists. To make such claims requires rigorous evidence that playing a specific game improves cognitive or brain performance.

In 2016, in fact, the Federal Trade Commission issued a US$50 million penalty to one of the most popular brain-training games at the time, Lumosity, for misleading consumers into thinking that they could achieve higher levels of mental performance at work or at school and prevent or delay cognitive decline by using its product.

If improving on a brain game helps the player get better only at that or highly similar games, maybe game developers need a different approach.

Put some challenge into it

In a study dubbed the Synapse Project, in which one of us, Ian McDonough, helped assess the final outcomes, one group of participants were tasked with engaging in a new activity with which they had little experience. They were assigned to either digital photography or quilting. Though these activities were not games, they were meant to be engaging, challenging and done in a social environment.

Another group was assigned activities that involved little active learning, such as engaging in themed activities related to travel or cooking, or more solitary activities such as solving crossword puzzles, listening to music or watching classic movies. These groups met for 15 hours a week over 14 weeks. All participants were tested at the beginning and end of the study on various cognitive abilities.

Those assigned to the new, challenging activities showed significant gains in their memory, processing speed and reasoning abilities relative to those assigned to the less challenging activities. None of the participants were directly trained on these cognitive tests, which means that the challenging activities enhanced skills that transferred to new situations, such as remembering a list of words or solving abstract problems.

Brain scans of participants showed that over the course of the study, those engaged in the more challenging activities increased their neural efficiency. In other words, their brains didn’t have to work as hard to solve problems or recall information.

The study also showed that the more time participants spent on their projects, the bigger their brain gains and the better their memory was at the end of the 14 weeks.

One difference between the types of activities engaged in the Synapse Project and traditional brain training is whether activities are done in a group or alone. Although other studies have found a benefit to social interaction, the Synapse Project found no difference between the social and solitary activities in the low-challenge group. So, challenge rather than the social components seems to be the driver of maintaining cognitive and brain health.

What you can do to maintain a healthy brain

You might be thinking it’s time to take up digital photography or quilting. But in the end, it’s not about those specific tasks. What matters most is that you challenge yourself, which often comes naturally when doing something new.

The new learning that often is accompanied by a sense of effort – and sometimes frustration – requires accessing the resources in the frontal lobe, which manages thinking and judgment, and the parietal lobe, which processes attention and combines different sensory inputs. These regions constantly talk to each other to keep the mind adaptable in all kinds of situations and prevent the brain from going into “habit mode.”

Where does this leave us? Well, on the one hand, games touted as “training your brain” may not be the best solution compared with other routes to improving cognition.

Ironically, you might already be training your brain by playing effortful games that are not marketed as “brain training.” For example, games such as Tetris or real-time strategy games such as Rise of Nations have shown improvements in players’ cognition. Research has even shown that playing Super Mario 64 can result in increases in brain volume in regions such as the hippocampus, the memory center of the brain.

While little evidence suggests that any brain-training game or program globally improves cognition, some may improve specific aspects of it. As with other activities, challenge is key.

If you’re a word person, try a numbers-based game. If you love math, consider a word game or puzzle. Choosing a task that makes you feel uncomfortable gives you the best shot at maintaining and even improving your cognition. Once you start feeling a sense of ease and familiarity, that’s a sign that it’s time to switch tasks, change the game or at least add some challenge by advancing to a new level of difficulty that feels just beyond your reach.

Ian McDonough, Associate Professor of Psychology, Binghamton University, State University of New York and Michael Dulas, Assistant Professor of Psychology, Binghamton University, State University of New York

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Donald Chi, University of Washington

For more than 50 million Americans, finding a dentist is a difficult – in some cases, impossible – proposition. Many rural communities don’t have a dentist. People of color and those with disabilities often lack access, and only about one-third of dentists accept Medicaid.

That’s why dental therapists – professionals who don’t have a full dentistry degree but are trained to provide basic dental care – are becoming increasingly popular. Dental therapists are now authorized to practice in 14 states, and they focus primarily on underserved populations.

Dr. Donald Chi, a pediatric dentist and professor of oral health sciences at the University of Washington, explains the kind of training that dental therapists receive, the critical need for them throughout the U.S., and how they have affected the communities they serve.

The Conversation has collaborated with SciLine to bring you highlights from the discussion, which have been edited for brevity and clarity.

Who lacks adequate dental care in the U.S.?

Donald Chi: Low-income people often have difficulty finding and accessing dental care. That population includes racial and ethnic minorities, people with disabilities or special health care needs, and people in rural areas who live a long distance from a dental office.

What are some of the effects of poor oral health?

Chi: Oral health touches every part of our lives as human beings. To eat, to socialize, to hold a job and to learn, you need your teeth, and you need them to be healthy.

Painful cavities can get in the way of sleeping, chewing your food and your employment. Imagine if you had missing teeth in the front of your mouth because you had them removed because of large cavities. There are numerous studies that show that people missing their front teeth can’t find or hold down jobs. Both the pain and aesthetic aspects of poor oral health can really create problems.

What are dental therapists, what training do they receive, and what services do they provide?

Chi: Dental therapists are a lot like physician assistants. They’re not full-fledged dentists, but they’ve received enough training to provide a limited set of dental procedures. Dental therapists typically get anywhere from two to four years of training after high school, and they’re trained to provide preventive care.

Dental therapists can administer cleanings and fluoride treatment as well as sealants, that is, coatings that protect your teeth from bacteria. And they can do some relatively simple procedures – for instance, small fillings and simple tooth extractions. But dentists are still needed for more complex treatments: bigger fillings, complicated tooth extractions, root canals, crowns and dentures.

Dental therapists are not substitutes for dentists. Dental therapists have a limited scope of practice, but that scope is critical.

In a community with lots of unmet dental care needs, dental therapists can put out small fires. Dentists can then focus on putting out the big fires. It’s a team-based effort – dental therapists work with dentists to make sure that all of a community’s needs are met.

In 2006, Alaska became the first state to authorize dental therapists. What did your research reveal about how Alaska’s plan worked?

Chi: What we found is that Medicaid recipients, both children and adults, were less likely to have teeth removed after the authorization of dental therapists. This meant that more people were keeping their teeth longer, and they were more likely to get preventive care, like fluoride treatment and cleanings.

What other lessons have you learned from other states with dental therapists?

Chi: The rest of the 13 states that have authorized dental therapists have dental therapy programs that have been running for fewer than 20 years, which is about how long Alaska’s program has run.

But we’ve seen data out of Minnesota showing that Medicaid enrollees were more likely to get dental care after dental therapy was introduced. And we see similar types of outcomes in other areas served by dental therapists. To see this almost immediate impact has just been remarkable.

Besides visiting the dentist, what other ways can people promote good oral health?

Chi: Healthy eating is a great way to promote oral hygiene, maintain tooth enamel and reduce the likelihood of gum disease.

I realize healthy eating can be hard because of the limited availability and the relatively high costs of healthy food. But minimizing the amount of sugar in your diet and staying away from juice and sugary beverages are both good ways to protect your teeth.

Brushing twice a day with a toothpaste that contains fluoride and drinking fluoridated water will also maintain good oral health.

Watch the full interview to hear more.

SciLine is a free service based at the American Association for the Advancement of Science, a nonprofit that helps journalists include scientific evidence and experts in their news stories.

Donald Chi, Professor of Oral Health Sciences, University of Washington

This article is republished from The Conversation under a Creative Commons license. Read the original article.