What is Osteoporosis?

Osteoporosis is a disease that weakens the bones and thus decreases their resistance. Those affected are thus more exposed to a risk of fracture.

There is generally accompanied by bone loss of bone fragility. This bone loss is due to an imbalance between bone formation and resorption.

The loss of bone density is finally accompanied by a modification of the bone architecture.

Osteoporosis is now recognized as a public health problem.
Epidemiology

Osteoporosis affects approximately 40% of women.
In humans

8% of men are also affected by osteoporosis. One third of women may thus be victim of a secondary fracture in osteoporosis, and this as early as 50 years.
Date of onset

Osteoporosis is a disease that starts at the time of menopause, to 50, and can extend for decades.
Risks

The major risk of osteoporosis is fracture. This risk is all the more important that the person is old.

Observed in osteoporosis fractures are of 3 types: fractures of the wrist, the neck of the femur and spine. Fractures can cause pain and a loss of extremely debilitating autonomy in daily life and a loss of self-confidence.
Symptoms

Osteoporosis is a disease that is often overlooked because it does sometimes cause any event nor any pain and it is discovered that on the occasion of a fracture.
Bone densitometry

Bone densitometry is a review that allows early diagnosis of osteoporosis, which allows to quickly implement a treatment and preventive measures. This review to assess the amount of demineralized bone.

Bone densitometry can also monitor the evolution of osteoporosis during treatment. Bone densitometry is not painful.

Absorption by the skeleton of a beam of energy through the bone is computer analyzed to assess bone density and the degree of osteoporosis.
Osteoporosis and menopause

The drop in estrogen during menopause increases the speed of bone turnover of bone loss leading to osteoporosis.

Tagged with:
Posted in Health

Sleeping longer could decrease the genetic predisposition to being overweight.

Several studies have already shown the importance of sleep for health, whether weight or cardiovascular health. In a recent unpublished study researchers have to highlight that sleep longer to change the activity of genes that predispose to overweight.

In reaching this conclusion American researchers followed 604 twins and 484 twins aged an average of 36.6 years. This tracking method to distinguish the influence of genes from the environment. Sleep patterns, the size and the weight of each participant have been noted.

The researchers were able to classify participants into three distinct groups: small sleepers (less than 7 hours of sleep per night), normal sleepers (between 7-9 hours of sleep) and the big sleepers (more than 9 hours of sleep per night). There while:

  • Among the biggest sleepers the activity of genes that predispose to overweight is 34%.
  • In small sleepers the activity of genes that predispose to overweight is 70%.
  • In normal sleepers the activity of genes that predispose to overweight is 60%.

In other words, two twins have the same genetic heritage sleep time modifies the activity of genes that predispose to overweight. Therefore, an additional study that highlights the impact of the environment on the activity of genes, thus leaving a hope important who fight against genetic predispositions.
The authors of the study conclude: “a shorter sleep period is associated with overweight greater and greater influence of genes on the (BMI) body mass index, suggesting as well as shorter sleep increases genetic for overweight or obesity risk. Conversely, a longer duration of sleep could remove this genetic influence. The next research deployed to identify genotypes that predispose to overweight should consider this role of sleep on the activity of the genes.”

Tagged with:
Posted in Health

Aldehydes: what are they? What are the impacts on our health?

What is it?

Aldehydes are substances that are classified in the category of volatile organic compounds, the famous VOC. These are organic compounds which one of the carbon atoms is a Carbonyl group. There are various aldehydes depending on the number of atoms of carbon, hydrogen and oxygen which constitutes them.

Where do they come from?

Aldehydes are used in the manufacture of certain materials for construction and insulation but are also present in many products for use as adhesives, varnishes, pressed wood…

Your home is probably traces of different aldehydes:

Formaldehyde
It is the best known of these compounds. It is found in many products in common use: insulating foams, lacquers, glues, varnishes, inks, resins, paper, products, pesticides, wood chipboard and plywood. It is also used in textiles as well as in certain medicines and cosmetics

Acetaldehyde
It is found in cigarette smoke but it comes also photocopiers, raw wood panels, particle board

Benzaldehyde
Found in some paints but it came also from photocopiers and parquet.

hexaldehyde
It comes from Particleboard, some paintings, wood panels or some wood treatment products. It is also emitted by books or new magazines.

butyraldehyde
It is issued by some copiers

isoveraldehyde
It comes from treated floors and some particle board

valeraldehyde
Found in some paints and particle board, but it is also emitted by the books and new magazines.

What are the health effects?

The best known and most studied of aldehydes is formaldehyde. This product is particularly irritating to the eyes, nose and throat. Since 2004, he is considered by who as a carcinogen for nasopharyngeal and nasal areas. Some epidemiological studies on the effects of prolonged exposure to formaldehyde have also put forth an impact on respiratory and allergic effects. People with asthma are particularly susceptible to exposure to these products that may aggravate their symptoms. Furthermore the aldehydes may be responsible for occupational asthma for those working in prolonged contact with these products, including workers in the building.

How to avoid?

When you purchase products maintenance type paint, glue, varnish etc., you can check with the manufacturer to find out the composition. Most important is to ventilate the pieces up when you use these products, and even continue to frequently ventilate a room which has been the subject of recent work.

Posted in Health

Ozone layer: what is it? What are the impacts on our health?

What is it?

Ozone is a chemical compound with 3 oxygen atoms (O3). It is a gas with a  pungent smell.

Ozone is based on the transformation of other pollutants such as nitrogen dioxide and carbon monoxide, is what is called a secondary pollutant. He especially in housing via outdoor air saturated with traffic but it can also be produced from domestic sources such as some photocopiers. However, recent models have ozone filters.

What are the health risks?

The three most encountered symptoms are cough, chest discomfort and pain on deep inspiration. Appear but less frequently, shortness of breath, nose, and throat irritation. Ozone also affects the respiratory function, as well as the volume and pulmonary flow. Asthmatics and athletes seem to be a population at risk to exposure.

How to avoid it?

If you have printers or photocopiers not equipped with ozone filters, make sure the parts in which they are located are well ventilated.

Tagged with: ,
Posted in Health

What is calorie density?

calorie density is used to measure the number of calories provided by a certain amount of food.
Vegetables have the lowest caloric density.

What is calorie density?

The calorie density allows you too:

measure the number of calories made per gram of food.
compare load caloric of the same quantity of food.
It is obtained by dividing 100 by the number of calories (kcal) made per 100 grams of food. Vegetables have a very low calorie count (0.1 for the salad) while chocolate has a high calorie count of 5.

Why focus on foods that are low in calorie density?

Because more one consumes calories, more one ages: when they consume 30-40% fewer calories, animals such as rats, mice, and fish live 20-30% longer than their congeners.

Low-calorie diets increase life expectancy, but be careful to not be severals vitamins and minerals and eat balanced

Whatever the food we eat, we swallow pretty much always the same amount of food: choosing foods low Calorie count is our stomach while reducing the number of calories consumed and by filling nutritional needs met.

Low and high calorie density foods

Foods for low calorie density or moderate preferred  high calorie desnity foods to avoid
Lettuce Nesquick cereal
Courgette cooked chocolate
Tomato biscuits
carrots Grilled bacon
grape fruit butter
broccoli cakes
manadrin pork fat
brown rice sweets
mackeral chips

Some nutritionist’s say thought that calorie counting does not work because 100 calories from one type of food maybe more or less beneficial than 100 calories of a different kind of food. That’s why it is not recommended to do calorie counting!

Tagged with: , ,
Posted in Health

Christian Rémésy: “need to reduce empty calories”

sweets3

Christian Rémésy: “need to reduce empty calories”
“What will we eat tomorrow? A huge question answered by Christian Rémésy in his last book.
The Director of research at INRA is also will discuss the various problems in the food chain. This is a opportunity for the nutritionist to expose to Healthlift his vision of the food industry and food in general. Interview.

You say in your book that “nutritional environment was upset in the last 50 years. Why and how has it changed?

The nutritional environment was upset in order to apply the logic of industrial production. The world is urbanized, the food industry has developed. And this industry has imposed on food a drastic treatment. Natural foods have become processed foods.

Today, all our knowledge in the field of nutrition could enable us to optimize food production.
The food industry poisons consumers?

We cannot say in this way but industrial production was not designed to be adapted to the needs of man. We cannot speak of poisoning in the proper sense but, in contrast, one can speak of a “energy poisoning”. From foods, the food industry extracts of fat, sugar, refined flour. All this by isolating the energy part of the Izvor, e.g. of fibres and micronutrients.

This is very worrying because we know what this causes on the organization. Found in the United States, countries where food transformations are very important, epidemics of obesity and metabolic diseases such as diabetes. Already well known the damaging effects of such food.

The food industry simply had a desire to produce. But obviously it does not arose many questions on the consequences long term of the tender which it offered consumers. And without a clear framing of the public authorities, it happened what had to happen…

It is ultimately the entire food chain which must be reformed. Should require that foods have a sufficient nutritional density. For example, a loaf of bread should be made with flour type 80. In a grain of wheat, minerals and other vitamins are in the envelope of the grain. By removing it, you keep finally only a quarter of vitamins and minerals originally present. Thus, a flour type 55 contains 0.55 grams of minerals for 100 grams while the integral flour (type 180) contains 1.80 grams per 100 grams. In white flour, there is little magnesium, little fiber, low B vitamins… substances yet present in the original grain. Legislators should have and able to directly require that the bread is made from flour type 80.
Can we have products taste good and good for health?

You know, the taste of the products is increasingly manipulated. To take the example bread, white bread has been systematically valued while it has no monopoly of good taste, far from it, since we find excellent breads bis or complete.

In addition, the food industry manipulates taste with aromas. But however cannot be against taste and health. Today, one can find healthy products that have taste.
What were the advantages and disadvantages of diets in 1950? And those for the present day?

The past was not so great as this. At the time, he had not a good variety of food. And diversity, it is the true progress of today.

Previously, the notions of dietetics were rudimentary, could not progress in this area. But I would like to point out that we could have done better, especially if we had a clear vision of the needs of man. It should do everything possible to preserve the complexity of food and their micronutrient content.

What are the basics of a good PSU?

For the good basics, take each class of foods one after the other.

For carbs, I advise to consume complex plant products (dried vegetables, breads complete…). Absolutely avoid purified sugars. These sugars are found in soft drinks, starch, clarified fruit juice…

For proteins: they should be half animal and half vegetable. A little meat (I think that should be avoided the excesses of animal protein), bread and dried vegetables, all this is very natural.

Finally, for fat, I have several recommendations to make. It be absolutely balanced fatty acids. The mixture of oil of olive and rapeseed oil seems essential to me.

We must also reduce the empty calories, i.e. reduce foods that contain that energy and few factors of protection for the body. This is the case for example of biscuits, industrial pizzas…
Vitamin C in fruit juice has the same effect on the body than that of fruit and vegetables?

Not at all! Most of the time, in a natural fruit, are polyphenols, carotenoids, vitamin E… While with fruit juice, there is less antioxidants, vitamin C finds himself isolated and is therefore less effective. I believe finally that it is best to keep the complexity of a food.
One speaks more in addition to the polyphenols. What could they be used in the near future?

Polyphenols are present in all foods, not plant products without polyphenol. Fruits and vegetables are very rich, wine and cider also… In grains, the concentration of polyphenols is lower. These micronutrients have a great antioxidant power. However, little is known about yet the physiological effects of polyphenols.
What do you think of products enriched in phytosterols (cholesterol close plant compounds family), omega-3?

There are margarine enriched with phytosterols. It is argued that it would be effective against cholesterol and prevention of cardiovascular disease, which is the last straw! In this case, isolated an element to highlight a selling point. But this argument is very reductive.

Finally, there’s not much to expect these new fortified products. Dairy 0% fat is 0% with sugar and more! There again, we add empty calories. Dairy products are naturally fat which are vectors of fat-soluble vitamins and which should therefore retain in part as such.

For omega-3-enriched products, I find we forget quickly that these fatty acids found in fatty fish, walnuts, etc. All of a sudden it starts to mention omega-3s, only omega-3. This is still a very reductionist view of nutrition. In my opinion, better to have a diversified natural products diet instead of buying this kind of fortified products.

How to make aware people that they should change their habits?

It should already change supermarkets. They should contain less processed products, 50% of the products should be from the countryside or the sea. The multitude of processed products should be limited.

We buy good products to prepare good meals. Many processed products are not of sufficient quality, the food industry should be able to provide consumers with much better food. Must and can find a good balance between natural products and products processed base. But many things need to be rethought, whether at the level of farming, food transformations or supermarkets. Of local markets should emerge.
Many scientists point the finger products refined… Why aren’t more challenged by the general public?

It is one of the big problems. The public should understand the concept of empty calories (as defined by Christian Rémésy in his book: ‘this term means that a food or ingredient brings energy with a very low accompaniment in non-energy compounds such as fibre, minerals, and micronutrients’.) The classics include “products snacks, chocolate bars, alcohol”, Editor’s note). This excess energy becomes dangerous for the organism. Intakes of micronutrients, minerals and vitamins are essential. The public should be able to select products with the micronutrient content was the best preserved.All too purified and too refined products should be abandoned in favor of more natural products: prefer a white bread buns, Virgin oils colored clear deodorized oils, cloudy fruit juices (or better the full fruit) to the limpid fruit juice. There’s a job to do on everyday products. Again for other examples: pasta should contain more dietary fiber, rice should at least be semi-fixed.

The public must now comply with these basic principles. A food, this isn’t anything. For its part, the farmer must be able to work in good conditions. And, yet again, foods should not be distorted.
The title of your book (what will we eat tomorrow?) question. Can you answer this?

Everything depends on what we are going to guide us. Currently, we are not going in the right direction, certainly…But in the future, should that power be richer in fruits and vegetables but also starchy base (rice, bread…). It is finally an old recipe as the world! It is far from all pills that you would want us to swallow in the best of the futuristic worlds. It would be desirable also that power is more balanced in essential fatty acids. I especially hope you will adopt Foods abundant and light, wellbalanced diet and at the same time pleasant dining and effective in the maintenance of health. All of this, it is finally back to basics with modern techniques.
And if it does not go in the right direction?

If this does not happen? Consumers will be like cats conditioned to eat their Kibbles, whereas before, our cats knew enjoy and complete the dishes of their masters. The men will be completely dependent on processed products and have even lost the taste of natural foods… Consumers will be passive. In short, it will be just about anything. The most resistant will hold the shot, but for others, this is not ideal…However, I do not think will be such an extreme situation.

Tagged with: , ,
Posted in Health

No mercy for sweets

sweets1

Confectionery does not promote cancer
FAKE
Confectionery manufacturers assert about sugars and health that: “no data does establish relationship between the consumption of sugar and the onset of cancers.” Confectioners have a selective reading of the scientific data, since several studies have shown instead that high consumption of sugar and foods rich in sugars, such as confectionery, increases significantly the risk of colon cancer. This risk is increased by 60% in a US study of 1997, and 40% in an Italian study published the same year. A prospective study of 35,000 women 1994 found an increased risk of 80 to 100% for large consumers of sugar. Similar observations were made for a long time in the animal. How can we explain this phenomenon? First, some forms of sugar, such as caramel, are directly carcinogenic. Furthermore, according to Edward Giovannucci (Harvard University, Boston), cancer of the colon would be favored by high insulin levels that accompany fast sugars and refined foods consumption. Insulin encourages indeed the intestinal mucosa cells to proliferate, with the risk of becoming uncontrollable.

Diabetes is not related to the consumption of sweets
FAKE
A major study published last year by the team of Dr. Walter Willett (Harvard School of Public Health) has shown that large consumers of sugar and sugary foods have a risk of diabetes type 2 (non-insulin-dependent) by 40%, compared with those who consume low sugars. When excess sugar is coupled with a deficit of fibres, the risk of diabetes is multiplied by 2.2. A Japanese study of 1993 had concluded the same. Non-insulin dependent diabetes which appears in adulthood, and whose impact continues to grow, is clearly linked to a food mode of Western type dominated by excess sugar, sweets, excessive food refining, and regression of fruits, vegetables, legumes, whole grains. The two also go hand in hand: a Spanish 1997 study, conducted with school children shows that high consumers of confectionery are also those who eat the least of raw vegetables and fruits.

Chewing gum increase the risk of dental caries
FAKE
Unlike sugar, xylitol – a sweetener – is not fermented by bacteria in the oral cavity: it therefore significantly reduces the risk of tooth decay. With sorbitol – another substitute for sugar – xylitol also promotes the remineralization of tooth enamel. Several clinical studies demonstrate the interest of chewing gum with xylitol. A recent study shows that, compared to a chewing gum with sugar, the use of a chewing gum with xylitol in infants result after 16 months a reduction by half of the number of cavities, with a likely already installed caries stabilization.

Children use confectionery such as pain killers
TRUE
One child out of 3 or 4 shows an excessive attraction to sugar and sugary foods. The work of Judith Wurtman (Massachusetts Institute of Technology, Cambridge) have shown that these children often have a lack of synthesis or use of serotonin, a chemical Messenger in the brain that plays a crucial role on mood. A deficit of serotonin can result in childhood by impulsivity, weeping, attention disorders. Daily, serotonin levels fluctuate with the amount of sugars in the diet, simple sugars challenging a rapid elevation of blood levels of tryptophan, an amino acid that gives birth in the brain serotonin. For Judith Wurtman, children high consumers of sweets make it an almost medical use to “inflate” their brain serotonin. Furthermore, clinical studies in infants have shown that sugar administration decreased the cries and tears.

A great accelerator of aging
By offering sweets and confectionery to their children, parents are a gift whose expensive darlings is would pass well, since he probably stood in the month of life less:
1. Mitochondria are the power plants of the cell, loaded to burn food in contact with oxygen to provide energy to the body. This combustion is flawed, insofar as it is accompanied by the production of free radicals, which eventually damage the mitochondria themselves. Of many chronic diseases, but also the classic manifestations of aging – fatigue, shortness of breath, find their origin in these alterations of the mitochondria. Confectionery and ‘recreational’ food contribute to accelerated aging by making an additional and unnecessary burden on the mitochondria.
2 – The consumption of sweets is accompanied by an increase in the rate of sugar in the blood. This is the origin of phenomena of glycation, in which sugar and proteins react together to form rigid, insoluble compounds that are causing wrinkles, but that also explain some alterations in organs, such as kidney failure.
3 – Excess sweets may also lead to elevation of triglycerides in the blood, an independent cardiovascular risk factor. Dr. William Grant (NASA Research Center, Hampton, Virginia) estimated in a recent study of 150,000 annual cardiac deaths directly related to sugar consumption in the United States. In women, the sugar would be even the first nutritional factor of cardiovascular risk, animal fats. But these works require confirmation.
4. In non-refined foods, sugars are accompanied with co-factors necessary for their use by cells, such as vitamin B1 and magnesium. Sweets contain none of these “chaperones”. To metabolize these empty sugars, the body is forced to dip into its scarce reserves of B1 and magnesium, at the risk of creating or increasing deficits. Deficiencies in vitamin B1 translates into memory disorders; deficiencies in magnesium by sensitivity increased stress and fatigue.

Tagged with: , ,
Posted in Health

Longevity: eat less salt and more fruits and vegetables!

A high sodium /  low potassium diets can be linked to an increase in the risk of death, especially cardiovascular.
The diets with lots of salt, little fruits and vegetables… Already associated with an increased risk of cardiovascular disease, diets of this type, rich in sodium and low in potassium, could also increase the risk of death. It is suggested by a study published in the journal Archives of Internal Medicine.

Authors followed 12267 people during nearly 15 years in order to assess the relationship between mortality and the consumption of sodium and potassium.

The results show that a significant intake of sodium is related to an increase of 20% of the mortality and conversely, a significant intake of potassium is linked to a 20% reduction in mortality. Moreover, a significant consumption of sodium associated with low intake of potassium is linked to increased mortality and cardiovascular mortality in particular.

Tagged with: , ,
Posted in Health

The modern diet is too acidic

In recent years, researchers are working on a new track that could explain the rise of the ‘modern’ our diet-related diseases: acid-base balance.
This balance, which is essential to the proper functioning of the body, would have been broken long ago with the advent of the modern diet.

Do you know the history of omega-3? 100 000 Years ago, as hunter-gatherers we ate as much omega-3 fatty acids than omega-6, and according to recent studies maybe even a little more. An ideal ratio for our body. Then agriculture and livestock arrived. And the food industry was born. Then our food evolved. Less fish, less nuts, dry fruit less. Therefore less omega-3. And at the same time more cereals and animals fed with these cereals, more fats and oils rich in omega-6 as sunflower oil so more omega-6. Result: of a 1: 1 omega-6/omega-3 ratio we have moved to a 15: 1 ratio! With the consequences we know now: cardiac mortality, mood disorders, asthma, inflammatory diseases.

And do you know that of the acid-base balance? It is somewhat the same story. The menu of our Homo sapiens by the beautiful part to plant brought him minerals such as calcium, magnesium, potassium. Our plates are now topped with meat and cereals with a good dose of salt (sodium chloride). This diet rich in animal protein and chloride has a major drawback: it is acidification!

Too acidifying menus

To function properly, our body must lie within an area of pH balanced. If the pH is too low, so too acidic (usually below), you suffer from a disease called chronic acidosis multiple potential consequences. What is the relationship with the menu of our Homo sapiens? A very close relationship: the acidity of our body depends on what we eat. Minerals can be classified into two categories according to their effect on the pH of the body. In the group of ‘acidifying’ minerals, are chlorine, sulfur and phosphorus. In the group of minerals: magnesium, calcium, sodium and potassium. The significant change that has occurred in our plates within 100,000 years preceding us has tipped the balance of consumption of basic minerals to a high consumption of acidic minerals.

Professor Anthony Sebastian Professor of medicine at the University of California San Francisco rated the Pral (see box) index of the diet of our ancestors and compared it to that of the modern diet.  From an average of – 88 mEq / day, or a very basic diet, we moved on to an average of + 48 mEq/day. Our society is immersed in chronic acidosis.

You salt your food? The chloride salt can acidify your body. You eat meat every day? Animal proteins provide sulfur amino acids. This sulphur joined chlorine to contribute to further lower your pH. You exit the fruits and vegetables? Damage, they are, with certain mineral waters, food the more rich in minerals are.

Health in danger

What consequences for your health? Researchers continue to explore this relationship between the acid-base imbalance and modern diseases. They already suspect the acidity to promote muscle wasting, kidney stones and high blood pressure. But above all it is now a very serious to explain the outbreak of osteoporosis. Why?

Because our bodies cannot function in an acidic environment. If our food does bring him enough basic elements, it will have to find  a way to redress the balance. How? Fetching the mineral substances in its reserves in the first rank of which: our bones. These contain some citrates and some bicarbonates, known for their buffer effect, meaning that they decrease the acidity of the body back in a normal operating area. The problem: in our bones, these substances are found in the form of citrate calcium or calcium bicarbonate. In drawing these elements, the body ‘pump’ calcium from our bones. Result: bone density may decrease, bones become brittle, it is osteoporosis. This may explain why, in studies, people who eat more animal protein have a greater risk of bone fracture than others, but this hypothesis is disputed by some scholars.

Thence to prevent and cure osteoporosis with food basifiants in the spotlight in our food, there is only one step. Already in 2001 the team the researcher Dr. Katherine Tucker in human nutrition at Tuft University of Washington, had shown that people who eat the most fruits, vegetables, magnesium and potassium had a better bone density.

To prevent chronic acidosis and avoid the risk of osteoporosis, more and more specialists recommend to consume a lot of fruit and vegetables, probably more than 8 servings per day. If you drink bottled water, choose a bicarbonate-rich water.  Healthlift classified mineral waters sold in France according to their power acidifying and alkalizing. First, in order to optimize the diet and health.

Posted in Health

A good acid-base balance may protect against type 2 diabetes

A good acid-base balance of the body could protect against type 2 diabetes.

How to improve its acid-base balance?

Acid-base balance of our stomach is crucial. When our body is too acidic, it draws on our reserves of alkaline minerals to restore the pH of the blood and tissues. Bones represent a large reserve of alkaline minerals, this is therefore ample scientific evidence support the idea that osteoporosis is a disease of the acid-base imbalance.

In an analysis of the famous “study of nurses’ more than 600 diabetics women between 1990 and 2000 were compared with healthy women. Harvard University researchers have found that women who had developed diabetes had lower than others, bicarbonate levels before even the onset of the disease. In other words: their body was more acidic than others.

These data suggest that an acid-base imbalance could favour the onset of type 2 diabetes but researchers remain cautious and conclude: “further research is needed to confirm these results of counselled more general, to understand what mechanism could explain these observations and determine if a dietary supplement or food changes can be a new strategy to prevent the onset of type 2 diabetes”.

HealthLift does not recommend to wait for new studies to improve the quality of food and to monitor its acid-base balance, given its importance for health in a comprehensive manner. To learn how to correct your acid-base balance, check out our articles.

 

Posted in Health