Does the Vitamin and Mineral Content of Food Influence Our Food Intake and Body Fatness?

The Claim: We Overeat Because Our Diet is Low in Vitamins and Minerals

We know that animals, including humans, seek certain properties of food.  Humans are naturally attracted to food that's high in fat, sugar, starch, and protein, and tend to be less enthusiastic about low-calorie foods that don't have these properties, like vegetables (1).  Think cookies vs. plain carrots.

In certain cases, the human body is able to detect a nutritional need and take steps to correct it.  For example, people who are placed on a calorie-restricted diet become hungry and are motivated to make up for the calorie shortfall (2, 3).  People who are placed on a low-protein diet crave protein and eat more of it after the restriction is lifted (4).  Humans and many other animals also crave and seek salt, which supplies the essential minerals sodium and chlorine, although today most of us eat much more of it than we need to.  At certain times, we may crave something sweet or acidic, and pregnant women are well known to have specific food cravings and aversions, although explanations for this remain speculative.  Research suggests that certain animals have the ability to correct mineral deficiencies by selecting foods rich in the missing mineral (5).

These observations have led to a long-standing idea that the human body is able to detect vitamin and mineral (micronutrient) status and take steps to correct a deficit.  This has led to the secondary idea that nutrient-poor food leads to overeating, as the body attempts to make up for low nutrient density by eating more food.  In other words, we overeat because our food doesn't supply the micronutrients our bodies need, and eating a micronutrient-rich diet corrects this and allows us to eat less and lose body fat.  These ideas are very intuitive, but intuition doesn't always get you very far in biology.  Let's see how they hold up to scrutiny.

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Food Reward Friday

This week's lucky "winner"... peanut M + M's!!!

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Early Warning Signs of Cancer: Are You at Risk?

Many of us don’t know the warning signs of the most common—and deadly—forms of cancer. An alarming new survey reports that 26 percent of Americans can’t name even one symptom of lung cancer, the leading cancer killer of both men and women.

Overall, fewer than half of those polled identified shortness of breath as a warning sign of lung cancer, and only 39 percent a cough. Some respondents correctly identified more specific symptoms of concern, such as cough that gets worse or coughing up blood. The survey was conducted in 21 countries by Ipsos MORI on behalf of the Global Lung Cancer Coalition (GLCC).

The findings are frightening, given that the disease kills nearly 160,000 Americans a year. “Patients are often diagnosed at a very late stage when treatment is no longer an option,” says Matthew Peters, MD,  chair of GLCC, in the press release. “If we can get patients diagnosed earlier, we can treat them and save lives. That is why being aware of the symptoms is so important.”

Warning Signs: When to See a Doctor

It’s tragically common for patients to ignore warnings of other types of cancer, adds Dale Shepard, MD, PhD, a cancer specialist in the department of solid tumor oncology at the Cleveland Clinic. “Cancer can almost always be cured if it’s caught early, but all too often, people wait so long to see a doctor that the disease has spread to the point that it’s no longer curable.”

If you notice any of the following unexplained warning signs, don’t delay—make the time to consult a doctor promptly.

• Unexplained weight loss. While most people would be happy to drop pounds without dieting, unexplained weight loss (of 10 or more pounds) or sudden loss of appetite are among the most common warning signs of cancer, says Dr. Shepard. This symptom is most likely to occur with cancers of the pancreas, stomach, esophagus or lung, reports the American Cancer Society (ACS). It may turn out not to be cancer—there are a number of other serious health conditions that may cause this symptom, including an overactive thyroid, diabetes, liver disease, and depression.

• Persistent low-grade fever. This can be the first symptom of certain cancers, particularly leukemia, Hodgkin’s disease or non-Hodgkin’s lymphoma. Low-grade fever—meaning a temperature between 99.8 and 100.8—can also be caused by a wide range of infections. 

• Worsening fatigue. “If you suddenly can’t get through the day without taking a 3-or 4-four nap, when you never need one before, that can be suggestive of cancer,” says Dr. Shepard. According to the ACS report, this symptom is particularly likely to occur with leukemia, as well as cancers that cause blood loss, such as colon cancer or stomach cancer. Other medical conditions that cause profound exhaustion include anemia, sleep disorders, heart problems, diabetes, fibromyalgia, and arthritis.

• A sore that doesn’t heal or skin changes. You probably know that moles that are asymmetrical (one half doesn’t match the other), have irregular borders, contain a variety of colors, or are larger than a pencil eraser can bewarning signs of melanoma, the deadliest form of skin cancer. What’s not well known, however, is that skin sores or changes (including a persistent rash) can also herald other forms of cancer. Dr. Shepard had a patient whose first symptom of colon cancer was a sore on his scalp that didn’t heal. He has also had patients with lung cancer and lymphoma whose symptoms included persistent rashes.

• Trouble swallowing or chronic hoarseness. These symptoms, along with lip sores that don’t heal, unusual bleeding, pain or numbness in the mouth, and chronic sore throat, can herald oral cancer. Other reasons for chronic hoarseness can include gastroesophageal reflux disease (GERD), allergies, cancer of the throat or laryngx, smoking, and underactive thyroid, reports the National Institute of Health. A wide range of esophageal disorders can impair swallowing.

• White patches in your mouth. Also known as leukoplakia, these thickened whitish or gray patches on the gums, inside of the cheeks, or the tongue are often mistaken for thrush (an infection that causes white patches). Unlike thrush, which can be scraped away, leukoplakia cannot be removed in this manner. While the condition isn’t always harmful, oral cancer often occurs near leukoplakia patches, the Mayo Clinic reports, and the patches themselves can develop cancerous changes.

• Blood in the toilet. This symptom is frequently dismissed by patients, says Dr. Shepard. “People are quick to think that the problem is a urinary tract infection even if they’ve never had one before. However, blood in the urine can also be a sign of bladder cancer and needs to be investigated by a urologist. Oftentimes, bladder cancer isn’t diagnosed until it reaches an incurable stage because people wait so long to see a doctor.” Similarly, it can be a dangerous mistake to dismiss blood in the stool as being triggered by a hemorrhoid, since it could also be a warning sign of colon cancer, as is any change in your normal bowel habits.

• Unexplained pain. This can be an early symptom of testicular or bone cancer. A headache that doesn’t get better with treatment, such as taking an over-the-counter pain reliever, may signal a brain tumor, while back pain can mark colon or ovarian cancer, the ACS reports. “Unexplained pain is one of the more common symptoms of cancer and always warrants a consultation with your doctor,” says Dr. Shepard.

• A lump or thickening. Several types of cancer, including those of the breast, testicles, and lymph nodes can be felt through the skin. A lump or thickening can either be an early or late sign of cancer, ACS reports. Also be aware that in some cases, breast cancer can cause red or thickened skin, rather than the expected lump, so any change in how your breast looks or feels needs to be checked out. 

• Any persistent, unexplained or troubling symptom. “If something doesn’t seem right, don’t assume it’s nothing,” says Dr. Shepard. ”Listening to your body and getting this symptom checked out sooner rather than later could save your life if the problem turns out to be cancer.”

Does "Metabolically Healthy Obesity" Exist?

Obesity is strongly associated with metabolic alterations and negative health outcomes including diabetes, cardiovascular disease, and some types of cancer (1, 2, 3, 4).  Excess body fat is one of the primary causes of preventable health problems and mortality in the United States and many other affluent nations, ranking in importance with cigarette smoking and physical inactivity.  Obesity is thought to contribute to disease via the metabolic disturbances it causes, including excess glucose and lipids in the circulation, dysregulated hormone activity including insulin and leptin, and inflammatory effects.  This immediately raises two questions:

1. Does metabolically healthy obesity exist?
2. If so, are metabolically healthy obese people at an elevated risk of disease and death?

Does metabolically healthy obesity exist?

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The 8 Worst Snacks for an Afternoon Slump

It's 3 p.m. You're hungry again and feeling sleepy. You might be tempted to reach for one of these common -- and deceptively healthy -- treats to perk yourself up, but don't. Our nutrition experts offer smarter picks to avoid an afternoon crash and stay full until dinner.

1. SKIP: Pretzels
 You may feel virtuous reaching for a bag of fat-free pretzels instead of fried potato chips. But don't do it. "It's not a snack that will energize you or keep your blood sugar level steady to get through the rest of your afternoon alert and focused," says registered dietitian Elisa Zied, author of Younger Next Week. "It provides calories, refined carbohydrates, too much sodium, and not much else to keep you nourished and satisfied long term."

Try instead: A whole-grain, high-fiber cereal mixed with two tablespoons of nuts, such as almonds, cashews, pistachios, hazelnuts, walnuts, or pecans, says Zied.

2. SKIP: Baked potato chips
 It's true that baked chips aren't bad as the regular variety, but they're still mainly fast-acting carbs (hello, blood sugar spike) with very small amounts of protein, fiber, and fat. Even so, "There are so many better, more filling foods that provide these nutrients that won't lead to the blood sugar crash that saps your energy," says Samantha B. Cassetty, M.S., R.D., nutrition director of the Good Housekeeping Research Institute. 

Try instead: A different kind of crunch: dry roasted edamame. "A 1/4 cup serving has a whopping 14 grams of protein and 8 grams of fiber with less salt than traditional chips," says Cassetty. "They're even a good source of iron -- a nutrient that many women fall short on."

3. SKIP: Sports and energy drinks
 Don't let healthy-sounding names deceive you. Like soda, energy drinks are pretty much straight sugar, which can cause -- you guessed it -- a sugar-fueled roller coaster ride. "Because there's no fiber and these drinks are often consumed on an empty stomach, the sugar will be absorbed rapidly," says registered dietitian Joan Salge Blake, a clinical associate professor at Boston University and a spokesman for the Academy of Nutrition and Dietetics. 

Try instead: Sipping on zero-calorie water or fun, flavored seltzers (also calorie-free). People often mistake thirst for hunger.

4. SKIP: An apple
Don't gasp. Yes, fruit is packed with vitamins, minerals, and fiber, but eating it alone won't keep you going. "Adding a little protein to the mix will help make it even more filling," says Cassetty.

Try instead: Pairing your fresh fruit with a few nuts, a dip made from nonfat Greek yogurt, a small schmear of nut butter, or a slice of protein- and calcium-rich cheese (think mini Babybel). 

5. SKIP: Frozen yogurt
The word "yogurt" makes it sound like a smart pick, right? Alas, frozen yogurt is full of sugar and calories (about 120 calories in a half cup). And it doesn't have as many probiotics or as much calcium as regular yogurt. Plus, it's very tempting to add some candy-based toppings.

Try instead: If you can't resist, indulge in moderation. "Get the smallest you can," says Blake. "And instead of adding candy on top, try fresh fruit." Better still: Grab a Greek yogurt topped with berries.

6. SKIP: Pita Chips
 "They have this huge health halo," says registered dietitian Karen Ansel, a spokesman for the Academy of Nutrition and Dietetics. "But they're really just straight carbs." And straight carbs will just cause your energy levels to crash. 

Try instead: Munch on the whole grain version of these chips -- or better yet, fresh veggies -- with a small amount of hummus.

7. SKIP: Smoothie
"If it's a smoothie just made with fruit and juice (all sugar), then you know you're going to crash," says registered dietitian Keri Gans, author of The Small Change Diet. Fruit is primarily carbs, which digest quickly in your body and that can lead to a slump. "And juices tend to be made with lots of fruit -- and therefore have lots of sugar," adds Cassetty. "Juicing also eliminates the fiber -- the filling part of fruit that also helps modify its impact on blood sugar." 

Try instead: Green tea is an energy-boosting options, say Ansel, because it contains an amino acid that aids alertness and concentration. Or, if you can't pass up the smoothie, go for a small size made with unsweetened yogurt.

8. SKIP: Candy bar
Tempting as it is, candy is obviously a no-no. "A little chocolate with its hint of caffeine can definitely perk you up," says Zied. "But your blood sugar will rise and fall flat soon after because candy's loaded with sugar and very low fiber."

Try instead: If it's a sweet treat you're after, get a nutty-chocolate fix from a protein-rich, low-sugar granola bar, like KIND or Kashi Dark Chocolate Coconut Layered Granola Bars.

12 Ways to Slim Down Your Diet

Maybe it was a Top Chef marathon or the realization that you could probably buy a new wardrobe with the money you were shelling out on kung pao chicken. Whatever the reason, you traded your takeout menus for cookbooks. But even though you're spending more time in the kitchen (whipping up healthy meals, no less), your pants aren't getting any looser. What gives? Chances are, you're making a few all-too-common mistakes. Before you throw in the dish towel, read on for the super simple fixes that can help you look Padma-esque in time for summer.

Fat trap 1: Overcooking pasta  Take that pot off the stove a little early and your bucatini will have a satisfying bite and keep you full for hours. "Hot water breaks down the bonds between starch molecules," says Johanna Burani, RD, the author of Good Carbs, Bad Carbs. The longer you boil your pasta, the quicker your body converts those carbs into fuel. This sets off a rapid rise in blood sugar that is followed by a hunger-inducing plunge. Al dente noodles take longer to digest, delivering a steady stream of energy.

The fix: Go with the shortest time in the recommended range on the back of the box, then bite into a slightly cooled strand. "There should be a tiny white circle of raw pasta in the center," Burani says. The residual heat will continue to cook the noodles, so they'll be perfectly al dente by the time you serve them.

Fat trap 2: Picking poultry instead of beef  Although turkey breast is about as lean as it gets, ground turkey often contains dark meat and skin, which edge up the calorie count. A four-ounce serving of ground turkey packs 204 calories and 14grams of fat, while the same amount of lean ground beef contains just 155 calories and six grams of fat.

The fix: Whether you're buying beef or turkey, "look for labels that say the meat is at least 90 percent lean," suggests Diane Henderiks, RD, the founder of Dishwithdiane.com. Or ask the butcher to grind up turkey breast or sirloin steak. Saute either in heart-healthy olive or canola oil (about 1 tablespoon per pound) to keep the meat moist for fewer than 30 extra calories a serving.

Fat trap 3: Adding hot sauce to everything Sure, it gives your eggs, tacos, and pizza a no-cal kick. But just a teaspoon of certain brands uses up nearly 10 percent of your daily sodium allotment, and too much of the mineral can take a toll on your waistline. According to a study from the University of California, San Francisco, people who ate a high-sodium diet gained more weight -- about one extra pound over a five-day period -- than those who consumed low-sodium versions of the same high-calorie meals. The researchers believe excess sodium increases your body's production of insulin, a hormone that turns sugar into fat.

The fix: "Fresh peppers, red pepper flakes, and cayenne pepper add heat without any sodium," Henderiks says. Miss the sauce? Try Tabasco, which contains a mere 35 milligrams of sodium per teaspoon, just 2 percent of the 2,300 milligrams most of us shouldn't exceed in a day.

Fat trap 4: Baking with gluten-free flour Whether it's because you have celiac disease, are gluten intolerant, or just want to experiment with nonwheat options, you've decided to pick up one of the new wheat-free flours or baking mixes. Unfortunately, just because they're gluten-free doesn't mean they're good for you. "Many of these flours and blends are made from white rice or potatoes, so they may contain a minimal amount of filling fiber," Burani says, but just as many calories and carbs as the regular stuff.

The fix: At the supermarket, scout out options made from brown rice, teff, or quinoa, such as those by Bob's Red Mill and Arrowhead Mills, and make sure a serving provides at least two grams of fiber.

Fat trap 5: Removing the chicken skin  Each piece of skin contains 69 calories and six grams of fat, so it makes sense to separate it from the breast before popping it in the oven, right? Not really. The skin locks in moisture, so you get tender, more flavorful chicken for not a lot of extra calories, explains Amy Myrdal Miller, RD, the director of culinary nutrition at the Culinary Institute of America at Greystone in St. Helena, California.

The fix: Don't remove the skin until right before serving, and the chicken won't need as much calorie-rich sauce, salad dressing, or mayo. The exception: If you're making soup or a casserole, the fat from the skin will drain into the dish, Myrdal Miller warns, so peel it off it beforehand.

Fat trap 6: Coating the pan with nonstick spray This healthy staple may not be as low in calories as you think. "Many people spray it on for about six seconds," says Bonnie Liebman, the director of nutrition for the Center for Science in the Public Interest. That's 36 calories and four grams of fat. While that doesn't sound like much, it adds up: If you coat your pan before saut?ing spinach, for example, and then again before folding in the eggs, you tack 70-plus calories onto that scramble.

The fix: To cut down on the amount of spray you need, use nonstick pans for cooking and a silicone mat or parchment paper for baking whenever possible. Or forgo the stuff altogether: "You can substitute chicken broth when sauteing vegetables," says Christine Gerbstadt, MD, RD, a spokeswoman for the Academy of Nutrition and Dietetics. Just heat a few tablespoons in a pan and stir in the veggies, adding more liquid as needed until they're cooked through. 

Fat trap 7: Skipping a step when you make meat sauce  Ground beef is one of the easiest ways to add protein to your pasta dinner: All you have to do is saute, season, and serve. But if you're not blotting the meat after it's cooked, you're missing out on a quick way to slash four grams of fat per three-ounce serving, according to scientists from Iowa State University. "This removes excess fat without altering the flavor," says Julie Garden-Robinson, PhD, RD, a food and nutrition specialist at the North Dakota State University Extension Service.

The fix: Drain cooked crumbles on a paper towel-lined plate for one minute, then pat the top with more paper towels. Or go a step further and rinse the beef. Doing so will remove more than half the fat, according to a study in the Journal of the American Dietetic Association. Just put the cooked meat in a strainer over a large bowl and pour hot water -- about four cups per pound -- over the top before mixing the beef into your marinara.

Fat trap 8: Dicing vegetables into tiny pieces You've been making oven-baked shoestrings instead of the fried kind -- hooray! But according to a Dutch review of research, switching to steak "fries" could help you cut even more calories. "The more pieces you cut something into, the more surface area there is for the oil to cling to, which equals extra calories and fat," Myrdal Miller says.

The fix: To ease up on the grease, chop potatoes and veggies at least a half inch thick, then pat them dry. Research suggests this helps create a crust that blocks oil from being absorbed by food. Cut calories even further when roasting or baking by using an oil mister to lightly coat the pieces instead of drizzling them with EVOO from the bottle.

Fat trap 9: Giving produce a quick rinse Fresh fruits and vegetables are a dieter's dream, but the pesticide residue on them can keep your calorie-burning machine from performing at its peak. In an International Journal of Obesity study, dieters with the highest levels of pollutants in their bodies had markers of slower metabolism than those with the lowest levels. "Pesticides may affect your thyroid's ability to function," explains lead author Angelo Tremblay, PhD, a professor of kinesiology at Laval University in Canada. And there's evidence that they also harm the functioning of mitochondria, the parts of a cell that convert fuel into energy.

The fix: Government researchers say you need to scrub fresh produce for at least 30 seconds to remove the residue. You can also minimize your exposure by purchasing organic produce, especially the kind with an edible peel, as well as organic beef and dairy products, because regular cattle feed can contain high concentrations of pesticides.

Fat trap 10: Sipping Pinot as you prep When you're adding wine to your risotto, it's tempting to pour yourself a glass. But that aperitif can pack on the pounds in more ways than one. According to a study in theAmerican Journal of Clinical Nutrition, sipping the equivalent of two drinks on an empty stomach slows your flab-burning capacity by as much as 73 percent for up to six hours. "Instead of converting fat into fuel, your body uses alcohol for energy," explains study author Marc Hellerstein, MD, PhD, a professor of endocrinology, metabolism, and nutrition at the University of California, San Francisco. And alcohol not only messes with your metabolism, but it also loosens your inhibitions and can encourage you to eat more.

The fix: Wait until you're seated with your meal before you start imbibing. Food slows the absorption of alcohol, which can offset its diet-damaging effects.

Fat trap 11: Serving veggies on the side There's nothing wrong with setting out a dish of steamed broccoli or roasted asparagus, but sneaking them into your main course can boost their benefits. Researchers from Penn State found that people who ate meals that incorporated vegetables -- think chicken casserole with squash and carrots -- consumed 350 fewer calories a day than those who had veggies only as a side dish. The likely explanation: Produce bulks up main dishes and adds filling fiber, so you feel satisfied and take in fewer calories.

The fix: "Experiment with mild-tasting vegetables that aren't overpowering," advises Jessica Shapiro, RD, a dietitian at the Montefiore Medical Center in New York City. She suggests adding cauliflower puree to macaroni and cheese, diced zucchini to lasagna, and shredded carrots tochicken salad.

Fat trap 12: Holding all the fat Banishing high-cal ingredients, such as cheese and nuts, seems smart. "But fat takes longer to digest than protein and carbs, so it keeps you full longer," Dr. Gerbstadt says. "It also adds flavor, which ups satisfaction." And the benefits extend even further: A study in the journal Health Psychology showed that people produced less of the appetite-stimulating hormone ghrelin after drinking a shake that was labeled "indulgent" rather than an identical one described as "sensible."

The fix: Sprinkle nuts or seeds over your salad or spread pesto on your sandwich. Besides whittling your waistline, you'll also increase your nutrient intake: Purdue University scientists found that just three grams of monounsaturated fat -- the amount in less than a teaspoon of olive oil -- helped the body absorb more cancer-fighting lycopene, lutein, and beta-carotene.

The 15 Jobs That Are Most Damaging to Your Health

In order to analyze jobs by their impact on workers' health, we took O*NET measures of six health risks in each of the 974 occupations in the database: exposure to contaminants; exposure to disease and infection; exposure to hazardous conditions; exposure to radiation; risk of minor burns, cuts, bites, and stings; and time spent sitting, since studies show that frequent inactivity shortens your lifespan. O*NET scores these factors on a scale from 0 to 100, with a higher score indicating an increased health risk. 


15. Refuse and Recyclable Material Collectors

Overall unhealthiness score: 55.0

What they do: Collect and dump refuse and recyclable materials into trucks.

Top three health risks:
Exposure to contaminants: 97
Time spent sitting: 69
Exposure to disease and infections: 63

14. Nuclear Equipment Operation Technicians

Overall unhealthiness score: 55.2

What they do: Operate equipment used for the release, control, or utilization of nuclear energy to assist scientists in laboratory or production activities.

Top three health risks:
Exposure to radiation: 89
Exposure to hazardous conditions: 77
Exposure to contaminants: 65

13. Medical, Clinical, and Cardiovascular Technologists and Technicians

Overall unhealthiness score: 55.3

What they do: Perform complex medical laboratory tests for diagnosis, treatment, and prevention of disease.

Top three health risks:
Exposure to disease and infections: 96
Exposure to hazardous conditions: 69
Exposure to contaminants: 68

12. Airline Pilots, Copilots, and Flight Engineers

Overall unhealthiness score: 55.7

What they do: Pilot and navigate the flight of fixed-wing, multi-engine aircraft, usually on scheduled air carrier routes, for the transport of passengers and cargo.

Top three health risks:
Time spent sitting: 93
Exposure to radiation: 73
Exposure to contaminants: 68

11. Derrick Operators, Oil and Gas

Overall unhealthiness score: 56.0

What they do: Rig derrick equipment and operate pumps to circulate mud through a drill hole.

Top three health risks:
Exposure to contaminants: 100
Exposure to minor burns, cuts, bites, or stings: 93
Exposure to hazardous conditions: 91

10. Surgical Technologists

Overall unhealthiness score: 57.3

What they do: Assist in operations, under the supervision of surgeons, registered nurses, or other surgical personnel. 

Top three health risks:
Exposure to disease and infections: 82
Exposure to contaminants: 81
Exposure to hazardous conditions: 59

9. Stationary Engineers and Boiler Operators

Overall unhealthiness score: 57.7

What they do: Operate or maintain stationary engines, boilers, or other mechanical equipment to provide utilities for buildings or industrial processes.

Top three health risks:
Exposure to contaminants: 99
Exposure to hazardous conditions: 89
Exposure to minor burns, cuts, bites, or stings: 84

8. Water and Wastewater Treatment Plant and System Operators

Overall unhealthiness score: 58.2

What they do: Operate or control an entire process or system of machines, often through the use of control boards, to transfer or treat water or wastewater.

Top three health risks:
Exposure to contaminants: 97
Exposure to hazardous conditions: 80
Exposure to minor burns, cuts, bites, or stings: 74

7. Immigration and Customs Inspectors

Overall unhealthiness score: 59.3

What they do: Investigate and inspect people, common carriers, goods, and merchandise, arriving in or departing from the U.S. or between states to detect violations of immigration and customs laws and regulations.

Top three health risks:
Exposure to contaminants: 78
Exposure to disease and infections: 63
Exposure to radiation: 62

6. Podiatrists

Overall unhealthiness score: 60.2

What they do: Diagnose and treat diseases and deformities of the human foot.

Top three health risks:
Exposure to disease and infections: 87
Exposure to radiation: 69
Time spent sitting: 61

5. Veterinarians and Veterinary Assistants/Technologists

Overall unhealthiness score: 60.3

What they do: Diagnose, treat, or research diseases and injuries of animals and perform medical tests in a laboratory environment for use in the treatment and diagnosis of diseases in animals.

Top three health risks:
Exposure to disease and infections: 81
Exposure to minor burns, cuts, bites, or stings: 75
Exposure to contaminants: 74

4. Anesthesiologists, Nurse Anesthetists, and Anesthesiologist Assistants

Overall unhealthiness score: 61.8

What they do: Administer anesthetic or sedation during medical procedures, using local, intravenous, spinal, or caudal methods or administer anesthetic, adjuvant, or accessory drugs under the direction of an anesthesiologist.

Top three health risks:
Exposure to disease and infections: 94
Exposure to contaminants: 79
Exposure to radiation: 71.8

3. Flight Attendants

Overall unhealthiness score: 62.3

What they do: Provide personal services to ensure the safety, security, and comfort of airline passengers during flight. Greet passengers, verify tickets, explain use of safety equipment, and serve food or beverages.

Top three health risks:
Exposure to contaminants: 88
Exposure to disease and infections: 77
Exposure to minor burns, cuts, bites, or stings: 69

2. Dentists and Dental Hygienists/Assistants and Dental Lab Technicians

Overall unhealthiness score: 62.9

What they do: Examine, diagnose, and treat diseases, injuries, and malformations of teeth and gums. May treat diseases of nerve, pulp, and other dental tissues affecting oral hygiene and retention of teeth. May fit dental appliances or provide preventive care.

Top three health risks:
Exposure to disease and infections: 87.8
Exposure to contaminants: 76.2
Time spent sitting: 73.6

1. Histotechnologists and Histologic Technicians

Overall unhealthiness score: 63.8

What they do: Prepare histologic slides from tissue sections for microscopic examination and diagnosis by pathologists.

Top three health risks:
Exposure to hazardous conditions: 94
Exposure to contaminants: 91
Exposure to disease and infections: 75

Best and Worst Health Trends of 2013

Each year comes with its own unique brand of health trends. Some wind up being passing fad diets, while others prove surprisingly on point. The key to healthy living is knowing which trends are worth your time. To that end, here are the year's shape-up and slim-down trends we'd like to forget—and the ones we hope will stick around into 2014.

Best: Water workouts

Whatever your favorite workout—be it Zumba, spinning, yoga, or jogging—you can now probably do it in a pool near you. And it's not just for show. By getting your sweat on in the water, you eliminate the joint-jolting and tiring impact of many exercises while adding all-over resistance for greater strength and weight-loss gains, according to the Stockholm University College of Physical Education and Sports. Bonus: People who do pool exercises enjoy their workouts more than those who stick to dry land, per research from Baylor University Medical Center.

Best: Fun runs

Whether it involves running through foam-covered obstacles or getting splattered with colored powder, fun runs have it right: Fun is the ultimate motivator, according to Edward L. Deci, PhD, a motivational researcher and professor of psychology at the University of Rochester. People who work out for the pure joy of working out rather than for a result (think: lose those last five pounds) actually stick with workouts longer and reap better results, he says. So grab your girlfriends and sign up!

Best: Going vegan

Somewhere between PETA's annual list of the sexiest vegan celebs and renowned food writer Mark Bittman's VB6: Eat Vegan Before 6:00 to Lose Weight and Restore Your Health…for Good, 2013 became the year of the vegan. Vegans tend to be thinner and have lower cholesterol and blood pressure than omnivores and vegetarians alike, according to a 2009 review in the American Journal of Clinical Nutrition. If you want to try an animal-product-free lifestyle—even just part time— make sure you get enough protein daily, advises Martica Heaner PhD, a nutritionist and exercise physiologist based in New York City. 

Best: Hybrid yoga

Ropes, hula-hoops, kickboxing moves, and even trampolines made their way into the yoga studio this year—and the combination caters to more than your attention span, says Melissa diLeonardo, an American Council on Exercise-certified personal trainer and a Life Fitness Master Trainer. By integrating non-yoga moves into your routine, you can train a wider variety of muscles for better total-body sculpting.

Best: Bike-sharing programs

Now, in dozens of cities across the United States, exercise can actually save you time. So bypass traffic and get a bike pass: One four-year study of 822 adults found that bike commuters gain less weight over the years than car commuters. Besides toning your legs, increasing your heart rate, and strengthening your core, biking can seriously boost your energy. One study in Psychotherapy and Psychosomaticsfound that biking decreases fatigue by 65%.

Best: Playground workouts

Girls (even grown ones) just want to have fun! And playground workouts—fromadult playground fitness parks across California to the jungle gym-inspiredSynrgy360 stations in gyms—are designed to help them have just that. "As adults, we just don't play enough. Play is good for your body and mind. These workouts give us an opportunity to let loose and explore new ways of burning calories while having fun," diLeonardo says. Plus, with bars for climbing, ropes for pulling, and platforms for jumping, playground workouts strengthen your entire body through natural, multi-joint exercises to improve your fitness both in and out of the gym.

Best: Exercise-specific footwear

Shoe fanatics, rejoice! Now stores stock Zumba, indoor cycling, and even CrossFit shoes—and they do more than make you look like a pro. "Footwear designed for specific activities can help improve performance and provide additional support when executing certain movement patterns," diLeonardo says. For example, shoes designed for dance-inspired classes generally have more lateral support and less tread so you don't twist your knee mid-spin. If you are starting a new class, talk to your instructor about the right footwear for the exercises involved.

Best: Intermittent fasting

The Fast Diet, The IF Diet, and The 5:2 Diet might sound like gimmicks, and they are definitely unintuitive, but a 2013 review in the British Journal of Diabetes and Vascular Disease suggests that fasting diets not only aid in weight loss but actually may help people with cardiovascular disease by decreasing inflammation, reducing blood pressure, and improving blood sugar and triglyceride levels. The key is following a healthy protocol, as some can lead to a binge-purge mentality, says dietician Alexandra Caspero, RD, owner of weight-management and sports-nutrition service delicious-knowledge. She advises talking to a nutritionist or healthcare provider to find the one that's right for you.

Worst: Open-bar gyms

Increasingly more gyms are serving their cool-down with a side of spirits: Finish a class and you get an all-you-can-drink pass. "Alcohol during or following an exercise class is a definite no in my book," says diLeonardo, who emphasizes the need to drink water, not alcohol. Why? According to one study in the Journal of Applied Physiology, alcohol drains your muscles' levels of glycogen, their primary source of fuel. The effect: Your muscles don't have the energy they need to repair, grow stronger, and increase your metabolism. Basically, post-exercise sips negate your workout.

Worst: The Whole30 Diet

As if the Paleo Diet wasn't strict or unsustainable enough, this year people turned to the Whole30 Diet, which is basically an extremist "caveman" plan. The month-long program prohibits the consumption of fiber-filled legumes and whole grains, calcium- and vitamin D-rich dairy, and even some Paleo-approved foods like coffee, alcohol, and honey, all of which have been linked to improved health and longevity, Caspero says. While the strict plants-and-meat diet will surely spur weight loss by eliminating unhealthy refined sugars, the diet is far from sustainable—and isn't designed to be that way. So what happens after the month ends? You yo-yo. And while weight lost from extremely restricted diets is typically from a combination of fat and lean tissues, weight regained is typically 100% fat, she says.

Worst: Hot classes

This year, hot Pilates, hot barre, and even hot weightlifting classes have joined Bikram yoga in cranking up the heat. But for what? "You don't need the heat to get a good workout," says diLeonardo. One 2013 American Council on Exercise studyfound that increasing the temperature does not make you work any harder or burn any more calories. All of the sweat just makes you think you do, all while putting you at risk of dehydration, she says. Also, while the ACE study found that temperatures of up to 95 degrees are safe for a person with zero health issues, researchers warn that many classes turn up the temps as high as 115 degrees.

Worst: Going gluten-free for no reason

About one in three Americans are cutting down on or completely eliminating gluten, per a 2013 survey from The NPD Group. If you're one of them, read your nutrition labels. "Gluten-free foods aren't automatically better for you, and plenty of them can make you gain pounds," says Seattle-based certified nutritionist Deborah Enos. "Gluten helps to hold food together. When food manufacturers remove gluten, they add in fat and sugar to help the food maintain its shape." Plus, a 2012 review in theJournal of the Academy of Nutrition and Dietetics shows that a gluten-free diet has no benefit—and can even harm gut health—in people without celiac disease or a gluten intolerance.

Worst: Vibration machines

Remember watching your mom jiggle her fat away with vibrating belts? Well, the vibration fad is back, but this time you stand on a pulsating platform to tone muscles, boost your metabolism, and reduce cellulite…or not. In one InternationalJournal of Sports Medicine study, women who completed 24 weeks of whole-body vibration training did not lose fat.

Worst: Too-intense workouts

Pushing yourself is great. But pushing yourself beyond your ability is counterproductive and dangerous. Unfortunately a slew of workout classes and DVDs tout exhaustion as the ultimate goal, sacrificing form for intensity and increasing your risk of injury, says performance enhancement specialist Martin Rooney. What's more, when working out at home to DVDs, it's challenging to know if you are keeping form even before fatigue sets in. Before signing up for any high-intensity interval classes (which we love!) or popping in a DVD, develop proper form with a personal or small-group trainer.

Worst: The Bulletproof Diet

An example of why you should read into who's behind your eating plan, The Bulletproof Diet wasn't drafted by an MD or nutritionist. It was designed by a Silicon Valley investor and computer security professional who lost more than 100 pounds, according to the diet's website. While his personal weight-loss is certainly inspiring, it doesn't provide rock-solid scientific evidence to support recommendations to eat 4,000-plus calories a day, not exercise, and scoop butter into their morning coffee. If it sounds too good to be true, it probably is.