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CRAIG MELVIN (09:21:40): Man, it`s hard to believe it`s been twenty years since The Sopranos premiered. Last night, our guy, Harry Smith, got to hang out not with just a few cast members, the cast.

HARRY SMITH (09:21:50): Thirteen of them all together. I caught up with everybody, just about everybody in the cast at The Sopranos Film Festival last night. Thirteen cast members from Edie Falco to Lorraine Bracco to Michael Imperioli. It was like a family reunion, but one person`s presence was definitely missed.

(Begin VT)

TONY SIRICO (09:22:15): You people don`t have any idea how great it was to work with James Gandolfini. He was the best.

HARRY SMITH (09:22:19): Steven, I have a sense you want to talk about Mister Gandolfini.

STEVEN VAN ZANDT (09:22:25): As I`ve said a thousand times, you know, you do a scene with Jimmy Gandolfini, you walk away a better actor. This was the greatest acting school one could imagine.

EDIE FALCO (09:22:34): It`s very unusual that he`s not here. And I don`t often feel his absence the way I do right now.

HARRY SMITH (09:22:41): Michael, talk to me about scenes you did with James Gandolfini. Do you have a favorite moment on screen with him?

MICHAEL IMPERIOLI (09:22:49): Um, yeah, I do.

HARRY SMITH (09:22:51): You can say it.

MICHAEL IMPERIOLI (09:22:52): So we had to throw Joey`s-- Joe Pan`s body off the cliff and then they were going to light the whole park. It took hours. So we were in the trailer and had a drink, which was a full bottle of wild turkey. By the time, I was ready to shoot, the bottle was empty. So they had to chain me and Jim`s ankles to trees because they were afraid we were going to fall off the cliff. Him and I walked to the edge and throw the thing off the cliff, and nobody fell.

HARRY SMITH (09:23:27): Do you have a favorite that you did with Jim?

JAMIE-LYNN SIGLER (09:23:29): I think when we did the college episode.

(09:23:31): (Excerpt from The Sopranos)

JAMIE-LYNN SIGLER (09:23:36): And I remember him saying to me just-- he could tell I was nervous. And he said just look in my eyes and trust me. And it was everything. And I`ve taken that with me just in my life.

DOMINIC CHIANESE (09:23:47): I remember when he-- on the golf course, when he insulted me, everybody cracked up except me, my character. He was great. And then he made me cry when he said-- I can`t even say it. He said don`t you love me?

(09:24:07): (Excerpt from The Sopranos)

DOMINIC CHIANESE (09:24:10): It`s more sweet than bitter.

ROBERT ILER (09:24:14): Sopranos might be the only relationship in my whole life where I look back and I can`t find a bad memory. We were talking the other day about when we used to go to the Emmys and this, like I don`t know how many awards we won. I don`t even remember which times we won, we lost. I just knew, like, oh, we were all going.

JAMIE-LYNN SIGLER (09:24:31): We showed up at the-- our first Emmys in a bus. We took a tour bus, all of us together.

ROBERT ILER (09:24:36): Yeah.

JAMIE-LYNN SIGLER (09:24:36): That`s amazing.

MICHAEL IMPERIOLI (09:24:37): And we lost best show and we all walked out.

STEVEN VAN ZANDT (09:24:43): We were pissed off.

KATHRINE NARDUCCI (09:24:44): That`s when I realized how big the show was. And when we got to the award show, I`ll never forget, when we got out of the car, I remember seeing Brad Pitt, all these big people, and they wanted to meet us. And I went, holy, this show is big. Wow.

HARRY SMITH (09:25:04): What people seem to be obsessed with is the last episode.

JAMIE-LYNN SIGLER (09:25:09): By the way, it`s very hard to park badly. I will say that.

HARRY SMITH (09:25:14): So you`re a good parallel parker?

JAMIE-LYNN SIGLER (09:25:16): I am a very good parallel parker.

HARRY SMITH (09:25:18): The music is playing, Don`t Stop Believing, in the background. Did you know he was going to cut it where he cut it?

EDIE FALCO (09:25:25): I never knew what was going on. That`s the truth. I really-- I didn`t. And I didn`t know what it meant, if it meant anything.

JOHN VENTIMIGLIA (09:25:36): People thought their cat pulled the plug out of the wall.

EDIE FALCO (09:25:39): That`s right.

JOHN VENTIMIGLIA (09:25:39): I mean, that`s where it went.

KATHRINE NARDUCCI (09:25:40): No, they thought the cable went down.

EDIE FALCO (09:25:42): That`s right.

HARRY SMITH (09:25:42): Was being on the show a blessing or a curse?

LORRAINE BRACCO (09:25:47): A blessing.

TONY SIRICO (09:25:48): Blessing.

EDIE FALCO (09:25:48): There`s no way it couldn`t be a blessing.

LORRAINE BRACCO (09:25:49): Blessing. EDIE FALCO (09:25:50): I mean, how could one look at this as anything but a blessing? We`re part of a cultural moment. Whether or not we knew it at the time, I certainly didn`t. But in retrospect, I mean, you can die and say you were a part of this show that people talked about for a long time.

(End VT)

CRAIG MELVIN (09:26:11): Wow.

HARRY SMITH (09:26:11): You know, they talk about losing that first year, but the show went on to win twenty-one Emmys, five Golden Globes. One of the other good stories is they were at the Emmys one year and the best actor goes to James. And they were all getting ready to stand up to applaud for James Gandolfini. James Spader.

DYLAN DREYER (09:26:29): Oh.

HARRY SMITH (09:26:29): They were like, what, what?

AL ROKER (09:26:31): Oh, man. But what`s so amazing is that even after all this time, in his loss, how much his presence was part of that day.

HARRY SMITH (09:26:39): David Chase, at one point, said if there is no James Gandolfini, how do I have a Tony Soprano?

CRAIG MELVIN (09:26:44): Yeah.

HARRY SMITH (09:26:45): If I don`t have Tony Soprano, how does the show exist? He was the magnet that pulled all those crazy parts together because Chase was also a guy who worked his whole life in TV, hated TV.

CRAIG MELVIN (09:26:56): Huh. HARRY SMITH (09:26:56): This was an anti-television television show, which made it so good.

CRAIG MELVIN (09:27:00): Soprano`s charact-- Tony Soprano`s character was, I would argue, one of the first in that genre where you had a guy who was despicable on so many levels.

AL ROKER (09:27:09): Yeah.

CRAIG MELVIN (09:27:09): He was a-- he was a mob thug, he was a killer, but he was complicated. He was depressed. He was anxious. It was just-- and so from week to week, you`re like, God, I really-- I hate Tony Soprano. The next week, you`re like, I love Tony Soprano.

DYLAN DREYER (09:27:21): Yeah.

HARRY SMITH (09:27:22): Unbelievably profane show.

CRAIG MELVIN (09:27:24): Yes.

HARRY SMITH (09:27:24): Unbelievably violent show. It was all this ambiguity, right?

CRAIG MELVIN (09:27:29): Yeah.

HARRY SMITH (09:27:29): And television isn`t supposed to be that traditionally. Until now, we`ve got it all over the place. I was there-- what`s the show with the meth guy in New Mexico?

AL ROKER (09:27:39): Oh, Breaking Bad.

CRAIG MELVIN (09:27:40): Breaking Bad.

HARRY SMITH (09:27:40): How does Breaking Bad exist without Tony Soprano?

CRAIG MELVIN (09:27:42): Without Tony Soprano.

AL ROKER (09:27:43): Absolutely.

CRAIG MELVIN (09:27:43): Yeah.

DYLAN DREYER (09:27:43): Because he can take it that far. What is your favorite scene?

HARRY SMITH (09:27:47): There is-- you know what? I loved all the little tiny stuff that was in the last episode, for instance, where there`s this big secret meeting and they go into the giant warehouse.

CRAIG MELVIN (09:27:55): Yes.

HARRY SMITH (09:27:56): And they`re sitting down. It`s freezing cold. And somebody says, anybody want water?

CRAIG MELVIN (09:28:00): That`s right.

HARRY SMITH (09:28:01): Like, how does that make any sense in such a non- sequitur?

AL ROKER (09:28:04): Yeah. For me, it was that weird scene where Tony has an upset stomach. He`s hallucinating. And Vincent Pastore`s character is talking to him as a fish.

HARRY SMITH (09:28:14): In a fish, exactly. There was a-- there was a note in one of the pieces I read that one of the HBO executives sort of questioned something that Chase was doing at some point. And it was just all the more reason to double down, right?

DYLAN DREYER (09:28:26): Yeah.

HARRY SMITH (09:28:27): The suits don`t get to touch this show.

CRAIG MELVIN (09:28:29): Harry Smith, that was-- that was fantastic.

HARRY SMITH (09:28:31): Very fabulous people.

CRAIG MELVIN (09:28:31): Of all of our cast reunions, that may very well be my favorite. Thank you. By the way, you can see Harry`s full interview with the cast on our website, today.com. We`ll be right back.

DYLAN DREYER (09:28:43): Still to come, for years, she hid a medical mystery.

KARISSA PUKAS (09:28:47): I was continuously getting chronically more and more sick.

DYLAN DREYER (09:28:51): How this YouTube star says her followers helped figure out the cause.

(09:28:55): Plus--

NATALIE ASATRYAN (09:28:56): And inhale up to cobra.

DYLAN DREYER (09:28:57): --find your inner Zen with the help of an amazing kid who`s making yoga history.

(ANNOUNCEMENTS)

AL ROKER (09:33:11): And welcome back. Karissa Pukas is a YouTube star with more than seven hundred thousand followers.

DYLAN DREYER (09:33:17): And when she came down with a mystery illness, she says some of the loyal fans helped figure out the cause.

(Begin VT)

KARISSA PUKAS (09:33:25): What is good, my YouTube friends?

DYLAN DREYER (09:33:26): This is twenty-seven-year-old Karissa Pukas, who posts her take on everything from fashion to fitness to food on her own YouTube channel. Last year, Karissa opened up to her fans about some personal health challenges she was having.

KARISSA PUKAS (09:33:40): I was continuously getting chronically more and more sick regardless of how healthy I was living. It made absolutely no sense.

(09:33:47): So the consultation went awesome.

DYLAN DREYER (09:33:51): When Karissa was twenty-two years old, she had breast implant surgery.

KARISSA PUKAS (09:33:55): Incision would be underneath the fold in my boob, and that`s pretty common, especially for the type of implant that I wanted as well as the look that I wanted.

DYLAN DREYER (09:34:03): What she wanted was to transform her B-cup to a DD using implants. The procedure was done by a surgeon in Australia where she lived at the time.

KARISSA PUKAS (09:34:13): I`m ready for surgery. So I will see you guys on the other side.

(09:34:16): Hi, everybody. I am out of surgery.

DYLAN DREYER (09:34:19): Karissa continued to document her recovery. And about a month after surgery, she returned to her regular activities. But six months later, she said she began to experience symptoms such as anxiety, fatigue, body odor and food intolerances. Visits to local health clinics seemed to offer no definitive answers to her medical mystery though one doctor diagnosed her with situational depression, something Karissa says she had never experienced before.

KARISSA PUKAS (09:34:47): In April, I believe, of 2017, I did a gut health video, letting you guys in at a really vulnerable moment in my life. I had a few comments saying, have you ever considered breast implant illness? And I looked into it. And what I found absolutely changed my life.

(End VT)

DYLAN DREYER (09:35:06): And Karissa joins us now. It`s nice seeing you here healthy and happy. This is the ultimate story of being your own advocate. You knew something was wrong and nobody was diagnosing it correctly. What all were your symptoms?

KARISSA PUKAS (Says Breast Implants Made Her Sick) (09:35:19): I was having a wild range of symptoms. First, started off with a lot of fatigue and a lot of anxiety that I never previously had and it was very overwhelming, especially living overseas, away from my family. I didn`t really have the support. Started into having really bad food intolerances. I was having bowl movements eight to ten times a day.

DYLAN DREYER (09:35:38): Wow.

KARISSA PUKAS (09:35:38): My joint pain was so uncontrollable it would wake me up in the middle of the night. I had awful smelling sweat, even after showering. It was just wrong. Something was wrong, but no one was listening.

AL ROKER (09:35:49): And so when did it start to dawn on you that it could be your implants?

KARISSA PUKAS (09:35:54): It was because of the video that I put out. And I received comments from different followers saying, have you ever considered it could potentially be breast implant illness? I`d never heard of it. And I almost had an ego response as my first response because you`re just like, go away, like it`s not my boobs. Like, it`s fine. It`s never been that. And the more I started reading into it and the more women`s stories that I uncovered, it was the same symptoms. It could not be any more the exact same thing that I was going through so.

DYLAN DREYER (09:36:22): Did you-- did you find a doctor who said, yes, this is definitely what`s causing it, and here`s why? Or did you say, let`s get these out of me, I want to start fresh?

KARISSA PUKAS (09:36:29): There is no doctor that will definitively say that breast implant illness is a medically recognized problem, which is unbelievable to me, with the amount of women that have struggled with the exact same problem.

AL ROKER (09:36:39): So once you realized this, how quickly did you move to get your implants removed?

KARISSA PUKAS (09:36:45): I realized in about-- I put the video out in probably April 2017 and then I truly believed it was that in about July 2017. And then I wasn`t able to book in and get my surgery until the following April, so this past April which was hard because you have that anxiety the whole time thinking about, like, I know these objects inside of me are making me sick. I swear it has to be this. There`s nothing else that makes sense.

DYLAN DREYER (09:37:09): And how quickly after they were removed did you start feeling like yourself again?

KARISSA PUKAS (09:37:13): It was almost immediate.

DYLAN DREYER (09:37:14): Really?

KARISSA PUKAS (09:37:14): It was so shocking. I had my family there. And when I was wheeled out of surgery, I had more color in my face than when I- - it`s unbelievable.

AL ROKER (09:37:20): You had pictures of that before you went in and then after. And it really is remarkable. Hold on. I think we`re going to get that right now.

KARISSA PUKAS (09:37:28): It was a night and day difference. I couldn`t believe it.

DYLAN DREYER (09:37:31): Wow. KARISSA PUKAS (09:37:32): But I started feeling better right away. I still had slight persistent gut troubles, as gut things do take a while to balance out. But nine months out, I am a hundred percent symptom free. And I`m so, so grateful. It`s given me my life back.

DYLAN DREYER (09:37:44): And no signs of depression or any none of that?

KARISSA PUKAS (09:37:46): No.

DYLAN DREYER (09:37:47): All of that is just--

KARISSA PUKAS (09:37:48): Completely gone.

DYLAN DREYER (09:37:48): Wow.

AL ROKER (09:37:49): What`s your message to other young women who are thinking about doing this, doing implants, or other body-altering surgeries? What`s your message to them?

KARISSA PUKAS (09:37:58): You know, I`m not anti-plastic surgery, but I am absolutely pro-information. And I feel that women are getting the short end of the stick. It`s not fair for the manufacturers to be doing these studies rather than a third party. It`s like asking the tobacco industry to self- regulate. How would that be safe for anyone? It`s not.

DYLAN DREYER (09:38:17): Right.

KARISSA PUKAS (09:38:17): And that`s the current situation that we`re in. And I don`t think that that is serving anyone at this point.

DYLAN DREYER (09:38:23): Well, the American Society of Plastic Surgeons estimates that more than three hundred thousand women underwent breast augmentation last year. And now, the FDA is creating a new registry to try and better understand the long-term impact. I mean, that could take a very long time.

KARISSA PUKAS (09:38:38): That`s the problem. And I think up until this point, too, it`s all been, you have to tell your doctor. And that`s the only way that they would know. But the doctors don`t have to then pass it on to any third party.

AL ROKER (09:38:49): Yeah.

KARISSA PUKAS (09:38:50): So they can just internalize it, never say a thing, and the patient goes home, wondering why they`re still sick. They never get answers.

DYLAN DREYER (09:38:54): Wow.

KARISSA PUKAS (09:38:54): I would have never found out this is what it was if it wasn`t for other women in the community sharing their stories. I`m so, so grateful.

DYLAN DREYER (09:39:01): Wow. You look amazing. I`m so glad your health is back.

KARISSA PUKAS (09:39:04): Thank you.

DYLAN DREYER (09:39:04): We did reach out to the American Society of Plastic Surgeons for reaction to Karissa`s story.

AL ROKER (09:39:09): And we`ve received a statement that reads, in part, ".decades of research show no causal relationship between breast implants and autoimmune diseases. No medical device is without risks, and all patients should consult their plastic surgeon if they experience a change in health."

DYLAN DREYER (09:39:28): But thank you very much for--

KARISSA PUKAS (09:39:29): Thank you.

AL ROKER (09:39:29): You want to say one thing?

DYLAN DREYER (09:39:30): Yeah.

KARISSA PUKAS (09:39:30): I was just going to say, would you rather trust women that have been through it or somebody that`s selling you a product?

DYLAN DREYER (09:39:37): It`s a good question. Karissa, thank you so much for sharing your story.

KARISSA PUKAS (09:39:40): Thank you for having me. I really appreciate this platform. And so many women do, too. If women are looking for more information on this, please check out the Facebook support groups. There are breast implant illness support groups with a ton of information in the files section. It is of the utmost importance that we share this because other women will know and find their way.

AL ROKER (09:39:57): Great information.

DYLAN DREYER (09:39:57): Absolutely. So important. Thanks so much. We`ll be right back.

(09:40:03): Tomorrow, Spike Lee is here to talk about BlacKkKlansman, his hit movie that`s getting awards show buzz.

(09:40:09): But first, Patrick Warburton on the mind-bending final season of his show, A Series of Unfortunate Events.

(ANNOUNCEMENTS)

CRAIG MELVIN (09:44:20): Patrick Warburton is a talented and very funny actor. He`s made us laugh with roles like that iconic Puddy on Seinfeld where he played Elaine`s not so smart boyfriend.

DYLAN DREYER (09:44:28): And these days, you can catch him on the third and final season of the Netflix show, A Series of Unfortunate Events.

AL ROKER (09:44:33): He plays the role of Lemony Snicket, the narrator who becomes part of the story. Patrick, good to see you.

PATRICK WARBURTON (09:44:39): Good to see you.

AL ROKER (09:44:40): And finally, the third season, you get to be in the-- we actually get to see you and you interact with the other characters.

PATRICK WARBURTON (09:44:47): Yes. It goes back in time, and they put wigs on me and all kinds of things, yeah. It was great. It was a wonderful experience.

CRAIG MELVIN (09:44:57): How is this role different from some of your others?

PATRICK WARBURTON (09:44:59): Well, Puddy wasn`t the sharpest tool in the shed. You know what I`m saying? You know, there have been a lot of, like, big and fun characters, like The Tick, or I`ve done some things that are a little bit more cerebral. But, you know, Lemony is very thoughtful and well-spoken and very articulate. He`s sort of like an ineffectual guardian angel. He`s always there but he doesn`t really get anything done.

DYLAN DREYER (09:45:25): So people who aren`t that familiar with the series, kind of take us back to how it all began. It`s all based on a book.

PATRICK WARBURTON (09:45:32): It`s based on a series of books, thirteen books by Daniel Handler. And the books were very well-read worldwide, some are between seventy and hundred million of this book series were sold. They made a movie years ago.

AL ROKER (09:45:47): Right, Jim Carrey.

PATRICK WARBURTON (09:45:49): Yeah.

DYLAN DREYER (09:45:49): Oh, yeah.

PATRICK WARBURTON (09:45:50): And one of the issues with that was that they tried to sandwich three books into one movie, and it wasn`t cohesive. And the great thing about the series that we take each book, turn it into two episodes that are both short-- about an hour. So it`s like a movie per book. And it seems to-- that format seems to work well. Bill Welch did all of our sets, who does all Tim Burton`s sets, and Barry works with them ever year.

CRAIG MELVIN (09:46:13): Beautiful sets.

PATRICK WARBURTON (09:46:14): Yeah.

AL ROKER (09:46:15): Did your kids read these books?

PATRICK WARBURTON (09:46:16): They didn`t. My eldest son, he-- he`s sort of-- you know, he would regulate everything, you know. So if he didn`t read it, the other kids didn`t. But it`s like, what`s the premise? Oh, the parents die in a fire. That sounds really sad. No.

AL ROKER (09:46:30): No.

PATRICK WARBURTON (09:46:31): I`m not going to read this.

DYLAN DREYER (09:46:32): Not happening.

PATRICK WARBURTON (09:46:33): He was out.

CRAIG MELVIN (09:46:33): Your most famous role is probably still Puddy. And I think a lot of folks don`t realize you were only in nine episodes. Like it`s not like you were--

DYLAN DREYER (09:46:41): That always blows my mind.

CRAIG MELVIN (09:46:43): Because the show is on day and night, it seems like you were--

PATRICK WARBURTON (09:46:47): Yeah. No, it was great-- it was great to do nine episodes of a sitcom and get paid scale and be in trouble of being typecast rest of your life.

CRAIG MELVIN (09:46:58): It was a blessing and a curse?

PATRICK WARBURTON (09:46:59): It was a blessing and a curse. But it was much more of a blessing. It`s been so much fun. And, you know, you just have to go out and reinvent after. But it was really odd because I was barely there ever.

AL ROKER (09:47:11): Yeah.

PATRICK WARBURTON (09:47:12): And I would avoid Jerry.

CRAIG MELVIN (09:47:13): Why?

DYLAN DREYER (09:47:14): Why?

PATRICK WARBURTON (09:47:15): Well, he`s a very sweet and generous man, but I knew that I could do nothing but just-- I would do nothing but stick my foot in my mouth. So all you want to do, because you knew how special it was to be there, stage nine, CBS, Bradford, you wanted to get invited back.

AL ROKER (09:47:28): Yeah.

PATRICK WARBURTON (09:47:29): So, okay, well, if I bump into Jerry, I`ll say something stupid like, wow, I bet you, you never would have expected this, huh? Wow. Show is doing great. I wanted to hit my marks, get a laugh, get out and then have him go, hmm, I like that character. We`ll bring him back.

DYLAN DREYER (09:47:43): Yeah.

AL ROKER (09:47:44): Bring him back.

PATRICK WARBURTON (09:47:44): So, yeah.

AL ROKER (09:47:45): And you got a garage band now.

PATRICK WARBURTON (09:47:46): I have a garage band now, yeah.

DYLAN DREYER (09:47:48): What`s the name of your band?

PATRICK WARBURTON (09:47:50): Well, we`re Pearl Jam cover band. So The Bearded Pearl Clams. That`s the name of the band.

AL ROKER (09:47:56): Wow.

PATRICK WARBURTON (09:47:57): But I`m doing ridiculous things. I have turned into a kid. I`m reliving-- I`m mid-life crisis time. We just play-- I actually just-- I have a friend who is the lead singer of the band, Burn the Ballroom. His name is Adriel. And he goes, I wrote a song for you. I go, cool. So he came and we recorded it. And we actually-- it`s on-- I guess he just put it on a few days on Spotify.

AL ROKER (09:48:21): All right.

PATRICK WARBURTON (09:48:22): It`s on YouTube.

CRAIG MELVIN (09:48:23): All right.

DYLAN DREYER (09:48:23): That`s awesome.

AL ROKER (09:48:23): Patrick Warburton, thank you. Always great to see you.

PATRICK WARBURTON (09:48:26): Pleasure, yes.

AL ROKER (09:48:26): Season three of A Series of Unfortunate Events streaming now on Netflix. We`ll be right back.

DYLAN DREYER (09:48:34): Tomorrow, eat your way to a healthy gut. Joy Bauer with the superfoods to add to your diet starting today.

(09:48:40): But first, she`s not just teaching yoga.

NATALIE ASATRYAN (09:48:44): I always say that there`s no age limit for changing the world.

DYLAN DREYER (09:48:46): How this amazing kid is using her passion to do a lot of good.

(ANNOUNCEMENTS)

DYLAN DREYER (09:52:53): We are back now with an amazing kid who is one of the country`s youngest yogis.

CRAIG MELVIN (09:52:58): Savannah Sellers, host of NBC`s Snapchat show Stay Tuned, got a private lesson. It`s pretty cool.

SAVANNAH SELLERS (09:53:03): It is pretty cool. She`s just thirteen, but her mantra is, age is just a number.

(Begin VT)

SAVANNAH SELLERS (09:53:10): When most people take a yoga class, they don`t expect the instructor to look like this.

NATALIE ASATRYAN (09:53:15): I`m Natalie. I`m thirteen, and I`m a yoga teacher. Has anyone here done yoga before?

SAVANNAH SELLERS (09:53:20): I certainly didn`t when I hit the mats with her for a private lesson.

NATALIE ASATRYAN (09:53:23): And inhale up to cobra, keeping your elbows bent.

SAVANNAH SELLERS (09:53:26): Meet Natalie Asatryan, America`s youngest female certified yoga teacher.

NATALIE ASATRYAN (09:53:31): I feel like a lot of people come to the class to see if I even can do it. Let`s go see if this girl actually, like, knows what she`s doing.

SAVANNAH SELLERS (09:53:37): Natalie fell head over heels for yoga when she was just five years old. By age nine, Natalie decided she couldn`t wait to be a yoga teacher. But making it official at that age was no simple task.

NATALIE ASATRYAN (09:53:48): We were calling studio after studio. We would, like, find people online that might be able to do it. Everyone said no because they said I was too young.

SAVANNAH SELLERS (09:53:56): After three years of searching, Natalie finally found a studio willing to teach her.

NATALIE ASATRYAN (09:54:00): Yeah, it was a hard process. It`s like the two hundredth-hour class and it was like twelve-hour days for fourteen days straight. And then it was a whole bunch of, like, philosophy stuff thrown at you. And you had to learn about like chakras and yamas and niyamas and like pranayama and all that stuff.

SAVANNAH SELLERS (09:54:17): And you`re doing this with a bunch of adults.

NATALIE ASATRYAN (09:54:18): Yes, a whole bunch of adults. The youngest person there was like in her twenties, besides me.

SAVANNAH SELLERS (09:54:23): And you were twelve?

NATALIE ASATRYAN (09:54:24): Yes.

SAVANNAH SELLERS (09:54:26): Now, an official instructor, Natalie`s gained followers of all ages.

NATALIE ASATRYAN (09:54:30): Bring your arms to a cactus and go forward.

(09:54:32): One time when I was teaching in the senior center, this woman came up to me and she said that no other yoga class that she`d never been able to do the poses. And she came to me and said that this is the first day of yoga class she`s actually been able to, like, follow and really do. And she, like, thanked me for making it so accessible to her.

SAVANNAH SELLERS (09:54:48): Another one of Natalie`s senior fans just happens to be the world`s oldest yoga teacher, one hundred-year-old Tao Porchon-Lynch. The two first met on Lynch`s ninety-ninth birthday.

(09:54:59): So the youngest and the oldest yoga teachers together.

NATALIE ASATRYAN (09:55:01): Yeah.

SAVANNAH SELLERS (09:55:02): How cool was that?

NATALIE ASATRYAN (09:55:03): It was a really fun experience. She gave me a whole bunch of, like, inspirational quotes and a whole bunch of wisdom that can really help me.

SAVANNAH SELLERS (09:55:10): In turn, Natalie is using her gift to help others. All the proceeds from Natalie`s yoga classes go to help the Red Cross, victims of Hurricane Harvey, local firefighters, and even building a school in Kenya.

NATALIE ASATRYAN (09:55:23): I really want to give those kids the opportunity to go to school, too, because education is the great equalizer. Once everyone is informed and has an education, they can go off and do whatever they want.

SAVANNAH SELLERS (09:55:33): With wisdom beyond her thirteen years, Natalie has this message for other kids.

NATALIE ASATRYAN (09:55:37): I always say that there`s no age limit for changing the world. It doesn`t, like, have to be yoga. It doesn`t have to be donating to a school. They can, like, help out with the ocean. They can do whatever they love and help some place in the world with what they`re doing.

(End VT)

SAVANNAH SELLERS (09:55:49): Natalie tells me she still gets nervous before each class, but when she`s teaching, that all goes away.

CRAIG MELVIN (09:55:54): Great story.

DYLAN DREYER (09:55:54): I bet it does.

CRAIG MELVIN (09:55:55): Great story, Savannah.

SAVANNAH SELLERS (09:55:55): Thanks, guys.

CRAIG MELVIN (09:55:56): Thank you. By the way, you can catch Savannah on Stay Tuned every day on Snapchat and Instagram. We`ll be right back.

(ANNOUNCEMENTS)

AL ROKER (09:58:21): Hey, guys. Before we hand this over to you, tomorrow, we`ve got Spike Lee--

JENNA BUSH HAGER (09:58:24): Oh, awesome.

HODA KOTB (09:58:24): What?

AL ROKER (09:58:24): --to talk about BlacKkKlansman.

CRAIG MELVIN (09:58:25): It`s going to be cool.

DYLAN DREYER (09:58:25): And what do you guys have coming up?

HODA KOTB (09:58:27): Oh, we have Neil Patrick Harris.

JENNA BUSH HAGER (09:58:27): Neil Patrick Harris.

HODA KOTB (09:58:29): And?

JENNA BUSH HAGER (09:58:29): It`s Thursday, Ambush Makeovers.

DYLAN DREYER (09:58:32): Oh, I love those.

JENNA BUSH HAGER (09:58:32): Have you ever heard of it?

DYLAN DREYER (09:58:32): A few times.

HODA KOTB (09:58:33): It`s our favorite franchise.

CRAIG MELVIN (09:58:35): We`ll see you tomorrow. Have a great day. Have a great show.

JENNA BUSH HAGER (09:58:37): Oh, thank you.

HODA KOTB (09:58:37): Thank you. We will.

(ANNOUNCEMENTS)

HODA KOTB (10:00:01): Today on Thirst-Day Thursday, Emmy and Tony winner Neil Patrick Harris reveals why he`s having so much fun being bad.

(10:00:07): Then, two sisters make their Big Apple dreams come true with hot Ambush Makeovers.

(10:00:12): And a little Throwback Thursday pop culture fun when we have a ball with the Harlem Globetrotters.

KELLY CLARKSON (10:00:19): I mean literally, I get puppies and wine with y`all. I love y`all.

ANNOUNCER (10:00:22): From NBC News--

KATHIE LEE GIFFORD (10:00:24): What?

HODA KOTB (10:00:24): What?

ANNOUNCER (10:00:25): --this is TODAY--

CHRISSY TEIGEN (10:00:27): I love you, guys.

ANNOUNCER (10:00:28): --with Kathie Lee Gifford--

KATHIE LEE GIFFORD (10:00:29): Hello, everybody.

HODA KOTB (10:00:30): Smile.

ANNOUNCER (10:00:30): --and Hoda Kotb--

HODA KOTB (10:00:32): This is crazy.

ANNOUNCER (10:00:33): --live from Studio 1A in Rockefeller Plaza.

KATHIE LEE GIFFORD (10:00:36): How do we do it day after day?

HODA KOTB (10:00:36): How do we do it day after day?

(10:00:41): Yes, it has arrived. Thirst-Day Thursday is here. Friday is knocking on the door. January 10th. Jenna Bush Hager in for KLG, a little JBH love.

JENNA BUSH HAGER (10:00:51): I like this. Electric Avenue from--

HODA KOTB (10:00:53): I know.

JENNA BUSH HAGER (10:00:54): Three people clapped, thank you.

HODA KOTB (10:00:55): That`s right. We do-- see, you have a posse.

JENNA BUSH HAGER (10:00:59): Three people I really like--

HODA KOTB (10:01:00): That`s all that matters.

JENNA BUSH HAGER (10:01:01): --you know, and they seem to like me.

HODA KOTB (10:01:04): We-- no. Like is an understatement. There`s a lot of love here. That`s Electric Avenue by Eddy Grant, an old throwback because it is Throwback Thursday.

JENNA BUSH HAGER (10:01:11): Oh, yeah.

HODA KOTB (10:01:11): It is.

JENNA BUSH HAGER (10:01:12): Do you do anything to celebrate Throwback Thursday?

HODA KOTB (10:01:13): No, I don`t. I did-- I did, by the way, yesterday look back at Haley`s old pictures just for fun. I was just looking back. And you cannot believe when you think about how a child, like, grows over a couple years, you just freak out. Like I just-- I was-- I don`t remember the baby stage. Like, I don`t remember. It`s bizarre.

JENNA BUSH HAGER (10:01:33): You know, Mila showed me a picture this morning.

HODA KOTB (10:01:35): Yeah.

JENNA BUSH HAGER (10:01:36): It`s like her hair is long.

HODA KOTB (10:01:37): What happened?

JENNA BUSH HAGER (10:01:37): Her hair is long.

HODA KOTB (10:01:39): What is happening?

JENNA BUSH HAGER (10:01:39): Wait, what else? You posted a video.

HODA KOTB (10:01:41): What, what?

JENNA BUSH HAGER (10:01:42): And I was looking at Instagram of a song that she was dancing to.

HODA KOTB (10:01:45): Oh, yeah, yeah, yeah, yeah, yeah. She sang to--

JENNA BUSH HAGER (10:01:48): The boxes?

HODA KOTB (10:01:48): --Chinese Boxes.

JENNA BUSH HAGER (10:01:49): Yes.

HODA KOTB (10:01:49): Chinese Boxes by Kim Richey.

JENNA BUSH HAGER (10:01:49): So she posted this and I was-- I was looking at it and Mila and Poppy heard the baby. And they said, oh, I want to see and it`s like Haley. And Poppy goes, Poppy`s dress.

HODA KOTB (10:02:00): Oh, she was wearing Poppy`s--

JENNA BUSH HAGER (10:02:02): One of the hand-me-downs. I love a hand-me- down.

HODA KOTB (10:02:06): By the way--

JENNA BUSH HAGER (10:02:07): But isn`t it weird that Poppy recognized it?

HODA KOTB (10:02:10): How did she remember?

JENNA BUSH HAGER (10:02:11): I don`t know.

HODA KOTB (10:02:11): By the way, here`s what I love about Jenna. She shows up with a grocery bag paper, pull off like-- they`re like one shoe in there, some clothes. And by the way--

JENNA BUSH HAGER (10:02:19): Some of it`s good.

HODA KOTB (10:02:20): --Haley was styling.

JENNA BUSH HAGER (10:02:21): I tried to go through it to make sure--

HODA KOTB (10:02:22): I can`t believe that was your-- that was her dress.

JENNA BUSH HAGER (10:02:23): --that it`s not like--

HODA KOTB (10:02:24): How are those kiddos, by the way?

JENNA BUSH HAGER (10:02:25): --you know, soiled.

HODA KOTB (10:02:26): Your kids.

JENNA BUSH HAGER (10:02:27): My kids are-- my kids got in trouble for the first time, like, together. And I`m used to-- listen, I have a twin sister.

HODA KOTB (10:02:35): Yeah.

JENNA BUSH HAGER (10:02:35): That`s like as mischievous as it can get--

HODA KOTB (10:02:37): Yes, yes.

JENNA BUSH HAGER (10:02:37): --because you`re the same age. But Poppy and Mila, we had a darling babysitter who actually works here at NBC.

HODA KOTB (10:02:43): Okay.

JENNA BUSH HAGER (10:02:43): She`s from Texas. She`s very kind.

HODA KOTB (10:02:46): Yes.

JENNA BUSH HAGER (10:02:46): And I feel like they witnessed that kindness--

HODA KOTB (10:02:48): Yeah, yeah.

JENNA BUSH HAGER (10:02:49): --and they took advantage. So I was at a Teach for Uganda event my sister put on. And I was looking at my phone on the way out the door. And she said I`m so sorry. They have locked me out. They locked your door of your room. They`re in your room and they have locked me on the other side for forty-five minutes.

HODA KOTB (10:03:05): Oh. JENNA BUSH HAGER (10:03:05): Bad behavior. Forty-five minutes.

HODA KOTB (10:03:09): Your first reaction was what?

JENNA BUSH HAGER (10:03:10): Furious.

HODA KOTB (10:03:11): Okay, okay.

JENNA BUSH HAGER (10:03:12): Because I don`t want them to be disrespectful to a babysitter.

HODA KOTB (10:03:15): Right. So what did-- what--

JENNA BUSH HAGER (10:03:16): So I called Henry and I`m like, how do we discipline?

HODA KOTB (10:03:19): Yes. What do we do? So how did you--

JENNA BUSH HAGER (10:03:20): And Henry was like just don`t, you know, overreact. Take some deep breaths. So I got home, they were naked. They had makeup.

HODA KOTB (10:03:29): Naked in your room.

JENNA BUSH HAGER (10:03:30): They were naked running around the house. She finally got them out of the room because I put on speakerphone and I told them I was calling the police.

HODA KOTB (10:03:38): Wait. She held the speakerphone up to the door?

JENNA BUSH HAGER (10:03:39): That is not overreacting?

HODA KOTB (10:03:40): You-- what did you say?

JENNA BUSH HAGER (10:03:41): Because they locked the door. I said I`m going to call the police. Is that overreacting?

HODA KOTB (10:03:47): So then they unlocked it?

JENNA BUSH HAGER (10:03:48): So they unlocked, they came out. They were running around the house naked.

HODA KOTB (10:03:52): With makeup on.

JENNA BUSH HAGER (10:03:52): They had my sound machine on in the room with like a song on it. They had put makeup all--

HODA KOTB (10:03:58): Oh.

JENNA BUSH HAGER (10:03:58): My makeup drawer-- I have to lock it, I don`t know how.

HODA KOTB (10:04:01): So wait, you walked in, you were livid?

JENNA BUSH HAGER (10:04:03): Well, I took deep breaths.

HODA KOTB (10:04:03): What were you? You did?

JENNA BUSH HAGER (10:04:04): I took deep breaths.

HODA KOTB (10:04:05): Yeah. What did you do?

JENNA BUSH HAGER (10:04:05): I wasn`t livid, I was disappointed.

HODA KOTB (10:04:08): Oh, God.

JENNA BUSH HAGER (10:04:08): In fact, actually later in the night when we watched the President`s address with the democratic response--

HODA KOTB (10:04:14): Yeah.

JENNA BUSH HAGER (10:04:14): --Henry goes, with the democratic response, that was you, wasn`t it? Like disappointed parents.

HODA KOTB (10:04:20): Wagging your finger.

JENNA BUSH HAGER (10:04:22): I was a disappointed parent just like--

HODA KOTB (10:04:24): So what do you do? Okay. So how do you-- because I`m getting into the discipline thing. I don`t know what to do.

JENNA BUSH HAGER (10:04:29): Me neither.

HODA KOTB (10:04:30): So what did you do?

JENNA BUSH HAGER (10:04:30): So I said your toys are going to be taken out of your room. And they were like, no, mama, no.

HODA KOTB (10:04:36): Did they say sorry?

JENNA BUSH HAGER (10:04:37): They cried. Poppy said sorry. Mila, I think it`s the age.

HODA KOTB (10:04:41): Yeah. What did she say?

JENNA BUSH HAGER (10:04:41): Five-year-olds have a harder time, I don`t know, I`m acting like I`m an expert, saying they`re sorry. So she acted like her eye hurt and was crying, crying, crying. I was like, Mila, it`s fine. We`ll talk about it tomorrow. I left the room. She called me back and she said I just feel so bad. I know. And then I`m like you can have your toys.

HODA KOTB (10:04:58): Right.

JENNA BUSH HAGER (10:04:59): And more toys.

HODA KOTB (10:05:00): Eat ice cream, do whatever you want.

JENNA BUSH HAGER (10:05:01): But we took their toys out of their room.

HODA KOTB (10:05:03): You did? You really did it.

JENNA BUSH HAGER (10:05:04): I know.

HODA KOTB (10:05:04): I guess they say when you say something, you have to follow through because if you kind of do it then they know it`s a game.

JENNA BUSH HAGER (10:05:09): If it had just been them playing when I was home, and they hadn`t locked the door--

HODA KOTB (10:05:13): Yes, one thing.

JENNA BUSH HAGER (10:05:14): --it was the locking the babysitter out.

HODA KOTB (10:05:15): Out. You had to lay down the law.

JENNA BUSH HAGER (10:05:17): So I laid it down.

HODA KOTB (10:05:18): Okay. So Haley will throw her fork, her food, her bottle. And then I`ll pick it up and I`m going to go here`s your fork. Come on, let`s not throw it anymore.

JENNA BUSH HAGER (10:05:27): Yeah.

HODA KOTB (10:05:28): Now, what do you do right then, right then?

JENNA BUSH HAGER (10:05:30): Evidently--

HODA KOTB (10:05:31): Yeah.

JENNA BUSH HAGER (10:05:32): --because Poppy went through this phase.

HODA KOTB (10:05:32): Yeah. What--

JENNA BUSH HAGER (10:05:33): What you do is you take them out of their high chair--

HODA KOTB (10:05:37): Oh.

JENNA BUSH HAGER (10:05:37): --where they were and they pick it up. You`re going to throw it, you`re going to pick it up.

HODA KOTB (10:05:40): You`re going to pick it up. Okay. So you don`t take it away and say, okay, no fork for you?

JENNA BUSH HAGER (10:05:45): Well, you could do that, too, probably.

HODA KOTB (10:05:46): Then they eat with-- yeah.

JENNA BUSH HAGER (10:05:46): But you have to eat.

HODA KOTB (10:05:48): Yeah, right, exactly.

JENNA BUSH HAGER (10:05:48): I think you say, okay, if you`re going to throw it, hold on, get out, you`ll go pick it up.

HODA KOTB (10:05:52): Okay. That`s good.

JENNA BUSH HAGER (10:05:53): And it may seem game-like at first but then they realize there`s like-- they don`t want to get out of their high chair every time to pick it up.

HODA KOTB (10:05:58): Right, right, right, right. So they stop throwing it.

JENNA BUSH HAGER (10:06:00): I don`t know. Does anybody know?

HODA KOTB (10:06:01): Okay. Go to Twitter.

JENNA BUSH HAGER (10:06:02): Do y`all know?

HODA KOTB (10:06:03): Because that`s where-- that`s where we find out all of our news. We`ll go to Twitter and tell us how you discipline two, three and four-year-olds in a way that they--

JENNA BUSH HAGER (10:06:11): And five.

HODA KOTB (10:06:11): And five. Because you know what, all I kept thinking was I just want Haley to be, like, a good, like generous person.

JENNA BUSH HAGER (10:06:15): I know.

HODA KOTB (10:06:16): I don`t want her to think that everything is always about her.

JENNA BUSH HAGER (10:06:19): But you know what, I`ll say I was really disappointed, I felt sad.

HODA KOTB (10:06:23): Oh, you`re sad.

JENNA BUSH HAGER (10:06:24): And I got in and I said it to-- well, I mean, I said to them I felt sad.

HODA KOTB (10:06:27): Yeah.

JENNA BUSH HAGER (10:06:27): But I did. I felt like, am I parenting gone awry? Like are they mean girls to do this to a babysitter?

HODA KOTB (10:06:32): Yeah.

JENNA BUSH HAGER (10:06:32): And I got-- and Maria yesterday goes, dude, that`s awesome. What do you mean? She goes, I think-- well, she didn`t say dude. She was like--

HODA KOTB (10:06:40): Maria Shriver doesn`t say dude very often.

JENNA BUSH HAGER (10:06:42): Yeah.

HODA KOTB (10:06:43): What`d she say?

JENNA BUSH HAGER (10:06:43): She said I love that.

HODA KOTB (10:06:44): Why?

JENNA BUSH HAGER (10:06:45): I go why. That they`re doing that together. How awesome is it that they have, like, a little partner in crime. And I was like, oh, Maria.

HODA KOTB (10:06:52): Maria has way--

JENNA BUSH HAGER (10:06:53): You`re right with everything.

HODA KOTB (10:06:53): --honestly of making everything seem less stressful.

JENNA BUSH HAGER (10:06:56): She`s right.

HODA KOTB (10:06:57): She`s right--

JENNA BUSH HAGER (10:06:58): Like it was cool--

HODA KOTB (10:06:58): --about everything.

JENNA BUSH HAGER (10:07:00): --but not cool. All right.

HODA KOTB (10:07:00): All right. So the word is out. We now know the story about the Oscars. For the last several week, are you kind of over the Oscars story?

JENNA BUSH HAGER (10:07:07): I have fatigue.

HODA KOTB (10:07:08): I do, too. So we`re trying to figure out who`s going to host? Is it Kevin Hart? He said he`s sorry. He said he`s sorry. He said he`s sorry like fifteen times. Ellen was backing him. All the stuff happened. He finally came out and basically put a pin in it and saying he wasn`t going to, right?

JENNA BUSH HAGER (10:07:19): He said no. He`s not hosting. So this is for the first time in thirty years they will have no host. The Oscars will have no host.

HODA KOTB (10:07:25): Okay.

JENNA BUSH HAGER (10:07:25): But they say that celebrities will take turns emceeing introducing musical acts and other things like that.

HODA KOTB (10:07:31): Yeah. I think it-- I think people might like that. I think if it had a big, like, song and dance number at the top--

JENNA BUSH HAGER (10:07:37): Yeah.

HODA KOTB (10:07:37): --it usually has everyone leaning in because everybody always says after the Oscars, I love that beginning music thing. And then afterwards, it got too long. So--

JENNA BUSH HAGER (10:07:44): So they can get all the celebrities--

HODA KOTB (10:07:45): Yeah.

JENNA BUSH HAGER (10:07:45): --to do a little something.

HODA KOTB (10:07:46): Do something fun like just have some cool sketch, musical sketch and then dispense with it and then start giving the awards. And the funny-- the presenters are funny.

JENNA BUSH HAGER (10:07:53): I know.

HODA KOTB (10:07:53): When the people are serious, they`re serious.

JENNA BUSH HAGER (10:07:55): My first instinct was like it will make it shorter.

HODA KOTB (10:07:57): Yes.

JENNA BUSH HAGER (10:07:59): That might be good.

HODA KOTB (10:08:00): I think that might be good.

JENNA BUSH HAGER (10:08:00): It`s long.

HODA KOTB (10:08:02): It`s way too long.

JENNA BUSH HAGER (10:08:02): And we`re tired.

HODA KOTB (10:08:02): Have you seen any of the movies, by the way?

JENNA BUSH HAGER (10:08:04): No. I saw A Star Is Born--

HODA KOTB (10:08:05): A Star Is Born.

JENNA BUSH HAGER (10:08:06): --which I loved.

HODA KOTB (10:08:07): Loved. Right. Did you see--

JENNA BUSH HAGER (10:08:08): Mary Poppins. Is that nominated?

HODA KOTB (10:08:10): I want to see that. I`m dying to see it.

JENNA BUSH HAGER (10:08:11): It`s so cute. Actually--

HODA KOTB (10:08:13): What?

JENNA BUSH HAGER (10:08:13): --maybe Haley would like it.

HODA KOTB (10:08:13): Haley would like that?

JENNA BUSH HAGER (10:08:14): If you could watch at home--

HODA KOTB (10:08:16): Okay.

JENNA BUSH HAGER (10:08:16): --so that she doesn`t take her shirt off like Poppy did.

HODA KOTB (10:08:18): So she did at the theater?

JENNA BUSH HAGER (10:08:20): Hm-Mm.

HODA KOTB (10:08:22): All right. So we`re guessing no opening monologue or anything at the Oscars, but it will be interesting to see.

JENNA BUSH HAGER (10:08:24): But whatever. You just said they should do an opening monologue--

HODA KOTB (10:08:28): I think it should be like a dance number.

JENNA BUSH HAGER (10:08:28): --montage.

HODA KOTB (10:08:30): Yeah. I think it should be a dance number.

JENNA BUSH HAGER (10:08:31): Okay. So there`s big news. Lady Gaga--

HODA KOTB (10:08:33): Yeah.

JENNA BUSH HAGER (10:08:34): --put something out on Twitter this morning. Again, how we get our news.

HODA KOTB (10:08:37): Yes.

JENNA BUSH HAGER (10:08:38): She talked about R. Kelly.

HODA KOTB (10:08:40): Yeah.

JENNA BUSH HAGER (10:08:41): She evidently did a song with him.

HODA KOTB (10:08:42): I didn`t even remember that she did that. But she did do one, and she was-- in hindsight, she said that she was upset that she had done that. She said she was-- she didn`t-- you know, was unaware of the allegations that were against him back then. She talked about her being a victim of sexual assault herself. So she wrote this. "I stand by these women one thousand percent. As a victim of sexual assault myself, I made both the song and the video at a dark time. I was angry and still hadn`t processed that trauma that had occurred in my own life."

JENNA BUSH HAGER (10:09:11): Yeah. So they did this song in 2011.

HODA KOTB (10:09:14): Yeah.

JENNA BUSH HAGER (10:09:14): And that`s probably why we don`t remember it.

HODA KOTB (10:09:15): Yeah.

JENNA BUSH HAGER (10:09:16): It was a long time ago. And she said that she`s going to take it off iTunes.

HODA KOTB (10:09:19): Yeah. She doesn`t want it being sold. It`s funny when you`re in a dark time in your life, it`s amazing like when you think about- - forget them for a second, but who you allow in.

JENNA BUSH HAGER (10:09:29): Interesting.

HODA KOTB (10:09:29): It`s weird that way. And this is not that at all, but I remember-- and this is like-- but you realize when you were at a weak point what you invite into your life. You don`t even realize you`re doing it. And I remember, you know, after I had broken up with my boyfriend at the time, I was in a laundromat. I remember it because I was sitting on the floor at a laundromat and the clothes were, like, going around and around. And I was like feeling like my life was just going down a bad path. And a police officer walked in and he said are you okay? And I said, no, I`m not okay. And in that moment, he kind of rescued me.

JENNA BUSH HAGER (10:10:03): Aw.

HODA KOTB (10:10:03): And then I started dating him.

JENNA BUSH HAGER (10:10:05): Wait. What?

HODA KOTB (10:10:06): Yeah. But then I realized-- but then I realized that I don`t always need rescuing. And he`s a rescuer, right? So when I`m at a weak point, I brought someone into my life who was super strong.

JENNA BUSH HAGER (10:10:17): To save you, yeah.

HODA KOTB (10:10:18): To save you. And then you realize when you get strong again, that`s actually not your person.

JENNA BUSH HAGER (10:10:22): Yeah.

HODA KOTB (10:10:23): But I think at all times in our life, we`re out of balance, and we invite in the thing at that point in our life that we either feel we need to help us or that may hurt us more. You don`t know what you`re going to invite in. And then when you get to be yourself, strong together--

JENNA BUSH HAGER (10:10:36): Yeah. You`re like why did I do that.

HODA KOTB (10:10:36): --you`re like wait. And then you feel bad because you`re like, wait, you know, this person, I don`t need to be saved every day.

JENNA BUSH HAGER (10:10:41): Yeah.

HODA KOTB (10:10:41): I`m not broken. And I think you learn that, like, when you go through stuff. So you wonder, when I think about, you know, Lady Gaga going through a terrible, traumatic time, you don`t know who you invite in during that moment.

JENNA BUSH HAGER (10:10:50): No. And maybe when you`re feeling vulnerable, you can`t listen to yourself. Like wait, should I be working with this person? You`re just like yes to everything without being discerning and realizing that you have value and that you don`t need to do every single thing.

HODA KOTB (10:11:03): And then they-- you know what`s funny because they always say-- and I think you have a great gut, and I`ve always liked that about you. But they always say trust your gut. But sometimes, I wonder like when you`re at a vulnerable place in your life, maybe your gut is off.

JENNA BUSH HAGER (10:11:14): Yeah. Should you?

HODA KOTB (10:11:15): Because at that point, you`re not yourself.

JENNA BUSH HAGER (10:11:17): Yeah.

HODA KOTB (10:11:18): You don`t know. Maybe you are, you know, making a bad choice.

JENNA BUSH HAGER (10:11:20): I like that she`s coming out, though, and saying enough is enough.

HODA KOTB (10:11:23): And that was that, of course, that docuseries and R. Kelly in it highlighted a bunch of allegations against R. Kelly saying that he physically, mentally and sexually abused women, and he denies all that stuff. Jada Pinkett Smith tweeted this, which I thought was interesting. She said "How is it that R. Kelly`s music sales have spiked substantially since the release of this docuseries Surviving R. Kelly? I need some help and understanding. What am I missing???"

JENNA BUSH HAGER (10:11:53): What is she missing?

HODA KOTB (10:11:54): I don`t know.

JENNA BUSH HAGER (10:11:55): Because that is--

HODA KOTB (10:11:56): I don`t know why.

JENNA BUSH HAGER (10:11:57): Nobody should be supporting somebody--

HODA KOTB (10:11:59): Yeah.

JENNA BUSH HAGER (10:11:59): --that has had this record. I mean, he says it`s not true. But--

HODA KOTB (10:12:04): Yeah. He-- yeah. He denies all the allegations there haven`t been, you know, any charges against him. But anyway, he`s not been convicted of any of the crimes. All right.

JENNA BUSH HAGER (10:12:13): Okay. So other bad-- some other bad news. Yesterday, Amazon CEO Jeff Bezos and his wife, MacKenzie, announced they are divorcing after twenty-five years together although--

HODA KOTB (10:12:23): Yes.

JENNA BUSH HAGER (10:12:23): --I`ll say his announcement said it wasn`t bad news, that they`re going to stay friends and--

HODA KOTB (10:12:26): Yeah. It seemed like it was amicable. I mean, the way they-- the statement read.

JENNA BUSH HAGER (10:12:30): Yeah.

HODA KOTB (10:12:30): I mean, it is interesting because she was with him before Amazon, before everything, when he was a dreamer, when he dreamt of this crazy idea. And she said, I`m with you, I`m with you. And then you fast-forward twenty-five years later, and for some reason--

JENNA BUSH HAGER (10:12:45): It didn`t work.

HODA KOTB (10:12:45): --you know, it didn`t work out. I was thinking about Terry Crews yesterday when he was saying that he got to this point. You wonder, like, do you go with the one who brung you? Do you stay with her or who knows what happened in that relationship?

JENNA BUSH HAGER (10:12:57): But I do love this thought.

HODA KOTB (10:12:59): What?

JENNA BUSH HAGER (10:12:59): I know that both of us after Terry Crews was here, it`s like, oh, maybe we could be slightly more supportive. She`s like-- if somebody said to me, hey, would this look good, this type of business--

HODA KOTB (10:13:09): Yeah.

JENNA BUSH HAGER (10:13:09): --and you couldn`t even understand it and you`re like yes.

HODA KOTB (10:13:11): Can you imagine-- that`s called blind faith.

JENNA BUSH HAGER (10:13:13): Yeah.

HODA KOTB (10:13:13): That`s called believing in somebody because you trust them implicitly regardless of all the other stuff.

JENNA BUSH HAGER (10:13:18): Okay.

HODA KOTB (10:13:18): Oh, I guess we have to go. All right. In their statement though, Bezos said this, quote, "If we had known we would separate after twenty-five years, we would do it all again. Though the labels may be different, we do remain a family." So--

JENNA BUSH HAGER (10:13:31): I love that.

HODA KOTB (10:13:31): --that`s a good way to--

JENNA BUSH HAGER (10:13:32): I know.

HODA KOTB (10:13:32): --end that. All right.

JENNA BUSH HAGER (10:13:33): All right.

HODA KOTB (10:13:33): We`re going to put the final touches on our ambush ladies.

JENNA BUSH HAGER (10:13:36): Don`t miss the big reveal when they walk our red carpet.

HODA KOTB (10:13:39): Plus, we`ve got an Emmy and a Tony winner in the house. Oh, nothing, he`s with Donnadorable.

DONNA FARIZAN (10:13:42): Yes, we do. I`m with the one, the only Neil Patrick Harris. And since you are the star of The Series of Unfortunate Events, what is the most unfortunate mishap you`ve had on television?

NEIL PATRICK HARRIS (10:13:53): Oh, my. Well, I ripped my pants once on James Gordon. I was in my underwear once hosting the Oscars. But I could probably safely say it`s the next segment that we`re going to walk in.

DONNA FARIZAN (10:14:03): Hopefully you won`t rip your pants, coming up next.

(ANNOUNCEMENTS)

END

Dear Dr. Roach: I have been suffering with small intestine bacterial overgrowth syndrome for five years. It started when I was treated for H. pylori with omeprazole. I've had two endoscopies, a colonoscopy and lab tests. I'm negative for celiac disease. I had a positive breath test four years ago. I've taken five courses of antibiotics, including rifaximin and neomycin with brief relief each time. I've followed gluten-free and low FODMAP diets and tried several acupuncture sessions to no avail. I'm now taking "herbal antibiotics" without any relief so far. I have well-controlled diabetes.

There does not seem to be consistent or reliable information or treatment recommendations other than antibiotics and diet. Can you guide me toward reliable literature? Do you have any advice for this ailment? I worry about long-term effects like malnutrition and emaciation.

D.D.

Small intestine bacterial overgrowth syndrome is when there are more bacteria in the small intestine than normal. It is uncommon but not rare, although its exact prevalence is unknown. The major symptoms are bloating, gas, abdominal discomfort and diarrhea. It can be complicated by weight loss and vitamin deficiencies.

The diagnosis is made by a breath test, and this ideally looks at both methane and hydrogen in the breath after consuming a test meal of sugar. Whether the breath test result is methanepredominant or hydrogen-predominant affects the likelihood of success of treatment.

The first thing to consider after making the diagnosis is why the SIBO is there. The small bowel has a "transit" time of intestinal contents fast enough that the bacteria normally present in the colon do not have time to go up into the small bowel. Conditions that slow the small intestine, including irritable bowel syndrome, opiate drugs and diabetes affecting the gut, all can predispose a person to SIBO, and treatment will not be effective if the underlying cause isn't attended to. Omeprazole and other proton pump inhibitors prevent the stomach from making acid: Without acid to kill bacteria, SIBO can occur, so these drugs need to be stopped in a person with SIBO. Celiac disease is associated with SIBO and is often undiagnosed.

In hydrogen-predominant SIBO, rifaximin for two weeks usually is effective; however, in methane-predominant SIBO, a combination of rifaximin and neomycin will be more effective. Both regimens are usually two weeks long. In people who fail appropriate antibiotics, many experts recommend an "elemental" diet, which is expensive and not particularly appetizing, for up to three weeks. This diet contains the nutrients, such as amino acids and sugars, already broken down, allowing for faster transit time.

It is probably more effective than a low FODMAPS diet (a diet that restricts certain carbohydrates). That is an effective treatment for some people with irritable bowel syndrome, even if it didn't work for you. Medication to improve how fast the small intestine squeezes may be helpful, especially in someone with diabetes. Erythromycin is one choice. Its effect of speeding up the gut is more important than its antibiotic effects. Probiotics often are recommended, but there is not good evidence to support their use. I doubt the effectiveness of herbal antibiotics (I'm not even sure what these are) or acupuncture for this condition.

If all of these fail, it's time to re-evaluate whether the diagnosis was correct (another breath test is probably appropriate), and think about alternative possibilities for the symptoms. Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth @med.cornell.edu

Chobani is growing up from its scrappy startup days.

This winter, the 10-year-old company launched 30 new items, more than it ever has in one season. The products are spread across three new lines: A lower-sugar alternative to its flagship Greek yogurts, Gimmies for kids[https://www.cnn.com/2018/11/29/business/chobani-kids-gimmies/index.html] and its first-ever non-dairy Chobani retail product, which hits shelves on Wednesday.

It's been an "unprecedented" period of expansion, said Peter McGuinness, Chobani's chief marketing and commercial officer. For now, Chobani is focused on filling the gaps in the yogurt aisle and encouraging more Americans to eat more yogurt.

Don't call it a yogurt

You may find Chobani's new product in the yogurt aisle, but you won't see "yogurt" on any of the packages.

The coconut-based products are available in single-serve cups and drinks. Cups come in vanilla, strawberry, blueberry, peach and slightly sweet plain, and drinks come in vanilla chai, strawberry, mango and slightly sweet plain. The company said that the coconut-based products contain about 25% less sugar than other plant-based yogurt alternatives. Coconut is the only base for now, but there may be others later.

The non-dairy yogurt alternative segment is still very small. But Chobani saw a parallel to its flagship product.

"Greek yogurt, ten years ago, was less than 1% of the market," McGuinness said. Now it's the most popular type of yogurt by far.

About 59% of yogurt shoppers said they bought Greek yogurt over a three-month period, according to a June survey conducted by the market research company Mintel and Lightspeed. Only 42% said they bought regular yogurt, and just 6% purchased non-dairy yogurt alternatives.

Mintel notes that non-dairy yogurt sales are growing, as are consumer interest and product development. And Chobani is entering into a competitive field. Danone's Silk makes almond milk yogurts and its So Delicious line include yogurt alternatives made from coconut milk. Stonyfield makes soy-based yogurt, and smaller companies like Kite Hill — which has funding from General Mills — also make artisanal plant- and nut-based yogurts.

But with its new products, Chobani hopes to grow the category, rather than take share from competitors.

Chobani's competitors use "yogurt" and "milk" to help customers understand the products. McGuinness said that Chobani's decision to avoid those words may put it at a disadvantage, at first, as customers figure out what dairy-free Chobani is.

"You can't call it a yogurt," McGuinness said. That's because yogurt is technically a dairy product. "We are being absolutely by the book because we think words matter," he said.

Plus, regulations may eventually require companies to stop referring to nut- and plant-based drinks as "milks," and non-dairy snacks as "yogurt," McGuiness said. If that happens, Chobani will be ahead of the game. And dairy products offer different health benefits than non-dairy ones. Chobani doesn't want to mislead customers with inaccurate comparisons.

Despite possible challenges, Chobani thinks people will prefer its product. When asked, consumers said they don't like the taste, texture or high sugar content of available plant-based products, McGuinness said.

Room to grow

Yogurt is an $8.5 billion sector in the United States, according to Mintel. Despite projections that the sector will shrink, McGuinness thinks the market could grow to between $12 and $13 billion. With the right products, advertising and pricing, that growth could take place over the next few years, he said.

To get there, Chobani and its competitors will have to educate the public on yogurt as a source of nutritional benefits, like calcium and probiotics. It also has to encourage US consumers to see yogurt in a new light: as a healthier alternative to sour cream or a base for dressings, soups and savory spreads. Chobani's cafes help "inspire" customers to think of creative ways to eat yogurt, McGuinness said.

"There's tons of growth to be had" in the yogurt sector, he noted. "You'll see us continue to innovate in the yogurt aisle."

Chobani has its eye on a number of emerging trends. "Probiotics are big, and I think they're going to be huge," McGuinness said. "Look to us to be championing probiotics ... there could be products that really specialize." Functional beverages, which may include probiotics, protein or vitamins, is another big trend.

The company is also looking at enhancing its line of Greek yogurts. "You'll have more fitness-oriented ones, you'll have more indulgent ones," he said. "It needs to be evolved."

And Chobani is looking beyond yogurt.

"Our founding vision was always better food for more people. It was never better yogurt for more people," McGuinness said. "I think that gives you all the clues you need."

By Danielle Wiener-Bronner, CNN Business

Jan 9 (Reuters) - OptiBiotix Health PLC:

* DISTRIBUTION AGREEMENT FOR CHOLESTEROL REDUCING CHOLBIOME

* ENTERED INTO A THREE YEAR DISTRIBUTION AGREEMENT WITH SILVEXPO TO DISTRIBUTE AND COMMERCIALISE OPTIBIOTIX'S OWN LABEL CHOLBIOME

* AGREEMENT GRANTS SILVEXPO NON-EXCLUSIVE RIGHTS FOR CHOLBIOME

* AGREEMENT EXTENDS SALES CHANNEL OF CHOLBIOME RANGE OF PRODUCTS INTO LARGEST EASTERN EUROPEAN MARKETS FOR PROBIOTICS Source text for Eikon: Further company coverage:

Will everyone please stop banging on about their abstinence, diet and exercise regimes? It’s the people who stay shtum who seem to succeed

Please do tell me what you are giving up in January. It is endlessly fascinating to have one conversation after another about booze, carbs and hot water with lemon. What a thrill I get when someone I hardly know starts going on about their glowing skin and improved sleep, or thumping themselves along in the dark on hard pavements, or the endorphin release to be had from a cross-trainer (yeah, sure).

Surely the people who will achieve their goals – this entirely atomised version of “taking back control” – are precisely the sort of people who just get on with it? You barely notice them not drinking or not ramming Pringles into their gobs. I am sure a figure can be put on the failure rate of the bangers-on compared with those who don’t say a word, but unfortunately, as I have not decided to become a better person by learning maths, I can’t produce it.

The aspiration to be healthier is a form of self-gentrification. In all our cities and small towns we can see the consequences of addiction: to smack, crack, spice, alcohol. We see it in our hospitals and in the rough sleepers in our shelters, and yet rehabs are closing down or are entirely privatised. Those who most need help are not able to access it and are caught in downward spirals of addiction and mental health issues. This is far more complicated than discussing gut bacteria. (You’ve got some. Eating revolting yoghurty stuff won’t make a lot of difference – but hey, fill your boots.)

This process of eliminating all that is bad from one’s life in order to feel better is just not possible for many people in the way that it is spoken about. We live in a social body, not isolated temples of purity.

If this insight doesn’t clearly demonstrate my own moral superiority, then pretending spirals of shredded courgette are pasta sure as hell won’t.

• Suzanne Moore is a Guardian columnist

From flax seeds to coconut oil, these ingredients will make your Veganuary easy and delicious

It’s a common misconception that being vegan is both tricky and dull. The truth is, there are simple food switches we can make to eat fewer animal products, and with the likes of Ben & Jerry’s introducing non-dairy versions of some of its most popular flavours, being vegan is now easier than ever.

Here are five simple store cupboard updates that will help you be a little more vegan …

Flax seeds

The sheer number of things you can use flax seeds for is, quite frankly, mind-boggling.

First off, flax eggs. One tablespoon of ground flax seeds mixed with 2-3 tablespoons of warm water becomes a mixture that has the same texture and volume as egg white. You can use these flax eggs in place of chicken’s eggs when binding bakes or adding body to things such as pancakes.

Ground flax seeds are also a powerful thickening agent for everything from porridge oats to pasta sauces. Adding a subtle nutty taste and a slightly crunchy texture, they work best with deep flavours such as curries.

What makes flax seeds even more essential for vegans is that they contain omega-3, the same kind of good fats you get from oily fish. These oils are essential for optimal brain function, blood flow and can even help reduce the risk of heart disease, so if you’re not getting enough flax seeds in your diet, now’s a great time to start.

Keep them whole, boil them with some water and you can even make your own glue or hair gel with them – check out the videos online if you don’t believe us[https://www.youtube.com/watch?v=os0gI1vx1tw].

A word of warning: once ground, flax seeds start to lose their beneficial properties over time, so if you buy them whole, grind them up in a smoothie maker and store them in the fridge. That way, you’ll get the most from these mighty, mini seeds.

Chickpeas

When we say chickpeas, you probably think hummus, and rightly so. Hummus has become a firm favourite in the UK over the past decade, enhancing mealtimes as a condiment and serving up a time-saving savoury snack when combined with veggies or pitta bread.

If you have a blender and have never made hummus, you’re missing a trick. It’s a whizz – just blitz a can of chickpeas with a tablespoon or two of tahini, olive oil, lemon juice and salt, then add a teaspoon of water at a time until it all turns into that wonderfully familiar, rich, pale, hummusy-textured gloop.

Chickpeas aren’t just tasty, though – they’re an excellent source of complex carbs and fibre.

And whatever you do with your can of chickpeas, don’t throw away the water. Known as aquafaba, this juice is rich in starch and is a great egg replacement for making meringues or macarons.

Pasta sauce

We’re all busy people, and having a staple, cost-effective “meal in minutes” recipe can be the difference between success and failure when embarking on a new diet. What’s handy is that vegan quick fixes can be pretty similar to non-vegan ones, with a piping hot, saucy bowl of pasta being up there with the best of them.

Other than puttanesca, which contains anchovies, most jars of tomato-based pasta sauces are free of animal product.

Nutritional yeast

The name might make you think of baking and bread, but unlike traditional yeast, nutritional yeast is deactivated, so it doesn’t rise when warmed and wet. It has a distinctly nutty, cheesy taste and looks a lot like fish food flakes.

An insider vegan secret for a long time, these tart, deep and earthy-tasting flakes can be sprinkled over pasta as a parmesan replacement, combined with probiotics, ground cashews and agar-agar – a vegan gelatine substitute – to make vegan cheese. They’re also excellent in a crumb coating when whizzed up with some flax seeds.

Coconut oil

In a world with no dairy, coconut oil reigns supreme as the most indulgent alternative around. Combined with almond butter and some agave, it’s a sweet, satisfying snack. Melted and ready to get sizzly, it’s the base flavour for the richest stir-fries and curries. And if you’re using cold-pressed coconut oil in baking, it adds a creamy, subtly tropical aroma and taste to everything from brownies to cookies.

Melting at around 24C (76F), it tends to stay solid at room temperature in most climates, and in a similar way to cocoa butter, becomes liquid when melted in our hands or mouth.

In addition, cold-pressed oil – the pricier variety – can raise levels of good cholesterol. Meanwhile, the cheaper, standard coconut oil carries no coconut flavour, so is an excellent, versatile fat for cooking coconut flavour-free dishes.

Make your Veganuary extra indulgent with Ben & Jerry’s non-dairy flavours such as Chocolate Fudge Brownie and Peanut Butter & Cookies. Get the inside scoop on the range at benjerry.co.uk/flavours/non-dairy[http://www.benjerry.co.uk/flavours/non-dairy]

It’s January and unless you've sworn off all social media, television and are avoiding all forms of public transport then you are unlikely to have managed to miss the constant barrage of adverts suggesting it’s time for a "new you." This doesn’t stop at starting the day with a probiotic yoghurt drink or downloading a running app.

In fashion, we can often be guilty of it too. Suggesting that a new year means it’s time, (in-between your new gym routine of course) to give yourself a style overhaul. To ask yourself what you really want to look like in 2019 and to shop accordingly. But this year, in this new “woke” era of sustainability perhaps, that’s not very um “woke” of us.

Instead of shopping and adding to our already crammed wardrobes, perhaps we should all look at what we already have, what we actually like and go from there.

If I were to appoint a face of this campaign, it wouldn't be a model or a blogger with a cult social media following. Leave them to their sponsored posts and selfies. Instead, it would be someone who's style I may not want to personally emulate but who's sane approach to shopping, I have come to quietly admire - the Duchess of Cambridge. Yes, working out what suits her and sticking to it is a theory the Duchess of Cambridge seems to be practising more and more; even if, like me, you aren’t a big fan of her style, you can’t deny it’s an admirable way of approaching getting dressed.

Of course, “style formula” and “signature look” are catchy phrases that are bandied around a lot in the fashion world, but when it comes to the Duchess of Cambridge, it’s becoming more and more evident with every public appearance that she is on a mission to make them part of her own personal fashion lexicon.

When the Duchess officially joined the royal family in 2011, she may not have had the opportunity to define what Duchess duties involve - state dinners, charity work and patronages - but she did have the opportunity to define what a Duchess looks like whilst performing said royal duties.

Fast forward eight years, and countless midi dresses and beige court shoes later, it seems the Duchess has finally found and hit her style stride, with those unflattering beige heels finally put into storage. It was a fact she was keen to emphasise with her first public appearance of 2019.

On Sunday the Duchess opted to wear a new version of a look that she really has carefully honed over the past three months: a coat that falls just below the knee, a shoe with a sensible heel height and most surprisingly of all, a coordinating headband.

For her new year debut, her coat came in the form of a blue Catherine Walker funnel neck style. She first wore the wool coat- which retails for £3000- as part of her maternity wardrobe whilst pregnant with Prince Louis, in February last year during a royal tour of Norway. In snowy climes, she paired it with fuzzy trimmed gloves and flat boots but for Sunday’s relatively warmer temperature, she opted for a pair of black court shoes from Prada- again, a style we have seen her photographed in before.

Looking at the Duchess's recent outings, it appears she really does know what does- and more importantly- doesn’t work for her. If she finds something that suits her, she’ll often buy or commission two versions. Take the burgundy coat she wore to the most recent Christmas Day service at Sandringham[https://www.telegraph.co.uk/fashion/royals/kate-meghan-show-different-style-strategies-christmas-sandringham/] . This was a re-make of a Catherine Walker style which she already owns in bottle green. First worn on St Patrick's Day in 2017, the duchess recently re-wore the original coat for the centenary of the end of World War One. Double breasted, a velvet collar and neatly cut on the shoulders - they're details that have all become synonymous with Kate’s style.

It’s a similar formula when it comes to dresses. A fit and flare silhouette, a high-neckline and a subtle not showy print - polka dots seem to be top of her list at the moment - either from the highstreet, LK Bennett[https://www.telegraph.co.uk/fashion/royals/duchess-cambridge-proves-polka-dots-arent-just-summer-dressing/] or more high-end, like the Alessandra Rich version she wore in a family portrait to celebrate Prince Charle's 70th birthday[https://www.telegraph.co.uk/fashion/style/duchess-cambridges-new-polka-dot-dress-royal-trend-year/] . Sure, on paper, it all sounds a bit safe - but under both intense media and public scrutiny plus cameras that are just waiting for her to put a well-heeled foot wrong, Kate always looks polished and professional.

But it’s her recent use of hair accessories, that is really underlining the idea that the Duchess is honing a signature style. Of course, this isn’t the first member of the royal family to create a go-to look. Princess Diana was known for her love of skirt suits, the Duchess of Cornwall is rarely seen without a string of pearls whilst the Queen’s signature is bright block colours.

However, this is the first time we’ve really seen the Duchess of Cambridge embrace a trend in such a strong manner. From scrunchies to slides, bows to bands, hair accessories were all over both the autumn/winter 2018 and spring/summer 2019 runway[https://www.telegraph.co.uk/fashion/news/5-hair-accessory-trend-loved-duchess-cambridge/] s. Miuccia Prada finished every one of her 50 summer 2019 looks with an exaggerated satin or studded headband and it’s a mantra the Duchess seems to have adopted too. Her go to milliner of choice? Jane Taylor who created the applique floral headband the Duchess wore to the christening of Prince Louis last July, the claret Halo style, Kate wore to the Christmas service at Sandringham alongside Sunday’s most recent iteration.

So what can we expect to see from the Duchess in 2019? Well, much of the same which in turbulent times is probably no bad thing. Yes Kate will reference a trend - the length of a hemline, a shape of a sleeve but she won't really emulate what's deemed in or out in fashion.

In five years time, her coats will still look fine. Let's face it, we're never going to see Kate in a pair of designer chunky trainers or spring summer 19's must have tie dye t-shirt. But would you really want the future Queen of England to dress like that influencer you scrolled past on Instagram this morning? Timeless style? Kate might just have it.

* Genetic testing[https://www.businessinsider.com/lunadna-pays-for-genetic-information-2018-12?utm_source=dowjones&utm_medium=ingest] will be a cornerstone of healthcare in 2019, experts say.

* There are two ways to do the testing: getting a costly but complete genetic workup through a doctor or opting for a cheaper at-home test like those sold by 23andMe[https://www.businessinsider.com/dna-testing-delete-your-data-23andme-ancestry-2018-7?utm_source=dowjones&utm_medium=ingest].

* Clinicians and advocates criticize the at-home approach, which they say prioritizes convenience over privacy[https://www.businessinsider.com/dna-testing-ancestry-23andme-share-data-companies-2018-8?utm_source=dowjones&utm_medium=ingest] and long-term health.

* But entrepreneurs counter that the at-home approach lets more people access information.

* Which method will win out, and at what cost?

As millions of Americans sat down to Thanksgiving dinner, biomedical researcher James Hazel[https://www.vumc.org/getprecise/person/james-hazel-phd-jd] sent out a stark warning about the genetic-testing kits[https://www.businessinsider.com/dna-testing-ancestry-23andme-share-data-companies-2018-8?utm_source=dowjones&utm_medium=ingest] that he surmised would be a hot topic of conversation.

Most of them are neither safe nor private.

Hazel reached this conclusion after reviewing the privacy policies and terms of service of nearly 100 genetic-testing companies that offer their services directly to individuals. Most people use these services either by submitting a sample of saliva[https://www.businessinsider.com/dna-testing-ancestry-23andme-share-data-companies-2018-8?utm_source=dowjones&utm_medium=ingest] or uploading their raw digital DNA signature to a public database. Their lofty common draw is enabling people to learn more about their health, family history, and ultimately their identity.

Hazel, a researcher at Vanderbilt University, studied companies ranging from popular startups like 23andMe — which offers health and ancestry information — to under-the-radar outfits such as GEDmatch, which simply houses genetic information to help people build family trees. His article[http://science.sciencemag.org/content/362/6417/898], which was published on Thanksgiving Day in the journal Science, found that nearly half lacked even a basic privacy document that governed genetic data.

Privacy isn't the only concern that experts have with consumer genetic tests. In addition to collecting sensitive data on ancestry, companies like 23andMe claim to show how your DNA affects your health. But clinicians, medical professors, and genetic counselors told Business Insider that this information is misleading and could put people at risk of missing warning signs for diseases like cancer.

"It’s very scary for us because patients think they’ve had a genetic test when they haven't," said Theodora Ross[https://profiles.utsouthwestern.edu/profile/127180/theodora-ross.html], the director of the cancer-genetics program at the University of Texas Southwestern.

Still, comprehensive genetic workups — the kind that require a doctor's visit — remain expensive and time-consuming.

That's led millions of Americans to rely on at-home kits for most of their genetic knowledge. This holiday season, genetic-testing kits broke sales records. Ancestry announced after Thanksgiving that it had sold 14 million DNA kits worldwide. 23andMe has assembled genetic data on more than 5 million customers.

Experts agree it's time for a different model, something between a pricey doctor-ordered test and the limited spit kits available in drug stores. And though several companies are trying new approaches[https://www.businessinsider.com/lunadna-pays-for-genetic-information-2018-12?utm_source=dowjones&utm_medium=ingest], none has emerged as a leader. In the meantime, sensitive customer data is being uploaded and housed in large databases — sometimes forever.

Your sensitive data can be shared with others — even if you've never taken a genetic test

For law-enforcement officials to arrest suspected Golden State Killer[https://www.businessinsider.com/r-california-man-arrested-in-golden-state-killer-case-suspected-in-12-slayings-2018-4?utm_source=dowjones&utm_medium=ingest] Joseph DeAngelo on charges including four murders and dozens of rapes, they did not need him to participate in any genetic-testing services.

Instead, DeAngelo's arrest hinged on the participation of several of his distant family members. At some point, 24 people distantly related to him uploaded their genetic data to a public DNA database called GEDmatch.

After creating a fake GEDmatch profile using DNA they'd gathered at the scene of a 1980 crime, investigators were led to those people. By cross-checking the list against several other databases such as census data and cemetery records, they were able to close in on DeAngelo.

That's something Hazel and other researchers call "reidentification." He said it's a significant risk for people, even if they haven't ever personally taken a genetic test.

"The fact that law enforcement has access to this with just a subpoena, that was the impetus for my article," Hazel said. "I wanted to use it to highlight the deficiencies of the system."

Still, the process required a specialist and years of work, Curtis Rogers, the cofounder of GEDmatch, told Business Insider.

"It takes many people, each supplying little bits of information, to begin the complicated process of solving a cold case," Rogers said.

'Informed consent' is not always informed

Most genetic-testing companies[https://www.businessinsider.com/dna-testing-ancestry-23andme-share-data-companies-2018-8?utm_source=dowjones&utm_medium=ingest] say they use something called "informed consent" to verify that people understand what their genetic data may be used for[https://www.businessinsider.com/dna-testing-delete-your-data-23andme-ancestry-2018-7?utm_source=dowjones&utm_medium=ingest]. Most well-established companies like Ancestry or 23andMe ask for consent when a customer signs up or registers their kit; others put it in a 10- or 20-page terms-of-service document.

Informed consent is especially important because some companies keep genetic data[https://www.businessinsider.com/dna-testing-delete-your-data-23andme-ancestry-2018-7?utm_source=dowjones&utm_medium=ingest] for a long time, sometimes indefinitely[https://www.businessinsider.com/dna-testing-delete-your-data-23andme-ancestry-2018-7?utm_source=dowjones&utm_medium=ingest]. That means it can be used in different ways, including for purposes like solving a murder, that customers might not have anticipated.

DNA data collected by the companies is also being used for drug research, like in the case of 23andMe's $300 million deal[https://www.businessinsider.com/dna-testing-ancestry-23andme-share-data-companies-2018-8?utm_source=dowjones&utm_medium=ingest] with pharmaceutical giant GlaxoSmithKline, and for research on longevity and aging[https://www.businessinsider.com/ancestry-google-release-first-genealogy-study-longevity-aging-genetics-2018-11?utm_source=dowjones&utm_medium=ingest], like in the case of Ancestry's now-ended partnership with Google spinoff Calico[https://www.businessinsider.com/google-calico-ancestry-dna-genetics-aging-partnership-ended-2018-7?utm_source=dowjones&utm_medium=ingest].

Read more: DNA-testing company 23andMe signed a $300 million deal with a drug giant. Here's how to delete your data if that freaks you out.[https://www.businessinsider.com/dna-testing-delete-your-data-23andme-ancestry-2018-7?utm_source=dowjones&utm_medium=ingest]

The conflict over informed consent mirrors a recurring debate in medicine about the role of gatekeepers in healthcare. Just as the web made it easy for patients to research their symptoms before reaching out to a doctor, consumer genetic tests have enabled people to query their genome without needing permission from a specialist.

Entrepreneurs say these new capabilities are empowering because they arm people with new information about themselves. Anne Wojcicki, the founder of 23andMe, has said repeatedly that giving individuals the ability to peek inside their genes allows them to be more active stewards of their health.

"My hope is that 23andMe, by being less and less regulated, will enable more people to open their eyes to science," Wojcicki said at a Fortune conference[http://fortune.com/2016/11/30/23andme-anne-wojcicki-dna/] in 2016.

An Ancestry spokesperson shared that sentiment.

"Our highest priority is protecting our customers’ privacy, starting with enabling our customers to always maintain ownership and control over their own data and educating them on how to manage their privacy settings," they said.

"Any data included in research collaborations is based on customers' voluntary explicit informed consent to participate in research."

But privacy advocates and clinicians disagree with this view. Genetics is a scientific field that even experts are only beginning to understand, they say. Although there are several genetic mutations that we can firmly say are related to disease, there are thousands of tweaks to our genome that we still have yet to even identify, let alone fully comprehend.

Some genetic tests could mislead you about your risk of disease

Today, 23andMe is the only genetic testing startup that does not require interacting with a physician to get information about how your DNA might affect your risk of disease. For $199, you can order its "Health and Ancestry" product online or buy one at a pharmacy.

But genetics experts and clinicians caution against using the test for anything beyond entertainment. The tests are not comprehensive, meaning they don't look at all your DNA. Experts say they are also frequently misunderstood by patients. Ross, the University of Texas Southwestern clinician, said that whenever a patient comes in with results from an at-home testing kit, she tells them to throw them away.

"When it comes to health, 23andMe is not helping. They're getting in the way," she said.

The 23andMe health report looks at some of the genes related to diseases, including breast cancer, celiac disease, Parkinson's, and Alzheimer's. It also tells you if you carry a genetic variant that you could pass on to your children, increasing their risk of genetic diseases like cystic fibrosis or sickle cell anemia.

The problem is that a 23andMe report that comes back negative for those genetic variants doesn't mean you're at a low risk of disease, because the tests don't look at all your DNA. Instead, they analyze only a small selection of all the genes that have been highly studied and are known to relate to disease risk.

"If you think of your DNA as a book, the vast majority of consumer genetic tests [let you] see a few letters on the page," Elissa Levin[https://www.linkedin.com/in/elissa-levin-0aa8884/], the senior director of clinical affairs for personal genomics startup Helix, told Business Insider.

"Those letters are very valuable if that is a particular mutation that's been highly studied," Levin added.

More important, while 23andMe tests for three of the tweaks known to be related to breast-cancer risk, there are other disease-linked mutations the test does not include[https://www.businessinsider.com/23andme-new-cancer-test-problem-genetics-testing-2018-3?utm_source=dowjones&utm_medium=ingest].

"If someone did a consumer genetic test, they could be misinformed that there's nothing there of concern, when in fact they've only looked at a very small part of their genome," said Lisa Alderson, the CEO of genomic service network and medical practice Genome Medical.

Read more: Genetics testing company 23andMe has a new cancer test, but scientists say it's dangerous[https://www.businessinsider.com/23andme-new-cancer-test-problem-genetics-testing-2018-3?utm_source=dowjones&utm_medium=ingest]

A 23andMe representative said the company makes all these limitations clear to customers when they sign up for the test, and added that the product has been thoroughly reviewed by federal regulators at the Food and Drug Administration.

"Our health product undergoes levels of FDA scrutiny beyond most clinical tests," the representative said. "Our health tests meet a bar above 99% accuracy and contain information that meets the FDA requirements for clinical validity, meaning it's information related to one's health that's been well established in scientific literature."

They also said that the 23andMe health report clearly states that a negative report does not mean you are free of disease risk. The report reads:

"[Name], you do not have the three genetic variants we tested. However, more than 1,000 variants in the BRCA1 and BRCA2 genes are known to increase cancer risk, so you could still have a variant not included in this test."

Current tests may leave out 'the part that may save your life'

The single most important missing element when it comes to at-home genetic tests may be the human element, experts say.

That facet of genetic testing — translating genetic findings into health guidance that people can use — is the same one that's vital to a good doctor's visit. A person-to-person interaction can make the difference between a patient feeling defeated and determined.

Say you learned from a genetic test that you were at a heightened risk of a certain kind of cancer, for example. You might be left feeling hopeless and anxious. But imagine if instead of simply being told you were at a higher risk of cancer, you were also told that you could take a medical imaging test each year that has a high chance of catching your cancer early, when there's still time to intervene and save your life.

That's a role many experts say must be played by humans, at least until we have technology that can replace them.

"When you sit down with your doctor or genetic counselor or whoever the human being is who's talking to you about your result, you get a completely different view of it then if you’re sitting on a computer or it comes in the mail," said Ross.

But there aren't enough doctors or genetic counselors to meet the current demand for genetic-testing services. According to a recent report[https://www.nsgc.org/p/bl/et/blogaid=879] from the National Society of Genetic Counselors, for every graduate of genetic counselor training programs, there are two to three jobs available.

That's something Helix's Elissa Levin thinks about a lot. She's been watching the development of chatbots[https://www.businessinsider.com/stanford-therapy-chatbot-app-depression-anxiety-woebot-2018-1?utm_source=dowjones&utm_medium=ingest] (robots that you can text or direct message with, similar to normal conversation) and wonders if they might one day play a role in helping deliver the findings of genetic tests.

"To me, part of the balance of providing something responsibly and making a safe and quality experience is making sure the information is provided in a really digestible way," she said.

But a new and better model hasn't emerged. There are some genetic testing services that let you order a genetic test through an independent physician who can help translate genetic findings remotely, including from Helix and a startup called Color Genomics[https://www.businessinsider.com/genetics-test-for-cancer-cholesterol-2018-5?utm_source=dowjones&utm_medium=ingest].

A brave new world for genetic testing?

Some startups are beginning to experiment with new models for genetic testing. For instance, Nebula Genomics[https://www.nebula.org/], says you can get your entire genome (your full book of genomic data, rather than simply a few letters) sequenced, own the data set, and earn digital money[https://www.technologyreview.com/s/610221/this-new-company-wants-to-sequence-your-genome-and-let-you-share-it-on-a-blockchain/] by sharing it.

Another approach is being pioneered by LunaDNA[https://www.businessinsider.com/lunadna-pays-for-genetic-information-2018-12?utm_source=dowjones&utm_medium=ingest]. Cofounded by Dawn Barry, a 12-year veteran of biotech giant Illumina, Luna is offering to pay people[https://www.businessinsider.com/lunadna-pays-for-genetic-information-2018-12?utm_source=dowjones&utm_medium=ingest] for their genetic information in the form of shares of LunaDNA.

Barry created Luna as one answer to the problematic genetic-testing landscape, which she said doesn't prioritize privacy or offer people control over their data.

"In many cases you're buying a product, but maybe you are the product, and those models don't feel as transparent as they should," Barry told Business Insider.

She said Luna ensures that when customers contribute their DNA data, that data is anonymized and maintained in what she called an "analytics sandbox," which protects it from hacking or leaks.

"If you want to delete your data, there's only one copy," Barry said. "It's gone. Your shares go back. You're forgotten about, so to speak."

NOW WATCH: Here's how many children you can have in a lifetime[https://www.businessinsider.com/how-many-children-you-can-have-lifetime-2018-11?utm_source=dowjones&utm_medium=ingest]

See Also:

* At least 13,000 people have donated money on GoFundMe for unproven cancer treatments, and it could be dangerous[https://www.businessinsider.com/gofundme-used-for-unproven-cancer-treatments-2019-1?utm_source=dowjones&utm_medium=ingest]

* The US government shutdown could hamper key operations of digital health[https://www.businessinsider.com/us-government-shutdown-could-impair-digital-health-2019-1?utm_source=dowjones&utm_medium=ingest]

* Alphabet's life-science company just raised another $1 billion for a mysterious bet on healthcare[https://www.businessinsider.com/verily-raises-billion-google-alphabet-ruth-porat-2019-1?utm_source=dowjones&utm_medium=ingest]

SEE ALSO: A tiny startup wants to pay you for your DNA, and it could lead to the next wave of medical innovation[https://www.businessinsider.com/lunadna-pays-for-genetic-information-2018-12?utm_source=dowjones&utm_medium=ingest]

DON'T MISS: I tried a test that let me peek inside my microbiome, the 'forgotten organ' that scientists say is the future of medicine — and what I learned shocked me[https://www.businessinsider.com/microbiome-gut-bacteria-test-forgotten-organ-future-medicine-ubiome-photos-2018-11?utm_source=dowjones&utm_medium=ingest]

Make your diet healthier than ever with these naturally prebiotic and probiotic foods –your gut microbes will thank you for it

From sourdough bread to sauerkraut and kimchi, fermented food is one of the hottest health trends right now. Foodies and health-conscious people alike are becoming increasingly aware of the role of our gut microbes – collectively known as our microbiome – in improving not only our digestive health but our overall wellbeing, including mental health[https://www.independent.co.uk/topic/MentalHealth].

We can give our microbes a helping hand by eating a wide variety of fibre-rich foods – vegetables, fruits, nuts, seeds and pulses – called prebiotics, which feed them. And we can increase the population of our microbiomes by including probiotic foods, like yoghurt and other fermented products, which naturally contain healthy bacteria.

“The slow fermentation process involved preparing foods like sauerkraut and kimchi (usually raw cabbage or other vegetables, with salt and spices), and miso, allows time for a diverse population of healthy bacteria and enzymes to be produced,”explains Abbas Kanani, pharmacist at Chemist Click[https://www.chemistclick.co.uk/].

“A byproduct is lactic acid, which prevents harmful bacteria from colonising the intestines, as well as looking after the lining of the gut.” As the popularity of probiotic foods increases, so too does the range and quality. Supermarkets are getting wise to our wants and artisan producers are increasing their reach with online sales – all great news for our health and our taste buds.We reviewed some of the most appealing gut-healthy foods on offer, looking at price, availability, how natural they are and, of course, how palatable.

RAW Sauerkraut: £4.39 for 410g, Ocado

When it comes to pure, unadulterated sauerkraut, this tastes as good as it gets. Made with raw white cabbage, salt and nothing else, this is organic and unpasteurised and needs to be kept in the fridge (important, as products that don’t require refrigeration have been irradiated, which kills off the bacteria).

It lacks the overly vinegary taste you can get with some pickled veg. The cabbage is crunchy and not too wet, the taste is clean, fresh and piquant. We love this in salads, soups or just by the forkful, straight from the jar (to maintain high levels of bacteria, you should avoid cooking fermented vegetables or add it at the end). It may not seem cheap but there’s a lot of it, so the whole family can get their fermented fill. Tip: the metal lid is confusing at first – use a bottle opener to prize it off.

Buy now[https://www.ocado.com/webshop/product/Organic-Raw-Fresh-Sauerkraut-Unpasteurised/99505011]

Cracking Kimchi: £6 for 220g, The Edinburgh Fermentarium

Another small-batch producer of krauts, kimchis, slaws and sauerkrauts, these condiments are all based on traditional recipes, but with a modern twist. The Cracking Kimchi is a Great Taste Award winner and a brilliant blend of chilli, ginger and other spices with Chinese leaves, cabbage, carrot, radish and bell pepper.

It taste fresh and piquant, spicy but not too hot or harsh like some Korean kimchis, as most of the heat seems to come from the ginger. Only certain products from the range are available at any one time, depending on what founder Ruth Munro has been busy fermenting. Everything is raw, unpasteurised, vegan, gluten, dairy and MSG free. Not the cheapest product on our list, but definitely worth a try for fermented foodies on the hunt for something new and interesting to serve up.

Buy now

Glenilen Farm Rhubarb & NaturalLive Yoghurt:99p for 140g, Waitrose

We loved this range of creamy, natural, probiotic and low-fat yoghurts – not least because they come in a small, recycled-glass jar. Over the past 10 years of trading, this has saved the equivalent of 100 tonnes of single-use plastic (plus the Glenilen Farm[https://www.glenilenfarm.com/jarsgallery/]haslots of ideas on how to reuse the jars).

As for what’s within, these are inspired by natural yoghurt-compote pots in France and, with the exception of the natural option, are made up of a fruit layer at the bottom, topped with creamy live yoghurt, produced on a family run farm in West Cork. Of the six flavours the sharp, tangy rhubarb impressed us most – a pot would make a healthy pudding or breakfast but feels like a treat. While there are no additives, there is a little sugar added to the fruit varieties, so go for natural if you want to avoid this.

Buy now

Bio-tiful Dairy Kefir Quark Cranberry & Chia: £1.45, Ocado

This snack pot of bio-live fresh cheese will appeal to anyone watching their weight or following a high-protein diet, as much as to those looking to boost their microbiome. It’s a unique combination made by fermenting skimmed Dorset milk with live kefir and quark cheese cultures. The result is a light snack, halfway between a cream cheese and thick yoghurt in texture, with a fresh, neutral flavour.

It could be spread on bread or crackers or enjoyed on it’s own – and comes with an optional topping of dried cranberries, chia and other seeds, and a disposable spoon. It’s low fat but high protein, providing over 21g per portion. As well as the billions of live bacteria, it provides calcium, vitamins B2 and B12 and phosphorus.

Buy now

The Collective Kefir Cultured Yoghurt in Madagascan Vanilla:£2.29 for 450g, Waitrose

The Collective is well known for its live yoghurts and fruits, but fermenting with kefir grains takes them to the next, gut-healthy level. Kefir yoghurt boasts 13 different bacterial strains (as opposed to an average two to five in natural yoghurt) and is a thicker, more indulgent option to other brands of pouring kefir.

With 30 per cent less sugar than typical flavoured yoghurts, and then only sugars from milk, fruit or blossom honey, it’s a great option for anyone watching their sugar intake. It’s a good source of protein, calcium and vitamin B2. All four flavours in the range are delicious but the Madagascan Vanilla tastes particularly rich and luxurious, with a natural sweetness that cuts through the tartness of the kefir. Perfect for weaning kids off sugar and onto gut-healthy goodies instead – we could eat the whole tub in one sitting.

Buy now

Green Goddess Raw Organic Cacao Powder:£4 for 250g, www.greengoddesswellness.com[http://www.greengoddesswellness.com]

Hard to believe something that smells and tastes so chocolatey could be good for you – but this is. Raw cacao (aka unprocessed cocoa) is a prebiotic fibre, so it fuels the good bacteria in your gut to help rebalance digestive and overall health.

Research published in the

American Journal of Clinical Nutrition[https://academic.oup.com/ajcn]

showed volunteers consuming high-flavanolcocoa for four weeks had significant increases in lactobacilli and bifidobacteria in their guts. This organic cacao is natural and unprocessed andhigh in vitamins, minerals and antioxidants, including iron and magnesium.

A healthy and versatile store cupboard item, you can satisfy chocolate cravings (minus the processed ingredients) by adding a spoonful to smoothies, shakes, baking, puddings, yoghurt, porridge or hot water for a virtuous hot chocolate (we liked it with oat milk, too).

Buy now

Clearspring Organic Japanese Brown Rice Miso: £2.79 for 150g, Holland & Barrett

Miso is a traditional Japanese seasoning and used to make sauces, dressings, marinades and soups. Clearspring makes its version by fermenting soya beans, cereal grains (brown rice in this instance), a koji culture and sea salt in cedarwood kegs over many months. The resulting paste has a rich, salty and moreish taste.

It’s a perfect example of umami, the fifth taste, and deeper and more complex than many cheaper, more commercially produced misos. A little goes a long way – although you’ll soon be adding it to everything. Clearspring recently celebrated 25 years as a family business, producing its organic, vegan, authentic Japanese foods. All the products are GM-free and free of artificial additives, MSG, colourings, preservatives and added refined sugars.

Buy now

Japan Centre Shiro White Miso: £2 for 300g, Japan Centre

This is an affordable, own-brand miso from superstore of Eastern wonders the Japan Centre (pay it a visit if you’re in London’s Piccadilly). It’s made in Hiroshima with GM-free soya beans and a high percentage of white rice, which gives it a more subtle, sweeter flavour than darker misos.

A healthy fridge staple, white miso is well-suited to salad or vegetable dressings (experiment with adding white wine or rice vinegar, lemon, mustard, olive oil or soy sauce). It’s good mixed with dashi for a noodle soup base; excellent on white fish and tofu.

Buy now

Osato Umai Ichiban Natto: £1.38 for 4 x 180g, Japan Centre

This is an acquired taste even in Japan. Like miso, it’s a savoury product made from soya beans that have been soaked, boiled or steamed, then fermented. But it has a much stronger taste – a little bit cheesy, a little bit musty – and pungent smell. Texture-wise it’s slimy and it looks and handles like a bowl of baked beans covered in sticky, stringy cheese.

It’s been called the Marmite of Japanese cuisine and it’s true to say you’ll either love or hate it. Once we got past the smell, we rather enjoyed the umami, cottage-cheese like flavour. If you dotoo, you’ll benefit from all the probiotic goodness inside, as well as protein, fibre and vitamin K2. This natto comes in a pack of four single-portion pots, with sachets of soy sauce and mustard to mix in if you want to. They’re delivered frozen and you need to consume them within a day.

Buy now

Fermented By LAB Kraut/Kimchi Veggie Box: £24 for 6 x 170g jars, www.fermentedbylab.com[http://www.fermentedbylab.com]

If you’re really into your ferments – and want them as natural and nourishing as they come – then you’ll love these hampers. They’re made by fermenting expert Alana Holloway, who learned to manage chronic, full-body eczema by nurturing her gut. She creates her organic, raw, unpasteurised products in her kitchen (the LAB in the name refers to Lactic Acid Bacteria, not a place!), using seasonal and largely British produce, and delivers throughout the UK.

Our favourite from the Autumn Collection was the zingy Ginger Beet Kraut, although the Winter Squash Kimchi has wonderfully warming kick, too. You can make a one-off purchase or set up a monthly subscription, and a box full of freshly made artisan krauts and kimchis will arrive on your doorstep, ready to fill your gut with its microbial goodies (you can also order kombucha and water kefir drinks).

Buy now

The Verdict: Best foods for a healthy gut

If you want to make a big difference to your gut health, adding some sauerkraut to your meals is an easy, tasty way. And RAW[http://www.ocado.com/webshop/product/Organic-Raw-Fresh-Sauerkraut-Unpasteurised/99505011] is a well-priced, tasty, easily available version with a flavour that will enhance most dishes – good for kraut aficionados and newcomers alike. If dairy is more your thing, The Collective’s Kefir Yoghurt[http://www.waitrose.com/ecom/products/the-collective-dairy-kefir-vanilla-yoghurt/466467-677208-677209] is a delicious way to pack in more healthy bacteria, ideal for nourishing fussy kids.

Hannah Ebelthite is co-author of bestselling gut-health book ‘ The G Plan Diet[https://www.amazon.co.uk/G-Plan-Diet-Illustrated/dp/191202375X/ref=pd_sim_14_3]’ (Aster, £12.99)

Daunted by all the advice out there? Let our experts narrow it down

HAVE MORE FUN

I've spent the past decade writing about the science of exercise, drilling into the nuances of the optimal fitness routine – how hard to push, how to alter your running form, even what to wear. But, I've come to believe that the most important question of all is the one asked by the emerging discipline of exercise psychology: How much did you enjoy it?

According to Panteleimon Ekkekakis, an exercise psychologist at Iowa State University, 97 per cent of adults recognize the importance of exercise for health, but as few as 3 per cent actually get the recommended amount of physical activity. The problem here is not an information gap; it's an enjoyment gap.

I got with the program last summer when a good friend of mine told me there was an opening in a regular game of pickup basketball on Friday nights in the basement of a local church.

Basketball and team sports in general, aren't everyone's cup of tea, but there are numerous ways of staying active that feel more like a game than a chore: signing up for a trail race rather than sticking to the treadmill; hitting the links (but leaving the cart behind); finding a reliable tennis partner or rock-climbing buddy.

Find a game that clicks for you in 2019, and you'll feel like I do on Friday evenings now: so eager to get out the door that you almost forget you're about to work out.

Alex Hutchinson, Jockology columnist

EAT WHOLE GRAINS

Your overall eating pattern matters most when it comes to health, so it's not easy to narrow down nutrition advice to one recommendation. That said, I can offer one piece of advice: Eat more whole grains.

I'm pretty sure it won't be popular advice with low-carbohydrate dieters. But, here's why you should eat more whole grains – and why I make a point of including foods such as oats, quinoa, brown rice, farro and millet in my diet every day.

Thanks to their fibre, antioxidant and phytochemical content, people who eat whole grains each day have been shown to have a lower risk of heart disease, stroke, type 2 diabetes, digestive tract cancers and hormone-related cancers (for exexample: breast, ovarian, uterine and prostate cancers).

Three daily servings of whole grain are also part of a dietary pattern associated with a slower rate of cognitive decline and protection from Alzheimer's disease. (One serving is equivalent to one-half cup of cooked whole grain or one slice of 100-percent whole-grain bread.)

Whole grains also help nourish your good gut bacteria, microbes to potentially help reduce the risk of allergies, type 2 diabetes, inflammatory bowel disease and obesity.

It doesn't have to be difficult, either. I add whole grains to my diet by eating oatmeal or stirring raw rolled oats into yogurt or kefir for breakfast, tossing cooked quinoa or bulgur into salads, adding precooked barley, wild rice or spelt berries to soups and chili and eating only 100-percent whole-grain bread.

I also use my Instant Pot to batch cook whole grains, so I have them on hand to add to weekday meals.

Leslie Beck, Food for Thought columnist

SET YOUR TIMER

If you want to improve your health in the new year, get a minute timer. Then set it to ring every half hour while you're awake.

When it goes off, get up and move.

Research shows that a sedentary lifestyle – sitting for most of the day at work and at home – leads to heart disease, diabetes and other chronic illnesses. But one intriguing study found that it's not just the total amount of sitting time that's the problem. Rather, it's how long you remain inactive at a stretch that seems to make things worse.

The study involved 8,000 middle-aged and older adults. On average, they sat for 12.3 hours over a typical day. During four years of follow-up, 340 of the participants died.

The results revealed that the volunteers who normally kept their sitting to less than 30 minutes at a time had a 55 per cent lower risk of death than those who tended to sit for longer stretches.

This suggests that taking a “movement break" every half hour mitigates the negative effects of sedentary time, says Keith Diaz, lead author of the study and an assistant professor of behavioural medicine at Columbia University in New York.

“It doesn't matter what type of movement you do," he says. “A nice casual stroll down the hall is enough to lower the risks incurred by sitting."

The researchers speculate that prolonged sitting may be particularly harmful in several ways. The lack of muscle activity could elevate blood sugar levels and cause blood to pool in the legs.

Of course, not everyone has the job freedom to go for a walk. But doing things such as contracting your leg muscles, pointing your toes up and down or other stationary exercises can help.

“Whenever you have an opportunity to move, do it," Diaz says.

Paul Taylor, Healthy Debate columnist

UP YOUR INTENSITY

For a stronger 2019, I recommend that you make your workouts shorter. The catch?

You're going to have to work a lot harder.

For years, I've been a slave to the standard three-day total-body training split (“split" is gymspeak for "schedule"), with each workout lasting upward of 90 minutes. As I get older and have more outside interests competing for my time, efficiency in everything becomes more important.

Shortening my training sessions and spreading them out over the course of five days rather than three has allowed me to maintain my overall weekly workload while cutting my daily gym time in half.

Of course, in order to achieve results, you still need to bust your butt. In the gym, intensity of effort – not duration – is the most important factor for success.

This follows what researchers have been learning in the lab. In his book The OneMinute Workout, McMaster University kinesiology professor Martin Gibala presents years of research proving that short bursts of high-intensity training burns more calories and elicits greater muscle stimulation than the typical slow-and-steady variation.

It's tough to come up with an excuse to not train when you remove the time factor.

Shorter workouts help keep you focused, and because you're training more often, you can add some variety to your routines rather than sticking with the same old approach.

Paul Landini, Phys Ed columnist

Chloe Lambert reports on what could be the big parental obsession for 2019 - getting the perfect balance of intestinal bugs

HEALTH Ask most parents about their child's digestive habits, and they'll probably say they already know quite enough. But it's starting to look like nurturing a healthy gut is the single best thing you can do for your offspring's future health.

Over the last decade, the gut - or rather the 100 trillion microbes living inside it, known as the microbiome - has been unearthed as a vital organ, controlling not only our digestion, but our immune system and even mood.

From depression to diabetes, asthma to cancer, obesity to anorexia, so influential is the microbiome that some researchers are calling it "the second brain".

Supermarket shelves are already heaving with probiotic smoothies and snacks, such as kombucha and kefir; next year, expect to see the arrival of gut-friendly ice cream and probiotic cleaning products.

The quest for a perfect balance of intestinal bugs seems set to be the next parental obsession.

Scientists are learning that children's microbiomes are particularly sensitive to external influences, and crucial to their long-term risk of disease.

Many believe that aspects of modern lifestyle - including the rise in caesarean sections, reliance on antibiotics, over-cleanliness and processed foods - distort the microbes in children's guts, thus driving health problems.

"A lot of experts believe the epidemic of allergies we're having is related to the gut microbiome being in a much worse state than it was 30 years ago for the average child," says Tim Spector, professor of genetic epidemiology at Kings College London and author of The Diet Myth. "Every parent really ought to know about this stuff."

Before the age of four or five, the microbiome is flexible, he explains. After this, it starts to resemble an adult's and becomes harder to tinker with.

"So there is this window where you can really mess it up with things like antibiotics, but also when it will really benefit from good foods and probiotics," he adds.

The moment a child is born - and their system exposed to bacteria for the first time - is particularly important. Studies have shown that those born by caesarean, for example, have different microbiomes that may raise their risk of health problems.

Last year, scientists reported that children born by C-section (with a third of births in the UK now carried out this way) were more likely to be obese by the age of five and have asthma by 12.

Experts think this could be because the first bacteria these babies are exposed to come from the mother's skin and the external environment, rather than those in the vagina - meaning their immune system doesn't get the same kick-start.

Then, there are antibiotics. Studies suggest as many as 80per cent of British children will be prescribed them in their first year, and while they are often necessary, there are fears that the drugs may have a profound impact on a child's microbiome, including raising the risk of resistance.

Dr Nigel Field, a UCL researcher whose Baby Biome Study is following 3,500 mothers and babies in Britain to map the links between children's gut bacteria and health outcomes, believes parents should be given more information about the potential pros and cons of antibiotic use.

"All babies born by caesarean, particularly elective, will effectively receive a slug of antibiotics, because the advice is to give them to the mother prophylactically to reduce the risk of wound infection, and they cross the placenta," he says.

"A mother may not always know or recall whether she was given them. I don't think there is a clear enough discussion with mothers about whether they want to prioritise the certain risk of an infection that could be treated later, or the uncertain long-term risk their baby might be more prone to asthma or other allergic conditions."

But whatever start a child has had, there are things parents can do to improve their microbiome.

There is growing interest in the idea of giving probiotics to babies to replace missing beneficial bugs, though the evidence is not yet clear. The practice of seeding - where microbes from a mother's vagina are swabbed and transferred to her newborn soon after a caesarean - is also gaining attention, but experts currently warn against it because of the unknown risks.

Unsurprisingly, breastfeeding is an excellent and safe way to get "good" bacteria flourishing.

An American study, published last year, found babies who were exclusively or mainly breastfed had microbiota most like their mothers'. "Along with the beneficial chemicals in breast milk, babies also pick up microbes from the mother's skin that they won't get from a sterilised bottle," says Prof Spector.

Hannah Doyle, author of The G Plan Diet and mother of twin sons, aged eight, says parents should focus on positive steps.

"You can't change what's happened in the past," she says. "My boys were born by caesarean and had more antibiotics than I would have wanted thanks to various infections. Breastfeeding is undeniably better for their microbiome, but it's hard. You have to be realistic and not beat yourself up. Remember, stress is also bad for the gut."

Doyle got interested in gut health four years ago and has made a conscious effort to widen her sons' diets. "We know that for a healthy microbiome, the key thing is a diverse diet with lots of plant-based foods," she says.

"I'm not holier than thou - given the choice, they would rather eat fish fingers and chicken nuggets and a lot of the time that's what they get. But I'll put some sauerkraut on the side, or make a miso dressing, or sneak something into their pudding - I'll make a smoothie with kefir, or pour it on their ice cream. It tastes like natural yogurt. I've also got them on to kombucha. Like all kids they love fizzy drinks and think it's really exciting."

She gives strong cleaning products a miss. "A bit of dirt is good. We also try to avoid antibiotics: I'm pro conventional medicine, but I ask the doctor: can we wait another day? "Can I take the prescription and see how they get on? It may be chance, but neither of them has needed antibiotics for three years now."

Doyle stresses that nourishingchild's be a fun foods, rather Parents tend to a budget, fussy eaters.

your child's gut should way to try new food than a chore. "Pa be busy, on with fuss "S t"So rather than restricting anything, I think - what can I add that's easy and tasty? It's another weapon can use to them the start in life."

FIVE WAYS TO BOOST YOUR CHILD'S GUT HEALTH

1 Fibre, fruit and vegetables are best for a healthy gut. Naturally probiotic foods, which encourage the growth of good bacteria, include onions, garlic, asparagus, artichokes, lettuce, green bananas, tarragon and chives. The additives in junk food can kill good bacteria.

2 Fermented foods and drinks increase the diversity of microbes. If your children squirm at sauerkraut and kimchi, try cheese and yogurt. Kefir and kombucha drinks are spreading from health food stores into supermarkets.

3 Don't m rgies.sterilise everything a baby touches. Exposure to dirt helps develop a strong immune system. A recent study found mothers who suck their child's dummy clean are helping to protect them against allergies. Let your children roll in the mud, pick things up off the floor, and play with animals. "You could be doing them more harm always washing their hands," says Prof Spector.

4 As many as one in 10 GP prescriptions for antibiotics are given to patients who don't need them. "We need to move away from the idea of antibiotics having no down side," says Prof Spector. "There's definitely evidence you're the them having more allergies and getting fatter."

5 If your child does require antibiotics, a probiotic supplement can help recover good gut bacteria. This may also be helpful after diarrhoea - though there's not enough evidence to recommend taking them when in good health. "If you can get your children used to the tastes of yogurt and kefir that's very useful," says Prof Spector. "It's a natural probiotic, which has more microbes in it, and is probably safer and better."

'The gut microbiome is in a much worse state than it was 30 years ago'

Food supplement Zenflore is available over the counter and is good for your brain as well as your gut

A daily probiotic pill could be the key to a happy mind as well as a healthy gut, according to new research.

The food supplement named Zenflore has become one of the first ‘psychobiotics’ available over the counter.

Traditionally, probiotics containing live bacteria and yeasts have been thought to be good for the gut.

Bur they have now been linked to a sense of happiness and a boost in brain power.

Breakthrough research carried out in Ireland three years ago found that bacterial culture bifidobacterium longum 1714 can increase activity in the areas of the brain associated with emotions, learning and memory.

In clinical trials, human guinea pigs taking the bacteria reported being less stressed and anxious.

Zenflore was then created wth the same bacterial strain by Cork-based company PrecisionBiotics.

Director Dr Eileen Murphy said: “We know people are interested in natural options to help them cope with everyday stress.

Doctors warning as antibiotic-resistant super-gonorrhoea on the rise in the UK[https://www.dailyrecord.co.uk/news/uk-world-news/doctors-warning-antibiotic-resistant-super-13820078]

“The gut-brain axis and more particularly the microbes within the brain-gut axis is one of the most exciting areas of research.

“Indeed, new research is showing that the gut bacteria may play a role in regulating stress responses.

“We have tested Zenflore in placebo-controlled clinical studies in people with everyday stress and we are very encouraged by the results.

“The gut has been called the second brain - there are multiple connections between the gut and the brain including via the vagus nerve.

“The gut produces more than 90 per cent of the serotonin found in your body - this is a neurotransmitter that can affect your mood and feelings of happiness and pleasure and research has shown that gut bacteria can impact its production in the gut.”

DR Victoria Manning, a 46-year-old GP, started taking Zenflore following a gallstone operation at the end of July.

Dad had no idea he was adopted until council worker let it slip by mistake[https://www.dailyrecord.co.uk/news/uk-world-news/dad-no-idea-adopted-until-13819613]

She said: “I’m one of these people that worries about everything and I used to take beta blockers to help me calm down as I would get palpitations but since I’ve been taking Zenflore I’ve not had to take them.

“I do feel calmer since I started taking Zenflore, previously I would feel anxious and nervous but the butterfly effect has calmed down.

“My sleep has also improved - previously I was waking up once or twice a night. Now I just sleep and I have more energy.

“Come 10pm I am ready for bed.

“I believe Zenflore treats the root cause rather than serving as a sticking plaster.

“Treating the gut as a primary cause of health problems makes sense to me. “

The findings of the clinical trial were published in 2016 in the Journal Translational Psychiatry.

Advice at NHS Direct states: “There’s some evidence that probiotics may be helpful in some cases, such as helping prevent diarrhoea when taking antibiotics, and helping to ease some symptoms of irritable bowel syndrome.

“But there’s little evidence to support many health claims made about them. For example, there’s no evidence to suggest that probiotics can help treat eczema.

“But for most people, probiotics appear to be safe.

“If you want to try them, and you have a healthy immune system, they shouldn’t cause any unpleasant side effects.”

Top news stories from Mirror Online

Ask most parents about their child’s digestive habits[https://www.telegraph.co.uk/health-fitness/body/tummy-troubles-how-to-improve-your-digestive-health/], and they’ll probably say they already know quite enough.

But it’s starting to look like nurturing a healthy gut is the single best thing you can do for your offspring’s future health. Over the last decade, the gut[https://www.telegraph.co.uk/beauty/body/looking-gut-could-transform-health/] – or rather the 100 trillion microbes living inside it, known as the microbiome – has been unearthed as a vital organ, controlling not only our digestion, but our immune system and even mood. From depression to diabetes, asthma to cancer, obesity and even anorexia, so influential is the microbiome that some researchers are calling it ‘the second brain’.

Supermarket shelves are already heaving with probiotic [https://www.telegraph.co.uk/health-fitness/nutrition/diet/probiotics-really-useless-time-give-good-bacteria/] smoothies and snacks, such as kombucha and kefir; next year, expect to see the arrival of gut-friendly ice-cream and probiotic cleaning products. The quest for a perfect balance of intestinal bugs seems set to be the next parental obsession.

Scientists are learning that children’s microbiomes are particularly sensitive to external influences, and crucial to their long-term risk of disease. Many believe that aspects of modern lifestyle – including the rise in Caesareans, reliance on antibiotics, over-cleanliness and processed foods – are distorting the microbes in children’s guts, thus driving health problems.

“A lot of experts believe the epidemic of allergies [https://www.telegraph.co.uk/health-fitness/nutrition/deal-dairy-milk-allergies-rise-500pc-do-dairy-better/] we’re having is related to the gut microbiome being in a much worse state than it was 30 years ago, for the average child,” says Tim Spector, professor of genetic epidemiology at Kings College London and author of The Diet Myth. “Every parent really ought to know about this stuff.”

Five ways to boost your child’s gut health[https://cf-particle-html.eip.telegraph.co.uk/8a59f791-e51d-4385-95f0-8528167cd4d3.html] Before the age of four or five, the microbiome [https://www.telegraph.co.uk/health-fitness/body/gut-feeling-home-microbiome-test-offers-glimpse-healthier/] is flexible, he explains. After this, it starts to resemble an adult’s and becomes harder to tinker with. “So there is this window where you can really mess it up with things like antibiotics, but also when it will really benefit from good foods and probiotics,” he adds.

The moment a child is born - and their system exposed to bacteria for the first time - is particularly important. Studies have shown that those born by Caesarean[https://www.telegraph.co.uk/news/2018/10/11/caesareans-now-used-one-four-uk-births-major-new-report-reveals/], for example, have different microbiomes that may raise their risk of health problems. Last year, scientists reported that children born by C-section (with a third of births in the UK now carried out this way) were more likely to be obese by the age of five and have asthma by 12.

Experts think this could be because the first bacteria these babies are exposed to come from the mother’s skin and the external environment, rather than those in the vagina – meaning their immune system doesn’t get the same kickstart.

Then, there are antibiotics[https://www.telegraph.co.uk/antibiotics/] . Studies suggest as many as 80 per cent of British children will be prescribed them in their first year, and while they are often necessary, there are fears that the drugs may have a profound impact on a child’s microbiome, including raising the risk of resistance.

Dr Nigel Field, a UCL researcher whose Baby Biome Study is following 40,000 mothers and babies to map the links between children’s gut bacteria and health outcomes, believes parents should be given more information about the potential pros and cons of antibiotic use.

“All babies born by Caesarean, particularly elective, will effectively receive a slug of antibiotics, because the advice is to give them to the mother prophylactically to reduce the risk of wound infection,” he says. “A mother may not even know that she is being given them.

“I don’t think there is a clear enough discussion with mothers about whether they want to prioritise the certain risk of an infection that could be treated later, or the uncertain long-term risk their baby might be more prone to asthma[https://www.telegraph.co.uk/science/2018/08/20/warning-tripling-asthma-cases-children-return-school/] or other allergic conditions.”

But whatever start a child has had, there are things parents can do to improve their microbiome.

There is growing interest in the idea of giving probiotics to babies to replace missing beneficial bugs, though the evidence is not yet clear. The practice of seeding – where microbes from a mother’s vagina are swabbed and transferred to her newborn soon after a Caesarean – is also gaining attention, but experts currently warn against it because of the unknown risks.

Unsurprisingly, breastfeeding is an excellent and safe way to get ‘good’ bacteria flourishing. An American study, published last year, found babies who were exclusively or mainly breastfed had microbiota most like their mothers’.

“Along with the beneficial chemicals in breastmilk[https://www.telegraph.co.uk/breastfeeding/], babies also pick up microbes from the mother’s skin that they won’t get from a sterilised bottle,” says Prof Spector.

Hannah Doyle, author of The G Plan Diet and mother of twin sons, aged eight, says parents should focus on positive steps.

“You can’t change what’s happened in the past,” she says. “My boys were born by Caesarean and had more antibiotics than I would have wanted thanks to various infections.

How to keep your gut happy[https://cf-particle-html.eip.telegraph.co.uk/830cced9-42e5-4d36-85dc-a0328abceaf1.html] “Breastfeeding is undeniably better for their microbiome, but it’s hard. You have to be realistic and not beat yourself up. Remember, stress is also bad for the gut.”

Doyle got interested in gut health four years ago and has made a conscious effort to widen her sons’ diets.

“We know that for a healthy microbiome, the key thing is a diverse diet with lots of plant-based foods[https://www.telegraph.co.uk/food-and-drink/features/seven-shades-green-type-vegan/],” she says.

“I’m not holier than thou – given the choice, they would rather eat fish fingers and chicken nuggets - and a lot of the time that’s what they get. But I’ll put some sauerkraut on the side, or make a miso dressing, or sneak something into their pudding – I’ll make a smoothie with kefir, or pour it on their ice cream. It tastes like natural yoghurt.

“I’ve also got them onto kombucha. Like all kids they love fizzy drinks and think it’s really exciting.”

She gives strong cleaning products[https://www.telegraph.co.uk/news/2018/02/15/household-cleaning-products-bad-lung-function-smoking-study/] a miss. “A bit of dirt is good. We also try to avoid antibiotics: I’m pro conventional medicine, but I ask the doctor: can we wait another day? Can I take the prescription and see how they get on? It may be chance, but neither of them have needed antibiotics for three years now.”

Doyle stresses that nourishing your child’s gut should be a fun way to try new foods, rather than a chore.

“Parents tend to be busy, on a budget, with fussy eaters. So rather than restricting anything, I think - what can I add that’s easy and tasty? It’s another weapon you can use to give them the best start in life.”

It all started with trail mix.

Naturopath Lupa Irie of Lupa's Kitchen is a student of natural remedies. After learning that sprouting seeds, nuts and grains would make their nutrients more accessible, she was inspired to sprout buckwheat and pumpkin seeds and mix them with coconut flakes, raisins and other ingredients to make a trail mix she called Morning Glory. Sprouted buckwheat seeds plus cinnamon, currants, dried apple slices, walnuts, chia seeds and goji berries became a mix she named Ray of Life.

She sold her mixes at local farmers markets and then at health food stores. Irie had been brewing kombucha since the 1990s, so she soon added that to her product mix, then sauerkraut.

"We use traditional food preparation techniques, just as our ancestors did," Irie said. "These methods make the nutrients in our food more accessible." Her motto, printed on each package, is "Therapy Through Food."

Daughter Claire, who joined her mom in 2013, said: "I wanted to see my mom achieve her dream. I said, 'Let's see what we can do in a year.' This has always been a passion for her. Starting Lupa's Kitchen was never about creating a business. It was about sharing her passion with other people."

That one year has stretched to six. The trail mixes have been in Whole Foods Market stores since 2013. The original two flavors soon were joined by two more, Maple Bliss and Tropical Paradise. But the kraut and kombucha were available only at farmers markets.

Then, twoyearsago, theydecided to make their kombucha available commercially, and, later in January, Lupa's Kitchen will become the first Georgia company offering kombucha in cans. It will be available in raspberry, ginger turmeric, passion fruit and hibiscus.

"We're very excited about the canned kombucha, which we introduced at Bonnaroo this year," Claire Irie said. "The cans are easily recyclable, easy to transport, and the kombucha still tastes great. You can take it to places you can't take glass, like parks and music venues."

Lupa's Kitchen brews, sprouts and mixes inside a small commercial building in the shadow of the Doraville MARTA station.

There are just three people on the team:the Iries and Cessy Lopez. The kombucha brewing room is lined with 30-and 50-gallon stainless steel fermenters. In the back of the room is a nursery for all the scobys needed for the week's production. ( "Scoby" is an acronym for "symbiotic culture of bacteria and yeast," and is the living host for the bacteria that turn tea and sugar into kombucha.)

"Kombucha is a living organism, and we really do find it enjoys a calm environment," Lupa Irie said. "We tell them 'good morning' when we come in. We really notice a difference in the way the kombucha tastes, and how it reacts, if we're stressed when we start a new batch."

There's a separate room for soaking and drying the seeds, nuts and grains that go into their trail mixes. "People don't realize it takes 48 hours to make our Maple Bliss mix," Clairesaid. "Thewalnutsandpecans are germinated, then dehydrated, then we add the flavors and dehydrate again.The germinating really makes a difference. If you taste the nuts after we're done, you'll find there's a liveliness and crispness that wasn't in the raw nuts."

For each batch of sauerkraut, Lupa hand slices the 40 pounds of cabbage, using a large wooden mandolin. "I like really thin strands, and this is the way to control that," she said.

The strands are sprinkled with salt as they go into one or more of the 5-to 20-gallon crocks the family has collected in its years of fermenting vegetables. Lupa uses a 24-inch-long kraut pounder to press the mixture in the crock until the cabbage is covered with a brine that forms from cabbage juice and salt. Then, the kraut is left to ferment, which turns the cabbage into a probiotic-rich cultured vegetable.

It's a business they've truly built by hand, but the Iries are quick to credit many people for helping along the way, including those who allow them to maintain flexible second jobs. Lupa works as a private chef, Claire as a catering captain, and they jointly teach classes on healthy eating.

They also give special thanks to the late Richard Thomas of R. Thomas Deluxe Grill in Buckhead. "Richard was the first person in Atlanta to give us a shot," Claire said. "He put our Morning Glory on his weekly deliveries of products to local health food stores.We would not be where we are without Richard."

An Alpine health clinic in Austria cured years of discomfort and left me feeling like a new person

'Time for a comfort break!" My companions around the conference table, after a long morning's brainstorming fuelled by bad coffee, biscuits and pastries, looked up gratefully as they took their leave. None, however, as grateful as me and none (hopefully!) would have realised how accurate a description this was. I'd been shifting in my seat uncomfortably for at least an hour, trying at once to ease my increasingly intense tummy pain and cover up the gurgling noises it was emitting. This was not an isolated incident more the stomachcrampingly sweet icing on a particularly indigestible cake.

For several years, abdominal pain, bloating and fatigue have become my own particular brand of norm. A GP identified my symptoms as irritable bowel syndrome (IBS), and prescribed healthy eating and a balanced approach to work and home life. Easier said than done. While psychologically I thrive on busyness and a managed level of "healthy" stress, even eating puritanically healthily (largely vegetarian meals, limited caffeine and alcohol, snacking on fruit) invariably made the pain worse, a depressing cycle that would have me reaching for the ham and cheese baguettes before a fortnight was up.

Thanks to thriceweekly gym classes, I was fitter and stronger than I'd been since having children nine years ago, yet my complexion was grey and puffy, my waistline distinctly blurred, and even when I felt at my most relaxed, family and friends would ask me why I was "edgy".

The tipping point for me was when a friend regaled me with talk of her transformative health kick and I burst into tears at the realisation of how bad I felt. And so I did something I'd always mentally filed under "for the rich, bored and spoilt": booked myself into a hotel hundreds of miles from home in the pursuit of wellbeing.

"Selfcare is healthcare" my friend Tracey reminded me by text, as I boarded the plane to Innsbruck, Austria, wondering what I was letting myself in for. "You're doing this for them," my husband reassured me, as I phoned home during my airport transfer, my children's reproachful farewell faces still fresh in my mind. "Maybe this won't be so bad after all," I thought, as I inhaled my first breath of soft pinescented mountain air.

But my first impression of Lanserhof a luxury modernist bolthole nestled into a Tyrolean mountainside was dismay. In the inviting dining room, people were eating! What about the fasting I'd come here for? My confusion continued through the first evening. Emerging from my cocoonlike bedroom (harmoniously designed hardwoodandwhitelinen interiors, stateoftheart fixtures, fullheight windows overlooking pine forest vistas and a roof terrace for soaking up the alpine rays), I was shown to my seat (guests are allocated a place, the idea that you focus on chewing, not chatting) and served a superhealthy but definitely solid threecourse meal.

The next morning, my regeneration started in earnest. After a medical examination and analysis (I do love an analysis) each guest is given a programme based on the six pillars of modern FX Mayr therapy: rest; purification; awareness; integration; sports and soul. A holistic healthover that you can continue at home.

My programme comprised an array of detoxifying treatments: massage, reflexology and steam wraps, alongside daily Kneipp and cryotherapy sessions, and analytics combining natural healing techniques with the latest medicine and nutritional insights, working alongside optional group classes such as Pilates, yoga, talks on gut health and earlymorning walks nature is central to the Lanserhof approach and this forest power walk is a wonderful way to wake up.

Food or lack thereof punctuates the day (and your mind), with appointments with supplements (Epsom salts to start the day, Basenpulver alkaline powder three times a day, bitters before you eat). Clear vegetable soup is served from 10am to noon to great excitement ("It's savoury! It's salty! It's not tea!"). Oh yes, the tea. Tea is a big deal at Lanserhof. Myriad varieties are available from selfserve stations around the clock. It's delicious and I couldn't get enough of it apart from during soup time, of course (and mealtimes you're not allowed to drink half an hour before or after).

As it turned out, I was allowed food breakfast (a menu of carbohydrate "chewers" and spread) and lunch (jacket potato and the same choice of spreads). No dinner. Each mouthful is to be chewed 3040 times to encourage saliva to aid digestion. For the first couple of days, this feels very odd. After that, it's addictive (if not very sociable).

The days that followed were full of discoveries. Not eating in the evening was surprisingly easy. And once I'd got through day three, when my caffeine/ histamine/sugar withdrawal symptoms gave me the worst headache I've ever suffered (it turns out there is a supplement to cure that), I woke up hungry but full of energy.

Tested for intolerances, I found I have offthescale fructose malabsorption (no wonder my fruitful healthy eating plan always failed). Dairy protein and gluten are not my friends either. The puffiness? Histamine intolerance (look it up: it's everywhere). Onions and garlic were once the bedrock of my home cooking not any more! And while calories are no longer the focus of healthy eating, it turns out on a good day I can only burn 1,500 of them. No wonder then, that during my short stay I averaged weight loss of 1lb a day.

After 24 hours, I had the feeling of being able to stand up straight the first time in years I'd not been cowed by internal discomfort. After 36 hours, a fellow guest proclaimed I looked like "a different Claire". I certainly felt like one. The tea and easily digested food along with the nightly application of a hot water bottle eased rather than irritated my insides. My tummy deflated like a balloon. I felt light in body and in spirit. After five days, I knew it had changed my life.

Lanserhof Lans was the original Lans Med clinic. It's now one of three resorts and has been renovated and extended to meet demand. Many of my fellow guests had been before, some returning two or three times a year. Talk was always of debilitating diseases their stays had cured diabetes, cirrhosis, colitis. There were whispers of even more serious ailments that had been reversed. Ten days out of life and several thousand pounds out of pocket is difficult to justify. But if it gives you the rest of your life back, it's a small investment in your future.

Thanks to the Energy Cuisine plan, continuing the good work when you leave is straightforward, if not easy. I've reintroduced some histamine and fructose gradually. Cookery lessons mean you know what to look out for when you shop if your lifestyle doesn't allow for daily baking of buckwheat bread. And as Dr Georg told me, "it's impossible to overeat if you chew correctly". Alcohol is now a weekly treat, not a daily pickmeup. Intermittent fasting by eating two meals a day is easier than you think my husband and I now do it Sunday to Friday.

Herbal tea, not so much. There are only so many shopbought bags one can take. Get me back to Lanserhof, danke schõn. Seven nights at Lanserhof Lans (0049 8022 18800; lanserhof.com) from €4,305 (£3,883), based on single occupancy in a double room.

WHY IS GUT HEALTH SO IMPORTANT?

Gastrointestinal health problems so prevalent in our timepressed, highstressed, processed lives are not just about digestive issues, but can be the root cause for other physical and mental health issues. Bowel problems can mean you're more likely to suffer from autoimmune diseases, depression and anxiety. Symptoms of poor gut health include abdominal pain, bloating after meals, reflux, or flatulence, but also less obvious ones, such as headaches, fatigue, joint pain, and immune system weakness.

Time to try something different? Today's retreats offer everything from detox to yoga, mindfulness and 'mud rituals'

The best destination spas range from space-age fantasies to gleaming temples of self-care, staffed by spiritual teachers and body workers who bring a lifetime of learning, wisdom and time-honoured tools to preserve mind, body and soul.

If you're looking for a serious detox/weight-loss programme, then northern Europe, particularly Germany and Austria, are your best bet. Generally speaking, India, Thailand, Sri Lanka, Bali and Vietnam are still the spiritual home of yoga, meditation and the more mindful aspects of wellness.

We are all living longer, but it's now about healthspan - and the smart money is on spa programmes promoting longevity via prevention, diagnosis and early detection.

This isn't old-fashioned pampering.

It's about self-preservation to try to combat our modern, sedentary and anxiety-filled lives.

Here's my pick of the best.

DETOX AND WEIGHT LOSS

1 BOLLANTS SPA, GERMANY

The great outdoors informs everything at this family-run resort in the forested Jugendstil park, from private jetties and segregated nude bathing in the wildlife garden to a yoga terrace on the river, plus meditation and woodland walks. Acupuncture and Nian massage continue natural detoxing. Naked bodies doing aquagym quickly become the norm.. Rooms from £117 (0049 6751 9339; bollants.de)

2 FX MAYR, AUSTRIA

Expect targeted fasting via a highly personalised programme, the FX Cure, devised by physicians and therapists to bring together nutrition, movement and treatments. This means small portions, simply prepared food such as buckwheat rolls, sheep's milk yogurt, creamy soups and mindful, even silent, stress-free eating - as they say, optimal digestion begins in the mouth. The centre itself is far from spartan: rooms feature blond wood, big windows and lake views.. Rooms from £158 (0043 4273 25110; original-mayr.com)

3 YEOTOWN, DEVON

This retreat balances activity with plant-based food and holistic treatments. Cosy eco cottages with wood burners may suggest holing up, but the five-day Yeotox is a back-toback itinerary of coastline hiking, outdoor circuits, archery, sea

WHY I L OVE… ACUPUNCTURE

Trisha Andres, wellness expert Granted, it's not the most relaxing of spa therapies but this evidence-based treatment does wonders for my back that no deep tissue massage can accomplish. Knots and pains gone! Besides that, I feel energised after a session.

kayaking, wild swimming and surfing. The emphasis is firmly on the positive - taking control of your physical and mental health. Action is counterbalanced by meditation, massage, Epsom salt baths and mindful vinyasa flow yoga.. Four-nights from £1,950 (01271 343803; yeotown.com)

4 LA RESERVE, FRANCE

St Tropez va-va-voom backed by Swiss science, Nordic walking along the Côte d'Azur and a personalised better-ageing Mediterranean menu add up to highly effective programmes based on the medical expertise of the Nescens brand. Daily two-hour guided walks (with an extra hour and personal training on the five-day programme) are integrated with beautiful bespoke spa treatments, including better-ageing body massage.

Rooms from £769 (0033 4944 49444; lareserve-ramatuelle.com)

5 AYURVEDA PARKSCHLOSSCHEN, GERMANY

An Indian ayurvedic retreat with German rigour is a force to be reckoned with: holistic therapies and a diet tailored to individual doshas for improved digestion. The liver detox programme recognises this organ as the body's detoxifying centre, counteracting depleted energy caused by overwork, alcohol, unhealthy food, insufficient sleep and stress with liver-cleansing, massage and veggie or vegan diet.. Rooms from £193 (0049 6541 7050; ayurveda-parkschloesschen.de)

6 RANCHO LA PUERTA, USA

Set up 78 years ago by Deborah Szekely, who is now 96 and still working at the property and lecturing weekly, the ranch is spread over 4,000 acres (1,620 hectares) of sun-scorched wilderness. The range of fitness activities and group classes is vast, and there's something for everyone (from salsa to Pilates and the more obscure pickleball - a paddle sport that combines elements of badminton, tennis, and table tennis). However, it's the hikes that you should come for - three, five or seven-milers that take you up sheer, sun-bleached mountain paths, or among scrubby flatlands at the base of Mount Kuchumaa.

Seven nights from £3,075 (001 800 443 7565; rancholapuerta.com)

7 VIVA MAYR ALTAUSSEE, AUSTRIA

These top Alpine medics follow the renowned detox programme that FX Mayr developed nearly 100 years ago, believing that all ailments stem from a dysfunctional intestine. Swallowing healing and cleansing local Glauber salts and magnesium citrate encourage good gut activity (golden rule: don't venture far from a loo) and address sluggish liver, high cholesterol and stress eating. As they say: "Weight loss isn't our aim, it just happens." But there's a softer side, too - aerial yoga, lake hikes, mountain climbs and soulsoothing views.

Rooms from £162 (0043 3622 71450; vivamayr.com)

8 BUCHINGER WILHELMI, GERMANY

With intermittent fasting now advocated by many gut specialists for biome brilliance, this monastic clinic on Lake Constance is where founder Dr Otto Buchinger devised his fasting method a century ago to cure his rheumatoid arthritis (physios and osteopaths are on hand to tackle niggles such as back pain). Vegetable broths, juices, herbal teas and laxatives are the only things to pass your lips, progressing from seven to 10 days. Take your mind offfood with yoga, hiking, meditation and music: you'll feel slimmer and energised on departure.. Rooms from £381 (0049 7551 8070; buchinger-wilhelmi.com)

NATURE HIT

9 BAWAH RESERVE, INDONESIA

An archipelago marine conservation area where you can kayak over coral, snorkel in a turquoise lagoon or explore the rainforest and view a 2,000-year-old tree - such island adventures even come with complimentary daily yoga, coconut scrubs and massages. Visit the huge conch-shell-shaped Aura spa, where rose-scented facials mingle with garden of deep calm massage and snooze-inducing foot mapping. Feast on barbecued seafood, vegetarian nasi goreng and soba noodles.. Rooms from £1,577 (0065 6322 3132; bawahreserve.com)

10 BURGENSTOCK, SWITZERLAND

Alpine nature is the star here, with sumptuous steam baths, panoramic saunas, hot tubs and 95F (35C) outdoor infinity pools, as well as an Alpine eco pool with variable temperature; ideally, follow a dip with a treatment using wonderful Susanne Kaufmann products, inspired by Alpine nature. Medical consultations precede cryotherapy, biotherapy, fasted training and Bürgenstock colour cuisine to create your nutritional profile. Opt for a Chalet room - a modern symphony of stone and walnut with lake views from the luxe double bathtub.

Rooms from £201 (0041 41 612 6000; buergenstock.ch)

11 BABYLONSTOREN, SOUTH AFRICA

The eight-acre garden at one of the Cape's most beautifully preserved Dutch farms is surrounded by Franschhoek's mountains, with neat rows of vegetables, orchards and butterflies, as well as donkeys and tortoises. The newly extended Garden Spa, with lap pool and whirlpool tub, is set among sunlight-dappled greenery and is full of herbs freshly picked from the garden. Enjoy the water ritual in the hammam, body wraps, bespoke facials and massages, some using bamboo rollers to smooth away tension.

Rooms from £267 (0027 21 863 3852; babylonstoren.com)

12 CAPELLA UBUD, INDONESIA

This fanciful tented retreat is set in an emerald rainforest above Bali's sacred Wos river, backed by shimmering rice paddies. There may be dimpled teak floors, ultracomfortable beds and hotel-standard bathrooms, but nature is up close and personal: the magical dawn chorus of tropical Balinese birds as the sun creeps across the forest floor is hugely healing. The jungle is interwoven into The Cistern outdoor rainforest pool, treatments are local, skilled and have a spiritual touch. Gung-ho guests can take part in jungle boot camps, mountain bike tours and paddy field workouts.. Rooms from £668 (0062 36120 91888; capellahotels.com)

13 CHABLE MAROMA, MEXICO

This nature-centric spa in a tangle of Yucatan jungle is mystical: huge, twisted trees, fireflies, iguanas and massive Lilliputian leaves. Centred around a spring-fed cenote, believed by the Mayans to access the underworld, Chablé oozes spirituality; a temazcal ceremony promises to shake offany bad karma. Even during treatments, nature is just beyond the windows, and guests can make their own herbal compresses from seedpods and camomile.

Rooms from £775 (0052 99838 70044; chablemaroma.com)

14 SAN LUIS, ITALY

Soaring mountains may seem enough of a nature hit, but why not take things to a new level by staying in a luxury treehouse with private sauna or lakeside chalet with secluded hot tub? The Italian mountains, dense pine forests and lake provide instant serenity, with more conscious immersions in nature via forest therapy: barefoot walking, hikes and lake swimming. Inside the wooden spa, open fires and black slate bring a stunning aesthetic. Gertraud Gruber products are out of this world.

Three nights from £810 (0039 04732 79570; sanluis-hotel.com)

15 NIHI SUMBA, INDONESIA

Adventurous types will relish the 90-minute hike through the jungle to the resort's off-grid spa, which is perched on a cliffoverlooking the Indian Ocean. Half-day or full-day spa packages offer unlimited treatments spanning blissful hair smoothies and Lulur body exfoliation to facials using coconut oil, mint leaf and green tea picked from the island. Treatment rooms are open-sided and surrounded by towering palm trees. The private beach cove is a blissful spot to relax.. Rooms from £602 (0062 3617 57149; nihi.com)

16 RUDDING PARK, NORTH YORKSHIRE

One of Harrogate's health-giving natural springs feeds directly into Rudding Park's award-winning rooftop spa and garden, which impresses with myriad facilities including herb-infused saunas and steam rooms, experience showers and relaxation areas. Swim outside in the heated hydrotherapy infinity pool or kick back in the open-air whirlpool next to the garden sauna. Treatments include kombucha facials, Rasul mud

WHY I LOVE… FACIALS

Jade Conroy, deputy hotels editor There is nothing more pleasurable than giving my face an hour of unadulterated attention: a draining massage, detoxifying scrub and blemishbusting mask. The glowy effects of a decent facial should last for up to two months. The best I've had was at Les Sources de Caudalie, a vinotherapy spa in Bordeaux.rituals, thermal detox wraps and beauty therapy. On warm days, the spa garden is a lovely spot for meditation.. Rooms from £203 (01423 844822; ruddingpark.co.uk)

DOCTORS IN THE HOUSE

17 SOUKYA, INDIA

Overseen by Dr Issac Mathai, Soukya is rated as the best holistic health centre in India (which is perhaps why the Duchess of Cornwall has stayed here). The centre treats people from more than 90 countries using natural healthcare systems such as Ayurveda, naturopathy (both excellent for detox and slowing accelerated ageing) and homoeopathy, plus 30 other treatment therapies. There's also an emphasis on helping women to achieve balance.. Rooms from £155 (0091 80280 17000; soukya.com)

18 CLINIQUE LA PRAIRIE, SWITZERLAND

Since 1931, CLP has been a pioneering (and eye-wateringly expensive) five-star medical retreat, combining innovative cell therapy with holistic wellness and Swiss hospitality. The reputation of the medical team is second to none, with 50 doctors and two operating theatres, as well as detailed medical testing followed by advice on ridding the body of toxins. Views of the Swiss Alps and Lake Geneva make this an ideal spot for recuperation; aerial yoga, Pilates and power walking are just some of the activities on offer. A stay here is worth it for those who can afford it.

Two nights from £3,264 (0041 2198 93311; laprairie.ch)

19 LANSERHOF TEGERNSEE, GERMANY

Guests flock to Alpine-pretty Lake Tegernsee for the LANS Med Concept: a top-notch clinic for a serious reboot.

Based on the Mayr Cure, combining intestinal cleansing with rest (tea-andwater), detoxification (no sugar, alcohol or raw food) and training (chewing thoroughly), individualised meal plans optimise digestive function. There are also programmes for weight loss, detox and holistic health, mental training, movement therapy, preventative capsule endoscopy (a pill camera records your intestinal health) and gene and DNA testing.

Seven nights from £1,552 (0049 8022 18800; lanserhof.com/tegernsee)

20 SHA WELLNESS CLINIC, SPAIN

Looking like a giant intergalactic ship that has landed in a sleepy Spanish suburb, SHA offers a wide range of programmes and specialists. A standout is its Mind and Body unit, overseen by Dr Bruno Ribeiro, a neuro and clinical psychologist. Gadgets help manage a super-stressed mind (Vladimir Putin is reputed to have visited) by way of intensive on-screen tests including brain photobiomodulation to increase attention span and reaction time.. Rooms from £281 (0034 9668 11199; shawellnessclinic.com)

21 VILLA STEPHANIE, GERMANY

Personalised programmes are at the heart of this former royal residence in Baden-Baden. Dr Harry König, the in-house medic, is passionate about integrative medicine - encompassing the importance of the relationship between practitioner and patient and focusing on the whole person. There is a hotshot medical team here for a head-to-toe MOT, supreme detoxing and diligent diagnostics including everything from naturopathy, organ cell therapy, aesthetic skin rejuvenation and weight-loss programmes.. Rooms from £452 (0049 72219 00602; oetkercollection.com/destinations/villa-stephanie)

22 LEFAY, ITALY

Above Lake Garda, eco-friendly Lefay focuses on traditional Chinese medicine, and has a team of medical experts and therapists. Put yourself in the hands of senior therapist Teddy for a balancing tuina massage or moxibustion (hot ash applied to meridians). Activities include yoga, lakeside energy work via qi gong and tai chi or walks in the energy gardens, from the highly charged summer red phoenix to calm autumn white tiger.. Rooms from £262 (0039 03652 41800; lefayresorts.com)

23 PARK HOTEL IGLS, AUSTRIA

Igls is a serious detox and medical clinic. Like many in these parts, it follows the Mayr principle of gut health, good nutrition and exercise. Cutting-edge medical testing, alternative procedures and internationally renowned experts from Innsbruck's university hospital help the focus on preventative medicine. It also incorporates locally grown ingredients in its kitchen, gentle exercise in the surrounding countryside and personalised treatments such as hydrotherapy Kneipp treatments followed by hot abdominal wrap or liver compresses.. Rooms from £133 (0043 5123 77241; sporthotel-igls.com)

24 FITNESS FIRST 24 SIX SENSES KAPLANKAYA, TURKEY

Overlooking five beaches, Six Senses Kaplankaya is a fitness freak's dream: vast hi-tech gym, yoga studio, squash, tennis and basketball courts. It offers Bod Pod body density calculations (also used by Nasa), while Erkan Günes, the director of exercise physiology, offers an evaluation worthy of a professional athlete. Soothe aching limbs in the watsu pool or salt grotto. Re-opens in April.

Rooms from £345 (0090 25251 10030; sixsenses.com/resorts/kaplankaya)

25 CANYON RANCH, USA

Strenuous exercise in the Arizona desert may sound crazy, but this resort provides world-class facilities and top wellness experts offering weight loss and stress management alongside spirituality and kick-ass fitness. As well as metabolic exercise assessments and trainers to push you beyond your limits, you can crunch your abs, hike, bike, swim, go horse-riding, learn survival skills or try an underwater treadmill. That "can-do" American vibe has never been more inspiring.. Rooms from £869 (001 800 742 9000; canyonranch.com)

26 VERDURA, SICILY

This eco-conscious, family-friendly destination is a sporty spa dream, offering holistic personal training, Kneipp baths, sports massage, shiatsu, tennis, football, swimming academies and a championship golf course. The centrepiece stone-and-glass spa has WHY I L OVE… MUD BATHS Charlotte Johnstone, hotel reviewer My skin radiates after a Rasul mud bath. I love smearing the clays over my face, torso and legs before the steam chamber clicks on and allows my skin to absorb the nutrients, then the clay is washed offby "warm rain" from the ceiling. Bliss.

Thalassotherapy pools and a hammam. Enjoy watersports in the pool (one of Europe's largest). Even the food puts fitness first, with smoothies and energising cuisine.. Rooms from £216 (0039 0925 998001; roccofortehotels.com)

27 PREIDLHOF, ITALY

Fitness indoor and out is on tap at Preidlhof. As well as mountain hikes, vineyard trails and the use of a fleet of Vespas to explore the area, there are punishing indoor workouts: HIIT circuits, abs sessions and aerial rope workouts. For recovery, the spa tower has 16 steam, sauna and relaxation options with eucalyptus-scented and salt-infused heat rooms. Note though that the Gault Millau-starred restaurant could be too much of a temptation for some.

Rooms from £143 (0039 04736 66251; preidlhof.it)

28 AMANOI, VIETNAM

Turquoise sea, tropical forest and pink granite boulders form a backdrop to the stunning Amanoi, where 36 villas with pool decks attract birds and butterflies to your door. Exercise sessions take place around a magnificent lotus pool, with tai chi in the open pavilion. Spa facilities include a Russian banya or hammam. Once you've recharged those batteries, a sunrise hike via a cactus and wild flower-lined trail to Goga Peak, teeming with wildlife, is an unforgettable way to feel in touch with nature.

Rooms from £972 (0084 25937 70777; aman.com/resorts/amanoi)

29 CUGO GRAN, MENORCA

Surrounded by vineyards and with sea views, this country house is the setting for a four-day programme that kickstarts changes and sows the seeds for long-term wellness and contentment. Wellness experts have combined mindful movement experiences such as Pilates, yoga, barre, HIIT, cardio, stretch classes, meditation, massage and nutritionally sound menus. The programme is shaped by ex ballet dancer Chrissy Sundt, founder of the hotel's Silver Linings retreat.

Rooms from £271 (0034 6734 62309; cugogranmenorca.com)

30 MINDFULNESS MARVELS 30 FOUR SEASONS JIMBARAN BAY, INDONESIA

It's difficult to remain stressed around Bali's magical energy.

Go back to source with a psychic reading from the love guru, then a massage by a waterfall surrounded by tropical flowers. Tour the garden's 300 shrines and visit Goa Gong cave temple for an uplifting water purification ceremony with a Balinese healer.

Rooms from £553 (0062 3617 01010; fourseasons.com/jimbaranbay)

31 EUPHORIA RETREAT, GREECE Ex-banker Marina Efraimoglou retrained in traditional Chinese medicine (TCM) and has opened an architecturally stunning wellness retreat in the Peloponnese, fusing East and West TCM, theta healing with meditation and biomedicine

WHY I L OVE… SEEING RESULTS

John O'Ceallaigh, luxury travel editor Muscle mass, percentage fat, resting metabolic rate and weight - I love receiving proof I've improved them all, with doctoraccredited data, during my checkout consultation. Never mind wishy-washy talk about "transformational travel", a proper medispa break yields improvements that are incontestable.among more "out there" programmes. George Leon, the molecular nutritionist, offers his innovative test, looking at the influence of lifestyle on individual gene expression. But, as Marina says, the aim, ultimately, is to become your own healer.

Three nights from £592 (0030 27313 06111; euphoriaretreat.com)

32 VANA, INDIA

This destination spa has established itself as a world leader in mindfulness. Set in the Himalayan foothills, its wellness architecture - curved walls, floor-to-ceiling windows with forest views and decluttered vibe - is therapy in itself. The meditation programme does the rest. In addition to abhyanga massage and shirodhara, you'll be staring into candle flames during trataka or trying Tibetan meditation to tame the mind.. Five nights from £1,655 (0091 13539 11114; vana.co.in)

33 KAMALAYA, THAILAND

With a spa built around an ancient meditation cave and stressmanagement mentors who are former monks, Kamalaya offers a physical, spiritual and mental revolution as therapists, gurus, yogis and life coaches reset daily habits through breathing techniques, meditation, exercise and inspiring lectures. The Embracing Change programme restores balance in cases of grief, relationship issues and anxiety. And there's dream spa food from antioxidant-rich green power juices to spicy green mango and prawn salad.

Rooms from £228 (0066 0774 29800; kamalaya.com)

34 ROSEWOOD PHUKET

Asaya, the health retreat at Rosewood Phuket in Thailand, is where to find Steve - a straight-talking Glaswegian Ayurvedic doctor who has worked with a host of A-list celebs. He says: "We don't do detoxes here. The body knows how to detox itself." The aim instead is mindfulness around how, when and why we eat, drink, smoke or gobble up social media. Emotional Freedom Technique, kinesiology, yoga and Pilates combine with plant-based menus and aromatherapy massages.. Rooms from £557 (0066 7635 6888; rosewoodhotels.com/en/phuket)

35 YOGA BLISS 35 SEN WELLNESS SANCTUARY, SRI LANKA

Regarded as one of the world's best yoga retreats, Sen has a huge yoga shala overlooking lush treetops that can hold up to 30 people. Visiting yogis of the highest calibre offer a programme to release, detoxify and relax. Alignment is key, hence the personalised treatments from worldclass osteopaths, alongside Ayurveda specialists. And there's acupuncture to reset the body's meridians.

Rooms from £210 (020 7486 3373; senwellnesssanctuary.com)

36 ANANDA I N THE HIMALAYAS, INDIA

India is, of course, the ancestral home of yoga, and Ananda takes the practice very seriously, bringing every aspect of mind, body and soul into alignment. The comprehensive holistic five, seven and 14-night programmes cleanse and detox through asana (posture) and pranayama (breathing), while achieving physiological, psychological or spiritual goals. New yoga retreats for groups up to 15 people include morning yoga, afternoon meditation, talks, Ayurvedic therapy, and spiritual "kirtan" sessions.

Three nights from £1,770 (0091 12445 16650; anandaspa.com)

37 COMO PARROT CAY, TURKS & CAICOS

Yoga is intrinsic to this chic resort set on its own private island with a mile-long beach. Choose from daily classes and private yoga instruction, plus five-day yoga retreats with some of the world's most respected yoga stars such as Elena Brower. There's also Pilates, meditation, beach workouts and a low-level spa overlooking wetlands. In-experts give talks and one-to-one consultations, with treatments from massage to acupuncture.. Rooms from £955 (001 64994 67788; comohotels.com)

38 ES SAADI, MOROCCO

Yoga retreats with Yin yoga expert Camille Satya are an antidote to fast living - holding poses longer for better focus, sleep and digestion. Stays include two daily yoga sessions, detox juices and infusions, alongside "slow food". The uber-tech hair analysis from Phyto Paris is brilliant - while the rose and argan oil facial is sublimely pampering, using gorgeous La Sultane de Saba products.

Rooms from £270 (00212 5243 37400; essaadi.com)

39 GROTTA GIUSTI, ITALY

With an underground thermal cave and hot spring lake, the 19th-century Tuscan villa's two-night spa package includes floating therapy in the grotto's natural steam room or scuba-diving in the underground lake. But a big draw is thermal yoga: asanas practised in this naturally warm, mystical underground labyrinth amplify sensations and raise body temperature, allowing guests to benefit from the cave's vapours.. Rooms from £130 (0039 0572 90771; grottagiustispa.com)

40 SANTANI, SRI LANKA

Reconnect and slow down at newish kid on the block Santani, already picking up awards as one of the best natural hideaways in Sri Lanka. Retreats specialise in yoga, detox, anti-ageing and weight loss, with mountain-biking, trekking and kayaking. The vibe is harmonious; accommodation is simple. The seven-night yoga retreat is brilliant for newbies as its accessible all-rounder combines two daily yoga and meditation sessions, three spa treatments, diet plan, nutrition workshops and cooking classes.. Rooms from £574 (0094 1125 59755; santani.lk)

41 MENOPAUSE GRAYSHOTT, SURREY

The seven-day health programme at this classic country house - a diet of healthy fats, moderate protein and gentle fibre, along with fermented food and probiotics - focuses on restoring good gut function by addressing liver health, gut bacteria, sleep and stress management. This benefits women during peri-and menopause as good gut bacteria eliminate excess hormones, especially oestrogen - the cause of hot flushes, night sweats, abdominal fat, disrupted sleep, breast tenderness and anxiety. Book a cosy Manor House room in the old original part of the building.. Rooms from £320 (01428 602020; grayshottspa.com)

42 PALACIO ESTORIL, PORTUGAL

Head of the clinical team is "hormone king" Dr Manuel Pinto Coelho, whose anti-ageing programme has politicians, actors, celebrities and countless women of a certain age jetting in to cure hot sweats and flagging libidos via hi-tech medical diagnostic tests. Nutritional advice and alternative treatments address tiredness, stress and incontinence - the latter via a mix of massage, physio and weights to strengthen downthere from the inside out.. Rooms from £120 (00351 2146 48000; palacioestorilhotel.com)

43 PALACE MERANO, ITALY

Don't be fooled by the grandeur - Palace Merano is one of the world's most hi-tech spas. When taking part in the detox programme, many seek help with the menopause: hormones are analysed, along with hematochemical tests and the blood's fatty acid profile. Advice is given on supplements and hormonal imbalance, as well as increasing exercise, reducing meat and alcohol intake, with hydrotherapy and cupping for drainage and detox.Five nights from £1,623 (0039 04732 71000; palace.it)

44 THERMAL WATER 44 GRAND RESORT, SWITZERLAND Still the ultimate in world-class health resorts, the main draw is the healing thermal waters from the mountains above the Tamina Valley, piped directly into Bad Ragaz. The spa makes full use of these waters with public access thermal baths from 63F-102F (17C-39C); you can swim from the inside out to be greeted by stunning, life-affirming mountain views. There's also the Swiss Olympic Medical Center, for top-notch sports physiology.. Rooms from £458 (0041 0 8130 33030; resortragaz.ch)

45 LES PRES D'EUGE´NIE, FRANCE

The thermal springs at Euge´nie-les-Bains have long attracted those in search of healing. These days pilgrims are as likely to head to Pre´s d'Euge´nie for its many baths and showers, such as the diluvial hydromassaging thermal shower, which involves being showered by multiple jets of thermal water. Or how about a thermal Turkish bath or citrus milk lustral bath with essential lemon, grapefruit and orange peel oils. Clean and definitely serene.. Rooms from £243 (0033 05580 50607; lespresdeugenie.com)

46 THE RETREAT HOTEL, ICELAND

The ultra-luxe Blue Lagoon resort has a subterranean spa, geothermal lagoon, hotel and restaurant. But the lagoon's geothermal seawater is the real star, originating in volcanic aquifers 1.3 miles deep and circulating through layers of lava to cleanse and rejuvenate. In-water treatments include slathering your body with silica, algae and minerals for the ultimate in exfoliation and revitalisation, or donning a float suit to enter a womblike state.. Rooms from £1,029 (00354 420 8800; bluelagoon.com/accommodation/retreat-hotel)

47 GAINSBOROUGH BATH SPA, BATH

With its Roman-style pillars, this spa offers a contemporary take on an age-old tradition. A spa circuit includes dipping in three natural thermal pools of varying temperatures, saunas, steam room, thermal water fountain and ice alcove. Spa Village Bath integrates the thermal waters with personalised aromatherapy, award-winning Asian therapies and in-bathroom access to the thermal waters. Even yoga gets in on the act, with aquasana - suspended stretching enhanced with tai chi and karate to improve balance, mobility and flexibility.

Rooms from £285 (01225 358888; thegainsboroughbathspa.co.uk)

48 WHY I L OVE… HOT STUFF Rosie Green, columnist So simple, but warmth, whether an under-the-towel pad, hot stone or a steamed flannel, is deeply joyous and comforting.

WOMEN'S RETREATS 48 BORGO EGNAZIA, ITALY East of Monopoli on the coast of Puglia, the Tarant Women's Wellness retreat at Vair Spa, a hushed candlelit spa with female therapists in floor-length gowns, is said to enable women to express emotions and feel empowered. At the heart of Tarant is an ancient purifying Apulian dance, the tarantella. According to folklore, a tarantula bite sent a local woman half-mad and the villagers danced and sang with her and cured her. Today's retreat centres on this traditional rhythmic dance, a Mediterranean diet and personalised treatments with shared villas for emotional bonding. Selected dates throughout 2019.. Four nights from £2,822 (0039 08022 55850; borgoegnazia.com)

49 OCEAN SOUL, INDONESIA

Like-minded women come together for collective empowerment and encourage a more balanced life at this nurturing retreat in Bali. On the yoga retreat, guests rise with the sun for yoga followed by breakfast and surfing before massages and more chilled-out yoga sessions before dinner. Pilates happens in an open-sided sala; while sybarites sink into Bali bliss with positive change therapy, reflexology and healing.

Rooms from £516 (0061 4072 15854; oceansoulretreat.com)

50 KURHOTEL SKODSBORG, DENMARK

Denmark's oldest wellness hotel, a sanatorium-turned-spa, offers an ultra-cosy interior of reindeer-skin throws, log fires and candles, a corking spa with great therapists (book a Bioeffect facial) and prolonged sessions in the sauna followed immediately with dips in the bonechilling Baltic. Ex-pro handball player and alpha female Rikke Hoerlykke leads a fantastic female empowerment retreat, and what a role model she is - toning your mental attitude as much as your butt. The two of you will match your personal goals with a tailor-made workout to take home.. Rooms from £167 (0045 4558 5800; skodsborg.dk)

For a guide to what to consider before booking a spa break, see: telegraph.co.uk/tt-spa10 TOP T IP Do your homework: ask to book a call with the spa director or lead wellness director ahead of your stay, or book through a specialist tour operator that can call on its clients' numerous case studies.

The time is right to embrace personal change and refresh body, mind and spirit - for good

THE LIFE-ENHANCING POWER OF SPAS

If the chimes of the New Year brought about a sobering realisation that it's almost 20 years since the world prepared to party like it's 1999, then you'll likely be feeling flatter than a warm glass of Christmas fizz about now. Yeah, yeah, hey…

Traditionally this is the time of year for personal reflection, when bathroom mirrors up and down the land face an onslaught of resolutions: "Thou shalt not forgo the gym in favour of boxset marathons or covet thy children's mealtime leftovers."

Denying the frailties of human existence is so last century, yet the post-Christmas crash reminds us that we can't have it all. As another year gets under way and with a new decade looming, the world is consumed with finding a sustainable future for our Blue Planet. The clock is also ticking on embracing permanent personal change in a bid to live well for longer.

Whether it's a focus on gut health (p12) or improved fitness (p14-15), wellness - a buzzword with 17th-century origins - is the ultimate investment in tomorrow.

The best spas can also be life-changing in surprising ways, from overcoming a fear of water in Bath (p19) - where else? - to how a nature retreat helped shape a new perspective for Xenia Taliotis after the death of her husband (p17) - a reminder of what a privilege it is to still be shuffling around on this mortal coil.

As you make travel plans for the year ahead, a spa should be high on the wish list - as important as a week or two in the sun for shining light on a stress-free lifestyle. In 2019, it's time to celebrate and explore the wonder of you.

Caroline Shearing, hotels editor New spas for all seasons

SPRING

MONKEY ISLAND ESTATE, UK

Expectations are high for Monkey Island's floating spa - the first of its kind in the UK - which occupies a specially made canal barge (under construction) on the River Thames.

The experience is fashioned as a "voyage" rather than a "treatment", and guests are expected to leave feeling as fresh-faced as the crisp daffodils. The former priory's heritage is also brought into play: pastilles and homemade elixirs made with plants and herbs grown in the estate's Experimental Teahouse take inspiration from ancient recipes brewed by monks who inhabited the island 800 years ago.

Opens March; monkeyislandestate.co.uk

AUTUMN

ANANTARA QUY NHON VILLAS, VIETNAM

With three al fresco treatment pavilions, one overlooking the ocean, Anantara's Quy Nhon outpost makes the most of its tropical setting.

Emancipation from daily life kicks off with a series of programmes focusing on spiritual tranquillity and holistic health renewal. Signature treatments include chakra-balancing massages using crystal-infused oil blends and precious stones, and three-and-ahalf-hour full-body massages preceded with a coconut milk bath.

There's also a yoga and meditation deck for mindful reflection.

Opens January; anantara.com

WINTER

SIX SENSES PARO, BHUTAN Paro has a scenic, tranquil setting, surrounded by mountains, vertiginous rice paddies and the ancient ruins of Drukgyel Dzong. The focus is very much on psychological well-being, with group meditation, bathing rituals and holistic therapy on offer; plus an outdoor sauna and dipping pool and treatments from hot stone baths to Swedana therapy.

Opens May; sixsenses.com Charlotte Johnstone For more of the world's best new spa openings see: telegraph.co.uk/ tt-spas2019

SUMMER

LEFAY DOLOMITI, ITALY

An outdoor pool with soaring views over the forested valley sets the tone at this wellness-oriented eco-retreat. The nearby resort of Madonna di Campiglio is popular during winter, but summers are sublime, attracting nature lovers to its flower-filled slopes. Classes for stretching and releasing tension will soothe aching limbs in the excellent fitness centre, alongside stress-busting treatments and an array of saunas, steam rooms and pools, plus medical programmes. There are 88 alpine-chic suites; the best of which is the Royal Pool & Spa Suite, featuring private treatment area, two saunas, and indoor/ outdoor whirlpool tubs.

Opens summer; lefayresorts.com

CoreBiome, a University of Minnesota spinoff firm focused on rapid genetic analysis of communities of microorganisms, is being acquired for undisclosed terms by OraSure Technologies, the Pennsylvania-based maker of personal HIV tests and kits for securely transporting genetic samples.

The deal to acquire CoreBiome is expected to close within the next week for an undisclosed upfront cash payment, with the possibility of milestone payments based on future performance, OraSure executives said Friday.

The acquisition of CoreBiome and a separate deal, also announced Friday, to buy a Belgian firm called Novosanis is expected to add as much as $7 million to OraSure’s top line revenue this year, and dilute OraSure’s adjusted earnings by up to 5 cents per share.

“The global microbiome market is expected to grow by double digits, from approximately $325 million in 2017 to $725 million or more in 2022,” OraSure CEO Stephen Tang said Friday.

The CoreBiome deal will allow OraSure capture new market segments, he said.

In the health care context, a “microbiome” is a community of microorganisms that collectively contain far more genetical material than their host, potentially exerting invisible influences on health.

For example, changes in the microbiome of natural bacteria in the human gut are thought to contribute to a wide range of health issues, from health care-acquired infections to allergies to mental health. Gut research is ongoing in all of those areas and many more.

The same technology can be used to analyze microbial communities in agricultural and environmental research.

CoreBiome’s key offering is quick and accurate analysis and characterization of these human and nonhuman microbiomes. Current applications include gut-microbe science, drug-discovery research, soil-productivity enhancement, and food- and water-quality monitoring, CoreBiome’s website says.

“Our goal has been to accelerate discovery of microbiome-based solutions combining genomics and machine learning innovation to help customers leverage that big data and to make world-class microbiome expertise available on-demand,” CoreBiome CEO Dan Knights said in a U news release about the deal.

CoreBiome, founded in 2016 in St. Paul, is one of 140 companies that have been launched out of the U’s Venture Center, and the fourth to be acquired in 18 months, the U said in its announcement.

OraSure executives were tight-lipped about their future plans for CoreBiome’s technology — in part because CoreBiome is still an earlier-stage company and its capabilities are still being built. A spokeswoman also cited competitive reasons in declining to comment.

The announcement said CoreBiome’s offerings will “leverage” the sales and marketing resources of OraSure’s DNA Genotek subsidiary, which offers products for secure at-home collection of biological samples like saliva and gut microbes for genetic analysis.

Joe Carlson • 612-673-4779

An 11-year-old boy who died on New Year’s Day after visiting family members in Brooklyn may have had a fatal reaction to fish proteins released into the air while his relatives cooked.

The sixth grader, Cameron Jean-Pierre, had asthma and was allergic to fish and peanuts, his father, Steven Jean-Pierre, said on Thursday in an interview[https://abc7ny.com/parents-speaks-out-after-boy-dies-from-smell-of-cooking-fish/5004794/] with WABC.

They had been visiting Cameron’s grandmother in the Canarsie neighborhood of Brooklyn, where one of his relatives was making fish, and Cameron had an asthma attack, Mr. Jean-Pierre said.

Cameron’s father treated his son with a nebulizer, a device they had used many times in the past to deliver medicine to the boy’s lungs.

At first, it seemed to work, he said. But then Cameron’s condition worsened and the family called for an ambulance.

“He said, ‘I feel like I’m dying,’” his father recalled. “I said: ‘Don’t say that! What are you talking about? Don’t say that.’”

Cameron’s father said he tried to do CPR, but by the time emergency workers arrived, the child was unconscious and unresponsive, the police said. Emergency workers brought him to Brookdale University Hospital and Medical Center in Brooklyn, where he was pronounced dead.

“My son’s last words were ‘Daddy, I love you, daddy, I love you,” Mr. Jean-Pierre told WABC. “He gave me two kisses. Two kisses on my face.”

Cameron’s mother, Jody Pottingr, suggested to WABC that the fatal reaction might have occurred when Cameron and his father returned briefly to the apartment to retrieve a forgotten item, at a time when his relatives thought the boy was gone. The family could not be reached for comment on Friday.

The New York City medical examiner is performing an autopsy as part of its investigation, a spokeswoman for the office said on Friday, adding that the results might not be released for weeks.

While the cause of death has not yet been determined, experts say Cameron’s combination of asthma and allergies could have been to blame.

“We would fully expect the coroner’s report will end up identifying this as a death from asthma induced by an airborne allergen,” said Dr. Robert A. Wood, a professor of pediatrics and the director of pediatric allergy and immunology at Johns Hopkins University School of Medicine.

It wasn’t the smell of the fish that would have produced the allergic reaction, experts said, but the proteins released by the cooking process.

Fish cooked on a stove could have sent steam and proteins into the air, causing an allergic reaction that would have set off Cameron’s asthma, Dr. Wood said. Cooking fish in an oven, however, would be unlikely to release proteins into the air, partly because the fish would be cooked at a lower temperature.

Hypersensitivity reactions after the inhalation of food particles are an “increasingly recognized problem in children,” according to a report[https://www.ncbi.nlm.nih.gov/pubmed/24992548] in the journal Allergy and Asthma Proceedings.

“Usually, respiratory manifestations include rhinoconjunctivitis, coughing, wheezing and asthma, but in some cases even anaphylaxis” — a severe, potentially life-threatening reaction — “has been observed,” the report said.

For patients who experience a respiratory reaction to a food, such as coughing, hoarseness or wheezing, epinephrine is considered the drug of choice.

“Albuterol and other asthma medications are less likely to be effective,” Dr. Wood said.

Allergies to fish and peanuts like the ones Cameron had are some of the most common allergies[https://www.foodallergy.org/about-fare/blog/eight-percent-of-us-children-have-food-allergy-pediatrics-study-finds] in the United States.

Peanut allergies rank first, followed by allergies to milk, shellfish, tree nuts, eggs and fin fish.

Although these allergens affect millions of children[https://www.foodallergy.org/sites/default/files/2018-04/FARE-Food-Allergy-Facts-Statistics.pdf], severe reaction to airborne foods is “extraordinarily rare,” Dr. Wood said, and fatal reactions are even more rare.

“Severe and fatal reactions to foods usually occurring by ingestion almost exclusively occur in patients who have asthma,” he added.

Cameron attended school in Piscataway, N.J., where the family had been living for the last two years, Mr. Jean-Pierre told WABC.

Teresa M. Rafferty, the superintendent of Piscataway Township Schools, said in a statement on Thursday that Cameron was “a good student and a positive and happy presence in the classroom.”

“Our crisis management procedures and counselors are in place to help our students through this tragedy,” she added.

A GoFundMe page[https://www.gofundme.com/cameron039s-homegoing] gathering donations for Cameron’s funeral described him as “the best son anyone can ask for” with a personality that “always lit up the room.”

“His untimely demise is one that we will never understand,” the page said, “but we ask that God carries his loved ones with a sense of peace through this tragedy.”

Susan Beachy contributed research.

* Life-Threatening Allergic Reactions Rising in Children[https://www.nytimes.com/2018/04/09/well/family/life-threatening-allergic-reactions-rising-in-children.html]

* Can You Develop Food Allergies at Any Age?[https://www.nytimes.com/2017/08/04/well/eat/can-you-develop-food-allergies-at-any-age.html]

* Could You Be Allergic to Additives in Food or Drugs?[https://www.nytimes.com/2017/11/07/well/eat/could-you-be-allergic-to-additives-in-food-or-drugs.html]

* Probiotics and Fish Oil During Pregnancy May Curb Allergies in Kids[https://www.nytimes.com/2018/03/07/well/family/probiotics-fish-oil-pregnancy-eczema-food-allergies-breastfeeding.html]

* New Product Is First to Claim It May Reduce Peanut Allergies[https://www.nytimes.com/2017/09/14/well/family/new-product-is-first-to-claim-it-may-reduce-peanut-allergies.html]

Deadlifts and six-packs alone are so 2018 – here’s how to find balance and boost your emotional and physical health

“Just try,” Francis says.

“No.” I dangle listlessly from the monkey bar.

“Just one,” he tries again, his palm flat to my mid-back. “I’ll help you.”

I imagine him employing the same tone with his toddler. “I don’t want to!” I spit out, petulantly. I jiggle my legs impatiently, “I want to get down.” Francis smiles. “OK, no worries.” He steps back and I jump to the floor.

Later, at the end of our workout session, he tilts his head sympathetically. “Why wouldn’t you have a go earlier?” I explain that I knew, categorically, that I wouldn’t be able to “heave my bulk over that stupid bar”. That I didn’t have the necessary strength to perform a chin-up, and that I already felt like an idiot – so why add fuel to that fire?

He gives me homework. “Tonight, when you’re in bed about to sleep, close your eyes and breathe through your nose; spend 10 minutes just breathing – lengthening your inhales and exhales – and thinking about which muscles are involved in a chin-up. Imagine those muscles working.”

Francis is a trainer at The Foundry, a swanky gym in London, where I’ve been a member (semi-committedly) for about two years. We are three weeks into my “holistic transformation”, an eight-week programme that is meant to start me on a path towards not just better physical health, but stronger emotional and mental health. As the gym’s cofounder Dave Thomas explains: “Improving your physique can improve your health, both mentally and physically, but it can also have the opposite effect. Being healthy is a much more complex state than having a six-pack.”

Embracing that complexity is about to become one of the biggest trends in the fitness industry. Jessica Harman of forecasting agency WGSN, tells me that in the past year, “the fitness industry has shifted focus from the performance, strength and shape of our bodies to our wellbeing and mental health”. Last year, Re:Mind became London’s first meditation studio[https://remindstudio.com/] – where for £22 a time, dedicated “calmers” guide you through sessions of “energising breathwork”, or encourage you to “focus on good intentions”. In the summer, boutique studio Frame[https://moveyourframe.com/] launched an initiative to educate its members about how different styles of movement impact on mood; new gym Mindset[https://www.mindsetfit.co.uk/] opened with an express focus on mental health, and the aim of helping gym-goers overcome “emotional barriers” through fitness; while Barry’s Bootcamp[https://www.theguardian.com/global/2018/apr/01/shape-of-the-future-how-barrys-bootcamp-changed-the-way-we-work-out] partnered with HUMEN, a charity that works [https://workforgood.co.uk/about/charities/view/humen] to improve men’s [https://workforgood.co.uk/about/charities/view/humen] mental health[https://workforgood.co.uk/about/charities/view/humen].

Feeling positive and excited about what you’re doing is just as important as results

“Brands like Equinox fitness club have integrated mindfulness practices into classes as well as employing sleep coaches for members,” says Victoria Buchanan, a researcher at trend forecasting agency The Future Laboratory. High-street gyms like Fitness First have taken up the mantle; last year they partnered with grassroots athletics organisation RunTogether[https://runtogether.co.uk/], working to support initiatives such as #RunAndTalk[https://runtogether.co.uk/running-support/runandtalk/] – which aims to improve mental health through running.

The programme I’ve signed up for promises to “transform my body and mind” – leaving me fitter, more motivated, less stressed. In real terms, this means I get personal-trainer-guided workouts (“We’d like you to train five times a week,” Francis says, at which I snort with laughter), nutritional advice (the first piece of which is to cut out one cup of coffee a day) and talks on managing stress. As well as creating a fitness programme for me, Francis checks in on my emotional and mental wellbeing at each session. It’s much cosier than the “abs first, questions later” approach that used to be the norm. The course is not cheap, but it’s easy to apply the same approach to your own regime (see panels below).

To start with, I often feel frazzled – tired, overwhelmed, distracted. As Francis points out, I have a tendency to lose focus halfway through an exercise (or even a sentence). “These are all things we can work on,” he says, soothingly. We discuss goals; I tell him I want to look like a Kardashian[https://www.theguardian.com/lifeandstyle/kim-kardashian] – curvaceous but thin, toned but grabbable. “That’s great,” he says and then disregards completely. “I think our first goal is to do a chin-up.” He points out that looking like a Kardashian is counterproductive, as “it’s not an action you can physically take”. Which is how I end up lying in bed three weeks later, meditatively focusing on my biceps and latissimus dorsi (the back muscles used in a chin-up).

Our workouts consist of three sessions of resistance training a week, with increasingly heavy weights, mixed with one or two cardio sessions. They’re always group-based (for the weights sessions, there are just three or four of us; for cardio, it’s more like a class, with around 12 others). Despite the group element, after the first week or so, each resistance workout is tailored to my mood or tiredness level. This is “nourishing movement”. “There has to be an element of enjoyment,” Thomas says. “Feeling positive and excited about what you’re doing is just as important as results. If you’re slogging through, you’re not getting the emotional benefit of exercise.”

Francis doesn’t take every session, but WhatsApps me most days – often about fitness and food, or sometimes just to ask how I am. The cynic in me knows that it’s all part of a service, but it’s encouraging to have the attention. The idea is to offer an impartial and nonjudgmental ear; he’s not a therapist and doesn’t purport to give me solutions to my personal problems, just the opportunity to chat if I want to. In fact, some therapists argue that talking while moving can foster a greater sense of openness – it’s less confronting than sitting opposite someone (whether therapist or friend) – while the endorphin rush and self-esteem boost you get from achieving a fitness goal could make it more likely you reach your emotional epiphanies. Well, that’s the theory. I don’t love discussing my feelings at the best of times, but especially not when I’m halfway through a squat.

Even walking for 10 minutes is better than nothing, especially if you’re outside

Instead, through the weeks, Francis concentrates on correcting “negative self-talk” (“let’s not say ‘heave my bulk’ any more, shall we?”) and thought patterns that, he theorises, are holding me back. “You focus on all the possible negative outcomes. From now on, when you’re in the gym I don’t want you to think about whether something might go wrong.” As well as meditative tasks, he sets homework for me, which includes talking to some of the other people who have signed up for the transformation (“a sense of community will help to keep you motivated,” he explains) and “spending some time on grass”. (“Like running?” I ask. “Yeah, or just walking, or hanging around. Just be outside on the grass for an hour if you can.”) Being in a natural environment, even if it is just a local park, he points out, may help me feel more clear-headed and less stressed.

I work on that chin-up until my arms become sore and my hands are calloused, but often get frustrated. “It’s not a ‘limiting belief’, it’s just a fact of nature,” I say at the end of my first month, no closer to getting my chin over the bar. I find it difficult to do five sessions each week, but do manage three – and I go outside every day, regardless. As Francis points out, “Even walking for 10 minutes is better than nothing, especially if you’re outside.” As the weeks go on, I find I’m drinking less alcohol (an unconscious choice, but since I’m committing to 7am gym sessions, a few wines seem masochistic). My quasi sobriety, combined with the exercise, means I’m also sleeping better. One morning, around six weeks in, I reach over to stop my 5.50am alarm and realise I’m actually looking forward to the session.

In the past, I had always thought of exercise as correcting a mistake: “I’m going to run because I ate five doughnuts yesterday.” Today, I want to exercise because I know it’ll be fun and because moving feels good.

It’s a much gentler way to transform than any I’ve tackled before, and by the end of the eight weeks, I feel less frazzled. I’m not a whole new person, but I do feel good; optimistic, even. I can deadlift more than my body weight, and – as of just a few days ago, I can do one chin-up. Jumping down from the monkey bars, I feel a frisson of pride. I look back on the work it took to get here (the early mornings, the hours of training, the meditative breathing) and allow myself to bask in the achievement. I turn and grin at Francis, who smiles and says: “OK, let’s try for two.”

The experts’ guide to… clearing your mind

Start small In his book Stick With It: The Science [https://www.amazon.co.uk/Stick-Science-Behaviour-Sean-Young-ebook/dp/B071WWSP2Y] Of Lasting Behaviour[https://www.amazon.co.uk/Stick-Science-Behaviour-Sean-Young-ebook/dp/B071WWSP2Y], psychologist Dr Sean Young breaks lifestyle changes down into dreams (long term), goals (medium term) and steps (short term). If the dream is to get fitter, then the goal might be to run 10k in the next three months, and the first step to get off the bus a stop early and walk the rest of the way. Each step should be small enough that it takes fewer than two days to accomplish. Stimulating the brain’s reward system every two days has been shown to keep us motivated over a longer period.

Reframe anxiety Dealing with chronically high cortisol levels might be the single most impactful thing you can do to improve mental and brain health. From altering our emotional responses, to impairing memory[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3753223/] and decision-making abilities, chronic stress physically ages brain tissue[https://www.bbc.co.uk/news/health-40610339]. Next time you’re feeling stressed, try telling yourself you’re actually excited. Physically, excitement and stress are very similar (sweaty palms, butterflies, pounding heart) and, according to researchers at Harvard Business School[https://www.hbs.edu/faculty/Pages/item.aspx?num=45869], this simple linguistic switch could be more effective than consciously trying to “calm down”.

Sit up straight Research shows[https://www.sciencedirect.com/science/article/pii/S0005791616301719] that adopting an upright posture (back straight, shoulders pulled back but relaxed) can, over a day, make someone with mild depressive symptoms feel significantly more positive, less tired and less introspective. The University of Auckland study looked at 61 people with mild to moderate depression and found that good posture was associated with higher self-esteem.

Exercise with others A 2017 study[http://jaoa.org/article.aspx?articleid=2661140] by the New England College of Osteopathic Medicine found that group exercise over 12 weeks improved emotional wellbeing by a quarter and reduced stress levels by the same amount. The same psychological benefits were not seen in those who exercised alone.

Piggyback on other habits According to a study from University College London[https://www.ucl.ac.uk/news/2009/aug/how-long-does-it-take-form-habit], it takes 66 days to form a habit. Behaviour-change psychologist Dr Aria Campbell-Danesh[https://www.dr-aria.com/], who goes by Dr Aria, recommends tagging your first small steps on to things you already do each day. “If your ritual is to make a cup of tea at 3pm, go for a five-minute walk beforehand. That’s 25 minutes more movement each week – an amazing start if your resolution is to get fitter.”

Cycle to improve memory As Dr Aria explains: “ Analysis of four decades of studies[https://www.sciencedirect.com/science/article/pii/S0006899310007547] found that cycling improves our brain’s ability to store and retrieve memories, both during and after cycling, whereas only a small improvement was found after running.” Results lasted well after the exercise was completed – the cumulative effect of a weekly bike ride could be impressive.

Take up resistance training to protect your brain This could mean deadlifts and squats in the gym, 10 press-ups at the end of a run or even carrying bags of heavy shopping – just make sure your muscles are moving against resistance at some point each day. Researchers from Rush University[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2838435/] Alzheimer’s Disease Center followed 900 people in a Chicago retirement community over four years. They found that those with greater muscle strength were significantly less likely to experience cognitive decline.

Eat Greek The Mediterranean diet has been consistently linked[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684076/] to a lowered risk of everything from coronary heart disease to numerous types of cancer. Recently, it has also been used to treat people with depression. “In one Australian study[https://foodandmoodcentre.com.au/media/smiles-trial/], a dietician encouraged people to eat Mediterranean-style,” explains Dr Brendon Stubbs, a clinical lecturer at the Institute of Psychiatry at King’s College London. “Half of the 67 participants switched to this diet, alongside their regular treatment [of psychotherapy, antidepressants or both] while the other half continued with their normal diet and antidepressant treatment. At the end of 12 weeks, those who’d switched their diets had a bigger reduction in depression symptoms.”

The experts’ guide to… boosting your body

Be kind to yourself Helen West is one of the dieticians behind The Rooted Project[https://www.therootedproject.co.uk/], a website that aims to dispel myths around food and nutrition. She recommends focusing on the positive steps taken, and not on the things we want to change. “Weight is not a behaviour – so it’s counterproductive to focus on it. Focus on actionable things, like eating more fruits and vegetables, finding a way to sneak more movement into your days, and trying to get more sleep.”

Try HIIT As we get older, our cells’ ability to create energy declines. However, a study by doctors at the Mayo Clinic[https://www.cell.com/cell-metabolism/fulltext/S1550-4131(17)30099-2] (a US-based medical centre) involving 72 participants across two age groups, found that high-intensity interval training (HIIT) not only halted but reversed this trend, boosting cells’ ability to generate energy by 69% in those between 65 and 80 years of age, and by 49% in younger individuals (18-30 years). You could start by alternating three minutes of fast walking and three minutes of slow walking for 30 minutes or more, four times a week.

Make time for recovery If you do decide to start a new, intensive gym regime, remember the importance of recovery. “Overtraining can cause inflammation, which has been linked to everything from cancer[https://scienceblog.cancerresearchuk.org/2013/02/01/feeling-the-heat-the-link-between-inflammation-and-cancer/] to depression[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542678/],” says The Foundry’s Dave Thomas. He advises wearing a tracker such as a Fitbit when you sleep, to work out your average resting heart rate. “If, the morning after you’ve trained, your resting heart rate is noticeably above normal – by 10-15bpm or more – it means you haven’t yet recovered and shouldn’t train that day.”

Move like a centenarian Turns out, though, that the secret to long life might not be down to how much you exercise, but to how much you move. In his study of what he called the world’s Blue Zones (areas such as Ikaria in Greece[https://www.theguardian.com/world/2013/may/31/ikaria-greece-longevity-secrets-age] where inhabitants regularly live past 100), writer Dan Buettner found that those who were healthiest in old age “live in environments that nudge them into moving every 20 minutes or so”.[https://www.bluezones.com/2016/08/diet-exercise-dont-work/] Walking, gardening or even just getting up at regular intervals were enough to keep Blue Zone-dwellers healthy throughout their lives. According to researchers at Maastricht University in the Netherlands[https://www.sciencedaily.com/releases/2013/02/130213173127.htm], low- to moderate-intensity movement spread throughout the day is associated with significantly improved insulin levels, compared with doing just an hour of intense exercise.

Hack your circadian rhythm “There are some fairly basic steps you can take to make sure that you’re not delaying the production of melatonin – the hormone that makes us sleep,” says Dr Mithu Storoni, author of Stress Proof[https://www.mithustoroni.com/]. “Having a big breakfast and an early, light dinner can help you sleep better, because food and digestion delays the onset of melatonin.” Equally, exercising in the morning rather than the evening, and making sure that your bedroom is between 18 and 21C will mean you’re more likely to drift off – warmer temperatures may disrupt our ability to fall into an REM sleep.

Cut down your eating hours Restricting meals to an eight-hour period (and having 16 hours of “fasting”) will help lower insulin levels and cause your body to start burning its fat stores. “This whole process is excellent news for brain health,” explains dementia specialist Dr Jamie Wilson. “Reducing insulin levels can have an impact on your generation of amyloid beta, one of the harmful proteins that have been linked to Alzheimer’s. 10am to 6pm are the usual hours, but it’s flexible.”

Add ferments to every meal A healthy and diverse[https://www.theguardian.com/lifeandstyle/2017/nov/06/microbiome-gut-health-digestive-system-genes-happiness] microbiome (the ecosystem of bacteria in our intestinal tract) is thought to improve our immune system and guard against everything from heart disease to depression. “Adding probiotic foods such as natural yoghurt, sauerkraut, kimchi, kefir and miso to every meal has been shown to increase the diversity of our gut bacteria,” says Storoni. “And, according to a meta-analysis of data published last year, this not only helps with general wellbeing, but also reduces feelings of anxiety.”

The experts’ guide to… nourishing your soul

Experience something awesome In his studies[https://www.theguardian.com/film/2018/nov/08/magic-medicine-review-mushrooms-robin-carhart-harris] into the impact of psychedelics on patients with depression, Dr Robin Carhart-Harris of Imperial College London noticed an interesting phenomenon. “After the treatment, people became more appreciative of nature and reported feeling more ‘connected’. They no longer felt isolated.” If half a tab of acid all seems a little too 1969, Carhart-Harris argues that just experiencing awe could have a similar effect – “by challenging our self-involved viewpoints and giving us a sense of perspective on our problems”. One way to do this is to write the story of a time you felt in awe of nature – according to a study at Stanford University Graduate School of Business[https://www.bauer.uh.edu/mrrudd/download/AweExpandsTimeAvailability.pdf], this quick task increased participants’ sense of wellbeing, as well as their willingness to give to charity; it even made them feel like they had fewer time pressures. The key is to understand yourself as a small part of a vast, living system – for that, nothing beats being outside in nature. A day trip to a forest, or an evening gazing at the vast night sky at a local observatory may be more effective than an indoor writing task.

Be grateful The words “gratitude journal” may make you cringe, but regularly writing a list of things you’re grateful for has, in one randomised control trial[https://www.ncbi.nlm.nih.gov/pubmed/12585811] , been shown to foster a deep and lasting sense of contentment. “The act of writing with a pen seems to be important,” says Dr Aria. “But this weekly 20-minute task saw participants’ moods improve.” In fact, eliciting the emotion of gratitude, even just once a week, led to a 28% reduction in perceived stress.[https://health.ucdavis.edu/welcome/features/2015-2016/11/20151125_gratitude.html] Each entry should be specific – “I’m grateful that my partner brought me tea in bed this morning,” rather than “I’m grateful for my partner” – and you should reflect on what it was about that moment that made you feel particularly good. During the task, participants reported falling asleep more easily and sleeping, on average, for 30 minutes longer each night.

Join a tennis club According to a study of more than 800 people[https://bmjopen.bmj.com/content/6/2/e010164.full?sid=8cb77b19-ec32-4851-ae68-b533dc25294a] (who were followed for the first six years after they retired by researchers at the University of Queensland), being a member of a club (of any kind) is associated with an increase in reported quality of life. Another study, by US researchers, who followed more than 8,000 people in Denmark for a period of 25 years, found that being a member of a tennis club was particularly beneficial; it conferred almost an extra 10 years of life[https://www.forbes.com/sites/stevensalzberg/2018/09/17/want-to-live-longer-take-up-tennis/#6e21d08c301b], compared with people who did not exercise (in comparison, indoor exercises like running on a treadmill conferred only one and a half extra years). The difference, the researchers theorised, was the element of “play”.

Find your meaning A sense of purpose, a passion or a thing, person or place that gives our life meaning has been shown to help guard against a number of health conditions. One wide-ranging Japanese study[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771589/] followed 3,000 people for an average of 13 years and found that men who reported having a greater sense of purpose were significantly less likely to die of a stroke or cardiovascular disease. One study asked participants[https://contextualscience.org/publications/through_the_windows_of_the_soul_a_pilot_study_usin] to spend a week taking photographs of all the most meaningful things, places and people in their lives. At the end of the week, they compiled all the photographs, and reflected on them. The result was that each participant had a stronger idea of their life’s purpose and reported a greater feeling of meaning and contentment.

• If you would like to make a comment on this piece, and be considered for inclusion on Weekend magazine’s letters page in print, please email weekend@theguardian.com[mailto:], including your name and address (not for publication).

Not even superfoods are immune to trends, and adaptogens look to be the hot health food in 2019. Alex McClintock reports that these supplements and other ingredients will be appearing soon on a smoothie menu near you

If you thought we reached peak superfood in 2018, think again.

Wellness-industry insiders say Instagram is driving an increasingly competitive search for new health foods and speeding up the turnover of trends, so if anything, you can expect to see even more exotic ingredients in your smoothies in 2019.

“It's weird to say, but the primary way we find new products is through Instagram," says Erin Baric, co-owner of the Simple Kitchen, a paleo-inspired Toronto café with a dizzying list of superfood-enriched cold drinks and lattes. “Influencers, especially from the States, are catapulting these ingredients into the public eye."

And with the exploding Instagram wellness scene firmly fixated on the idea of food as medicine, it seems like the new year's biggest ingredients will be those that purport to offer benefits for both mental and physical health.

Leading the pack are what's known as “adaptogens," supplements said to help the body adapt to stress and fatigue. These include plants, herbs and mushrooms used in Ayurvedic and traditional Chinese medicine, often ground into a powder and added to drinks.

“It's time for adaptogens to go mainstream," says Desiree Nielsen, a Vancouver-based dietitian and the host of The Urban Vegetarian on Gusto. “It's a new wrinkle in the idea of functional foods; using traditional powders and dusts to boost drinks and recipes in a way that goes beyond the basic nutritional benefits."

Other adaptogens include cordyceps, a caterpillar fungus said to combat fatigue; maca, a Peruvian root with purported libidoboosting effects; and chaga mushroom, which may reduce stress. However, Jennifer Sygo, Toronto dietitian and the author of Unmasking Superfoods, sounds a cautionary note about jumping on the adaptogen bandwagon: “I think adaptogens are intriguing, but are we going to reach a point five years from now where they're put in a pile with a bunch of other herbs, where the reliability is questionable, you don't know the appropriate dose and the research that would tell us that isn't great? I suspect so."

For her part, Sygo says one of the biggest shifts will be toward environmental accountability in health foods, a trend Nielsen also identified. If so, products such as chaga mushrooms harvested in Quebec and Vancouver-produced spirulina could be the next big things. “It's great to say that some berry from the jungle is good for you," Sygo says. “But if you're destroying the jungle to get it or transporting it thousands of miles with a huge carbon footprint so you can get your antioxidants, that's not the most appropriate way to get your nutrition." ASHWAGANDHA The biggest star among adaptogenic ingredients, ashwagandha is a plant that has been used in Ayurvedic medicine for thousands of years. Usually consumed as a powder made of roots and leaves, it can be mixed into milkshakes or lattes to hide its pungent and bitter flavour.

“I am an ashwagandha superfan," Nielsen says. “I've been using it for over a year now and it has helped me manage stress and improved my gut health, but it tastes terrible."

Other users report it helping with pain, inflammation and anxiety. Sygo, however, has mixed feelings.

“I tend to feel that if something has been used for that length of time there's probably a reason.

The issue is that there are very few good clinical trials and it's very difficult to ensure the product you're getting is high quality."

MCT OIL “Remember when everyone was crazy for coconuts? That has really boiled down to something called MCT oil," Baric says.

If you haven't heard of medium-chain triglyceride oil yet, you will in 2019. Extracted from coconut oil, it's the superstar ingredient of the ketogenic diet scene, where it's most often used in cooking or added to coffee.

Advocates say it can promote weight loss, enhance mental clarity and even help treat epilepsy, but Sygo isn't totally sold.

“If you just take MCT oil, you're not necessarily going to get all the benefits you might from a ketogenic diet, which, by the way, also needs to be tested with research."

MACADAMIA MILK In the seemingly ever-expanding universe of plant-based milks, expect to see macadamia milk appearing at a café near you in 2019.

“It started with almonds and soy, but now you can milk anything," Baric says. “The sky's the limit in the nut world."

As with MCT oil, the popularity of macadamia milk has been driven by keto dieters, who prize it for being low in carbohydrates.

But it's also a favourite of baristas, who appreciate its silky texture and lack of bitterness.

Macadamia milk is a source of minerals and hard-to-find omega-7 fatty acids, which may have anti-inflammatory effects. Sygo does point out that, for the full healthy effect, you're probably better off eating the whole nut, which contains all that plus fibre and protein.

More vegetables. Improved gut bacteria. Cocktails with less alcohol.

Many of the predictions about what we’ll eat and drink in 2019 point to a quiet, restorative and potentially grim time ahead. Then again, these forecasts always arrive carrying the clean, healthy pine scent of New Year’s resolutions.

The good news: There will be cheese tea. And salad robots, according to the prognosticators.

As we pored over dozens of lists handicapping the next big food trends, and interviewed the people who get paid to drill into consumer behavior, we kept in mind that everyone could be dead wrong. Food forecasting is not a science[https://www.nytimes.com/2016/12/27/dining/food-trend-predictions.html], or even an art. Still, the game is a fun one.

Here are some of the most intriguing guesses at what and how Americans will be eating in the new year.

The Next Lettuce

The great romaine scare of 2018 — a strain of E. coli that was eventually traced[https://www.nytimes.com/aponline/2018/12/13/health/ap-us-med-lettuce-outbreak.html] to a reservoir in California — has helped make lettuce ripe for a new star in 2019. The current darling of the restaurant salad, Little Gem lettuce, was denounced this month[http://www.grubstreet.com/2018/12/bad-dining-trends-2018.html] as overexposed by New York magazine’s restaurant critic, Adam Platt.

Expect to see little-known varieties showing up on menus, and an explosion in lettuces grown hydroponically, many of them in urban container farms[https://medium.com/neodotlife/vertical-farming-paul-gauthier-76e81ace79d0]. Some chefs are rallying around celtuce[https://www.supermarketnews.com/consumer-trends/10-food-trends-2019/gallery?slide=1], a lettuce with a leafy, bitter top and a stalk that’s kind of a cross between celery and asparagus. Chinese cooks know it as wosun. Even wild weeds like dandelion greens or sorrel may get a shot. Whichever wins, kale is still over.

The New Flavor Profile

Sour and funky, with shades of heat. This is what happens when you mix the interest in fermenting with the millennial palate. Melina Romero, who has the title of trend insights manager at CCD Helmsman[https://www.ccdhelmsman.com/], a food research and product development firm in Emeryville, Calif., explained the generation that loves global mash-ups and bold flavors[https://www.foodservice-snacks-desserts.com/productsandbrands/industrynews/snacking-the-world-in-their-hands?gclid=EAIaIQobChMIsraS5p6d3wIVAo3ICh2BqQ5LEAMYASAAEgKQAvD_BwE] this way: “They grew up with Flamin’ Hot Cheetos, and while they still want spicy, I think, beyond that, they have grown to become interested in flavors that are acquired — sour flavors and even funky flavors like fermented foods.”

The Thing You Will Try Against Your Better Judgment

Cheese tea, an import from Taiwan, will hit the American mainstream this year. Green or black tea is sipped through a cap of cream cheese blended with cream or condensed milk, which can be either sweet or slightly salty. It’s already a hit[https://www.nbcbayarea.com/news/local/Steap-Creates-San-Francisco-Twist-on-Cheese-Tea-456722743.html] in San Francisco, where they make it with Meyer lemon and mascarpone.

The Big Health Fix

Anything to do with your gut flora. That means you can expect more ways to ingest probiotics and prebiotics and foods designed to improve the bacterial health of your intestinal tract, according to several grocery store chains[https://www.krogerstories.com/krogers-top-food-trends-for-2019/] and wellness market analysts. As the obsession with digestive health dovetails with the fascination for fermenting, kimchi, sauerkraut and pickled things will work their way into new territory. Smoothies with kefir will be popular, and kombucha will show up in unexpected places like salad dressings.

The Hot Diets

Diets that emphasize fat over carbohydrates will continue to dominate. Instagram says video posts using the hashtag “keto” — the name of a high-fat, low-carb diet — grew fivefold over the past six months. Hannah Spencer, a registered dietitian who tracks the food service industry for the market research company Mintel[http://www.mintel.com/], said the keto diet might be losing its edge. Still, she added, restaurants will add more low-carb options. The term “pegan” — a cross between a paleo and a vegan diet — will take hold. Pinterest says the number of searches for the term rose 337 percent in the past six months.

The New Sheet-Pan Supper

With barely any cleanup and a deep whiff of nostalgia (remember your first Scout camping trip?), cooking dinner in foil packets is poised for popularity. Pinterest notes that searches for “foil-pack dinners” have jumped nearly eightfold in the past six months.

The Driest Drinks

At the bar, lighter wines, natural wines and drinks with less or no alcohol will be popular. Americans ages 18 to 34 are more interested in spirit-free cocktails than any other demographic group, according to Mintel. As a result, bartenders will replace high-alcohol liquors like gin with lower-alcohol wines like Prosecco in mixed drinks, and make more use of shrubs, craft vermouths, botanicals and distilled nonalcoholic spirits like Seedlip[https://seedlipdrinks.com/]. This may force bars to try to come up with better names than the no-jito or the no-groni. Outlier prediction: Forbes magazine is betting that the breakfast cocktail[https://www.forbes.com/sites/lizazimmerman/2018/12/16/wine-and-cocktail-trends-for-the-new-year-and-beyond/#197b341111c2] will be big.

The Case Against Waste

With the plastic straw and the plastic bag increasingly out of fashion, restaurants, food manufacturers and groceries will face new pressure to reduce other packaging waste[https://www.nytimes.com/2018/09/29/style/healthy-bowls-salad-waste.html]. In a recent Mintel survey, 36 percent of diners said they wanted restaurants to cut back on packaging. (The number is even higher among baby boomers.) Restaurants that serve food on plastic with disposable cutlery will have an incentive to invest in reusable plates and forks. Cutting waste in the increasingly robust carryout and delivery markets will get new attention, too.

The Playlist Ploy

Restaurants will keep seeking ways to expand their brands beyond food; Dunkin’ Donuts has put its name on a Saucony running shoe[https://www.runnersworld.com/gear/a19595602/saucony-dunkin-donuts-shoes/], and KFC recently sold out of fire logs that smell like fried chicken[https://www.theroot.com/kfc-is-selling-firelogs-that-smell-like-fried-chicken-s-1831130588]. For higher-end restaurants, the vehicle of choice will be the customized Spotify playlist. David Chang has already issued one[https://open.spotify.com/playlist/1pFH4rogNq0DgajtZnDZqp], as has Flour & Water[https://open.spotify.com/playlist/05MjsuHl9mnkGj0bOdv4gy] in San Francisco.

The Plant-Based Main Course

Substantial vegetable entrees will become a fixture on restaurant menus, in the way that alternatives to dairy creamers became standard at coffee bars a few years ago. Many diners have started to eat less red meat or abandon animal protein altogether, whether for health, environmental or ethical reasons. A few corporations have banned meat consumption[https://money.cnn.com/2018/07/13/technology/wework-meat-ban/index.html] on their campuses. In Los Angeles, a member of the City Council this month proposed a law [https://losangeles.cbslocal.com/2018/12/05/la-city-council-vegan-option-climate-change-wildfires/]that would require a substantial vegan protein entree be available at movie theaters and other large entertainment centers.

The Motherless Meat

Laboratory-grown proteins will enter the mainstream. KFC, Tyson Foods and Cargill are investing heavily, and the products are catching on so fast that ranchers have started campaigns to stop the engineered proteins from being called “meat,” Forbes reports[https://www.forbes.com/sites/eustaciahuen/2018/11/30/foodtrends/#75c8668d507e]. Prepare for the next generation of plant-based alternatives to dairy products: substitutes for cheese, butter and ice cream made with nuts, soy or coconut.

The Tech Advancement You’ll Hate Until You Need It

Salad-making robots will show up in hospitals and airports, where freshly made food is not easy to find at all hours. The systems rely on chilled containers of fresh ingredients that are restocked during the course of the day. Push a few buttons on a keypad and the robot makes a custom salad topped with dressing.

The Hope for Dope

Major food and beverage companies are researching ways to get THC, the psychoactive component of marijuana, and cannabidiol, a part of the plant that may have therapeutic properties, into more food and drinks. The authors of the federal farm bill have removed hemp[https://www.fresnobee.com/news/business/agriculture/article223111305.html] from the list of controlled substances, and Gov. Andrew M. Cuomo is pushing to legalize recreational use of marijuana[https://www.nytimes.com/2018/12/17/nyregion/marijuana-legalization-cuomo.html?module=inline] in New York.

The New ‘It’ Vegetable

It’s a tie between mushrooms [https://indd.adobe.com/view/2cb60334-4f5f-447f-93fa-570e233fc653]— which have acquired what food marketers call a health halo and are expected to pop up in teas, desserts, jerky and cocktails — and sea vegetables, which most people just call seaweed. Consumption of seaweed is growing 7 percent annually in the United States, James Griffin, an associate professor at Johnson & Wales University, told Nation’s Restaurant News[https://www.nrn.com/food-trends/6-food-trend-predictions-2019]. It checks all the boxes: healthful, environmentally sound and full of umami.

The New ‘It’ Cuisines

It’s a tossup. The market research firm Technomic says popular dishes will come from eastern Mediterranean nations[https://www.technomic.com/newsletters/technomics-take/7-key-trends-2019] like Lebanon, Syria and Turkey. Baum & Whiteman, a consulting firm based in New York, is betting on food from the “Stans” — Kazakhstan, Tajikistan and Uzbekistan. The global buyers for Whole Foods Market have money on flavors from the Pacific Rim[https://media.wholefoodsmarket.com/news/whole-foods-market-unveils-top-10-food-trends-for-2019]. The San Francisco food consultant Andrew Freeman is calling it for Georgia[https://afandco.app.box.com/s/dse4zxz7qi3nn6g4r2e8ldg8rjeo74gp], with its Instagrammable star, khachapuri — the cheese-filled bread boat topped with a runny egg. The prognosticators at the Kind food company are pulling for the flavors of Africa[http://kindassets.kindsnacks.com/KINDHealthySnackingTrendreport.pdf], though they did not specify a country.

The Cause of the Year

How a restaurant or food company cares for its employees, its purveyors, its customers and its community will move up the priority list in 2019, Mr. Freeman said. More chefs will become first responders[https://www.nytimes.com/2017/10/30/dining/jose-andres-puerto-rico.html], providing food at disaster sites. Companies will fine-tune training for how employees should treat one another. Immigrants and their role in American food culture will be front and center.

Sara Brito, a founder and the president of the Good Food 100 list, said in her 2019 trend report[http://goodfood100restaurants.org/work/new-year-new-food-system-top-10-trends-that-will-dominate-2019/] that customers will demand that restaurants tend to more than just how food tastes.

“They need to demonstrate they care about the whole system and story of food,” she said, “including the environment, farmworkers, animal welfare and inclusion in the workplace.”

PHOTO: Millions of investment dollars are pouring into companies trying to put marijuana byproducts into food and drink. (PHOTOGRAPH BY Jim Wilson/The New York Times FOR THE NEW YORK TIMES)

Keep eating well and be inspired to cook with these on your kitchen shelf

Get those good intentions off to a flying start with a new healthy cookbook for 2019. The new year is a great time to revamp your recipe repertoire, whether you’re looking to lose weight, support a fitness regime or feed the whole family something nutritious.

We’ve been on the lookout for sensible advice and easy to follow recipes, alongside beautiful photography.

Dishes needed to be in equal parts delicious, inspiring, yet on the whole, uncomplicated. Before splurging, be sure to consider your lifestyle – if you don’t get home until late every night and are only cooking for one, it’s unlikely you’ll need one containing feasts for a crowd.

The last thing you want is for this to sit on the shelf for the next 12 months.

Read more

10 best vegan chocolate bars

9 best vegan cookbooks

9 best Japanese whiskies

Having said that, there’s no better feeling than cracking the spine of a new cookbook, rolling up your sleeves and coming up with a cracking dish at the end of it. So without further ado, read on for our favourite new healthy cookbook releases to take you through January, and beyond.

Tom Kerridge’s Fresh Start

: £7.99, Amazon

Michelin star chef Tom Kerridge has had a well-documented weight loss journey and since changing his old habits, has lost a hugely inspiring 12 stone. Now, following on from his books

Lose Weight For Good

and

The Dopamine Diet

is

Fresh Start,

a book encouraging us to get back in the kitchen and ditch our reliance on ready meals.

The book accompanies a BBC series of the same name where he aims to give even the most basic cook the confidence to create everyday homemade food. Helpful sections include veggie suppers, batch cooking and weekend feasts, so there’s something for every occasion. We can’t wait to make the Asian-style griddled squid salad, crab mayo on griddled sourdough and corn cakes with Mexican beans – although perhaps not all at once.

Buy now

Veggie Lean in 15

by Joe Wicks: £8.49, WHSmith

Although Joe still eats meat himself, this book came about as a result of becoming more aware of the impact his food choices make on his health and the environment. Like many of us, that means a shift to eating more plant-based food. He also talks about the need to reduce our plastic consumption when shopping.

In short this book feels like a very grown up Joe Wicks. Of course, ensuring we’re getting enough protein and staying lean is still high on Joe’s priorities, so the book ends with a training section featuring HIIT exercises. In the “Fast Food” chapter you’ll find the likes of chipotle midget tree tacos with sour cream and peri-peri halloumi burgers. Most recipes are for one person which is ideal if you live alone but make them equally easy to scale up. As Joe says, “Veggie Lean in 15 is the veggie book for the meat lover”.

Buy now

Happy Food

by Niklas Ekstedt & Henrik Ennart: £11, Foyles

Part cookbook, part educational tool,

Happy Food

tackles more than just diet, looking at how our gut health works alongside our mental health too. It’s a real dream team, with Swedish chef Ekstedt's recipes (such as the kale salad with parmesan and basil gremolata) complementing Ennart's fascinating scientific research. Recipes are more sparse than your average cookbook (there’s only 38 in total), but when they do appear they include beautiful photography. If you’re interested in improving your mental health and overall wellbeing through diet, this is definitely worth a read.

Buy now[https://www.foyles.co.uk/witem/food-drink/happy-food-how-eating-well-can-lift,niklas-ekstedt-henrik-ennart-9781472959980]

Blackberry Cottage Cakes with Secret Ingredients From Aubergine to Zucchini Book

by Kate Saunders: £24.99, Blackberry Cottage

Can cake ever really be healthy? Well Kate Saunders thinks so with this collection of cakes containing hidden vegetable ingredients. Be warned, there’s still plenty of sugar and butter used throughout, so healthy might be pushing it slightly, but the veggies make up the bulk of the ingredients, so it’s certainly an innovative way of getting in your five a day.

The book begins with aubergine and chocolate cake and ends with a delicious zucchini and cinnamon sponge with a recipe or two for each letter in between. We loved the fun tips and facts scattered about and couldn’t wait to start surprising people with our seasonal bakes.

Buy now

Naturally Delicious Snacks & Treats

by Gracie Tyrrell, Sophie Tyrrell: £9.99, Waterstones

You might know Gracie and Sophie better by their collective name – the Squirrel Sisters. Their health and wellness company make award-winning 100 per cent natural snack bars that are stocked everywhere from Waitrose& Partners to Whole Foods and many more. This book contains both sweet and savoury “snack-sized” recipes, as the girls believe we’re more likely to make good health choices if it’s convenient and simple. From seed and salted honey energy balls to spiced lamb samosas, these 70 recipes are super easy to follow.

Buy now

The Seedlip Cocktail Book

by Ben Branson: £14.99, Amazon

January is a great time to look at your drinking habits and if you do decide to cut back, there’s no better name in the biz than Seedlip. Widely becoming available in restaurants and bars as a truly grown up non-alcoholic alternative, founder Ben now brings us this cocktail book so you can become an expert mixologist at home.

It features recipes using the three Seedlip flavours– Spice 94, Grove 42 and Garden 108 – and then works to complement the flavour profile, resulting in aromatic, refreshing or citrus spiked long and short cocktails. There’s a beautiful photograph to accompany each recipe, which have been created by the Seedlip team, as well as some of the best bars in the world.

Buy now[https://www.amazon.co.uk/Seedlip-Cocktail-Book-Ben-Branson/dp/1787630102]

Good Food, Sorted: Save Time, Cook Smart, Eat Well

by Chris Bavin: £18.99, Foyles

You might know Chris Bavin from the BBC show Eat Well For Less, in which he helps families live a healthier lifestyle on a budget. Featuring over 100 family-friendly recipes, the premise of this book is similar – it’s all about getting healthy, balanced meals on the table with minimum fuss. As a former market trader, Chris knows a thing or two about making ingredients go further. Expect freezer friendly recipes, batch cooking and quick weeknight dinners that will appeal to even the fussiest of eaters. Highlights include quick spicy sausage ragu, posh fish finger sandwiches, herb-crusted lamb with creamy butter beans and leeks and vegan chilli.

Pre-order now

Gordon Ramsay Ultimate Fit Food

by Gordon Ramsay: £8.99, Amazon

Gordon practises what he preaches in this new healthy cookbook – when he’s not in the kitchen you’ll find him running ultramarathons – but of course diet and exercise go hand in hand. All of these recipes have been analysed by a nutritionist, and split into three sections – healthy (for maintaining a healthy weight), lean (for losing weight) and fit (for an active lifestyle). Seared tuna and vegetable skewers with wasabi dipping sauce may not sound like your average diet food, but what would you expect from this celebrity chef.

Pre-order now

Farmacy Kitchen Cookbook

by Camilla Fayed: £17.39, Amazon

The restaurant of the same name opened back in 2016, offering a range of fresh, seasonal, nutritionally balanced plant-based meals, and this book from founder Camilla Fayed offers more of the same. The book begins with a thorough chapter on their philosophy, outlining mindful eating, fasting and digestion before moving onto delicious dishes. We particularly liked the “Earth Bowls” section which includes flavours from around the world.

Buy now

The Verdict: Healthy cookbooks

We’ve long been a fan of Tom Kerridge[http://www.amazon.co.uk/Tom-Kerridges-Fresh-Start-Kerridge/dp/147296280X]’s style of writing and find his recipes are always incredibly popular with friends and family. Whilethis doesn’t claim to be a diet cookbook, recipes are delicious, easy to follow and highly nutritious.

Stacey Smith is the founder of food & drink website

Crummbs

Fat-shaming and snooty diet advice are rightly targeted in this polemic. But Warner’s anger is oddly limited: why doesn’t he blame the food industry?

I never quite knew what the word “sophistry” meant, until I read this book. I had a vague idea that it was something to do with making a false argument. But I looked the word up and saw that this wasn’t quite right. Sophistry means the clever use of arguments that seem true. In Chaucer’s time, it used to mean cunning, or craft. The original ancient Greek sophists were people, according to Plato, who were virtuoso athletes of words. Above all, sophists are plausible. That’s what makes them so dangerous.

This is what came to mind reading the latest screed by Anthony Warner, who worked for many years at Premier Foods, one of the biggest food companies in Britain, which manufactures Mr Kipling cakes, Angel Delight desserts and Batchelors Super Noodles[https://www.theguardian.com/food/2018/oct/24/instant-noodles-student-recipes-felicity-cloake-masterclass], among many other branded processed foods. Ten years ago, the Belfast Telegraph described Warner as TV presenter Loyd Grossman’s “Italian development chef” because Warner was the person who helped Grossman develop his own-brand pasta sauces. But that was before Warner transmogrified into “ The Angry Chef[https://angry-chef.com/] ”, the name of an expletive-ridden blog that he started writing in 2016 “exposing lies, pretension and stupidity in the world of food”. He could have called himself “The Angry Consultant to the Food Industry” but it wouldn’t have had quite the same ring. In 2017 the blog gave rise to a book, The Angry Chef: Bad Science and the Truth About Healthy Eating[https://www.theguardian.com/lifeandstyle/2017/jun/18/angry-chef-debunking-detox-diets-wellness-nutrition-alternative-facts].

To begin with, many in food writing circles considered Warner a breath of fresh air. I was one of them, going so far as to write a blurb for the book, welcoming it as a “bracing and funny tirade against the nonsense and harm done by food fads”. I liked the way he skewered the quackery of alkaline diets and the absurd overuse of coconut oil and other so-called superfoods. I knew that Warner worked for the food industry, but I didn’t feel that this had an undue impact on his arguments. Maybe there was an element of “my enemy’s enemy is my friend” in my liking for Warner’s writing. Over the course of my life, too many people close to me have developed eating disorders and when Warner attacked the restrictive rules and “nutribollocks” of the clean eating trend, his anger seemed righteous.

But the more I read Warner’s blogs and articles (he is now a columnist for the Sunday Times), the more I started to find his anger oddly limited. He seemed to have plenty of fury for the “pretension and stupidity” of health bloggers and detox regimes but remarkably little anger for the food industry that has marketed sugary junk foods to vulnerable consumers, including children, on an unprecedented scale, with catastrophic consequences for human health. When I went back and reread The Angry Chef I was struck that, in between the funny parts about liars and charlatans, there were curious overstatements and binary oppositions. In Warner’s world, if you question the prevalence of sugar in our diets you are a prejudiced, judgmental, pseudo-scientific “nutrition expert”. “To give a child a bowl of breakfast cereal and a glass of orange juice is now to be a social pariah, guilty of the vilest abuse,” he writes. Really? If that were true, our eating habits would be very different.

And now we come to his new book on the causes of obesity, which suggests that everything you thought you knew about nutrition and weight is wrong. On first glance, there is much here that seems both plausible and just. For one thing, Warner recognises that obesity has complex and multifaceted causes and it is not – as so many persist in claiming – a collapse in willpower. Warner makes a plea to end the dreadful way in which people with obesity are stigmatised by the media. “Shaming fat people does not help them. It makes their lives harder. It makes their health worsen,” he writes. He is right about this. Throughout the book, Warner positions himself not so much as an angry chef as a cuddly teddy bear on the side of tolerance, love and compassion. He urges us to “stop judging people by how they look” and to relish the simple things in life such as sharing sandwiches in the park.

The strangeness of the book emerges when you start to examine what he is actually saying about the causes of modern obesity and, more widely, of diet-related illness such as type 2 diabetes[https://www.theguardian.com/society/2018/nov/22/type-2-diabetes-obesity-now-affects-nearly-7000-young-britons] and heart disease. He implies that it is not really about carbs, nor about sugar and anyone who suggests otherwise is probably some snooty middle-class person who shops at Wholefoods. He writes derisively of New York City mayor Michael Bloomberg’s “infamous (failed) attempt to halt the sale of supersize soft drinks[https://www.nytimes.com/2012/05/31/nyregion/bloomberg-plans-a-ban-on-large-sugared-drinks.html] ” in the city (although Warner admits we do need to cut down a bit on sugar “if only because of the associated dental problems”). Obesity is also not really about microbes, Warner insists. He lambasts microbe expert Tim Spector for an experiment involving Spector’s student son showing that just 10 days of eating nothing but McDonald’s meals led to a 40% reduction in the diversity of his gut bacteria. This was a “shameless publicity stunt” Warner writes, and anyway, it proves nothing.

Warner also encourages us to discard the notion that obesity results from calorific confectionery being pushed on us in every supermarket and newsagent on a scale never seen in the past. The only reason that there is so much chocolate in the supermarket, according to Warner, is because of our moralising culture of guilt. “In places where Twix and Dairy Milk do not occupy the role of guilty pleasures, they fail to dominate the supermarket shelves.” This is pure sophistry. He does not mention the fact – which is no secret, if you read trade journals on confectionery – that the excessive quantity of sweets in our shops is part of a deliberate strategy by retailers and manufacturers to create “interruption points” as we walk around stores.

What does he think caused the transformation of our bodies over the past few decades, if it isn’t food?

In Warner’s book, obesity is not about an over-supply of calories, and it is not about the rise of takeaways near schools or wider changes to our food environment, so there is little point in trying to reform the obesogenic environment we live in. “Often the environmental account is little more than a thin disguise for contempt,” he insists. “Mostly the idea is that fat people need to be coerced into more middle-class food options, cooking from scratch, meals round the table, less fried chicken, more hummus.” By equating sound advice with coercion, he makes it impossible to offer sound advice. It is possible to hate fat-shaming and still to want to apportion some of the blame where it belongs, with the food industry. But that’s precisely what Warner wants to rule out.

So what does he think caused the transformation of our bodies over the past few decades, if it isn’t food? Warner’s candidates include poverty, stress and poor housing. He is right that all of these factors strongly correlate with poor diets, but he always seems to miss out the part of the argument that brings eating into the equation. One of his preferred explanations for obesity is genes. His proposition is that “larger people go for larger people, and tend to produce more children when they do”. It is certainly true – as genetic studies involving twins have confirmed – that our individual responses to food, including our appetite, have a strong genetic component. But Warner does not have a convincing explanation for why either genes or poverty would suddenly be driving weight gain, given the rapid rise in obesity across the world from 1980 onwards.

At moments, his confusing arguments segue into outright inaccuracy. In Warner’s closing chapter, he writes about Amsterdam, which may be the only place in the world – outside of famine zones – where child obesity is actually declining. In 2012, the city’s deputy mayor Eric van der Berg launched the “Amsterdam healthy weight programme”[https://www.theguardian.com/society/2017/apr/14/amsterdam-solution-obesity-crisis-no-fruit-juice-enough-sleep], which included a whole tranche of measures, from workshops on healthy cooking for parents to bans on junk food marketing at sports events. In just four years, rates of child obesity fell by 12%. Amsterdam has become a beacon for nutrition campaigners around the world, proof that it is possible to make radical improvements to the environment in which children live and eat.

How did Amsterdam do it? Warner wants us to believe that the success was “unique to Amsterdam” and not much to do with food. He insists that Van der Berg saw that the “focus should not be on anything as trivial as what children were eating”. This is wildly misleading. If you look at the information given to families by the programme, it is very much about what children are eating (as well as about exercise, sleep and limiting the use of electronic devices). Children in Amsterdam are encouraged to avoid eating too much sugar and saturated fat and to eat four servings of vegetables and two of fruit every day, and to be active for at least an hour a day. The Amsterdam advice on children’s food is quite specific, urging parents to limit “crisps, croissants, chips, pizza, sausage rolls” as well as cookies, pastries, packaged snacks and soft drinks.

Warner also claims that in Amsterdam, “instead of getting rid of school vending machines selling sugary drinks, the decision was taken to allow them” while entrusting children to make “better decisions”. Again, this is an outright falsehood. One of the key elements in the Amsterdam programme was that at participating primary schools, children were allowed to drink only water and milk. “Drink water from the tap” has been one of the single biggest messages of the whole campaign, reinforced in schools and at home.

If you think that the question of what children eat is “trivial”, this is the book on obesity for you. It will chime with many people’s wish not to be lectured at by people who claim to know better, and goes to great lengths to absolve the food industry and its relentless marketing of processed food from playing any role in modern diet problems.

• The Truth About Fat is published by OneWorld. To order a copy for £13.19 (RRP £14.99) go to guardianbookshop.com [https://guardianbookshop.com/truth-about-fat.html?utm_source=editoriallinkutm_medium=merchutm_campaign=article] or call 0330 333 6846. Free UK p&p over £15, online orders only. Phone orders min p&p of £1.99.

Can clean-up queen Marie Kondo convince a self-confessed collector of sweet wrappers to mend his ways?

I am flying across America to meet Marie Kondo, a diminutive Japanese Mary Poppins who transforms people’s lives by helping them to tidy their homes. Below, cities blossom and sprawl: millions of homes in which people fight, make love, cook, pick their nose, watch TV and accumulate clutter. Kondo has been in a few of them, kneeling to offer respect to the house before helping those who live there to purge, throwing out anything that does not spark joy. On the plane, I listen to the audiobook of her bestselling tome, The Life-Changing Magic of Tidying Up: The Japanese Art of Decluttering and Organizing[https://guardianbookshop.com/life-changing-magic-of-tidying-362214.html]. It is easy to see why it has sold 10m copies. Kondo has hitched tidying to the bandwagon of wellbeing, and is prone to saying things like: “Putting your house in order is the magic that creates a vibrant and happy life.” And,

“To go throughout life without knowing how to fold is a huge loss.” I would like to have a vibrant and happy life. I would like to know how to fold. Making order from disorder feels like a balm for these turbulent times.

Like a lot of messy people, I first heard about Kondo through my other half, who hoped it would cure my hoarding tendencies. Did I want to be cured? Not enough, perhaps, since I had waited until now to read her book. When I told a friend that I was interviewing Kondo, she responded: “OMG, my sister-in-law read Marie’s book and basically made my brother get rid of everything… and now she uses ‘Kondo’ as a verb.” This is a pretty good summation of Kondo’s method, in which people end up discarding 75% of their belongings. For accumulators like me, it’s the equivalent of going cold turkey.

My last surviving grandmother died in September, and I thought of the way she had reduced the things in her life until they barely filled the few rooms in which she lived. Kondo would approve. My grandmother raised five children in a council house, and was supremely unsentimental about her possessions. If they weren’t useful, out they went. She knew how to fold. She did not greet her home by crouching on the floor and acknowledging its beneficence. She did not thank her shoes for their hard work. After her death, I was able to choose a few small mementoes – one of her needlepoints; a plate; an unremarkable tea caddy. They would all meet Kondo’s threshold for sparking joy. But what about the First World War trench spade I recently found on eBay, with its handle on which someone’s initials were engraved? What about the voluptuous blue milk jug I tracked down, after reading about its designer, Eva Zeisel[https://www.britannica.com/topic/Eva-Zeisel] ? “Why,” was all my husband could muster, when I pushed it on to a shelf with the rest of my bric-a-brac. And what would Kondo say about my childhood collections of bookmarks and shells and badges and tins and old bottles and – yes, really – sweet wrappers that I somehow imagined gifting to a museum one day?

It’s about understanding what needs to go versus what’s important to you

Marie Kondo

Inside a Spanish-style 1920s home in West Hollywood, a young woman is energetically pointing me towards a bottle, its label splotched with grease. “It’s a probiotic vinaigrette with pine pollen and charcoal,” she explains. We are at a long wooden table dotted with glass jars of pale blue anemones that might be made of silk. At one end, three women tap at laptops; at the other is a spread of salad greens, baby roast potatoes, cuts of poached salmon and marinated tofu. There are dips with gluten-free crackers, but no bread. Through the sliding glass doors, a pool glints prettily in the afternoon sun. I am offered a drink and request a coke. My host’s face creases into a portrait of regret. “We’re a wellness company,” she explains. Water is fine.

We are waiting for Kondo to materialise. Her book is four years old, but there has been another since and a new show on Netflix aims to amplify its message of transformation through tidying. Each episode is bookended with Kondo arriving on the threshold of an untidy home and departing 30 minutes later, leaving miracles in her wake. Tears are shed, marital strains resolved and garbage bags of stuff are carted to the charity shop, destined to become someone else’s crap.

Kondo, who has trademarked her system as the “KonMari Method”, is rare among organising professionals for rejecting so-called storage solutions. She is not trying to sell anything except her manual for tidying. Even that, she suggests, can be discarded once it’s fulfilled its purpose. She is especially hard on books, preferring to keep hers in a cupboard. Books left on shelves for a long time are likened to a “praying mantis lurking in the grass.” The KonMari Method requires participants to work through a hierarchy of possessions: clothes first, books second, then papers, miscellany (Kondo uses the Japanese word komono ) and, finally, sentimental items. But in the episodes of the show I watched, we never see anyone sorting through books – the emphasis seems to be on clothes and the kitchen.

When Kondo, beaming and immaculate in a cream ribbed sweater and subtle makeup, enters the room she is holding a mug of herbal tea, a signifier in her book for wellbeing. I clap my hands and say: “Herbal tea of course!” to show that I’ve done my research, but my bright enthusiasm sounds forced and is followed by a silence. Kondo speaks only a little English. I do not speak Japanese. So, we sit in a room with a translator and Mallory, a member of the KonMari team who is keen for me to know that the story has evolved beyond tidying.

Later I receive an email in which she explains: “We’re building a lifestyle brand around Marie’s philosophy.” There is a new website, on which guest contributors, such as Arianna Huffington[https://www.theguardian.com/technology/2017/jul/30/uber-ariana-huffington-travis-kalanick-ceo], give tips on sleeping, and an inevitable YouTube channel. In an introductory video, we see Kondo making matcha tea, playing with her children on the beach, and doing something healing with a crystal and a magnet. “If you want to lead a life that sparks joy,” she says, “there is only one thing you must do, and that is to tidy your home.” If it all makes you think of Gwyneth Paltrow’s phenomenally successful Goop[https://www.theguardian.com/film/2018/sep/05/gwyneth-paltrow-goop-to-pay-out-over-unproven-health-benefits-of-vaginal-eggs] that’s the partly the point. “I think that would be a great model,” Mallory concedes.

When she was five, Kondo began reading home magazines. She was, to put it mildly, obsessed. There were no windows in her 100sqft room, so she cut out images from calendars and stuck them to her wall to simulate the vistas she wanted. When I ask what kind of pictures, she thinks back. “A beautiful sky, a forest and then a picture of a window with a flower box,” her translator says. Visualising the home that you want to inhabit, and by extension the life you want to live, is a key step in KonMari. Taking cues from her five-year old self, Kondo suggests we look through magazines to see what sparks joy. “Is it a pink flower in a vase, or is it the colour purple? Then you have to think: what can I do to make my home look more like that photo?”

At 15, Kondo looked at her collection of scented erasers and tossed them out, along with five bags of clutter. The erasers had mouldered in a box for a decade. Why had she held on to them for so long? They were like those piles of photos we all have, sitting in boxes, awaiting the day we finally resolve to put them in albums. Kondo was preternaturally wise. She knew that no such day would ever come.

Although joy is her benchmark for determining what to keep, Kondo seems less militant about her method than her book suggests. When I run through the list of my childhood collections, she is sympathetic. “A lot of people hit a roadblock because they feel they have to throw something away, but that’s not the point,” she says. “It’s about understanding what needs to go versus what’s important to you.” Meaning I get to keep my sweet wrappers? “Of course!” she replies, but then adds, confusingly: “Many people have a lot of important items they want to keep, but you should push off the most difficult things to the very end.” Even photographs, for Kondo, are vessels for nostalgia. Keeping them may prevent us from moving forward.

She tells stories of clients who flourished after KonMari-ing their home. A publicist for a luxury fashion magazine believed she had the perfect job until Kondo entered her home. “None of the clothes she had sparked joy – they were all $2,000 jackets from big brands, expensive clothes,” recalls Kondo. “She realised her job didn’t spark joy and she’s now a freelance writer who travels all around the world.” Then, perhaps noticing that she’d drawn a portrait of a rich privileged woman doing privileged things, she says: “Actually, something that’s even deeper for me is couples who are on the verge of getting divorced, who went through the KonMari process, and were able to realise that there was so much joy between them.” Sometimes, too, it can go the other way. “I’ve seen cases where people broke up, and needed to break up, and some cases where they split and came back together.”

Before parting, I ask Kondo if she can think of a bad habit that she’s not been able to purge. She frowns hard and gives the question some thought, turns to the translator and blushes as if confessing a shameful secret. The translator turns to me, and says: “I love wearing slippers, but I take them off in random places around the house – I can’t keep them on for long, so they’re scattered.” We all laugh a little too loudly.

Back in New York, I walk through my door, remove my shoes, and thank them. And then I look at the disordered surfaces, the piles of unread magazines. My heart sinks. Kondo had conceded that for creative people clutter can be a good thing, but cautioned that it was not an endorsement for excess. What was the right level of clutter for me? The next morning, as instructed, I pile my bed high with all the clothes from my closet, and hold each in turn. It is not perfect – I keep my practical but joyless white shirts – but I end up with a pile of 40 or so garments ready to recycle. Over the next few days I find myself creating homes for possessions that have wandered forever around the apartment like nomads. I gather all the loose change that has accumulated on various surfaces ($8.17) and take it to the bank, and discard all the pens that no longer work.

But I avoid tackling my books. We all have too much stuff, that much is clear, but we’re cluttered in other ways, too, submerged in our social media, bombarded by advertising, overloaded with email. My books feel like an antidote to that. They might represent more stuff, but they’re tactile, poetic, ghosts from the past. Aren’t material things also a mooring amid the tenuousness of so much else? Do we all want to live in homes that feel like hotel rooms? There is clutter we want to shed from our lives, but there is also clutter we want to embrace. In time, like my grandmother, I may come to find those books, that pretty blue milk jug, and that century-old trench spade a burden. But that time is not now.

Tidying Up with Marie Kondo premieres on Netflix on New Year’s Day

Get your fix ofgoodies free from any animal productsdelivered direct to your home

With more of us converting to veganism than ever before (almost 170,000[http://veganuary.com/blog/veganuary-2018-the-results-are-in/] people took part in Veganuaryin January 2018), the demand for vegan food and lifestyle products is stronger than ever. It’s heartening to discover that there are lots of ways to make a vegan lifestyle just that little bit easier and subscription boxes are an excellent way to discover just how easy veganism can be. Offering everything from vegan beauty, vegan snacks, vegan recipes and even vegan cleaning products, these vegan parcels are a hassle-free way to make a plant-based and animal-friendly lifestyle easier than ever.

We tested out the latest vegan subscription boxes on the market to see how they fared, considering the variety of products, packaging, value for money and how they benefit a vegan lifestyle. Here’s 12 of the best.

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The Deluxe Vegan Larder Monthly Subscription Box: £24.99, Vegan Larder

Set up by two vegan foodies, Vegan Larder is both a hub of recipes and a shop offering a range of vegan gift and subscription boxes (which also comes as a gluten-free option). We opted to try their deluxe monthly subscription box and, whilst the packaging itself was no-frills, inside was a fantastic mix of vegan and palm oil free products from both independent and ethical companies.

Whilst there’s a few snack boxes on the market, we loved that this box contained a variety of vegan foods, such as drinks (a raw hot chocolate), snacks (such as kale crisps and sliced mango) and cooking essentials (a seaweed cooking rub, organic vegetable stock, amino seasoning and a chunky tapenade). The box offers amazing variety and the chance to discover new brands which might not yet be on your radar –the perfect introduction to all things vegan.

Buy now[https://theveganlarder.com/product/the-vegan-larder-subscription-box/]

Natural Wellness Box: From £25, Natural Wellness Box

Veganism extends far beyond the food on our plate, with animal products found in everything from supplements to beauty products. The Natural Wellness Box offers a solution to this with a beautiful mix of natural, vegan and cruelty-free beauty, health and wellness products. At £35, the box tends to feature more upmarket items, with two standout items being Potion London probiotic (useful, as many probiotics aren’t vegan-friendly and this one is worth £30 alone) and a pot of Villiers floral facial steam (worth £16).

It also contained face oil, an organic travel candle, pukka herbal tea and a superfood energy bar; making it incredible value for money. Whilst the focus is on cruelty-free and green beauty, any vegan would be thrilled to receive this mix of upmarket pampering and wellness goodies.

Buy now[https://naturalwellnessbox.co.uk/collections/natural-wellness-box-subscriptions]

Large Vegan Subscription Box: £20, Vegan Sweet Boxes

Always trying to satisfy your sweet cravings? This new Hull-based company Vegan Sweet Boxes has you covered. Their large vegan subscription box is everything you and your sweet tooth could possibly want; with a mixture of chocolate (such as Bourneville), healthier options (coconut bites) and retro sweets (Love Hearts, Rainbow Drops and Parma Violets). Whilst there’s no denying the potential of tooth decay with this box, we couldn’t help but be impressed with just how much variety there was. If you are not quite up for the challenge, they also offer a small vegan subscription box, at a very reasonable £12.

Buy now[https://www.vegansweetboxes.com/ourboxes.html]

SourcedBox: From £18.95, SourcedBox​

If you can’t stop snacking, then SourcedBox offers the perfect solution. It’s one of the few boxes on our list that focuses solely on healthy, vegan snacks that contain no refined sugar, artificial preservatives or additives, delivered direct to your door. Boxes can be purchased as a one-off or through a variety of subscription options. We received November’s box and enjoyed the variety of snacks on offer to cater to both sweet and savoury palates. Our box included delights such a natural energy drink, herbal tea, raw energy bars, vegetable crisps and vegan macaroons - all from small health-conscious brands.

Buy now[https://shop.sourcedbox.com/subscribe/100037898_SourcedBox%E2%80%8B]

Lifestyle Box: From £8, Vegan Kind

The first of two boxes from online supermarket The Vegan Kind, the Lifestyle Box is a fantastic budget option, with prices starting from £8 a box with annual subscriptions or £13.35 for one-off boxes). Inside our brightly coloured box was a cookbook (the usual value of which was £15 alone), a vegan toothbrush, recipe cards and a mix of healthy snacks, such as vegetable crisps, chocolate quinoa snacks and melt-in-your-mouth raw peanut butter cups. This is a great introduction to all things vegan and, what’s more, a proportion of the box’s proceeds goes to a different charity each month.

Buy now[https://www.thevegankind.com/subscribe/lifestyle-delivery]

All Plants: From£40.50, All Plants

Want to eat a varied vegan diet but can’t stand cooking? This is where All Plants comes in with their plant-based dishes which are prepared by chefs, frozen and then delivered to your door, in 100 per cent recyclable packaging. Dishes are both vibrant and inventive, with highlights including Cashew Mac, Golden Sesame Satay, BBQ Burrito Bowl and Paella Roja. They’re nutritionally balanced too, and proof alone that a vegan diet doesn’t have to be boring, with dishes carefully planned to ensure they meet the needs of a plant-based diet, with foodstuffs being high in iron, protein and calcium.

Buy now[https://allplants.com/pages/get-started]

The Vegan Goodness Box: From £8.50, The Goodness Project

The Vegan Goodness Box is a carefully curated bundle of vegan and cruelty-free products at a great price. We loved the new brands this box introduced us to: from Ananda’s Vegan Waggon Wheel (if you buy one vegan snack, let this be it!), to Ten Acre crisps and Raw Halo’s vegan chocolate. The three different sizes of subscription (letter-box friendly, mini goodness and maxi goodness) mean you can pick the exact snacking option that works for you, plus one per cent of the company’s net profits go to charity.

Buy now[https://thegoodnessproject.co.uk/healthy-vegan-gluten-free-subscription-box]

Save the Planet Box: £22.99, SuliBox​

Whilst some people transition to veganism for health reasons, others turn to it to do their part in living a more sustainable life. Although there’s now plenty of boxes to satisfy your vegan food cravings, it can still be difficult to source eco-friendly and sustainable lifestyle products. That’s where the SuliBox comes in. Available in three sizes (Eco-box at £13.99, Extra Eco-Box at £16.99 and Save the Planet Box at £22.99), the SuliBox is a mixture of sustainable living products, including cleaning and lifestyle products.

We received a non-plastic, recycled dish scrubber, an eco-friendly travel mug, all natural chewing gum, a gingerbread soap, handmade chocolates and a reusable shopping bag. With items that we’d never think to check were vegan –chewing gum can contain gelatine, for example –the box not only challenges you to think more about the planet but provides a range of products to get you started.

Buy now[https://www.sulibox.co.uk/subscribe/]

Vegan Taster Box Subscription: £18, The Protein Ball Company

Getting a protein hit on a vegan diet can present some challenges, so we love this vegan taster box subscription from UK husband and wife team The Protein Ball Company. The taster box subscription contains 12 packets of their vegan protein snacks in a mixture of different flavours: Lemon + Pistachio, Goji + Coconut, Peanut Butter + Jam and Raspberry Brownie and offers 7g of protein per pack.

Whilst being a one-brand box offers less variety than others on our list, the fact that the product is gluten-free, high in fibre and natural (the protein comes from brown rice and pea), it makes a great option for stocking up on healthy snacks and is perfect for gym goers.

Buy now[https://www.theproteinballco.com/vegan-taster-box-subscription]

Beauty Box: From £12.75, Vegan Kind

We’ve already featured one box from Vegan Kind, but were so impressed that we couldn’t help but include a second. As well as offering a lifestyle box, Vegan Kind also offer a bi-monthly beauty box that costs as little as £12.75 on an annual plan. The box, which offered approximately £80 worth of products, contained a lovely mix of all aspects of vegan beauty, including an avocado sheet mask, hair serum, false eyelashes, face oil, eyeshadow and eyeliner, included items from smaller brands as well as established beauty favourites, such as haircare brand Umberto Giannini. A must-buy for beauty lovers.

Buy now[https://www.thevegankind.com/subscribe/beauty-uk-plans/]

Optimal Health Box: £40.50,Vegan Apron

There are a few options for vegan recipe boxes but none are so quintessentially vegan as Vegan Apron, which boasts 100 per cent compostable, biodegradable and recyclable packaging (using denim as an insulator instead of wool), largely organic ingredients straight from local farms and a plethora of innovative vegan recipes (with gluten-free also an option). The Optimal Health box is centred around plant-based whole foods without oil, which is thought to be beneficial for heart health.

It came crammed with brown paper bags containing everything we needed to make a comforting bowl of ‘Neeps and Taties Soup’; hearty Shepherdless Pie and Maple Walnut Hassleback Butternuts. If you’re up for a challenge and keen to learn new, vegan recipes, then give Vegan Apron a try.

Buy now[http://veganapron.com/product/optimal-health-box]

Vegan Subscription: From £10, Chocolateeha

Trying to find decent vegan chocolate can be a bit of a minefield. Whilst many alternatives often contain palm oil or are packed with refined sugar, Chocolateeha is the exception. Made from scratch, their vegan chocolate, which comes in decadent flavours such as Orange and Cardamom, Coconut Raspberry and Cinnamon Coffee, contains 50 per cent minimum cocoa solids and all natural, organic ingredients.

Their subscription options (which also allow you to select your own flavours) can be delivered weekly, monthly or every few months. For those who want to be even healthier, why not opt for their raw vegan subscription box, which contains a higher proportion of cocoa solids (72 per cent)and organic maca powder.

Buy now[https://chocolateeha.com/product/vegan-subscription-box/]

The Verdict: Vegan subscription boxes

Our top pick is Vegan Larder –a great box which is perfect for those seeking vegan cooking inspiration. For beauty lovers, the Vegan Kind is a great way to discover new brands whilst Suli Box shows us that a vegan lifestyle goes far beyond the food on your plate.

These cheeses made from soya, nut or coconut might be even better than the real thing

Being a vegan might mean going dairy-free, but it doesn’t mean you have to miss out on cheese. Whether you're looking for options made from soya, nut or coconut, there are more options than ever before, with some created for Christmas. Here’s our round-up of the best

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9 best vegan subscription boxes

Caramel Pecan Vegan Creamed Chease: £7.95, Tyne Chease at Yumbles​

While hard vegan cheeses have been on the market for years, a truly indulgent cream cheese has been tougher for crafters to handle. However, this glass jar of Caramel Pecan Creamed ‘Chease’ – the first of two entries by family-run artisan company Tyne Chease – comes close to perfection. Organic cashew nuts provide the tangy creamy base whilst the mix of crunchy pecans and syrup-like dates provide complimentary levels of sweetness.

At £7.95, it’s a little on the pricey side, but that’s expected for a focus on organic and natural ingredients, including probiotics and Himalayan salt). What’s more, a four-week shelf life means you can tuck into it well into the new year. Overall, it’s the perfect complement to your cheeseboard this festive season.

Buy now

After Dinner Blueberry Wedge: £2.89, Violife

Violife is pretty much the king of vegan cheese: it’s been around long before veganism became popular and is known for its wide variety of nut-free, soy-free and dairy-free cheese (coconut oil is the main ingredient).

This after-dinner blueberry wedge is great value for money. It’s packed with blueberries – it also comes in a more traditionally festive cranberry variety should you prefer it – and contains added vitamin B12, a much-needed nutrient for many vegans.

It tastes a little dry when sliced, but it comes into its own melted.

Buy now

The Vegan Cheese Collection Taster Box: £23.40, The Naturally Vegan Food Company at Yumbles

Why have one cheese when you can have four? Northampton-based The Naturally Vegan Food Company has come up with a perfect taster box for your Christmas party. A collection of two generously sized ‘cheeze balls’ (a smokey paprika infused version and an original – both of which taste convincingly like Cheddar), a creamy cashew spread and an Italian cooking cheese (an excellent replacement for Parmesan, which tastes fantastic sprinkled on pretty much anything).

The collection is made using organic almonds and cashews; as well as vegan staples such as tofu, cider vinegar and nutritional yeast. Its focus on organic and natural ingredients makes this the perfect choice for health-conscious, vegan foodies this Christmas,

Buy now

Nush Almond Milk Cream Cheese Style Spread Chive: £2.75, Ocado

Nush is a relatively new brand of nut-based yoghurts – and its recently added two flavours of cream cheese. Stocked in most major supermarkets, Nush’s cheese offering is both affordable (one of the cheapest options in our roundup) and healthy. With 93 per centalmonds, the spread also contains live vegan cultures, something that many vegans miss out on when ditching dairy products).

It also tastes great. It’s surprisingly creamy and one of the easiest of our cheeses to spread, making it perfect for your Christmas-morning bagels.

Buy now[https://www.ocado.com/webshop/product/Nush-Almond-Milk-Cream-Cheese-Style-Spread-Chive/424000011]

Vegan Cheese Selection Box: £17.09, Tyne and Chease at Yumbles

Looking to put on a proper spread? This vegan cheese selection box is for you. It contains 10mini-cheeses with unusual flavours such as za’atar spice, Ethiopian spice and sundried tomato.

Tyne and Chease delivers on taste. With all these cheeses being made by hand, they taste just as rich and smooth as their dairy-containing equivalents, avoiding the slightly synthetic aftertaste of some cheaper brands.

Add the crackers and throwa party.

Buy now

Violife Cheeseboard: £5, Asda

With vegan products previously being restricted to health food shops and online, it’s great to see mainstream supermarkets now offering value options, too. And what could be more purse-friendly than a cheeseboard for a fiver?

This cheeseboard combines three of Violife’s most popular flavours in 150g portions: the surprisingly meltable mature block (a great all-rounder whatever the time of year and a perfect base for cauliflower cheese); the zesty cranberry wedge and a rich blu wedge. The perfect starter kit for a great vegan Christmas and one of the few cheese brands that are also nut-free.

Buy now

Cranberry Wensleydale Alternative: £1.75, Asda

Asda delivers again with its own brand of cheese. This Wensleydale Cranberry Cheese alternative is new this winter, along with a range of other flavours (Cheddar, and garlic and chive).

At £2 for a substantial 200g block, it’s the cheapest item in our roundup: yet despite it being a budget buy, it more than delivered on flavour. Upon opening the packet, we were taken in by an authentic, Wensleydale-esquearoma and were impressed by how smoothly it crumbled.

Low-cost doesn’t mean low on cranberries either: it combined a generous helping of large cranberry chunks with a smooth, mild Cheddar taste.

The downside is it does rely on some thickeners and regulators not found in some of the handmade choices on our roundup.

But overall, this product delivers on both the price test and taste test.

Buy now[https://groceries.asda.com/product/fruit-flavoured-smoked/asda-wensleydale-cheese-with-cranberry/910001972140]

Vegan Cheese Kit: £32.99, Mad Millie

If the above options haven’t whetted your appetite, then why not make your own? Mad Millie’s Vegan Cheese Kit contains instructions, recipes and equipment to create your individual take on vegan halloumi, cream cheese, feta ricotta, mozzarella and mascarpone.

While it seems daunting at first, you only need a handful of ingredients (usually your choice of nuts, salt, spices and dairy-free milk) and recipes are labelled by their difficulty level.

It’s the most expensive option on our list, but if you like to know exactly what goes into your food, struggle with multiple intolerances or want to take your Christmas hostess skills to the next level, then the Vegan Cheese Kit could be for you.

Buy now

White Cheddar and Cranberry: £6, Kinda Co.

Vegan founder Ellie set out to find the perfect plant-based cheese several years ago, after struggling to satisfy her cheese cravings. The result is Kinda Co: which sells a range of inventive, nut-based cheeses both online and at vegan festivals across the country.

Not only do they focus on healthy ingredients (such as miso, natural cultures and apple cider vinegar), but all items use glass jars and biodegradable wax paper in a bid to cut down on plastic. The white Cheddar and cranberry slice is a new take on a Christmas classic.

White miso gives the cheese an addictive tang, which is perfectly suited to the dried strawberries, while the mixture of cashew nuts and coconut oil creates a creamy base.

If you're planning on making an order, look out for theFaux Lox+Dill Cream cheese variety (£7), which uses fermented carrots as a convincing substitute for smoked salmon.

Buy now

The Verdict: Best vegan cheeses

Tyne and Chease’s indulgent Caramel Pecan Creamed Cheese[http://www.yumbles.com/tyne-chease/caramel-pecan-creamed-chease.html] gets our vote for an indulgent festive purchase.

If you’re looking for something more budget-friendly, we love Asda’s Cranberry Wensleydale[http://groceries.asda.com/product/fruit-flavoured-smoked/asda-wensleydale-cheese-with-cranberry/910001972140] alternative.

Finally, if you’revegan and health-conscious, then the Naturally Vegan Food Company[http://www.yumbles.com/the-naturally-vegan-food-company/the-vegan-cheese-collection-gift-box.html]’s taster box is perfect for a Christmas spread.

If you're a fan of the Mediterranean diet, get ready to do a victory dance. For the first time, the Mediterranean diet has won the gold as 2019's best overall diet in rankings announced Wednesday by US News and World Report.[https://urldefense.proofpoint.com/v2/url?u=https-3A__health.usnews.com_best-2Ddiet&d=DwMGaQ&c=W8uiIUydLnv14aAum3Oieg&r=eBiGgXECL5TyZF9gR9BlqdKJx8U4imeJ9qFasPBXfo8&m=w1Nmgk-z5mWEnG8B8LINPhBR6Vs7KF98HJflk0lJ0wY&s=4UEHjOrGr7b_yR6--uGiMZWUY_M-1mwf9hjfb3KPmBI&e=]

The analysis of 41 eating plans also gave the Mediterranean diet the top spot in several subcategories: best diet for healthy eating, best plant-based diet, best diet for diabetes and easiest diet to follow.

The high accolades are not surprising, as numerous studies found the diet can reduce the risk for diabetes[http://www.cnn.com/2009/HEALTH/08/31/mediterranean.diet.diabetes/index.html], high cholesterol[https://www.cnn.com/2016/08/29/health/mediterranean-diet-statin-study/index.html], dementia[https://www.cnn.com/2017/07/17/health/mediterranean-style-diet-prevents-dementia/index.html], memory loss[https://www.cnn.com/2015/10/21/health/mediterranean-diet-healthier-brain/index.html], depression[https://www.cnn.com/2018/09/26/health/mediterranean-diet-depression-study-intl/index.html] and breast cancer.[https://www.cnn.com/2017/03/07/health/mediterranean-diet-breast-cancer-study-food/index.html] Meals from the sunny Mediterranean region have also been linked to stronger bones[https://www.cnn.com/2016/03/28/health/mediterranean-diet-wins-again-helps-bones/index.html], a healthier heart [https://www.cnn.com/2016/04/26/health/mediterranean-diet-heart-attack-stroke/index.html]and longer life[https://www.cnn.com/2014/12/03/health/mediterranean-diet-longevity/]. Oh, and weight loss[https://www.cnn.com/2016/07/18/health/high-fat-mediterranean-diet-benefits/index.html], too.

The diet features simple, plant-based cooking, with the majority of each meal focused on fruits and vegetables, whole grains, beans and seeds, with a few nuts and a heavy emphasis on extra virgin olive oil. Say goodbye to refined sugar and flour except on rare occasions. Fats other than olive oil, such as butter, are consumed rarely, if at all.

Meat can make a rare appearance, usually only to flavor a dish. Instead, meals may include eggs, dairy and poultry, but in much smaller portions than in the traditional Western diet. Fish, however, are a staple.

"It's more than a diet, it's a lifestyle," said Atlanta registered dietitian Rahaf Al Bochi, who teaches the Mediterranean diet to her clients. "It also encourages eating with friends and family, socializing over meals, mindfully eating your favorite foods, as well as mindful movement and exercise for a complete healthy lifestyle."

What is a 'best diet?'

To judge the diets, a panel of experts in heart disease and diabetes, nutrition, diet, food psychology and obesity reviewed research about the diets from medical journals, government reports and other resources.

Angela Haupt, assistant managing editor of health for US News and World Report, said the experts then ranked the diets in seven categories: "how easy it is to follow, its nutritional completeness, its ability to produce short-term and long-term weight loss, its safety and its potential for preventing and managing diabetes and heart disease."

In 2018, the top spot for best overall diet[https://www.cnn.com/2018/01/04/health/keto-worst-diet-2018/index.html] was a tie between the Mediterranean diet and the DASH diet, which stands for dietary approaches to stop hypertension, or high blood pressure. This year, DASH came in second, with third place going to the flexitarian diet, a plant-based diet that allows meat on rare occasions. Fourth place was a tie between the brain-focused MIND diet and Weight Watchers.

What do all of these diets have in common? They require the use of minimally processed foods and focus on fruits, vegetables, beans, lentils, whole grains, nuts and seeds, said internist Dr. Sharon Bergquist, who founded the lifestyle medicine and wellness programs at Atlanta's Emory University.

"These minimally processed plant-based foods affect our health in a very deep way," explained Bergquist, who was not on the US News and World Report panel of experts.

"They reduce inflammation, reduce oxidative stress, balance our gut bacteria, and they're getting at the root cause of disease," she added. "It's the same consistent theme that helps with overall health."

CNN contributor and registered dietitian Lisa Drayer says the highest-ranked diets have another important commonality: They allow for the occasional indulgence.

"Whether it's a glass of red wine on the Mediterranean diet or a piece of cake on Weight Watchers, it allows people to plan for an indulgence that would otherwise be forbidden," Drayer said. "So much about weight loss is mental, and being able to incorporate all foods, including a treat, is really important for any healthy eating plan."

The lowest-ranked overall diets were the Dukan diet, the Body Reset diet, the Whole30 diet and the popular keto diet, which all focus on high-protein or high-fat foods with minimal carbohydrates.

"Those are diets that have few substantiated claims, are extremely restrictive, harder to follow, and they eliminate entire food groups, which is really not something that's substantiated by science," Bergquist said.

Best overall diet for weight loss

For this category, the panel of experts looked at a diet's short-term and long-term weight loss success, weighing both equally. The popular Weight Watchers diet came out on top.

"Weight Watchers uses a point-based system that assigns very low or zero points to fruits and vegetables," Bergquist said, adding that it recently began assigning no points for plant-based sources of protein like beans, lentils and tofu.

Weight Watchers, which also won first place in the best commercial diet category, has an important component needed in any successful diet: support. In addition to in-person meetings and optional one-on-one consultants, the plan offers an online community.

"We find that people really want to talk about their diets," Haupt said. "That's just something that helps people stick with them. And Weight Watchers has great support built into the program, and that really seems to resonate with people."

Second place for overall diet for weight loss went to Volumetrics, a diet that focuses on using low-calorie, high-density foods such as broth-based soup and nonstarchy fruits and vegetables to reduce hunger.

"It's all about energy density," Drayer said. "It explains why a low-calorie salad or a soup eaten before a meal will help you eat fewer calories for the entire meal, compared to if you skipped the salad or the soup."

Third place was a three-way tie between the flexitarian diet, the vegan diet and Jenny Craig, which also came in second for the best commercial diet.

Best diet for quick weight loss

Haupt stresses that the quick weight loss category is for the person who needs to lose a few pounds for a special occasion, as the diets were evaluated for only a two-month period.

"Effectiveness as a short-term diet does not mean that it is a good idea for long-term weight loss, which is more important for your health, "she said. "In fact, one of our experts said these techniques often contradict everything we know about long-term weight management."

According to Bergquist, these diets can be deceptive because of their initial success.

"In the short term, they may show a slightly faster rate of weight loss," she said, "but in the long term, there's no evidence that these diets are any faster or better at helping people lose weight."

What's the winner in this category? The HMR diet, which is designed for those who need to improve their health quickly by losing a significant amount of weight under close medical supervision. It offers at-home and in-clinic options, and all meals and snacks are delivered for a specific period of time.

"The calorie range for the in-clinic option is pretty low, and that's why they're providing the medical supervision to make sure that people are staying healthy while they're on the program," Haupt said.

Second place was a four-way tie: Weight Watchers, a version of the Medifast meal-replacement plan called Optavia, and the Atkins and the keto diets, which both emphasize low-carb, higher-fat meals that place the body into a state called ketosis, in which it burns fat cells for energy.

Drayer is concerned with any type of diet that is too restrictive in food choices and worries about the role of ready-to-eat meals, shakes and snacks.

"They're not necessarily teaching you how to eat healthfully on your own and how to make healthy choices," she said, adding that she had seen this happen all too often in her own clients.

"They were so severely restricted, and they didn't know how to incorporate other foods back into their diets in a reasonable way," Drayer said. "So they not only regained their weight back, but they gained even more weight than where they started, which is really distressing."

Best diets for diabetes and heart health

No surprise here: The Mediterranean diet ranked first in best diet for diabetes and tied for first place in best heart-healthy diet.

"The foods in the Mediterranean diet are really high in antioxidants, vitamins, minerals and fiber, which are all key components for reducing the risk for chronic disease," said Al Bochi, who is also a spokeswoman for the Academy of Nutrition and Dietetics.

The six-way tie for best heart-healthy diet also includes the DASH diet; the MIND diet; the vegan diet; the Dr. Dean Ornish diet, which he says is the only scientifically proven program to reverse heart disease in a random clinical trial without drugs or surgery; and the TLC diet, short for therapeutic lifestyle changes.

The Ornish diet program to reverse heart disease focuses on more than an extremely restrictive diet; it also addresses exercise, stress reduction and social support.

The TLC diet was created by the National Institutes of Health's cholesterol education program and is focused on lowering the body's bad cholesterol, known as LDL. However, it can also be used for weight loss.

When it comes to diabetes, four diets tied for second place in the US News and World Report ranking: the DASH diet, the flexitarian diet, the Volumetrics diet and the Mayo Clinic diet, which says it provides personalized meal plans, weight and fitness trackers and the expertise of nearly a dozen experts.

Why rank diets?

Haupt says the goal of the US News and World Report diet rankings is to clear away clutter.

"New diet trends are a dime a dozen," she said. "We want to provide comprehensive, trustworthy information that highlights the diet standouts and those that don't perform so well in an array of different categories."

Bergquist agrees that expert rankings provide value to the consumer who wants to lose weight safely and improve their health.

"It's a chance for experts to help the general public separate diets that are looking for their 15 minutes of fame from diets that are based on what we know about the fundamentals of healthy eating," she said. "It's really replacing controversy and confusion with consensus."

By Sandee LaMotte, CNN

In the first of a four-part series about de-stressing your life, Dr Rangan Chatterjee reveals the small dietary changes that will have a big impact on your mood, energy levels - and waistline

What's your big goal for the year ahead? For millions, it's to lose weight. For others, it might be to drink less, to exercise more, to eat better, sleep well or simply feel happier. Most of us are aware that these goals are interconnected.

But what if I told you that the one thing underpinning all of them ? and which you must tackle first, if you want to achieve any of them ? is stress? Many of us are blasé about stress, particularly on a day like today, assuming the odd break means we can get away with burning the candle at both ends forever. In fact, the World Health Organisation calls stress "the health epidemic of the 21st century."

As I explained in yesterday's Telegraph, up to 80 per cent of all GP consultations are now thought to be somehow related to stress ? and it can have devastating long-term consequences on the body. Every day, I see patients in my south Manchester surgery who are stressing themselves to an early grave. I know a local accountant who is go-go-go the entire time. He never switches off, and his wife is worried. But because he has no serious symptoms at the moment, he won't listen to either of us. He assumes nothing's going wrong and that the stress isn't harming him. But it's probably damaging his body so much that, within a few years, I suspect he'll be hit with a serious health crisis.

Too much stress contributes to the development of obesity, type-2 diabetes, high blood pressure, cardiovascular disease, strokes and Alzheimer's disease. Stress is also a key player in insomnia, burnout and auto-immune disease, as well as many mental health disorders such as anxiety and depression. Yesterday, I explained that stress is a two-way street. It makes us more likely to binge on bad food and alcohol, sleep badly and skip exercise ? poor lifestyle choices that are significant stressors on our bodies, themselves.

The very existence of stress generates more stress, and the more of it piles up, the less we're able to cope. So, over the next four days, I'm going to give you a series of practical solutions to help you de-stress the four key corners of your life: your diet, your day, your relationships and your digital world. Most of them are simple and some take fewer than 15 minutes a day, but start slowly, and pick one or two of the easiest tips from each, before building up.

You're not aiming for perfection in any one corner, but balance across all four. The more you do, the easier it becomes to do the rest. If you're not sure where to start, pick the one thing you feel you can do straight away and try it for the next seven days. Bit by bit, I've seen these tools change the lives of thousands of my patients. I know they'll do the same for you.

What stress does to your weight Stress, whether physical or emotional, is detected by a part of the brain called the hypothalamus, which sets in motion a series of processes that prime your body to deal with danger. Sugars are released into our blood so that we can run faster. At the same time, muscle and liver cells within our body become resistant to the hormone insulin, so that this sugar remains in our bloodstream and available for the most important organ of all, our brain.

Our heart starts to beat faster and our blood pressure rises, while non-essential processes such as digestion are switched off. These effects are the phenomenal creations of evolution. But they've been designed to work for us in short, sharp bursts. The big problem in modern society is that we're surrounded by triggers that continually activate our stress state. Long-term insulin resistance contributes to the development of type-2 diabetes and obesity. If attention is diverted away from digestion for too long, complaints such as constipation, bloating, indigestion and IBS will result.

And short-term inflammation ? the result of your immune system firing up to help you recover quickly, in case you're wounded ? can become chronic when it is not switched off. Chronic inflammation is at the heart of many serious complaints that I see in my surgery every single day, including obesity and type-2 diabetes.

All of these, combined, can cause our bodies to "hold" on to weight, no matter what our food intake. Stress and the gut Trying to tackle the stress of modern life by practising meditation or going on a break, while helpful, might have only a limited effect if the lifestyle choices we're making in the kitchen are generating constant stress signals in our body through our gut. We don't think of that cheese and pickle baguette as something akin to a radio station or a book. But, effectively, that's what it is. The body reads information from that baguette, then sends it to the brain.

A key part of that communication stream comes from a hidden world we didn't have much understanding of until recently: our gut microbiome, a massive population of different bugs that, in total, weigh about as much as the human brain.

Studies on animals find that an absence of gut bugs increases our reactivity to stress. This has led to some scientists calling them "our brain's peacekeepers". As amazing as it sounds, if we treat our gut bugs poorly, they can make us feel anxious and depressed. But if we treat them well, they can lighten our mood - as well as our weight. Here's how...

1. Eat the alphabet Eating a diverse diet rich in fibre is one of the single best things we can do to live a more stress-free life, as it will encourage a diverse and resilient microbiome. If we increase the variety of vegetables, low-glycaemic fruits (such as blueberries and cherries) and fibre-rich foods such as beans and legumes in our diet, we'll increase the amount of fibre we're eating, which encourages the growth of gut bugs, sending signals to your brain that everything is good. Eating fermented foods such as kimchi, sauerkraut or kefir, which introduce beneficial bacteria into your body, will also improve your gut health. Aim to eat at least 26 different plant foods every single month - to help you achieve this goal, you can download my Eat The Alphabet chart from drchatterjee.com/alphabetchart and pin it up in your kitchen.

2. Protect your microbiome Modern life, it seems, is at war with our gut bugs. Besides the usual culprits - sugar, alcohol and smoking - highly processed foods, such as ready meals, biscuits, many breakfast cereals and some highly processed breads, can have a terrible effect on their health.

Some additives, emulsifiers, pesticides and artificial sweeteners can decimate them, as well as antibiotics used in food production and often over-prescribed by GPs. And our modern obsession with hygiene means that we are nuking many of our gut bugs with constant use of antibacterial sprays and hand-washing. Do your best to avoid what you can.

3. Restrict your eating window Our gut bugs thrive when they get a break from food, giving them chance to clean up the gut wall. Give yourself a 12-hour window every day without food; for example, if you finish your evening meal at 7pm, don't have your breakfast until 7am the next day. When my patients time-restrict their food intake, I have noticed it help with weight loss, blood-sugar control and general stress levels, as well as digestive disturbances such as indigestion and heartburn.

Evidence is also growing that an earlier dinner time is better for your weight, blood-sugar balance and stress levels. I recommend that you try to finish eating at least three hours before going to bed. For example, if 10pm is your bedtime, you want to finish your evening meal by 7pm. You may find this tricky at first if you are not used to it, but stick with it. Within one or two weeks of starting, patients often report back to me that their heartburn, indigestion and sleep quality improve as well. If you have to work late, consider taking some food with you or eating dinner in an early evening break.

4. Find your personal exercise prescription One of the major problems with the human stress response is that it evolved to put us in fight-or-flight mode. But today's stressors are very rarely physical - we won't do much good by physically assaulting or running away from our email inbox, as much as we might like to. Exercise gives our body what it needs and is expecting: a physical workout that helps ease us out of fight-or-flight mode. Do a form of stress-busting exercise every day - as simple as a brisk walk at lunchtime, a highintensity interval session or a long jog. The key is to move your body as much as possible each day, in any way you like, and do a form of strength training at least twice a week.

It is also possible to over-exercise and cause your body more stress. If you've been super busy at work and didn't sleep particularly well, it may be that you're closer to your stress threshold and would benefit from a restorative form of exercise such as yoga or Pilates, rather than pounding away on the treadmill.

5. Treat yourself to sleep If you're not prioritising your sleep, it's highly likely that you're not getting enough. Sleep tends to be the first thing to be pushed to the side, because we just don't realise how much we need it and how much stress a lack of it can cause.

If you look in the brain, you see a collapse in memory, attention, cognitive function, decision-making capacity and ability to learn new things.

In the body, levels of adrenalin, noradrenalin and cortisol increase, inflammatory markers go up, and we become resistant to insulin, which makes it more likely that we will develop type-2 diabetes.

Sleep deprivation is also linked to obesity because it causes hunger and satiety hormones to reverse, meaning that our appetite goes up and we feel less full, making weight gain more likely. If you are lacking in sleep, you're going to be significantly less likely to eat the alphabet because you'll be craving sugary junk food.

So, if you've had a bad day, rather than sitting on the sofa eating pizza, washing it down with half a bottle of wine and staying up late into the evening on social media, I'd like you to dim the lights, switch off your screens and gorge yourself on a generous portion of extra sleep.

Tomorrow: Raise your stress threshold ANDREW Sign up for the Telegraph 365 newsletter and get a bitesize tip on how to improve your mind and body, every day of 2019 telegraph.co.uk/ 365daily Adapted from The Stress Solution by Dr Rangan Chatterjee, published by Penguin Life (£16.99). To order your copy for £14.99 plus p&p, call 0844 871 1514 or visit books.telegraph.co.uk

Modern life is at war with our gut bacteria, which increases our reactivity to stress

Politics, science, technology, TV, books … here’s what to expect in the year ahead

A year is much more than just 365 days, or one orbit of the Earth around the sun. One year produces so many events and human stories that in 2018 alone, the Guardian published more than 73,000 news articles.

Much of what happens is unpredictable. But with 2019 only hours old, there are a few things that can confidently be foretold.

Politics and elections

Brexit may be clear as mud, but if it’s making you queasy then here are a few fixed political points in the year to steady the balance.

It’s a busy year for elections, with four of the world’s most populous democracies holding votes.

Europe holds parliamentary elections from 23-26 May to elect 705 new MEPs. Watch closely to see how well the populist far-right does. It’s been gaining ground across the continent, but will the attentions of Steve Bannon[https://www.theguardian.com/world/2018/nov/21/steve-bannons-rightwing-europe-operation-undermined-by-election-laws], formerly of Breitbart and the Trump White house, help or hinder?

Before that, Nigerians head to the polls in February. Sitting president Muhammadu Buhari faces a record 78 opposition candidates, some of whom accuse him of failing to deal adequately with corruption.

Following an illness earlier this year and five months spent recuperating in London, there have also been bizarre suggestions that he has been replaced by a body double[https://www.theguardian.com/world/2018/dec/04/nigeria-election-buhari-battles-body-double-rumours-and-economic-woe]. That would certainly make campaigning in the world’s seventh most populous country easier.

Other major democracies going to the polls include India, where Narendra Modi is seeking a second term, and Indonesia, where the one-term incumbent faces a challenge from yet another rightwing populist candidate.

Speaking of rightwing populists, Brazil’s newly elected and controversial president Jair Bolsonaro takes office on 1 January. Other notable votes take place in Thailand (February), South Africa (May), Argentina (October) and Canada (October).

And finally, in Japan, Emperor Akihito will abdicate in April owing to health concerns after heart surgery and treatment for prostate cancer. This will be the first time a Japanese emperor has abdicated in two centuries.

What summits are there to climb?

The last time France hosted the G7 summit of the world’s most industrialised nations in 2011, migration was a fringe issue, Emmanuel Macron was a little-known investment banker and the riots were happening across the channel in the UK.

This time around, President Macron will welcome his peers to Biarritz in August. Priorities are likely to include climate change, the Global Partnership for Education, towards which Macron pledged €500m (£452m) of funding, and migration.

The G7’s larger cousin, the G20, will meet in Japan in June. Founded after the financial crash of 2008, the summit promotes cooperation and a focus on global financial markets. The G20 has been criticised[https://www.theguardian.com/world/2018/nov/29/g20-summit-argentina-2018-ten-years-later-populism] for becoming “a stage for an increasing number of authoritarian and populist leaders who are there to perform for their restive followers back home”. According to the Guardian’s economics editor Phillip Inman, this year’s version will be “increasingly hampered by Donald Trump’s protectionist policies”.

Another year means another COP – the abbreviation for the annual UN climate summits that warn, with increasing severity, how imperilled we are by our carbon addiction. Alas, this year’s host, Brazil, has pulled out owing to “budget restrictions[https://www.theguardian.com/world/2018/nov/28/brazil-reneges-on-hosting-un-climate-talks-under-bolsonaro-presidency] ”. If the summit goes ahead, discussion will surely centre on Trump’s continued disavowal of the Paris agreement, and a review of the 2030 UN Sustainable Development goals, four years on from their implementation.

The Women Deliver conference[https://wd2019.org/], which is held once every two years on women’s equality and gender rights, will take place in June in Canada, with Justin Trudeau billed to speak – the first time a sitting leader of a country has done so.

What anniversaries and milestones are coming up?

As 2018 marked the 100th anniversary of the first world war armistice, so 2019 will see the 100th anniversary of the Treaty of Versailles, the formal end of the conflict. It is also the 70th anniversary of the founding of Nato, the collective defence pact originally set up to “keep the Russians out, the Americans in and the Germans down”.

The internet is poised to pass a notable milestone meanwhile, with predictions that the number of global users will pass the 50% mark[https://www.theguardian.com/technology/2018/oct/18/exclusive-dramatic-slowdown-in-global-growth-of-the-internet] in 2019. In the US, for the first time ever the population will have more people older than age 60 than younger than age 18.

In births and deaths, 2019 is the 500th anniversary of the death of original renaissance man Leonardo Da Vinci and the 200th anniversary of the birth of Queen Victoria. It also marks the 250th anniversary of Captain Cook reaching New Zealand, and the 20th anniversary of the creation of the euro.

What’s happening in science?

This year will mark the 50th anniversary of Neil Armstrong and Buzz Aldrin’s moon landing. No human has been back since 1972. Perhaps a moment to rekindle interest in our cosmological outrider[https://www.theguardian.com/science/2018/nov/19/space-how-far-have-we-gone-and-where-are-we-going].

The year will also see the first private spacecraft from SpaceX and Boeing take crews to the International Space Station. There will also be the first images of a black hole from the Event Horizon telescope, and the first results from the ESA’s Trace Gas Orbiter probe, which is circling Mars to work out if methane plumes are due to life on the planet.

Back on Earth, the landmark agreement to redefine the kilogram will come into place in May. Rather than being tied to a lump of metal stored in a Parisian vault, the new definition will be a reflection of Planck’s constant, a number rooted in the quantum world. The weight is over.

2019 could see the first birth in the UK of a baby with DNA from three parents. The process of mitochondrial transfer was legalised in Britain in 2015 and Professor Alison Murdoch has since been pioneering the technique in Newcastle, with the first woman selected to take part in the process this year.

John Vary, a futurologist at John Lewis’s Innovation Labs, notes some broader, science fiction-style developments which may also intrigue us in 2019.

“In 2019, we could reach a point where customers can share their DNA with shops so that retailers can tailor products to a customer’s genetics or ancestry,” he predicts. “Waitrose & Partners is piloting DnaNudge[http://www.dnanudge.com/], an app which will use shoppers’ DNA to help them make healthier choices while food shopping. Another example is OME Health[https://ome.health/], which offers health plans built on a person’s gut microbiome, genetics blood markers and other health data.”

Will there be a global recession?

Despite 2019 being the Chinese year of the pig – a symbol that denotes wealth – in the western world there may be an economic downturn ahead. According to economics editor Phillip Inman: “A recession looms in the UK, Europe and the US. It is possible once the impact of slowing growth in China and rising interest rates are put together, since most of the momentum after the financial crash of 2008 was based on cheap borrowing and the rapid expansion of Chinese trade. Without these two essential elements, the major economies are heading for trouble. Most doomsayer analysts consider 2020 a more likely year for a slump, with the seeds sown in 2019 by poor policy making.”

The World Bank is predicting[http://www.worldbank.org/en/publication/global-economic-prospects] a global slowdown in 2019, as the stimulative impact of Donald Trump’s tax cuts wane in the US and China is forced to restrict borrowing by state and private businesses.

Central banks are also poised to tighten monetary policies. “The US Federal Reserve is due to increase interest rates at least twice in 2019,” Inman says. “It is also expected to further unwind its quantitative easing policy. An increase in the cost of borrowing is already hitting the US housing market which is reaching levels of distress last seen in the run up to the 2008 financial crash.”

The World Trade Organisation could be unableto judge trade disputes between countries in 2019. When he took office, Donald Trump blocked the appointment of judges to the WTO to replace retirees, leaving a large number of vacancies. The WTO needs a minimum number of legal experts to judge cases and could be inquorate as early as spring 2019[https://www.npr.org/2018/09/20/650052772/experts-say-trumps-hostility-to-the-wto-could-cripple-it?t=1543581394966].

What should I buy in 2019?

There will be no shortage of new technological releases in 2019. Samsung is due to launch follow-ups to its critically acclaimed Galaxy S and Note[https://www.theguardian.com/technology/2018/aug/22/samsung-galaxy-note-9-review-phone-bluetooth-s-pen] series, while Apple will be announcing a new iPhone in September, and Google the Pixel 4 phone in October.

Amazon will be announcing new products in September, likely to be iterations of its home management Echo devices, and Apple will unveil new Macs and tablets in October. In terms of tech developments, the Guardian’s assistant technology editor Samuel Gibbs predicts that the biggest advance will come in the form of flexible screens in 2019.

Futurologist John Vary adds that the voice search enabled by products such as Google Home and Amazon’s Alexa will develop to “enable people to find items however they describe them and in any language”. While augmented reality could enhance personalised shopping to mean “smart home tech could act as your own shopper, alerting retailers in advance when you’re looking for a product,” he says.

What can I (binge) watch?

With Channel 4 moving to new headquarters in Leeds in 2019, the Guardian’s TV editor, Lanre Bakare, picks the fourth season of comedy Catastrophe and Brexit: The Uncivil War, as ones to watch on the channel next year. Catastrophe tells the story of a couple raising a child conceived in a one night stand. The two-hour Brexit drama meanwhile stars Benedict Cumberbatch as Leave campaigner Dominic Cummings, and is based on first-hand accounts of the campaigns leading up to Britain’s referendum on leaving the EU in 2016.

Further recommendations include big-budget sequels – the final season of fantasy thriller Game of Thrones, airing on Sky Atlantic in April. There’s also the third season of the brooding American noir True Detective in January. Moonlight Oscar winner Mahershala Ali takes the lead from season two’s Colin Farrell and Rachel McAdams. Finally, everyone’s favourite local Norwich radio presenter returns to the BBC with a satirical take on a live talk show in February on This Time … With Alan Partridge.

On the big screen there is a volley of new releases to look out for. With 2018 being a record-breaking year for box office takings, major studios will be hoping to replicate their success with a slate of blockbusters: a live-action Lion King in July, Captain Marvel in May – the franchise’s first female-led film – Toy Story 4 in June, Terminator 6 and Frozen 2 in November, and the final instalment of the Star Wars sequel trilogy, Star Wars IX, in December.

The Guardian’s film editor Catherine Shoard’s picks include King’s Speech director Tom Hooper’s adaptation of the Andrew Lloyd Webber musical Cats, starring Idris Elba, Taylor Swift, Judi Dench and Ian McKellen. There is also the Downton Abbey movie; Martin Scorsese’s The Irishman, starring Godfathers Al Pacino and Robert De Niro; Get Out director Jordan Peele’s latest horror, Us; an adaptation of Donna Tartt’s novel The Goldfinch starring Nicole Kidman; and Greta Gerwig’s adaptation of Little Women, starring 2018’s newcomer Timothée Chalamet.

Valued at more than $93bn, the games industry almost doubles the revenue of the international film industry, and the Guardian’s games editor Keza MacDonald has some selections for 2019. Keza picks out Harry Potter Go, made by the creators of Pokémon Go, as “another potential world-conquering mobile game”, she says, this time based on the Harry Potter universe. There is also Sekiro: Shadows Die Twice – a horror samurai game from the director of Dark Souls, “one of the best games of the decade”, according to MacDonald; and The Last of Us Part 2, an “intense, cinematic game about a survivor of a world-decimating outbreak – far from the usual boring zombie story”.

Further reading

Adele by Leila Slimani (February)

One of the runaway bestsellers of 2016 was Slimani’s Lullaby, a chilling tale of a homicidal immigrant nanny, and Slimani hopes to continue this success with a new novel telling the story of a sex-addicted Parisian journalist.

Black Leopard, Red Wolf by Marlon James (February)

Marlon James releases the follow-up to his Man Booker Prize-winning 2015 novel, A Brief History of Seven Killings. With Black Leopard, James creates an imaginary ancient world built on African mythology to tell the story of a hunter tracking a lost child. It is the first in a new trilogy, Dark Star.

The Liar by Ayelet Gundar-Goshen (March)

Israeli author Gundar-Goshen pens her third novel on a teenage girl who accuses an older minor celebrity of sexual assault. A fictionalised tale building on the #MeToo movement of 2017-18.

The Other Americans by Laila Lalami (March)

Pulitzer prize finalist Lalami writes a novel charting the American immigrant experience through the eyes of a Moroccan family living in California. It is already earning praise from the likes of JM Coetzee.

Clear Bright Future by Paul Mason (April)

Journalist Paul Mason follows up on 2016’s Postcapitalism, which formulated a collapse of capitalism as we know it, with a theorisation of what makes us human and how we are still capable of changing the future.

The Heartland by Nathan Filer (April)

Former mental health nurse Nathan Filer publishes his second book, a collection of first-person encounters and essays on the diagnosis and treatment of schizophrenia.

What will we eat in 2019? If some prognosticators have their say, we'll be crunching on salads of celtuce, a lesser-known green, mixed with either high-end bespoke vegetables personally designed by chefs, or virtuous ugly produce destined for the trash. Maybe they'll be topped with a crunch of chulpe corn or watermelon seeds.

We'll tear into interesting forms of bread - bing, from China, and manaeesh, from the Levant. There will be CBD in everything, smokeless smoke in everything, and real milk in nothing - not in our milkshake IPAs, which are not what they sound like (they're brewed with lactose) - because pea milk and oat milk are taking over.

"Regional flavours" will be important, specifically those from India, the Pacific Rim and "the 'stans" - Kazakhstan, Tajikistan and Uzbekistan. Plant-based eating will continue to grow. Some products that were formerly shelf-stable, such as granola bars and olive oil, are going to need to be refrigerated. It will be a good year for dietitians, who are poised to become the new celebrity chefs. We'll pay for our sandwiches with cryptocurrency, as if that's no big deal.

Then again, it's not like 2018 panned out exactly how the prediction-makers thought it would. Yes, we ate artisan pickles and drank Cristalino tequila and had ghee and plenty of veggie-forward dishes. It's true that Jewish delis are on the upswing, and Israeli cuisine hit its stride. And tsukemen, or brothless ramen, got more popular. But why didn't we get really into deep-frying, or Tanzanian barbecue seasoning? Chain restaurants never picked up on "trash fish." Norwegian and Icelandic "Arctic cuisine" has yet to hit the mainstream. Other predictions - locally sourced produce, Instagrammable foods, "authentic ethnic cuisine" and street food - were already in, some for more than a decade.

What is a trend, anyway? There's no set way to measure one, no threshold of sales or number of products on the market past which a food becomes Certifiably Trendy, especially because food trends, like fashion, trickle down into mainstream ubiquity. There's just a bunch of market researchers and food industry consultants and publicists and journalists, a little bit of data, a looming Dec. 31 deadline and an intangible notion of what feels cool and new.

"The science to predicting a trend is to figure out, what is actually happening here? Is it just now, is there some sort of immediacy to it or does this actually have a longevity?" said Jenny Zegler, associate director of food and drink for consumer research company Mintel. "And, what does that mean, and what is that reflective of, in terms of what consumers want?"

Some trend lists come from huge teams of professional trendspotters and industry-watchers, and some come from just one person with a finger on the pulse. But all of the predictions tend to fall into one of four categories. In the first category are the vague, evergreen, massive buzzword trends - like "plant-based foods" and "specialized diets" - that will both always and never be trends, because they're so all-encompassing. But don't count them out, says Zegler, whose report for Mintel pinpoints three trends: sustainability, foods for healthy aging and enhanced convenience foods. A list should be measured by its goals, Zegler says: theirs is global in scope, and based on the work of 91 analysts in 13 countries, backed by actual consumer research data, and geared toward large brands for whom a menu change is a major supply-chain overhaul and a big gamble.

"I think a lot of what we're trying to do is identify things that are already happening," Zegler said. It's "not necessarily that companies that we work with are astounded by this prediction. It's more of, you know, this is where we should be going, and this is what we should be looking at."

What many of us think of as trends, such as Thai rolled ice cream or "souping" or cake pops, are actually fads.

"A fad is something that kind of comes quick and goes and maybe makes a viral sensation," said Zegler, but a trend has staying power. "That is really impactful, especially in a business sense, that you know if you're going to switch to make everything this new cool flavour, you want to make sure that it's the flavour that's going to last."

But calling a major cultural force already at play within the industry a trend has another benefit: you can never be wrong. That extends to things that Zegler would call fads, too: among this year's lists, there are predictions that za'atar and orange wine and CBD will become trendy. They're in the second category - specific "predictions" that are already trendy, in some circles, at least. Za'atar might not be everywhere yet, but it's long been having a moment in the independent restaurant scene.

That's the other tricky thing about trend lists: whom are they for? When food media, which tend to live in coastal cities, see a list that predicts rainbow-coloured unicorn food as the next hot thing, they might think it's hopelessly outdated. Meanwhile, if you go by sales figures, that trend is still making its way throughout the U.S.: it was one of the most-searched food trends on Google this year, and it hit mainstream ubiquity, perhaps, when Sam's Club began selling a unicorn cake.

"We used to say facetiously that when something appeared on a Marriott menu, you knew the trend was over," said Michael Whiteman, president of Baum & Whiteman, a restaurant consulting group.

Whiteman's list says the big trends for next year will be more widespread culinary use of robots, an escalation of the "meal kit wars," katsu sandwiches, Szechuan hot pot, and the aforementioned bing and food from the 'stans - the latter, something that Whiteman has noticed becoming rapidly popular throughout Brooklyn, where so many trends begin.

"Could I be wrong on that? I certainly could," he said.

That's the third category: trends that may or may not take off - who knows? Whiteman's list comes from travel, his many years of experience and intuition.

"You know, something catches your eye," Whiteman said. "And over the course of a year you see three or four places and you say, 'Well, let's watch this.' ... I wish I had a scientific answer for you."

The end-of-the-year list rush is real.

"Over the past 10 years, the number of people making predictions online has probably quintupled," said Whiteman, in part because journalists write about them (guilty). And, any company can use a food trend list as a branding and engagement opportunity, which is why you see lists from Google and Chase Bank.

The fourth category, of course, is trend predictions that seem to hit the perfect sweet spot: still under the radar enough, but gaining momentum, and poised to take off. For this year, that might include Peganism (paleo veganism), lab-grown meat, shelf-stable probiotics (active beneficial bacterial cultures in foods that don't need to be refrigerated), as well as healthy desserts made with ingredients such as taro pudding and quinoa.

"I tend to look at what the independent (restaurants) are doing, because that tends to be where trends start," Thorn said. "If they make it into the smaller chains, we really have something going. It's an open question of when it becomes really mainstream. If it goes to casual dining, like TGI Fridays, if it makes it to fast food, like McDonald's, it's a thing."

But most of the people reading these predictions aren't restaurateurs or food producers. They might not even live in cities where these trends are readily accessible. But from late December through early January, they'll eat them up nonetheless.

"It is something that people want to be part of," Zegler said. "They want to be part of that leading edge. They want to be the first one in their friend group to identify this." Most of all, she adds, "They want to be able to post on Instagram."

Cutting back stress could change your life - Dr Rangan Chatterjee talks Maria Lally through his four-step plan

When I arrive at Dr Rangan Chatterjee's Wilmslow home, I walk into his kitchen to find him strumming the guitar. "I love playing," he explains, "and it's great for de-stressing."

Stress is exactly what I'm here to talk about. Chatterjee, who has been a GP for more than 17 years, has just written his second book, The Stress Solution - the follow-up to last year's Amazon number one bestseller, The 4 Pillar Plan: How to Relax, Eat, Move and Sleep Your Way to a Longer, Healthier Life.

"When I wrote the first book, the pillar nearly everybody spoke to me about was the stress and relaxation one," Chatterjee says. "Around the same time, I was noticing that nearly all the problems I was seeing in my surgery were related to stress. Whether it was a low libido, insomnia, inability to concentrate, not enjoying their job, depression or anxiety, it was clear that stress was often the root cause."

Yet he believes we've become so used to feeling stressed, that we've normalised it. "So much has been written about eating healthily, exercising - even sleep has been talked about a lot recently. But because you can't quantify it like weight or sleep, it felt like stress wasn't getting the same attention, despite the fact that up to 80 per cent of GP appointments are stress related."

So this is his prescription: The Stress Solution: The 4 Steps to Reset Your Body, Mind, Relationships and Purpose follows the same winning formula as his first book - taking you through revolutionarily simple steps to de-stress all four corners of your life - and will be serialised all week in The Daily Telegraph from tomorrow, to help you start your year as you mean to go on.

As well as his medical background, the 41-year-old star of BBC One's Doctor in the House draws on his own experiences as a busy, working father-of-two, juggling his GP patients with hosting the number one iTunes podcast, Feel Better, Live More, which has had more than one million downloads and featured guests from gut health "guru" Dr Megan Rossi and sleep expert Prof Matthew Walker.

Chatterjee's wife, Vidh, is a former criminal barrister who left her job to raise the couple's two children - they have an eight-year-old son and a five-year-old daughter - and now helps with her husband's business behind the scenes. "I get it," he says. "I get that we're all stressed, because I live that life to a certain extent, too. My wife and I juggle a lot. We're not perfect. We don't always get it right."

To demonstrate, he leaps off his kitchen stool to show me what he calls the "Cupboard of No Return" - aptly enough, as he opens the door, a golf ball falls out.

"I talk about this cupboard in the book," he says. "Most of us have them (I tell him I have a Drawer of Doom in my house) and they're crammed with the shrapnel of everyday family life, like broken screwdrivers, receipts, one child's glove and light bulbs that may or may not work. These cupboards aren't just the result of a stressful life, but they generate stress, too, by overwhelming and frustrating us."

He calls these "micro-stress doses", or MSDs, and the more they pile up, the less we're able to cope, and the more likely we are to fall out with others, binge on bad food and alcohol and store up problems that will inevitably tumble out on top of us at the worst possible moment.

So why are we all so overwhelmed? ""We're bombarded with App messages, texts dia alerts showing us me everybody else is all trying to have these with a constant need d have more."

"Our lives are supposed to be more convenient because of technology, but in reality it's suffocating us," says Chatterjee. "We're emails, WhatsApp and social media what a great time having. We're amazing lives to do more and Not to mention takes two salaries raise a family these days: "Both parents in the household often work; people move away from their families don't have support around them; working hours among the longest in Europe and bosses can now email us day and night in away couldn't 10 years "S'Stresseeps our health in other ion that it often ries to hese rents old ople m and port our are gest our w nd they ars ago. s intother ways.

If you're overwhelmed, you won't find time to nourish yourself through good food choices or exercise. Instead, you'll try to soothe your stress with sugar, wine-o-clock or bingewatching Netflix until midnight." As a result, most of our new year's resolutions tend to focus on the symptoms, rather than the root cause of our problems.

"In January, you may summon up the willpower to stop eating sugar, but if you're not addressing your stress you'll always crave sugar and then feel stressed about it," Chatterjee says. "It's the same with sleep: you can try early nights and lavender pillow spray, but the key is reducing stress. When you take small steps to tackle it, everything, from your health to your happiness and your relationships, will improve."

To understand stress, he says, we have to go back to evolution: "The stress response evolved to keep us safe. If a lion was chasing us, a series of biological changes happened in the body to help get us away from danger.

But when people have those responses day to day - sugar pouring into their bloodstream, their blood pressure soaring, cortisol and adrenalin pumping around - they begin to feel tired, sluggish and anxious. They put on weight, they can't sleep, their blood pressure becomes high and the sugar in their bloodstream raises their risk of type-2 diabetes. People talk of it as a diet-driven illness, but stress is also a contributor."

Besides contributing to the development of obesity, type-2 diabetes, high blood pressure, cardiovascular disease and strokes, stress is also a key player in insomnia, burnout and auto-immune disease, as well as many mental health disorders, such as anxiety and depression.

"Cortisol kills the nerve cells in your hippocampus, a small organ located within your brain, linked to memory, which is why chronic stress is linked to Alzheimer's," says Chatterjee. "When you're stressed, your body also diverts its resources away from non-vital functions like digestion and hormone production that aren't crucial to survival, so you get digestive issues and your libido goes. I'm seeing an epidemic of low libido at the moment."

And of course, as stress mounts, you react to everything in a disproportionate way: "You see problems where no problems exist, because stress causes you to use the emotional part of the brain, the amygdala, rather than the logical one. Your brain is on high alert to danger, but from a deadline rather than a lion. It's like you want to run away from your life."

Mental health problems are now so rife that one in four of us experiences them each year. "That's a staggering statistic and we're not doing anything about it," says Chatterjee. "GPs aren't trained in dealing with stress and are prone to medicating it, rather than addressing the cause."

This new book, then, prescribes a mixture of tips he follows himself and things his patients have tried and reported back to him as having worked: "I'm not going to tell you to do two hours of yoga a day. What the book gives people is simple tools they can use in a busy life."

Such as? "In the book I talk a lot about technology: I'm not against it but I've put boundaries in place that have changed my life. I have an old-fashioned alarm clock to wake me up and I leave my phone in the kitchen from 9pm onwards. I took notifications off my phone so I'm not drawn into it, and have a golden hour in the morning, where I won't look at my phone at all. I have an out-ofoffice on my email that explains I only check my emails on set days. I used to spend a Friday evening replying to 100 emails, but now I've taken back that time and spend it with my family instead, and I don't feel guilty about not replying to people."

For the high-powered but timepressed, carving out space for hobbies - such as guitar playing - or simply getting off screens and outside, is even more essential: "I love music but Iscre a o was flitting from song to song on my phone. So I now have an old-fashioned record player and I listen to an entire album, in the order the songs should be listened to. I don't binge-watch TV shows, because delayed gratification is a good de-stressor. As a family we play cards, read, muck about in the garden and do park runs.

"Lastly, it sounds simple, but do what you love. I had a patient who was a stressed CEO, beginning to dislike his job. I asked him what he loved doing and he said collecting trains. I prescribed him to collect them again and three months later he was a different person, and enjoying his job again."

Another key theme running through the book is to prioritise human connection over electronic communication: "Be around people you love," urges Chatterjee con communica and make sure you put your phone down while you're with them.

"Women are quite good at socialising and confiding in their friends, but men less so. Years ago there was the pub culture and yes, it was about boozing, but it was also about social banter and unwinding. But with the decline of the pub and more men sharing childcare, they're becoming increasingly lonely, with males aged 30 to 50 among the loneliest in society.

A few years ago, I realised I was neglecting my friendships - which was unknowingly causing stress - so twice a year I get together with my best university friends and we go on golf weekends. We need to plan it, but even if I go feeling exhausted I come back refreshed. It's not about the golf - that's just the glue that gets us together and gets us talking."

Chatterjee is nothing if not pragmatic; he knows we'll never completely rid ourselves of stress - nor should we wish to.

"Stress is like coffee: the right amount gets you up and going, and motivates you to be the best version of yourself.

"But like coffee, too much stress can tip you over the edge. So it's not about eliminating all stress, but keeping tabs on it, so you're energised by life, rather than burnt out by it."

Find out how, starting tomorrow... The Stress Solution by Dr Rangan Chatterjee is published by Penguin Life (£16.99). To order a copy for £14.99 plus p&p, call 0844 871 1514 or visit books.telegraph.co.uk Your anti-stress prescription for 2019 Don't miss Dr Chatterjee's four-part stress solution, which will be published in The Telegraph every day this week: Tuesday Lose your stress stone Wednesday Raise your stress threshold Thursday De-stress your relationships Friday The digital diet (that actually works)

'Stress is like coffee: the right amount gets you going, too much tips you over the edge'

Newly knighted cancer scientist Mel Greaves explains why a cocktail of microbes could give protection against disease

Mel Greaves has a simple goal in life. He is trying to create a yoghurt-like drink that would stop children from developing leukaemia.

The idea might seem eccentric; cancers are not usually defeated so simply. However, Professor Greaves is confident and, given his experience in the field, his ideas are being taken seriously by other cancer researchers.

Based at the Institute of Cancer Research in London, Greaves has been studying childhood leukaemia for three decades. On Friday, it was announced that he had received a knighthood in the New Year honours list for the research he has carried out in the field.

“For 30 years I have been obsessed about the reasons why children get leukaemia,” he says. “Now, for the first time, we have an answer to that question – and that means that we can now start thinking about ways to halt it in its tracks. Hence my idea of the drink.”

In the 1950s, common acute lymphoblastic leukaemia – which affects one in 2,000 children in the UK – was lethal. Today 90% of cases are cured, although treatment is toxic, and there can be long-term side effects. In addition, for the past few decades, scientists have noticed that numbers of cases have actually been increasing[https://www.theguardian.com/society/2017/apr/11/recorded-childhood-cancers-rise-worldwide-world-health-organization] in the UK and Europe at a steady rate of around 1% a year.

“It is a feature of developed societies but not of developing ones,” Greaves adds. “The disease tracks with affluence.”

Acute lymphoblastic leukaemia is caused by a sequence of biological events. The initial trigger is a genetic mutation that occurs in about one in 20 children.

“That mutation is caused by some kind of accident in the womb. It is not inherited, but leaves a child at risk of getting leukaemia in later life,” adds Greaves.

For full leukaemia to occur, another biological event must take place and this involves the immune system. “For an immune system to work properly, it needs to be confronted by an infection in the first year of life,” says Greaves. Without that confrontation with an infection, the system is left unprimed and will not work properly.”

And this issue is becoming an increasingly worrying problem. Parents, for laudable reasons, are raising children in homes where antiseptic wipes, antibacterial soaps and disinfected floorwashes are the norm. Dirt is banished for the good of the household.

In addition, there is less breast feeding of infants and a tendency for them to have fewer social contacts with other children. Both trends reduce babies’ contact with germs. This has benefits – but also comes with side effects. Because young children are not being exposed to bugs and infections as they once were[https://www.theguardian.com/society/2018/may/21/most-common-childhood-cancer-partly-caused-by-lack-of-infection], their immune systems are not being properly primed.

“When such a baby is eventually exposed to common infections, his or her unprimed immune system reacts in a grossly abnormal way,” says Greaves. “It over-reacts and triggers chronic inflammation.”

As this inflammation progresses, chemicals called cytokines are released into the blood and these can trigger a second mutation that results in leukaemia in children carrying the first mutation.

“The disease needs two hits to get going,” Greaves explains. “The second comes from the chronic inflammation set off by an unprimed immune system.”

In other words, a susceptible child suffers chronic inflammation that is linked to modern super-clean homes and this inflammation changes his or her susceptibility to leukaemia so that it is transformed into the full-blown condition.

From this perspective, the disease has nothing to with power lines or nuclear fuel reprocessing stations, as has been suggested in the past, but is caused by a double whammy of interacting prenatal and environmental events, as Greaves outlined in the journal Nature Reviews Cancer earlier this year.

Crucially, this new insight offers scientists a chance to intervene and to stop leukaemia from developing in the first place, he adds. “We do not yet know how to prevent the occurrence of the initial prenatal mutation in the womb, but we can now think of ways to block the chronic inflammation that happens later on.”

To do this, Greaves and his team have started working on the bacteria, viruses and other microbes that live in the human gut. These help us digest our food but they also give an indication of the bugs we have been exposed to in life. For example, people in developed countries tend to have far fewer bacterial species in their guts, it has been found – and that is because they have been exposed to fewer species of microbes in the early stages of their lives, a reflection of those “cleaner” lives they are now living.

“We need to find ways of reconstituting their microbiomes – as we term this community of microbes. We also need to find which are the most important species of bacteria for priming a child’s immune system.”

To do this, Greaves is now experimenting on mice to find out which bugs are best at stimulating rodent immune systems. The aim would then be to follow up with trials on humans in two or three years.

“The aim is to find six or maybe 10 species of microbes that are best able to restore a child’s microbiome to a healthy level. This cocktail of microbes would be given, not as a pill, but perhaps as yoghurt-like drink to very young children.

“And it would not just help prevent them getting childhood leukaemia. Cases of conditions such as type 1 diabetes and allergies are also rising in the west and have also been linked to our failure to expose babies to bacteria to prime children’s immune systems. So such a drink would help cut numbers of cases of these conditions as well.

“I think the prospect is incredibly exciting. I think we could use this to reduce the risk not just of leukaemia but a number of other very debilitating conditions.”

Leukaemia: the facts

Blood cells are manufactured in bone marrow. Red blood cells, which carry oxygen round our bodies, white blood cells, which fight infection, and platelets, which stop bleeding, are created when your body needs them. But when a person develops leukaemia, too many white blood cells are released, which stop the normal cells in your bone marrow from growing. As a result, the amount of normal red cells, white cells and platelets in your blood is reduced – and your health suffers.

Of the many types of leukaemia, the most common in young people are acute lymphoblastic leukaemia and acute myeloid leukaemia.

Source: Teenage Cancer Trust[https://www.teenagecancertrust.org/get-help/ive-got-cancer/types-cancer/leukaemia?gclid=Cj0KCQiA05zhBRCMARIsACKDWjeKlxqH1FS1ByEa4yVK2k4-nQ1UA88oUdhKAQ_avmur2Zt6OCHp5wQaAg8ZEALw_wcB]

The new products, looks and colours to know about - read on for your most gorgeous year yet.

1. Colour your lashes

'This spring it's all about elegant coloured lashes,' says Shiseido make-up artist Gregoris Pyrpylis. And if you think anything but black mascara is too 'out-there' is for you, think again. The 2019 approach means subtle, flattering shades such as deep plum and blue, which make the whites of the eyes pop. Perfect for women who want to add a touch of colour in a grown-up way. Controlled Chaos Mascara, £21, Shiseido (shiseido.com, launching in April)

2. DIY microblading

Microblading - an almosttattoo-style treatment where pigment is implanted into your eyebrows to make them fuller and thicker - was one of the biggest in-salon hits of 2018. But if that still sounds scary, good news: thanks to a new ultraresistant, smudge-proof, transferproof brow gel from L'Oréal, you can have defined brows that last 24 hours without having to commit to an inasive treatment. Unbelieva'brow Brow Gel, £14.99, L'Oréal Paris (lorealparis.co.uk, from January)

3. Wing it back

Eyeliner has taken many shapes and colours over the past few seasons, but thanks to Burberry's spring/summer 2019 look (left), the wing is back. The grown-up twist this season is a flattering brown hue, which is much easier for women over 40 to wear. Cat Eye Liner in Chestnut Brown, £30, Burberry (uk.burberry.com)

4. 'Eyelighter' is the new highlighter

Clarins's new palette (pictured previous page) has four gorgeous 'eyelighters' to throw the right kind of shade over your lids this spring. A great alternative to shimmer if you don't want to look too overdone. Our favourite shade is Ready in a Flash.

Limited Edition Eyes & Brows Palette, £32, Clarins (clarins. co.uk, launching 6 January)

5. Embrace crystals

Make like Louise Redknapp (right) and try the hottest new wellness trend, crystal readings. Promising to restore energy levels and help you find balance, practitioners use stones as part of this holistic therapy. 'In this digital age, our regimes should be empowering and recharging,' says healer Emma-Lucy Knowles, who treats Louise. £85 for 30 minutes (emmalucyknowles.com)

6. Revival of rose

Roses have long been used in cosmetics to make them smell delicious. But now, following Lancôme's extensive research, the flower is being utilised as a regenerating active ingredient in skincare, working wonders on stressed, inflamed skin. Absolue Soft Cream, £190, Lancôme (lancome.co.uk)

7. Stretch your mind

Everyone knows that you should stretch your muscles post-workout, but what about stretching your mind? Personal trainer Dalton Wong has introduced a depressurising massage for the head and neck, which is set to become a big trend for 2019. Think of it as a supercharged head massage with lasting tension-releasing benefits: sign us up.

Stretch Your Mind, Head & Neck Massage, £60 for 30 minutes (twentytwotraining.com)

8. Go for a refill

The moment for refillable beauty products is now, as we try to cut down on plastic waste in all areas of our lives. 'This movement is a big step for the beauty industry,' says Andrew McDougall, associate director at trend forecaster Mintel Beauty & Personal Care. 'Kiehl's, Le Labo, Mac and Rituals are some of the brands that offer refillable packaging with money offfor refilling,' adds co-founder of Cult Beauty Alexia Inge. Our top picks for refillable beauty products are Guerlain's Abeille Royale collection and anything from the Kjaer Weis make-up range. As part of Lancôme's pledge to be more green, its new Absolue range will be entirely refillable too.

9. Grassy scents

Inspired by unruly weeds, wild plants and flowers, Jo Malone's Wild Flowers & Weeds collection offers five fresh scents that will be distinctive additions to your spring fragrance wardrobe come March. In true Jo Malone style, they are all wearable for any occasion and will look great on your dressing table, too. WildFlowers&Weeds colognes, from£49, JoMalone (jomalone. co.uk, from March)

10. The no-gymworkout

Emsculpt is a revolutionary treatment that is said to tone and tighten your body in just one week. It uses high-intensity electromagnetic energy to trigger what are called 'supramaximal contractions' in your muscles (those that go beyond the voluntary contractions that you make when you exercise). Muscle tissue is then forced to remodel its inner structure, which results in muscle-building and body-sculpting.

Emsculpt treatments start from £800 with Dr Galyna Selezneva (drritarakus.com)

11. Take a bow

At last, a sophisticated hair accessory that we can all wear. Velvet bows adorned the ponytails of the models at Emilia Wickstead spring/summer 2019 and make a stylish addition to any outfit. Wear yours high to make a statement, or low at the nape of your neck for a more sophisticated twist. They've even got the royal seal of approval from the Duchess of Cambridge, who has been seen wearing one on many an occasion (below right in J C Crew).

12. The tech revolution

'Brands are developing app based tools that work along your skincare to further enhance your regime,' says Lopo Champalimaud, CEO sof Treatwell. Leading the charge, La Roche-Posay has developed My Skin Track UV, a necklace device that monitors your exposure to the sun and warns you when it's at a level likely to cause damage. Meanwhile Wayskin's skin-analyser tool (top left) measures skin hydration, ambient UV levels and humidity, then sends data your phone to help you to adjust your skincare accordingly. Clever, huh? Skin Analyzer, £90, Wayskin (cultbeauty.com)

13. Have better sex…

Yes, you read right. 'Sexual well-being is a huge focus for 2019 to ensure women are feeling their best at all times,' says Cult Beauty's Alexia Inge. 'Women are talking more openly about their sexual needs, and brands have jumped on board. Female sexual well-being has finally found its mojo.' Gwyneth Paltrow is leading the trend with a range of vibrators on her website. Fireman Vibrator, £35, Smile Makers (shop.goop.com)

14. Melatonin is the new smart-ager

Plastic surgeon Dr Marko Lens has discovered that melatonin - a hormone known for its ability to help you sleep - also stimulates fibroblasts (cells that produce collagen), making it a potent night-time skin restorer. He has formulated his new serum to include a blend of melatonin and other restorative ingredients such as honey and vitamin E, to help repair the skin overnight. Melatonin Night Repair Serum, £165, Zelens (zelens.com, available from January)

15. The non-invasive colonic

The importance of gut health should not be ignored. Cleanse yours with the Tummy Tapping Technique treatment, a massage that's a great natural alternative to a regular colonic. It uses gentle tapping to activate the function of the liver, gallbladder and pancreas to help flush your system naturally.

£120 for an hour (nevillehairandbeauty.net)

16. Dry shampoo 2.0

Whether it's motherhood, work or simply life getting in the way, dry shampoo has become an essential part of every busy woman's hairstyling kit. But the problem with aerosols is they can sometimes leave a chalky residue - so Redken is launching a dry shampoo in paste form. This savvy hair enhancer cleanses and adds volume for a natural-looking lift - with no nasty white powder left behind. Dry Shampoo Paste, £19.55, Redken (lookfantastic.com, launching on 1 February)

17. Grown-up pastel hair

According to backstage hair maestro Guido Palau, '2019 is set to be the year of mature women experimenting with coloured hair. Shades like pink evoke a fun yet classy feel,' he says, proven by the candyhued Julia Roberts (right). Colorista Washout Hot Pink Neon Semi-Permanent Hair Dye, £4.99, L'Oréal Paris (boots.com)

18. The no-surgery eye lift

Remember the 'vampire facial' made famous by Kim Kardashian a few years ago? Now it's been developed to target dark circles. Dr Kambiz Golchin has patented a new version of the platelet-rich plasma (PRP) facial, a technique that uses your own blood to alleviate dark under-eye circles and mild hollowness. PRP Under-Eye Cocktail, £1,000 (kambizgolchin.com)

19. Light therapy skincare

Expect your skincare regime to become a little more technical in 2019, with hi-tech devices enhancing our everyday creams and lotions. According to Lopo Champalimaud of Treatwell, red-and blue-light therapies are set to become the norm at home in the new year. The Light Salon, a London-based express rejuvenation bar, is launching the first silicone LED face mask to DIY at home, (pictured far left) in February. £395 (thelight-salon.com)

Begone 2018! You were a scary, slimy, greedy, divisive, nasty, long and brutish year - much like the man who dominated it from his perch in the White House.

We've seen homeless caravans, Brexit wars, French riots and crashing markets, along with hurricanes, tsunamis and globally destructive tweet-storms.

Donald Trump sucked up much of Earth's oxygen as every third conversation quickly led to Uknowho.

- What's for dinner, dear? - Trump steak, honey ... er, sorry, I mean rump steak. God, I can't get that man OUT OF MY BRAIN!!! - Relax, dear. Lets just eat at Donald's ... er, McDonald's.

As always, Guru Josh is peering into the future with his kale-enhanced, probiotic, self-driving crystal ball that's 80-per-cent right 50 per cent of the time. So trust me when I tell you what's coming. In Montreal: A fast-growing movement called les gilets oranges (the "orange-jackets") will erupt like France, with their own distinct demands.

The protesters will insist all Montreal road construction stop at once, as it's a heavy burden on the poor, the middle-class, the rich and super-rich.

Better to keep our collapsing roads and sewers than lose our sanity, they cry.

Like Paris, massive protests will spread through Montreal in an effort to block traffic and bring the city to a halt.

But given our usual construction chaos, no one will notice the difference. In the U.S.: As Trump finally runs out of Cabinet members and advisers to fire, he will fire the only people left: his son-in-law, then his daughter and finally Melania.

He will remain alone in the White House, a mad king ruling by late-night tweets. Health: After years of being told sitting is bad for us, armies of people bought standing desks, including a good friend.

Now, several new studies show prolonged standing is worse than sitting, causing back, leg and even possible heart problems. My friend has dumped his and taken a stand for sitting.

What next? It won't be long before we see "exercise desks" where you must jog, bike or row in order to power your computer. The harder you exercise the more computer time you'll get.

Slow down and the screen loses its resolution and eventually fades to black-and-white. In tech news: Most phones now have "screen time" apps that warn when you're online overdosing. But they're proving to be just another excuse to check your phone.

"Ohmigod, I've been online 9 hours, 17 minutes - it was only 8 hours, 43 minutes when I looked a minute ago. Geez, I'm terrible. Hmm ... I wonder how much screen time I had yesterday at this hour? I'd better check!" 2019 will bring a related phone app called "Trump time" that records how many times a day you say "Trump" in conversation.

You'll set a warning alarm for the 100th time, or 30th, or even for "Zero Trump." Then an alarm will chirp, saying "Change topic! Change topic! Change topic - or change president!" Mount Royal: The consultation committee on the mountain will finally release its report, which will be as bureaucratic as the consultation that baffled many during summer.

It will conclude Montrealers want more driving access over Mount Royal but not total access, as many cyclists don't want any cars, many dog owners don't want any cyclists and the squirrels think we're all nuts.

After heated debate, city hall will announce a made-in-Montreal compromise. They will slow down mountain traffic by installing hundreds of potholes dug up and transported from streets where they weren't needed.

They will also post signs along the road inspired by our Montreal no-parking signs, saying: "Welcome to Mount Royal: No cars permitted Mon. through Fri., 7 a.m.-11 a.m. and 15 p.m.-19 p.m. except hearses, mourners, city trucks, handicapped drivers, diplomatic cars, ride-sharing vehicles, carpools or families with barbecues, coolers, chairs, sleds, skis, toboggans and ... For further regulations, see the back of this sign."

It will prove the perfect Montreal solution. Just like our no-parking signs, drivers will slow down so much to read them everyone will be safe. Science: NASA will announce a major discovery: they have found the exact location of The Cloud, which many of us have wondered about for years.

Some crackpots at Silicon Valley will claim The Cloud is actually several vast computer warehouses in California, owned by Google and Apple, but you can't fool me. I know fake news when I see it. Good news: Despite a grim year, it's reassuring to read books like Factfulness to remind us things are rarely quite as bad as they seem. Some facts: 80 per cent of oneyear-olds worldwide have had at least one vaccination. Over 90 per cent of children go to primary school. Under 10 per cent of the world lives in extreme poverty, compared to 50 per cent in 1966.

That's partly why world life expectancy is now 70.

So despite our many problems, the world is a better place for most people than ever before.

Here's to a happy, healthy and better New Year and may all your conversations be Trump-free. joshfreed49@gmail.com

More vegetables. Improved gut bacteria. Cocktails with less alcohol.

Many of the predictions about what we'll eat and drink in 2019 point to a quiet, restorative and potentially grim time ahead. Then again, these forecasts always arrive carrying the clean, healthy pine scent of New Year's resolutions.

The good news: There will be cheese tea. And salad robots, according to the prognosticators.

As we pored over dozens of lists handicapping the next big food trends, and interviewed the people who get paid to drill into consumer behavior, we kept in mind that everyone could be dead wrong. Food forecasting is not a science, or even an art. Still, the game is a fun one.

Here are some of the most intriguing guesses at what and how Americans will be eating in the new year.

The Next Lettuce

The great romaine scare of 2018 -- a strain of E. coli that was eventually traced to a reservoir in California -- has helped make lettuce ripe for a new star in 2019. The current darling of the restaurant salad, Little Gem lettuce, was denounced this month as overexposed by New York magazine's restaurant critic, Adam Platt.

Expect to see little-known varieties showing up on menus, and an explosion in lettuces grown hydroponically, many of them in urban container farms. Some chefs are rallying around celtuce, a lettuce with a leafy, bitter top and a stalk that's kind of a cross between celery and asparagus. Chinese cooks know it as wosun. Even wild weeds like dandelion greens or sorrel may get a shot. Whichever wins, kale is still over.

The New Flavor Profile

Sour and funky, with shades of heat. This is what happens when you mix the interest in fermenting with the millennial palate. Melina Romero, who has the title of trend insights manager at CCD Helmsman, a food research and product development firm in Emeryville, Calif., explained the generation that loves global mash-ups and bold flavors this way: ''They grew up with Flamin' Hot Cheetos, and while they still want spicy, I think, beyond that, they have grown to become interested in flavors that are acquired -- sour flavors and even funky flavors like fermented foods.''

The Thing You Will Try Against Your Better Judgment

Cheese tea, an import from Taiwan, will hit the American mainstream this year. Green or black tea is sipped through a cap of cream cheese blended with cream or condensed milk, which can be either sweet or slightly salty. It's already a hit in San Francisco, where they make it with Meyer lemon and mascarpone.

The Big Health Fix

Anything to do with your gut flora. That means you can expect more ways to ingest probiotics and prebiotics and foods designed to improve the bacterial health of your intestinal tract, according to several grocery store chains and wellness market analysts. As the obsession with digestive health dovetails with the fascination for fermenting, kimchi, sauerkraut and pickled things will work their way into new territory. Smoothies with kefir will be popular, and kombucha will show up in unexpected places like salad dressings.

The Hot Diets

Diets that emphasize fat over carbohydrates will continue to dominate. Instagram says video posts using the hashtag ''keto'' -- the name of a high-fat, low-carb diet -- grew fivefold over the past six months. Hannah Spencer, a registered dietitian who tracks the food service industry for the market research company Mintel, said the keto diet might be losing its edge. Still, she added, restaurants will add more low-carb options. The term ''pegan'' -- a cross between a paleo and a vegan diet -- will take hold. Pinterest says the number of searches for the term rose 337 percent in the past six months.

The New Sheet-Pan Supper

With barely any cleanup and a deep whiff of nostalgia (remember your first Scout camping trip?), cooking dinner in foil packets is poised for popularity. Pinterest notes that searches for ''foil-pack dinners'' have jumped nearly eightfold in the past six months.

The Driest Drinks

At the bar, lighter wines, natural wines and drinks with less or no alcohol will be popular. Americans ages 18 to 34 are more interested in spirit-free cocktails than any other demographic group, according to Mintel. As a result, bartenders will replace high-alcohol liquors like gin with lower-alcohol wines like Prosecco in mixed drinks, and make more use of shrubs, craft vermouths, botanicals and distilled nonalcoholic spirits like Seedlip. This may force bars to try to come up with better names than the no-jito or the no-groni. Outlier prediction: Forbes magazine is betting that the breakfast cocktail will be big.

The Case Against Waste

With the plastic straw and the plastic bag increasingly out of fashion, restaurants, food manufacturers and groceries will face new pressure to reduce other packaging waste. In a recent Mintel survey, 36 percent of diners said they wanted restaurants to cut back on packaging. (The number is even higher among baby boomers.) Restaurants that serve food on plastic with disposable cutlery will have an incentive to invest in reusable plates and forks. Cutting waste in the increasingly robust carryout and delivery markets will get new attention, too.

The Playlist Ploy

Restaurants will keep seeking ways to expand their brands beyond food; Dunkin' Donuts has put its name on a Saucony running shoe, and KFC recently sold out of fire logs that smell like fried chicken. For higher-end restaurants, the vehicle of choice will be the customized Spotify playlist. David Chang has already issued one, as has Flour & Water in San Francisco.

The Plant-Based Main Course

Substantial vegetable entrees will become a fixture on restaurant menus, in the way that alternatives to dairy creamers became standard at coffee bars a few years ago. Many diners have started to eat less red meat or abandon animal protein altogether, whether for health, environmental or ethical reasons. A few corporations have banned meat consumption on their campuses. In Los Angeles, a member of the City Council this month proposed a law that would require a substantial vegan protein entree be available at movie theaters and other large entertainment centers.

The Motherless Meat

Laboratory-grown proteins will enter the mainstream. KFC, Tyson Foods and Cargill are investing heavily, and the products are catching on so fast that ranchers have started campaigns to stop the engineered proteins from being called ''meat,'' Forbes reports. Prepare for the next generation of plant-based alternatives to dairy products: substitutes for cheese, butter and ice cream made with nuts, soy or coconut.

The Tech Advancement You'll Hate Until You Need It

Salad-making robots will show up in hospitals and airports, where freshly made food is not easy to find at all hours. The systems rely on chilled containers of fresh ingredients that are restocked during the course of the day. Push a few buttons on a keypad and the robot makes a custom salad topped with dressing.

The Hope for Dope

Major food and beverage companies are researching ways to get THC, the psychoactive component of marijuana, and cannabidiol, a part of the plant that may have therapeutic properties, into more food and drinks. The authors of the federal farm bill have removed hemp from the list of controlled substances, and Gov. Andrew M. Cuomo is pushing to legalize recreational use of marijuana in New York.

The New 'It' Vegetable

It's a tie between mushrooms -- which have acquired what food marketers call a health halo and are expected to pop up in teas, desserts, jerky and cocktails -- and sea vegetables, which most people just call seaweed. Consumption of seaweed is growing 7 percent annually in the United States, James Griffin, an associate professor at Johnson & Wales University, told Nation's Restaurant News. It checks all the boxes: healthful, environmentally sound and full of umami.

The New 'It' Cuisines

It's a tossup. The market research firm Technomic says popular dishes will come from eastern Mediterranean nations like Lebanon, Syria and Turkey. Baum & Whiteman, a consulting firm based in New York, is betting on food from the ''Stans'' -- Kazakhstan, Tajikistan and Uzbekistan. The global buyers for Whole Foods Market have money on flavors from the Pacific Rim. The San Francisco food consultant Andrew Freeman is calling it for Georgia, with its Instagrammable star, khachapuri -- the cheese-filled bread boat topped with a runny egg. The prognosticators at the Kind food company are pulling for the flavors of Africa, though they did not specify a country.

The Cause of the Year

How a restaurant or food company cares for its employees, its purveyors, its customers and its community will move up the priority list in 2019, Mr. Freeman said. More chefs will become first responders, providing food at disaster sites. Companies will fine-tune training for how employees should treat one another. Immigrants and their role in American food culture will be front and center.

Sara Brito, a founder and the president of the Good Food 100 list, said in her 2019 trend report that customers will demand that restaurants tend to more than just how food tastes.

''They need to demonstrate they care about the whole system and story of food,'' she said, ''including the environment, farmworkers, animal welfare and inclusion in the workplace.''

Alain Delaquérière contributed research.

What will we eat in 2019? If our nation's prognosticators have their say, we'll be crunching on salads of celtuce, a lesser-known green, mixed with either high-end bespoke vegetables personally designed by chefs, or virtuous ugly produce destined for the trash. Maybe they'll be topped with a crunch of chulpe corn or watermelon seeds. We'll tear into interesting forms of bread - bing, from China, and manaeesh, from the Levant. There will be CBD in everything, smokeless smoke in everything, and real milk in nothing - not in our milkshake IPAs, which are not what they sound like (they're brewed with lactose) - because pea milk and oat milk are taking over. "Regional flavors" will be important, specifically those from India, the Pacific Rim and "the 'stans" - Kazakhstan, Tajikistan and Uzbekistan. Plant-based eating will continue to grow. Some products that were formerly shelf-stable, such as granola bars and olive oil, are going to need to be refrigerated.

It will be a good year for dietitians, who are poised to become the new celebrity chefs. We'll pay for our sandwiches with cryptocurrency, as if that's no big deal.

Then again, it's not like 2018 panned out exactly how the prediction-makers thought it would. Yes, we ate artisan pickles and drank Cristalino tequila and had ghee and plenty of veggie-forward dishes. It's true that Jewish delis are on the upswing, and Israeli cuisine hit its stride. And tsukemen, or brothless ramen, got more popular on menus in the United States. But why didn't we get really into deep-frying, or Tanzanian barbecue seasoning? Chain restaurants never picked up on "trash fish." Norwegian and Icelandic "Arctic cuisine" has yet to hit the mainstream here. Other predictions - locally sourced produce, Instagrammable foods, "authentic ethnic cuisine" and street food - were already in, some for more than a decade.

What is a trend, anyway? There's no set way to measure one, no threshold of sales or number of products on the market past which a food becomes Certifiably Trendy, especially because food trends, like fashion, trickle down into mainstream ubiquity. There's just a bunch of market researchers and food industry consultants and publicists and journalists, a little bit of data, a looming Dec. 31 deadline and an intangible notion of what feels cool and new.

"The science to predicting a trend is to figure out, what is actually happening here? Is it just now, is there some sort of immediacy to it or does this actually have a longevity?" said Jenny Zegler, associate director of food and drink for consumer research company Mintel. "And, what does that mean, and what is that reflective of, in terms of what consumers want?"

Some trend lists come from huge teams of professional trend-spotters and industry-watchers, and some come from just one person with a finger on the pulse. But all of the predictions tend to fall into one of four categories. In the first category are the vague, evergreen, massive buzzword trends - like "plant-based foods" and "specialized diets" - that will both always and never be trends, because they're so all-encompassing. But don't count them out, says Zegler, whose report for Mintel pinpoints three trends: sustainability, foods for healthy aging and enhanced convenience foods. A list should be measured by its goals, Zegler says: Theirs is global in scope, and based on the work of 91 analysts in 13 countries, backed by actual consumer research data, and geared toward large brands for whom a menu change is a major supply-chain overhaul and a big gamble.

"I think a lot of what we're trying to do is identify things that are already happening," Zegler said. It's "not necessarily that companies that we work with are astounded by this prediction. It's more of, you know, this is where we should be going, and this is what we should be looking at."

What many of us think of as trends, such as Thai rolled ice cream or "souping" or cake pops, are actually fads.

"A fad is something that kind of comes quick and goes and maybe makes a viral sensation," said Zegler, but a trend has staying power. "That is really impactful, especially in a business sense, that you know if you're going to switch to make everything this new cool flavor, you want to make sure that it's the flavor that's going to last."

But calling a major cultural force already at play within the industry a trend has another benefit: You can never be wrong. That extends to things that Zegler would call fads, too: Among this year's lists, there are predictions that za'atar and orange wine and CBD will become trendy. They're in the second category - specific "predictions" that are already trendy, in some circles, at least. Za'atar might not be everywhere yet, but it's long been having a moment in the independent restaurant scene.

That's the other tricky thing about trend lists: Whom are they for? When food media, which tend to live in coastal cities, see a list that predicts rainbow-colored unicorn food as the next hot thing, they might think it's hopelessly outdated. Meanwhile, if you go by sales figures, that trend is still making its way throughout the country: It was one of the most-searched food trends on Google this year, and it hit mainstream ubiquity, perhaps, when Sam's Club began selling a unicorn cake.

"We used to say facetiously that when something appeared on a Marriott menu, you knew the trend was over," said Michael Whiteman, president of Baum & Whiteman, a restaurant consulting group.

Whiteman's list says the big trends for next year will be more widespread culinary use of robots, an escalation of the "meal kit wars," katsu sandwiches, Szechuan hot pot, and the aforementioned bing and food from the 'stans - the latter, something that Whiteman has noticed becoming rapidly popular throughout Brooklyn, where so many trends begin.

"Could I be wrong on that? I certainly could," he said. That's the third category: trends that may or may not take off - who knows? Whiteman's list comes from travel, his many years of experience and intuition.

"You know, something catches your eye," Whiteman said. "And over the course of a year you see three or four places and you say, 'Well, let's watch this.' . . . I wish I had a scientific answer for you."

The end-of-the-year list rush is real. "Over the past 10 years, the number of people making predictions online has probably quintupled," said Whiteman, in part because journalists write about them (guilty). And, any company can use a food trend list as a branding and engagement opportunity, which is why you see lists from Google and Chase Bank.

Some might have an agenda: When Tyson, the country's largest meat producer, predicts protein from animal and alternative sources will be very important in 2019, it's not wrong: We've been seeing more and more meat and protein snacks on the market, and more innovation in the "motherless meat" realm. But both sides of the coin benefit Tyson: The company continues to produce fresh and frozen chicken, and has also invested in Beyond Meat, which makes plant-based burgers.

"I don't think any list is 100 percent objective, because we all have dreams of what we'd like to see," said Bret Thorn, senior food and beverage editor for Nation's Restaurant News.

Straddling the line, industry-watchers say, is Whole Foods - which, yes, uses its year-end list to promote its products, but also has its finger on the pulse. This year, the company is predicting good things for eco-friendly packaging, exotic ice cream, and snacks made of ocean greens beyond seaweed. (Whole Foods is owned by Amazon, which shares an owner, Jeffrey P. Bezos, with the Washington Post - but that doesn't mean our office break room is stocked with exotic ice cream.)

"At the end of the day, the consumer is in control of what trends truly take off, but we always hope to be the first place they go to find them," said Rachel Bukowski, Whole Foods' team leader for product development, in an email. "Probably the closest thing to a 'miss' that we see is when we're a little too early on a trend."

The fourth category, of course, is trend predictions that seem to hit the perfect sweet spot: Still under the radar enough, but gaining momentum, and poised to take off. For this year, that might include Peganism (paleo veganism), lab-grown meat, shelf-stable probiotics (active beneficial bacterial cultures in foods that don't need to be refrigerated), as well as healthy desserts made with such ingredients as taro pudding and quinoa.

"I tend to look at what the independent [restaurants] are doing, because that tends to be where trends start," Thorn said. "If they make it into the smaller chains, we really have something going. It's an open question of when it becomes really mainstream. If it goes to casual dining, like TGI Fridays, if it makes to fast food, like McDonald's, it's a thing."

But most of the people reading these predictions aren't restaurateurs or food producers. They might not even live in cities where these trends are readily accessible. But from late December through early January, they'll eat them up nonetheless.

"It is something that people want to be part of," Zegler said. "They want to be part of that leading edge. They want to be the first one in their friend group to identify this."

Most of all, she says, "They want to be able to post on Instagram."

maura.judkis@washpost.com

What will we eat in 2019? If our nation's prognosticators have their say, we'll be crunching on salads of celtuce, a lesser-known green, mixed with either high-end bespoke vegetables personally designed by chefs, or virtuous ugly produce destined for the trash. Maybe they'll be topped with a crunch of chulpe corn or watermelon seeds. We'll tear into interesting forms of bread - bing, from China, and manaeesh, from the Levant. There will be CBD in everything, smokeless smoke in everything, and real milk in nothing - not in our milkshake IPAs, which are not what they sound like (they're brewed with lactose) - because pea milk and oat milk are taking over. "Regional flavors" will be important, specifically those from India, the Pacific Rim and "the 'stans" - Kazakhstan, Tajikistan and Uzbekistan. Plant-based eating will continue to grow. Some products that were formerly shelf-stable, such as granola bars and olive oil, are going to need to be refrigerated.

It will be a good year for dietitians, who are poised to become the new celebrity chefs. We'll pay for our sandwiches with cryptocurrency, as if that's no big deal.

Then again, it's not like 2018 panned out exactly how the prediction-makers thought it would. Yes, we ate artisan pickles and drank Cristalino tequila and had ghee and plenty of veggie-forward dishes. It's true that Jewish delis are on the upswing, and Israeli cuisine hit its stride. And tsukemen, or brothless ramen, got more popular on menus in the United States. But why didn't we get really into deep-frying, or Tanzanian barbecue seasoning? Chain restaurants never picked up on "trash fish." Norwegian and Icelandic "Arctic cuisine" has yet to hit the mainstream here. Other predictions - locally sourced produce, Instagrammable foods, "authentic ethnic cuisine" and street food - were already in, some for more than a decade.

What makes a trend? There's no set way to measure one, no threshold of sales or number of products on the market past which a food becomes Certifiably Trendy, especially because food trends, like fashion, trickle down into mainstream ubiquity. There's just a bunch of market researchers and food industry consultants and publicists and journalists, a little bit of data, a looming Dec. 31 deadline and an intangible notion of what feels cool and new.

"The science to predicting a trend is to figure out, what is actually happening here? Is it just now, is there some sort of immediacy to it or does this actually have a longevity?" said Jenny Zegler, associate director of food and drink for consumer research company Mintel. "And, what does that mean, and what is that reflective of, in terms of what consumers want?"

Some trend lists come from huge teams of professional trend-spotters and industry-watchers, and some come from just one person with a finger on the pulse. But all of the predictions tend to fall into one of four categories. In the first category are the vague, evergreen, massive buzzword trends - like "plant-based foods" and "specialized diets" - that will both always and never be trends, because they're so all-encompassing. But don't count them out, says Zegler, whose report for Mintel pinpoints three trends: sustainability, foods for healthy aging and enhanced convenience foods. A list should be measured by its goals, Zegler says: Theirs is global in scope, and based on the work of 91 analysts in 13 countries, backed by actual consumer research data, and geared toward large brands for whom a menu change is a major supply-chain overhaul and a big gamble.

"I think a lot of what we're trying to do is identify things that are already happening," Zegler said. It's "not necessarily that companies that we work with are astounded by this prediction. It's more of, you know, this is where we should be going, and this is what we should be looking at."

What many of us think of as trends, such as Thai rolled ice cream or "souping" or cake pops, are actually fads.

"A fad is something that kind of comes quick and goes and maybe makes a viral sensation," said Zegler, but a trend has staying power. "That is really impactful, especially in a business sense, that you know if you're going to switch to make everything this new cool flavor, you want to make sure that it's the flavor that's going to last."

But calling a major cultural force already at play within the industry a trend has another benefit: You can never be wrong. That extends to things that Zegler would call fads, too: Among this year's lists, there are predictions that za'atar and orange wine and CBD will become trendy. They're in the second category - specific "predictions" that are already trendy, in some circles, at least. Za'atar might not be everywhere yet, but it's long been having a moment in the independent restaurant scene.

That's the other tricky thing about trend lists: Whom are they for? When food media, which tend to live in coastal cities, see a list that predicts rainbow-colored "unicorn" food as the next hot thing, they might think it's hopelessly outdated. Meanwhile, if you go by sales figures, that trend is still making its way throughout the country: It was one of the most-searched food trends on Google this year, and it hit mainstream ubiquity, perhaps, when Sam's Club began selling a unicorn cake.

"We used to say, facetiously, that when something appeared on a Marriott menu, you knew the trend was over," said Michael Whiteman, president of Baum & Whiteman, a restaurant consulting group.

Whiteman's list says the big trends for next year will be more widespread culinary use of robots, an escalation of the "meal kit wars," katsu sandwiches, Szechuan hot pot, and the aforementioned bing and food from the 'stans - the latter, something that Whiteman has noticed becoming rapidly popular throughout Brooklyn, where so many trends begin.

"Could I be wrong on that? I certainly could," he said. That's the third category: trends that may or may not take off - who knows? Whiteman's list comes from travel, his many years of experience and intuition.

"You know, something catches your eye," Whiteman said. "And over the course of a year you see three or four places and you say, 'Well, let's watch this.' . . . I wish I had a scientific answer for you."

The end-of-the-year list rush is real. "Over the past 10 years, the number of people making predictions online has probably quintupled," said Whiteman, in part because journalists write about them (guilty). And, any company can use a food trend list as a branding and engagement opportunity, which is why you see lists from Google and Chase Bank.

Some might have an agenda: When Tyson, the country's largest meat producer, predicts protein from animal and alternative sources will be very important in 2019, it's not wrong: We've been seeing more and more meat and protein snacks on the market, and more innovation in the "motherless meat" realm. But both sides of the coin benefit Tyson: The company continues to produce fresh and frozen chicken, and has also invested in Beyond Meat, which makes plant-based burgers.

"I don't think any list is 100 percent objective, because we all have dreams of what we'd like to see," said Bret Thorn, senior food and beverage editor for Nation's Restaurant News.

Straddling the line, industry-watchers say, is Whole Foods - which, yes, uses its year-end list to promote its products, but also has its finger on the pulse. This year, the company is predicting good things for eco-friendly packaging, exotic ice cream, and snacks made of ocean greens beyond seaweed. (Whole Foods is owned by Amazon, which shares an owner, Jeffrey P. Bezos, with the Washington Post - but that doesn't mean our office break room is stocked with exotic ice cream.)

"At the end of the day, the consumer is in control of what trends truly take off, but we always hope to be the first place they go to find them," said Rachel Bukowski, Whole Foods' team leader for product development, in an email. "Probably the closest thing to a 'miss' that we see is when we're a little too early on a trend."

The fourth category, of course, is trend predictions that seem to hit the perfect sweet spot: Still under the radar enough, but gaining momentum, and poised to take off. For this year, that might include peganism (paleo veganism), lab-grown meat, shelf-stable probiotics (active beneficial bacterial cultures in foods that don't need to be refrigerated), as well as healthy desserts made with such ingredients as taro pudding and quinoa.

"I tend to look at what the independent [restaurants] are doing, because that tends to be where trends start," Thorn said. "If they make it into the smaller chains, we really have something going. It's an open question of when it becomes really mainstream. If it goes to casual dining, like TGI Fridays, if it makes it to fast food, like McDonald's, it's a thing."

But most of the people reading these predictions aren't restaurateurs or food producers. They might not even live in cities where these trends are readily accessible. But from late December through early January, they'll eat them up nonetheless.

"It is something that people want to be part of," Zegler said. "They want to be part of that leading edge. They want to be the first one in their friend group to identify this."

Most of all, she says, "They want to be able to post on Instagram."

maura.judkis@washpost.com

Q. What are the consequences of taking antibiotics on your gut microbiome? Does the gut ever fully recover?

A. Most gut bacteria recover quickly, but there can be long-lasting consequences from taking antibiotics. The changes, however, are not necessarily harmful.

The gut microbiome, the roughly 10 trillion to 100 trillion bacteria and other microorganisms that live in the digestive tract, contributes to health by synthesizing vitamins, metabolizing drugs and fighting pathogens. Anything that disrupts the balance of microorganisms, such as antibiotics, which can kill both ''good'' and ''bad'' bacteria, has the potential to cause disease.

Data from a 2016 study suggest that exposure to antibiotics in infancy can alter the gut microbiome and weaken the immune response for years to come. Other studies have linked the use of antibiotics in children to an increased lifetime risk of asthma, obesity and inflammatory bowel disease, effects thought to be mediated by the gut microbiome.

Antibiotics can also have long-lasting effects on adults. Researchers at Stanford screened more than 900,000 genetic samples from the stool of healthy men and women who took the antibiotic ciprofloxacin. They found that most of the gut microbiome returned to normal after four weeks, but that the numbers of some bacteria still remained depressed six months later. In a longer, larger follow-up study, they concluded, ''Antibiotic perturbation may cause a shift to an alternative stable state, the full consequences of which remain unknown.''

In an example of a potentially beneficial effect of altering the gut microbiome, evidence suggests that antibiotics can suppress the formation of a molecule in the gut that increases the risk for heart disease.

The National Institutes of Health Human Microbiome Project is using advanced genetic techniques to sequence all the genetic material of the gut microbiome. As newer data becomes available, a nuanced understanding is emerging: Antibiotics may exert both beneficial and harmful effects on the gut microbiome.

Do you have a health question? Ask Well

Quench your thirst with our pick of the best ginger beers on the market

The origins of ginger beer can be traced back to the colonial spice trade, when the drink was made from a meeting of spices from the East and sugar cane from the Caribbean. As a naturally fermented product, ginger beer contained up to 11 per cent alcohol in the nineteenth century, before being reduced to two per cent by the 1855 excise tax laws.

The modern (and considerably easier) method of producing ginger beer occurs by squeezing ginger and accompanying flavours into a soft drink base. This more sanitised incarnation of the ginger beverage is often referred to as ginger ale, which is characterised by being less spicy and more carbonated than its ballsier brother. However, the demarcation lines between the two have been blurred by time, and most ginger based beverages are referred to by the catch-all title of ginger beer.

Read more

14 best alcohol-free drinks

9 best alcohol-free beers

10 best foods for a healthy gut

When assembling the list below, we focussed our attentions on alcohol-free ginger beers and ales. For those who prefer their ginger brews steeped in alcohol, as history dictates, look out for Crabbie’s Alcoholic Ginger Beer, a four per cent ABV beverage which cloaks its strength in a swirl of sweetness and spice. For a ginger beer with an emphasis on alcohol, try Badger’s Blandford Fly, a 5.2 per cent ABV golden ale with a tickling of ginger.

If you like your drinks fizzy and fiery, there’s lashings to choose from. We root out some of the best on the shelves.

Breckland Orchard Ginger Beer with chilli: £19.20 for 12 x 275ml, BigBarn.co.uk

Family owned Breckland Orchard produce a plethora of pleasant pops, all of which have been inspired by traditional British flavours. Amongst their ranks, you’ll find cream sodas, elderflowers and cloudy lemonades. Their ginger beer is a piquant, subtly nuanced number with an added peppery punch delivered by a sparky nip of chilli. This is ginger beer made as god intended.

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Cawston Press Ginger Beer: £0.76 for 330ml, Super Food Market

Cawston’s cloudy ginger offering is mixed with apple juice which has a mellowing effect on the ginger. There’s still a spicy burn to be enjoyed, but the apple-y addition keeps it in check with a clean, sharp acidity which enhances this drink’s lip-smacking long, dry finish.

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Gingerella Ginger Ale: £1.60 for 330ml, The Whisky Exchange

Flexing its ethical credentials, this ginger drink from the Karma Cola collection is organic, Fairtrade and GMO free and comes clad in groovy, hipster friendly packaging. It’s light and clean tasting, with a refreshing lemon tang and heat from the Sri Lankan ginger is bolstered by a dash of capsicum. A drink for those who like their ginger served sweet, wet and fizzy.

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Belvoir Organic Ginger Beer: £2.24 for 750ml, Ocado​

Belvoir's beer is a cloudy, low carbonated treat, with citrus and herbal notes layered with warming ginger spices. It’s the most lemon-forward of all the drinks we tested and makes for an elegant and refreshing summertime drink when chilled and served over ice. Belvoir have winter covered too – their tasty Spiced Ginger Punch comes packing seasonal spices of cinnamon, nutmeg and cloves.

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Schweppes Golden Ginger Ale: £2.20 for 200ml, Urban Drinks

Schweppes ginger ale is not designed for chugging neat – it’s a mixer, whose purpose is to bless cocktails with a soft, gingery kiss. The carbonation on this frisky number is cranked up to the max and carries with it a sweetness and subtle mellow spice that compliments, but doesn’t overpower. Add it to a glass of scotch for a fine fireside sipper on a cold winter's eve.

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Dalston’s Ginger Beer: £15.99 for 24 x 330ml, Epicurium​

This feisty can of fizz dishes out an initial hit of citrus and slight bitterness from the lime, followed by a long, slow swagger of flaming ginger spices. For those wishing to ramp up its potency, drop two shots of dark rum into a glass of Dalston’s and you’ve got yourself a quick ‘n’ dirty Dark ‘n’ Stormy’ cocktail.

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Luscombe Hot Ginger Beer: £30.89 for 24 x 270ml, The Drink Shop

The clue is in the name of Luscombe’s fearsome ginger offering. An initial fervent fizz quickly dissipates to reveal a tantalising twang of orange peel and lemon citrus before the fun really starts. The ginger hit is extra spicy and long lasting, dishing out piping hot punishment to your palate. The smooth, dry finish leaves you thirsty for more.

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Franklin & Sons Ginger Beer: £2.69 for 750ml, Ocado​

Born from a Victorian sweet shop family business in Rickmansworth, Hertfordshire, Franklin & Sons brew their ginger with malted barley for five days. Just before the sugar turns to alcohol, the process is halted (some might say prematurely) and the drink is bottled. It’s brewing origins are evident from the brown bread whiff you get when popping the cap, and the barley flavours are quite prominent but complement the ginger beautifully. A zip of lemon adds to its complex mashup of spices and citrus and it tastes sweet and old fashioned – but in a good way.

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Fever Tree Ginger Beer: £23.98for 24 x 200ml, Amazon

Not content with knocking out fine tonic waters, Fever Tree’s foray in to the ginger beer market is a well-balanced beverage that carries a fragrant aroma and warming spices on a wave of soft carbonation. It works wonders as a mixer - try using a can in a Moscow Mule: 2oz vodka, 2oz lime juice) - but can also hold its own as a thirst quenching glugger.

Buy now[https://www.amazon.co.uk/Fever-Tree-Ginger-Beer-200ML/dp/B00H2WXKQA]

Old Jamaica Ginger Beer: £0.40for 330ml, Sainsbury’s

Old Jamaica is the ubiquitous ginger inhabitant of the supermarket shelves. It’s an unabashedly sweet pop with a long, spicy finish, packed to the hilt with fizz that’ll rattle your tonsils. Old Jamaica also comes in light and extra fiery incarnations, but good old regular is our pick of the bunch.

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The Verdict: Ginger beer

If you’ve got drinks to mix, reach for the Fever Tree[https://www.amazon.co.uk/Fever-Tree-Ginger-Beer-200ML/dp/B00H2WXKQA], but for a stand-alone treat, charge your glass with a Breckland Orchard[https://www.bigbarn.co.uk/product/ginger-beer-with-chilli-posh-pop-great-taste-1-star-2018/16458/] and bathe in its warm ginger glow.

Throughout history, every time humans have explored new places, one of the biggest issues we have faced is infectious diseases – on both sides.

Not only did explorers bring pathogens to local populations whose immune systems couldn't fight off an unfamiliar disease, but those locals also harbored bacteria and viruses that infected the adventurers.

So what happens if there's life on Mars and humans travel there?

"Anytime there's a new introduction, on both sides, there's a lot of risks. We all can be harboring things that can create risk for the other side," said Pardis Sabeti, professor of immunology and infectious diseases at Harvard University. "There's all sorts of ways that when different life forms interact for the first time, all sorts of intentional and unintentional destruction can happen."

NASA has been sending rovers to Mars for decades, including InSight, which recently landed there, but the landers get thoroughly scrubbed before they're launched into space. And none of the vehicles have made a return trip to Earth.

With human travel to Mars on the horizon – NASA recently put the timetable at least 25 years – we must be prepared for the potential that a Martian microbe could harm us, said Sabeti, who speaks about that possibility on National Geographic's "MARS" series.

"There's not a high reason to think that there's an infectious disease there that can infect us and become problematic to us, but if it could, then it could rapidly become really problematic," she said.

But a bigger issue could be us: Human bodies contain trillions of bacteria, and those could infect the Red Planet instead, said Casey Dreier, chief advocate and senior pace policy adviser at The Planetary Society, a nonprofit organization that promotes space exploration.

"Every spacesuit is just leaking off viruses and bacteria that just are coming from the microbiome of the astronauts," Dreier said. "If we introduce microbes to Mars, would those inadvertently consume or wipe out or take over these potential habitable niches on the surface of Mars or in the subsurface of Mars, and actually destroy any life potentially hanging out on the Red Planet?"

That's why sending robots instead of humans to grab the first samples is important. While even robots can harbor some bacteria after being thoroughly scrubbed, they're far cleaner than us.

"We're not in this pristine Star Trek kind of universe, where you can just pop down to any planet and not worry about the implications of your own presence," Dreier said. "In the past, NASA has baked their spacecraft at 500 degrees for four days to try to sterilize them. Notably, that does not work for humans. They're not very functional afterwards."

There's still a lot of microbes and diseases on Earth we don't understand, and if we find something on Mars that is different from life on Earth it could be even harder to get a handle on it.

"We sequence enough things on Earth that we kind of have a good sense of what the tree of life looks like," Sabeti said. "Imagine that you generate a sequence but the sequence doesn't amount to anything you've ever seen before."

"If they're different enough from anything we've seen before, we have no way of placing it into context and trying to get a toehold to understand it," Sabeti added.

That's also why we'll need to bring samples from Mars that may or may not contain life back to Earth for extensive studies.

"There would actually be a huge pressure to bring some of these sample microbes back to Earth in order to fully characterize them and try to understand them at a deep level," Dreier said

And that means we need extremely advanced biocontainment facilities to hold them – not just to reduce any potential risk of a Martian microbe poses to things on Earth, but to avoid contaminating samples with our own human bacteria.

"The act of exploration carries with it a risk, not just for you, but for the place you're exploring," Dreier said. "If we find life on a sample from Mars that would be one of the biggest discoveries in human history."

From poor sleep to excess sugar, and too much time indoors, here's how to take the stress out of your festive celebrations...

Christmas Day is almost upon us in all its overwhelming glory. Coming after three weeks of ramped-up work stress, never ending present-buying and more late nights and alcohol than is strictly good for us, it's little wonder Christmas is rarely as harmonious as Instagram would have us believe.

"I'm sure behind every rosy photo lies weeks of tension," says Cary Cooper, a professor of psychology and health at Manchester Business School at the University of Manchester. "Because, let's face it, the whole festive period is loaded with stress and expectation."

But, from good champagne to going your separate ways after Boxing Day, there are plenty of ways to make this week less stressful.

Delegate and get outside ...says Professor Cary Cooper, psychologist My wife and I have four grown-up children, and six grandchildren under seven, so I know a thing or two about Christmas stress. Something we've learnt over the years is to limit the time we all spend as a unit: the whole family gets together for two days... and then that's it. My wife and I have time with our family, and then we head off to Portugal. Everybody goes their separate ways.

In the past 50 years, rather than living in the same towns and villages, families have been scattered across the country, so at Christmas there's this tendency to get together for four or five days. Then pressure begins to build - especially when you factor in conflicting personalities, young children and different parenting techniques - and people start getting on one another's nerves.

To counter this, don't stay cooped up all day sitting in front of the TV eating and drinking. My daughter - whose house we go to - lives near London's Dulwich Park, so whatever the weather, we go for a walk. Some decide to stay home in the warm, and that brings me on to my next point: let people do what they want on Christmas Day, but have space from each other.

Lastly, if you're the host, delegate. Mothers - even working ones - tend to bear the brunt, so make it clear from the start that chores such as buying alcohol, making pudding or laying the table, must be split. Don't be polite, otherwise you'll end the day a seething, put-upon mess.

Avoid social jet lag ... says Dr Guy Meadows, clinical director of The Sleep School I feel very "bah, humbug" saying this, but Christmas takes a toll on your sleep. First, there's the build-up, with too many late nights, then you go into several days of celebrating, building up to New Year's Eve.

To help with this, I have "catch-up nights". On the nights you're not going out, make your day as healthy as possible. Avoid caffeine, eat light, balanced meals, limit tech use, stay off work email, wind down with a proper book or bath - then go to bed an hour earlier than usual.

This will ensure your sleep is as good as it can be to set you up for nights out; get as much bang for your buck as possible. During the Christmas break, go for early nights over lie-ins, because the latter confuse your biological sleep clock and you'll end up with social jet lag.

On Christmas Day and Boxing Day, the earlier you drink, the better - so you can stop boozing several hours before you go to bed. It takes the body an hour to metabolise one unit of alcohol. If you drink half an hour before bed, your body will still be busy metabolising alcohol, causing a night of semi-wakefulness and an inability to fall into REM (rapid eye movement) sleep, which is the deep, restorative kind needed to feel properly rested.

Christmas can already be an emotional, busy and stressful time, and good sleep puts you in a better space to deal with everything it has to throw at you.

A Christmas Day run and good champagne ... says personal trainer Matt Roberts I have a few Christmas traditions passed down from my own father, including a Christmas Day run. When I was growing up, my dad and I used to run around the Chester Walls on Christmas morning, and it stuck. My own kids get up early and we open presents together, and then I head off for a run around Hyde Park.

I schedule it into my Christmas morning, like stockings or presents. Everybody you bump into - whether it's kids in the park trying out new Rollerblades, or dog walkers and other runners - is super-friendly, and there's a real festive atmosphere, with everybody shouting "Happy Christmas!" to each other across the park. I only run for 20 minutes, which is enough to set me up for the day without taking me away from family for too long.

In our house, brunch is a bigger deal than Christmas lunch. We have organic smoked salmon, poached eggs, quails' eggs, roasted tomatoes and mushrooms, washed down with a glass of Dom Perignon. Rather than masses of junk food and drink, I have a little bit of really good stuff.

For Christmas lunch, I use coconut oil on my roasties and fill my plate with plenty of vegetables - roasted carrots, parsnips, spinach and broccoli - before reaching for anything else.

Clearly, there is more sugar, carbs and alcohol around, which I enjoy. But if I have too much, I feel lousy, so I limit rather than avoid them. But you can't do a huge amount of damage in a few days, so I just enjoy myself.

Watch your blood sugar levels ...says Gabriela Peacock, nutritionist to the Duchess of Sussex When it comes to limiting Christmas stress, the best place to start is with blood sugar levels, which regulate everything from your energy levels, to your cravings, concentration and ability to sleep.

I keep mine in check with protein at every meal, which slows down how quickly sugar from your food is released into your bloodstream. So Christmas Day breakfast always includes either eggs, smoked salmon, full-fat plain yogurt (this is especially good because it's fermented, which improves gut health) topped with berries, or porridge in nut milk.

The Christmas break isn't the time to be watching what you eat, but you can make small shifts, such as: choosing organic meat and dairy where possible, eating lots of different colours of fruits and vegetables, eating berries every day and adding spices such as ginger, turmeric and coriander to your meals.

Instead of hitting the chocolate tin in the evenings, snack on good fats' such as dark chocolate, and hummus with good-quality rye crackers, rather than the cheap, white ones. As a mixer for spirits, I use diluted coconut water instead of slimline or regular tonic, which is full of sweeteners or sugar and disrupts blood sugar levels.

Probiotics are good for pre-toxing - preparing your body for toxins - so I always take them throughout December and January. And lastly, I catch up on sleep and try not to worry about what may go wrong on the day: after all, if you get enough sleep and aren't stressed, your body can get away with a lot more indulgence.

'Don't stay cooped up all day sitting in front of the TV, eating and drinking'

'Instead of hitting the chocolate tin in the evenings, snack on good fats'

What will we eat in 2019? If some prognosticators have their say, we'll be crunching on salads of celtuce, a lesser-known green, mixed with either high-end bespoke vegetables personally designed by chefs, or virtuous ugly produce destined for the trash. Maybe they'll be topped with a crunch of chulpe corn or watermelon seeds.

We'll tear into interesting forms of bread - bing, from China, and manaeesh, from the Levant. There will be CBD in everything, smokeless smoke in everything, and real milk in nothing - not in our milkshake IPAs, which are not what they sound like (they're brewed with lactose) - because pea milk and oat milk are taking over.

"Regional flavours" will be important, specifically those from India, the Pacific Rim and "the 'stans" - Kazakhstan, Tajikistan and Uzbekistan. Plant-based eating will continue to grow. Some products that were formerly shelf-stable, such as granola bars and olive oil, are going to need to be refrigerated. It will be a good year for dietitians, who are poised to become the new celebrity chefs. We'll pay for our sandwiches with cryptocurrency, as if that's no big deal.

Then again, it's not like 2018 panned out exactly how the prediction-makers thought it would. Yes, we ate artisan pickles and drank Cristalino tequila and had ghee and plenty of veggie-forward dishes. It's true that Jewish delis are on the upswing, and Israeli cuisine hit its stride. And tsukemen, or brothless ramen, got more popular. But why didn't we get really into deep-frying, or Tanzanian barbecue seasoning? Chain restaurants never picked up on "trash fish." Norwegian and Icelandic "Arctic cuisine" has yet to hit the mainstream. Other predictions - locally sourced produce, Instagrammable foods, "authentic ethnic cuisine" and street food - were already in, some for more than a decade.

What is a trend, anyway? There's no set way to measure one, no threshold of sales or number of products on the market past which a food becomes Certifiably Trendy, especially because food trends, like fashion, trickle down into mainstream ubiquity. There's just a bunch of market researchers and food industry consultants and publicists and journalists, a little bit of data, a looming Dec. 31 deadline and an intangible notion of what feels cool and new.

"The science to predicting a trend is to figure out, what is actually happening here? Is it just now, is there some sort of immediacy to it or does this actually have a longevity?" said Jenny Zegler, associate director of food and drink for consumer research company Mintel. "And, what does that mean, and what is that reflective of, in terms of what consumers want?"

Some trend lists come from huge teams of professional trendspotters and industry-watchers, and some come from just one person with a finger on the pulse. But all of the predictions tend to fall into one of four categories. In the first category are the vague, evergreen, massive buzzword trends - like "plant-based foods" and "specialized diets" - that will both always and never be trends, because they're so all-encompassing. But don't count them out, says Zegler, whose report for Mintel pinpoints three trends: sustainability, foods for healthy aging and enhanced convenience foods. A list should be measured by its goals, Zegler says: theirs is global in scope, and based on the work of 91 analysts in 13 countries, backed by actual consumer research data, and geared toward large brands for whom a menu change is a major supply-chain overhaul and a big gamble.

"I think a lot of what we're trying to do is identify things that are already happening," Zegler said. It's "not necessarily that companies that we work with are astounded by this prediction. It's more of, you know, this is where we should be going, and this is what we should be looking at."

What many of us think of as trends, such as Thai rolled ice cream or "souping" or cake pops, are actually fads.

"A fad is something that kind of comes quick and goes and maybe makes a viral sensation," said Zegler, but a trend has staying power. "That is really impactful, especially in a business sense, that you know if you're going to switch to make everything this new cool flavour, you want to make sure that it's the flavour that's going to last."

But calling a major cultural force already at play within the industry a trend has another benefit: you can never be wrong. That extends to things that Zegler would call fads, too: Among this year's lists, there are predictions that za'atar and orange wine and CBD will become trendy. They're in the second category - specific "predictions" that are already trendy, in some circles, at least. Za'atar might not be everywhere yet, but it's long been having a moment in the independent restaurant scene.

That's the other tricky thing about trend lists: whom are they for? When food media, which tend to live in coastal cities, see a list that predicts rainbow-coloured unicorn food as the next hot thing, they might think it's hopelessly outdated. Meanwhile, if you go by sales figures, that trend is still making its way throughout the U.S.: it was one of the most-searched food trends on Google this year, and it hit mainstream ubiquity, perhaps, when Sam's Club began selling a unicorn cake.

"We used to say facetiously that when something appeared on a Marriott menu, you knew the trend was over," said Michael Whiteman, president of Baum & Whiteman, a restaurant consulting group.

Whiteman's list says the big trends for next year will be more widespread culinary use of robots, an escalation of the "meal kit wars," katsu sandwiches, Szechuan hot pot, and the aforementioned bing and food from the 'stans - the latter, something that Whiteman has noticed becoming rapidly popular throughout Brooklyn, where so many trends begin.

"Could I be wrong on that? I certainly could," he said.

That's the third category: trends that may or may not take off - who knows? Whiteman's list comes from travel, his many years of experience and intuition.

"You know, something catches your eye," Whiteman said. "And over the course of a year you see three or four places and you say, 'Well, let's watch this.' ... I wish I had a scientific answer for you."

The end-of-the-year list rush is real.

"Over the past 10 years, the number of people making predictions online has probably quintupled," said Whiteman, in part because journalists write about them (guilty). And, any company can use a food trend list as a branding and engagement opportunity, which is why you see lists from Google and Chase Bank.

The fourth category, of course, is trend predictions that seem to hit the perfect sweet spot: still under the radar enough, but gaining momentum, and poised to take off. For this year, that might include Peganism (paleo veganism), lab-grown meat, shelf-stable probiotics (active beneficial bacterial cultures in foods that don't need to be refrigerated), as well as healthy desserts made with ingredients such as taro pudding and quinoa.

"I tend to look at what the independent (restaurants) are doing, because that tends to be where trends start," Thorn said. "If they make it into the smaller chains, we really have something going. It's an open question of when it becomes really mainstream. If it goes to casual dining, like TGI Fridays, if it makes it to fast food, like McDonald's, it's a thing."

But most of the people reading these predictions aren't restaurateurs or food producers. They might not even live in cities where these trends are readily accessible. But from late December through early January, they'll eat them up nonetheless.

"It is something that people want to be part of," Zegler said. "They want to be part of that leading edge. They want to be the first one in their friend group to identify this."

Most of all, she says, "They want to be able to post on Instagram."

More vegetables. Improved gut bacteria. Cocktails with less alcohol.

Many of the predictions about what we’ll eat and drink in 2019 point to a quiet, restorative and potentially grim time ahead. Then again, these forecasts always arrive carrying the clean, healthy pine scent of New Year’s resolutions.

The good news: There will be cheese tea. And salad robots, according to the prognosticators.

As we pored over dozens of lists handicapping the next big food trends, and interviewed the people who get paid to drill into consumer behavior, we kept in mind that everyone could be dead wrong. Food forecasting is not a science[https://www.nytimes.com/2016/12/27/dining/food-trend-predictions.html], or even an art. Still, the game is a fun one.

Here are some of the most intriguing guesses at what and how Americans will be eating in the new year.

The Next Lettuce

The great romaine scare of 2018 — a strain of E. coli that was eventually traced[https://www.nytimes.com/aponline/2018/12/13/health/ap-us-med-lettuce-outbreak.html] to a reservoir in California — has helped make lettuce ripe for a new star in 2019. The current darling of the restaurant salad, Little Gem lettuce, was denounced this month[http://www.grubstreet.com/2018/12/bad-dining-trends-2018.html] as overexposed by New York magazine’s restaurant critic, Adam Platt.

Expect to see little-known varieties showing up on menus, and an explosion in lettuces grown hydroponically, many of them in urban container farms[https://medium.com/neodotlife/vertical-farming-paul-gauthier-76e81ace79d0]. Some chefs are rallying around celtuce[https://www.supermarketnews.com/consumer-trends/10-food-trends-2019/gallery?slide=1], a lettuce with a leafy, bitter top and a stalk that’s kind of a cross between celery and asparagus. Chinese cooks know it as wosun. Even wild weeds like dandelion greens or sorrel may get a shot. Whichever wins, kale is still over.

The New Flavor Profile

Sour and funky, with shades of heat. This is what happens when you mix the interest in fermenting with the millennial palate. Melina Romero, who has the title of trend insights manager at CCD Helmsman[https://www.ccdhelmsman.com/], a food research and product development firm in Emeryville, Calif., explained the generation that loves global mash-ups and bold flavors[https://www.foodservice-snacks-desserts.com/productsandbrands/industrynews/snacking-the-world-in-their-hands?gclid=EAIaIQobChMIsraS5p6d3wIVAo3ICh2BqQ5LEAMYASAAEgKQAvD_BwE] this way: “They grew up with Flamin’ Hot Cheetos, and while they still want spicy, I think, beyond that, they have grown to become interested in flavors that are acquired — sour flavors and even funky flavors like fermented foods.”

The Thing You Will Try Against Your Better Judgment

Cheese tea, an import from Taiwan, will hit the American mainstream this year. Green or black tea is sipped through a cap of cream cheese blended with cream or condensed milk, which can be either sweet or slightly salty. It’s already a hit[https://www.nbcbayarea.com/news/local/Steap-Creates-San-Francisco-Twist-on-Cheese-Tea-456722743.html] in San Francisco, where they make it with Meyer lemon and mascarpone.

The Big Health Fix

Anything to do with your gut flora. That means you can expect more ways to ingest probiotics and prebiotics and foods designed to improve the bacterial health of your intestinal tract, according to several grocery store chains[https://www.krogerstories.com/krogers-top-food-trends-for-2019/] and wellness market analysts. As the obsession with digestive health dovetails with the fascination for fermenting, kimchi, sauerkraut and pickled things will work their way into new territory. Smoothies with kefir will be popular, and kombucha will show up in unexpected places like salad dressings.

The Hot Diets

Diets that emphasize fat over carbohydrates will continue to dominate. Instagram says video posts using the hashtag “keto” — the name of a high-fat, low-carb diet — grew fivefold over the past six months. Hannah Spencer, a registered dietitian who tracks the food service industry for the market research company Mintel[http://www.mintel.com/], said the keto diet might be losing its edge. Still, she added, restaurants will add more low-carb options. The term “pegan” — a cross between a paleo and a vegan diet — will take hold. Pinterest says the number of searches for the term rose 337 percent in the past six months.

The New Sheet-Pan Supper

With barely any cleanup and a deep whiff of nostalgia (remember your first Scout camping trip?), cooking dinner in foil packets is poised for popularity. Pinterest notes that searches for “foil-pack dinners” have jumped nearly eightfold in the past six months.

The Driest Drinks

At the bar, lighter wines, natural wines and drinks with less or no alcohol will be popular. Americans ages 18 to 34 are more interested in spirit-free cocktails than any other demographic group, according to Mintel. As a result, bartenders will replace high-alcohol liquors like gin with lower-alcohol wines like Prosecco in mixed drinks, and make more use of shrubs, craft vermouths, botanicals and distilled nonalcoholic spirits like Seedlip[https://seedlipdrinks.com/]. This may force bars to try to come up with better names than the no-jito or the no-groni. Outlier prediction: Forbes magazine is betting that the breakfast cocktail[https://www.forbes.com/sites/lizazimmerman/2018/12/16/wine-and-cocktail-trends-for-the-new-year-and-beyond/#197b341111c2] will be big.

The Case Against Waste

With the plastic straw and the plastic bag increasingly out of fashion, restaurants, food manufacturers and groceries will face new pressure to reduce other packaging waste. In a recent Mintel survey, 36 percent of diners said they wanted restaurants to cut back on packaging. (The number is even higher among baby boomers.) Restaurants that serve food on plastic with disposable cutlery will have an incentive to invest in reusable plates and forks. Cutting waste in the increasingly robust carryout and delivery markets will get new attention, too.

The Playlist Ploy

Restaurants will keep seeking ways to expand their brands beyond food; Dunkin’ Donuts has put its name on a Saucony running shoe[https://www.runnersworld.com/gear/a19595602/saucony-dunkin-donuts-shoes/], and KFC recently sold out of fire logs that smell like fried chicken[https://www.theroot.com/kfc-is-selling-firelogs-that-smell-like-fried-chicken-s-1831130588]. For higher-end restaurants, the vehicle of choice will be the customized Spotify playlist. David Chang has already issued one[https://open.spotify.com/playlist/1pFH4rogNq0DgajtZnDZqp], as has Flour & Water[https://open.spotify.com/playlist/05MjsuHl9mnkGj0bOdv4gy] in San Francisco.

The Plant-Based Main Course

Substantial vegetable entrees will become a fixture on restaurant menus, in the way that alternatives to dairy creamers became standard at coffee bars a few years ago. Many diners have started to eat less red meat or abandon animal protein altogether, whether for health, environmental or ethical reasons. A few corporations have banned meat consumption[https://money.cnn.com/2018/07/13/technology/wework-meat-ban/index.html] on their campuses. In Los Angeles, a member of the City Council this month proposed a law [https://losangeles.cbslocal.com/2018/12/05/la-city-council-vegan-option-climate-change-wildfires/]that would require a substantial vegan protein entree be available at movie theaters and other large entertainment centers.

The Motherless Meat

Laboratory-grown proteins will enter the mainstream. KFC, Tyson Foods and Cargill are investing heavily, and the products are catching on so fast that ranchers have started campaigns to stop the engineered proteins from being called “meat,” Forbes reports[https://www.forbes.com/sites/eustaciahuen/2018/11/30/foodtrends/#75c8668d507e]. Prepare for the next generation of plant-based alternatives to dairy products: substitutes for cheese, butter and ice cream made with nuts, soy or coconut.

The Tech Advancement You’ll Hate Until You Need It

Salad-making robots will show up in hospitals and airports, where freshly made food is not easy to find at all hours. The systems rely on chilled containers of fresh ingredients that are restocked during the course of the day. Push a few buttons on a keypad and the robot makes a custom salad topped with dressing.

The Hope for Dope

Major food and beverage companies are researching ways to get THC, the psychoactive component of marijuana, and cannabidiol, a part of the plant that may have therapeutic properties, into more food and drinks. The authors of the federal farm bill have removed hemp[https://www.fresnobee.com/news/business/agriculture/article223111305.html] from the list of controlled substances, and Gov. Andrew M. Cuomo is pushing to legalize recreational use of marijuana[https://www.nytimes.com/2018/12/17/nyregion/marijuana-legalization-cuomo.html?module=inline] in New York.

The New ‘It’ Vegetable

It’s a tie between mushrooms [https://indd.adobe.com/view/2cb60334-4f5f-447f-93fa-570e233fc653]— which have acquired what food marketers call a health halo and are expected to pop up in teas, desserts, jerky and cocktails — and sea vegetables, which most people just call seaweed. Consumption of seaweed is growing 7 percent annually in the United States, James Griffin, an associate professor at Johnson & Wales University, told Nation’s Restaurant News[https://www.nrn.com/food-trends/6-food-trend-predictions-2019]. It checks all the boxes: healthful, environmentally sound and full of umami.

The New ‘It’ Cuisines

It’s a tossup. The market research firm Technomic says popular dishes will come from eastern Mediterranean nations[https://www.technomic.com/newsletters/technomics-take/7-key-trends-2019] like Lebanon, Syria and Turkey. Baum & Whiteman, a consulting firm based in New York, is betting on food from the “Stans” — Kazakhstan, Tajikistan and Uzbekistan. The global buyers for Whole Foods Market have money on flavors from the Pacific Rim[https://media.wholefoodsmarket.com/news/whole-foods-market-unveils-top-10-food-trends-for-2019]. The San Francisco food consultant Andrew Freeman is calling it for Georgia[https://afandco.app.box.com/s/dse4zxz7qi3nn6g4r2e8ldg8rjeo74gp], with its Instagrammable star, khachapuri — the cheese-filled bread boat topped with a runny egg. The prognosticators at the Kind food company are pulling for the flavors of Africa[http://kindassets.kindsnacks.com/KINDHealthySnackingTrendreport.pdf], though they did not specify a country.

The Cause of the Year

How a restaurant or food company cares for its employees, its purveyors, its customers and its community will move up the priority list in 2019, Mr. Freeman said. More chefs will become first responders[https://www.nytimes.com/2017/10/30/dining/jose-andres-puerto-rico.html], providing food at disaster sites. Companies will fine-tune training for how employees should treat one another. Immigrants and their role in American food culture will be front and center.

Sara Brito, a founder and the president of the Good Food 100 list, said in her 2019 trend report[http://goodfood100restaurants.org/work/new-year-new-food-system-top-10-trends-that-will-dominate-2019/] that customers will demand that restaurants tend to more than just how food tastes.

“They need to demonstrate they care about the whole system and story of food,” she said, “including the environment, farmworkers, animal welfare and inclusion in the workplace.”

* Beneficial human microbiota, largely found in the gut, can help people digest food and maintain a healthy immune system.

* The diversity of microbiota among residents of urbanized countries has decreased dramatically in the past several decades.

* At the same time, the incidence of inflammatory diseases has gone up.

* A group of scientists believes these trends are related, and they are calling for the creation of a vault that would store beneficial gut bacteria from remote populations.

* These populations have yet not been exposed to antibiotics and processed foods, and the scientists say their microbiota samples are still very diverse.

Human microbiota — most of which are beneficial bacteria in the gut[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426293/] — can strengthen immune systems, fight off invading germs, and help people digest food.

These microbiota have evolved for millions of years, but the diversity of most people's gut bacteria has decreased dramatically in the past few generations. Many inflammatory diseases, such as asthma and diabetes, have become a lot more common during this time period.

A group of researchers led by Rutgers University professor Maria Gloria Dominguez-Bello believes that changes in our microbiota could be the main factor underlying the rise of these diseases. The prevalence of antibiotics and processed foods in Westernized countries, they say, is contributing to the loss of microbial diversity and could be causing health problems.

"We think the two are connected but we haven't formally demonstrated causation," Dominguez-Bello told Business Insider. "But if we don't do anything, by the time we understand the complex problem, there will not be any traditional peoples left, and that diversity we have disappears. It will be too late."

To preserve the long-term health of humanity, the researchers are calling for the creation of a global vault[http://www.microbiotavault.org/] that would store the microbiota of people who do not use processed foods or antibiotics. The contents of this germ vault — stool samples and other microbiota from people's skin, mouth, and nose — would come from communities with a high diversity of gut bacteria, such as remote parts of Latin America and Africa.

The proposal's authors — Dominguez-Bello, Jack Gilbert from the University of Chicago, Martin Blaser from New York University Langone Medical Center, and Rob Knight from the University of California San Diego — say the microbiota vault needs to open soon because a growing percentage of the global population is becoming urbanized. In the United States, most people's microbiota is currently only half as diverse as the microbiota of hunter-gatherers in the Amazon.

Dominguez-Bello previously conducted a study[https://msphere.asm.org/content/3/4/e00193-18] that immersed urban people in the diet and lifestyle of a rainforest village in Venezuela. The study participants only ate low-fat, high-fiber foods that were unprocessed. They bathed in rivers without using shampoo or soaps, went to bed early, did not use electricity, and woke up at sunrise.

While the urban children saw an increase in microbiota diversity after the 16-day immersion, the urban adults did not, Dominguez-Bello found.

Read more: Here's how Americans' gut bacteria compares to that of remote hunter-gatherer tribes[https://www.businessinsider.com/americans-gut-bacteria-compared-to-papua-new-guineans-2015-4?utm_source=dowjones&utm_medium=ingest]

The proposed microbiota vault would function as a storage facility for existing collections of gut bacteria, Dominguez-Bello said, emphasizing that the vault would not be responsible for collecting new samples. However, she hopes its creation would help empower scientists in developed countries to maintain their own collections of microbiota from local residents.

Each set of microbiota samples in the vault would only be owned by the depositor and whoever else has rights to the collection through the Institutional Review Board.

The vault is similar in concept to the Svalbard Global Seed Vault[https://www.businessinsider.com/svalbard-global-seed-vault-upgrade-2018-2?utm_source=dowjones&utm_medium=ingest], a massive collection of crops that could be crucial to humanity's survival in the event of a large-scale disaster.

While the scientists have not yet chosen a location for the microbiota vault, Dominguez-Bello told Business Insider that the vault would ideally be in a cold place. It should also be located in a politically and economy stable country whose leaders support the creation of the vault, she said. The global seed vault, which opened in 2008[https://www.croptrust.org/about-us/our-history/], is located in Norway.

In their proposal, which was published in the journal Science,[http://science.sciencemag.org/content/362/6410/33/tab-pdf] Dominguez-Bello and her team said scientists may be able to stop diseases in the future by inserting lost microbiota back into the human population.

For now, Dominguez-Bello's team is working on standardizing the protocol for freezing microbiota samples. They want to use multiple methods — not just freeze drying — because every type of cell preservation kills off some proportion of samples. One preservation method could save bacteria that are killed off using another technique, she said.

Dominguez-Bello said she hopes her team can find a site for the vault sometime in 2019. The scientists are focusing on fundraising, and still need to gather about $300 million to make this project possible. While starting the vault is not nearly that expensive, Dominguez-Bello said an endowment is necessary to make the vault sustainable long-term.

NOW WATCH: Here's how many children you can have in a lifetime[https://www.businessinsider.com/how-many-children-you-can-have-lifetime-2018-11?utm_source=dowjones&utm_medium=ingest]

See Also:

* The company behind Marlboro just made a huge bet on Juul, and the move makes the Silicon Valley e-cig startup more valuable than Airbnb[https://www.businessinsider.com/altria-considering-juul-investment-2018-11?utm_source=dowjones&utm_medium=ingest]

* Cigna is closing its $67 billion deal with Express Scripts, creating a new healthcare giant[https://www.businessinsider.com/cigna-closes-67-billion-deal-with-express-scripts-2018-11?utm_source=dowjones&utm_medium=ingest]

* The most popular diets wealthy people want to try next year[https://www.businessinsider.com/most-popular-diets-wealthy-people-want-to-try-in-2019-2018-12?utm_source=dowjones&utm_medium=ingest]

Food makers are devising more expensive sizes and flavors of their treats and breakfast foods, a subtle strategy to cover rising costs as tough competition holds down prices elsewhere in the supermarket.

Gilding the lily can pay off. Mondelez International Inc.'s new fudge-dipped Oreo Thins Bites cost 56 cents an ounce at Walmart, compared with 30 cents an ounce for standard Oreo Thins cookies and 18 cents an ounce for traditional Oreos.

Similarly, Hershey Co. is designing new stand-up pouches of candy coming out in the spring that will cost more per ounce than current bags. And General Mills Inc. on Wednesday said higher prices and demand for more expensive products lifted sales 2% in its latest quarter.

"The key on pricing is to make sure you keep it in line with what consumers can afford, and they're feeling pretty good right now," General Mills Chief Executive Jeff Harmening said in an interview.

From Kellogg Co., Eggo waffles flavored with imported vanilla cost 28 cents an ounce, compared with 23 cents an ounce for the standard version, according to prices at Peapod, the grocery-delivery service of Ahold Delhaize NV. And Kellogg's new Special K probiotic cereal goes for about 26 cents an ounce, compared with roughly 22 cents an ounce for its traditional Special K, according to prices at Walmart Inc.'s Jet.com online service.

The introduction of these more expensive varieties is one reason dry-grocery prices rose nearly 2% in the year ended in November, according to Nielsen. By volume, dry-grocery sales were flat over that period.

"They can charge a premium, even though the input costs have mostly stayed the same," said Andrew Csicsila of the consulting firm AlixPartners.

Food makers and grocers are used to tough negotiations over what to charge shoppers. Stores want a tight lid on prices. That said, grocers and other retailers have proven more amenable to higher prices on new flavors or styles of an existing product than to raising prices on familiar packaged foods, whose sales have fallen. Amazon.com Inc. has been pressing brands to rethink their packaging and product varieties to make online sales more profitable.

Hostess Brands Inc., the producer of Twinkies and Ding Dongs, is creating new flavors of premium snack cakes called Bakery Petites "to attract new consumers at higher price points," Chief Executive Andrew Callahan said on a recent conference call. Bakery Petites cost 47 cents an ounce at a Walmart in Chicago, more than double the price-per-ounce for Twinkies.

Kroger Co. Chief Executive Rodney McMullen said food makers need to demonstrate that their new flavors and styles are distinct enough to draw shoppers away from the standard version of their product.

"Creating something I didn't know I need is innovation," Mr. McMullen said in an interview.

Innovation can resonate with customers -- if they are getting what they want. Jed Cusimano, a 39-year-old product manager in health-care data integration, said convenience is the most important thing he looks for when grocery shopping. "Individually wrapped snacks. Single serve. It's worth paying extra for that than getting a big bag of chips or something," he said.

"I'll pay extra for resealable packaging, to keep the food fresh. It's worth it," said Lisa Posey, who is in her 50s and lives in Chicago. "I'm single and don't have kids so I don't go through food as quickly, and I can afford to pay a little more."

Price is still top of mind for shoppers, with 77% of 1,035 consumers surveyed by the Food Marketing Institute trade group saying they picked their primary supermarket based on low costs. Variety and selection of goods was close behind as a motivating factor, at 74%.

Prices for shelf-stable goods are rising, federal data show. Snacks, spices, salad dressings, sweets, cookies, cakes and juices were among the goods that saw annual prices increases, according to consumer-price index data released Wednesday. Costs of carbonated beverages posted the steepest annual increases in more than two years.

California-based Smart & Final Stores Inc. has received requests to raise prices from about half of its 1,500 main suppliers. The chain of more than 300 stores is pushing back, but price increases have occurred and officials expect more to come next year, said Chief Executive David Hirz.

Smart & Final and other grocers are stocking more of their own low-price store-brand items in hopes that customers won't feel the shopping trip is getting more expensive overall.

License this article from Dow Jones Reprint Service[http://www.djreprints.com/link/DJRFactiva.html?FACTIVA=WJCO20181220000059]

Food makers are devising more-expensive sizes and flavors of their treats and breakfast foods, a subtle strategy to cover rising costs as tough competition holds down prices elsewhere[https://www.wsj.com/articles/big-food-faces-pressure-from-retailers-demanding-discounts-1504216666] in the supermarket.

Gilding the lily can pay off. Mondelez International Inc.'s new fudge-dipped Oreo Thins Bites cost 56 cents an ounce at Walmart, compared with 30 cents an ounce for standard Oreo Thins cookies and 18 cents an ounce for traditional Oreos.

Similarly, Hershey Co. is designing new stand-up pouches of candy coming out in the spring that will cost more per ounce than current bags. And General Mills Inc. on Wednesday said higher prices and demand for more expensive products

lifted sales 2% in its latest quarter[https://www.wsj.com/articles/general-mills-struggles-to-lift-sales-in-north-america-11545223015].

"The key on pricing is to make sure you keep it in line with what consumers can afford, and they're feeling pretty good right now," General Mills chief executive Jeff Harmening said in an interview.

From Kellogg Co., Eggo waffles flavored with imported vanilla cost 28 cents an ounce, compared with 23 cents an ounce for the standard version, according to prices at Peapod, the grocery-delivery service of Ahold Delhaize NV. And Kellogg's new Special K probiotic cereal goes for about 26 cents an ounce, compared with roughly 22 cents an ounce for its traditional Special K, according to prices at Walmart Inc.'s Jet.com online service.

The introduction of these more expensive varieties is one reason dry-grocery prices rose nearly 2% in the year ended in November, according to Nielsen. By volume, dry-grocery sales were flat over that period.

"They can charge a premium, even though the input costs have mostly stayed the same," said Andrew Csicsila of the consulting firm AlixPartners.

Food makers and grocers are used to tough negotiations over what to charge shoppers. Stores want a tight lid on prices. That said, grocers and other retailers have proven more amenable to higher prices on new flavors or styles of an existing product than to raising prices on familiar packaged foods, whose sales have fallen[https://www.wsj.com/articles/so-long-hamburger-helper-americas-venerable-food-brands-are-struggling-1499363414]. Amazon.com Inc. has been pressing brands to rethink their packaging and product varieties[https://www.wsj.com/articles/amazon-targets-unprofitable-items-with-a-sharper-focus-on-the-bottom-line-11544965201] to make online sales more profitable.

Hostess Brands Inc., the producer of Twinkies and Ding Dongs, is creating new flavors of premium snack cakes called Bakery Petites "to attract new consumers at higher price points," Chief Executive Andrew Callahan said on a recent conference call. Bakery Petites cost 47 cents an ounce at a Walmart in Chicago, more than double the price-per-ounce for Twinkies.

Kroger Co. Chief Executive Rodney McMullen said food makers need to demonstrate that their new flavors and styles are distinct enough to draw shoppers away from the standard version of their product.

"Creating something I didn't know I need is innovation," Mr. McMullen said in an interview.

Innovation can resonate with customers—if they are getting what they want. Jed Cusimano, a 39-year-old product manager in health-care data integration, said convenience is the most important thing he looks for when grocery shopping. "Individually wrapped snacks. Single serve. It's worth paying extra for that than getting a big bag of chips or something," he said.

"I'll pay extra for resealable packaging, to keep the food fresh. It's worth it," said Lisa Posey, who is in her 50s and lives in Chicago. "I'm single and don't have kids so I don't go through food as quickly, and I can afford to pay a little more."

Price is still top of mind for shoppers, with 77% of 1,035 consumers surveyed by the Food Marketing Institute trade group saying they picked their primary supermarket based on low costs. Variety and selection of goods was close behind as a motivating factor, at 74%.

Prices for shelf-stable goods are rising, federal data show. Snacks, spices, salad dressings, sweets, cookies, cakes and juices were among the goods that saw annual prices increases[https://www.wsj.com/articles/companies-raise-prices-betting-consumers-can-pay-more-1540978200], according to consumer-price index data released Wednesday[https://www.wsj.com/articles/u-s-consumer-prices-flat-in-november-11544621659]. Costs of carbonated beverages posted the steepest annual increases in more than two years.

California-based Smart & Final Stores Inc. has received requests to raise prices from about half of its 1,500 main suppliers. The chain of more than 300 stores is pushing back, but price increases have occurred and officials expect more to come next year, said Chief Executive David Hirz.

Related

* Amazon Targets Unprofitable Items, With a Sharper Focus on the Bottom Line[https://www.wsj.com/articles/amazon-targets-unprofitable-items-with-a-sharper-focus-on-the-bottom-line-11544965201?mod=article_inline] (Dec. 16)

* U.S. Consumer Prices Flat in November, Posing Dilemma for Fed[https://www.wsj.com/articles/u-s-consumer-prices-flat-in-november-11544621659?mod=article_inline] (Dec. 12)

* That Big Mac and Coke Now Comes With a Side Order of Inflation[https://www.wsj.com/articles/companies-raise-prices-betting-consumers-can-pay-more-1540978200?mod=article_inline] (Oct. 31)

Smart & Final and other grocers are stocking more of their own low-price store-brand items in hopes that customers won't feel the shopping trip is getting more expensive overall.

Kroger executives say they have pushed back on some food makers' proposals to raise prices, with plans to stock more of their cheaper private-label[https://www.wsj.com/articles/kroger-shares-jump-on-strong-sales-report-1529584568]goods next to those items. Making Kroger-branded salad dressing and pasta sauce also gives them firsthand knowledge of what a food costs to make, these executives said, providing additional leverage over food makers.

J.M. Smucker Co. said low prices on competing store brands have made it difficult to charge more for its Jif peanut butter. Smucker, too, is planning to introduce new products next year to draw in new customers.

"Our goal is to protect profit," Chief Executive Mark Smucker said on a conference call.

Write to Heather Haddon at heather.haddon@wsj.com[mailto:heather.haddon@wsj.com] and Annie Gasparro at annie.gasparro@wsj.com[mailto:annie.gasparro@wsj.com]

Move over Bifidobacterium and Lactobacillus. There's a new health-promoting gut bacterium in town, and it's called Akkermansia muciniphila.

You will not find its benefits at the bottom of a yogurt cup. But a new study has identified more than one way to nurture its growth in the gut, and offered evidence that it may maintain - and even restore - health as we age.

Published in November in the journal Science Translational Medicine, the new research found that in mice and monkeys, whose metabolisms had grown cranky with age, taking steps to boost A. muciniphila in the gut reduced the animals' insulin resistance.

Insulin resistance is the gradual impairment of the body's ability to efficiently use food for fuel. It is best known as a way station on a patient's path to developing Type 2 diabetes.

But insulin resistance is also linked to a rogue's gallery of ills, from obesity and inflammation to the sagging immunity and frailty that comes with advancing age. If a readily available means of slowing or reversing insulin resistance could be identified, it might have broad and powerful anti-aging effects (in addition to protecting some of the world's 650 million adults who are obese against developing Type 2 diabetes).

First identified in 2004, Akkermansia muciniphila inhabits the large intestine and is thought to account for between 1 per cent and 5 per cent of all intestinal bacteria in adults. Scientists suspect it helps preserve the coat of mucous that lines the walls of our intestines. It may also play a role in making the polyphenols we eat in plant-based foods more available to our cells.

Evidence is mounting that A. muciniphila is involved in obesity, glucose metabolism and intestinal immunity.

For instance, a 2018 study of cancer patients suggests that it plays a role in immune response. Compared to patients who failed to be helped by a new generation of immunotherapy, those who did had a greater abundance of Akkermansia in their guts. When researchers took the stool of a patient who responded positively to the cancer-fighting therapy and transplanted it into lab animals with human cancers, the recipients became more likely to respond positively to the same treatment.

In the new research, a team from the National Institute on Aging examined the molecular chain of events that appears to result from A. muciniphila's depletion in mice and macaque monkeys. And they assessed the effects of restoring this gut microbe to elderly animals.

First, they documented that the guts of older animals had markedly smaller populations of A. muciniphila than the guts of young animals, and that as A. muciniphila became more scarce, so did butyrate, one of the gut's key protectors.

The deficiency of these two substances caused the mucous walls of the aged animals' intestines to thin and grow leaky. That corrosive process unleashed a chain of events that touched off inflammation, prompted an immune response and, in a final step, increased insulin resistance.

Key to that final step was the accumulation in the gut of a specific kind of immune cell called 4BL cells. If the detrimental chain of events was to be disrupted, the accumulation of those 4BL cells probably had to be stopped, the researchers surmised.

The researchers also documented what appeared to be a role for A. muciniphila in fostering healthy diversity among the garden of other microbes that colonize the gut. In animals with scant populations of A. muciniphila, a host of other common gut bacteria - as well as their beneficial byproducts, particularly butyrate - also suffered.

When the researchers gave aged mice butyrate, the result was higher A. muciniphila levels and levels of insulin resistance that approached those seen in the younger animals.

They got the same results when they gave aged mice and macaque monkeys the antibiotic enrofloxacin, a broad-spectrum antibiotic used in veterinary medicine. In both animals, enrofloxacin - which is not considered safe for use in humans - routinely wiped out the 4BL cells that were thought to be a key link in the chain leading to insulin resistance. With them out of the picture, A. muciniphila levels rose and insulin resistance largely disappeared, demonstrating their pivotal role.

The results suggest "that the insulin resistance and other pathologies associated with aging and even frailty can be ameliorated by targeting" the cascade of events that flow from the depletion of Akkermansia muciniphila, the study authors wrote. Belgian researcher Patrice Cani, who is exploring a probiotic form of Akkermansia that could increase its presence in the human gut, said the new findings are "perfectly in line" with studies that have shown the bacteria's impact on insulin sensitivity.

Finding the power of this gut bacteria in macaque monkeys is a particularly important step that supports "even more the need for future research in humans," added Cani, who is based at the Catholic University of Louvain in Belgium.

Cani and his colleagues have just finished a small study in humans to investigate the safety and the feasibility of taking Akkermansia in a form that will boost its populations in the gut - a first. The results to date have been encouraging, he said.

Kombucha - as purveyors of the elixir claim - has a multitude of health benefits: It can aid your digestion, colonize your gut with healthy bacteria and boost your immunity. And lately, it can get you drunk.

All kombucha has a little bit of alcohol in it. But lately, brewers are upping the ante, making kombucha with more than 5 percent alcohol in it - more than the average beer. And many of them claim that the drink's health benefits remain intact. Get tipsy! For your health! Livin' the dream, right?

That's not entirely how it works, some experts say, but it's certainly part of the drink's appeal - and why it's such a quickly growing category.

"It's definitely a healthy beverage," said Tarek Kanaan, who co-founded Unity Vibration, an early producer of high-alcohol kombucha, with his wife, Rachel. "When I drink a gluten-containing beer, I feel a lot heavier and a bit more affected," Rachel Kanaan said.

Kombucha is a fermented tea that dates back to ancient times, with its roots in Asian culture. It is made by brewing tea and sugar, and leaving it to ferment with a SCOBY, an acronym that stands for symbiotic culture of bacteria and yeast. The fermentation also produces alcohol. The end result is a drink that's tart and sour, lightly carbonated and chock full of probiotics. With our culture's increased focus on gut health, kombucha has soared in popularity in the past 10 years, commanding entire refrigerated sections of your local grocery store.

In 2010, the Alcohol and Tobacco Tax and Trade Bureau cracked down on kombucha producers after tests of various brands revealed that the drinks contained anywhere from 0.5 percent alcohol by volume to 2.5 percent. Some stores were carding purchasers of kombucha, and Whole Foods pulled drinks from its shelves. Under federal law, kombucha with an ABV of 0.5 percent or more must be regulated as an alcoholic beverage. Commercial kombucha makers changed their formulas and implemented additional testing to comply with the regulations.

That's when the Kanaans decided to go a different route and begin brewing their kombucha as an alcoholic beverage (they also make a nonalcoholic version).

"It's old-style brewing, like Belgians or lambics," Rachel Kanaan said. "In the second ferment, it's open-air fermented, too. It's allowed to brew, and then we bottle and we do bottle conditioning, which is much better than other companies that are force-[carbonating]." Their kombucha beer comes in several flavors: raspberry, ginger, bourbon-peach and a KPA, or kombucha pale ale. Like other boozy kombuchas, it has emerged as a popular choice - and an alternative to cider - for those who avoid gluten.

Other kombucha brewers charted a similar course. You'll see brands such as Boochcraft, Kombrewcha and Wild Tonic selling brews with from 3.2 to 8 percent ABV. That puts them at the level of a beer (typically a 4.5 percent ABV) and below a wine (typically 11.6 percent).

Big beer companies are getting in on the game, too. This year, Full Sail Brewing Company launched Kyla, a line of hard kombucha. Combining two trends, one of them is infused with cold-brew coffee. In June, Molson Coors acquired the California company Clearly Kombucha, which makes typical, low-alcohol kombucha. (The company has "no immediate plans to introduce a hard kombucha," a spokesman said.)

And Boston Beer, which owns Samuel Adams, told The Washington Post it has plans to introduce a new brand, Tura Hard Kombucha, in early 2019. The name comes from the word "natural," and the brand will start with the flavors blueberry-ginger and hibiscus-wild berry. Distribution will begin in six states, including California and New York, before expanding.

"Drinkers can expect a fruit-forward aroma, mild sweetness, delicate touch of bubbles and a clean finish," a company spokeswoman said via email. "Tura is also low in calories and sugar, 4 percent ABV, and gluten-free, which drinkers have told us is important to them."

The drink will also contain shelf-stable probiotics, meaning it does not have to be refrigerated, unlike other drinks. "We experimented with a number of probiotics and selected one that remains viable in varying conditions, such as wide-ranging temperatures," the spokeswoman said. "When the probiotics are added to Tura, they're in a dormant state and then activate when they are consumed."

But there are questions about whether probiotics can survive in boozier kombucha at all.

"Probiotics don't like alcohol, period," said Holly Lyman, founder of Wild Tonic, which brews a 5.6 and a 7.6 percent ABV kombucha. "We don't pretend to have any probiotics in our high- alcohol [kombucha] because alcohol killed them. And we've done a lot of testing on products out on the market, and there's not a lot of viable probiotics in even lower-alcohol versions, even though companies claim that there are."

Tarek Kanaan said that an independent lab's testing of their kombucha, which ranges from 7 to 8 percent ABV, has "confirmed significant amounts of bacteria and yeast, gluconic acid and acetic acid that were comparable with what you would find in an average kombucha tea purchased at a store."

Nutritionists aren't sure how much the probiotics in kombucha really help us to begin with. There have not been enough studies to say for sure, said Ginger Hultin, a registered dietitian, nutritionist and spokeswoman for the Academy of Nutrition and Dietetics.

"Your gut microbiome is different than mine. To think it's simple, or that one drink can help you, or one strain can help you, that's probably a huge oversimplification," Hultin said. "There's so much to learn."

But kombucha has health benefits other than probiotics, Lyman contends. "In the higher- alcohol versions, the beneficial acids" - acetic, lactic, glucuronic, butyric - "are still there."

Boozy kombucha producers have to be careful about making health claims, though. Because the FDA strictly regulates that language in alcohol, "You're not going to see health claims with an alcoholic kombucha like a regular kombucha," Hultin said. Instead, it will be something vague: "Now you can enjoy the party and the day after," says the Boochcraft label, seemingly implying that the drink may not give you a hangover.

Because, when it comes down to it, boozy kombucha is still booze. "Alcohol is not healthy for you, innately," said Hultin, who recommends that consumers of hard kombucha treat it like a beer or a wine, and stay within the recommended daily limit.

That might be tough, because they're also pretty delicious. With flavors such as Wild Tonic's tropical turmeric, Unity Vibrations' ginger and Boochcraft's apple-lime-jasmine, the drinks are pleasingly sweet and sour, and effervescent in a celebratory way. You could toast with it, like champagne.

"It's kind of a no-brainer to use the [kombucha] beer and the tea in cocktails," Rachel Kanaan said. Many bars on the West Coast serve hard kombucha on tap, and as the trend grows, we'll be seeing it more and more alongside cider and other alternatives to beer. And cicerones, or beer experts, are beginning to take it seriously, too: This year at the Great International Beer, Cider, Mead & Sake Competition, a new category was created for hard kombucha. (Wild Tonic swept it.)

"Look at coconut water, look at cold-pressed juices: All of these categories started out as little slivers," Tarek Kanaan said. Soon, "the beer coolers are going to be dominated with kombucha beer."

maura.judkis@washpost.com

Throughout history, every time humans have explored new places, one of the biggest issues we have faced is infectious diseases – on both sides.

Not only did explorers bring pathogens to local populations whose immune systems couldn't fight off an unfamiliar disease, but those locals also harbored bacteria and viruses that infected the adventurers.

So what happens if there's life on Mars and humans travel there?

"Anytime there's a new introduction, on both sides, there's a lot of risks. We all can be harboring things that can create risk for the other side," said Pardis Sabeti, professor of immunology and infectious diseases at Harvard University. "There's all sorts of ways that when different life forms interact for the first time, all sorts of intentional and unintentional destruction can happen. "

NASA has been sending rovers to Mars for decades, including InSight, which recently landed there, but the landers get throughly scrubbed before they're launched into space. And none of the vehicles have made a return trip to Earth.

With human travel to Mars on the horizon – NASA recently put the timetable at least 25 years – we must be prepared for the potential that a Martian microbe could harm us, said Sabeti, who speaks about that possibility on National Geographic's "MARS" series.

"There's not a high reason to think that there's an infectious disease there that can infect us and become problematic to us, but if it could, then it could rapidly become really problematic," she said.

But a bigger issue could be us: Human bodies contain trillions of bacteria, and those could infect the Red Planet instead, said Casey Dreier, chief advocate and senior pace policy adviser at The Planetary Society, a nonprofit organization that promotes space exploration.

"Every spacesuit is just leaking off viruses and bacteria that just are coming from the microbiome of the astronauts," Dreier said. "If we introduce microbes to Mars, would those inadvertently consume or wipe out or take over these potential habitable niches on the surface of Mars or in the subsurface of Mars, and actually destroy any life potentially hanging out on the Red Planet?"

That's why sending robots instead of humans to grab the first samples is important. While even robots can harbor some bacteria after being thoroughly scrubbed, they're far cleaner than us.

"We're not in this pristine Star Trek kind of universe, where you can just pop down to any planet and not worry about the implications of your own presence," Dreier said. "In the past, NASA has baked their spacecraft at 500 degrees for four days to try to sterilize them. Notably, that does not work for humans. They're not very functional afterwards. "

More: Bill Nye: We are not going to live on Mars, let alone turn it into Earth

More: I trained to be an astronaut on a mission to Mars at Space Camp. Here's what it's like.

More: How to become an astronaut: Tales from Mae Jemison and Leland Melvin about training for space

More: Life on Mars: Will humans trash the planet like we have Earth?

There's still a lot of microbes and diseases on Earth we don't fully understand, and if we find something on Mars that is vastly different from life on Earth it could be even harder to get a handle on it.

"We sequence enough things on Earth that we kind of have a good sense of what the tree of life looks like," Sabeti said. "Imagine that you generate a sequence but the sequence doesn't amount to anything you've ever seen before. "

"If they're different enough from anything we've seen before, we have no way of placing it into context and trying to get a toehold to understand it," Sabeti added.

That's also why we'll need to bring samples from Mars that may or may not contain life back to Earth for extensive studies.

"There would actually be a huge pressure to bring some of these sample microbes back to Earth in order to fully characterize them and try to understand them at a deep level," Dreier said

And that means we need extremely advanced biocontainment facilities to hold them – not just to reduce any potential risk of a Martian microbe poses to things on Earth, but to avoid contaminating samples with our own human bacteria.

"The act of exploration carries with it a risk, not just for you, but for the place you're exploring," Dreier said. "If we find life on a sample from Mars, or some hint of life from the past, that would be one of the biggest discoveries in human history. "

Kelp noodles, tahini ice-cream … who dreams up these lists of food trends and what we’ll be eating in 2019?

This time of year brings with it plenty of quite stupid traditions, and few of them more daft than the food industry’s annual announcement of what it believes we will all be eating next year[https://www.theguardian.com/lifeandstyle/2014/dec/10/food-trends-foam-foraging-silly-enjoyable-jay-rayner]. When I first noticed this particular brand of crystal-ball-gazing several years ago, I remember thinking: well, I guess it’s better than “What your star sign has in store for you”. But I’ve come to my senses now. Who comes up with this stuff? Is it possible they’ve never once stepped inside a supermarket, cooked dinner, or even ordered a takeaway? I sometimes get the feeling that these lists are generated by someone – or something – who does not eat at all.

According to what I’ve read so far, 2019 will be the year of Pacific-rim flavours such as dragon fruit and dried shrimp; shelf-stable probiotics (which seems to be an incredibly unsexy way of describing kimchi); and various new kinds of “frozen treats” (think tahini-flavoured ice-cream). Seaweed and hemp will be big, and so, too, will fake meat in the form of vegan jerky and faux bacon snacks – and, no, before you get excited, this doesn’t mean we’ll all be passing off Frazzles as the latest thing in canapes (alas).

Finally, there is fat. In the age of the low-carb diet, apparently the search is on for “new sources” of fat: dieters need the energy it provides. I think this means that these people, with their strange breath and their joyless attitude to potatoes, are going to be eating a lot more coconut butter in the near future[https://www.theguardian.com/lifeandstyle/2016/sep/18/health-without-wealth-eat-well-for-less]. But, to be honest, by the time I got to this point my own energy levels were so low, there seemed to be nothing for it but to go downstairs and eat the Twix I stashed in the fridge earlier.

What will you be eating in 2019? Pretty much the same as you ate in 2018, I expect. What will I be eating in 2019? Ditto. Most of us don’t go in for the kind of preposterousness that comprises these lists, not only because life is too short to track down a dragon fruit, but because, with good reason, we’re suspicious of such stick-on modishness. What has it to do with us, and our lives? As it happens, I ate a small scoop of sallow-looking tahini ice-cream in a horribly fashionable restaurant only the other night, and while it wasn’t actively unpleasant, it seemed kind of pointless: as if the chef had forgotten to add the chocolate or the vanilla. It was certainly frozen, or just about, but a treat it most definitely was not.

These people, with strange breath and a joyless attitude to potatoes, are going to be eating a lot more coconut butter

You will say that these predictions are just so much silly marketing talk, and that people who work in commercial food development have to be seen to be doing something beyond improving the “recipe” of this or that ready meal – and in a way, you’d be right. Why am I getting so het up? All the same, I see this kind of thing as all of piece with our increasingly weird, confused and disconnected relationship with food. If, at one end of the scale, you’ve got the kind of disordered eating that involves scoffing a family-sized bag of Doritos in one go, at the other, you’ve got this stuff: nonsensical drivel about “wellness-focused” condiments, “fat bombs” and kelp noodles.

If I could gaze into a crystal ball and see 2019 in food, what would I like to find there? (Apart, perhaps, from a giant bag of Frazzles.) Well, this isn’t a prediction, but it remains a desperate hope, and it is that some time quite soon we will return to what the experts refer to as intuitive eating – by which they mean that we will put aside our crazy diets and loopy fads once and for all, and instead eat a little of everything, as and when it is easily available, whenever we like, though preferably at mealtimes. We will do this without feeling guilty or conflicted about it, and always, if possible, in the company of family and friends. The words “wellness-focused” will mean, as they do now, nothing at all to us, but we will nevertheless feel much better: happier, more in balance, perfectly at ease in our own kitchen cupboards.

Increasing your vitamin intake through diet, along with other lifestyle changes, can keep your body's natural defences in top condition

Our immune system[https://www.mirror.co.uk/all-about/immune-system]guards against infection 24 hours a day, 365 days a year. No wonder it can be overworked at times.

So, rather than waiting for the first sign of a sniffle, here are some tips on how to keep your body’s natural defences fighting fit throughout the day.

Lemon water: Drinking a pint of warm lemon water is a great way to start the day.

As well as boosting hydration, it is a simple way to increase vitamin C intake and is thought to help digestion.

Lemon water has a long tradition in traditional Chinese and Ayurvedic medicine, as it is believed to cleanse and detoxify.

Live bacteria supplements: These aid digestion and support the immune system, over 70 per cent of which resides in the gut lining.

Taken over the winter months, they can shorten colds and reduce the severity of symptoms.

Multi-strain products, such as Bio-Kult Multi-Strain Advanced Formula, £9.25 from bio-kult.com, with 14 different strains, are believed to have more positive benefits.

Some evidence suggests that taking them just before a meal enhances survival of the bacteria.

Most people also find it easiest to remember to take supplements with their breakfast.

Make lunch colourful: With meal deals and pack-ups often consisting of sandwiches and crisps, many people’s lunches are distinctly beige and lacking in nutrients.

The different colour pigments in fruit and vegetables indicate their different health properties.

Orange varieties are high in beta-carotene, while purple ones have proantho­cyanidins, with powerful antioxidants.

As the immune system needs a variety of nutrients to stay healthy, eating a rainbow of different colours is important.

So pack a fresh rainbow salad with good quality protein.

Take a walk: Eating lunch in front of your computer is bad for digestion. Going for a stroll outside offers a number of health benefits, such as lowering cortisol levels and increasing vitamin D.

Protein-rich snacks: Many people get an after-lunch lull, which means they reach for cakes and biscuits by 3pm. Instead, have protein-rich snacks on hand.

Not only does protein help stabilise blood sugar levels, reducing energy crashes, but it also provides the building blocks for many of the body’s immune cells. Diets too low in protein have been shown to have a negative impact on immunity.

Unsalted nuts, seeds, boiled eggs, oatcakes topped with smoked salmon or mackerel, veg sticks with hummus and chia pudding are all good protein-rich snacks.

Exercise: Regular moderate exercise has immune-enhancing effects and boosts the gut microbiome in some individuals. Why not join MoveGB to check out exercise classes in your area?

Eat early: Avoiding meals too late at night is thought to have a number of benefits for digestion and quality of sleep.

Emerging research is also indicating that having an overnight fast of 12-16 hours has other health benefits, such as cleansing damaged cells.

Go to bed early: Studies have shown that people who had a good night’s sleep after vaccinations created more protective anti-bodies than those who were sleep-deprived.

Prolonged periods of not getting enough sleep are likely to have a negative effect on immune function.

Sticking to a regular bedtime and avoiding blue-light from electronic devices for at least an hour before bed helps to regulate circadian rhythms and production of sleep hormone melatonin.

Soaking in a magnesium salt bath and reading a book may also help you to drop off.

We've long been obsessed with our heart health. Now it's time to pay more attention to our digestive system.

Why taking care of your gut is as important as maintaining a healthy heart.

By Sushrut Jangi

Almond cakes and lemon squares sit under glass bowls at Violette Bakers, a gluten-free bakery in Cambridge's Porter Square, and I can't decide what to eat.

“Are those gluten-free oats?" a patron asks the server, who repeats what must be a mantra here: “Everything is gluten free."

A minute later, I meet baker and owner Leesteffy Jenkins, who estimates that about 60 percent of her typical customers have eliminated gluten from their diets. Some, like herself, have been diagnosed with celiac disease, while others may simply be more sensitive to gluten-containing foods.

Nursing moms with colicky babies may want something without gluten, Jenkins says. “And I've got people who can't eat egg, soy, or dairy that want alternative options."

Among other questions (how do you hold a cookie together without gluten or egg?), I wonder why our city, like many across the United States, has become so gut sensitive. Jenkins thinks food sensitivities among children are driving adults to adapt their diets as well. Yet the changing food culture reflects a greater trend: People are increasingly interested in healthy food--and in how what we eat impacts the gut. As a gastroenterology fellow at Brigham and Women's Hospital, I'm intrigued by this rising popular fascination rife with both myth and fact. For instance--while gluten-free diets are necessary for those with true celiac disease, such restrictive intake can prove nutritionally taxing for others, without any clear clinical benefit demonstrated in trials.Much of the gluten-free movement rests on a niche market supporting a surging $4.7 billion for-profit industry that shows no signs of slowing.

The vital functioning of the intestines has long been a point of neglect--and, perhaps, disgust--among the public. In the long swath of medical history, the gut was considered a system of “lower functions" compared to those of the brain and the heart. From the brain, Hippocrates said, come “joys, delights, laughter . . . sorrows, griefs, despondency, and lamentations." The heart, Aristotle reasoned, is where all sensation lives. What comes from the gut other than our waste? Nowadays, the gut is no longer taboo, but rather the topic of cocktail parties, national bestsellers, a star-studded documentary,and an HBO episode. And for good reason: Medical researchers increasingly say that intestinal health is more important than we have previously believed. The dense and delicate nerve networks that ensheathe the bowels and the long arm of the immune system that patrols the gut wall suggest that the intestines not only digest food, but may regulate mood, emotion, and play a central role in immunologic response to disease.

Consequently, patients want to know whether stool tests are useful, what probiotics they should take, whether specific diets might help in illnesses ranging from multiple sclerosis to depression. Now that the gut is in the spotlight, we should model its care after how we've historically treated the heart: Prevent future illness by doing the right things now. We must not take the dangers of failing to care for the gut lightly.

Colon cancer rates are spiking among younger people, a population that doesn't usually get screened with colonoscopies. The American Cancer Society estimates that there has been about a 50 percent increase of cases of colon cancer among people under age 50 in the past two decades, with the largest increases among those in their 20s and 30s. In Massachusetts, colon cancer is the third-leading cause of cancer deaths overall. What's behind this disturbing change?

“The trend for rising colorectal cancer rates is in parallel with the increase of obesity," says Rebecca Siegel, a strategic director and researcher at the American Cancer Society, who has pioneered much of the work in this arena. Based on that research, this past spring the American Cancer Society lowered its colon cancer screening recommendation to start at age 45, rather than at 50, for people at average risk.

In November, I met Darin Sabine, 34, at the Dana-Farber Cancer Institute. Sabine, who recently became fire chief in Newington, New Hampshire, was there receiving a chemotherapy infusion targeting his metastatic colon cancer.

Sabine has spent much of his career fighting blazes, but the conflagration that now threatens his life began with a spot of blood in his stool when he was just 27.

“I went to the doctor multiple times, who figured I probably had an ulcer or hemorrhoids," he recalls. “I even brought up colon cancer to my doctor, who said something like, 'You're way too young for that!' " But in the summer of 2017, Sabine developed flu-like symptoms, and a CAT scan revealed he had metastatic colon cancer. Now, he's hoping to qualify for new clinical trials in case the chemotherapy fails to stop the cancer from spreading.

Among older adults, the gut starts to break down in various ways. The much-hyped gut microbiome--a teeming ecosystem of trillions of organisms--becomes more sparse in later years, potentially due to less healthy eating habits, lifestyle changes conferred from living in nursing homes or long-term care facilities, and overuse of antibiotics. The lower diversity of bugs leaves the elderly gut open to invasion by dangerous bacteria like Clostridium difficile,

which kills thousands of elderly patients in the United States each year.In Massachusetts, 90 percent of deaths from C. diff in 2014 occurred in people age 65 and older.

Older adults face other intestinal difficulties, too. The elderly gut doesn't move food and stool along as well, a problem compounded by the lack of fiber in our diets. Many seniors I treat suffer from a constipation epidemic afflicting older Americans, with nearly half of older adults suffering from its symptoms and associated complications, like diverticulosis. These patients rely on daily laxative regimens to keep their bowels functioning properly.

So what can we do--both the young and the old alike--to avoid these unpleasant medical problems?

Get screened for colon cancer.

Almost 1 in 3 adults over age 50 still isn't being screened with a colonoscopy. Many of the reluctant people I meet in my clinic fear the test, though the procedure itself is very safe and bothers few; the prep has also gotten a lot easier. Several companies, such as ColonaryConcepts, are developing “tastier" bars and beverages to replace the infamous drink. As an alternative, people can also opt for a stool fecal immunochemical test (FIT) that looks for hidden blood in the stool--the downside is you have to get the test once a year. I'm frustrated by the numerous men and women who are diagnosed with a preventable colon cancer because they never got screened close to their 50th birthday--and later develop incurable colon cancer. While Massachusetts leads in colon cancer screening compared to the rest of the country, we still have more work to do to prevent unnecessary deaths, especially among the Hispanic and African-American communities where screening practices lag.If you're younger than 50 and have a family history of GI cancers, ask your doctor if you should be screened, too.

Pay attention to bodily changes.

Given alarming spikes in cancer rates, younger people should be alert to changes in their own gut symptoms--and even look at their bowel movements now and then. Blood can color the stool as black as tar or a bright red. “Most men don't look," Sabine points out. “Call me weird, but that's when I noticed the blood." Younger people should also look out for unexplained weight loss or persistent changes in bowel habits, which can be a sign of cancer or, more commonly, other debilitating conditions of the GI tract, like inflammatory bowel disease and celiac disease, which tend to strike when people are in their 20s and 30s. If you decide to shell out money for a pricey “functional stool test" at a wellness center, know that they are almost impossible to interpret or act on without professional medical help. It's best to discuss your symptoms and validate any third-party analyses with your doctor.

Improve your diet--but be wary of fads.

Diet reform is good for both young and old guts. Avoid processed deli meats and red meat while feeding the dense jungle of bacteria in the colon with fibers, fruits, and vegetables. Siegel says unhealthy and sedentary lifestyles rife with fast foods and processed meats are contributing to the rise in colon cancer among young people. “A lot of people go to the deli and buy very expensive Boar's Head turkey breast and think they are eating healthy," Siegel says. Shifting away from the standard Western diet to the Mediterranean diet--composed primarily of plant-based foods, olive oil, fish, and mixed nuts--supports both gut health and a healthy heart. Sprinkling food with curcumin--the activated ingredient in turmeric--may dampen inflammation.Another key is routine exercise to stave off obesity, which does wonders for the gastrointestinal tract and reduces cancer risk. While particular diets are effective in treating specific gut conditions, you should consult with a gastroenterologist or nutritionist before pursuing anything radical.

Limit use of antibiotics.

Probiotics are often considered a panacea in mainstream wellness movements, but they have proven useful only in a small percentage of conditions so far, including in some people with inflammatory bowel disease, irritable bowel syndrome, and in some who develop diarrhea from antibiotics. The popularity of probiotics belies their effectiveness--which remains otherwise limited--and there is no evidence supporting their use in healthy people. Antibiotics, however, continue to be rampantly overprescribed and not only raise the risk of C. diff infection in the gut, but can further breed resistant “superbugs" that also take up residence in the intestine. When prescribed antibiotics--especially among the elderly--it's best to ask your doctor whether these are truly necessary.

Sushrut Jangi is xxxxx. Send comments to magazine@globe.com.

Sushrut Jangi is xxxxx

I drink kefir almost every day. I like the slightly tangy flavour and the hint of carbonation. I'll admit, though, that the possibility of health benefits has not escaped my attention.

Kefir is made by culturing milk with "kefir grains," which are not grains at all but small particles of a spongy mixture of various bacteria and yeasts. The beverage falls into the category of "probiotics," defined by the World Health Organization as "live micro-organisms, which when administered in adequate amounts confer a health benefit on the host."

The health benefits that have been attributed to probiotics include improvement of irritable bowel syndrome (IBS), reduction of the risk of diarrhea as a consequence of antibiotic therapy, better immune function and even improved mental health. Such discussions centre on the potential effects of probiotics on our microbiome, the incredibly complex mixture of microorganisms that populate our gut.

Irritable bowel syndrome is a catch-all term for a collage of symptoms that include diarrhea, constipation, bloating and abdominal pain. Although no clear cause has been identified, some studies have shown that IBS sufferers have a different composition of microbes in their feces than people who are not afflicted. This has prompted research into the treatment of the condition with probiotics, with some evidence of success.

One problem is the delivery of potentially beneficial bacteria to the gut, given that the acidity of the stomach does not make for a friendly environment for bacteria. The usual solution is to pack the microbes into an acid-stable capsule that traverses the stomach but dissolves in the alkaline medium of the gut. Several studies using Bifidobacterium infantis 35624 (found in "Align") have indeed shown a greater reduction in bloating and abdominal pain than with placebo.

Perhaps the most intense focus with probiotics has been on their potential to counter the side effects of antibiotics, mainly diarrhea.

Antibiotics are extremely useful, but they are rather indiscriminate in their antimicrobial effect, wiping out some "good" bacteria as well as those that cause disease. The "good" bacteria play a role in keeping some of the nasty microbes that can cause diarrhea in check by competing for the available food supply. If their number falls, the unchecked "bad" bacteria, Clostridium difficile being a classic example, multiply, and cause misery. In theory, reestablishment of a healthy microbiome should alleviate the problem.

Although many probiotic supplements claim to do exactly that, evidence is rather underwhelming. Two recent studies from the Weizmann Institute of Science in Israel show that adjustment of the composition of the microbiome with a view toward benefits is a very complex matter.

First, most studies assume that the composition of the microbiome is reflected by the composition of bacteria in fecal matter. This may not be the case.

Immunologist Eran Elinav and his team enlisted 25 healthy volunteers who were willing to undergo endoscopies and colonoscopies in order to map their baseline microbiomes at different parts of the gastrointestinal tract. As it turns out, the microbial content of stool samples only correlated partially with that in the gut suggesting that fecal matter is not a good proxy for gut bacteria.

Next, for four weeks some of the volunteers took a commercially available probiotic supplement containing 11 strains of bacteria, while others took a placebo. Then they were all scoped again. Surprisingly, to a greater or lesser extent, the probiotics were mostly pooped out. They tended to be retained more by volunteers who had lower levels of the probiotic strains in their natural microbiota in the first place, suggesting that for successful treatment, probiotics may have to be custom designed by taking into account individual microbiomes.

Even more perturbing were the results seen after the volunteers were treated with antibiotics for a week. As expected, this altered their microbial community significantly. Some subjects were then given a daily dose of probiotics, some a placebo, and some had the pleasure of experiencing transplants of their own feces that had been collected before the antibiotic treatment.

The probiotic subjects did not show the expected benefits. It took five months before their microbial community was re-established. The control group saw theirs re-established in just three weeks, while the fecal transplant subjects fared the best, their microbiome recovered in just a day. But don't attempt this at home.

While the conclusion about probiotics seems to be that some probiotics may be useful for some conditions sometimes, there is better news on the prebiotic front.

Prebiotics are nondigestible food components that promote the growth of beneficial microbes in the intestines. A study with 45 volunteers showed that taking a commercial supplement of galactooligosaccharides (Bimuno) for three weeks resulted in a reduction of the stress hormone cortisol.

Maybe I should add Bimuno to my daily regimen of kefir, given that trying to tease reliable information out of all the probiotics studies is stressful. joe.schwarcz@mcgill.ca Joe Schwarcz is director of McGill University's Office for Science & Society (mcgill.ca/oss). He hosts The Dr. Joe Show on CJAD Radio 800 AM every Sunday from 3 to 4 p.m.

Q:

Can drinking pickle juice help with acid refl ux?

A: Some people swear by sipping pickle juice to curb acid refl ux, a digestive disorder where stomach acid irritates the esophagus, since cucumber skin is a good source of gut-healthy lactobacillus bacteria. But these benefi cial probiotics are usually removed during processing and fermentation—so the true benefit may be negligible.

If you’re looking for natural, proven ways to lessen acid reflux symptoms, try these tips:

• Eat smaller portions during meals.

• Try a low-fat, heart-healthy diet.

• Exercise regularly and be active throughout the day.

• Lose weight if you are overweight or gain weight if you are underweight.

• Avoid constipation.

• Avoid known triggers (like smoking, alcohol, heavy or fatty meals, excessive caffeine and raw onions).

• Don’t exercise immediately after eating—wait a few hours instead.

— CHRISTINE LEE, MD,

gastroenterologist

Q:

Why is my asthma worse in cold weather?

A: Asthma can be harder to control during winter months as cold, dry air irritates your airways and causes the muscles inside to spasm. Plus, colds, fl u or other respiratory tract infections can exacerbate asthma symptoms.

But there are a few simple things people with asthma can do that will make a big diff erence:

Get your fl u vaccine. And while you’re at it, ask your doctor whether you need a pneumonia vaccine.

Limit outside exercise. Even people without asthma sometimes experience shortness of breath when they exercise in cold weather. Indoor activities like fi tness classes or swimming may be better options.

Sport a scarf. Covering your mouth when you’re outside will help protect your airways by warming the air before you breathe it in.

Invest in a humidifi er. Even indoors, the air can be dry, so a humidifi er may help ease breathing. Just be sure the reservoirs and filters stay clean.

Wash your hands. It’s the best way to prevent respiratory illnesses. When you wash them, do so for at least 20 seconds with soap and water. Use hand sanitizer when you’re out and about.

Make sure you have your asthma action plan in place. That way, if you do get sick, you know what to do before your symptoms get severe.

— EMILY PENNINGTON, MD,

pulmonologist

What looks like a half-defl ated football but performs more than 500 of the essential tasks that keep your body healthy? If you guessed the liver, you’d be right.

“Your liver is a silent powerhouse,” says Tamar Hamosh Taddei, MD, associate professor of medicine, digestive diseases, at Yale School of Medicine in New Haven, Conn.

Tucked under your right rib cage, this 3-lb. organ cleans toxins from your blood; produces bile to help you digest what you eat and drink, turning that food and drink into nutrients; maintains your blood’s clotting function so you don’t bleed to death; and gives you physical energy.

Because your liver is such a crucial multitasker, you need to keep it healthy—yet unfortunately, 5.5 million Americans currently have some kind of chronic liver disease, according to the American Liver Foundation. Some of the most common liver conditions include:

•

Fatty liver disease, characterized by a buildup of fat in your liver cells

•

Bile duct disease, which stops bile from moving to your small intestine

•

Hemochromatosis and Wilson disease, genetic conditions that cause a buildup of iron and copper, respectively, in the liver

• Hepatitis C, caused by a virus that can be transmitted by blood or through sexual activity

• Cirrhosis, or scarring of the liver, typically as a result of years of untreated liver disease

One of the most important things you can do to prevent and manage chronic liver conditions is to be honest with your doctor. “Talk about a family history of liver disease and your habits—such as drinking too much, drug use and sexual history,” Taddei says.

Here are a few other ways to help your liver do its best work.

Get the right tests. Your doctor will usually order liver function tests as part of a routine blood screen or follow-up visit after you’re prescribed medication. Here’s what common tests determine: > A liver function test checks protein and liver enzyme levels and detects the possible presence of liver disease. ALT (alanine transaminase), AST (aspartate transaminase), ALP (alkaline phosphatase) and GGT (gamma-glutamyl transpeptidase) tests look for these high levels. > A bilirubin test checks for the presence of this orange-yellow fluid, which your liver may leak if it is damaged. > A liver biopsy tests for cancer and infection.

Take the lowest possible dose of over-the-counter (OTC) meds. Too much acetaminophen, the active ingredient in Tylenol, can be damaging to the liver. Acetaminophen is often contained in allergy and cold medications—sometimes listed as “APAP” or “acetam”—so check labels to make sure you’re not doubling up on the medication.

Researchers from the University of California at San Diego also found that proton-pump inhibitors (PPIs), often taken to reduce acid reflux, can increase the gut bacteria enterococcus, causing infl ammation that could lead to chronic liver disease. If you’re concerned, talk to your doctor about lowering your dose.

Eat (and drink) smart. “Your food should ideally be fresh, meaning it doesn’t come out of a package,” Taddei says. Processed foods that are packed with sugar and saturated fat can up your risk of diabetes, which adversely affects your liver function.

You probably know to limit alcohol for optimal liver health—but coffee may have protective effects. A study from the Erasmus University Medical Center in Rotterdam, Netherlands found that three cups per day can potentially prevent hardening of the liver and stop the progression of advanced liver disease, likely thanks to coff ee’s antioxidants.

Stay active. Research shows that both aerobic and resistance exercises improve insulin resistance and help the fatty acids in your system oxidate, both powerful tools in fighting fatty liver disease. Walk, run, do Pilateswhatever activity you love best, and keep at it for 30

• minutes five times a week.

Compared with women who have never given birth, those who recently had babies may have a slight increased risk of breast cancer that peaks after about five years and then gradually declines, according to a study published this week.

The degree of risk increases with the mother's age at the time she gave birth.

The results sound disturbing, especially for women who already have more than enough stress taking care of young children. But even with the increase, the risk of breast cancer in young women before menopause remains very low, researchers say.

''We don't want women to feel alarmed or frightened,'' Hazel B. Nichols, an epidemiologist at the University of North Carolina Lineberger Comprehensive Cancer Center, and the lead author of the study, said in an interview.

The results, based on pooled data from 15 studies involving 890,000 women, were published in Annals of Internal Medicine.

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To show that the risk is small, Dr. Nichols explained that in women between the ages of 41 and 50 who had given birth in the previous three to seven years, the study found that 2.2 percent developed breast cancer, while in those who had not had babies, the figure was 1.9 percent. The increase in risk lasted for about 20 years. No rise in risk was detected in women who had babies before age 25.

But having children also seems to make it less likely that breast cancer will develop later in life, when the disease becomes more common, said Dr. Katrina Armstrong, physician in chief at the Massachusetts General Hospital and an expert on cancer prevention, who wrote an editorial that accompanied the study.

The median age at diagnosis is 62. Other studies have shown that women who had children appear to gain a protective benefit against breast cancer later in life, which Dr. Armstrong said is likely to far outweigh the earlier rise in risk.

''In almost every study, the overarching result is that having children reduces your risk of breast cancer over your life time,'' Dr. Armstrong said in an interview.

She added that although the transient increase in risk is small, it is important for women who have given birth recently to see a doctor if they notice anything abnormal in their breasts, and not to chalk it up to some quirk of pregnancy, childbirth or breastfeeding.

Both researchers said that the findings should not influence women's decisions about if or when to have children. But they said the information, combined with other factors like family history, reproductive history and genetic tests, could help women and their doctors assess their individual risks and decide if and when to begin screening tests like mammography.

For instance, Dr. Armstrong said, a woman who had no children before 25 and gave birth in her late 30s might decide to start screening earlier.

Health authorities differ in recommendations about when mammography should begin and how often it should be done.

The studies were observational, meaning they were not controlled experiments, but were based on following patients' histories and looking for patterns and associations. Such studies cannot prove cause and effect, but in this case they are the only source of information because women cannot be picked at random and assigned to groups that either do or don't have babies.

Paradoxical as it may seem that childbirth could both raise and lower the risk of breast cancer, researchers say that appears to be the case. The pattern has turned up in study after study.

The reason is not known, but there are possible explanations. The risk might increase after birth, Dr. Nichols said, because ''there is rapid cellular proliferation in the breast, and any time where tissue or cells are rapidly growing, there is a small potential for errors to be made when a cell is copying or dividing, or if there is an error in the cell, there's an opportunity for it to be copied and reproduced many times.''

As for the protective effect of childbirth, she said that when breast tissue goes through the complete development process involved in producing milk, it becomes less susceptible to developing cancer later in life.

Dr. Armstrong said other factors might also be involved, like changes in the immune system related to pregnancy or to the stress and fatigue of caring for young children, or to changes in the microbiome in the breast.

The average age of women entering the studies was 41.8 years, ranging from 16 to 54.9. On average, they were followed for 10.8 years, but not past 55. Those who had children when they were young were followed for decades, long enough for researchers to see that the risk gradually diminished, and at about 24 years after the last birth, the protective effect actually emerged.

Because so many women were studied, the researchers were able to get meaningful information about various factors that could influence the odds of developing breast cancer. They found that the transient risk increased in women who had more than one child or were older at their first birth, and in those who had a family history of breast cancer. Contrary to popular beliefs, breastfeeding did not lower the risk that followed childbirth, though it does appear to have a protective effect later in life.

Most breast cancers, 70 percent or 80 percent, are ''ER positive,'' meaning that the hormone estrogen helps them grow. The study found that in women who had another type of breast tumor -- ER negative, or not sensitive to estrogen -- the late-in-life benefit of childbirth never kicked in.

Dr. Nichols said that the point of the study was to help determine how the risk factors for breast cancer change over the course of a woman's life.

''We have to move to really understanding the biological mechanisms,'' Dr. Armstrong said. ''We're going to have to take these studies and the transformation in our ability to study human biology, using new tools like genomics, proteomics and immunology. Otherwise, you just create a kind of pregnancy scare.''

Q:

Can drinking pickle juice help with acid refl ux?

A: Some people swear by sipping pickle juice to curb acid refl ux, a digestive disorder where stomach acid irritates the esophagus, since cucumber skin is a good source of gut-healthy lactobacillus bacteria. But these benefi cial probiotics are usually removed during processing and fermentation—so the true benefit may be negligible.

If you’re looking for natural, proven ways to lessen acid reflux symptoms, try these tips:

• Eat smaller portions during meals.

• Try a low-fat, heart-healthy diet.

• Exercise regularly and be active throughout the day.

• Lose weight if you are overweight or gain weight if you are underweight.

• Avoid constipation.

• Avoid known triggers (like smoking, alcohol, heavy or fatty meals, excessive caffeine and raw onions).

• Don’t exercise immediately after eating—wait a few hours instead.

Q:

Why is my asthma worse in cold weather?

A: Asthma can be harder to control during winter months as cold, dry air irritates your airways and causes the muscles inside to spasm. Plus, colds, fl u or other respiratory tract infections can exacerbate asthma symptoms.

But there are a few simple things people with asthma can do that will make a big diff erence:

Get your fl u vaccine. And while you’re at it, ask your doctor whether you need a pneumonia vaccine.

Limit outside exercise. Even people without asthma sometimes experience shortness of breath when they exercise in cold weather. Indoor activities like fi tness classes or swimming may be better options.

Sport a scarf. Covering your mouth when you’re outside will help protect your airways by warming the air before you breathe it in.

Invest in a humidifi er. Even indoors, the air can be dry, so a humidifi er may help ease breathing. Just be sure the reservoirs and filters stay clean.

Wash your hands. It’s the best way to prevent respiratory illnesses. When you wash them, do so for at least 20 seconds with soap and water. Use hand sanitizer when you’re out and about.

Make sure you have your asthma action plan in place. That way, if you do get sick, you know what to do before your symptoms get severe.

— EMILY PENNINGTON, MD,

pulmonologist