A Woman Dies After Childbirth, and Her Husband Asks Why

After Amy Lam prematurely went into labor and gave birth to their baby at home, her husband, Gilbert Kwok, thought the worst was over. Once emergency responders had arrived and loaded Ms. Lam, 34, into an ambulance, the couple took photos with the newborn and called family members, smiling and elated that — despite the unexpected circumstances — their son had arrived.

Less than 12 hours later, on Aug. 1, Ms. Lam was pronounced dead. She had bled to death after a series of surgical procedures at Harlem Hospital Center.

On Monday, on behalf of Mr. Kwok and Ms. Lam’s family, lawyers filed a notice of claim against the hospital, run by NYC Health & Hospitals, as well as more than a half-dozen doctors who treated Ms. Lam, alleging malpractice and medical negligence.

Nearly two months after Ms. Lam’s death, an autopsy from the New York City medical examiner’s office is still pending, leaving many questions unanswered. Mr. Kwok, 33, has been left to care for their premature newborn, Zachary, and their 3-year-old son, Abel, while also grappling with his wife’s sudden, inexplicable death.

“When the boys ask me what happened, how do I answer them?” Mr. Kwok said in an interview last week.

NYC Health & Hospitals would not comment on the case because of pending litigation and patient privacy laws. But Robert de Luna, a spokesman for the agency, said it is committed to ensuring patient safety and providing the best care and experience. “Our thoughts are with the family during this difficult time,” he said.

The United States is one of the few countries in the world whose maternal mortality rate has risen in recent years despite improvements in health care, according to a study released last week by the Institute of Health Metrics and Evaluation.

But the increase in recent years has been driven largely by heart problems and chronic medical conditions, like diabetes and obesity, researchers say.

Maternal deaths caused by hemorrhaging, as in Ms. Lam’s case, have been on the decline nationally, according to a study published last year in the journal Obstetrics & Gynecology.

Amy Lam

Amy Lam

In New York City, 38 pregnancy-related deaths were caused by hemorrhaging from 2006 to 2010, the most recent data available. More than 630,000 live births took place during those years, according to the city’s Department of Health and Mental Hygiene.

Dr. Mary E. D’Alton, chairwoman of the department of obstetrics and gynecology at Columbia University Medical Center, said maternal deaths from hemorrhaging were “still quite rare,” though, she added, “I don’t think we can say it’s a problem of the past.”

Dr. D’Alton also works with the Safe Motherhood Initiative to help decrease preventable deaths related to childbirth. Still, she said, “There are rare exceptions when, despite the best management, death may not be preventable.”

Ms. Lam and Mr. Kwok, both natives of Hong Kong, had come to New York for Ms. Lam’s graduate studies at Columbia University’s business journalism program. She had graduated in May 2015 and was working as a reporter at Brightwire Inc., a financial news agency. But what she wanted most was a younger brother for Abel, Mr. Kwok said.

The couple had planned to move back to Hong Kong, but when Ms. Lam became pregnant, they decided to wait until October to avoid taking Ms. Lam on a long international flight. Moreover, they wanted the baby to be born an American citizen, with a United States passport. They trusted that the country’s medical care was the best.

The baby was due at the end of August. Doctors told Ms. Lam her pregnancy was healthy and normal, but that the baby might come a bit early, Mr. Kwok said.

Early he came. On the eve of Aug. 1, Ms. Lam was sleeping with Abel in her bed, just like any other night in their Harlem apartment. Feeling contractions, she went to Mount Sinai Beth Israel hospital, following instructions from her obstetrician. After being examined, she was told that she was not yet ready for labor, and that she should return home.

She went back to sleep in her apartment, and woke the next morning feeling intense pain and contractions. Around 11:30 a.m., she went into labor in the bathroom, and after a neighbor helped deliver the baby, was transported to the closest hospital, Harlem Hospital.

Ms. Lam had not yet delivered the placenta, so she was transferred to a labor ward where a doctor tried to remove the retained placenta manually. The procedure was unsuccessful, and Ms. Lam went into shock, her blood pressure dropping, according to the notice of claim, which was compiled using records from Harlem Hospital.

After a delay, Ms. Lam underwent a dilation and curettage procedure in which doctors removed her placenta by scraping the walls of her uterus. Toward the end of the surgery, her blood pressure dropped, her heart rate increased and doctors suspected she had begun to hemorrhage.

Ms. Lam gave birth to Zachary in the bathroom of her apartment in Harlem. A neighbor helped with the delivery.

Hilary Swift for The New York Times

Ms. Lam gave birth to Zachary in the bathroom of her apartment in Harlem. A neighbor helped with the delivery.

“However, the source and cause of the bleeding was not obtained and identified, nor were required steps taken to properly treat and address the internal bleeding,” according to the notice of claim filed by the family’s lawyer, Susan M. Karten.

At 5 p.m., she was admitted to the intensive care unit, where she received rapid blood transfusions. But her vital signs were worsening, and her internal bleeding was progressing. Doctors asked Mr. Kwok for consent to perform an additional “exploratory” procedure. He said he did not understand much of what was happening, and was never told just how serious her condition was.

“They said they needed to find out why she was unstable,” Mr. Kwok said.

Doctors said the surgery would take several hours, so Mr. Kwok left the hospital to pick up Abel, who had been home with a neighbor all day. Back at home, at 9:32 p.m., he posted a photo on Facebook of the couple, smiling with their newborn son in the ambulance earlier that day.

“Promise me that we will take million more selfie again,” Mr. Kwok’s post read.

At 10 p.m., after Mr. Kwok had arrived home, he got a call from the hospital. Ms. Lam’s heart had stopped.

After trying to resuscitate her multiple times, doctors declared her dead at 10:37 p.m.

When Mr. Kwok went inside the hospital room with Abel to see her, he told the toddler that his mother was just sleeping, and that he should say good night to her.

“I just wanted her to wake up,” Mr. Kwok said, crying. “I feel like my heart got ripped out.”

At Ms. Lam’s funeral in Chinatown later in August, her coffin was covered in red, white and yellow flowers and surrounded by a Hello Kitty stuffed animal and children’s toys. During the service, Abel ran around the room wearing a black funeral band on his arm, seemingly oblivious to what was happening. Next to Mr. Kwok, in the front row, lay Zachary, in a car seat, having left the hospital just a few days earlier.

“There’s so many what ifs,” Mr. Kwok said later. “What if we didn’t have a baby? What if we didn’t go to Harlem Hospital? Or what if we just didn’t come to the United States at all?”

Mr. Kwok has tried to maintain a sense of normalcy in the home, for Abel’s sake. After walking the toddler home from his summer camp recently, Abel started pointing in random directions, asking his father to keep walking.

When Mr. Kwok asked him why, he said, “I’m looking for Mommy.”

Mr. Kwok did not hesitate. “Let’s find Mommy,” he said.

No time to work out? Try exercising on the job

This article is part of a series aimed at helping you navigate life’s opportunities and challenges.

Young people frequently say that they want to exercise, but they just can’t find the time.

The solution just might be in-office interval training. That means taking part in short bursts of intense exercise — while in the office. Recent studies show that very short but intense exercise rapidly builds and maintains fitness and health, even when the workout is only a few minutes long.

Work the stairs

You can complete an excellent, effective — and very brief — workout in an office stairwell, says Martin Gibala, a professor of kinesiology at McMaster University in Canada and an expert on interval training.

Stairwell interval training requires only one minute of strenuous exertion, he says.

For a study that he and his colleagues presented earlier this year, they asked 12 out-of-shape women in their 20s to warm up for two minutes by slowly walking up and down stairs in a campus office building. Then the women ran up the steps “as fast as safely possible,” Dr. Gibala says, for 20 seconds. They walked down and along a flat corridor for two minutes, ran back up the stairs for another 20 seconds, walked for two minutes, and ran up for a final 20 seconds. They then cooled down with three minutes of stair and corridor walking. The entire session lasted 10 minutes, which would easily fit into a lunch break. (If you do this, you may want to bring and change into workout clothing to avoid sweating in your work clothes and freshen up afterward with a bird bath in an office restroom.)

They completed three of these abbreviated stair workouts per week for six weeks. By the end, their aerobic fitness had improved substantially, the researchers reported, by about as much as if they had been running or cycling each week for hours.

Lift weight at your desk

To change body shape, you almost certainly need to also perform some type of weight training, exercise scientists agree. As with the stair training, weight work can be done during your workday. Keep a five-pound dumbbell near your desk and perform arm curls while you are on the phone. Stand on the edge of a stair during a midmorning break and let your heels drop, then slowly rise up until you are standing on your tiptoes on the stairs. Repeat that exercise 10 times and you can strengthen and tighten muscles throughout your legs.

Fidget your way to fitness

Parents and teachers may once have urged you to sit still, but wiggling, tapping your toes, standing briefly, and otherwise fidgeting as much as possible at your desk is in fact good for your body. In one recent study, college students showed healthier blood flow in their lower legs if they fidgeted than if they did not. Even better, a 2008 study found that among office workers, those who frequently fidgeted burned as many as 300 calories more each day than those who resolutely stayed still.

Find seven minutes to exercise

For a fast, full-body weight-training and interval program, close your office door and cue up the Scientific 7-Minute Workout. The program targets muscles in the upper body, lower body and core, improves aerobic endurance, and can be completed in less time than most of us spend dithering about how to get to the gym.

New Ebola Vaccine Gives 100 Percent Protection

In a scientific triumph that will change the way the world fights a killer, an experimental Ebola vaccine tested on humans in the waning days of the West African epidemic has been shown to provide 100 percent protection against the lethal disease.

The vaccine has not yet been approved by any regulatory authority, but it is considered so effective that an emergency stockpile of 300,000 doses has been created for use should an outbreak flare up again.

Since Ebola was discovered in the former Zaire in 1976, there have been many efforts to create a vaccine. All began with a sense of urgency but then petered out for lack of money. Although only about 1,600 people died of Ebola over those years, the grotesque nature of their deaths has lent the disease a frightening reputation.

Ultimately, only the explosive 2014 outbreak that took 11,000 lives in Africa and spread overseas, killing a handful of people in Europe and the United States, provided the political and economic drive to make an effective vaccine.

The test results of the trial in Guinea were released Thursday in The Lancet.

A volunteer receiving the experimental Ebola vaccine at a clinic in Conakry, Guinea, in 2015.

Yann Libessart/Medicins Sans Frontieres, via European Pressphoto Agency

A volunteer receiving the experimental Ebola vaccine at a clinic in Conakry, Guinea, in 2015.

The vaccine was not ready in time to stop the outbreak, which probably began in a hollow, bat-filled tree in Guinea and swept Liberia and Guinea before being defeated. But the prospect of a vaccine stockpile has brought optimism among public health experts.

The vaccine opens up new, faster, more efficient ways to encircle and strangle the virus. .

The new vaccine has some flaws, experts said. It appears to work against only one of the two most common strains of the Ebola virus, and it may not give long-lasting protection. Some of those who get it report side effects like joint pain and headaches.

The Lancet study was done in 11,841 residents of Guinea last year. Among the 5,837 people who got the vaccine, none came down with Ebola 10 or more days later. There were 23 Ebola cases among the thousands of others not immediately vaccinated.

How Social Isolation Is Killing Us

My patient and I both knew he was dying.

Not the long kind of dying that stretches on for months or years. He would die today. Maybe tomorrow. And if not tomorrow, the next day. Was there someone I should call? Someone he wanted to see?

Not a one, he told me. No immediate family. No close friends. He had a niece down South, maybe, but they hadn’t spoken in years.

For me, the sadness of his death was surpassed only by the sadness of his solitude.

Every day I see variations at both the beginning and end of life: a young man abandoned by friends as he struggles with opioid addiction; an older woman getting by on tea and toast, no longer able to clean her cluttered apartment. In these moments, it seems the only thing worse than suffering a serious illness is suffering it alone.

Social isolation is a growing epidemic — one that’s increasingly recognized as having dire physical, mental and emotional consequences. Since the 1980s, the percentage of American adults who say they’re lonely has doubled from 20 percent to 40 percent.

About one-third of Americans older than 65 live alone; half of those over 85 do. People in poor health — especially those with mood disorders like anxiety and depression — are likelier to feel lonely. Those without a college education are the least likely to have someone they can talk to about important personal matters.

A wave of new research suggests social separation is bad for us. People with less social connection have disrupted sleep patterns, altered immune systems, more inflammation and higher levels of stress hormones. One recent study found that isolation increases the risk of heart disease by 29 percent and stroke by 32 percent.

Another analysis that pooled data from 70 studies and 3.4 million people found that socially isolated individuals had a 30 percent higher risk of dying in the next seven years, an effect largest in middle age.

Loneliness can accelerate cognitive decline in older adults, and isolated individuals are twice as likely to die prematurely as those with more robust social interactions. These effects start early: Socially isolated children have significantly poorer health 20 years later, even after controlling for other factors. All told, loneliness is as important a risk factor for early death as obesity and smoking.

The evidence on social isolation is clear. What to do about it is less so.

Loneliness is especially tricky because accepting and declaring our loneliness carries profound stigma. Admitting we’re lonely can feel as if we’re admitting we’ve failed in life’s most fundamental domains: belonging, love, attachment. It attacks our basic instincts to save face, and makes it hard to ask for help.

I see this most acutely during the holidays when I care for hospitalized patients, some connected to IV poles in rooms devoid of family or friends — their aloneness amplified by cheerful Christmas movies playing on wall-mounted televisions. And hospitalized or not, many people report feeling lonelier, more depressed and less satisfied with life during the holiday season.

New research suggests that loneliness is not necessarily the result of poor social skills or lack of social support, but can be caused in part by unusual sensitivity to social cues. Lonely people are more likely to perceive ambiguous social cues negatively, and enter a self-preservation mindset — worsening the problem. In this way, loneliness can be contagious: When one person becomes lonely, he withdraws from his social circle and causes others to do the same.

Dr. John Cacioppo, a psychology professor at the University of Chicago, has tested various approaches to treat loneliness. His work has found that the most effective interventions focus on addressing “maladaptive social cognition” — that is, helping people re-examine how they interact with others and perceive social cues. He is collaborating with the U.S. military to explore how social cognition training can help soldiers feel less isolated while deployed and after returning home.

The loneliness of older adults has different roots — often resulting from family members moving away and close friends passing away.

Ideally, experts say, neighborhoods and communities would keep an eye out for such older people and take steps to reduce social isolation. Ensuring they have easy access to transportation, through discounted bus passes or special transport services, can help maintain social connections.

Religious older people should be encouraged to continue regular attendance at services. Those capable of caring for an animal might enjoy the companionship of a pet. And loved ones living far away from a parent or grandparent could ask a neighbor to check in periodically.

But more structured programs are arising, too. For example, Dr. Paul Tang of the Palo Alto Medical Foundation started a program called linkAges, a cross-generational service exchange inspired by the idea that everyone has something to offer.

The program works by allowing members to post online something they want help with: guitar lessons, a Scrabble partner, a ride to the doctor’s office. Others can then volunteer their time and skills to fill these needs and “bank” hours for when they need something themselves.

“In America, you almost need an excuse for knocking on a neighbor’s door,” Tang told me. “We want to break down those barriers.”

The program now has hundreds of members in California and plans to expand to other areas of the country with a recent grant from the Robert Wood Johnson Foundation.

“We in the medical community have to ask ourselves: Are we controlling blood pressure or improving health and well-being?” Tang said. “I think you have to do the latter to do the former.”

Increasingly, research confirms our deepest intuition: Human connection lies at the heart of human well-being. It’s up to all of us to maintain bonds where they’re fading, and create ones where they haven’t existed.

Your Liver Doesn’t Know It’s the Holidays

Over the holidays, many of us will drink, stay up past bedtime, eat an extra slice of pie and sleep in. Fun as they are, these activities can tamper with our circadian rhythms, the feedback loops that sync our body’s functions to our external environment.

The liver, which helps regulate your body’s metabolism, gets thrown off by unhealthy patterns of sleep or by changes in diet or alcohol consumption. If you’re experiencing indigestion or your energy levels are low after too many holiday parties, your liver could be out of sync. In recent years, more and more research in the field of chronobiology, the science of biological rhythms, suggests the importance of maintaining a consistent schedule for the sake of your liver, which has a clock of its own.

Circadian rhythms are important for helping the liver anticipate the body’s demands throughout the day, like stockpiling energy after meals and releasing it when we sleep, said Felix Naef, a professor of quantitative biology at the Swiss Federal Institute of Technology in Lausanne.

Recent studies have examined how alcohol affects circadian rhythms. This year, researchers reported that night shift workers given two to four glasses of wine each day for a week had altered circadian rhythms and “leakier” intestinal linings than day workers, which could put them at risk of alcoholic liver disease.

Dr. Garth R. Swanson, a gastroenterologist at Rush University Medical Center in Chicago and an author of the study, says he believes this risk applies to any drinkers who frequently shift their circadian rhythms by more than two hours.

“People don’t have to be working night shifts for months or years,” he said. “You could potentially put yourself at risk just by doing a series of bad behaviors for a relatively short amount of time.”

Other studies in mice have implications for understanding the liver’s cycles.

Last month, Dr. Naef and a team of researchers reported finding more than 500 proteins in mice liver cells that shift in abundance over the course of the day. These proteins ultimately help the liver filter blood and process fats and sugars. When they are thrown off their tight schedules, the liver might lag in important processes like detoxification and digestion.

Our daily liver cycles are molded by an interplay between sleep, food and alcohol. Sleep affects the master clock in our brain. Like most other bodily organs, the liver is partly governed by this central rhythm.

But the liver also has its own internal clock, which can be affected by food and alcohol.

In studies with mice, John Y. L. Chiang, a professor of biochemistry at Northeast Ohio Medical University, has found that even short-term changes in either sleep or diet can affect the liver’s ability to contribute to fat digestion. Chronic disturbances, he said, may lead to fat accumulation in the liver, which can cause “many different problems: fatty liver disease, diabetes, obesity, heart disease and even cancer.”

Alcohol can also knock a mouse’s liver rhythms out of whack, said Shannon M. Bailey, a professor of environmental health sciences at the University of Alabama at Birmingham. Her team recently found that feeding mice moderate levels of alcohol for a month significantly disrupted the functioning of their liver clocks.

To keep your liver’s clock consistent this holiday season, avoid extreme behaviors, said Lei Yin, an assistant professor of physiology at the University of Michigan.

That means maintaining your central circadian rhythm with a regular sleep schedule. You can stay up a little later, but try to avoid doing so more than two hours past your normal bedtime. A helpful tip is to go on a walk in the mornings. “Light is the most powerful way to reset our internal clock,” Dr. Yin said.

It also means staying cognizant of how food and alcohol affect your liver’s timers. Try to stick to normal mealtimes. And it’s fine to drink a little, but avoid binge drinking, which is defined as more than four or five drinks in two hours.

In the short term, sticking to these guidelines might ease your transition back to reality, once the holidays are over. In the long term, maintaining a regular schedule and drinking less can safeguard your metabolism and prevent disease.

New Year’s resolutions, anyone?

The Year of Conquering Negative Thinking

Here’s a New Year’s challenge for the mind: Make this the year that you quiet all those negative thoughts swirling around your brain.

All humans have a tendency to be a bit more like Eeyore than Tigger, to ruminate more on bad experiences than positive ones. It’s an evolutionary adaptation that helps us avoid danger and react quickly in a crisis.

But constant negativity can also get in the way of happiness, add to our stress and worry level and ultimately damage our health. And some people are more prone to negative thinking than others. Thinking styles can be genetic or the result of childhood experiences, said Judith Beck, a psychologist and the president of the Beck Institute for Cognitive Behavior Therapy in Bala Cynwyd, Pa. Children may develop negative thinking habits if they have been teased or bullied, or experienced blatant trauma or abuse. Women, overall, are also more likely to ruminate than men, according to a 2013 study.

“We were built to overlearn from negative experiences, but under learn from positive ones,” said Rick Hanson, a psychologist and senior fellow at the Greater Good Science Center at the University of California, Berkeley.

But with practice you can learn to disrupt and tame negative cycles.

The first step to stopping negative thoughts is a surprising one. Don’t try to stop them. If you are obsessing about a lost promotion at work or the results of the presidential election, whatever you do, don’t tell yourself, “I have to stop thinking about this.”

“Worry and obsession get worse when you try to control your thoughts,” Dr. Beck said.

Instead, notice that you are in a negative cycle and own it. Tell yourself, “I’m obsessing about my bad review.” Or “I’m obsessing about the election.”

By acknowledging your negative cycle and accepting it, you are on your way to taming your negative thoughts. Acceptance is the basic premise of mindfulness meditation, a practice that helps reduce stress and reactivity. You don’t necessarily have to close your eyes and meditate every day to reap the benefits of mindfulness. You can remind yourself to notice your thoughts in a nonjudgmental manner, without trying to change or alter them right away.

Accepting negative thoughts can also help lessen their weight. Getting mad at yourself for worrying or telling yourself to stop worrying only adds fuel to the negativity fire.

After you’ve accepted a negative thought, force yourself to challenge it.

Let’s go back to the setback at work. Perhaps not getting the promotion made you worry about your overall competence and you were berating yourself about your skills. Ask yourself, “Why would one setback mean that I am incompetent?” Or you might ask, “What have I done in the past that shows I am actually a very competent worker?”

If you’re having trouble challenging your negative thoughts, try this approach. Imagine that your friend is the one who received the bad news. What advice would you give him or her? Now think of how that advice might apply to you.

A study conducted at Ohio State University found that this method — known as Socratic questioning — was a simple way to reduce depressive symptoms in adults. In the study, 55 adults were enrolled in a 16-week course of cognitive therapy sessions. Researchers studied videotapes of the sessions and found that the more frequently therapists used Socratic questioning, the more the patients’ depressive symptoms lessened. The study’s authors theorized that Socratic questioning helped patients examine the validity of their negative thoughts and gain a broader, more realistic perspective on them.

There will be times when your bleak thoughts are actually valid, but your projections about what’s next are not. Consider this scenario: Your partner has left you for someone else. “My partner doesn’t love me anymore,” might be accurate, said Dr. Beck, but “No one else will ever love me,” is probably not.

Now move from a place of inaction to action to counteract the negative thought. If you are worried about feeling unloved, check in with friends and family members. If you are feeling insecure at work, make a list of your accomplishments. Perhaps ask your best friend to write you a letter telling you all the ways in which you are a good, kind person. Reread the letter daily.

Dr. Hanson, author of “Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence,” said it may be helpful to ask yourself if you are accomplishing anything by dwelling on your negative thoughts. If you’re ruminating on your financial problems during a run around the track in hopes of finding a solution, then that is useful. But fretting for lap after lap about the president-elect or a foreign crisis is not going to accomplish anything.

When your negative thoughts are making you feel agitated and overwhelmed, take a deep breath, and then another. Practicing controlled breathing can help lower the stress response and calm anxious thoughts.

Finally, if your thoughts are making you feel seriously distressed and interfering with your ability to work and relax, consider seeing a mental health professional. Therapists who specialize in cognitive therapy, a type of therapy that teaches practical ways to cope with persistent and unwanted thoughts, may be particularly helpful. If the underlying source of your thoughts is clinical depression or intense anxiety, you might want to talk with a professional about the root cause of your negative thinking patterns and discuss medications that can be helpful.

While you are sorting out what approach works best for you, give yourself a break and have compassion for your overwrought thoughts.

“The more you dwell on the negative, the more accustomed your brain becomes to dwelling on the negative,” said Dr. Hanson, who suggests asking yourself, “Are my thoughts helping to build me up, or tear me down?”

A Gut Makeover for the New Year

If you’re making resolutions for a healthier new year, consider a gut makeover. Refashioning the community of bacteria and other microbes living in your intestinal tract, collectively known as the gut microbiome, could be a good long-term investment in your health.

Trillions of microbial cells inhabit the human body, outnumbering human cells by 10 to one according to some estimates, and growing evidence suggests that the rich array of intestinal microbiota helps us process nutrients in the foods we eat, bolsters the immune system and does all sorts of odd jobs that promote sound health. A diminished microbial ecosystem, on the other hand, is believed to have consequences that extend far beyond the intestinal tract, affecting everything from allergies and inflammation, metabolic diseases like diabetes and obesity, even mental health conditions like depression and anxiety.

Much of the composition of the microbiome is established early in life, shaped by forces like your genetics and whether you were breast-fed or bottle-fed. Microbial diversity may be further undermined by the typical high-calorie American diet, rich in sugar, meats and processed foods. But a new study in mice and people adds to evidence that suggests you can take steps to enrich your gut microbiota. Changing your diet to one containing a variety of plant-based foods, the new research suggests, may be crucial to achieving a healthier microbiome.

Altering your microbiome, however, may not be easy, and nobody knows how long it might take. That’s because the ecosystem already established in your gut determines how it absorbs and processes nutrients. So if the microbial community in your gut has been shaped by a daily diet of cheeseburgers and pepperoni pizza, for example, it won’t respond as quickly to a healthy diet as a gut shaped by vegetables and fruits that has more varied microbiota to begin with.

“The nutritional value of food is influenced in part by the microbial community that encounters that food,” said Dr. Jeffrey Gordon, the senior author of the new paper and director of the Center for Genome Science and Systems Biology at the Washington University School of Medicine in St. Louis. Nutritional components of a healthy diet have to be viewed from “the inside out,” he said, “not just the outside in.”

One of the questions the study set out to answer was how individuals with different diets respond when they try to improve their eating habits. The scientists harvested gut bacteria from humans, transplanted them into mice bred under sterile conditions, and then fed the mice either American-style or plant-based diets. The scientists then analyzed changes in the mice’s microbial communities.

Of interest, the scientists harvested the gut bacteria from people who followed sharply different diets. One group ate a fairly typical American diet, consuming about 3,000 calories a day, high in animal proteins with few fruits and vegetables. Some of their favorite foods were processed cheese, pepperoni and lunch meats.

The other group consisted of people who were devotees of calorie restriction. They ate less than 1,800 calories a day and had meticulously tracked what they ate for at least two years, sticking to a mostly plant-based diet and consuming far less animal protein than the other group, a third fewer carbohydrates and only half the fat.

This calorie-restricted group, the researchers found, had a far richer and more diverse microbial community in the gut than those eating a typical American diet. They also carried several strains of “good” bacteria, known to promote health, that are unique to their plant-based diet. “Their choices as adults dramatically influenced their gut community,” said Nicholas W. Griffin of Washington University, the paper’s lead author.

The study, published in Cell Host & Microbe, is not the first to report findings suggesting dietary shifts can induce persistent changes in a gut microbial community, said Dr. David A. Relman, a professor of medicine, microbiology and immunology at Stanford University, who was not involved in the current research. He noted that other studies had found even more profound effects.

After the human microbiota was transplanted into the mice, the mice got to eat either like typical Americans or like the calorie restrictors.

Mice that had a microbiota conditioned by the typical American diet had a weaker response to the plant-based diet. Their microbial communities didn’t increase and diversify as much. “They all responded in a predictable direction, but with not as great a magnitude,” said Dr. Griffin.

Another aspect of the study suggests the company you keep may also enrich your gut microbiota — at least in mice. At first the animals were kept in separate cages. Then, when they were housed together, the microbes from the communities conditioned by plant diets made their way into the American-diet microbiome.

It’s not clear how that translates to humans: Mice eat one another’s droppings when they live together, so they easily share the bacterial wealth. Still, it’s possible humans have other ways of sharing bacteria, Dr. Griffin said. “We know from previous work and other studies that spouses who live together will develop microbial communities that are similar to each other,” he said.

Perhaps the best way to cultivate a healthier microbiome is to eat more fiber by consuming more fruit, vegetables, whole grains, legumes, and nuts or seeds, said Meghan Jardine, a registered dietitian who was not involved in the current study but has published articles on promoting a healthy microbiota. (She is also affiliated with the Physicians Committee for Responsible Medicine, which recommends a plant-based diet.) She urges people to aim for 40 to 50 grams of fiber daily, well above levels recommended by most dietary guidelines.

“When you look at populations that eat real food that’s high in fiber, and more plant-based foods, you’re going to see they have a more robust microbiota, with more genetic diversity, healthier species and fewer pathogenic bacteria living in the gut,” she said.

what is the most important meal of the day

what is the most important meal of the day
what is the most important meal of the day

Breakfast as the name suggests, that is, people get up early after eating the first meal. The reason why a lot of digestive system check items are required to eat breakfast, because in accordance with the normal diet, only breakfast before our stomach there is no digestible food, is really fasting, blood sugar is also low. It can be seen that the most important role of a reasonable breakfast is to provide the body with heat, in addition, there is more and more evidence that eating balanced diet has a lot of benefits to the body:
1. Breakfast for the body to add enough energy, contribute to the concentration of brain attention. Especially children and adolescents, many studies have shown that children who eat breakfast in class will be more focused, memory effects and response speed will be faster, eye coordination between the ability to be stronger and more creative.

2. Eating breakfast helps to control weight. Regular feeding can make it easier to achieve a balance between energy consumption and intake, helping to reduce overeating and reduce the risk of ingestion of energy. Breakfast special food can also help people develop low-fat, light diet habits.

3. Breakfast in the protein, fat can extend the time of gastric emptying, stable and sustained for the body to provide energy to prevent the occurrence of hypoglycemia.

5. Milk, eggs as breakfast common food can provide the human body with high quality protein, plenty of calcium and rich fat-soluble vitamins, is highly nutritious food.

6. people who eat breakfast in the next day intake of more vitamins and minerals, reduce the intake of saturated fat and cholesterol, is conducive to the health of the cardiovascular system.

7. eat breakfast, the body can be more abundant, you can engage in high-intensity sports activities, enhance physical fitness.
So what exactly is a healthy breakfast? The breakfast that can do the above should contain the following foods:
Adequate complex carbohydrates. In the case of conditions, try to choose the whole grain of food, such as whole wheat bread, whole wheat biscuits and so on. Refined sugar such as candy and so easy to make your blood sugar fluctuated, adverse health.
Dairy products. You can choose to strengthen the vitamin AD or refined milk, if lactose intolerance can choose yogurt, especially with probiotics live milk products.
High-quality protein, in addition to the amino acid pattern of almost perfect eggs, lean meat, fish, peanut butter is also a good source of protein.
vegetable and fruit. You can choose some fresh, easy to process the consumption of vegetables and fruits as part of breakfast, pay attention to the difference between fruit drinks and fruit juice, should use 100% pure fruit juice, and appropriate against some of the water to avoid excessive concentration.
A little nutty. Pistachio, cashew nuts, walnuts are rich in a variety of unsaturated fatty acids, not only can reduce the feeling of hunger in the morning, but also help to prevent cardiovascular disease.