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Posts Tagged 'fiction'
Digestive Health – The facts on fiber and why it's important
Posted by: Ann Blanton on: March 2, 2013
Foods high in fiber
photo by: www.flickr.com/photos/a-culinary-photo-journal/3133739205/
Digestive Health – The facts on fiber and why it's important
by Ann Blanton
If you want to reap the benefits of a healthy lifestyle, the key component is to eat a high fiber diet. Most people don't even come close to consuming the amounts that are required on a daily basis. On average, most adults obtain as little as ten to fifteen grams of fiber a day.
What is it?
Fiber is a main factor for a healthy well-balanced diet. It's a type of carbohydrate that the body cannot digest and comes from plant based foods such as fruits, vegetables, grains, nuts and legumes. Without being broken down into nutrients, fiber passes completely through the digestive tract rather than being absorbed into the bloodstream.
Why it's important
Fiber offers cancer fighting properties and prevent certain types of cancer. The edible section of plants are opposed to absorption and have maximum helpful elements to fight against disease..
Other health factors for a high fiber diet include: a reduction in blood pressure, lowering cholesterol, glucose levels and inflammation. It also promotes weight loss because it produces fullness in the intestines by decreasing food intake.
How much is enough
The recommended intake should consist of 14 grams for every one thousand calories you take in on a daily basis. So if you're consumption is two thousand calories, you should be eating at least 28 grams of fiber.
To determine how much fiber is enough, depends on your age and gender. Women 50 and younger, should aim for 25 grams a day. Those 51 and over, should be getting 21 grams each day. Men 50 and younger, should include a maximum intake of 38 grams, and men 51 and over should try to get 30 grams on a daily basis.
Types of fiber
There are two types of fiber, soluble and insoluble. Soluble dissolves in water and is found in most fruits It forms into a gel in the digestive tract and allows food to move quickly through the system. Soluble fiber also maintains healthy cholesterol levels and promotes a much healthier cardiovascular system. Insoluble fiber is quite the reverse and does not evaporate in liquid. Instead, it adds bulk to the stool and passes quickly through the stomach and intestines unless there is fat, protein or soluble fiber to slow down the process. Both types are recommended daily for a well-balanced diet.
Soluble fiber foods
The foods listed below foods are high in soluble fiber and are loaded with vitamins, minerals and nutrients and can also help reduce cholesterol levels.
Plums, pears, prunes
Grapefruits, oranges, lemons and limes
Brussel sprouts, broccoli
chick peas
kidney pinto and lima beans
Insoluble fiber foods
Foods that are high in insoluble fiber incorporate the kernel and the bran. The bran is the outer portion that covers the kernel. Here is a list of the following foods.
Whole grain breads and cereals
Wheat bran
Whole wheat flour, bread and cereal
Seeds and nuts
Beans, lentils and brown rice
Strawberries, blueberries, blackberries and cranberries
Grapes and raisins
Peaches, pears, nectarines and apricots
Apples, oranges and melons
Leafy greens such as kale, spinach, lettuce and collards
Corn and peas such as snow, snap and pea pods
Broccoli, cauliflower, cabbage and Brussel sprouts
Onions, shallots, leeks, scallions, green peppers, celery and garlic
Cucumbers and tomatoes
You should never eat these foods alone or on an empty stomach. Insoluble fiber foods should always be eaten with large quantities of soluble fiber to keep the gastro colic reflex steady This stimulates the movement into the gastrointestinal tract.
There are many health benefits from eating a high fiber diet. Some of them are listed below:
Lowers bad cholesterol levels, LDL
Reduces the risk of certain types of cancer such as prostrate, breast, ovarian and uterine. According to clinical studies, there are conflicting results whether a high fiber diet can prevent colon cancer.
Lowers the risk of developing hemorrhoids and diverticular disease, which are small pouches in the colon
Improves blood sugar levels and Diabetes
Helps prevent heart disease
Relieves irritable bowel syndrome (IBS)
Reduces the formation of gallstones and kidney stones because it regulates blood sugar
Skin breakouts and rashes
Inhibits the severity of a stroke and the chances of recovery
Assists healthy weight management
So, get in your daily dose of fiber and greatly improve your health.
Always, I appreciate your feedback, so leave all your comments.
I've had many articles published at Fitness Plus Magazine. Here's the link to view them if you want to check them out. http://fitplusmag.com/magazine/author/annblanton/ I also had a story story published as an anthology in a book titled, "Heartscapes".
John 6:35: And Jesus said unto them, I am the bread of life. He that cometh to me shall never hunger, and he that believeth on me shall never thirst.
Sleep deprivation and weight gain
Posted by: Ann Blanton on: February 15, 2013
Photo by: http://www.flickr.com/photos/ericparker/3001736018
Sleep deprivation and weight gain
by Ann Blanton
Our bodies need the basic necessities to function properly. These requirements include: food, water and sleep.
Maybe you've been packing on the pounds but don't know why. You've been eating a healthy diet and exercising, but instead of losing those unwanted pounds, you're gaining. You're doing whatever it takes, yet the numbers on the scale keep adding up.
Do you drink more coffee throughout the day and eat comfort foods to "boost" your energy levels? If this is the case, then you might want to ask yourself this question. Are you getting the adequate amount of sleep? If the answer is no, then perhaps sleep deprivation is sabotaging your ability to lose weight
How less sleep causes weight gain
Some researchers say it could be mayhem with your fat cells if you don't get enough shut-eye; which can lead to weight gain and other health problems such as obesity and diabetes. New studies show that too little sleep and the quality of sleep may play an important role in the activity of hormones and appetite. Leptin and ghrelin are hormones that can equally affect the appetite.
Because energy levels might be much lower with reduced sleep, an individual is more likely to make inappropriate food choices and therefore, exercise less. The end result is obviously packing on the pounds. The ability to make good or bad food choices are often comprised when sleep is diminished.
New research shows that an additional 300 plus calories were consumed by women who have slept as little as four hours a night compared to those who sleep nine hours. Then again, men have been known to eat more than 200 calories with inadequate sleep patterns. Individuals who sleep less reported more cravings, usually foods that are high in carbohydrates, high fats and sugary foods. On the other hand, those who sleep more have less hunger.
So how much sleep do you need?
Each person has their own individual needs, but depending on age, determines how much sleep is required. Let's take a look at some examples according to different stages of life.
Newborns -12-18
Infants – 14-15
Toddlers -12-14
Preschoolers – 11-13
School age children – 10-11
Teens – 8 – 9.50
Adults – 7-9
Individuals who get at least seven to nine hours each night, are more able to keep their weight controlled, have fewer cravings and less late night snacking.
So, if you're a night owl and stay up late with late with David Letterman or Jay Leno, it's time to "hit" the sack earlier and get a few more zzz's.
Tip: Get in the habit of going to bed every night at the same time and get up at the same time each morning.
Scripture from Psalm 62:1 – My soul finds rest in God alone; my salvation comes from him.
As always, I appreciate all your comments.
I've had many articles published at Fitness Plus Magazine. Here's the link to view them if you want to check them out. http://fitplusmag.com/magazine/author/annblanton/ I've also had a short story titled, "Shattered Spirit", published in a book of short stories titled, "Heartscape".
To barf or not to barf
Posted by: Ann Blanton on: January 23, 2013
- In: Nutrition
- 48 Comments
This is my dog, Peaches. Isn't she adorable?
Proper nutrition is just as important for our four-legged friends as it is for humans.
To barf or not to barf
by Ann Blanton
Do you and Fido spend hours at the vet for allergies, dry itchy skin, hot spots, dental problems and a host of other diseases? If so, have you considered switching your cherished companion to an all-natural food plan? It may sound difficult, but after you read this blog post, you'll have all the information you need to put your pet on the road to good health and nutrition.
Maybe you're one of the millions of people who currently practice good nutrition. If so, has it improved your health; maybe even extended your life? Good nutrition is just as important for your pets' health as it for humans, so why not do the same thing for your loyal companion? With proper nutrition, your four-legged friends can be just as healthy, happy and free from disease as their owners.
What is it?
Barf, which means, bone and raw food, consists of fresh meat, including bones and vegetables that are uncooked unlike commercial dog foods. What's more, the barf diet is organic, not processed, has no preservatives, grains additives; fillers or byproducts; and contain only the highest quality of fresh ingredients.
The fresh food plan was designed to improve the health of your pet with evolutionary nutrition. Holistic veterinarians have been prescribing the barf diet to their patients for many years with beneficial results. "I agree with the barf diet, because it is based on what dog's ancestors and current wild canids eat," says homeopathic veterinarian, Dr Susan Maier. "It contains what their bodies naturally need to provide optimum health."
Raw or ground?
That's up to you. But, if you're like most people, with little or no free time, preparation can be very time consuming. A number of web sites offer fresh quality ground meat, (bones included) and vegetables that are properly prepared, prepackaged and ready to be delivered frozen right to your door. All you need to do is thaw out the package in the refrigerator and serve your dog his favorite meal.
By now, if you're thinking how disgusting this sounds, consider this. Although, your canine is a beloved family member, all dogs are still considered hunters and scavengers who thrive on raw meat. That's why dogs who barf, make cheerful and much stronger companions for years to come.
Let's take a look at some of the healthy benefits that raw foods provide.
Teeth, gums and breath – When feeding commercial dog foods, most dogs accumulate tarter build up which often leads to bad breath and sometimes even tooth loss. Hence, when feeding raw crunchy bones, you won't have to worry about expensive cleanings because it naturally eliminates plaque and freshens breath.
"Dogs on raw food have healthier mouths and overall, very little tarter. Some of the "doggie" breath is related to an imbalance of micro flora in the gut," explains Dr. Maier. "The odor may come from the mouth or stomach. Processing kibble often destroys many nutrients in the food, leading to an imbalance in the micro flora."
Skin and coat – If you're dog has dry itching skin, a sparse coat or infections, the barf diet is just what the doctor ordered. "By providing the proper nutrients, in the most digestible form provides the building blocks needed for a healthy coat," Dr. Maier says.
Allergies – "Many allergies are because of poor nutrition, causing leaky gut syndrome," says homeopathic veterinarian, speaker and author, Dr. Christina Chambreau. "Most dogs' allergies resolve because of the nutrition and improved vibrational pattern."
Disease – "Every disease can be helped with a fresh food diet as it provides the nutrients needed for health," explains Dr. Chambreau.
Foods to feed – Feeding Fido proteins like beef, chicken, lamb, turkey, pork, vegetables and fruit can improve physical well-being. You might also consider adding dairy and yogurt to Fido's new diet. Thus, when feeding yogurt, make sure it contains active, live cultures. These cultures are a natural form of Probiotics that help aid digestion.
Foods to avoid – Dr. Chambreau says, "Avoid grapes and raisins because of the recent deaths caused from them. Avoid large amounts of onions, (garlic is ok). No chocolate."
Supplements – Calcium is an essential vitamin; but if your dog is consuming crunchy raw bones, calcium is not necessary.
Water consumption – Unlike highly processed kibble, the water from a fresh food diet has not been removed. The barf diet has a higher moisture content, so if Fido is drinking less, don't panic.
Making the transition – According to Steve Brown, co-author of "See Spot Live Longer", a properly prepared raw diet is a gradual process. "A good way to do it is to feed raw for one meal and kibble for another. The more fresh food for dogs, the better. There are many types of raw diets, but a properly prepared, ancestral-type diet is best because it is high in protein, has balanced fats, low in carbohydrates, antioxidants and a trace of mineral rich," he explains.
Tips to remember – Always wash your hands after handling raw food. Keep counters clean and sanitized and thoroughly wash your pet's bowl after each meal to prevent bacteria from setting in.
Now that you know all the basics to improve the optimal health of your best-friend, a properly balanced all-natural diet is by far, the best approach. If you're still in doubt, here are a few helpful links for more information.
You can also purchase some useful books at the following links.
I would love to hear your feedback, so send me all your comments.
I've had many articles published at Fitness Plus Magazine. Here's the link to view them if you want to check them out. http://fitplusmag.com/magazine/author/annblanton/ Currently, I just had my first short story titled, "Shattered Spirits", published as an anthology in a book titled, "Heartscapes".
Lower your cholesterol without medication
Posted by: Ann Blanton on: January 17, 2013
- In: Health
- 30 Comments
Cholesterol lowering properties
photo by: avlxyz
Lower your cholesterol without medication
by Ann Blanton
Your doctor just phoned with the numbers for your cholesterol. You've been doing everything to keep your numbers in check with good nutrition, exercise, good sleep habits and minimal stress. So what gives?
Maybe you're a smoker or consume alcohol on a regular basis; if this is the case, it's time to 'kick' the habit. High cholesterol is also a condition that's heredity, so if it runs in your family, it doesn't matter how good your health habits are, you're still at risk.
Let's take a look at some ideas to help lower your levels without taking prescription medications. There's no guarantee you'll lower your cholesterol by following these steps; so follow your doctor's advice and do whatever he tells you.
Lifestyle changes–
It's crucial to pay special attention to your diet. You should allow at least five recommended servings of fruits and vegetables each day. You'll want to maintain a diet that is made of 2/3 fruits and vegetables, and 1/3 of other foods. Cholesterol lowering foods such as avocados, onions, garlic, shiitake mushrooms, oat bran, olive oil, chili peppers, fatty fish including salmon and tuna, flax seed and beans such as black, kidney, pinto and navy, play an essential role in lowering LDL and sometimes raising HDL levels.
You already know that exercise is the best way to a healthy lifestyle. Specialists have reported that thirty minutes of brisk walking three times a week can help reduce cardiovascular disease, heart attack and stroke. That should be enough to get your motor up and running. Plus, it's fun, easy and no gym membership is necessary. All you need is a good pair of walking shoes.
Good nutrition doesn't have to be as difficult as it sounds. A few simple tips might be all you need. Eat a diet that is rich in good fats such as salmon, nuts and olive oil. Avoid foods containing saturated and trans fats such as lard, margarine and processed packaged snacks. These foods include, chips, cookies and baked goods. Saturated fats consist of fatty meats, whole milk, cream and cheese. You don't have to cut out all the fats, just the unhealthy ones.
Sleep habits
Good sleep habits are a top priority to help fight infection, maintain good heart health and longevity. "Sleep deprivation often leads to bad food choices and snacking," says cardiologist Frank Pearl. If you're sleep deprived, it can cause the overproduction of insulin which causes the body to make more cholesterol.
Fish oil and heart disease
It's time to discover the truth about fish oil. Does it prevent heart disease and lower cholesterol? Let's take a look at the facts. A diet that is rich in omega threes, including salmon, sardines, mackerel and cold water fish, will reduce the development of heart disease according to some researchers. This is only because they've been investigating fatty acids in the form of fish oil supplements.
Although fish is known to decrease heart disease, it's unknown if fish oil supplements have the same results. Then again, fish oil can reduce certain heart possibilities. Fish oil has been found to decrease certain blood fats called triglycerides, raise HDL, the good cholesterol and thin the blood. This is why eating fish helps to prevent heart attacks.
Stress and Cholesterol
Stress is a significant factor that often increases the affect of unhealthy lifestyle choices. These behaviors involve poor eating habits, inactivity and smoking, all of which are linked to high cholesterol. Usually all individuals have some kind of stressful situations in their life, but major stressful events can be difficult to avoid and eventually lead to poor health.
So, rather than going through the drive through at McDonald's why not grab a salad instead. Your heart will thank you.
I've had many articles published at Fitness Plus Magazine. Here's the link to view them if you want to check them out. http://fitplusmag.com/magazine/author/annblanton/ Currently, I also had my first short story published as an anthology in a book titled, "Heartscape".
As always, I appreicate all your comments.
Weight Management – Why women gain weight
Posted by: Ann Blanton on: January 12, 2013
Photo by:
Weight Management – Why women gain weight
by Ann Blanton
If you're someone who gets frustrated or discouraged every time you step on the scale, you're not alone. Every day weighing can sabotage you from accomplishing your weight loss goals, so you might want to limit yourself from getting on that pesky contraception.
First, it's important to know that daily weighing is not required. There are many causes why the numbers on the scale increase rather than decrease. Let's discuss what some of those reasons are.
Salt does not make you gain fat. Why? Because it contains no calories. Yet, weight gain is certainly a temporary possibility if consumptions are too high. This is simply because it causes your body to retain water. The body naturally tries to eliminate extreme amounts by diluting it with water. Then again, weight loss is more likely if your consumption is too low. For this reason, it removes water. Foods that are highly processed are more likely to have higher contents of sodium.
I like to think of glycogen as a tank that's filled with stored carbohydrates. On any given day, if you fail to take in adequate amounts of carbohydrates, your glycogen supply will diminish. When this happens, your appetite could slightly increase; and your body will replace its fuel with water. It's not uncommon to experience shifts in water weight up to approximately two pounds daily without changing your activity level or calorie consumption.
If you've been including weight training along with cardiovascular activity into your daily routine, don't be alarmed if you see increased weight gain. Long lean muscle has positive effects on the body for many reasons. It boosts metabolism, protects the bones against disease such as osteoporosis by preventing bone loss, gives you with a sexy physique and provides confidence by increasing your self- esteem. What's more, if you don't use it you'll lose it.
Let's take a moment to talk about why weight fluctuations are often a result of menstruation. Fluid retention or edema is frequently the culprit during this time of the month, because hormonal changes are usually taking place. At this time, some women experience difficulty with bowel movement that can also lead to water retention.
During the pre-menstrual cycle, magnesium levels typically plummet. When this happens, it creates a lower production of insulin levels. As the levels drop, sugar cravings take place. Most often, the end result is weight gain.
Peri–Menopause and Menopause
Weight gain often becomes a problem for women who are approaching the years of peri-menopause and menopause, particularly around the mid section. Although a hormonal imbalance takes place for many women, hormones alone are not entirely the problem. The difference between genetics and lifestyle principles are also linked. Along with the aging process, metabolism clearly slows down and muscle mass begins to decline. Failure to do something about this, your body composition will change from a reduced amount of muscle to additional fat.
Sleep Deprivation
Sleep deprivation can often be the cause of many negative effects on the body. Lack of sleep decreases your energy level, affects motivation to exercise and often results in eating more than what's normally required for the body. Little or no sleep causes a rise in ghrelin; the hormone that stimulates the appetite. So, if you're not dropping those few extra pounds, perhaps you're not getting enough shut- eye.
Let's face it, stress is a way of life! With today's economy, who wouldn't be stressed. Acute stress may lead to appetite loss, whereas, chronic stress may enhance appetite. Prolonged stress triggers the hormone cortisol by releasing it into the body. When this happens, it affects metabolism; it can also lead to depression, sleep deprivation and obesity. The best way to reduce stress is through physical activity.
The tiny butterfly gland located in the middle of the neck can wreak havoc on the entire body if it's not controlled. Hypothyroidism (underactive), is an autoimmune disease that affects the thyroid by not producing enough of the hormone, T4 (thyroxine). When levels become low, it instantly signals the brain and tells the thyroid to release more T4. When this happens, if affects the metabolic rate which in turn affects the body to burn fat, as a result, unexpected weight gain.
It's not uncommon for certain types of prescription medications to cause weight gain. This is because some medications can increase appetite, quench your thirst for sugary drinks, increase water retention and reduce the ability to burn fat. If this is a concern and you experience these side effects, you might want to talk to your health care professional.
So, what do you think, is it true, does the scale really lie? The next time you step onto the scale, take all these facts into consideration.
Stop by often. I always appreciate your comments.
I've had many articles published at Fitness Plus Magazine. Here's the link to view them if you want to check them out. I've also had my first short story published as an anthology in a book titled, "Heartscape". http://fitplusmag.com/magazine/author/annblanton/
Farm raised chickens vs. free range- what's the difference?
Posted by: Ann Blanton on: January 4, 2013
- In: Nutrition
- 4 Comments
Home, home on the range
Photo by: Brookford Farm
Farm raised chickens vs. free range- what's the difference?
by Ann Blanton
Farm raised
Have you ever noticed the yellow color of a chicken purchased at your local market? The reason behind this is because these birds have been raised where they can scarcely move, stretch or engage in normal behaviors. The overcrowded space is so limited, these poor chickens can barely flap their wings. Confided circumstances such as these put stress on chickens. When chickens are stressed, they naturally produce disease.
These birds have been raised in coops with other chickens that sit around in their own feces and have been injected with antibiotics and hormones. This hardly sounds appetizing right? No wonder people are concerned about the foods they eat and where it comes from. Consuming healthy protein is a major factor for a healthy lifestyle, eliminate disease and increase energy level.
Free range
This in itself is pretty self-explanatory. It simply means these little guys are free to roam. They're not raised in chicken houses like farm raised birds; they're not diseased because they don't sit in their own feces or the feces of other chickens. Unlike there farm raised friends who live six weeks, free range chickens live, approximately eight weeks longer. A diet for a free-range bird consists of natural grass, grains and seeds, and are not addicted to drugs.
Be cautious of farmers who say there hens are free-range. If their diet consists of corn, soy and synthetics, they are not free-range.
Which eggs are best?
Considering the conditions of the farm raised hens, eggs produced from free-range chickens are naturally healthier, more nutritious and are much healthier for the planet.
Nutritional facts:
Approximately free range eggs contain 1/3 less cholesterol, 1/4 less saturated fat, 2/3 more vitamin A, twice as many omega-3-fatty acids, triple the amount of vitamin E, 7 times more beta carotene and as much as 6 times more vitamin D.
Remember, the answer may differ depending on the farms.
When thawing a chicken, do so on the bottom shelf of the refrigerator. By applying this helpful tip, you can prevent salmonella from spreading. Placing a chicken on the top shelf will allow the juices to drip on the lower shelves, which can spread salmonella to other food items.
I've had many articles published at Fitness Plus Magazine. Here's the link to view them if you want to check them out. http://fitplusmag.com/magazine/author/annblanton/ I've also had my first short story published as anthology in a book titled, "Heartscapes".
Milk does the body good
Posted by: Ann Blanton on: December 28, 2012
- In: Health
- 7 Comments
Got Milk?
Photo by: http://www.flickr.com/photos/osakasteve/46313188
Milk does the body good
by Ann Blanton
As children we were told to drink milk because it helps to build strong bones and teeth. But, as adults, we don't think it still applies, so we have the tendency to slack off. This couldn't be further from the truth; simply because this creamy white fluid is a natural source of vitamin D and calcium.
An important mineral called calcium help to maintain strong bones and muscles, including the most vital muscle of the body – the heart. Without it, the body will take calcium from your bones, which is the only other source that it has. It can also put you at risk for thin and brittle bones later in life. It takes one single cup to get one third of your daily calcium requirements.
There are many health reasons why you can benefit from vitamin D. Let's take a look at some of those causes.
1. Vitamin D provides calcium balance in the body that can prevent osteoporosis and arthritis.
2. It also regulates blood pressure, reduces stress and tension.
3. Relieves aches and pains by reducing muscle spasms
4. Helps fight against depression.
5. It also aids in the secretion of insulin.
To reap the benefits, any amounts will suffice. However, according to experts, three eight ounce glasses daily will provide you with all the calcium you need, plus seventy- five percent of vitamin D. This tasty wellness drink provide important nutrients from protein which include vitamin A, B12, D, potassium, phosphorous, riboflavin and niacin.
The importance of these vitamin include:
Vitamin A – Facilitates the immune system, normal vision and good skin.
B -12 – Assists healthy red blood cells and nerve tissue.
Vitamin D– Helps in the absorption of calcium.
Niacin – It's important for the significance of the nervous system. It also keeps enzymes functioning normally and helps the body process sugars and fat.
Potassium – Helps to keep a good blood pressure
Phosphorus and Riboflavin – Strengthens bones and gives you energy
Disease Prevention – Osteoporosis
It's crucial to build strong bone mass during childhood and throughout adolescence, in order to prevent osteoporosis. Although milk is the preferred source of calcium for overall bone health, there are other ways to stop bone loss. These tips contain:
1. A healthy lifestyle of no smoking or the intake of alcoholic beverages.
2. A balanced diet rich in calcium and vitamin D.
3. Weight bearing and resistance training exercises
4. Bone density testing
Memory Loss – Vitamin B-12 is an important key factor to maintain the nervous system. Some scientists have discovered that milk has the best source of B-12 that can decrease the damage to the brain. Studies show that by drinking two cups daily, can protect against memory loss, dementia and Alzheimer's disease.
Diabetes – Some studies show that milk may lower the risk of type 2 diabetes in middle aged or older women.
More diseases – Other findings such as chronic diseases like coronary heart disease, stroke and colorectal cancer have also declines due to the consumption of milk.
Weight Loss – New research shows that milk can also help fight against the battle of the bulge. Two glasses of milk each day can help you drop those unwanted pounds. Typically, adults who have consumed the highest amounts of calcium and vitamin D, lost an average of twelve pounds over a period of time.
Beauty benefits – Hair, Nails and Skin
Research has discovered that the essential vitamins found in cow's milk can provide, healthy, beautiful, shiny locks. The proteins and lipids work to strengthen hair, while the calcium promotes hair growth and aids in hair loss.
Nails – Fingernails need the proper nutrition to grow just like the rest of your body. Calcium is one of the minerals that can help. Although calcium may support healthy nail growth, it will not help them grow faster.
Skin – Vitamin A is an excellent source for good eyesight, but it also tackles skin problems like wrinkles and pigmentation changes. Because milk is high in hormones, if you're acne prone, you might need to reduce your intake.
Whole milk is also high in fat and calories, therefore, if you're watching your weight, you can switch to the low- fat version.
Stop by often. I always appreciate all your comments.
I've had many articles published at Fitness Plus Magazine. Here's the link if you want to check them out. http://fitplusmag.com/magazine/author/annblanton/ I've also had my first creative story published as an anthology in a book titled, "Heartscape".


text:
(Gray News) - (Gray News) – Americans love a good holiday. Easter is no exception.
The National Retail Foundation (NRF) says 79 percent of U.S. adults plans on celebrating Easter this year.
To do that, they'll be opening their pocketbooks.
Americans are expected to drop more than $18 billion for the holiday. They'll spend it on everything from candy and clothing to gifts, flowers and food, according to Prosper Insights and Analytics, which conducted the survey for NRF.
That's averages out to $151.25 per person.
Here's the breakdown:
-- Food – $5.74 billion
-- Clothing – $3.27 billion
-- Gifts – $2.87 billion
-- Candy – $2.49 billion
-- Flowers – $1.29 billion
-- Decorations – $1 billion
-- Greeting cards – $780 million
Here's how the rest of the holiday shakes out, according to the study.
About half of us plan to attend church on Easter.
About a third of us will hold Easter egg hunts.
And just over half of Americans (54 percent) plan to cook a meal for the holiday, while 16 percent are opting for restaurants.
Apparently, the other 30 percent plan to eat with those who are making Easter dinner or will just do without.
Copyright 2019 Gray Television Group, Inc. All rights reserved.

subset: commoncrawl


text:
Local students seek help to keep music program alive
Kids practice using pencils instead of instruments
Students at Donegal Elementary School want so badly to be in the school band that they practice their music using pencils because they have no instruments.
WTAE first told viewers about the school during a donation drive a few months ago, but now the need is even bigger because there aren't enough instruments to go around.
Band director Tom Murphy was leading his musicians recently with their version of "Let's Go Band," but while some members were reaching to hit the right notes, not everyone had an instrument to take part.
Fifth-grader Angel Ritenour played a pencil trying to keep up with the clarinets, and she was not alone. Money is tight for the district and the families, and that makes it hard to supply instruments for the band.
So Murphy has students improvise. Some play pencils, while others use their imagination playing air clarinets.
"I see everyone else playing it, and I think it would be fun," said Ritenour. "I don't like fingering along with a pencil because I think it makes me look weird, so I'd rather have the clarinet."
It's unfortunate we have students who want to be part of our band program, which is fantastic, but the school district doesn't have enough instruments for them to be a part of our band program," Murphy said.
Murphy got great response from former band members, who donated old instruments.
"It made me feel proud to finally get to play something and not get left out," said Shelby Burnsworth, who received a trumpet.
Murphy hopes to drum up more support from families once they see what his kids are doing. He hopes people will pitch in so kids can erase the memories of playing a No. 2 pencil instead of an instrument.
He hopes help will come soon so the kids will be able to play music and not just read it in time for their holiday concert.


text:
Jason Whitlock of FoxSports.com (@whitlockjason) started it with a Tweet stating, "NFL media, which I am one, scared lockout is damaging their profile. They're panicking and trying to create hysteria (clicks). Too invested." Pro Football Talk's Mike Florio (@profootballtalk) wasn't about to let that pass unaddressed. So, he used about 100 characters to state, "... So, basically, millionaire journalists like you should protect themselves by covering every sport?"
'Twas on from there. People who don't make millions of dollars covering football or every sport are chiming in on, and tipstering about, what must be a very boring Saturday from sea to shining sea. Side note to the editors of America: Please give football writers some assignments to get their minds away from the emptiness enveloping their very souls. Think of it as a class-action binky.


text:
Phllipe Berteaux
Primary Practice Areas
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- Marvell
- 7, avenue Ingres
- Paris, 75016
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Feb 10, 2009 | ISBN 9780385737197 | 5-8 years
"A [Canada-to-Mexico] migrating butterfly provides Hurry, a Texas tortoise, with perspective on the world beyond his garden. 'Maybe one day, you'll break out of that shell, grow wings, and fly away,' the butterfly remarks to Hurry. 'I doubt it,' he replies, then contentedly settles down to hibernate. He wakes in the spring to see the same butterfly alight on a milkweed plant depositing an egg, which hatches, grows, and metamorphoses under Hurry's watchful eye. . . . Together with its informative afterword, this is a particularly attractive, affecting introduction to the wonder of species diversity and the elegant continuum of life."—Booklist, Starred


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NORD gratefully acknowledges Joshua W. Knowles, MD, PhD, Attending Physician, Stanford Center for Inherited Cardiovascular Disease and Chief Medical Advisor, The FH Foundation, Karen Greendale, MA, CGC, Consultant, The FH Foundation, and Mitchel Pariani, MS, CGC, Genetic Counselor, Stanford Center for Inherited Cardiovascular Disease, for assistance in the preparation of this report.
SummaryFamilial hypercholesterolemia (FH) is a diagnosis which refers to individuals with very significantly elevated low-density lipoprotein (LDL) cholesterol (LDL-C) or "bad cholesterol" and early onset of coronary artery disease if not sufficiently treated. In heterozygous familial hypercholesterolemia (HeFH), an individual inherits a DNA variant (alteration) for FH from one (affected) parent. In homozygous familial hypercholesterolemia (HoFH), an individual inherits a causal FH genetic variant from two affected parents. For the purposes of this report, "FH" will refer to HeFH unless otherwise stated. FH is one of the most common genetic diseases and affects at least 1 in 250 individuals. If DNA testing is performed, most will be found to have a pathogenic variant in one of three relevant genes. Others may express these clinical findings for other reasons or may carry a variant in a gene or genes that have yet to be discovered. FH is characterized by very high levels of LDL-C, as well as of total cholesterol. The condition greatly increases the risk of hardening of the arteries (atherosclerosis), which can lead to heart attacks, strokes and other vascular conditions. Untreated individuals with FH have a 20-fold increased risk for coronary artery disease (CAD). Untreated men have a 50% risk of a nonfatal or fatal heart attack (coronary artery blockage) by age 50 years; untreated women have a 30% risk by age 60 years. If one or more other risk factors for CAD are present, especially cigarette smoking or diabetes mellitus, the risk of developing symptomatic CAD is even higher. FH is treatable and the associated cardiovascular disease is largely preventable with early and intensive treatment, using statins, additional drugs, and other means. In 2015, the FDA approved PCSK9 inhibitors as an effective treatment for individuals with FH who have an elevated LDL-C despite treatment with maximally tolerated statin therapy. Family members of an affected individual found through "cascade screening" or "family screening" who have not yet exhibited symptoms and who are appropriately treated are likely to live a normal lifespan. Untreated family members will have very high cholesterol and early onset CAD. HoFH is very rare (~ 1 in 250,000). LDL-C levels are usually, though not always, > 400 mg/dl. Severe vascular disease including CAD and aortic stenosis are often seen by the teenage years. Without very aggressive treatment including LDL-C apheresis and HoFH specific medications, mortality is common before age 30.
IntroductionIn 1973, Joseph Goldstein and Michael Brown identified and characterized a cell membrane protein they called the LDL receptor and the variation in the low-density lipoprotein receptor gene (LDLR) that interfered with its function. Normally functioning receptors lower the blood levels of LDL-C by taking up the lipoproteins that carry LDL-C in the liver. Pathogenic variants in this gene cause a decrease either in the number or function of the receptors, resulting in the extreme LDL-C elevations seen in FH. Goldstein and Brown became the first investigators to identify a variation that caused a metabolic disorder when only a single abnormal gene was present. In 1985 they won the Nobel Prize in Medicine for this work. Their pioneering work and the subsequent studies of LDL-C metabolism in FH patients greatly contributed to our knowledge about the link between cholesterol and heart disease and led to the development of numerous therapeutic agents that benefit a very large number of individuals with high cholesterol. Since that time, other genes causing FH such as the apolipoprotein B-100 gene (APOB) and the proprotein convertase subtilisin/kexin type 9 gene (PCSK9) have been identified (see below). Importantly, there is a great deal of evidence showing that early diagnosis and intensive treatment can prevent illness and death due to FH.
Heterozygous Familial Hypercholesterolemia
Vascular Conditions
People with FH have very high levels of LDL-C from birth. In children, LDL-C levels are usually > 160 mg/dl and in adults they are usually > 190 mg/dL, which can lead, if untreated, to CAD, cerebrovascular disease, peripheral vascular disease and/or other serious conditions.
Most common is CAD due to atherosclerotic plaque build-up in the arteries supplying the heart (atherosclerosis), which can result in chest pain or discomfort (angina), heart attack (myocardial infarction) or sudden death. Untreated people with FH have an approximately 10 to 20-fold increased risk for CAD.
Less common are cerebrovascular disease, peripheral vascular disease and aortic aneurysm. Cerebrovascular disease may occur due to cholesterol build-up in the arteries supplying the brain, which may cause stroke or transient ischemic attack (TIA).
Peripheral vascular disease is due to cholesterol build-up in the arteries supplying the legs which may cause pain when walking that is relieved by rest (claudication) and at its most severe, pain at rest or critical lack of blood flow.
Extravascular Clinical Features of FH
Xanthomas are firm nodules caused by cholesterol buildup as a result of the very high levels of LDL-C. The most common sites are the Achilles tendon and the tendons on top of the hands. Achilles tendon xanthomas may cause tendonitis, an inflammation of the tendon that may tear or rupture. Tendon xanthomas are seen in ~20% of individuals with HeFH in the current era and in a much higher percentage of those with HoFH.
Xanthesmas are cholesterol deposits on, above or under the eyelids often seen in patients with FH. They may also be seen in individuals with normal cholesterol levels, particularly as they age.
Corneal arcus is a white, grey or blue opaque ring around the edge of the cornea in the eye, often seen in patients with FH. Since corneal arcus is common in African Americans with normal cholesterol levels and becomes increasingly common in the general population with age, it is only useful as a diagnostic tool in younger individuals, particularly in those under age 45.
Note: the longer an individual is treated, the less likely you are to see these extra-vascular findings.
Homozygous Familial Hypercholesterolemia
Individuals with HoFH exhibit extremely high LDL-C levels, usually above 400 mg/dL. They usually have xanthomas by early childhood. Planar xanthomas affecting the skin on the hands, elbows, buttocks and knees in a young child are diagnostic for this condition. Corneal arcus surrounding the entire inside edge of the cornea is often present. Most individuals with HoFH experience severe CAD by their mid-20's if not aggressively treated. Narrowing of the heart valve leading to the aorta (aortic stenosis) often occurs, which may make it necessary to replace the aortic valve. Very aggressive therapy is needed to reduce the likelihood of vascular events. Most affected people will require filtering of their blood (LDL apheresis) and/or medications specifically approved by the FDA for HoFH (lomitapide, PCSK9 inhibitors or mipomersen).
Often the other medications that are the mainstay of treatment for HeFH (such as statins) are relatively ineffective in HoFH. This is because the mechanism of action of statins normally "triggers" the liver to express additional LDL receptors. In the most severe cases of HoFH, the LDL receptors are completely inactive which makes this response futile. Statins can be effective in individuals with HoFH if there is some residual LDL-R activity, or if they have causal DNA variants in the APOB or PCSK9 genes.
In FH there is a "dose effect" so that HoFH is more severe than HeFH.
HeFH occurs when a child inherits a nonfunctional copy of one of their FH genes from an affected parent and a functional copy from their unaffected parent. Each egg or sperm they produce has a 50% chance of getting the nonfunctional copy (passing down FH) and a 50% chance of getting the functional copy, Therefore, the risk of passing the FH from the affected parent to a child is 50% in each pregnancy. New, spontaneous variants appear to be very rare.
Most individuals with HoFH have inherited one mutated gene from each parent, such that each parent has HeFH. These parents have a 25% risk in each pregnancy to have a child with HoFH, a 50% chance of having a child with HeFH, and a 25% chance that the child will inherit a normal gene from each parent. The risk is the same for males and females.
When one parent has HeFH and the other has HoFH, there is a 50% chance with each pregnancy to have a child with HeFH and a 50% chance to have a child with HoFH.
When one parent has HoFH and the other has two normal genes, all children will have HeFH.
When both parents have HoFH, all children will have HoFH.
Specific Gene Variants
Of patients with identifiable pathogenic gene variants, a LDLR gene variant is the most common cause of HeFH, accounting for ~90% of pathogenic variants. Since the original pathogenic variant discovered by Goldstein and Brown, over 1600 other variants in the same gene have been identified. An adequate number of functioning LDL receptors are needed to remove cholesterol from the bloodstream.
A pathogenic variant in the APOB gene is responsible for ~10% of FH cases; this variation is seen most commonly in those of European Caucasian ancestry. Apolipoprotein B-100 is a protein that binds to LDL receptors, which enables uptake of lipoproteins by the liver and reduces the cholesterol level in the blood. Pathogenic variants in the APOB gene lead to faulty uptake and increased cholesterol level.
PCSK9 gene variants are responsible for only a small percentage of FH cases. The normal PCSK9 gene codes for an enzyme that breaks down the cholesterol receptors after they have done their job. A pathogenic variant in this gene is unlike most variants, which cause dysfunction of the affected gene. The PCSK9 variant increases the gene's function, leading to too few remaining LDL receptors and thus an increase in the LDL cholesterol level.
Recent research suggests that the gene and the type of DNA variant an individual has may confer individual risks. However, there is wide enough variation even among those data sets.
Recent studies have shown that FH is as common as 1 in 220, making it one of the most common genetic diseases. However, most individuals go undiagnosed and most are undertreated given their very high risk. Small subpopulations around the world have a higher incidence, such as Lebanese Christians (1/85), Afrikaners in South Africa (1/72 – 1/100), French Canadians (1/270), and Ashkenazi Jews originating from Lithuania (1/67) known as a founder affect.
The frequency of HoFH across populations is estimated to be 1 in 1/160,000 to 1 250,000. HoFH is more likely to occur in countries where the prevalence of HeFH is very high, especially those where consanguinity (marriage between relatives) is common.
FH should be considered in an untreated child with LDL-C above 160 mg/dL and in an untreated adult with LDL-C above 190 mg/dL, or in those with a personal and/or family history of early CAD, physical signs such as those described under "Symptoms" or a relative known to have FH.
FH can be diagnosed using DNA testing or by utilizing one of three well-accepted sets of criteria — Simon Broome (UK), Dutch Lipid Clinic Network (Netherlands), or MEDPED (US). DNA testing confirms the diagnosis and is considered the "gold standard", but is not always necessary or feasible. DNA testing should definitely be considered when it's not clear whether an individual is affected or not, and is very helpful for testing family members. Recent studies also suggest that individual risks for CAD vary among the affected gene and type of DNA variation (substitution vs. partial deletion of a gene, etc.).
Once an individual is diagnosed with FH (either with or without the use of DNA testing) a process called "cascade screening", "cascade testing" or "family screening" (testing of close relatives, in a step-wise fashion) is recommended to identify those with FH before symptoms appear, so that early and intensive treatment can be initiated and disease and death prevented. If a pathogenic variant is identified, risk in the patient's first degree relatives (parent, sibling, child) and when appropriate, more distant relatives, can be assessed via DNA testing by tracing the altered gene through the family. If DNA testing is not performed, another version of cascade screening can be implemented using cholesterol testing. Cascade screening by either means has been shown to be effective in finding patients with FH who were not being appropriately treated. A genetic counselor can help a family through this process. (http://www.nsgc.org/page/find-a-gc-search )
Cascade screening has been shown in numerous studies to be cost-effective and has been recommended by the National Institute for Health and Clinical Excellence (NICE) in the UK. The Office of Public Health Genomics at the Centers for Disease Control and Prevention considers cascade screening of relatives of those with FH a "Tier 1 application" which means that there is good evidence that implementation will prevent disease and save lives.
HoFH is easily identified in infants and young children by the presence of planar xanthomas, corneal arcus, and exceedingly high total and LDL-C; LDL-C is usually greater than 400 mg/dL. The parents are "obligate heterozygotes" who are considered to have HeFH until proven otherwise.
Clinical Testing and Workup
Evaluations Following Initial Diagnosis
To establish the extent of disease and needs of an individual diagnosed with FH, the following evaluations are recommended in adults and children:
• Pre-treatment lipid values
• Lipoprotein(a) levels when possible as lipoprotein(a) is an additional risk factor for CAD
• Exclusion of concurrent illnesses (kidney disease, acute myocardial infarction, infection) that can affect lipid values
• Lipid panel including total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides
• Consultation with a lipid specialist or clinician with expertise in FH
• Medical genetics or a genetic counseling consultation
In children, noninvasive imaging modalities (e.g., measurement of carotid intima-media thickness) are recommended in some guidelines to help inform treatment decisions.
Treatment of FH is focused on reducing the LDL-C levels in order to decrease the risk for atherosclerotic heart disease.
Adults with FH
Lifestyle intervention
Dietary changes such as restricting saturated fat and eliminating trans-fats have significant cholesterol-lowering impact. Decreasing dietary cholesterol and increasing soluble fiber are also helpful. The diet should primarily be made up of vegetables, whole fruit and grains, nuts and legumes. Seafood, lean poultry and low fat dairy products are the preferred sources of animal protein. Weight loss and aerobic exercise have modest effects on cholesterol level but can help to lower blood pressure and blood sugar levels and thus cardiovascular disease risk.
Cholesterol lowering medication
For adults, treatment should begin as soon as possible after diagnosis. Almost all will require cholesterol-lowering drug therapy. A firm diagnosis of FH should prompt more aggressive treatment than would otherwise be undertaken in a patient with "garden variety" high cholesterol. Some guidelines state that the untreated cholesterol level should be reduced by at least 50%; others suggest that less than 100 mg/dL is the goal. Goals may be even more stringent when additional risk factors such as diabetes or atherosclerosis are present. Patients with FH should be referred to a lipidologist if these goals cannot be reached in the primary care setting.
Pharmacotherapy should initially be statin-based, followed by addition of other drugs if the targeted LDL-C level is not achieved with statins and lifestyle changes. Preference should be given to one of the higher potency statins (atorvastatin or rosuvastatin) used at the maximal dose.
Muscle injury (rhabdomyolysis) is the major risk of statins but is very rare, seen in approximately 1/10,000 of those taking these drugs. Damage to the liver does not occur at a higher rate than in people not taking a statin. However, myalgia (muscle pain) is a relatively common side effect occurring in 10-15% of patients. Mild myalgia with or without mild creatine kinase elevations (less than 5 times the upper limit of normal) are not necessarily a reason to discontinue statins or other cholesterol lowering medications.
Other drugs such as ezetimibe (Zetia), bile acid sequestrants (colesevelam, Welcol), or PCSK9 inhibitors (approved in 2015 for the treatment of HeFH and HoFH) may be necessary.
In patients who cannot achieve the desired LDL-C level, a procedure called LDL apheresis (similar to dialysis for kidney disease) may be necessary. LDL apheresis is indicated if the LDL-C level (on maximally tolerated medical therapy) is > 300 mg/dl in individuals without known CAD or > 200 mg/dl in those with known CAD.
Children with HeFH
Parents should discuss with the pediatrician when to initiate treatment in a child with FH. Treatment should be considered when LDL-C level is greater than 190 mg/dl, or greater than 160 md/dl with at least two other risk factors present. The National Lipid Association guidelines recommend referral to a lipid specialist, management of diet and physical activity from an early age, and consideration of statin treatment. Atorvastatin and rosuvastatin, two of the stronger statins, are approved for use in children by the Federal Drug Administration, as are all of the weaker statins. The goal is at least a 50% reduction in LDL-C or LDL-C below 130 mg/dL.
Children or Adults with HoFH
Early initiation of therapy and monitoring using CT coronary angiography and other imaging are recommended; these patients often require additional treatment strategies, as pharmacological treatment and lifestyle changes may not be sufficient. Statins are usually started as soon as the diagnosis is made (though may not be effective as explained above). Two new drugs (lomitapide and mipomersen) have now been FDA-approved for the treatment of adults with HoFH, and should be considered for these patients, especially if LDL-C level cannot be controlled using other drugs. A PCSK9 inhibitor (evolocumab) was also approved for HoFH. Additional options include LDL apheresis or liver transplantation.
LDL apheresis
Using a process similar to kidney dialysis, blood is withdrawn from a vein via a catheter and processed to remove LDL particles. Normal blood products are returned via another catheter. LDL-C levels will decrease approximately 50% but will rise between apheresis sessions, so they are necessary approximately weekly or every other week. The procedure is effective and well tolerated though time-consuming and only available in 50-60 sites in the US.
Liver transplantation
Liver transplant is extraordinarily rare and may become even less common with the new medications available. As the donor liver will have normal LDL receptors, the LDL cholesterol quickly normalizes after the procedure, but the risks of any organ transplant are significant and include complications from major surgery and the effects of lifelong suppression of the immune system. Donor organs are often not available. Patients with familial pathogenic APOB or PCSK9 gene variants have normal LDL receptors, so liver transplantation is not an option for them.
Various imaging modalities such as echocardiograms, CT angiograms and cardiac catheterization may be recommended to monitor individuals with HoFH.
Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.
For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:
Toll-free: (800) 411-1222
Email: [email protected]
Some current clinical trials also are posted on the following page on the NORD website:
For information about clinical trials sponsored by private sources, in the main, contact:
For more information about clinical trials conducted in Europe, contact:
Wiegman A, Gidding SS, Watts GF, et al. Familial hypercholesterolaemia in children and adolescents: gaining decades of life by optimizing detection and treatment. Eur Heart J. 2015 Sep 21;36(36):2425-37. doi: 10.1093/eurheartj/ehv157. Epub 2015 May 25.
Knowles JW, O'Brien EC, Greendale K, et al. Reducing the burden of disease and death from familial hypercholesterolemia: A call to action. Am Heart J. 2014 Dec;168(6):807-11. doi: 10.1016/j.ahj.2014.09.001. Epub 2014 Sep 16.
Sturm, AC. The role of genetic counselors for patients with Familial Hypercholesterolemia. Curr Genet Med Rep. 2014;2: 68-74.
Raal FJ and Santos RD. Homozygous Familial Hypercholesterolemia: Current perspectives on diagnosis and treatment. Atherosclerosis. 2012;223:262-8.
Blom, DJ. Familial hypercholesterolaemia. S Afr Fam Pract. 2011;53(1):11-18.
Goldberg AC, Hopkins PN, Toth PP, et al. Executive Summary. Familial Hypercholesterolemia: Screening, diagnosis and management of pediatric and adult patients. J Clin Lipidology. 2011;5:133-40.
Kwiterovich PO Jr. Clinical implications of the molecular basis of familial hypercholesterolemia and other inherited dyslipidemias. Circulation. 2011;123:1153-1155.
Ned RM and Sijbrands EJ. Cascade screening for Familial Hypercholesterolemia (FH). PloS Curr. 2011;3:RRN 1238.
Lughetti l, Bruzzi P, Predieri B. Evaluation and management of hyperlipidemia in children and adolescents. Curr Opin Pediatr. 2010;22:485-93.
McCrindle BW, Urbina EM, Dennison BA, Jacobson MS, Steinberger J, Rocchini AP, Hayman LL, Daniels SR. Drug therapy of high-risk lipid abnormalities in children and adolescents: a scientific statement from the American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee, Council of Cardiovascular Disease in the Young, with the Council on Cardiovascular Nursing. Circulation. 2007;115:1948-1967.
Expert panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults: Executive Summary of The Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486-97.
Goldstein JL, Brown MS. The Cholesterol Quartet. Science. 2001;292 (5520):1310-1312.
Youngblom E, Pariani M, Knowles JW. Familial Hypercholesterolemia. 2014 Jan 2 [Updated 2016 Dec 8]. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993-2017. Available from: https://www.ncbi.nlm.nih.gov/books/NBK174884/ Accessed March 7, 2017.
Learn Your Lipids – Patient information from the Foundation of the National Lipid Association. http://www.learnyourlipids.com/ Accessed March 7, 2017.
Kindt I, O'Brien EC, Marquess M, Greendale K, Wilemon K and Knowles JW Proceedings of the Familial Hypercholesterolemia Foundation's Inaugural Familial Hypercholesterolemia Summit: Awareness to Action. March 17, 2014. https://thefhfoundation.org/proceedings-fh-foundations-inaugural-familial-hypercholesterolemia-summit-awareness-action Accessed March 7, 2017.
Medline Plus – U.S. National Library of Medicine, National Institutes of Health. Familial Hypercholesterolemia.5/5/2016. https://medlineplus.gov/ency/article/000392.htm Accessed March 7, 2017.
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2005-P SAC$1 MS67 Certification #03902497, PCGS #15020
Expert Comments
Jaime Hernandez
By Andrew Vickery: The 2005-P Sacagawea Dollars were introduced on January 24, 2005. The U.S. Mint began offering the 2005 Sacagawea Dollars on the same day that the 2005 Kennedy Half Dollar coins also went on sale.
In 2005, the Mint offered both Philadelphia and Denver Sacagawea Dollars, approximately three months earlier than it did in previous years. This was in response to customer complaints of new products being issued too late.
Customers were given the option of ordering the 2005-P Sacagawea Dollars in rolls which contained 25 coins each. Each roll of 25 coins was priced at $35.50 or $10.50 over the face value of the roll.
The Mint also offered 250 count bags at $347 each, or $97 over face value. In previous years, customers were offered the option of ordering 2,000 count bags, however in 2005 that option was discontinued.
MS60 - MS64: Most Uncirculated coins fall in this grade range. The coins are very common in grades of MS60 to MS64.
MS65: In MS65 grade, they require some searching and picking out the nicest examples from rolls and bags to find coins in this grade. They are not necessarily common in this grade but MS65 coins can be easily found with proper searching.
MS66: In MS66 grades they require lots of searching through bags and rolls and on occasion, you might get a few MS66's from a sealed mint bag or even one or two coins from an unsearched roll.
MS67: In MS67 grade they are much more challenging and you probably have to search several bags and many rolls before you even find one example in this grade or higher.
MS68: In MS68 grades they are very scarce and it becomes extremely challenging to find a coin in this grade. Even after searching many bags and hundreds of rolls there is no guarantee of finding an MS68 example.
MS69: Extremely tough to find a coin in this grade or higher. As of 2010, PCGS has graded on single example in MS69 with none being graded higher.
Glenna Goodacre/Thomas D. Rogers Sr.
26.50 millimeters
8.10 grams
88.5% Copper, 6% Zinc, 3.5% Manganese and 2% Nickel
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Steve Fisher revived his career, SDSU
-- SAN DIEGO -- Forget assistant coaches. When Steve Fisher arrived at San Diego State in 1999, he needed a priest.
That was the only way to secure the attention of a community filled with San Diego Chargers and Padres fans. Because back then, it would've taken a miracle to boost an Aztecs program that hadn't earned a trip to the NCAA tournament since 1985. Only a higher power could draw men and women to Viejas Arena when sunbathing was clearly a better option than buying a ticket to watch the bad basketball SDSU had played for years.
But now, look at what the 68-year-old, aw-shucks coach has done at San Diego State. And even on that rare day when it's raining in paradise, which has Fisher fighting the sniffles, he can look back and see what he's accomplished and what's next for a program that has been raised from the dead.
San Diego State, at 21-1 (10-0 in the Mountain West), is the No. 5 team in the country. And then there's the other big project, one he cannot wait to be finally finished.
In June, school officials will put the first shovels in the ground on the site of a new practice facility. It's significant compared to what the place looked like when he arrived. Back then, there was nothing but dirt atop a four-win program. Disinterested students treated Viejas Arena like a graveyard. They drove by, but rarely entered.
Fisher had enjoyed years of support as the former head coach of a Michigan team that won a national title in 1989 under his guidance. He recruited the Fab Five before a scandal led to his 1997 firing.
He'd essentially hit reset on his career when he accepted San Diego State's offer to coach its program just two years after he'd exited Ann Arbor.
But Fisher didn't pout. He simply accepted that responsibility. He hit the streets and became an evangelist for SDSU hoops.
"I spoke at 79 different events my first 365 days," Fisher says. "Kept count of them. From small little coffee groups of 15 or 20 to the national rotary group in downtown San Diego, 400 [people], and everything in between to spread the word about San Diego State basketball."
He made promises of a bright future that his team's five-win season in his first year failed to back. So the stands were still empty in those early years.
"You'd come here and you'd be able to count the number of fans here on your hand," said Brian Dutcher, an assistant on Fisher's staffs at Michigan and San Diego State. "There'd be 100, 200, 500 fans, maybe. So it was tough, it was kind of a dead environment."
That's significant if you're going to understand the length of Fisher's ride. Banners for SDSU's six NCAA tourney appearances now jut from the ceiling at Viejas Arena. The Aztecs, who will play at Wyoming on ESPNU at 11 p.m. ET, have won 20 or more games for nine consecutive seasons (including this one) and they've won seven Mountain West titles since his arrival. The team's vibrant fans -- "The Show" -- are nationally recognized for their fervor.
Twenty-five years after he was thrust into the role of interim coach, after which Michigan went on a magical six-game run to the national title, Fisher's San Diego State team is in contention for a No. 1 seed a little more than a month from now on Selection Sunday. Xavier Thames (18.1 PPG, 44.3 percent from beyond the arc, 1.7 SPG) is the top player on a team with wins over ranked teams Creighton and Kansas, and whose only loss was against No. 2 Arizona.
And -- get this -- the Aztecs also have territorial bragging rights, a laughable idea 15 years ago. Fisher smirks about that one.
"I heard [Bill Walton] say [recently] on the Arizona-Stanford game, 'Arizona, they played tough road games. They went to San Diego State and won a tough game there. San Diego State's the best program in the state of California,'" Fisher says. "And people are saying that. And I think there's facts to back it up, too."
Fisher and San Diego State are college basketball's true started-from-the-bottom-now-we're-here tale. He's traveled a complex path that has included Michigan's only national title, the creation of the Fab Five, the scandal that followed and the rise of SDSU basketball.
You have to revisit his past to understand his present.
The title, the aftermath
Fisher had a vision for his time at Michigan. After winning the title and luring arguably the most famous recruiting class of all time to Ann Arbor, he figured he'd have an eternal presence on campus.
"I would retire at Michigan and they'd name a building after me," Fisher said. "That's what I always thought."
It was a reasonable idea.
Late in the 1988-89 season, Bill Frieder left for Arizona State and Fisher became interim head coach right before the NCAA tournament was set to begin. Frieder had tried to avoid the midseason mess and conceal his plan to leave for Tempe, Ariz., after the season, but once Michigan athletic director Bo Schembechler learned of it, he wouldn't allow Frieder to remain. Enter Fisher.
The late-season transition was not complicated for players. Frieder had always given his assistants significant duties. He wasn't a dictator. And that made the switch easier for everyone.
"When [Frieder] left, when I became the interim [coach], it was not the first time I got up and gave the game plan to the team," Fisher said. "They'd seen me lead practice. Bill gave me a lot of responsibility and flexibility and freedom."
But players had a few concerns about Fisher. The meticulous coach didn't watch film, he consumed it. Every play broken down, every mishap addressed. In the VCR age, those sessions would last forever, according to former Michigan standout Terry Mills.
"He always wanted you to watch film," said Mills, who is now a radio analyst for Michigan basketball. "As players, we never wanted to watch film. Back then it was VHS. You had to fast forward and rewind it, and if you watched with Fisher, you'd be there all night. When he cut those lights off, many guys found ways to get to sleep."
Mills, Loy Vaught, Rumeal Robinson and Glen Rice helped the program win the title with an 80-79 overtime victory against Seton Hall in the championship game. The Fab Five of Chris Webber, Jalen Rose, Juwan Howard, Ray Jackson and Jimmy King are the most popular figures in the program's history. But Fisher's first Michigan team is the only one that captured gold.
Fisher was a relatively unknown assistant for the bulk of the 1988-89 season. After that national championship run, however, he was a rock star.
"I went from an obscure assistant to the White House," Fisher said. "I stayed all night in the White House. Went up to President Bush's home, walked in the Rose Garden with he and his wife, sat next to Bob Hope and Audrey Hepburn at a state dinner. Bob Hope jumped up and knew who I was. Three weeks ago, half the people in Ann Arbor didn't know who I was. Strange things happen in life."
Nothing as strange and unexpected as his exit.
As a pay-for-play scandal surfaced, athletic director Tom Goss fired Fisher in 1997. In 2002, a federal investigation revealed that Webber and three other players had been paid $616,000 by booster Ed Martin. That same investigation did not identify any direct ties between Martin's scheme and Fisher. But it still stained the coach's legacy, especially after the school forfeited 112 victories.
It was a dramatic shift in the forecast of his career; the sunny skies had given way to a rainstorm.
"I know that I did a good job in every regard," Fisher said. "I know I didn't cheat. Was firing fair? I was the leader of the team, the captain of the ship. I think had they wanted to they could have worked through it, but they didn't want to."
Fisher is a glass-half-full guy. And today, he speaks about that difficult period without anger. He's moved on. But the troubling days and weeks that followed his firing comprise the pages of his worst chapter.
His son, Mark, had been a freshman at Michigan for a few weeks when he was fired. He had another young son, Jay, and a wife, Angie, who wanted to know what was next for their family.
"Initially, you feel all the things that go into when you get fired from a very high profile, public position," Fisher said. "You're sad, mad, embarrassed, feel sorry for yourself and then, that wears off and you say, 'OK, I've got a life. What do I want to do? What will I do from there?'"
After sitting out the 1997-98 season, Fisher got the itch again. So he called Geoff Petrie, then the general manager of the Sacramento Kings, who offered him a job as an assistant for the 1998-99 campaign. He was comfortable, even though his family had remained in Ann Arbor for the season.
Later that year, San Diego State athletic director Rick Bay called. Fisher toured the university, talked to folks on campus and looked around Viejas Arena.
He knew he'd found a new home.
The next, final chapter
Fisher recognizes that he can't coach forever.
But if he retires soon -- "I'm for sure going to stay another year and what happens after that will all be year to year," he says -- it won't be the result of limited energy. He's still spry and vibrant.
"He still grinds at the job," said Dutcher, who has been named SDSU's head-coach-in-waiting. "He watches the tape, he puts the hours in. It's not like he's just riding off. He still wants to get this program to a Final Four. That's what his goal is, to get us to the Final Four and have a chance at a national championship. He's not going to rest until that happens."
Even if it doesn't, his legacy at SDSU is unmatched.
Season tickets have been sold out for the last two seasons (Viejas has a capacity of 12,414). Want a spot in the first three rows? Those season tickets will cost you $50,000 minimum -- but that small sum includes free food and drinks. Philip Rivers, Marshall Faulk, Stephon Marbury and Stephen Strasburg have all visited Viejas Arena to see the best college basketball team in California.
The players are different, too. In Fisher's first year on the job, he received a call from a man who talked about a kid who couldn't play for Rick Majerus at Utah but would be a star for his program.
"I said to him, 'The last time I looked, I'm in the league with Rick Majerus and I have to have people that cannot only play with me but can beat Rick Majerus,'" Fisher says. "People thought anybody can play at San Diego State."
The Aztecs can play with anyone now. Thames is an All-America candidate. Dwayne Polee II, Winston Shepard and JJ O'Brien provide talent and experience.
Fisher said Tulane transfer Josh Davis, who is averaging 9.0 PPG and 11.0 RPG, is the best rebounder he's ever had. Yes, better than former San Diego State star and current San Antonio Spurs standout Kawhi Leonard.
Davis said the weather didn't woo him as much as the coaching staff's familial approach. Before Fisher and his staff reached out to Davis, they visited his mother in North Carolina.
"That meant a lot to me [for them] to be concerned about my mom rather than just come through me," he says.
Even though he's surrounded by young men 50 years his junior, Fisher is still old school. His players can't wear earrings on the road. He says he refuses to "hip-hop with them."
That's not completely true.
"He actually knows Tupac, Biggie, all the old-school rappers," Thames says. "He was around [Jalen Rose] and those guys with the Fab Five. I'm sure he knows a little bit, but every time we play music in the locker room, [it's] 'What is this crap?'"
He's a coach, not a friend. But the veteran finds ways to connect with his players.
"I find out what makes you tick and I play off that," he says. "I think we've got good people skills as a staff."
Fisher initially assumed he could rely on his Midwestern roots to lure breadbasket kids to the beach. But it's hard to recruit players across the country on a budget and even tougher to cure their homesickness once they land. So Fisher and his staff quickly changed their recruiting philosophy by recognizing that they had to focus on the West Coast.
They went to nearby AAU tournaments. They talked to every high school coach in the San Diego area. They built relationships.
The effectiveness of that approach is evident within his latest crop of incoming players.
San Diego State has been enhanced by solid transfers and junior college players under Fisher. But the 2014 recruiting class features four high school players, three of whom are top-100 prospects per RecruitingNation (Malik Pope, Trey Kell, Zylan Cheatham). Angelo Chol, who's sitting out this season after transferring from Arizona, will be eligible next year, too. They're all from the region. Kevin Zabo, a Canadian guard, will join them.
"We set out to build relationships, to invest our time in other people, to prove that we were who we said we were, and we would call people sometimes when we knew they had no players," Fisher says. "Everybody calls you when you have a player."
Or when they think you need one.
SDSU officials will break ground on that new practice facility in the coming months. From his grand office on campus -- think midsized condominium -- Fisher smiles about it all as he stares out the window through his thin-framed glasses and swivels in his black leather chair.
Yeah, it's just a building, but it will give the Aztecs more flexibility with practice times. Plus, these trinkets tend to boost recruiting, although the climate usually helps Fisher's pitch.
"The weather and the girls," Thames says, "that helped a lot, too."
Fisher's achievement with Rice and Co. in the national title game 25 years ago commenced this initial ascent. That's where it all began. His murky departure from Michigan, however, is now just a footnote in his career. Fisher is judged by many by what he's doing now.
And right now, he's the author of a remarkable story.
At the outset, it appeared that San Diego State would never reach this place. And there were no guarantees that Fisher would, either.
But here they are, overtaking some of the nation's blue-chip programs in the rankings and stealing their recruits, too. Just 15 years ago, the Aztecs were afterthoughts in their own community. Now they're a national title contender in a packed arena.
"He's been redeemed, but it doesn't surprise me at all," Frieder says.
But Fisher resents that word: redemption.
"I don't like to call it that," he says. "I have great pride in what I did back at Michigan. We had great success. ... It didn't end the way I wanted it to end. The last chapter wasn't good. But I think that what we're doing now is we're proving to people that might have doubted [that] there's substance there and they can coach and teach and they're good, honest, honorable people. But I knew that. I wasn't out to prove that."
Maybe SDSU will name a building after him one day.
And maybe he'll smile when the sun's rays kiss the letters as he drives by.
Maybe, Fisher will admit then that redemption is the only word that fits.


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Didn't seem like that took very long. Fast & Furious is now on DVD if you like that sort of thing – dumbasses not obeying the speed limit led by a grunting Shrek with big muscles also known as Vin Diesel. Ugh. He's disgusting.
Shrek showed up on the carpet last night because the event was also an opportunity to screen his short film Los Bandoleros. He wrote and directed it – something about a prequel to a scene in the movie? Whatever. The point is Shrek is trying to be a filmmaker now.
I will wait here until you stop laughing. Take your time.
Executives in Hollywood have a lot of money to piss away, non? If you had several thousand dollars lying around, would you give it to Shrek Diesel and tell him to make a movie? Especially when Friday Night Lights begs for renewal every year?
I f-cking hate people.
Photos from Amelie Mucci/LE/Splashnewsonline.com
Shrek Diesel DVD


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I was shaken by new stats on a crucial shift in online user behavior–only 5 to 15% of your website users are coming in through your home page. Tip of the hat to Gerry McGovern's take on the decline of the home page for clarifying what works now for nonprofit marketing online .
As a result, your site users:
- Won't be "introduced" to your organization (as happens when they enter via the front door, or home page).
- Aren't likely to know the breadth and depth of content and tools on your sites.
- Won't be asked to give or subscribe to your e-news (usually buttons featured on home page).
What to do about the decline of your nonprofit's home page:
- Feature Donate and Subscribe (to e-news) on every page throughout the site, above the fold (e.g. visible without a user scrolling down).
- Label navigation elements (buttons, menu bar) to be broadly accessible and include on every page.
- Write/revise content to provide context, so users understand and can act, no matter what page they've come from (which may be Amazon, a competitor's site, weather.com or another page on your org's site).
- Include a site search engine window on every page. It's the easiest way to reduce user frustration level.
This is just one of several critical shifts in site usage patterns I've been meaning to share with you. I'm in the process of reconfiguring my consulting site, Nancy Schwartz & Company, and have reviewed current trends in site usage to make it as effective as possible. I'll be sharing other tips on site design out with you in posts to come.
P.S. Get more in-depth articles, case studies and guides to nonprofit marketing success — all featured in the twice-monthly Getting Attention e-update. Subscribe today .


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Your smartphone may not be the first place you go to when looking for advice on your yoga practice--after all, the latter is about being in touch with your body and mind, while the other is about being in touch with ... everyone and everything else. But sometimes your smartphone can be a great yoga companion--for example, when you're trying to master a particularly difficult pose without the help of your teacher.
Yoga apps number in the thousands, and they're not all just repeats of the same poses and basic workouts. While some apps certainly are full-featured yoga guidebooks, others focus on particular types of yoga, such as the art of yogic breathing, or airplane yoga (apparently, that's a thing). We've rounded up ten yoga apps to help you in your practice--whether you're a beginner looking to learn the basics or an advanced user looking to tackle highly challenging poses.
Daily Yoga--iOS, Android, Windows Phone 8 (Free, with subscription options)
If you want a full-featured yoga app, Daily Yoga is a good place to start. This multiplatform app offers several beginner workouts for free, as well as more-advanced workouts that you can purchase for a monthly subscription fee of $2 to $3 a month. Along with training sessions, Daily Yoga offers a library of poses with videos and written instructions, a music library, and a community in which you can post your workouts and achievements (and rank yourself against other Daily Yoga members).
This app has a couple of minor issues, though: First, the training sessions are plugins and must be downloaded separately. Second, the Windows Phone 8 version of this app doesn't exist--only individual versions of the app features (Daily Yoga for Abs, Daily Yoga for Chest, and so on) exist, and you must download each separately.
All-in Yoga--iOS ($2; HD version, $5)
All-in Yoga is an attractive, full-featured app with a pretty pink-and-purple color scheme. This app features dozens of workouts (found under My Programs), a pose library with over 300 poses, a calendar that helps you track your workouts, and a magazine with tons of yoga-oriented articles.
The app also offers premium features, such as special fitness programs, music, and the option to add custom poses to the pose base, for a subscription fee of $18 per year. All-in Yoga comes in both a regular and a tablet-optimized version, so iPad users can take advantage of their tablet's larger screen.
Simply Yoga--iOS, Android ($3)
If you simply want to work out, the aptly named Simply Yoga will help you do just that. It lets you pick the duration of your workout: 20, 40, or 60 minutes. For each time limit, the app offers two workouts; you can also create custom workouts. The workouts are easy to follow, with video, audio cues, and the name of each pose in both English and Sanskrit. Simply Yoga FREE lets you try the first workout for each time limit before you make the full purchase.
Yogify--iOS (Free, with in-app purchases)
Yogify is a new yoga app from Electronic Arts. This elegantly designed app is free to download and comes with five free classes. After the first five classes, which include three beginner classes, one intermediate class, and one advanced class, each additional class is an extra $2 (or $4 for an entire level; $10 unlocks all classes).
Each class features a seamless video with audio cues, so you can practice quickly and easily wherever you are. The full Yogify experience boasts 35 hours of yoga over 50 classes and more than 275 yoga poses. There's no pose library, but at the beginning of each class you'll see a list of each poses used; you can click on each one to see pictures and written explanations.
BreatheMate--iOS (Free)
Pranayama, or the art of yogic breathing, is often neglected in yoga classes--simply because it isn't all that interesting to spend a lot of time, well, breathing. Luckily, this is one of the easiest parts of yoga to practice on your own (and a cornerstone of yoga practice).
BreatheMate is an iOS app that helps you follow the 1:4:2 breathing pattern (breathe in, hold, breathe out). The app lets you choose your breath length (4, 8, 12, 16, or 20 seconds) and then it vibrates or chimes (or both) to let you know when to breathe.
Universal Breathing: Pranayama--iOS, Android ($5-$6)
If you're looking to delve a little deeper into the art of pranayama, look at Universal Breathing: Pranayama. The app features a structured course to help gradually reduce your breathing rate. This app lets you customize your breathing pattern (for example, you can choose how long to breathe in, hold, and breathe out) and tweak multiple options, such as how many breaths you want to take per minute. The app also features different difficulty levels, information on both pranayama and breathing in general, and links to related articles.
Airplane Yoga--iOS ($4)
Airplanes are pretty stressful places, generally speaking. So it follows that practicing yoga might make an airplane trip a slightly more relaxing experience. But how do you practice yoga on a plane? Easy, just download Airplane Yoga, which features 24 sitting and standing yoga poses that you can perform on a plane.
About half of the poses are demonstrated in video clips, and all feature illustrations and audio cues. The app also includes a section on "strategies for Zen-like air travel," which includes tips for planning, packing, and getting through the airport stress-free.
Yoga in Bed: Awaken Body, Mind & Spirit in 15 Minutes--iOS ($5)
Getting out of bed is ... also pretty stressful. Luckily, there are actual yoga poses you can do in bed. 'Yoga in Bed: Awaken Body, Mind & Spirit in 15 Minutes' is a universal iOS app that walks you through 20 stretches and poses that you can do without (really) getting up. Okay, I'll admit that 'Yoga in Bed' is a little misleading, since most of the poses do involve actually moving around, not just lying still. I was picturing something along the lines of corpse pose, with my eyes closed, and the covers pulled up. But while the postures in Yoga in Bed do require movement, they're all fairly gentle and relaxing. Each pose is also demonstrated with a video clip.
Gratitude Journal--iOS ($1)
Gratitude is an important part of the yoga practice for several reasons: It's essential to overall health and well-being, it's about letting go of negative thoughts and feelings and embracing the positive, and it helps you be at peace with your body and spirit. And a great way to remind yourself of all the things you have to be grateful for is by keeping a gratitude journal.
Gratitude Journal is a simple little app that helps you do just this. With this app, you can rate each day, write down things you're grateful for, and add photos and quotes. You can also record the weather, change the font, and bookmark entries, and there's even a calendar with little hearts for each day you complete your journal.
MindBody Yoga--iOS (Free)
Sometimes you just want to find a yoga class--not practice yoga on your own. In these instances, you can turn to MindBody Yoga, a free iOS app that uses your current location to find yoga classes near you. It lists classes and times, studio names, and address/phone numbers, as well as instructor info.
You can view search results as a list or on a map, and you can also book some classes directly through the app. This app might not be so useful if you already have a yoga studio you like, but it's great for finding drop-in classes when you're traveling.
Find your Zen
You can uncover plenty more yoga apps where these came from. If you're looking for something specific, such as yoga for weight loss, yoga for therapy, or face yoga, there's an app for that. (And you thought Yoga in Bed was unusual).
If you practice at a specific studio, there may be an app for that, too. If you just want to read about yoga and the practice, there's an ebook for that. And if you're looking for a laptop that's as bendy as you are ... check out the IdeaPad Yoga 13. Go forth, and find your Zen!


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"[An] expertly crafted thriller."—Entertainment Weekly, "The Must List"
"With her riveting debut, The Weight of Blood, Laura McHugh makes a strong bid at cementing a new tradition of regional crime fiction while keeping tourism low in the Ozarks. . . . [A] powerful sense of place is the anchor of The Weight of Blood. The well-drawn townspeople and oppressive, dread-soaked atmosphere sprout from the soil of Henbane. . . . The prose is strong, with evocative paint strokes in all the right places. McHugh is an artful, efficient writer who tells her story in vicious blows. . . . McHugh has crafted a sharp, haunting tale of blood in the Ozarks, as substantial as it is pleasurable to read."—Los Angeles Times
"Laura McHugh's atmospheric debut, The Weight of Blood . . . conjures a menacingly beautiful Ozark setting and a nest of poisonous family secrets reminiscent of Daniel Woodrell's Winter's Bone."—Vogue
"Fantastic . . . a mile-a-minute thriller."—The Dallas Morning News
"Gripping . . . Her prose will not only keep readers turning the pages but also paints a real and believable portrait of the connections, alliances, and sacrifices that underpin rural, small-town life. . . . Strongly recommended for readers who enjoy thrillers by authors such as Laura Lippman and Tana French."—Library Journal (starred review)
"The sinister tone builds relentlessly."—The Plain Dealer
"A fantastic novel, rich in character and atmosphere . . . This is one you won't want to miss."—Karin Slaughter, author of Unseen
"A suspenseful thrill ride that satisfies in all the right ways . . . Daniel Woodrell had better watch his back. . . . The Weight of Blood is a tense, taut novel and a truly remarkable debut."—BookPage
"Laura McHugh's vivid and enthralling The Weight of Blood centers on a mother and daughter in a seemingly benign yet deeply horrifying small town. It kept me on the edge of my seat from the first page to the last."—Vanessa Diffenbaugh, author of The Language of Flowers
"The Weight of Blood pulled me in and wouldn't let go. What starts as Lucy's coming-of-age story becomes a chilling tale about the price of secrets. As the menace deepens, so does the tension. Laura McHugh has written a terrific novel."—Meg Gardiner, Edgar Award–winning author of The Shadow Tracer
"McHugh's debut is as lush and evocative as its Ozark setting, with luminous prose and characters you can't help rooting for, even as the mystery surrounding them intensifies and the odds against them grow more and more harrowing. I couldn't put it down."—Carla Buckley, author of The Deepest Secret
"In this clever, multilayered debut, McHugh deftly explores the past of an Ozark Mountain family . . . with plenty to hide and the ruthlessness to keep their secrets hidden. . . . This is an outstanding first novel, replete with suspense, crisp dialogue, and vivid Ozarks color and atmosphere."—Publishers Weekly
"In this riveting debut, Laura McHugh weaves together the stories of two women, separated by a generation, who each reveal pieces of a story that gains momentum and power as its shape becomes clear. This novel will keep you up all night."—Christina Baker Kline, author of Orphan Train
"Once I picked up Laura McHugh's The Weight of Blood, I couldn't put it down. I kept turning pages long into the night, bewitched by the enchanting Ozark landscape and the haunting murder mystery at its heart. The Weight of Blood is the kind of novel that leaves the reader breathless and wanting more."—Amy Greene, author of Bloodroot
"An elegant time bomb of a novel, a coming-of age story that holds you captive from the first sentence and doesn't let go of you after the last."—Tracy Guzeman, author of The Gravity of Birds
"[A] suspenseful novel, with a barn burner of a plot . . . McHugh shows herself to be a compelling writer intimately familiar with rural poverty and small-town weirdness."—Booklist