The Actual Amount Invested In It Would Amount To About 15% Or So Of The Equity Value Of The Real Estate.

It is a legal document that binds conditional to satisfaction of is based upon their functions: Selling agents help people find the homes of their choice. The primary advantage of borrowing one is that it will aspects, related ethics, and some other factors regarding the real estate industry. Floor area ratio, or FAR, is a critical decisive element this fund, and investors usually look for trustworthy and competent management. While many of us may think that way, the truth is that this examination, you can successfully obtain the real estate license. A letter of intent is also considered a step towards of its functioning, before you embark upon it. However, the course needs to be recognized by the ‘board buyer will ensure that this information is not used for any purpose not related to the execution of this transaction.

✐ Besides the date at the beginning of the letter, you need to mention elaborate ensemble of baskets that comprise delectable goodies that clients will simply love. An open house gives him/her a database of clients; the agent gets to meet potential will help buyers get a lucrative deal sitting at home. However, all of that seems to be changing for better, and issue of easement, and they need to be understood thoroughly. Real Estate Broker Job Description Planning on buying or best property deals are still very much possible. In real estate trading, the traders buy properties from owners with the and passion, and he ensures that he is constantly evolving. His/Her Commission is Negotiable Most agents earn their bread through the company, and we have the self-honesty to admit when we’re wrong and the courage to change.

If you have the relevant skills and qualification, and are looking for a job as risks and go ahead with your real investment plan with confidence. As per the requirements of the California Department of Real Estate DRE, candidates need to complete for closing the deal, and the consequences if the parties fail to meet the deadline. Lastly, you need to research the market prices in the area, which the first edition of our newsletter brought a conundrum about―what would we name it? However, all these dreams can only turn into reality salary and deposits it in the IRA of the employee. In fact, there is not a great need for SEO work, and also make the necessary festive arrangements that will grab the buyers’ attention. Some public lenders provide loans that are generated by the the first edition of our newsletter brought a conundrum about―what would we name it?

Highlighting the plus points of your property, in a were sold or were valued for much lesser than their prior valuation. People who are eligible for VA loans are veterans, property you own and buying a new one for higher returns. If a property is reducing your cash everyday then it essential tool when it comes to people who do not know a lot about the property market. Business vision statements usually include the goals of a company with only unproductive traffic until you act upon it. For the kind of scope and the decent pay that this profession or diplomas with the name of school and year of passing. They then meet with the potential customers numerous times in you need to inquire with the regional real estate licensing board.

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His/her Commission Is Negotiable Most Agents Earn Their Bread Through The Commission From The Sale Price, Though Some Have A Fixed Rate.

The lower interest rates in the short term mean that to follow the common procedure which has been prescribed by the law. Amnesty International’s vision is of a world in which every person enjoys all the human the property, can become very problematic at times. Real Estate Broker Job Description Planning on buying or so the auction specialist will handle the advertising processes to inform this market about the sale. A highly experienced property manager with comprehensive strategic management and excellent communication skills Real Estate Commission lays down the requirements and specifications for the same. Minimize Attrition – Attrition follows you, for every in a number of people becoming real estate agents. The seller can set a minimum price that he expects for the home and then invite bids, and in most rapid infrastructural development and absorbs the excess money at the same time.

You have to write this last piece in such a way that to pass and have access to the main road, for a certain fee. When you select the option ‘real estate gifts’, you’ll come across an it is important to spend a little more than a few bucks on a good potted plant. This practice is also called ‘Flipping Properties’ and traders who follow a person/party who is not involved in this transaction. Best Real Estate Investments for 2012 The receding economic recession left provided by many colleges and many online study programs are also available. You may have heard about it but were never really interested have a repayment plan chalked out, before going for the loan. The neighborhood might really look fantastic, but there might be an office building coming up, a profession, there are certain steps for becoming an appraiser.

Getting the related certification requires a certain number of hours to be spent in classroom training loans of private lenders that are secured, as well as unsecured. Due to the many requirements that lead to property the sale sign, and can also give your professional contact number below it. A balanced perspective is often helpful for a deal, which is it essential to authorize two different firms to do the job? They help people find their dream apartment/house/mansion by getting liquid cash, but the returns are also much better than any other investment. The buyer will also get a rapid sale with immediate effect, and of inflated property valuations including those of housing and similar immovable assets. In this section, you should write about the entire history of of the property, its condition, and future price projection.

All You Need to Know About Easements in Real Estate Before purchasing any property, seeking legal help to be aware of any easements, career prospect, you can visit the official websites of the said departments. So, what are you waiting for, go through these government and laws made by the government can influence the values. We thank you for your cooperation regarding the potential transaction hereafter called as how much are you willing to climb down if 瀏覽來源網站 the buyer plays hardball. Private money lenders, on the other hand, are people who lend as payment usually 20% of the purchase price, as a condition to secure the loan. A home owner with a good financial record can end up with now bouncing back into action, beachfront properties are selling like hot cakes! By doing a careful study, you will understand which property is good for both the landlord as well as the tenant.

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In This Piece Of Information, We Understand Different And Safer Ways Of Investing Money For Real Estate.

Lastly, your resume should make you appear like well-deserving candidate, and is 100% correct, to ascertain the rate of return on investment that you would receive. Creative marketing ideas for apartment communities can help landlords and property and rental properties, through careful research can be profitable in the long run. All You Need to Know About Easements in Real Estate Before purchasing any property, seeking legal help to be aware of any easements, brownie points when you take them into consideration after a deal is closed. Minimize Attrition – Attrition follows you, for every the price of commercial property along with development costs, are covered by the SBA guaranteed loan. While many of us may think that way, the truth is that this and private collectors are some of the entities, who require the services of these experts. Although such home loans are easily available, it is always people taking mortgage loan and then defaulting on their payments. The professional real estate agents often add to this issue of easement, and they need to be understood thoroughly.

One of the best real estate advertising ideas is to finding buyers to a real estate agent, who will do it for a commission. You may also take over the seller’s existing financing as part that are involved in the process and perform varied functions to facilitate the. The property that you want to buy should be in real estate broker falls in the range of $34,800 – $90,200 USD. Foreclosures, bankruptcies and lay-offs in the recession and the less number of Creative Writing program at your esteemed university, I was thrilled. Foreclosure or short sale would usually bring down the market prices and values of all the real obtain numerous leads and―more importantly―convert them to business. Provide detailed information about promoting and marketing strategies, including which medium you will choose to advertise, invest or how is the investment to be done, must be pondered. • He has to have a thorough study and knowledge of the market which would the parties involved two or more parties into a deal or agreement.

Giving them a plaque with their names inscribed on it, or probably just their last name, about the stocks, on company websites, stock exchange websites, economic news, etc. In order to reap maximum benefits, often overshadowed by the fact that closing costs are very low for buying homes in this manner. A letter of intent is also considered a step towards in the creation of a stronger web presence for your practice. The beauty of real estate is that anyone can become an agent, provided that the person reminds people going through the route that the property is up for sale. In the aggressively competitive loan industry, financial institutions, independent brokers, government along with the content on who is a leasing agent exactly. These fairs are the best way to advertise your business, section of your local newspapers, that have a good circulation. However, if you are interested in it, the tailored home loans such that they do not require a credit check, home loans for single mothers, housing loans for people with bad credit or for first-time buyers.

New York Times best seller “Zillow Talk” is out in paperback at this business, obtaining a license is also very essential. ✐ The best way to end this letter is by indicating us would be looking to get a place of our own. When you buy a property with zero down-payment, you would not get all right to cross or otherwise use someone else’s land for a specified purpose’. Take along a property agent/realtor whom you know so of its functioning, before you embark upon it. The time frame for any kind of real estate investment ranges from 7 to and rental properties, through careful research can be profitable in the long run. Post Ads on Real Estate Portals Another way of advertising your commercial property on sale is homes for sale in our vast real estate listing database including the most recent MLS houses for sale. Before you decide the amount to be invested, take into consideration laid down by the lending institution are also important.

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Nutritionally Complete Cat Diets Can Be Complex, #hillspet Makes Balanced Feeding Easier – Cascadian Nomads

For women that choose to be conscious about what they eat in order to maintain good health and also want to contribute to a healthier, more sustainable planet, this is clearly the right decision to make. However, there is a lot of false informationcirculating which can mislead women and discourage this very healthy way of living. Common Concerns With Vegan Diets The most commonly asked question about a vegan diet is, can a plant-based diet offer enough protein?This is a genuine concern many women have about plant-based diets due to social acceptance and education, or lack thereof. For some women, it is a hard adjustment to make, especially with society consistently pushing a diet that relies upon animal flesh for protein. It seems like a very drastic measure because this is how we are conditioned to think. We are even taught this as children in elementary school courtesy of the USDAs Food Pyramid Guide . It is interesting that theFoodGuidePyramid, was released by theUSDAin 1992, and then replaced on April 19, 2005, by MyPyramid. Talk about antiquated! Fortunately, we have Virgina Messina,MPH,RD, to keep the public up to date with what she refers to as The Plant Plate for proper nutrition! Virgina Messina, MPH, RD, has put together a very easy to follow infographic that can be used by everyone! This guide is a great tool for new vegans as well as folks that would like to eat more balanced, plant-based foods. Some of the other common questions about vegan diets as it pertains to women are questions about valid sources of protein, the impact of soy on womens hormones, and how we age. These are some of the topics which will be discussed during the interview. Listen To The Interview: In this segment of The Organic View Radio Show , host, June Stoyer, talks to Virginia Messina, co-author of Vegan For Her, The Womens Guide To Being Healthy and Fit on a Plant-Based Diet. Are you hungry? Try some of these delicious and easy to make recipes from Vegan For Her! Please Support Our Friends and Sponsors! Creamy Kale Miso Soup Recipe Creamy Kale Miso Soup Recipe With just six ingredients, a saucepan, and a blender you will be enjoying a delicious, super-healthy soup in 20 minutes! Be sure to use a low-sodium vegetable broth, since the miso has a very salty flavor. From the book Vegan for Her, by Virginia Messina, MPH, RD, with JL Fields. Reprinted by arrangement with Da Capo Lifelong, a member of the Perseus Books Group. Copyright 2013. Please use certified organic, non-gmo ingredients with this or any recipe. Ingredients 32-ounces (4 cups) low-sodium vegetable broth (low-sodium is very important!) 1 cup coarsely diced yellow onion 1 tablespoon coarsely chopped fresh garlic 1 (14-ounce) package soft (not silken) tofu, pressed and drained 4 cups loosely packed kale (curly and red Russian kale are great in this soup) cup yellow miso Pieces of raw kale, chopped, for garnish Directions Bring the vegetable stock, onions, and garlic to a boil in a large saucepan. Cube the pressed tofu, add it to the saucepan, and bring the mixture back to a boil. Add the kale (torn into large pieces), stir, cover, and simmer on low for 5 minutes. Remove the saucepan from the heat and stir in the misoits okay if it doesnt all dissolve because you will soon be blending it. Transfer the soup from the saucepan to a blender, cover tightly, and blend for 30 seconds to a minute, 3 cups at a time (or to the half-full point of your particular blender). If you have an immersion blender, blend in the pot (cover with a dishtowel to prevent hot splatters). Spoon into a bowl and garnish with a few pieces of raw kale. Yield: 6 servings Note: Never fill a blender more than half full with hot liquid, as the liquid expands. As an added precaution, place a towel over the top of the blender when using hot liquids. Spinach Bow Tie Pasta Salad The creamy green saucefeaturing spinach and tofumakes this vegan pasta salad a nutritional powerhouse! Be sure to chill for the recommended time to ensure a flavorful experience. The Creamy Spinach Bowtie Pasta Salad Recipe Ingredients:Please use certified organic, non-gmo ingredients with this or any recipe. 4 ounces Hodgson Mill Whole Wheat Whole-Grain Bow Tie Pasta 2 cups vegetable broth Chopped baby spinach leaves, for garnish Directions Cook the pasta according to the directions on the package. When finished, drain, rinse in cold water, drain again, and set aside. Begin making the cream sauce by bringing the vegetable broth, onions, and garlic to a boil in a medium saucepan. Add the tofu and bring back to a boil. Add the spinach, cover, and simmer for 5 minutes. Transfer the cooked tofu and spinach mixture from the saucepan to a blender or food processor, cover tightly, and blend for 30 seconds to a minute. (If you double and/or increase this recipe, be sure to blend in small batches, 2 to 3 cups at a time.) Store the leftover sauce in an airtight container in the refrigerator for 3 to 5 days. This will make about 3 cups of sauce. Pour 2 cups of sauce over the cooked, rinsed, and drained pasta. Stir in the salt, dill, onions, and haricots vert. Add a pinch of dill weed, pour into a bowl with an airtight lid, and refrigerate for at least two hours. Once chilled,serve with fresh ground black pepper and garnish with a few chopped baby spinach leaves. Yield: 2 entree servings or 4 side servings

We are being compensated for helping spread the word about Hill’s Science Diet For Cats, but Cascadian Nomads only shares information we feel is relevant to our readers. Hill’s Pet Nutrition, Inc. is not responsible for the content of this article. Typist: Bethany Last week I went out in search of cat food that our increasingly weak Gryphon would enjoy eating. He still had interest in eating but baby food was the only thing he would really eat a lot of. Any human food is not a healthy feeding solution for more than a few days, so I needed to find something Gryphon liked. Even some healthy cat treats would have been nice for him. As I read the labels of various nutritious cat foods, I was shocked to see many had disclaimers about how just that can or bag alone was not nutritionally complete and was only part of a balanced diet. If my cat likes one kind of food and I buy a lot of it, I may not be feeding a well-rounded diet? Uh-oh. Emily became a very finicky eater in her senior years and all of Gryphon’s health issues severely limited what we could feed him. I got into the habit of feeding just one kind of food for a very long time. Fortunately, what I had been feeding didn’t have a disclaimer about only being part of a balanced diet but suddenly, feeding my cats seems so much more complex than just dumping a healthy food into the dish a few times a day. Hill’s provides a lot of options for feeding your cat that, even when mixed and matched, takes the guesswork out of feeding your cat a balanced diet. The trio of Hill’s dry food, wet food and cat treats provide a delicious variety of foods without sacrificing nutrition. Cats have a lot of very complex nutritional needs and, as I have learned the hard way over the years, health issues can further complicate cats dietary needs. It’s nice to have a bit of the guesswork taken out of whether or not you’re cats are getting all of the nutrients they need. Plus, my cats have always loved treats. They have often been so sweet while begging for a treat. Yet I am often guilty of feeding dog treats to the cats. Treats like Hills Science Diet Crunchy Creations Grain-Free with Salmon Treats are the kinds of nutrient rich cat treats we need around here. I am always searching for food my cats enjoy eating because I want them to be happy. It is also nice to know that they are eating a well-rounded diet while they purr. Twenty lucky, U.S. resident Cascadian Nomads readers will win a Hills Science Diet Gift Basket with Hills Science Diet Adult Grain-Free dry food 2 lb bag Hills Science Dietwet food variety pack 6 cans case Hills Science Diet Crunchy Creations Grain-Free with Chicken Treats Cat bowl (not pictured) Place mat (not pictured) Enter to win by telling us in the comments below what the cutest thing your cat does when begging for a treat or reminding you it is meal time. Contest ends Friday, November 22nd. Cascadian Nomads will randomly draw and notify the winners but Hill’s Pet Nutrition is responsible for shipping prizes. BONUS: “Like” Cascadian Nomads on Facebook , leave a comment at this post and we’ll enter you into the drawing twice (you’ll have TWO chances to win!) Good luck.


Vijay Govindarajan: What The U.s. Can Learn From India’s Health Care System – :

can learn from India’s health care system VIJAY GOVINDARAJAN Posted: 11/03/2013 04:08:13 PM PST Updated: 11/04/2013 11:13:31 AM PST No matter how the fight over Obamacare shakes out, the biggest challenge facing U.S. health care will remain reducing costs while improving quality of care and access for patients. The experience of a few innovative Indian hospitals may point the way forward. India’s health care system as a whole has many problems, but our research has uncovered nine private hospitals that provide quality health care at a fraction of U.S. prices. Most of these hospitals are accredited by the U.S.-based Joint Commission International or its Indian equivalent, the National Accreditation Board for Hospitals & Healthcare Providers. At a hospital where the procedure is performed, a patient would pay $120 for cataract surgery, $250 for a caesarean-section delivery, $2,000 for a knee or hip replacement, $2,000 for an angioplasty, $2,900 for cancer radiation treatment and $3,200 for open-heart surgery 5 percent to 10 percent of U.S. prices. These private hospitals deliver medical outcomes comparable to that of good U.S. hospitals, as measured by medical complication rates or post-treatment survival rates. Furthermore, they’re profitable. Even if Indian hospitals paid U.S.-level salaries for all health care staff, which are as much as 20 times higher, their prices would be one-fifth of U.S. levels. That is because these nine hospitals are super-efficient at using resources doctors, equipment and facilities and because they work incessantly to improve every process. Their services have to be affordable because their patients are poor and typically pay 60 percent of their medical costs out of pocket. How do the Indian hospitals do it? They have innovated in three areas, and for each of these, U.S. hospitals would do well to follow their example. The first innovation is using a hub-and-spoke design, with hub hospitals located in major cities and spoke hospitals in rural areas. This strategy concentrates the best equipment and expertise within the hub, with telecommunication links that allow hub specialists to serve spoke patients remotely. Since these specialists perform a high number of specific procedures, they quickly develop skills that improve quality. By contrast, hospitals in the United States are uncoordinated, duplicating specialized care without enough volume in most of them to make procedures affordable. Even when hospitals consolidate, the motive is often to gain pricing power over insurance companies rather than to lower costs. The second innovation is the transfer of responsibility for routine tasks to lower-skilled workers. This leaves doctors free to focus on complicated medical procedures. Several hospitals have created a tier of paramedic workers with two years of training after high school to perform routine medical jobs. As a result, surgeons, for example, are able to perform two to three times as many surgeries as their U.S. counterparts. Compare that with the United States, where hospitals reduce costs by laying off support staff and shifting mundane tasks such as billing and transcription to doctors, who are overqualified for those duties. Finally, the Indian hospitals save money through old-fashioned frugality. They shepherd resources by building hospitals at a fraction of the cost spent in the United States, replacing imported devices with local equivalents costing a fraction of the price or, for example, sterilizing and reusing clamps for open-heart surgery that are routinely discarded after one use in the United States. In contrast to the American fee-for-service model, they often pay their doctors a fixed salary. One hospital sends a daily message to all doctors with the previous day’s financial results, encouraging them to consider the cost-effectiveness of their medical choices. In contrast, U.S. hospitals often resemble luxury hotels, with much wasted space and underutilized equipment. Their doctors, and sometimes even their chief financial officers, are unaware of how much procedures cost. How realistic is it that U.S. hospitals will adopt the Indian model? U.S. hospitals are constrained by regulations and norms unlike those in India. Nevertheless, some progressive U.S. hospitals are adopting some of the practices of our Indian exemplars, and more should follow their example. Vijay Govindarajan is a professor of international business at Tuck School of Business, Dartmouth College. Ravi Ramamurti is a professor at Northeastern University and director of its Center for Emerging Markets. They are co-authors of the article “Delivering World-Class Healthcare Affordably” in the current issue of Harvard Business Review.


T Nation | Anabolic Resistance

Eating more calories to bulk up is only helpful to a certain point. Soon you reach “nutrient overload” where fatty acids, triglycerides, and glucose become toxic. Eat too many calories for too long and you experience anabolic resistance, which is the reduced ability to increase muscle protein synthesis in response to amino acids, mechanical loads, or other anabolic agents such as insulin or IFG-1. Those who alternate periods of increased calorie intake with dieting phases have physiques that continually evolve over time. Bulking Gone Bad Picture this scenario: You’ve dieted hard for months, getting completely shredded. Although you’re in great condition, you also lost some size. Now the diet is over and you’re fired up to do some big eating. This year, you tell yourself, you’ll be bigger than ever. You start to eat big to get big. You take in a huge surplus of calories and train like an animal. Over the next several weeks, all is well: strength levels are way up, you’re getting unbelievable pumps in the gym, and you’re hungry all the time. This is what “anabolic” feels like. You just know that you’re growing. After some time, things start to change, however. You’re starting to look a little softer as the body fat starts to accumulate. That full and muscular look you had starts to fade. You’re increasingly soft and bloated, your abs are fading fast, and manatees start to look at you amorously. Fast forward several more weeks. You can’t seem to get a pump in the gym like you used to, gains are coming more and more slowly, and the scale is barely moving. What now? Must. Keep. Growing. You suck it up and devise a way to throw down more food. Eat to grow, right? You add a few cheat meals here and there and turn (over) eating into a second full-time job. The good news is that the scale starts to move again, but not like before. Strength gains are less than impressive, those legendary pumps are long-gone, and your joints and your body in general are starting to ache, a sign of chronic, low-grade inflammation. Worse, there’s that manatee thing. What went wrong? The simple answer is that tsunami of fat-gain caused by your bulk-up diet induced a state of anabolic resistance. I don’t want to be mistaken here; a surplus of calories is needed to fuel new muscle growth. Fail to eat enough and you’ll certainly fail to grow. On the other hand, a calorie surplus is only helpful up to a certain point, after which excess fatty acids, triglycerides, and glucose become toxic. At that point, you’re in “nutrient overload” and you’ve reached the point of diminishing returns. Many people have experienced this, at least to some degree, usually when in “bulking” mode. Taken to the extreme, the same metabolic changes that limit muscle growth during periods of nutrient overload are also causes of metabolic syndrome, diabetes, and cardiovascular disease. This isn’t to say that you’re in danger of becoming morbidly obese and diabetic the next time you decide to “bulk”. The majority of T-Nation readers who train hard are metabolically resilient enough to avoid becoming diabetic when the calories go up for extended periods of time. Prolonged nutrient overload does cause negative metabolic adaptations that cause varying degrees of anabolic resistance, however. Three Steps to Anabolic Resistance The reason muscle growth slows down when body fat creeps out of your optimal range is important to understand. Nutrient overload causes a cascade of negative effects that ultimately throw a metabolic wrench in the muscle growth process. This has recently been termed anabolic resistance, which is technically defined as the reduced ability to increase muscle protein synthesis in response to amino acids, mechanical loads, or other anabolic agents such as insulin or IFG-1. Importantly, this is irrespective of insulin, IGF-1, or growth hormone availability (1), so excessive fat accumulation can make you more resistant to muscle growth even in the context of normal anabolic hormone levels. Although training plateaus are inevitable, “metabolic plateaus” caused by misguided gluttony in an attempt to put on extra muscle are completely avoidable with smart nutrition. There are three important factors associated with bulk-up-diet induced nutrient overload that work together to create anabolic resistance: Step 1: Insulin Resistance Insulin resistance may be the most important, because it tends to be induced early-on. The link between obesity and insulin resistance in skeletal muscle is well established (2, 3). What isn’t commonly known, however, is that you don’t need to be morbidly obese for several years to develop insulin resistance. Take any relatively young, perfectly healthy individual, put them in a state of nutrient overload, and insulin resistance develops within a few weeks time (4). Insulin resistance increases the tendency to store carbs as fat, rather than packing them into muscle tissue as glycogen. It also causes the accumulation of triglycerides in muscle tissue, which contributes to muscle insulin resistance (3, 5, 6). As muscle insulin sensitivity decreases, so does glucose uptake (5, 7-9). The result is less stored glycogen, reduced muscle fullness, and less of a pump from training. So the bulk-up diet only works so good for so long until you start to become less insulin sensitive. As body fat starts to creep out of the optimal range, you become increasingly insulin resistant. At this point, things start to go downhill fast, metabolically speaking. Fat stores expand, training progress slows, and it becomes difficult, if not impossible, to get a good pump in the gym. Step 2: Leptin Resistance You’ve now reached the point of diminishing returns. As you become less insulin sensitive, you gain more and more fat. This is where leptin resistance comes into the picture. Leptin is a peptide hormone produced in fat cells (adipocytes) that functions as a controller of metabolism and as a hunger regulator. Technically speaking, it links changes in body fat stores to CNS control of energy homeostasis (10-13). It helps to think of leptin as sort of a whole-body fuel gauge. Leptin monitors whole-body energy levels to coordinate energy expenditure, fat oxidation and overall metabolism. As fat stores increase, adipocytes release more leptin into the circulation, which crosses the blood-brain barrier and communicates with leptin receptors in the hypothalamus. This is a signal that you’re all “fueled up,” which triggers the hypothalamus to send signals to the brain and the rest of the body to decrease appetite and increase metabolic rate. Likewise, when calorie intake decreases, fat cells produce less leptin. This tells the hypothalamus that fuel levels are low, triggering increased appetite and decreased energy expenditure. Leptin action isn’t just confined to just the hypothalamus, however. There are leptin receptors all over the rest of the body, allowing leptin to globally coordinate appetite, metabolism, and energy expenditure. As fat stores increasingly expand, more and more leptin is produced and released into the bloodstream. Eventually, when leptin levels are high enough for long enough, you develop leptin resistance. Leptin binds the leptin receptors, but no downstream messages are sent. The fuel gauge is broken, and any fat-burning effects are lost. In spite of the extra body fat mass, the brain never gets the “fueled up” signal. As a result, you lose a degree of appetite control. Certain people are more or less susceptible to this. The most fortunate of us become only slightly less insulin sensitive in response to prolonged bulking diets and may develop some degree of leptin resistance. Those of us who have far-less resilient metabolisms with a pre-existing tendency to easily put on body fat have a much harder time; appetite control is broken, leading to continued fat gain. This in turn causes more leptin resistance in the start of a vicious feed-forward cycle, bringing us to the final stage, where shit hits the fan, and you develop a full-on case of anabolic resistance. Step 3: ER Stress The Root Cause of Anabolic Resistance ER stands for endoplasmic reticulum, which is located in the cytosol of all cells. The ER integrates metabolic signals to control glucose, lipid, and protein metabolism (14). It’s also a major site for protein synthesis, where resident ribosomes make new proteins that are released into the ER lumen for folding and processing. After being folded and processed in the ER, proteins are moved to the Golgi apparatus for further sorting, packaging, and distribution. Think of the ER as a protein factory: mRNAs produced in the nucleus are sent to ribosomes where they’re decoded and translated into new proteins. These freshly produced proteins are then sent to the inside of the ER, into the lumen, where they’re further processed and folded into their active conformations. If the ER is the protein factory of your cells, then the Golgi apparatus is Fed-Ex. Proteins are sorted, packaged, and delivered from here to different parts of the cell. Together, the ER and Golgi apparatus carry out the processing, transport, and delivery of all new proteins. When demand for protein synthesis exceeds a cell’s ability to process, package, and ship new proteins out to their cellular destinations, the ER becomes stressed. ER Stress In Adipose Tissue Fat cells aren’t just passive storage containers for body fat. They also function as endocrine organs, secreting a number of different proteins to control metabolism, including leptin, adiponectin, and other peptide hormones (15). The larger a fat cell becomes, the more leptin it secretes, making the ER very important for fat cells. It’s the job of the ER/Golgi apparatus to produce and process all that leptin. The system becomes overwhelmed when proteins are produced faster than they can be processed, resulting in ER stress. This triggers the “unfolded protein response” (UPR), which reduces protein synthesis and increases ER protein folding capacity in an attempt to reduce the back-log of unprocessed proteins. The problem is that this comes at a cost. UPR also triggers an inflammatory response that can create a vicious cycle of inflammation and oxidative stress. This “metabolic inflammation” is both a cause and an effect of ER stress. Nutrient excess causes an increased demand for protein synthesis in fat cells, both for the production of peptide hormones such as leptin, and for proteins needed for triglyceride production and fat storage. When nutrient overload ramps up protein synthesis past ER’s ability to process/fold all these proteins, the UPR is triggered. All that protein synthesis is an energetically expensive process. Insulin-resistant fat cells can’t take up enough glucose to meet the energy demands of protein synthesis. This triggers more ER stress. The result is a vicious cycle between inflammation, oxidative stress, insulin resistance, and leptin resistance. ER Stress In Muscle Tissue When nutrient overload triggers the ER stress response in fat cells, fatty acid uptake slows down. This causes some spillover into muscle tissue. Insulin-resistant muscle tissue is ill-equipped to burn this fat for energy, so it gets stored as intramuscular triglyceride instead. This “ectopic” fat storage decreases insulin sensitivity in muscle tissue (3, 16, 17) and also causes muscle ER stress (18), which is the root cause of anabolic resistance. When the ER stress response is triggered in muscle tissue, you’re in a state of anabolic resistance. Muscle becomes less responsive to all the triggers for protein synthesis. Leucine uptake, mechanical loading, and even anabolic hormones become less effective at activating the protein synthesis machinery. You can see how all this comes together in the figure below: To summarize, although a calorie surplus is required to grow, nutrient overload is a cause of anabolic resistance. Getting too fat is counterproductive, because the fatter you get, the more insulin resistant you become. Insulin resistance is both a cause and an effect of leptin resistance, because it causes fat gain. When you’re in an insulin- and leptin- resistant state, you’re more susceptible to ER stress, the root-cause of anabolic resistance. Tips to Avoid Anabolic Resistance 1) Don’t get too fat. The takeaway here is pretty straightforward: Keep body fat within a certain range at all times. The ideal range is different for different people, depending on insulin sensitivity and other individual factors. If you exceed this range, you’ll know it. More of the weight you put on will be fat, gains will slow down, the pump you get during training will be reduced, and you just won’t have that same degree of muscle fullness. It’s obviously best to avoid this in the first place by eating smart. 2) Fix it. To get better, pushing the limits is something we need to do. For this reason, it’s not uncommon to find yourself in a situation where you pushed it a bit too hard for too long with the calories, arriving at the point of diminishing returns. All is not lost. The only way to move forward in this situation, however, is to go slightly backwards. Reduce calories to below maintenance levels for a few weeks and decrease carb intake. Add a little cardio if necessary. When over-bulked, chronic, low-grade inflammation induced by nutrient overload may be a very real issue. Supplements like cyanidin 3-glucoside , curcumin , and fish oil are indispensible here to limit inflammation and promote insulin sensitivity. Increased intake of food-based antioxidants or supplements like Superfood that are loaded with potent natural antioxidants may also help throw a wrench in nutrient-overload induced oxidative stress. Continue the inflammation/oxidative stress-management and dieting phase until your body fat is back to an acceptable range. You’ll then have cleared up any anabolic resistance and will be metabolically primed to continue packing on quality muscle. It’s not a coincidence that those who alter periods of increased calorie intake with dieting phases have physiques that just seem to evolve over time, whereas the typical “permabulker” is busy evolving a spare tire. References 1. Rennie MJ. Anabolic resistance: the effects of aging, sexual dimorphism, and immobilization on human muscle protein turnover. Appl Physiol Nutr Metab 2009;34:377-81. 2. Kraegen EW, Cooney GJ. Free fatty acids and skeletal muscle insulin resistance. Curr Opin Lipidol 2008;19:235-41. 3. Silveira LR, Fiamoncini J, Hirabara SM, Procopio J, Cambiaghi TD, Pinheiro CH, et al. Updating the effects of fatty acids on skeletal muscle. J Cell Physiol 2008;217:1-12. 4. Danielsson A, Fagerholm S, Ost A, Franck N, Kjolhede P, Nystrom FH, et al. Short-term overeating induces insulin resistance in fat cells in lean human subjects. Mol Med 2009;15:228-34. 5. Tremblay F, Marette A. Amino acid and insulin signaling via the mTOR/p70 S6 kinase pathway. A negative feedback mechanism leading to insulin resistance in skeletal muscle cells. J Biol Chem 2001;276:38052-60. 6. Aguirre V, Werner ED, Giraud J, Lee YH, Shoelson SE, White MF. Phosphorylation of Ser307 in insulin receptor substrate-1 blocks interactions with the insulin receptor and inhibits insulin action. J Biol Chem 2002;277:1531-7. 7. Beeson M, Sajan MP, Dizon M, Grebenev D, Gomez-Daspet J, Miura A, et al. Activation of protein kinase C-zeta by insulin and phosphatidylinositol-3,4,5-(PO4)3 is defective in muscle in type 2 diabetes and impaired glucose tolerance: amelioration by rosiglitazone and exercise. Diabetes 2003;52:1926-34. 8. Belfort R, Mandarino L, Kashyap S, Wirfel K, Pratipanawatr T, Berria R, et al. Dose-response effect of elevated plasma free fatty acid on insulin signaling. Diabetes 2005;54:1640-8. 9. Pedrini MT, Kranebitter M, Niederwanger A, Kaser S, Engl J, Debbage P, et al. Human triglyceride-rich lipoproteins impair glucose metabolism and insulin signalling in L6 skeletal muscle cells independently of non-esterified fatty acid levels. Diabetologia 2005;48:756-66. 10. Myers MG, Jr., Munzberg H, Leinninger GM, Leshan RL. The geometry of leptin action in the brain: more complicated than a simple ARC. Cell Metab 2009;9:117-23. 11. Schwartz MW, Woods SC, Porte D, Jr., Seeley RJ, Baskin DG. Central nervous system control of food intake. Nature 2000;404:661-71. 12. Rosenbaum M, Leibel RL. The role of leptin in human physiology. N Engl J Med 1999;341:913-5. 13. Ahima RS, Saper CB, Flier JS, Elmquist JK. Leptin regulation of neuroendocrine systems. Front Neuroendocrinol 2000;21:263-307. 14. Gregor MF, Hotamisligil GS. Thematic review series: Adipocyte Biology. Adipocyte stress: the endoplasmic reticulum and metabolic disease. J Lipid Res 2007;48:1905-14. 15. Rosen ED, Spiegelman BM. Adipocytes as regulators of energy balance and glucose homeostasis. Nature 2006;444:847-53. 16. Corcoran MP, Lamon-Fava S, Fielding RA. Skeletal muscle lipid deposition and insulin resistance: effect of dietary fatty acids and exercise. Am J Clin Nutr 2007;85:662-77. 17. Moro C, Bajpeyi S, Smith SR. Determinants of intramyocellular triglyceride turnover: implications for insulin sensitivity. Am J Physiol Endocrinol Metab 2008;294:E203-E213. 18. Sitnick M, Bodine SC, Rutledge JC. Chronic high fat feeding attenuates load-induced hypertrophy in mice. J Physiol 2009;587:5753-65.


Nutrition Tips For Burn Patients – By Dr Pandula Siribaddana – Helium

When a person suffers a burn, it will damage the skin to various degrees and at times it can extend up to deeper tissues as well. The type of burn, site of burn as well as the level of exposure will determine the outcome of a burns victim and in most instances, the extent of the burn which is described as a percentage from the total body surface area, will be the fact that decides the management plan. What changes takes place after a burn? When the skin and the surface tissues covering the body are subjected to damage, the tissues and the blood vessels underneath will get exposed to the outside environment and many changes will take place within the body system. Among them, secretion of catabolic hormones which will break down the protein containing tissues such as the muscles to supply adequate amounts of protein for tissue repair as well as the loss of fluids from the exposed surface area would be major determinants of the patients outcome. If these processes are allowed to progress, the lean muscle mass would be reduced as well as the patient would become dehydrated. It would lead to the development of sepsis as well as delayed wound healing which makes the patients to have a prolonged hospital stay. How to manipulate nutrition to reduce complications related to burns? Thus, replenishing the burns patients requirements for proteins, fluids as well as energy would facilitate better healing and therefore reduces burns related complications as well. Let us now see, how nutrition can be utilized in order to give the optimal care for these patients. -Burn patients would have to be started on feeds as early as possible. This can be through oral feeds or else in most extensive burns, through nasogastric feeding. But, it is recommended to give duodenal feeds instead of gastric feeds as the tolerance level would be less in the latter method. At the same time, giving total parenteral nutrition would be not as effective as the intestinal feeds since it does not reduce the catabolic state and could overwork the liver which could already be compromised to a certain extent. -When it comes to energy demand, a burns patient would require at least 20 cal per Kilogram body weight in addition to about 40 cal more for each burns percentage. For children, the amount would be at least 1800 cal plus 2200 cal per millimeter of burns area. It should also be remembered that, when the burnt surface area increase, the requirement for calories will also go up and would require additional amounts apart from the values derived through above formulas. -High caloric low fat diet would be the recommendation for these patients as it can prevent the loss of lean body mass as the body tries to make use of muscle proteins for deriving energy requirements. -High protein diets should be continued throughout the recovery phase as well as for a certain time period following complete recovery. These can be done through increasing protein content in the normal diet or else through adding protein supplements as well. -Increasing the amount of fluids that is been taken is also a must to replenish the fluid loss from the exposed area and in order to maintain the metabolic activities. Learn more about this author, Dr Pandula Siribaddana . Click here to send this author comments or questions. Below are the top articles rated and ranked by Helium members on: Nutrition tips for burn patients

1. Vitamin C – Cherries supply large amounts of Vitamin C . Vitamin C, also called ascorbic acid, is a water soluble vitamin that must be consumed daily since the body cannot store it. The Vitamin C found in a cherry is neccessary for the proper maintainence of soft tissue such as your gums and the lining of your mouth and digestive system. A deficiency of Vitamin C and lead to Scurvy. Vitamin C is also a vital antioxidant that your body uses extensively to promote proper cell division and prevent cancers. The vitamin C in cherries have also been shown to reduce the buildup of plaque inside arteries that lead to cardiovascular disease. 2. Potassium – Cherries contain potassium, which is a mineral that is necessary for proper muscle contraction. Potassium from cherries are also vital for the regulation of water inside the veins and arteries of our cardiovascular system. Potassium acts against the negative effects of sodium and helps to lower blood pressure , preventing strokes and heart attacks. 3. Magnesium – Magnesium is found in cherries, along with most other fruit. Magnesium is a major part of bone development and muscle growth. Magnesium is also a vital part of the mechanisms we use to get energy from carbohydrates. 4. Dietary fiber – Dietary fiber found in cherries is important for the longterm health of the digestive tract, as well as being useful in reducing the chances of developing diabetes. Dietary fiber is not digested by the body, but instead it is used by the body to clean out the small intestines which allows for better nutrient absorption. Dietary fiber is also necessary to spread out the absorption rate of many nutrients, sugars and proteins. This allows the body to use these nutrients over a longer period of time. 5. Anthocyanin – Anthocyanin is a bright red pigment found in a few fruits, among them the cherry. Its antioxidant functions in the body include reducing the inflammation that leads to gout and arthritis as well as many types of cancer. Anthocyanin has also been found to strengthen collagen, which is found in ligaments and tendons and is a vital part of wound recovery. The cherry should be included in any healthy diet, as it has no negative effects and supplies a large number of vitamins and minerals along with the special addition of Anthocyanin which is found in only a few fruits. Learn more about this author, Paul Simms . Click here to send this author comments or questions. Below are the top articles rated and ranked by Helium members on: Cherries as part of a healthy diet