In this Mayo Clinic Minute, Zajac demonstrates the best pre-golf resistant exercises.
 
Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video (1:04) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.
 

Resistance training

 Mayo Clinic doesn't just advise golfers on resistance exercises and strength. For 25 years, it has served as the official medical sponsor of the WM Phoenix Open, providing on-site care for athletes, event staff and spectators. Supporting one of the world's largest golf events, from heat-related illness to musculoskeletal injuries, reflects deep expertise in both prevention and knowing when specialized care is needed.
 
Resistance training is essential for golfers. It strengthens muscles, ligaments and tendons while improving core stability, mobility and functional strength. These benefits can translate into better swing control, more consistent contact and improved endurance throughout 18 holes. Just as important, targeted strength work helps protect the lower back, shoulders and wrists — areas commonly affected by golf-related injuries.
 

Golf exercises to consider

Zajac recommends focusing on three key areas:

• Rotator cuff and shoulder (rows/scapular strengthening): Strengthening the upper back and shoulder stabilizers supports posture and helps control the club throughout the swing.
• Core (plank and side plank): A strong core improves rotational stability and balance, allowing for more efficient power transfer while reducing strain on the spine.
• Glutes and legs (bridge exercises): Golf is played on one leg at a time. Building lower-body strength and balance enhances stability during the swing and helps generate power from the ground up.

 Perform these exercises on non-golf days two to three times per week. A consistent strength routine can help you stay steady, swing with confidence and avoid a season-ending bogey. 

Related post:

• Mayo Clinic Minute: Are the yips just nerves or something more?

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Each year, Mayo Clinic donates over 53,000 pounds of food to Community Food Response in Rochester, Minnesota, reducing waste and supporting local people in need. 

Three days a week, Community Food Response volunteers fill paper bags with food retrieved from all over Rochester, Minnesota. By 3:30 p.m., cars stretch down the city block. Some people arrive on foot, often from nearby homeless shelters.  

Each bag contains enough food for three meals for three people. Typically, at least one item — a salad, a sandwich, a bottle of milk — is from Mayo Clinic.  

"We want to get food to people in need rather than into the waste stream," says Aaron Clark, manager of Food Service Operations at Mayo Clinic in Rochester. "This is our way to extend Mayo values into the community."

His team uses forecasting tools to anticipate Mayo Clinic's food needs and reduce waste. Still, some surplus is inevitable. Community Food Response simplifies sharing it with neighbors.  

On distribution days, drivers pick up prepared, fresh and frozen foods from nearly two dozen local places — restaurants, supermarkets, hospitals, caterers. Last year, Mayo contributed over 53,000 pounds of food to the organization. 

A recent Mayo Community Contributions grant also helped Community Food Response purchase new freezers, coolers, food packaging and other necessities, ensuring the collaboration can continue.   

Bringing healing through meals  

Community Food Response began in 1993 after a Mayo physician and Rochester restauranteur asked, "What happens to the city's leftovers?" Their curiosity led to a grassroots effort that now feeds hundreds of people in the local community.  

By some estimates, 1 in 5 Minnesota households struggle with food access. In 2025, food security was named a priority area in Olmsted County's Community Health Needs Assessment for the first time.  

From logistical to financial, "there are many reasons for food insecurity," says Chris Tatting, board president for Community Food Response and a hospital operations manager at Mayo Clinic in Rochester. "Whether someone is food insecure for several years or one week, we can help." 

For Mayo Clinic, this offers an opportunity to meet an everyday need while supporting long-term health. "The best healthcare we can provide is preventing diseases if possible. Nutrition plays a big role in that," says Dr. Sara Bonnes, medical director for Food and Nutrition Services at Mayo Clinic. "This isn't just about access to food — it's about access to nourishing food."   

Every Monday, Wednesday and Friday, Community Food Response volunteers, some of whom are Mayo staff members, have the privilege of providing that.   

On a recent weeknight, a woman in the food line shared that she was fleeing domestic violence. Due to her health, she could only eat liquids, so the team packed up nutritious drinks, soups, yogurts and juices.  

"She cried. I cried," a Community Food Response coordinator posted on the nonprofit's Facebook page. "This is what we do for our community." 

From surplus to sustenance 

To find a home for every type of food, Mayo Clinic in Rochester also collaborates with Ronald McDonald House in Rochester, offering Mayo meals to families of hospitalized children. Across the enterprise, other food rescue efforts minimize waste while helping people in need:   

• Mayo Clinic in Florida supports Meals on Wings, which repurposes unused hospital food to provide meals for Jacksonville seniors, and Feeding Northeast Florida, a local food bank that rescues food and distributes it to hundreds of other organizations.  

• Mayo Clinic in Arizona recently awarded a Community Contributions grant to the Society of St. Vincent de Paul, which includes a food pantry network, a kitchen that makes 7,000 meals a day and a food reclamation center that rescues millions of pounds of food annually.   

• Mayo Clinic Health System donations and volunteers support local food shelves and organizations, such as Community Table, ECHO Food Shelf, Feed My People Food Bank and The Salvation Army. 
  
  

Through these collaborations, surplus becomes sustenance. Stewardship becomes service. And Mayo Clinic helps meet an essential need within local communities.    

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DEAR MAYO CLINIC: For the past several years, I've been competing in half-marathons. This year, I've decided to challenge myself and enter full marathons. What recommendations do you have for preventing sports injuries as I go to this next level?

ANSWER: Congratulations on continuing to stretch your goals — and for thinking about preventing injury before you begin more intense workouts. For anyone striving to boost their performance, injury prevention shouldn't be separate from your training program; it should be embedded into it. That includes incorporating it into warmups, strength sessions and practice design.

Preventing sports injuries

What does that look like? Starting with your warmup, think of it as preparing your system for the activity you're about to do. Your warmup should go beyond static stretching and focus on dynamic movements that activate the muscles that you're going to use in training and competition.

Then add sports-specific patterns to your warmup. For example, if you're a basketball player, jumping is a key movement. So, add that to your warmup. Not only does jumping mimic gameplay, but it also raises your heart rate and preps your system for the activity.

Remember, when you're designing your training program, you’re training for capacity, not just the sport itself. That means building general strength, having a good aerobic base, and sound technique and movement quality. 

That's what underlies your ability to progress to a higher level. Even elite athletes have become injured because they haven't built that capacity. Sudden spikes in the intensity and volume of exercise can lead to overuse injuries.

One of the key elements of building capacity and preventing injuries is progressive load management. The principle behind progressive load management means not going from zero to 100, but gradually increasing volume or intensity to build capacity.

Before you take any activity to the next level, address any underlying conditions. If you have knee pain while running, work with a physical therapist or an orthopedic or sports medicine clinician so you're not pushing through an injury and potentially making it worse.

Looking at your own experience, you've already built the capacity for running a half-marathon. A full marathon doubles the distance, making it a perfect example of how to apply progressive load management. That increased distance is a significant load not only on your cardiovascular system, but also on the orthopedic structures like bones, tendons and ligaments.

To condition your body and build capacity, design your running program so that over the next several months, you gradually increase mileage each week until you're at full marathon distance.

For someone who is coming back from a sports injury, the same progressive load management applies. A sports medicine specialist will work with the athlete to gradually rebuild strength, measuring progress along the way. Before getting back onto the court or field where they'll be expected to deliver 100%, they'll need to simulate the sport. 

One group of athletes particularly susceptible to overuse injuries is youth and adolescents. While participation in multiple sports is encouraged, young athletes still need time to build the physical capacity required for each sport as they transition between seasons. Gradually increasing training demands, rather than jumping from zero to 100, is key to reducing the risk of injury.

Pitchers are particularly vulnerable to overuse injuries. Finding the right balance between adequate time off and maintaining arm strength and conditioning can be challenging. Although there are published recommendations for annual time away from throwing, many athletes enter the season having done little or no arm-specific training in the offseason.

To reduce injury risk, conditioning and capacity building should begin well before the season starts. High-quality return-to-throwing programs, which are available both in person and online, can help guide athletes through a structured, progressive plan to safely get back in the game.

While the emphasis in youth sports is often on pitchers, catchers also throw at similar or higher volumes. They may not be throwing at the same velocity, but the volume is there. It's important to take this into consideration when tracking pitch counts. Pitching and catching in the same game should be avoided in most situations.

For student athletes, single-sport specialization and year-round competition are not in their best interest when it comes to injury prevention. Athletes need time away from each sport to allow their bodies to recover.

Participating in multiple sports is generally better for any athlete's overall physical health and helps reduce the risk of overuse injuries. It also promotes broader skill development and improved overall athleticism. By varying movement patterns and training demands, the body becomes more adaptable and is given a break from repetitive stress. Athletes often gain transferable skills that improve performance in their primary sport while also enhancing motivation and mental well-being.

Taylor North, D.O., Sports Medicine, Mayo Clinic Health System, Eau Claire, Wisconsin

The post Mayo Clinic Q&A: Sports injury prevention strategies that boost performance appeared first on Mayo Clinic News Network.

DEAR MAYO CLINIC: Fiber has been getting a lot of attention in the news lately. What exactly is dietary fiber, and why is it important to my overall health?

ANSWER: Dietary fiber refers to the parts of plant-based foods that your body can’t digest or break down. Unlike proteins, fats or simple carbohydrates, fiber passes through the digestive system largely intact. Because your body can't digest it, fiber becomes an important fuel source for the trillions of microbes that live in your gut.

As food moves through the digestive tract, nutrients your body can absorb are taken up earlier in the process. What remains — much of which is fiber — travels to the colon, where gut bacteria use it for energy. 

Dietary fiber is often associated with digestion, but its role in the body goes far beyond keeping you regular. Fiber plays an important part in gut, heart, immune and metabolic health. Research shows that adequate fiber intake helps:

• Lower cholesterol levels and reduce blood pressure.
• Improve blood sugar control, aiding in the prevention and management of type 2 diabetes.
• Decrease the risk of colorectal cancer, stroke and chronic inflammation.
• Manage a healthy weight.
• Regulate immune responses.
• Maintain a healthy and diverse gut microbiome, which supports many aspects of overall health.

Fiber is often described as soluble or insoluble, based on whether it dissolves in water or not. However, this distinction is less important for overall health than how fiber functions in the body. A more meaningful way to think about fiber is whether it’s fermentable or nonfermentable. Here’s what this means:

• Fermentable fiber can be broken down by gut microbes and used as fuel. This process produces beneficial compounds, such as short-chain fatty acids.
• Nonfermentable fiber isn’t readily used by microbes and mainly adds bulk to your stool, which helps support regular bowel movements.

While you may hear about the benefits of taking supplements to add fiber to your diet, but fiber is best obtained from food rather than supplements. That’s because many whole foods contain a mix of different fibers, which is especially beneficial for gut health. Fiber-rich foods include:

• Fruits, such as berries, pears and apples.
• Vegetables, like broccoli, Brussels sprouts and leafy greens.
• Legumes, including lentils, chickpeas and beans.
• Nuts and seeds, such as almonds, chia seeds and flax seeds.
• Whole grains, including whole-wheat bread, oats and wheat bran.

It's important to eat a variety of these foods. The more different types of fiber-rich foods you eat, the more different types of fiber you'll get, which is optimal for your health. Making small, sustainable changes, such as choosing whole-grain bread instead of white bread or swapping chips for nuts or fruit, can add up over time.

Most adults who are in good health should aim for 30 to 40 grams of fiber per day. However, your fiber needs can vary by age and general health. For example, older adults may need to balance fiber intake with adequate calories and protein. 

As you increase your fiber intake, you may experience some abdominal discomfort, bloating and gas. To prevent or lessen these symptoms, gradually add more fiber to your diet rather than increasing your intake all at once. A helpful approach is to:

• Increase fiber intake by about 3 grams per week. This can be as easy as adding just 1/2 cup peas, squash or cauliflower; 1 cup carrots; 1 medium sweet potato; 1 cup brown rice; 3 tablespoons of shredded coconut; or 2 tablespoons of sesame seeds.
• Maintain that level for seven to 10 days before increasing again.
• Drink plenty of water, aiming for 80 ounces a day.

Slowly increasing your fiber intake allows your digestive system and gut microbes time to adapt, and any symptoms will improve after a short while.

Fiber is an essential part of a healthy diet. By eating a variety of plant-based foods, increasing fiber intake gradually and staying well hydrated, you can support gut health and overall well-being while making fiber goals more achievable and sustainable.

Purna Kashyap, M.B.B.S., Gastroenterology, Mayo Clinic, Rochester, Minnesota

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Metabolic experts at Mayo Clinic say combining the two in some instances can be an effective way to treat obesity.

Watch: The Mayo Clinic Minute

Edited by: Kevin Sullivan, Senior Communications Specialist, Mayo Clinic

Journalists: Broadcast-quality video (1:02) is in the downloads at the end of this post. Please courtesy: "Mayo Clinic News Network." Read the script.

"Obesity is a disease, and to overcome it, we need to use all the modalities, or tools, we have available," says Dr. Omar Ghanem, a Mayo Clinic metabolic surgeon.

However, it's not a one-size-fits-all approach.

"Some patients might benefit only from medications, some patients might benefit only from surgery, but a portion of patients might benefit from the combined therapy," Dr. Ghanem says.

He says some patients experience greater weight loss when combining bariatric surgery, also called metabolic surgery, with GLP-1 medications. Ideal candidates include patients who start obesity treatment with a higher body mass index, those who are preparing to undergo a complex surgical procedure, such as a transplant, and patients who need to lose more weight for their overall health or those looking to maintain their weight after metabolic surgery.

"Neither GLP-1s nor bariatric surgery are magic. These are tools, and the patient has to use those tools correctly to be able to overcome obesity," Dr. Ghanem says. "Each case is different. Go to your provider, talk to your specialist, and trust them to help you make the right decision for your health. Our patients have to put a lot of effort to overcome the disease. They're not just choosing the easy way out, they're choosing the healthy way out."

Related posts:

• Bariatric surgery paves way for heart transplant after end-stage heart failure 
• New year, new focus on health: Mayo Clinic expert highlights effective treatment options for obesity

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Postpartum experiences are as unique as the pregnancies that come before them. Because of this, it can be difficult to recognize what's normal and what could be a complication — even if you've given birth before. 

The postpartum period is generally defined as the first six weeks after birth. "Postpartum begins immediately following birth and extends through the time when your body and mind are recovering from pregnancy and delivery," says Dr. Kylie Cooper, a maternal-fetal medicine specialist at Mayo Clinic.

Recovery isn't the same for everyone, and for some people, the postpartum timeline can be longer. While the spectrum of what is considered typical postpartum is wide, there are warning signs of complications you should never ignore.

Dr. Cooper discusses postpartum complications, how to recognize them and when to seek care.

The signs you shouldn't ignore

Dr. Cooper says consistent improvement is the best indicator of typical recovery

"In general, recovery should tend toward improvement. So, if you feel like things are getting worse, or new symptoms come up, we definitely want you to reach out for care."

Dr. Kylie Cooper

The first two weeks after delivery carry the highest risk for serious complications, though they can sometimes occur later. "The most common complications we see in that time frame are high blood pressure, hemorrhage or bleeding complications, infection, anxiety and postpartum depression," says Dr. Cooper.

While many postpartum concerns are common and treatable, some rare but serious complications can develop during this time, which is why new or worsening symptoms should never be ignored.

"These include blood clots, like deep vein thrombosis or pulmonary embolism, as well as postpartum heart issues like cardiomyopathy," says Dr. Cooper.

If you experience any of these symptoms, you should seek care as soon as possible because they can indicate serious complications:

• Worsening pelvic or incision pain, or pain that doesn't improve.
• New, heavy or increased bleeding.
• Headaches that don't improve with medication.
• Confusion or behavior changes.
• Fever or flu-like symptoms.
• Mood changes, anxiety or depression.
• Extreme fatigue that doesn't improve with rest.
• Shortness of breath, trouble breathing or chest pain.

"Symptoms related to pain, mood changes and energy levels can be dismissed as normal postpartum symptoms. While the postpartum time frame can be a challenging time, these symptoms shouldn't be dismissed," says Dr. Cooper.

Mental health-related postpartum complications

After delivery, your body undergoes a significant hormonal shift that can affect your mood and emotions in various ways. While this is expected, symptoms usually improve in a couple of weeks. When these feelings linger or cause depression or anxiety that doesn't improve, it could indicate postpartum depression. In rare cases, a serious and life-threatening condition called postpartum psychosis can develop.

"While 'baby blues' might initially cause people to feel off or be tearful, that should improve, and it should not persist," says Dr. Cooper.

She says these feelings can improve with treatment and support.

If you think you or a loved one are experiencing symptoms of mental health-related postpartum complications, the National Maternal Mental Health Hotline (1-833-TLC-MAMA) and Suicide & Crisis Lifeline (988) offer free and confidential 24/7 resources.

After the six-week postpartum visit

After your six-week postpartum visit, your care will transition back to your primary care team. But this shouldn't mean the end of postpartum care.

"It's becoming increasingly recognized that this is a much longer process, extending up to a year after delivery. I think it's important that we acknowledge that many people are not done recovering at the six-week mark — not by a long shot," says Dr. Cooper.

If you had physical or mental health complications during the postpartum period, this transition is crucial to ensure your long-term wellness. "This is a really important time frame to ensure we help patients establish their preventive care because pregnancy complications can impact long-term health," says Dr. Cooper.

As you continue to monitor your health and well-being during this period, it's important to pay attention to symptoms that may arise or persist beyond the initial recovery phase, as these can often be treated. "Pelvic floor symptoms are often dismissed. For example, there's this misnomer that once you have children, you will have pelvic floor issues. And that's an accepted part of your future, but it shouldn't be," says Dr. Cooper. "These are issues that can be treated and improved."

Getting the support you need postpartum

Support plays an important role in recognizing postpartum complications. Partners, family members and caregivers may notice subtle changes before you do, especially during a time marked by sleep deprivation and physical recovery.

"Sometimes partners or family members are the first to recognize that something isn't right," says Dr. Cooper. "If you notice changes that concern you about your loved one, it's important to speak up and help them seek care."

Dr. Cooper emphasizes that it takes a village to provide postpartum support, and the fetal and maternal care team at Mayo Clinic aims to be part of that village. "In our practice, we have a team approach with obstetric providers, perinatal mood specialists, lactation consultants and pelvic floor physical therapists, and we all work together to make sure that the patient has the care they need."

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DEAR MAYO CLINIC: I’m confused about prebiotics and probiotics. Could you help me understand what they are and how they could benefit my health?

ANSWER: You're not alone in wondering about the health benefits of prebiotics and probiotics. Even the names can be confusing.

The human gastrointestinal tract houses roughly 100 trillion microorganisms (good bacteria). These microorganisms make up what's called the gut microbiome.

These good bacteria fight off bad bacteria to help keep our intestinal tract healthy. 

Probiotics: Promoting digestion, benefiting health

Let's start with probiotics. Probiotics are living organisms, also known as microbes. They're primarily bacteria and yeast whose main role is to aid digestion and improve overall health. Probiotics help strengthen the gut barrier, aid in the absorption of nutrients, and replace less beneficial or harmful microbes. 

Research shows that probiotics can treat and even prevent conditions such as gastrointestinal (GI) tract infections, irritable bowel syndrome (IBS), lactose intolerance, allergies, cystic fibrosis, urogenital infections, diarrhea, high cholesterol, eczema and certain cancers. 

Probiotics also may support dental health by treating and preventing tooth decay, periodontal disease and bad breath. 

In addition to aiding digestion, another essential role of probiotics is promoting a healthy immune system and preventing chronic diseases. 

Some examples of probiotics include fermented foods, such as certain yogurts, many cheeses, pickled vegetables, apple cider vinegar, fermented teas and sauerkraut. Probiotic supplements also are available in pill or powder form. 

Prebiotics: Feeding probiotics

Prebiotics are the food for probiotics. They help feed the probiotics through fermentation and metabolization, which are beneficial to the gut. These microorganisms contribute to a variety of processes, including cell energy, immune function, hormone regulation, anti-inflammatory responses and bowel management. 

Research indicates that high prebiotic consumption may enhance our immune system, help regulate blood sugar levels, reduce the risk of colorectal cancer and increase calcium absorption. When good bacteria (probiotics) are fed an abundance of healthful food (prebiotics), our bodies will be healthier.

Prebiotics are found in foods that contain:

• Dietary fibers, which the body doesn't fully digest.
• Resistant starches, which are a form of carbohydrate that isn't digested in the small intestine. Instead, it ferments in the large intestine. 

The most common prebiotics are inulin, oligosaccharides and pectin, which are found in fibrous foods. Foods containing prebiotics include most fruits and vegetables — especially green bananas, asparagus and onions — as well as garlic, nuts, seeds, oats, barley, potatoes, and legumes such as soybeans, dried beans, peas and lentils.

Adding probiotics and prebiotics to your diet

Food composition changes with cooking, so to get the most benefit from prebiotics and probiotics, it's important to pay attention to cooking methods. For example, boiling potatoes is better than baking them. When potatoes are boiled and then chilled, they develop a white starchy film, which is the most beneficial part. Serving beans and legumes hot increases their starch content, which is good for your gut.

Eating most fruits and vegetables while they are fresh and raw will provide healthful prebiotics. 

Researchers suggest gradually introducing these foods into your diet. Adding a lot of new foods containing prebiotics and probiotics may produce gas, cause bloating and lead to gut discomfort.

Anne Harguth, Nutrition, Mayo Clinic Health System, Waseca, Minnesota

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Mayo Clinic expert explains why it is important to act before perimenopause

JACKSONVILLE, Fla. — Weight gain is common in women during perimenopause and after menopause, but the physical changes underlying it start much earlier in adulthood. Daniela Hurtado Andrade, M.D., Ph.D., an endocrinologist and obesity expert at Mayo Clinic in Jacksonville, explains why it is important to start counteracting those changes before perimenopause arrives.  

"Weight changes are not only characteristic of midlife or menopause. Data have shown that weight gain starts early in adulthood," Dr. Hurtado says. "Around age 30, your muscle mass starts decreasing gradually as part of the natural aging process, and this is exacerbated in midlife due to menopause."

The decreasing muscle mass will lead to a lower metabolism, a risk factor for weight gain, Dr. Hurtado says.

Adding to the challenge of achieving a healthy weight before and after menopause are many of the features of modern life, Dr. Hurtado says. For example, an abundance of processed foods high in sugar and fat; technology such as escalators, elevators and cars that allows people to move from place to place without walking; and the difficulty of unplugging from devices that keep people connected to work and sedentary for longer hours, with less time spent on physical activity. 

Being aware that weight-related physical changes start earlier than midlife may help people be mindful about the importance of establishing and maintaining a healthy lifestyle, including adequate diet and exercise (at least 150 minutes per week), well ahead of menopause, Dr. Hurtado says. It may help to track what and how much you eat, to understand how much you need to eat to feel satisfied and avoid overeating, she adds.

To mitigate muscle mass loss that occurs with aging, a healthy diet should include enough protein and exercise should include resistance training and possibly high-intensity interval training, Dr. Hurtado says.  

"And this is even more important if we are engaging in a weight-loss intervention because we know that weight-loss interventions are also associated with muscle mass loss, which can have a significant impact on the weight-loss outcomes," she says. "One of the reasons why we hit a plateau when we are losing weight is because we are losing muscle mass and our metabolism slows down."

While a healthy lifestyle is essential, it may only get someone so far in pursuit of a healthy weight, Dr. Hurtado says. The body is genetically programmed to survive, so losing weight is perceived as  negative and our bodies will try to fight it. Some people can sustain low-calorie diets for a period of time and lose weight, but eventually they may start feeling hungry, eating more and gaining weight.

"As soon as some people even think about losing weight or restricting their calories, their brain overrides those thoughts: 'No, you're actually hungry, so you're going to eat as much as you need to make sure that you do not lose weight,'" Dr. Hurtado says. "There is a proportion of people in whom diet and exercise alone will work, but for the majority, they will not due to the complex regulation of energy balance."

Many people who live with overweight or obesity will need a tool such as a medication, an endoscopic bariatric procedure or bariatric surgery to help them achieve sustained weight loss, Dr. Hurtado says. In addition to nutritional and behavioral support, they also may benefit from physical therapy or occupational therapy to help them find ways to become physically active, she adds.

In the early 40s, and perhaps even earlier, it is important for women and their healthcare team to start discussing aging-related weight changes that are happening and will happen, Dr. Hurtado says.

"Every visit with a doctor is an opportunity, especially in these times when overweight and obesity are so highly prevalent," she says. "We want to prevent rather than treat something that may be more difficult to treat for several reasons. Lifestyle interventions are the core of all weight management interventions. While we need to understand that there is no magic pill, there are tools that can facilitate adhering to lifestyle changes."

Dr. Hurtado emphasizes that obesity is a disease.

"Starting the conversation about weight management with that message may help people have a different perspective: 'OK, so they are talking about something that is not my fault, but actually has a biological basis,'" Dr. Hurtado says. "Realizing that weight problems are a disease and not a character flaw can help them think about it differently and could be very impactful on the outcomes of weight loss interventions."

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news.   

Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu

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With support from a Mayo Clinic Community Contributions grant, the Peer Recovery Program at Mayo Clinic's Emergency Department in Rochester, Minnesota, helps patients struggling with substance use find hope and healing.  

Seven years ago, Cedric Weathersbee spent many nights on a family friend's front porch. Although he couldn't go inside for breakfast, he was grateful for a spot to sleep. 

At age 37, after years of alcoholism, Cedric was homeless, out of work and estranged from his family. Without a clear path forward, he began contemplating suicide. "I couldn't see my life without drinking," he says, "and I knew I didn't want a life with drinking in it."  

Then he arrived at the Saint Marys Emergency Department (ED) at Mayo Clinic in Rochester.  

Cedric doesn't know how he got there, but he does remember meeting Cheryl Laugen, a peer support specialist from Recovery is Happening. With funding from a Mayo Clinic Community Contributions grant, the Rochester nonprofit provides on-call support for ED patients facing substance-related crises.  

It's by design that every peer support specialist has their own story of substance use.  

"They bring the compassion and empathy of lived experience to the bedside," says Dr. Robert Hyde, an emergency medicine physician at Mayo Clinic.  

Right away, Cheryl could see Cedric had hit rock bottom. She knew how critical it was to meet him there.  

"For individuals like us, these moments of desperation are when our brain says, 'I have to make changes,'" she says. "But that window of opportunity is often very small."  

As Cedric shared, Cheryl smiled. That little human kindness, long absent from his life, gave him courage.  

"There was no judgment. There was no telling me what to do," says Cedric. "Cheryl instilled hope in me that things could be better. She motivated me to try to move forward." 

A community of support 

Substance use is a key community health priority for Olmsted County. Often intersecting with needs related to housing, employment and mental health, it requires a coordinated network of support. 

"ED visits manage acute problems, but substance use disorder needs long-term management," says Dr. Hyde. "Peer supporters are a bridge to recovery. Often, they're the most impactful part of the patient's visit." 

After addressing immediate needs, peer support specialists can help patients create a recovery plan, connect them to local resources, or even accompany them to treatment facilities.  

It was Cheryl who told Cedric about Doc's Recovery House, a sober living community, where he moved after detoxing at a rehabilitation facility. Eleven months later, he was ready to begin rebuilding his life.  

But Cedric's journey to healing — and helping others — wasn't finished yet. 

Discovering a new purpose 

Some months later, Cedric began drifting away from his support system. When a bad day at work became a bad week, he checked into an extended stay hotel and started drinking. Even after relocating to his brother's house, he didn't stop — and soon he was facing an ultimatum: sober up or leave.  

Cedric decided to detox one more time.  

As his body recovered, his mind wandered to all the times he could have died or gone to jail but hadn't. He'd tried to quit drinking 30 or 40 times, and despite so many relapses, he was still here.  

Could there be a purpose behind it all?  

"There were just too many coincidences," Cedric says. "I concluded that something greater than myself was looking out for me." After a lifetime of atheism, "that cracked the door to spirituality," which led to long-term sobriety. He'll celebrate his sixth "sober birthday" in February.  

His spiritual revelation also led to a realization — he wanted to devote his life to serving others.  

Shortly after detoxing, Cedric took a class that taught him to support others as Cheryl had supported him. After joining Doc's Recovery House as a peer support specialist, he also became a licensed alcohol and drug counselor. Now the men's program manager, Cedric has guided hundreds of residents toward healing.  

"It brings me great joy to see that man I met in the Emergency Department giving back in a meaningful way — to see how far he's come and talk to people he's helped," says Cheryl. "He's come full circle."  

Although he doesn't work in the hospital setting, Cedric emulates Cheryl in every interaction.    

"I try to support and empower others to do what they want to do," he says. "It's about walking alongside them."  

Every time he sees Cheryl at a recovery event, Cedric thinks about their first encounter at Saint Marys.   

"That was the first step toward where I am today," he says. "I'm really grateful to be in Rochester. I'm grateful I'm sober. What I have now is happiness and actual purpose."  

Learn more 

• Visit Rochester Recovers, a Mayo-supported website, to find recovery resources in the Rochester, Minnesota area.  

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ROCHESTER, Minn. — Resolutions to improve health typically include measures such as more exercise, a healthier diet and stopping smoking. But what about your gut microbiome? Taking steps to protect and improve it can benefit digestive health and more, says Purna Kashyap, M.B.B.S., a gastroenterologist at Mayo Clinic who specializes in the gut microbiome and gastrointestinal disorders.

"The microbiome is essentially a community of bacteria, fungi, viruses and all of their genes," Dr. Kashyap explains. "The skin, lungs and reproductive system each have their own microbiomes. The gut microbiome is probably the most diverse in our body. Its microbes perform several functions. The body's other microbiomes tend to be more specialized."

Your gut microbiome is as unique as your fingerprint. These bacteria perform important jobs, including breaking down fiber and starches; synthesizing vitamins and amino acids, such as vitamins B and K; and producing short-chain fatty acids (SCFA) that help prevent disease. They also maintain the intestinal barrier, a protective gut lining.

"For example, when you eat an apple, your stomach and small intestine break down some of it. The rest of the apple goes to your colon, where bacteria do the rest of the work for you," says Dr. Kashyap, the Bernard and Edith Waterman Director of the Microbiomics Program at the Mayo Clinic Center for Individualized Medicine.

"As the bacteria break down the apple's fiber, they produce substances that are good for the cells of the colon and the body."

If you lose these healthy bacteria, it creates an opportunity for some of the bacteria that cause disease to thrive. One example is Clostridioides difficile, or C. diff, a bacterium that can infect the colon, the longest part of the large intestine. Symptoms can range from diarrhea to life-threatening damage to the colon. Risk factors for C. diff infection include antibiotic use, hospitalization and certain medications that affect the immune system.

"If you take antibiotics, your microbiome might change for a short time, but it usually goes back to its original state," Dr. Kashyap says. "The same thing can happen with other changes or behaviors, such as traveling or eating a lot of fast food. Think of your microbiome like a rubber band. You can stretch it a bit, and it bounces back. But if you stretch it too much, it might get disrupted."

In addition to gut infections like C. diff, microbial imbalances are thought to play a role in other diseases and symptoms, including colon cancer; diabetes; depression and other mood disorders; Alzheimer's disease; Parkinson's disease; and cardiovascular disease. More research is needed to understand ties between the gut microbiome and these diseases, Dr. Kashyap says.

How far you can stretch your microbiome depends on several factors. Those include how long the disruption lasts. This is one reason it's important to avoid overusing antibiotics, Dr. Kashyap says.

Some underlying diseases, such as inflammatory intestinal diseases can affect which communities of bacteria can thrive in your gut and which can't. These include inflammatory bowel diseases such as Crohn's disease and ulcerative colitis.

Dr. Kashyap is studying the interactions between gut bacteria and dietary carbohydrates and how they influence the gastrointestinal system. His long-term goal is to develop new biomarkers and microbiota-targeted therapies for treatment of functional gastrointestinal disorders, including irritable bowel syndrome and chronic bloating, also known as functional bloating.

Lifestyle can also play an important role in the health of your gut microbiome, Dr. Kashyap adds: "Gut bacteria eat what you eat. If you eat a lot of sugary, salty, fatty foods such as snacks, sweets and highly processed foods or consume a lot of alcohol, you'll starve bacteria. As a result, they will try to get nutrients from your gut lining and will damage it in the process."

On the other hand, if your diet is loaded with a diverse array of fruits, vegetables and fiber, you'll nourish a diverse microbial community in your gut.

"The more diverse your gut microbes, the farther you can stretch things before you experience disruption," Dr. Kashyap says. "Happy bugs, happy life."

Other lifestyle habits will help to protect gut health:

• Drink plenty of healthy fluids such as water and limit or avoid alcohol.
• Exercise for at least 30 minutes most days.
• Don't smoke.
• Manage stress.

For more information about the microbiome and microbiome research at Mayo Clinic, visit Mayo Clinic Press and the Mayo Clinic Center for Individualized Medicine.

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About Mayo Clinic
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Media contact:

• Sharon Theimer, Mayo Clinic Communications, newsbureau@mayo.edu
  

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