A Plant-Based Diet Can Reduce Your Risk for Type 2 Diabetes, If You Do It Correctly
By Ginger Vieira
Type 2 diabetes is far more complicated than simply having eaten too much sugar.
However, preventing the escalation of prediabetes into type 2 diabetes can be simpler for some.
Approximately 22 percent of people diagnosed with prediabetes are able to prevent it from progressing to type 2 diabetes, according to a recent study from the Aging Research Center at the Karolinska Institute in Stockholm.
Research (Trusted Source) published this week concluded that one of the most crucial factors in preventing type 2 diabetes and bringing blood sugars back into a healthier range comes down to embracing a plant-based diet.
"Plant-based dietary patterns, especially when they are enriched with healthful plant-based foods, may be beneficial for the primary prevention of type 2 diabetes," explained the report.
"Plant-based" is a trendy term these days — and often implies veganism — but in this context, the focus of a plant-based diet is on eating mostly "real" food, including some animal protein and carbohydrates.
Processed Foods vs. Plant-Based Diet
The most immediate benefit of a plant-based diet on the prevention of type 2 diabetes is the impact that non-plant-based foods have on blood sugar levels and insulin resistance.
However, research suggests the impact is actually broader.
"Plant-based diets may also reduce the risk of type 2 diabetes through lowering the risk of excess weight gain," the researchers noted.
"Multiple interventional and observational studies have indicated that increased consumption of plant-based foods can lead to short-term weight loss or prevention of long-term weight gain," explained the researchers. "In turn, it is likely that a considerable proportion of the protective association between plant-based diets and risk of type 2 diabetes can be attributable to weight control."
Experts in diabetes care and prevention agree.
"What if we had a world without processed food in it?" said Mara Schwartz, CDE, RN, a coordinator of the Diabetes Prevention Program at Self Regional Healthcare in Greenwood, South Carolina. "We wouldn't have the weight problems we have now if it weren't for processed food. It would be very difficult to become obese while eating a whole-food, plant-based diet."
Indulging in a bag of chips and a milkshake is a lot easier than eating a bowl of homemade whipped cream with fresh blueberries and strawberries.
In Schwartz's work, she has seen the difference in outcomes when a client commits to changing their nutrition habits.
"People truly have to understand that what they put in their mouth affects their health," Schwartz, who has lived with type 1 diabetes for decades, told Healthline. "You're gonna have to commit to yourselves and acknowledge that your current diet is hurting you."
The recent research recommends focusing on a plant-based diet of fruits, vegetables, whole grains, legumes, and nuts.
"Moreover, refined grains, starches, and sugars can also be characterized as plant-based, although they are independently associated with a higher risk of type 2 diabetes," the researchers said.
The study also found a "protective" association against the development of type 2 diabetes when people consumed higher amounts of vitamins, minerals, and antioxidants through plant foods and lower amounts of red meats and processed meats.
The study doesn't advise against eating healthier animal products, such as organic eggs, and lean proteins, like chicken, turkey, and pork.
It Isn’t Just Insulin Resistance
The short-term and long-term effects of an unhealthy diet actually create a more serious problem with metabolism, cravings, and relationship with food.
Schwartz points to Susan Peirce Thompson, author of the book, "Bright Line Eating," who explained the destructive cycle that junk-quality food has on several aspects of the hormones related to our cravings and body weight.
"By eating the wrong foods, we increase our insulin levels," said Schwartz. "Increased insulin levels actually block the production of leptin."
Leptin is a lesser-discussed but crucial part of managing your appetite. It's a hormone produced by your body's fat cells and your small intestines. Its primary role is to regulate your appetite by signaling to your brain that you're full.
When a person develops "leptin resistance" from excessive amounts of leptin in their system along with insulin resistance, your brain thinks you're starving, creating an insatiable type of hunger that leads to mindless eating, craving junk food, and eating more processed carbohydrates.
Reversing this starts with making major changes in your diet by reducing heavily processed, packaged foods and focusing every meal on whole foods.
Transitioning to a plant-based diet doesn't require a costly diet program, buying "diet" products, or learning how to cook a variety of time-intensive, complicated meals.
Instead, start with a look at the nutrition labels on the packages of the processed foods you currently eat.
"If you can't pronounce half of the things on the list of ingredients, you shouldn't be eating it," advised Schwartz. "If you were cooking a meal with whole foods, you wouldn't go to the store and also buy common additives like Yellow 5 or sodium benzoate or carrageenan to put into that meal."
Processed foods, reminded Schwartz, were made for convenience and for profit, but few are actually healthy. Just because a box of cookies is labeled as organic doesn't mean it's not still a processed, packaged item void of any valuable nutrition.
Schwartz also cautions against filling your diet with vegan "plant-based" products such as frozen vegan meats.
"Sometimes when people follow a vegan diet, they're eating a lot of processed foods that are no better for you than a greasy burger. Just because something is vegan doesn't mean it's automatically healthy if it's loaded with highly processed ingredients like soy protein isolate, and a slew of preservatives, added flavors, chemicals, and tons of sodium," she said.
And it's important not to fall for advertising phrases such as "whole-grain" or "low-fat" on the packaging.
"Even a whole-wheat pasta is heavily processed. If it was truly whole wheat, you'd see chunks of actual wheat in there — and you don't because it's been broken down through processing, combined with a variety of additives, and packaged to make you think it's a whole food," Schwartz explained.
A low-fat, whole-wheat English muffin, for example, is still a heavily processed product that offers little to no original vitamins, minerals, or quality nutrition. It's made of processed flour and more than a dozen additives to make it taste good.
But what should you eat instead?
This Doesn’t Have to Be Complicated
"It doesn't take that much more time to make something that's not processed. You can buy riced cauliflower and spiralized zucchini noodles ready-to-go at the store these days," said Schwartz.
Breakfast could be eggs, berries, and a serving of whole oats, or a lower-carb option of almonds.
Lunch could be a giant bowl of greens with a serving of black beans, cucumber, chicken, and a careful serving of your favorite salad dressing.
You can make simple swaps for high-starch or highly processed grains, for example, including wild rice instead of white rice and farro or quinoa instead of pasta.
Sweet potato or brown rice may be high in carbohydrates — something to be careful about as a person with diabetes, since carbohydrates are the first macronutrient with the biggest impact on blood sugar levels — but they'll still offer far more nutrition and less of a blood sugar spike compared to processed bread and pasta.
If you do still want some pasta, Schwartz suggests quickly sautéing a variety of vegetables and then adding a small amount of pasta to the plate. Even though the goal is to focus on eating more vegetables, that doesn't mean it has to be entirely vegetables.
"It's very hard to overeat a healthy meal because the fiber from the vegetables is so filling," she said.
And the vegetables don't have to always have been freshly diced — a simple bag of frozen microwave vegetables is still better for you than a bag of chips.
What About Carbohydrates?
Typically, when you significantly reduce or remove animal products from your diet, you inevitably increase the amount of carbohydrate you're eating in order to still consume adequate calories.
For those with diabetes, even the American Diabetes Association has reversed its stance on low-carbohydrate diets as a tool for improving blood sugar levels. The organization now recommends a lower-carb approach.
Schwartz avoids carbohydrates in her personal diabetes nutrition management because she feels eating them simply leads her to crave more carbs, never feeling fully satisfied.
Other experts in diabetes care agree that a plant-based diet that includes too many servings of carbohydrates isn't the best option.
"I do not feel grains are a healthy choice for a diabetic," Ryan Attar, ND, MS, who lives with type 1 diabetes and has devoted his healthcare work at the Connecticut Integrative Medical Center to helping the diabetes population.
"What do grains offer our bodies? Very energy-dense, carbohydrate-dense foods, which have very little nutrient value. The amount of nutrients in grains are so low that by law grains must be fortified," Attar told Healthline.
Attar compared grains in general to a long chain of glucose molecules paired with a list of synthetic vitamins added to it.
He also argued that choosing brown rice over white won't have a big impact on how significantly it spikes your blood sugar.
"The amount of increased fiber and nutrients in whole grains is very small. Take a look at white versus brown rice. Both have the same amount of carbohydrates, 45 grams in 1 cup. The brown rice has 3 grams more fiber than white rice. Leaving you 41.5 grams of starchy carbohydrate versus 44.4 in white rice," he said.
Attar suggests nixing grains from your diet completely but still striving to eat a diet largely focused on plants.
"Get those nutrients from eating more non-starchy leafy greens instead," he said.
Blurry Lines of a ‘Healthy’ Diet
A plate full of plant-based food can still contribute to being overweight and higher blood sugar levels if you're not being mindful about how much you're eating.
"Portions do matter, no matter what you're eating," said Schwartz. "If you're eating a 12-ounce steak with three cups of mashed potatoes and a huge wallop of blue cheese dressing on your side salad, you're overdoing it."
Instead, cut the steak in half, swap the potatoes — or at least most of the potatoes — for greens. Keep the dressing on the side to dip your fork into instead of covering the salad with it.
"Eating something in moderation is also a very vague plan," said Schwartz, who often sees her clients struggle with using this common terminology to include less-than-healthy items in their diet too frequently.
Committing to a Plant-Based Diet
"The difference between the patients who succeed in improving their blood sugars and the patients who don't often comes down to a willingness to commit and make changes," said Schwartz.
"There's always an excuse if you let yourself make one for choosing junky processed food over real food. I've had a stressful day. I was hungry and the cafeteria was closed. I was at a party. I didn't say no to cake because I might offend someone. It's too expensive to eat healthy."
If you can afford cigarettes, Netflix, or fast food, you can afford healthier food.
"You learn how to eat from how you were raised, but you can change those habits, too. Take more ownership over the fact that you do have control over what you put in your mouth," said Schwartz.
Reposted with permission from our media associate Healthline.
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By Sara Lindberg
Whether you've hit a workout plateau or you're just ready to turn things up a notch, adding more strenuous exercise — also known as high-intensity exercise — to your overall fitness routine is one way to increase your calorie burn, improve your heart health, and boost your metabolism.
However, to do it safely and effectively, there are some guidelines you should follow. Keep reading to learn more about the benefits of vigorous exercise and how to safely dial up the intensity of your workouts.
What Is Considered Strenuous Exercise?<p>When it comes to exercise, the intensity of how hard you work out is just as important as the duration of your exercise session. In general, exercise intensity is divided into three categories:</p><ul><li>low</li><li>moderate</li><li>vigorous or strenuous</li></ul><p>For an activity to be vigorous, you need to work at 70 to 85 percent of your maximum heart rate, according to the<a href="https://www.heart.org/en/healthy-living/fitness/fitness-basics/target-heart-rates" target="_blank"> American Heart Association</a>. Examples of vigorous exercise include:</p><ul><li>running</li><li>cycling at 10 mph or faster</li><li>walking briskly uphill with a heavy backpack</li><li>jumping rope</li></ul><p>Low to moderate exercise is easier to sustain for longer periods since you work below 70 percent of your maximum heart rate and, sometimes, well below that level.</p><p>To reap health benefits, the <a href="https://www.hhs.gov/fitness/be-active/physical-activity-guidelines-for-americans/index.html" target="_blank">Physical Activity Guidelines for Americans</a> recommends that people age 18 and older get one of the following:</p><ul><li><strong>150 minutes</strong> of moderate-intensity aerobic activity per week</li><li><strong>75 minutes</strong> of vigorous aerobic activity per week</li><li><strong>combination of both types</strong> of activity spread throughout the week</li></ul>
Strenuous Exercise Vs. Moderate Exercise<p>Increasing your exercise intensity is fairly simple to do. You can still participate in your favorite activities — just at a more vigorous pace.</p><p>One of the benefits of more strenuous exercise is that you can reap the same rewards as moderate-intensity exercise but in less time. So, if time is of the essence, doing a more strenuous 20-minute workout can be just as beneficial as doing a slower 40-minute workout session.</p><p>Here are some examples of <a href="https://www.cdc.gov/nccdphp/dnpa/physical/pdf/pa_intensity_table_2_1.pdf" target="_blank">strenuous vs. moderate exercise<span></span></a>.</p><table><tbody><tr><th>Moderate intensity</th><th>Strenuous intensity</th></tr><tr><td>bicycling at less than 10 mph</td><td>bicycling at more than 10 mph</td></tr><tr><td>walking briskly</td><td>running, or hiking uphill at a steady pace</td></tr><tr><td>jog-walk intervals</td><td>water jogging/running</td></tr><tr><td>shooting baskets in basketball</td><td>playing a basketball game</td></tr><tr><td>playing doubles tennis</td><td>playing singles tennis</td></tr><tr><td>raking leaves or mowing the lawn</td><td>shoveling more than 10 lbs. per minute, digging ditches</td></tr><tr><td>walking stairs</td><td>running stairs</td></tr></tbody></table>
Benefits of Vigorous Exercise<p>Besides being more efficient, turning up the heat on your fitness sessions can benefit your health in a variety of ways. Let's take a closer look at some of the evidence-based benefits of a higher intensity workout.</p><ul><li><strong>Higher calorie burn.</strong> According to the <a href="https://www.acefitness.org/education-and-resources/professional/expert-articles/5008/7-things-to-know-about-excess-post-exercise-oxygen-consumption-epoc/?utm_source=Rakuten&utm_medium=10&ranMID=42334&ranEAID=TnL5HPStwNw&ranSiteID=TnL5HPStwNw-hYlKnAcfzfixAUsvnO6Ubw" target="_blank">American Council on Exercise</a>, working out at a higher intensity requires more oxygen, which burns more calories. It also contributes to excess post-exercise oxygen consumption (EPOC) or the "afterburn effect" that allows you to continue burning calories even after you finish working out. This means your metabolism will stay elevated for longer after a vigorous exercise session.</li><li><strong>More weight loss.</strong> A <a href="https://www.healthline.com/health-news/interval-workouts-will-help-you-lose-weight-more-quickly" target="_blank">higher calorie burn</a> and an elevated metabolism will help you lose weight more quickly than doing low- or moderate-intensity exercise.</li><li><strong>Improved heart health.</strong> According to a <a href="https://www.ncbi.nlm.nih.gov/pubmed/16377300" target="_blank">2012 study</a>, high- and moderate-intensity exercise appears to offer low chance of cardiovascular events, even in those with heart disease. Cardiovascular benefits may include improvements in:<ul><li><a href="https://www.healthline.com/health/diastole-vs-systole" target="_blank">diastolic blood pressure</a></li><li><a href="https://www.healthline.com/nutrition/15-ways-to-lower-blood-sugar#TOC_TITLE_HDR_1" target="_blank">blood sugar control</a></li><li>aerobic capacity</li></ul></li><li><strong>Improved mood.</strong> High-intensity exercise may also boost your mood. According to a large <a href="https://www.jstage.jst.go.jp/article/jpts/27/4/27_jpts-2014-736/_article" target="_blank">2015 study</a> that analyzed the data of more than 12,000 participants, researchers found a significant link between strenuous exercise and fewer depressive symptoms.</li><li><strong>Lower risk of mortality.</strong> According to a 2015 <a href="https://www.ncbi.nlm.nih.gov/pubmed/25844882" target="_blank">study</a>, researchers found that vigorous activity may be key to avoiding an early death. The study, which followed 204,542 people for more than 6 years, reported a 9 to 13 percent decrease in mortality for those who increased the intensity of their exercise sessions.</li></ul>
How to Measure Exercise Intensity<p>So, how do you know for sure that you're exercising at a strenuous level? Let's look at three ways to measure the intensity of your physical activity.</p><h3>1. Your heart rate</h3><p>Monitoring your heart rate is one of the most reliable methods for measuring exercise intensity. Exercising at 70 to 85 percent of your maximum heart rate qualifies as vigorous exercise intensity.</p><blockquote><strong><strong>WHAT IS YOUR MAXIMUM HEART RATE?</strong></strong>Your maximum heart rate is the fastest your heart can safely beat. To find out what your maximum heart rate is you need to subtract your age from 220. For example, for a 40-year-old person: <ul><li>220 bpm (beats per minute) minus age</li><li>220 – 40 = 180 bpm</li></ul>To work out at a vigorous pace, you'll want to exercise within 70 to 85 percent of your maximum heart rate. For example: <ul><li>180 x 0.70 (70 percent) = 126</li><li>180 x 0.85 (85 percent) = 153</li></ul>For a 40-year-old person, a vigorous training range is 126 to 153 bpm.<br></blockquote><p>You can check your heart rate while you're working out by wearing a heart rate monitor or <a href="https://www.healthline.com/health/how-to-check-heart-rate" target="_blank">taking your pulse</a>.</p>
How to Add Vigorous Activity to Your Workout<p>Adding strenuous activity to your weekly workout routine requires some careful planning. Fortunately, many of the activities that you do at a moderate level can easily be performed at a higher intensity.</p><p>One way of incorporating vigorous aerobic activity into your routine is to do a <a href="https://www.healthline.com/nutrition/benefits-of-hiit" target="_blank">high-intensity interval training (HIIT)</a> workout. This type of workout combines short bursts of intense activity — typically performed at 80 to 95 percent of your maximum heart rate — with recovery periods at 40 to 50 percent maximum heart rate.</p><p>To sustain this level of training, consider following a 2:1 work to rest ratio. For example, a <a href="https://www.healthline.com/health/treadmill-weight-loss#hiit" target="_blank">treadmill workout </a>or outdoor running session could include:</p><ul><li>running at 9 to 10 mph for 30 seconds</li><li>followed by walking at 3 to 4 mph for 60 seconds</li><li>alternating this work-to-rest ratio for 20 to 30 minutes</li></ul><p>Playing a fast-paced sport like soccer, basketball, or racquetball is another effective way to add strenuous activity to your fitness routine. Participating in <a href="https://www.healthline.com/health/benefits-of-a-spin-class" target="_blank">cycling classes</a> or swimming laps are other ways to build more strenuous exercise into your workouts.</p>
Safety Tips<p>Before you turn up the intensity on your workouts, it's important to keep the following safety tips in mind.</p><h3>Check with your doctor</h3><p>If you have a health condition or you haven't been active in a while, make sure you talk to your doctor before you start a high-intensity exercise routine. Your doctor can advise you on a safe level of exercise or how to become more active in the safest way possible.</p><h3>Build up the intensity slowly</h3><p>Going from low- or moderate-intensity workouts to vigorous exercise requires time and patience. While you may be ready to jump in with both feet, the safest way to add more vigorous exercise is to do it in bite-size increments. Pushing yourself too quickly can result in injuries and burnout.</p><p>For example:</p><ul><li><strong>Week 1:</strong> Swap out one moderate-paced cardio session for a HIIT workout.</li><li><strong>Week 2:</strong> Swap one moderate-paced session with a HIIT workout, and also add a circuit strength training session to your weekly routine.</li><li><strong>Week 3 and 4: </strong>Repeat weeks 1 and 2 before you start adding more high-intensity exercise to your weekly routine.</li></ul><p>It's also a good idea to space out your vigorous workouts throughout the week. Try not to do two strenuous sessions back-to-back.</p><h3>Don't forget the recovery time</h3><p>Your body requires more time to recover from a vigorous workout compared to a low- or moderate-intensity session.</p><p>To help your body recover, make sure to always include a cooldown and <a href="https://www.healthline.com/health/exercise-fitness/static-stretching" target="_blank">stretch routine</a> after strenuous physical activity.</p><h3>Stay hydrated</h3><p><a href="https://www.healthline.com/nutrition/7-health-benefits-of-water" target="_blank">Staying hydrated</a> is especially important when you're exercising hard. Not drinking enough fluids can affect the quality of your workout and make you feel tired, lethargic, or dizzy. It may even lead to <a href="https://www.healthline.com/health/dehydration-headache" target="_blank">headaches</a> and <a href="https://www.healthline.com/health/pain-relief/how-to-stop-leg-muscle-cramps" target="_blank">cramps</a>.</p>
The Bottom Line<p>Turning up the intensity of your workout sessions can be an effective way of boosting your overall health and fitness. It's also an easy way to save time when trying to fit a workout into your day.</p><p>To play it safe, always start slow and pay attention to how your body feels.</p><p>While vigorous exercise offers many health benefits, it's not appropriate for everyone. If you have a health condition or you haven't been active in a while, make sure to talk with your doctor before working out at a more strenuous level.</p>
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By Jeffrey Miller
In January 2015, food sales at restaurants overtook those at grocery stores for the first time. Most thought this marked a permanent shift in the American meal.
Solving the Age-Old Problem of Spoiled Cheese<p>People have eaten pasta and cheese together for hundreds of years. Clifford Wright, the doyen of Mediterranean food history, says <a href="http://www.cliffordawright.com/caw/food/entries/display.php/topic_id/16/id/105/" target="_blank">the first written recipe</a> for macaroni and cheese was created in the court of the king of Naples in the 13th century, while <a href="https://food52.com/blog/9916-the-history-of-macaroni-and-cheese" target="_blank">the first reference</a> in an English language cookbook likely appeared in Elizabeth Raffald's 1769 book "The Experienced English Housekeeper."</p><p><span></span>An internet search for macaroni and cheese recipes will turn up over 5 million hits, but many still prefer to get theirs in a box – the kind with pasta that comes in shapes ranging from shells to Pokemon characters, accompanied by a packet of powdered cheese sauce.</p><p>Boxed macaroni and cheese was one outcome of the quest for ways to keep cheese longer. Some cheese gets better as it ages – a well-aged cheddar is one of life's delights – but once most cheeses hit their prime, <a href="https://www.dairyfoods.com/articles/91548-how-to-maximize-cheese-shelf-life" target="_blank">they tend to quickly go bad</a>. Before household refrigeration became common, many retailers wouldn't even stock cheese in the summer because it spoiled so quickly.</p><p>Processed cheese solved this age-old problem.</p>
When Natural Was Nasty<p>Today, food that's simple, pure and natural is <a href="https://theconversation.com/how-was-french-cuisine-toppled-as-the-king-of-fine-dining-66667" target="_blank">all the craze</a>, while <a href="https://apnews.com/c06a1200807c4b82a03452d08d480692" target="_blank">disdain for processed foods</a> is practically a credo among sophisticated consumers.</p><p>But when Kraft's different forms of processed cheese came out, they found widespread acceptance despite their strange textures. The fact that it wasn't natural didn't seem to bother consumers at all. In fact, as international food historian Rachel Laudan <a href="https://online.ucpress.edu/gastronomica/article/1/1/36/93394/A-Plea-for-Culinary-Modernism-Why-We-Should-Love" target="_blank">has noted</a>, back then, "natural was something quite nasty." She describes fresh milk as warm and "unmistakably a bodily secretion." Throughout the history of cookery, most recipes aimed to transform an unappetizing raw product into something delightful and delectable.</p><p>So for most consumers, processed foods were a godsend. They kept well, tended to be easily digestible and, most importantly, they tasted good. Many of them could be easily prepared, freeing women from spending entire days cooking and giving them more time to pursue professions and avocations.</p><p>In some ways, processed foods were also healthier. They could be fortified with vitamins and minerals, and, in an era before everyone had access to mechanical refrigeration, the fact that they kept well meant consumers were less likely to contract diseases from spoiled, rotten foods. Pasteurization of dairy products virtually <a href="https://www.the-scientist.com/foundations/rethinking-raw-milk--1918-65126" target="_blank">eliminated diseases like undulant fever</a>, while foods processed and canned in large factories were less likely to harbor food-borne illnesses that could crop up due to faulty or improperly sanitized equipment used by home canners.</p>
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Some fires won't die.
They survive underground during the winter and then reemerge the following spring, as documented in places like Alaska. They're called "overwintering," "holdover," or "zombie" fires, and they may have now awoken in the Arctic Circle — a fast-warming region that experienced unprecedented fires in 2019. The European Union's Copernicus Atmosphere Monitoring Service is now watching these fires, via satellite.