Team Metabolic Health

Ozempic maker Novo Nordisk on Wednesday said data showed its hotly anticipated weight loss pill prompts greater and more rapid weight loss than its blockbuster treatment Wegovy, amid competition from Mounjaro maker Eli Lilly, pharma titans like Pfizer and biotech upstarts.

Novo Nordisk is developing a weight loss pill. (GETTY)

Key Facts

Participants taking Novo Nordisk’s experimental weight loss treatment amycretin lost up to 13% of their body weight over 12 weeks in an early stage Phase 1 clinical trial, according to an abstract of data to be presented at the annual meeting of the European Association for the Study of Diabetes in Madrid on Wednesday.

In the early stage trial, Novo evaluated how patients fared when taking one or two 50 mg amycretin pills a day or an inert placebo.

Patients taking two pills a day lost up to 13% of their body weight after 12 weeks and patients taking one amycretin pill a day had weight loss of more than 10%, according to the abstract data, while those on the placebo had 1.1% weight loss.

While the study does not compare amycretin directly against existing obesity treatments and has not been subjected to external scientific scrutiny by publication in a peer reviewed journal, the results hint at the potential for greater and more rapid weight loss than Novo’s blockbuster injection Wegovy, which was around 6% at 12 weeks.

Novo said the trial suggests the drug is safe and has a similar side effect profile to Wegovy and Ozempic, which commonly includes mild or moderately severe gastrointestinal complaints like nausea, vomiting and diarrhea.

Amycretin targets the same GLP-1 hormone as other weight loss and diabetes drugs like Novo’s Ozempic and Wegovy and Lilly’s Mounjaro and Zepbound, as well as stimulating receptors for another hormone, amylin, which regulates hunger.

When Will Weight Loss Pills Be Available?

The best weight loss drugs on the market at the moment, Lilly’s tirzepatide and Novo’s semaglutide, are only available as injections, which many people find off putting and can be challenging and expensive to produce. Pharma titans like Pfizer, Roche and Novo, are all racing to crack into this lucrative sector with alternatives like weight loss pills and early data suggests they could be as, or even more, effective than current treatments. However, obesity pills are unlikely to replace injections completely. Experts told Forbes oral medications can often come with restrictive dietary practices, like taking it on an empty stomach, that many users find unappetizing, and need to be taken daily rather than less frequent weekly injections. It can also be challenging to find a formulation that works well and is tolerated by patients and the less direct method of delivery means pills often require more of the active ingredient to produce the same effect, a major supply issue given chronic shortages for injections already on the market.

What To Watch For

Though the trial is small, Novo’s head of development Martin Lange Holst said the results are promising and justify further clinical research into the pill. Novo is also testing a subcutaneous form of amycretin that, like Wegovy, would be delivered by regular injection. The early stage trial is ongoing and data is expected to be released in 2025. Novo will decide whether to accelerate development of amycretin and proceed directly to a large-scale Phase 3 trial—skipping an intermediate stage of testing to what is often the last stage of testing before a company seeks regulatory approval—in a pill or subcutaneous form once this data is available, Holst reportedly said.

Credit: Forbes

Team Metabolic Health

Pfizer (PFE.N), opens new tab is trying to increase doctor awareness of and testing for a rare lung cancer mutation to help boost use of its drug Braftovi, which the pharmaceutical maker anticipates could grow to become the standard of care.

The company presented three-year follow-up data from a Phase 2 study on Saturday looking at patients with BRAF V600E-mutant metastatic non-small cell lung cancer who received Braftovi and another Pfizer drug, Mektovi, as a first treatment. The study showed they had a median of over two-and-a-half years of progression-free survival, a measure of how long treated patients live before their cancer gets worse.

Pfizer company logo is seen at a Pfizer office in Puurs, Belgium, December 2, 2022. REUTERS/Johanna Geron/File Photo 

Chris Boshoff, Pfizer’s Chief Oncology Officer, said the new data supports the use of the drug as standard of care for that group and said it expects to get market penetration of up to 60% in lung cancer patients with the mutation.

He said approximately 2% to 3% of lung cancers have the mutation in question.

Standard of care for such patients is currently an immunotherapy paired with chemotherapy, Boshoff said. The combination of Braftovi and Mektovi has been approved for patients with non-small cell lung cancer with the mutation since last year.

“All patients with lung cancer should be tested for BRAF mutations, and that could be done with a simple blood test,” he said. “It’s a relatively easy test to identify these patients who clearly would benefit significantly from having a targeted therapy.”

He said that fewer than 50% of lung cancer patients in the U.S. are currently tested for the mutation. That number is even lower globally.

“This is a space where Pfizer is particularly well equipped, not just in the US, but globally, to encourage testing and to help educate physicians, pathologists, patients, and patient advocate groups,” Boshoff said. He said the test is covered by insurance in the U.S.

What if robots had artificial muscles?

Pfizer sold close to $400 million of Braftovi and Mektovi last year, but analysts are not currently forecasting significant growth for the drugs, according to LSEG data.

One area where Boshoff said Braftovi could expand its market is in colorectal cancer, where BRAF-mutated cancers make up 10% of the cancers. Data from the company’s late-stage study in colorectal cancer is expected to be announced by the end of the year, he said.

Credit: Reuters

Team Metabolic Health

A popular prescription drug that is used to treat type 2 diabetes or to manage weight in adults seems to be both safe and effective for weight loss in children – at least in the short term, according to new results.

Liraglutide (brand name Victoza or Saxenda) belongs to the same class of medicine as semaglutide, which is the drug behind Ozempic and Wegovy.

The subcutaneous injection was first approved in the US as an adjunct therapy for type 2 diabetes in 2010. Four years later, it was approved for weight management in adults who are considered overweight or obese.

Despite its surging popularity, the long-term effects of liraglutide and similar drugs are still being investigated, even among adults. Their use among children remains controversial.

While some scientists have warned that liraglutide may be dangerous or have unintended consequences for kids in the long run, in 2019, the US Food and Drug Administration approved liraglutide for use in patients with type 2 diabetes who are 10 years or older.

To date, no medications are currently approved for the treatment of obesity in children younger than 12.

A phase 3 clinical trial among 82 participants has now provided initial results that liraglutide, combined with other lifestyle interventions, is both safe and effective as a weight loss drug for children as young as six years old.

Roughly a year after starting the trial, which was funded by liraglutide maker Novo Nordisk, participants between the ages of 6 and 12 who were given the liraglutide reduced their body mass index by 5.8 percent. Those given a placebo over the same period showed increased BMIs by about 1.6 percent.

Children at this age are still growing, so it is expected that some weight gain would occur without drug treatment over the course of a year.

All participating children were counseled by qualified health care professionals and encouraged to eat healthily and exercise for an hour or so a day.

“In our study, diastolic blood pressure and… a measure of blood sugar control improved more in children receiving liraglutide than in those receiving the placebo,” explains lead researcher and pediatrician Claudia Fox from the University of Minnesota Twin Cities. Fox has received grant and contact support from Novo Nordisk and another pharmaceutical company, Eli Lilly.

The prevalence of negative side effects was about the same among both groups, although transient gastrointestinal issues, like nausea and vomiting, were nearly 30 percent more common in the liraglutide group.

“To date, children have had virtually no options for treating obesity,” argues Fox.

“They have been told to ‘try harder’ with diet and exercise. Now with the possibility of a medication that addresses the underlying physiology of obesity, there is hope that children living with obesity can live healthier, more productive lives.”

In an accompanying editorial, pediatricians Julian Hamilton-Shield and Timothy Barrett argue that Fox and her colleagues have provided “much-needed evidence” for the effects of liraglutide on young children with obesity.

But body composition was not measured in the trial, and BMI is a poor surrogate for fat mass, they note.

After treatment was ceased, children in the liraglutide group of the trial showed increased BMI scores, “which is worrisome because it implies the ongoing need for pharmacotherapy to prevent BMI rebound,” explain Hamilton-Shield and Barrett.

The same concerns also apply to adults taking these medications. Once the injections are stopped, studies have found the average patient typically regains about two-thirds of their lost weight within a year.

Significant fluctuations in weight during childhood could be a serious risk for ongoing development.

In a commentary published last year, some scientists (with no conflicts of interest to declare) warned that “little attention has been paid to the possible unintended consequences or adverse impact of these medications on children and adolescents during their critical period of growth and development.”

Given that the long-term side effects of incretin mimetics are still being realized in adults, there’s every reason to tread cautiously.

The study was published in the New England Journal of Medicine.

Credit: sciencealert.com

Team Metabolic Health

Reducing fat accumulation may help mitigate risk, per new study

A higher volume of epicardial adipose tissue (EAT) — meaning more fat accumulated near the heart muscle and arteries that supply the heart — significantly increases the risk for early heart disease in people with Cushing’s syndrome.

That’s according to a study from China that assessed risk factors for left ventricular diastolic dysfunction, or LVDD, a condition that affects the ability of the heart’s left ventricle, or chamber, to fill with blood before contraction.

“These results suggested that reducing EAT accumulation may be promising to mitigate the risk of LVDD development in patients with [Cushing’s syndrome],” the researchers wrote.

The study, “Epicardial adipose tissue volume highly correlates with left ventricular diastolic dysfunction in endogenous Cushing’s syndrome,” was published in Annals of Medicine.

Higher risk of heart disease seen for patients vs. healthy people

Cushing’s syndrome comprises a group of conditions characterized by high levels of the stress hormone cortisol, produced by the adrenal glands, located atop the kidneys.

Cushing’s disease, the most common form of the syndrome, is caused by a tumor in the brain’s pituitary gland, which produces excessive levels of ACTH, a hormone that triggers cortisol production.

The syndrome is associated with several risk factors of cardiovascular disease, including diabetes, marked by high levels of blood sugar, high blood pressure, also known as hypertension, and dysregulation of the levels of fatty molecules in the blood. Cardiovascular complications are the main cause of death in this patient population.

Additionally, evidence suggests that exposure to excessive levels of cortisol may cause changes in the heart’s structure and function, and increase the risk of heart failure.

Now, a team of researchers from Tongji Medical College at Huazhong University of Science and Technology set out to evaluate the potential impact of high cortisol levels on certain types of body fat, including EAT. The team also sought to identify risk factors for LVDD, an underlying mechanism associated with heart failure, in people with Cushing’s syndrome.

The researchers retrospectively analyzed data from 86 adults with endogenous Cushing’s, and 86 healthy people matched for age, sex, and body mass index (BMI), a ratio of height and weight (used as the control group).

Cushing’s disease was the most common form of the syndrome, accounting for the diagnosis of 48 patients (55.8%).

Compared with the control group, the individuals with Cushing’s had significantly higher cardiovascular risk factors, including higher blood pressure, higher blood sugar levels, and more severe problems with fat metabolism. Also, a significantly higher proportion of these patients had hypertension (74.42% vs. 6.98%) and diabetes (48.84% vs. 2.33%) relative to the controls.

Moreover, Cushing’s patients had significantly higher EAT volume (150.3 vs. 90.6 cubic centimeters) and area of visceral fat, or the fat that accumulates around abdominal organs (166.81 vs. 80.28 cubic centimeters). There also were significant differences regarding heart structure and function parameters between the two groups.

More study needed into impact of excess corisol on fat deposits

A total of 50 patients (58.1%) had LVDD, while the remaining 36 (41.9%) did not. Those with LVDD were significantly older, had significantly higher EAT volume (175.28 vs. 142.16 cm3) and visceral fat area (194.06 vs 152.14 cm2), and a significantly lower E/A ratio, a measure of left ventricle function.

Moreover, EAT volume was significantly higher in patients with ACTH-dependent Cushing’s (173.6 vs. 129.91 cm3), as well as visceral fat (188.7 vs. 145.2 cm2), compared with those with ACTH-independent Cushing’s.

Statistical analyses adjusted for potential influencing factors showed that a higher EAT volume was significantly and independently associated with an increased risk for LVDD.

In turn, higher blood levels of HDL-C — known as so-called good cholesterol — and higher estimated glomerular filtration rate, indicating better kidney function, were protective factors against LVDD.

Using a cutoff value of 139.252 cubic centimeters, EAT volume was able to discriminate Cushing’s patients with LVDD with a sensitivity of 84% sensitivity and a specificity of 55.6%. A test’s sensitivity is its ability to correctly identify those with a given disease, while specificity refers to correctly identifying those without it.

Overall, “these results underscored the potentially pivotal role of excessive cortisol-induced EAT deposition in the development of LVDD in [Cushing’s syndrome] patients,” the researchers wrote.

“Future studies with larger sample sizes are required to validate our results and explore the impact of excess cortisol on EAT deposition, as well as identify additional risk factors for the development of LVDD in [Cushing’s],” the team concluded.

Credit: cushingsdiseasenews.com

Team Metabolic Health

The market for weight-loss treatments is expected to see 16 new drugs vying for a slice of the lucrative business currently dominated by Novo Nordisk (NOVOb.CO), opens new tab and Eli Lilly (LLY.N), opens new tab, according to estimates from analysts at Morningstar and Pitchbook.

In a joint report published on Monday, analysts estimated the market for obesity treatments could expand to $200 billion by 2031. The 16 drugs could launch by 2029, with roughly $70 billion of the GLP-1 market coming from these new challengers.

Boxes of Wegovy made by Novo Nordisk are seen at a pharmacy in London, Britain March 8, 2024. REUTERS/Hollie Adams/File Photo

The market for weight-loss treatments is expected to see 16 new drugs vying for a slice of the lucrative business currently dominated by Novo Nordisk (NOVOb.CO), opens new tab and Eli Lilly (LLY.N), opens new tab, according to estimates from analysts at Morningstar and Pitchbook.

In a joint report published on Monday, analysts estimated the market for obesity treatments could expand to $200 billion by 2031. The 16 drugs could launch by 2029, with roughly $70 billion of the GLP-1 market coming from these new challengers.

WHY IT’S IMPORTANT

Surging demand for Novo’s Wegovy and Lilly’s Zepbound has sparked interest among competitors to test their own weight-loss treatments. Companies such as Amgen (AMGN.O), opens new tab and Pfizer (PFE.N), opens new tab are currently testing their drug candidates in clinical trials.

These developments come amid criticism from lawmakers over the high costs associated with these medications. The new entrants, however, are expected to drive down prices as they vie for market share, according to the report.

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CONTEXT

The potential new treatments include those from Boehringer Ingelheim and Zealand Pharma (ZELA.CO), opens new tab, along with competitors from Roche (ROG.S), opens new tab, Amgen (AMGN.O), opens new tab and Pfizer (PFE.N), opens new tab, according to the report, provided that the drugs clear clinical trials.

Other entrants include those by Structure Therapeutics (GPCR.O), opens new tab, Viking Therapeutics (VKTX.O), opens new tab and Altimmune (ALT.O), opens new tab, along with next-generation drugs by Novo and Lilly.

Analysts, last year, had forecast the obesity market would be $170 billion by 2031, but have recently raised their estimates, partly due to anticipated higher diabetes market penetration.

The report projects 41% individuals with diabetes and nearly one-quarter of nondiabetic obesity patients will be on a GLP-1 drug by 2031.

WHAT’S NEXT

Analysts expect significant acquisitions by major pharmaceutical companies in the obesity sector over the next 18 months, targeting smaller companies specializing in obesity drug development.

Potential acquisition targets include firms such as Structure, Viking and Altimmune.

Private companies such as NodThera, Corteria and Diasome have a higher-than-50% chance of being acquired, according to PitchBook data.

Credit: Reuters

Team Metabolic Health

Liraglutide is an older version of the popular GLP-1 drugs, which include Ozempic. But questions remain about starting kids on a lifelong drug so young.

In a late-stage clinical trial, a drug similar to Ozempic was shown to reduce body mass index in kids ages 6 to 11 with obesity, according to results published Tuesday in the New England Journal of Medicine.

The findings bring the phenomenon — and the controversy — of the latest new and powerful weight loss drugs to the youngest age group yet. With the exception of drugs for rare genetic disorders that cause obesity, there are no pharmaceutical options for obesity in children under 12.

The new trial looked at liraglutide, the active ingredient used in two of Novo Nordisk’s older GLP-1 drugs: Saxenda, a weight loss drug, and Victoza, a diabetes drug. Semaglutide, another GLP-1 also from Novo Nordisk, is the drug in Ozempic and Wegovy. 

All are intended for lifelong use.

Given that 6 to 11 are crucial ages for a child’s development, there are concerns about how the medications might impact their growth, said Dr. Roy Kim, a pediatric endocrinologist at Cleveland Clinic Children’s in Ohio.

“We do not know the long-term effectiveness and safety of these medicines in children,” Kim said. “While the medicine was well tolerated, there are concerns about this category of medicines and possible pancreas problems, thyroid cancer risk and bone health over the lifetime.”

A growing number of kids in the U.S. have obesity, including 1 in 5 kids ages 6 to 11, according to the Centers for Disease Control and Prevention. 

How well the drug works

The trial included 82 children with an average BMI of 31 who either got a once-daily injection of liraglutide or a placebo for 56 weeks. 

Every child and their parents in the study also met regularly with a lifestyle coach to discuss healthy eating and exercise before starting the injections, said lead study author Dr. Claudia Fox, an associate professor of pediatrics at the University of Minnesota. Fox serves as a principal investigator for clinical trials sponsored by both Novo Nordisk and Eli Lilly.

Once the kids began taking the medication, they met less often with the coaches — about once every one to two months, Fox said. 

Figuring out how well the drug worked wasn’t as simple as measuring weight loss because the kids are still growing, and each child grows at different rates, Fox said. So instead of looking at overall weight loss like in adult studies, they decided to focus more on BMI, which takes into account both weight and height.

“A five-pound change for a 6-year-old is very different from a five-pound change for a 10-year-old,” she said.  

After 56 weeks, kids who got liraglutide saw an average BMI reduction of 5.8%, while the kids who got a placebo saw a 1.6% increase. Nearly half of the kids on liraglutide saw their BMI go down by at least 5%, compared to just 9% in the placebo group.

“To me, this sort of suggests that perhaps it is better to intervene earlier rather than wait until a kid is an adolescent,” Fox said.

The medication was well tolerated — similar to the findings in the adult trials — although gastrointestinal side effects were more common in the kids who got liraglutide, she said. The most common side effect was vomiting, followed by nausea and diarrhea. Older kids, she added, were able to give themselves the injections, while younger kids needed their parents to do it.

A spokesperson for Novo Nordisk said that it has submitted an application to the Food and Drug Administration to expand the approval of liraglutide for weight loss in children ages 6 to 11. 

Is 6 too young for a weight loss drug? 

As childhood obesity rates rise, some doctors have advocated for more aggressive approaches and earlier treatments. 

In 2023, the American Academy of Pediatrics released new guidelines for treating childhood obesity, recommending for the first time weight loss drugs and, in some cases, surgery for children ages 12 and up. For kids under 12, the guidelines endorsed working closely with pediatricians and other health care providers to focus on lifestyle changes.

Dr. Sarah Armstrong, a professor of pediatrics at Duke University and a co-author of the American Academy of Pediatrics guidelines, said that medication will probably be necessary for children with severe obesity; that is, a BMI of at least 35.

“It is pretty clear that without effective treatment, this does tend to get worse, not better, over time,” Armstrong said. “If a child has severe obesity and maybe has developed some early life comorbidities, it’s probably the right thing to do.”

Still, she has some concerns about use of medications in young kids because of the long-term nature of treatment.

“What happens to kids if you put them on medication that makes them less hungry while they’re still growing?” Armstrong said. “Are they going to have delayed puberty? Are they going to have delayed growth? Will it somehow affect their bone density? Will it create disordered eating patterns that are going to cause other problems later in life?” 

Kim, of Cleveland Clinic Children’s, said the weight loss in the trial was “relatively small” but promising. He also noted shortcomings of the trial, including that the study group and duration was small, with only 82 children taking the drug or a placebo for 56 weeks.

He also noted that the ethnic and racial makeup of the children in the trial “does not reflect the populations most seriously impacted by the obesity epidemic.” More than two-thirds of the kids in the trial were white. 

Despite the shortcomings, “it is exciting because it is a taste of what’s to come,” Kim said. “We know there are more potent medicines, given once a week, that are on the market and approved for adults and adolescents.”

Wegovy, approved for people ages 12 and up, is a weekly injection, as is Zepbound, from Eli Lilly. Zepbound is only approved for adults.

Dr. Shauna Levy, a specialist in obesity medicine and the medical director of the Tulane Bariatric Center in New Orleans, said that while diet and exercise must continue to be mainstays for treating children with obesity, some kids would benefit from the drug.

“In my practice, I have seen 18 year olds with BMI of 60+ that are already suffering from their disease,” Levy wrote in an email. “We have long thought that weight is something that kids grow out of as they age; now that we understand obesity better we know that not only do not grow out of obesity, but it needs to be actively treated.”

Credit: NBC News

Team Metabolic Health

A daily weight loss pill from Novo Nordisk was shown to lower body weight by up to 13% after three months in a Phase 1 clinical trial, according to findings presented Tuesday at the European Association for the Study of Diabetes annual meeting in Spain.

The rate of weight loss with the experimental pill, called amycretin, appears to be more rapid than what’s seen for other drugs.

“It’s roughly double the weight loss rate seen with current GLP-1 agonists and approaching procedural or surgical-level outcomes,” said Dr. Christopher McGowan, a gastroenterologist who runs a weight loss clinic in North Carolina. “It shows potential promise.”

Dr. Susan Spratt, an endocrinologist and the senior medical director for the Population Health Management Office at Duke Health, said the results looked impressive.

“How could they achieve weight loss that quickly?” Spratt asked. “It’s almost like a miracle pill.”

The findings are early — more research is needed, particularly over a longer period of time — and the drug can’t be directly compared to existing weight loss drugs because they weren’t tested in a head-to-head trial. The results also haven’t been published in a peer-reviewed journal.

Credit: NBC News

Team Metabolic Health

A healthy Indian plate should have fruits and veggies in one half, and pulses, millets and eggs in another half.

A balanced diet consists of all the important nutrients required for the body to generate energy for proper functioning. The bodily functions carried out at all times require energy that we get from the food choices that we make. From plant-based diet to animal protein, the diet we consume should have all the essential nutrients. From protein, to carbohydrates, to healthy fats to vitamins to minerals, the body requires each of these nutrients.

According to the guidelines, a healthy plate of food should consist of fruits and vegetables as the half. The other half should consist of cereals, millets, pulses, flesh foods, eggs, nuts, oilseeds, milk and curd. (Unsplash)

Dietary guidelines for Indians:

According to the Dietary guidelines for Indians 2024, developed by Indian Council for Medical Research (ICMR) and National institute for Nutrition, for a 2000 Kcal Indian diet per day, certain portions are recommended for healthy eating. According to the guidelines, a healthy plate of food should consist of fruits and vegetables as the half. The other half should consist of cereals, millets, pulses, flesh foods, eggs, nuts, oilseeds, milk and curd.

However, according to the dietary patterns observed in Indians, people tend to consume less micro-nutrient rich food items such as whole grains, pulses and fresh produce. People also have the chronic habit of overconsuming cereals. The guidelines further stated that cereals can be consumed for 45 percent of the daily energy needs – for the rest of energy, we should focus more on less carbohydrate-rich nutrients.

The ICMR and NIN guidelines further observed the chronic unhealthy dietary patterns in Indians – ultra processed foods high in sugars, salt and fats can contribute to health conditions. This unhealthy eating habit combined with a sedentary lifestyle further contributes to micronutrient deficiencies and obesity rates. The study further observed the role of aggressive marketing in influencing people to make dietary preferences – this had steered people away from nutritious choices on their plate. In foods and beverages, high content of sugar, sodium and saturated fats can harm health.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Credit: Hindustan Times

Team Metabolic Health

An epilepsy drug could help people with a common breathing problem that causes them to snore and gasp loudly at night, it has been claimed.

Sulthiame, a drug sold under the brand name Ospolot, appeared to reduce symptoms of obstructive sleep apnoea in a recent international clinical trial of 298 patients.

Lead author Jan Hedner, professor of respiratory medicine at Sahlgrenska University Hospital in Gothenburg, Sweden, found improvements in those on the highest doses of the drug.

Bhik Kotecha, consultant ear, nose and throat surgeon at Nuffield Health Brentwood Hospital, Essex, said lifestyle changes such as weight loss and reduced alcohol intake could also help with sleep apnoea.

Professor Kotecha described sleep apnoea as a condition in which a patient stops breathing momentarily, but repeatedly, during sleep.

He said: “The main symptoms of sleep apnoea include snoring, poor and fragmented sleep, periodic gasping for breath, morning headaches and daytime sleepiness.”

Ms Hedner found after 12 weeks, those taking Sulthiame had up to 50% fewer occasions where their breathing stopped and higher levels of oxygen in their blood during sleep.

A common misconception is that snoring and sleep apnoea are the same thing.

What causes general snoring?

“Snoring occurs as a result of a turbulent airflow and can affect both children and adults,” explained Mr Kotecha.

“If the airway becomes constantly obstructed, then the patient could develop sleep apnoea.”

Children often snore due to enlarged tonsils and adenoids.

“There is a plethora of evidence that demonstrates that the removal of tonsils and adenoids in these children dramatically improves their quality of sleep as well as their cognitive function,” said Mr Kotecha.

“In adults, the problem could be due to an obstruction in the nose as a result of a deviated nasal septum or nasal polyps.

“More commonly, it is the redundant, floppy soft palate in the throat that is the culprit.”

But, because the majority of symptoms happen when asleep, it can be hard to detect.

How can it be treated?

As the effects of Sulthiame need to be investigated further, Mr Kotecha said there were other ways to treat the condition.

Options included nasal CPAP (continuous positive airway pressure), oral appliances, nasal sprays, antihistamines and lifestyle changes like weight loss and reduced alcohol intake.

Surgeries such as minimally invasive radiofrequency surgery, tonsillectomy and laser or robotic surgery can also be offered to select patients.

“Minimally invasive radiofrequency surgery can improve the upper airway by shortening and stiffening the soft palate, reducing the bulkiness of the tongue and improving nasal patency,” added Mr Kotecha.

Credit: BBC News

Team Metabolic Health

Microwaves preserve a lot more nutrients in food than traditional methods of cooking, states the nutritionist.

Microwaves are one of the best technological innovations that can reheat or bake food items in very less time, without us supervising the cooking. However, how safe is it? Does it zap the nutrients out of the food items and make it less healthy for our consumption? Nutritionist Shyla Cadogan, RD, in a recent article, delved into the mechanisms to find answers.

Microwaves use electromagnetic waves that are absorbed in the molecules of the food – this allows the food to get cooked faster (AI generated)

How do microwaves cook food?

Microwaves use electromagnetic waves that are absorbed in the molecules of the food – this allows the food to get cooked faster. It has been observed that even in traditional methods of cooking – such as stir frying, or boiling can affect the nutrient composition in food in some ways. It has been observed that cutting the vegetables into too small pieces can also make them lose their nutrient composition in some ways – this effect is seen lesser in the case of microwaves.

Nutrients that are preserved:

Nutrients such as carbs, fats, proteins, and fiber are required for the body to generate energy – microwaves ensure to preserve these nutrients in food. Microwaves lower the energy and require comparatively less time to cook the food, more nutrients can be preserved in the process. The sodium, potassium, and phosphorus content are also preserved in the food when we microwave it.

Is standing in front of microwave safe when it’s on?

According to the strong safe standards followed by the manufacturers of microwaves, it is considered safe to stand in front of a microwave when it is switched on. However, it is still advised to avoid standing in front of it, in case there is a leak or damage that we cannot predict.

The nutritionist further stated that while cooking in any form can affect the nutrient composition in food, microwaving food is a lot more convenient and healthier alternative to the traditional methods. Reheating food using the microwave can actually preserve a lot more nutrients than doing it in a pan on stove.

Disclaimer: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.

Credit: Hindustan Times

Team Metabolic Health

The change of seasons brings mood changes known as “autumn fatigue” for some workers.

“Stresstember” has arrived—bringing weather changes, routine shifts and a higher risk of burnout. With Google searches for “fall fatigue” up 348%, it’s clear early fall is a challenging transition for many workers. Autumn fatigue is real, and it comes with the natural changes that come along as summer turns to fall.

Pix Credit: GETTY

The end of summer, marked by shortening days, a cloud of malaise and anxiety and back-to-office mandates, can lead to a stessed out and sometimes a burnt-out workforce. Productivity drops by 20% during summer, with over half feeling distracted and many struggling with post-vacation blues and the September surge once they’re back at work.

It’s no wonder that boosting productivity is a top priority in early fall. But for some workers, the “winter blues” and seasonal affective disorder (SAD) are challenges. If you’re like most people with SAD, your symptoms start in the fall and continue into the winter months, sapping your energy and making you feel moody. The changes in the amount of daylight can affect the body’s circadian rhythm (the body’s inner clock) in a way that it gets out of balance.

4 Ways To Gear Up For ‘Autumn Fatigue’

But there are ways to cope with the fall changes. Avery Morgan, productivity expert and chief communications officer at EduBirdie, shared her top four tips to survive what she calls “fall fatigue”:

1. Adopt the ‘slow living’ mindset. Morgan suggests a transition from the summer turmoil to a more relaxed, slow-living atmosphere. “You can start by reviewing your tasks and cutting back on anything that is depleting your energy,” she says. “Be comfortable saying ‘no’. This is your chance to reboot your internal clock: start your days with quiet mornings that set a calm tone, enjoy mindful meals that nourish both body and soul and wind down with relaxing evenings that help you decompress. Focus on creating a balanced routine that prioritizes rest and reflection, allowing yourself to fully recharge and embrace a more peaceful, intentional pace of life.”

2. Master the art of JOMO (Joy Of Missing Out). “The pressure to catch up on everything in fall might be intense,” Morgan explains. “But, guess what? Life won’t end if you miss out on something.” She believes it can be extremely liberating and recommends that next time you’re tempted to attend every party you’re invited to, go to a concert or plan a packed weekend, consider whether it adds value to your life. “If not, embrace the joy of missing out,” she adds. “Spend that time doing something that makes you happy, like a single movie night or simply going to bed earlier.”

3. Schedule ‘me time’ like a boss. If summer has left you feeling exhausted, and the thought of fall’s busyness is adding to your stress, it’s time to reclaim your energy by prioritizing ‘me time’, according to Morgan. “Set aside at least an hour each day just for yourself—no distractions, no interruptions,” she advises. “Whether it’s to read, go for a stroll, do a skincare routine or take a power nap, this is your uninterrupted 60 minutes. Treat this time as sacred, just as you would any important meeting. The key is consistency—stick to this practice and you’ll create a solid defense against the burnout that often creeps in during autumn.”

4. Get social, but make it soulful. Morgan points out that fall socializing can be both beneficial and exhausting. She advises prioritizing quality over quantity. “Instead of accepting every invitation, prioritize spending time with those who lift your energy and make you feel great—especially the people you don’t see often but truly love,” she suggests. “Plan more low-key gatherings that allow for deeper conversations, like getting coffee with a close buddy or throwing a small dinner party. And if you’re feeling exhausted, feel free to turn down plans that don’t fuel your spirit, helping you to preserve your energy for the months ahead.”

Don’t Let September Become ‘Stresstember’

Ultimately, it’s up to each of us to make a conscious attempt to enter the new season in our own way, a healthy, non-stressful way. I would add two additional tips to keep September from turning into “Stresstember.”

Take Microsteps and Microbreaks. Arianna Huffington, founder and CEO of Thrive Global, cites five Microsteps you can take in the workflow of your day: sleep, good nutrition, movement, stress management and social connection with others. Taking micro-breaks—five or ten minutes—throughout the workday also helps you unwind and reset your energy level. After hours of sitting, short breaks are effective energy management strategies that can be as simple as stretching, walking up and down stairs, snacking, deep breathing, yoga or a five minute mindful meditation.

Practice mindfulness. Keep your awareness in the present moment while you navigate the workday. During seasonal changes, if you start to feel overwhelmed, your mind can wander into the past or future, paralyzing you. Practice bringing your mind back into the present. One of the simplest ways to do that is to use your breath as a focal point. Deep breathing in through the nose and out through the mouth and focusing on each inhalation and exhalation—following your breath through to a full cycle from the beginning when the lungs are full back down to when they’re empty—calms down your mind so that you can take action and enjoy this beautiful time of year.

Credit: Forbes

Team Metabolic Health

Poor weight loss process can be due to various reasons and one such can be slow, metabolic rate. Read on to understand what daily habits may cause your metabolism to slow down.

Metabolism is one bodily process that is essential to convert the food into energy. This further affects the weight loss regime as well. Everyday lifestyle can be a major reason that affects the metabolic rate slowing down weight loss. Sometimes we do make mistakes and don’t even realise how it may affect our body.

5 Reasons Why Your Metabolism is Getting Slow

Poor Sleep Quality: Sleeping for 7-8 hours, minimum, is a cardinal aspect of lifestyle that is often underrated and not prioritised. Poor quality and less hours of sleep lowers metabolism and increases chances of weight gain. The disruption of body’s circadian rhythms affects the health. Insufficient rest can lead to weight gain and a sluggish metabolism, making it harder to burn calories effectively.

Skipping Meals: Missing out any meal of the day should not be a practise. It can also be a one of the reasons that may lead to a slower metabolism as your body enters conservation mode to preserve energy. Regular meals help maintain steady energy levels and support metabolic processes.

Sedentary Lifestyle: This is a major cause of several health issues. The hustle world were most of us are stuck to screen and glued to our seats is a root cause of high cholesterol, weight gain, and several other issues. A lack of physical activity can slow down your metabolism. Regular exercise, especially strength training, helps build muscle mass, which burns more calories at rest. Incorporating movement into your daily routine is crucial for metabolic health.

High-Stress Levels: Chronic stress can lead to elevated cortisol levels, which may contribute to weight gain and a slower metabolism. Finding healthy ways to manage stress, such as through meditation, yoga, or hobbies, can help keep your metabolism functioning optimally.

Poor Hydration: Dehydration can negatively impact your metabolic rate. Drinking enough water is essential for various bodily functions, including digestion and nutrient absorption. Staying hydrated can help keep your metabolism running smoothly.

Low Protein Intake: A diet low in protein can slow down your metabolism, as protein has a higher thermic effect compared to fats and carbohydrates. Including adequate protein in your meals can help increase energy expenditure and support muscle maintenance.

Being mindful of these habits is essential for maintaining a healthy metabolism. By making changes such as eating regularly, getting enough sleep, staying active, managing stress, staying hydrated, and increasing protein intake, you can support your metabolic health and enhance your overall well-being.

Credit: india.com

Это очень важно для обеспечения надежного пользовательского опыта независимо от браузера или устройства. Язык программирования Чтобы не мешать друг другу при тестировании, используйте разные окружения или разделите данные для автотестов и ручного тестирования. Тогда при проверке определенного сценария вы не столкнетесь с проблемой случайного изменения данных. – автоматизация тестирования API (ApplicationProgrammingInterface) – программного интерфейса программы.

Примеры успешных проектов компании PNN с применением автоматизированного тестирования:

Автотесты МОГУТ находить баги (и то, после тщательного анализа результатов автотеста). Основное предназначение таких тестов — это быстро предоставить фидбек, что те или иные части приложения не сломались после последних изменений. Тем самым — уберечь команду (и тестировщиков в частности) — от бесконечного автоматизация ui тестов box регрессионного тестирования каждого релиз кандидата. В процессе оптимизации автотестов не упускайте из виду важный момент — качество проверок.

• Для тестирования мобильных приложений в Украине широко используется Appium — кроссплатформенное решение для автоматизации мобильного тестирования.
• Но вероятнее всего из-за того, что вы не программист или просто ваши проекты были достаточно банальными с точки зрения технологий и решаемых задач.
• Автоматическое тестирование может полностью решить многие из задач и даже выполнить более сложные тесты, которые невозможно сделать вручную.
• В то же время, автоматизация может помочь этого избежать – за вас все сделает компьютер.
• Такой вид тестирования считается классическим методом, обычно его проводит опытный тестер.

Автоматизированное тестирование

Но вероятнее всего из-за того, что вы не программист или просто ваши проекты были достаточно банальными с точки зрения технологий и решаемых задач. Часто надо перебрать много вариантов, чтобы только выбрать потенциально возможный. И тут тестирование – это не банальщина, потому что надо оценить насколько решение справляется с поставленной задачей. Если вы хотите внедрить автоматизацию на своем проекте, свяжитесь с нами. Подберем наиболее https://deveducation.com/ эффективное решение и настроим систему тестирования под ваши специфические требования. При тестировании функционала онлайн-школы часть кейсов все равно нужно выполнять вручную.

Благодарю за отличную возможность получить

На самом деле, невнимательны бывают и пользователи, и мы с вами не всегда идеально понимаем нюансы бизнеса, для которого разрабатываем продукт, или не можем покрыть все сценарии. Тест переходил по ссылке и проверял, чтобы новая страница открывалась, причем только сам факт этого. Однако открытие страницы с надписью «У вас нет прав для просмотра» тоже проходило как успешный сценарий, хотя таковым не являлось. В любом случае процесс можно улучшить, и автотесты — мощный инструмент для этого. Некоторые задачи тестирования, такие как низкоуровневое регрессионное тестирование,  могут быть трудозатратными и требующими много времени если выполнять их вручную. Кроме того, мануальное тестирование может недостаточно эффективно находить некоторые классы ошибок.

Для обеспечения непрерывной интеграции и доставки (CI/CD) автоматизированные тесты UI часто интегрируются в процесс разработки программного продукта. Это позволяет автоматически запускать тесты после каждого коммита кода, а также интегрировать их с системами управления версиями и системами непрерывной интеграции, такими как Jenkins, GitLab CI и CircleCI. Благодаря такой интеграции тестирование становится неотъемлемой частью процесса разработки, позволяет выявлять проблемы на ранней стадии и способствует частому выпуску высококачественного программного обеспечения. Менеджеры проектов, работающие в сфере разработки программного обеспечения, также могут воспользоваться этим курсом для лучшего понимания процесса автоматизированного тестирования и его роли в разработке программ. В ходе реализации данных проектов мы используем автоматизированное тестирование, с целью сократить время создания одних и тех же заявок в 2 – 3 раза. QA автоматизация играет ключевую роль в повышении скорости, эффективности и гибкости процесса тестирования ПО.

Курс “Продвинутый Python” разработан для тех, кто уже имеет базовый уровень Python и стремится расширить свои знания, чтобы более эффективно использовать этот язык в современных проектах. Участники этого курса получат глубокое понимание расширенных возможностей Python, что позволит создавать сложные и высокоэффективные программные решения. Некоторое время назад ко мне в команду пришел запрос на автоматизацию тестированию проекта, построенного на платформе SalesForce. Я решил расписать задачи/идеи и проблемы с которыми мы сталкивались на проекте. Так как объем, полученных знаний и опыта довольно велик статью придется разбить на несколько частей. Первая часть скорее вводная и дающая общее представление о том из чего состоит автоматизация в SalesForce.

Программа курса также включает практическую реализацию проектов с учетом пожеланий студентов. И вот спустя 9 месяцев на проекте я делюсь своими мыслями, идеями и болью насчет возможности и подходов к автоматизации тестирования SalesForce. UI-тестирование — это деятельность, направленная на проверку качества пользовательского интерфейса, его соответствия нормам и требованиям. Проводить такое тестирование можно вручную, а можно подключить специальные инструменты в зависимости от целей. Совместное использование тестов поможет разработчикам быстро проверить свои изменения перед отправкой их на тестирование. Тесты могут быть запущены при каждом коммите нового кода, быстро оповещая разработчика об ошибках.

Много другого-разного конечно существует, но давайте посмотрим реалиям в лицо. Какая разница с какого типа проектами использовать Scrum или Kanban? Это процессы, которые позволяют организовать работу над любого рода проектом (даже не IT). У вас есть свой процесс, который лучше и помогает вам делать быстро и качественно проекты? Каждый из этих инструментов играет ключевую роль в нашем процессе тестирования, обеспечивая надежность и легкость в управлении тестами. Robot Framework — это универсальный фреймворк для автоматизации тестирования, который поддерживает различные типы тестов, такие как веб, мобильные, и API.

Чем больше у вас таких тестов, тем больше времени приходится тратить на их исправление и поддержку. Как следствие, доверие к результатам таких тестов снижается из-за частых ложно-позитивных срабатываний. В какой-то момент всё время автоматизатора начинает уходить на ремонт упавших скриптов, ничего нового уже не создается. Часто бывает, что по прошествии некоторого времени изначальные ожидания не оправдываются, потому что довольно дорогая инвестиция в автоматизацию не приносит профита. Попробуем разобраться, почему так происходит и как не допустить повторения распространенных ошибок.

Они стараются избегать сложных и труднодоступных для тестирования проектов и в конечном итоге улучшают общее качество продукта.6. Прямое взаимодействие спользователемДля некоторых проектов,особенно для стартапов и небольших команд, отзывы пользователей могут быть основным источником информации о качестве продукта. Для некоторых проектов, особенно для крупныхи сложных систем, роль QA по-прежнему очень важна. Однако при определенных условиях, при наличии правильных инструментов и подходов, вы можете успешно развивать свой проект без профессиональной команды контроля качества. Важно учитывать детали каждого проекта и находить баланс между качеством, стоимостью и временем разработки. В современном быстро меняющемся мире разработки программного обеспечения, обеспечение качества и надежности приложений является чрезвычайно важным.

Суть BDD заключается в критериях приемки, которые определяются до начала разработки, в соответствии с планированием на основе приемочных тестов. Эти критерии выражаются таким образом, чтобы описать желаемое поведение приложения, а не технические детали. Эта спецификация затем направляет процесс разработки, гарантируя, что программное обеспечение создается с учетом потребностей и поведения пользователя. В зависимости от проекта и вашего уровня понимания юнит тестов и работы разработчиков выберите подход который вам подходит. Вообще написание понятных и детальных тест-кейсов, как и ведение документации в целом — настоящее искусство. Хорошая практика — использовать ревью тест-кейсов, которые может выполнять как один из коллег, входящих в команду тестировщиков, так и ее лид или бизнес-аналитик.

Автоматизацию тестирования лучше всего начинать с применения ко всей работе стандартной пирамиды, в основе которой лежат юниты и интеграционные тесты от разработчиков. Нет, выполнение любого вида тестирования требует специальных знаний и профессиональной подготовки. Она ускоряет тестирование, снижает вероятность ошибок и освобождает время для других задач. Курс автоматизации Python может помочь повысить эффективность работы, развить новые навыки и расширить твои возможности во многих сферах жизни и карьеры. Забудь о сухих лекциях и скучных домашних задачах – на курсе Автоматизация на Python ты будешь учиться путем создания реальных программ! Каждая тема – это крутой практичный кейс, поэтому уже во время учебы ты сможешь закрыть множество своих рабочих задач.

И как раз выгодно уже сейчас выделиться на фоне мануальных тестировщиков, для которых была цель лишь войти в ИТ, но дальше развиваться они не хотят. Автоматизированное тестирование выполняется с помощью специальных скриптов, при этом вмешательство человека сводится к минимуму, а точность и скорость проверок гораздо выше. Чтобы тебе было легче определиться, в этом материале мы расскажем о каждом виде тестирования, особенностях, а также назовем их плюсы и минусы. Не знаю по поводу 95 %, но из моего опыта — почти десяток проектов, больших и маленьких — ни одного примера полноценного использования ТДД.Я не к тому, что это плохо. Согласен что проблема не только в селекторах, просто селекторы это самое частое что я видел. В вашем случае возможно проблема с дизайном теста и тестового окружения.

Раз их непросто нанимать, то тяжело расширять команду, а значит зарабатывать деньги. Percy работает параллельно с тестами, делая скриншоты для визуального сравнения. Это помогает нам выявлять расхождения в интерфейсе, которые могут быть неочевидны через традиционные методы тестирования. Даже крупнейшие компании и QA департаменты неспособны симулировать взаимодействие с веб-приложениями тысяч пользователей одновременно.

Этот растущий рынок свидетельствует о все более широком признании автоматизированного тестирования как ключевого компонента, обеспечивающего эффективное и качественное создание программных продуктов. По мере развития технологий и повышения сложности программного обеспечения автоматизированное тестирование становится краеугольным камнем в стремлении к совершенству разработки программного обеспечения. Такое согласование с принципами agile не только стимулирует развитие, но и включает обеспечение качества в структуру процесса разработки. Автоматизированное тестирование предполагает использование специального программного обеспечения (помимо тестируемого) для контроля выполнения тестов и сравнения ожидаемого  фактического результата работы программы.

Также они познакомятся с различными инструментами для разработки и тестирования программного обеспечения. Развитие области тестирования привело к автоматизации множества различных проверок. Одной из областей тестирования, где активно применяются автоматические тесты – регрессионное функциональное тестирование. Если в продукте есть малоизменяемые, но при этом критичные части, требующие большого количества проверок, необходимо создание фреймворка автоматизации тестирования. Selenium является одним из самых популярных инструментов для автоматизации веб-тестирования.

Тестируются интерфейсы, предназначенные для взаимодействия, например, с другими программами или с пользователем. Здесь опять же, как правило, используются специальные фреймворки. Основы тестирования, создание тест-кейсов, баг-репортов, работу с инструментами автоматизации и процесс разработки ПО. И если ты думаешь, что тестировщики просто кликают по кнопкам и сообщают, что всё сломано, то ты явно не встречался с QA Automation. Автоматизация тестирования — это тот магический инструмент, который позволяет проверять приложения быстро, эффективно и без ошибок. Мы углубимся в изучение темы, изучая продвинутые возможности Cypress, эффективную обработку асинхронных запросов и интеграцию с другими библиотеками.

Team Metabolic Health

Self-medicating gorillas may hold clues to future drug discovery, according to scientists.

Researchers in Gabon studied tropical plants eaten by wild gorillas – and used also by local human healers – identifying four with medicinal effects.

Laboratory studies revealed the plants were high in antioxidants and antimicrobials.

One showed promise in fighting superbugs.

Great apes are known to self-medicate by selecting plants with healing properties.

A wounded orangutan recently made headlines for using a plant paste to heal an injury.

In the latest study, botanists recorded the plants eaten by western lowland gorillas in Gabon’s Moukalaba-Doudou National Park.

They selected four trees that were likely to be beneficial, based on interviews with local healers: the fromager tree (Ceiba pentandra), giant yellow mulberry (Myrianthus arboreus), African teak (Milicia excelsa) and fig trees (Ficus).

The bark of the trees – used in traditional medicine to treat everything from stomach complaints to infertility – contained chemicals with medicinal effects, from phenols to flavonoids.

All four plants showed antibacterial activity against at least one multidrug-resistant strain of the bug, E. coli.

The fromager tree in particular showed “remarkable activity” against all tested strains, they say.

“This suggests that gorillas evolved to eat plants that benefit them, and highlights the huge gaps in our knowledge of the Central African rainforests,” said Dr Joanna Setchell, an anthropologist at the University of Durham, UK, who worked on the study with Gabonese scientists.

Gabon has vast unexplored forests, which are home to forest elephants, chimpanzees and gorillas, as well as many plants unknown to science.

Poaching and disease have led to a huge number of western lowland gorillas disappearing in the wild.

They are classed as critically endangered on the International Union for Conservation of Nature’s Red List.

The research is published in the journal PLOS ONE.

Credit: BBC News

Team Metabolic Health

The recall was initiated over concerns that the affected products may have been spoiled due to a malfunctioning refrigeration unit on a trailer

A popular brand of macaroni and cheese sold at retail chains, including Target, is being recalled over the risk of causing “adverse health consequences.” Reser’s Fine Foods issued a voluntary recall of two of its macaroni & cheese products last week, Newsweek reported. The affected products were distributed in California, Illinois, Minnesota, North Dakota and South Dakota, according to a notice by the US Food and Drug Administration (FDA).

A popular macaroni and cheese brand sold at Target has been recalled (Representational Image)

Mac & cheese sold at popular retail stores recalled

The Oregon-based corporation initiated the voluntary move over concerns that the recalled products may have been spoiled due to a malfunctioning refrigeration unit on a trailer. The two varieties of mac and cheese that have been pulled back by the manufacturer are 12 oz Reser’s American Classics Macaroni & Cheese White Cheddar and 12 oz Reser’s American Classics Macaroni & Cheese.

The affected products which bear the codes 71117.02009 and 71117.02123 on their bar code were sold across at Target, Safeway, and Stop & Shop. The recall notice received a Class II risk categorization, referring to “a situation in which use of or exposure to a violative product may cause temporary or medically reversible adverse health consequences or where the probability of serious adverse health consequences is remote,” the FDA said.

However, the two mac and cheese varieties are not the only products that have been pulled back by the company.

The following 12 products have also been recalled by the brand:

Reser’s Essential Everyday Original Potato Salad – 16 oz

Reser’s American Classics Scalloped Potatoes – 12 oz

Reser’s American Classics Asiago Creamed Spinach – 12 oz

Reser’s Kit HF Pudding Banana – 4.8 lbs

Reser’s Sweet Corn with Butter – 4 lbs

Stonemill Kitchens Green Goddess Pasta Salad – 5 lbs

Reser’s Raspberry Parfait Desserts – 8 lbs

Gravy Homestyle – 4 lbs

Reser’s Smokehouse Potato Salad – 5 lbs

Reser’s American Classics Egg Salad – 12 oz

Baked Scalloped Potatoes – 2.5 lbs

Potatoes Creamy Deluxe Special Request – 5 lbs.

Credit: Hindustan Times