Do Your Patients Hate Exercise? Suggest They Do This Instead

 Have patients who want to lose weight? Tell them to put on their dancing shoes. 

Dancing can be an effective fat-loss tool for people who are overweight or have obesity, according to a recent meta-analysis in PLOS One. People who danced regularly lost about four more pounds — including three and a half pounds of fat — than those who didn't dance. They also shaved an extra inch off their waists. 

Participants who danced three times a week for at least 3 months reaped maximum benefits. And the more they let loose, the better — more creative dance forms led to more pronounced improvements in body composition. 

The study builds on previous research that suggests dance can be beneficial for weight loss and overall health. A 2017 meta-analysis found that dance significantly improved body composition, blood biomarkers, and musculoskeletal function. Other research has linked dance with improvements in cognitive function, mental health, and quality of life.  

What makes dance special? It's a full-body workout that might be easier to stick with than other exercises. "Enjoyment" is key for sustainability, the researchers wrote: "As a form of physical activity that integrates exercise, entertainment, and sociality, dance possesses innate advantages in fostering motivation for exercise."

"The best exercise is the one you'll do every day, and something that you like to do," said Nicholas Pennings, DO, chair and associate professor of family medicine at Campbell University, Buies Creek, North Carolina. (Pennings was not involved in the study.) For patients who enjoy dancing, dance could be that thing — or at least one workout to add to the mix. 

Help your patients get started with these tips. 

• Frame it as a hobby, not exercise. Ask what hobbies they used to enjoy in high school, suggests Deirdre Mattina, MD, a cardiologist at the Cleveland Clinic and a former professional dancer. " This can sometimes evoke happy memories of younger years and perhaps hobbies that they'd given up because they thought they were too old," she said. If they used to play sports or dance, that's your in. "I usually talk about hot yoga as a transition to get back their flexibility and then something like a dance aerobics or Zumba class to start."
• Recommend a group class. "Any intervention promoting social relationships is expected to increase adherence," said Giulio Marchesini Reggiani, MD, a recently retired professor of internal medicine and dietetics at the University of Bologna in Italy. "You are motivated by the group, and you create a relationship among participants, and this means that you are no longer alone." Try local gyms, health clubs, or even dance studios (yes, where kids go — they offer adult classes, too).
• Help patients find their unique groove. Mattina has some patients who take cardio dance classes, some who line dance, and others who pole dance or heels dance. "Those are the things that keep it fun," she said. "It doesn't seem like exercise. It seems more like going out and hanging out." 
• Encourage those who "don't know how to dance." You don't need fancy choreography or the grace of a prima ballerina. "Simply move aided by the music," said Marchesini Reggiani. "As long as you start engaging in physical activity, you improve your health, and you improve your movement." Suggest patients start with beginner Zumba or a step class to get the hang of moving to a beat. Or try a home dance video, like Barre Blend by BODi (which offers a 14-day free trial). "You can try taking a couple classes in the privacy of your own home first, so you feel comfortable getting out there and doing it with a group," said Mattina.
• Modify as needed. If a patient has mobility limitations or lower-body pain, they can still dance — just do the upper-body portion of the moves. "Dance involves both upper and lower body movement, and so many dance activities could easily be performed in a chair," said Pennings. A good joint-friendly option: Some health clubs offer dance classes that take place in a swimming pool.
• Involve the whole family. Support from a partner can help patients stick with exercise, said Marchesini Reggiani, and dance can also help a couple strengthen their bond. Invite kids and grandparents to join, too. "Dancing is something that can be done at any age," said Marchesini Reggiani. "For kids, it is important to make it fun," said Pennings. "Start when they are young with music they are familiar with and enjoy." For skeptical partners? "Keep it simple and nonjudgmental," he said.
• Remind patients to warm up. We lose flexibility with age, so ease into it, said Mattina. Many classes include warmups, but if you're at home, do a few minutes of light cardio — jumping jacks, jogging in place, or brisk walking — before stretching. Or just put on a slow song and start lightly bouncing to the beat or stepping your feet to one side, together, then to the other side and together.
• Tell them to take dance breaks. No time to join a class? Break up the workday with a few 10-minute dance parties. (That's about three songs.) "Short bursts of exercise throughout the day, like if you do 10 minutes of exercise six times a day, actually has a greater health benefit than doing 60 minutes of continuous exercise," said Pennings. It helps counter the negative effects of prolonged sitting "by increasing blood flow and increasing utilization of your muscles."
• Manage expectations about weight loss. Patients often have outsized expectations about how much weight they'll lose when starting a new exercise regimen, Pennings said. Dancing burns about 300 calories per hour, so it takes roughly 12 hours to lose one pound. Consistency over time is the key. "My goal is to both emphasize the health benefits of exercise while maintaining realistic expectations about weight loss," said Pennings. Focus less on the weight part and highlight other benefits: Dancing builds strength, balance, and coordination, said Pennings. It can help improve blood pressure and other heart health markers and boost cognition in older adults. And it's fun.  

https://www.medscape.com/viewarticle/do-your-patients-hate-exercise-suggest-they-do-this-instead-2024a100022t

9th Circuit: Enemy Of Cities Trying To Shut Down Homeless Camps

 by Charlotte Allen via The Epoch Times,

Nearly half of America’s homeless population - some 42 percent - lives in nine Western states stretching from Alaska and Montana to Arizona and Hawaii. The vast majority of them - 30 percent of America’s homeless - live in California alone, even though California accounts for only 12 percent of the general population of the United States.

The reason isn’t simply the temperate climate of the West’s coastal cities that makes living on sidewalks amid trash, crime, rodents, and disease more tolerable—or the free meals and other benefits that the progressive governments of those cities typically offer. One major factor is that the nine states are under the thumb of the Ninth U.S. Circuit Court of Appeals, most of whose judges are still famously liberal despite a short-lived influx of Donald Trump appointees.

The Ninth Circuit, alone among federal appeals courts, has made it nearly impossible for states and cities in the West to enforce their longstanding public nuisance laws that ban camping, sleeping, and lodging on public sidewalks and in public parks and buildings. The Ninth Circuit deems such enforcement “cruel and unusual punishment” that violates the Eighth Amendment of the U.S. Constitution. That, in turn, makes it impossible for cities to clear their streets of the tent encampments that are not only unsightly and dangerous but are also public health hazards for the street people themselves.

Take the city of San Francisco, with one of the highest homelessness rates in the nation. More than 4,000 homeless people, many of them alcoholics, drug addicts, or mentally ill, live mostly outdoors in the city’s downtown and Tenderloin districts that have become so-called “doom loops” because businesses and residents are fleeing the filth and crime. San Francisco has been fighting a legal battle in federal court since 2022 over its efforts to get rid of homeless encampments in its central city. All to no avail. On Jan. 11, a three-judge panel of the Ninth Circuit issued a 2–1 ruling upholding a federal district judge’s preliminary injunction that bars the enforcement of state and city anti-camping laws in San Francisco pending a full trial that has yet to take place.

Signing onto the Ninth Circuit’s opinion, in a lawsuit filed by the ultra-progressive Coalition on Homelessness, were Circuit Judges Lucy Koh and Roopali Desai, both appointed by President Joe Biden. The lone dissenter was Trump appointee Patrick J. Bumatay. Judge Bumatay pointed out that the Eighth Amendment had originally been designed to protect Americans against barbarous methods of punishment—whipping and torture, for example. It wasn’t supposed to be used to strike down criminal laws themselves, especially longstanding anti-vagrancy laws typically enforced by small fines and misdemeanor convictions. Otherwise, “we impermissibly usurp powers left to the States and crown ourselves czars over homeless policy,” Judge Bumatay wrote.

The ruling was no surprise. California and its neighboring states have been hamstrung by the Ninth Circuit since 2018—by a decision in a case titled Martin v. City of Boise that created a precedent for using the Eighth Amendment to strike down anti-camping laws—in this case, a Boise ordinance aimed at the tent encampment that had cropped up in the Idaho capital. The theory was Boise was actually punishing people simply for being homeless, because the homeless often have no other place to sleep besides public places.

“[S]o long as there is a greater number of homeless individuals in a jurisdiction than the number of available beds in shelters,” Boise couldn’t enforce its ordinance, the Ninth Circuit ruled.

The Martin decision had an electric effect. Homeless advocates launched federal lawsuits all over the West to try to get anti-camping ordinances invalidated, and they usually succeeded. Meanwhile, localities covered by the Ninth Circuit scrambled to change their laws to comply with Martin and still do something about the tent encampments.

One of those localities was Grants Pass, a town of 38,000 in southern Oregon. The Grants Pass ordinance was milder than Boise’s. It allowed only civil penalties, such as being barred from parks, not criminal fines or jail terms, for such offenses as putting down bedding in a public place. But the Ninth Circuit was even tougher on Grants Pass than it had been on Boise. In 2022, it issued a 2–1 ruling (amended slightly in 2023) that not only did localities have to make alternative shelter space available before they could enforce their anti-camping policies, but they also had to ensure there was a bed available for every single homeless person who happened to be in the locality at any given time. Beds provided by religious organizations such as gospel missions, which typically set behavioral standards, didn’t count.

Fortunately, on Jan. 12, the U.S. Supreme Court agreed to review the Johnson v. Grants Pass decision. As well it should. Not a single other federal appeals court has accepted the Ninth Circuit’s Eighth Amendment line of reasoning. Two federal circuits, the Fifth and the Eleventh, covering mostly Southern states, have actively rejected it. So has the California Supreme Court, not otherwise known for conservative leanings. Dozens of Western states and cities, including progressive San Francisco and Los Angeles, had filed amicus briefs urging the Supreme Court to overturn Grants Pass and allow them to try to alleviate the crime, squalor, and human misery that tent camps foster.

Even California’s liberal Gov. Gavin Newsom had submitted an amicus brief arguing that the Ninth Circuit was essentially permitting “dangerous” homeless encampments to become permanent fixtures in his state’s cities and towns. San Francisco complained that it had spent $672 million on shelter beds for its homeless population but still hadn’t managed to comply with Grant Pass’s unworkable standards.

The Ninth Circuit seems to be administering its own form of cruel and unusual punishment—on localities that believe their public places should be available for all their citizens to enjoy. It’s time for the Supreme Court to put a stop to this travesty of Eighth Amendment interpretation.

https://www.zerohedge.com/political/ninth-circuit-enemy-cities-trying-shut-down-homeless-camps

Why did NIH abruptly halt research on the harms of cell phone radiation?

 In a shocking reversal, the National Toxicology Program (NTP) of the National Institute of Environmental Health Sciences has quietly disclosed that it will stop studying the biological or environmental impacts of cell phone radiofrequency radiation.

This decision comes despite results from the program’s carefully engineered and reviewed decade-long $30 million animal studies that found cancer, heart damage and DNA damage associated with exposure to cell phone radiofrequency radiation at levels comparable to those experienced by Americans today. 

The sudden end of civilian government efforts to study potential health impacts of wireless radiation constitutes a glaring abdication of responsibility. In contrast, the U.S. Department of Defense continues to study this problem.

The European Union is providing multi-million dollar grants for multidisciplinary studies. The French government regularly monitors towers and phones and has recalled millions of phones for excessive radiation or other concerns, reflecting public concerns about both psychological and physiological impacts. In 2019, French Minsters passed an order ensuring phones had consumer information that included that teenagers and pregnant women avoid exposing their abdomens to wireless radiating devices.

Just last year, the NTP declared on its 2023 fact sheet that it would perform follow-up studies to better understand the effects found in the long term animal studies. So what happened? At this juncture, it is unclear. Have the follow-up studies been completed already? Working with Swiss national engineering and U.S. government experts, the NTP had devised small-scale systems for exposing animals experimentally to controlled levels of wireless radiation. Yet results from these exposure systems have neither been publicly shared nor published.

In a sudden and inexplicable turnaround of this long-scheduled and heavily reviewed workplan, the NTP now states that no more research on wireless radiation is planned due to costs of the studies and technical challenges. One must ask what is driving this flipflop. What has led to this sudden change in priorities, so that such an exponentially growing environmental exposure no longer merits study?

The sole explanation from NTP for this turnaround raises more questions than it answers: “The research was technically challenging and more resource-intensive than expected. No additional [wireless radiation] studies are planned.”

This defies modern medical and even casual public knowledge and concerns. For example, infertility clinics ask men what their habits are with respect to cell phones and other wireless devices. They tell them to take these phones off their bodies and out of their pockets because there is evidence of a correlation in rodents between wireless radiation exposure and low sperm count, poorer sperm quality, decreased testosterone and damage to the testes.

Studies have also linked carrying a cell phone in one’s bra to increased risk of breast cancer. The list of adverse health effects associated with this exposure is long and our use of these devices growing constantly.

Whether the government stops doing the research or not, we are all a part of a massive research study. Billions of people worldwide are being exposed to ever-increasing levels of wireless radiation. Children are uniquely vulnerable due to their rapidly developing brains. In effect, there is no control group. This makes it difficult, but not impossible, to discern the effects of wireless radiation in human populations.

It is the ultimate arrogance and folly to stop doing research on this major growing environmental pollutant when we have ample evidence of harm. 

The civilian government’s decision to stop research on cell phone radiation is consistent with the Chinese proverb, “If you don’t want to know, don’t ask.”

When it comes to understanding how wireless radiation affects biology, the cessation of studies makes no sense. The complexity of the issue should not become an excuse for ignoring one of the fastest growing environmental pollutants in the world today. 

If the civilian government has run out of money for this, there’s an easy remedy: Charge a fee of two cents per month to to every device owner, internet provider and manufacturer and use the funds to train scientists to carry out independent monitoring and research.

Surely, it’s worth a few pennies a month to find out how wireless radiation affects our health, and how to reduce its impact on ourselves, as well as the birds, bees and trees on which our planet depends.

Devra Davis, a former senior adviser to the assistant secretary for Health in the Department of Health and Human Services, is the founder and president of Environmental Health Trust. She is the author of “Disconnect: A scientist’s solutions for safer technology.”

https://thehill.com/opinion/technology/4437988-why-did-nih-abruptly-halt-research-on-the-harms-of-cell-phone-radiation/

'U.S. Officials Call for More Programs, Education to Improve Diets in America'

 Leaders of the U.S. Department of Agriculture (USDA) and FDA described efforts the Biden administration is making to help Americans eat healthier at the "Food Is Medicine Summit," hosted by HHS on Wednesday.

In his opening remarks, Secretary of Agriculture Tom Vilsack shared that his commitment to healthy eating is personal.

"I've struggled with my weight all my life and with body image issues," he said, recalling being made fun of by a teacher who said the reason he couldn't complete a math problem was because he was fat.

"When you've had experiences like that, you understand and appreciate obesity in a completely different and personal context, and you understand the emotional toll that obesity can take," he added.

Vilsack said that, despite growing up in an orphanage, he was lucky to have a lot of support as a child. In today's environment where community is lacking, "that kid becomes isolated and some really serious consequences can occur."

One of the efforts the USDA has made is to encourage all states to offer a summer feeding program. Vilsack said it's hard to understand why 15 states will not participate in such programs.

FDA Commissioner Robert Califf, MD, also spoke about efforts made by his agency to improve Americans' eating habits.

"Number one on our list of urgent issues right now is getting more information [and] better information on the food packages themselves," he said. The agency has already made some changes, such as the inclusion of added sugars on updated food labels.

Largely in response to the FDA's efforts, manufacturers have begun to reduce the amount of trans fats in foodopens in a new tab or window, Califf noted. In addition, the agency is encouraging the food industry to commit to voluntary sodium reductionsopens in a new tab or window, and is working to more clearly define the term "healthy"opens in a new tab or window on food labels.

It may sound crazy, and some will wonder why it has taken so long, he said. However, the goal in defining the claim that a food is "healthy" is to incentivize manufacturers to meet certain criteria, which could change "the underlying composition of the diet that people have ... we're very enthusiastic, and hope we'll get that across the finish line."

Shifting gears a little, Califf also talked about the role of physicians in educating patients.

"Amazingly to me, doctors are still listed by people as the most trusted source for nutritional information, which seems a little weird since medical education includes very little about nutrition," he said.

While he would like to see that education improve, given the shift towards "team-based care," the burden need not only fall on doctors, he noted.

Lastly, the commissioner cautioned that changes to food labels and improving the guidance patients receive will not alone be enough to compete with the food industry. More research is also needed, he stressed.

"If all we do is present facts so people can make decisions, we're not going to win versus this sophisticated advertising that I learned a lot about [while working in Silicon Valley], which plays on emotions, and subliminal signals that cause people to be hungrier," he said. "We've got to understand the connection between what's in the food and what's in this gut-brain axis that the [GLP-1 agonists] are now uncovering is a biological phenomenon. It's not just willpower."

"We've got to have the scientific basis, and then we've got to follow through," he added.

https://www.medpagetoday.com/primarycare/dietnutrition/108545

After State Lawsuit, Health System Erases or Refunds $158M in Medical Bills

 Providence healthcare system is refunding nearly $21 million in medical bills paid by low-income residents of Washington -- and it's erasing $137 million more in outstanding debt for tens of thousands of others -- to settle the state's allegations that it overcharged those patients and then used aggressive collection tactics when they failed to pay.

The announcement Thursday came just weeks before Attorney General Bob Ferguson's case was set for trial against Providence Health & Services, which operates 14 hospitals in Washington under the Providence, Swedish, and Kadlec names.

The state argued that the medical system's practices violated Washington's charity care law, which is considered one of the strongest in the country. It requires hospitals to notify patients about the availability of financial aid and to screen them to see if they're eligible for discounts before trying to collect payment.

Providence trained its staff not to accept it when patients said they couldn't afford the bills, Ferguson said.

"Hospitals -- especially nonprofits like Providence -- get tax breaks and other benefits with the expectation that they are helping everyone have access to affordable healthcare," Ferguson said at a news conference. "When they don't, they're taking advantage of the system to their benefit."

Recently expanded, the law now covers roughly half of all residents, making them eligible for free or reduced-cost care at hospitals in the state, according to Ferguson's office. It applies to out-of-pocket hospital costs, including co-pays and deductibles.

Those earning up to four times the federal poverty standard could qualify for assistance. For example, a family of four earning $120,000 a year could be eligible for a 50% discount, depending on the hospital.

In a statement posted to Providence's website, the organization said it was simplifying how it provides information about financial aid to patients and working to make the application process clearer.

"Charity care and financial assistance are vital resources for patients who cannot afford health care," said Providence Chief Financial Officer Greg Hoffman. "Providence is committed to providing support to those who need it most, and we will continually evaluate our efforts and make sure they fully meet the needs of those we serve."

Providence has already erased about $125 million in medical debt following the state's lawsuit 2 years agoopens in a new tab or window, said Ferguson, a Democrat who is running for governor. Under the settlement, Providence will also pay $4.5 million to the attorney general's office for legal fees and the costs of enforcing the charity care law.

In all, about 65,000 patients will see their outstanding debt erased and 34,000 will receive refunds, plus 12% interest, for bills they managed to pay despite difficult circumstances. The debts being erased range from less than $1 to $262,000, while those receiving refunds will get amounts varying from under $1 to $293,000, Ferguson's office said.

The latter category includes Kevin and Evangeline Holloman, who spoke at the news conference. The couple said that after their daughter was born in 2020 at Swedish hospital in Seattle, they received a bill for $7,000 and were put on a payment plan of $250 per month.

But when they missed a payment, Swedish immediately sent them to a collection agency without informing them, they said. They eventually wiped out their emergency savings and used a tax return to pay off the balance.

"We had to restart from ground zero with our kid, and having to set aside money again in case anything were to happen," Evangeline Holloman said. "Having your security ripped out from under you like that is really hard."

The state is still pursuing related consumer protection claims against two debt-collection firms Providence used.

Ge Bai, PhD, an accounting professor at Johns Hopkins University who focuses on healthcare finance and policy, said the settlement could encourage other states to strengthen their charity care laws or seek to better enforce them. Bai was listed as an expert witness for Washington state in the case.

"Washington has a pretty comprehensive charity care law -- many states don't even have that," Bai said. "It also has a chilling effect for hospitals in other states: State attorneys general are taking this seriously."

https://www.medpagetoday.com/practicemanagement/practicemanagement/108546

Keep a Close Eye on Amazon's Ventures Into Healthcare

 Amazon is ubiquitous. Consumers rely on the website for convenient access to entertainment, groceries, fast (and luxury) fashion, and even ... chicken harnesses

opens in a new tab or window.

Right. But should we trust Amazon for healthcare? Will the company's entry into digital health, prescription drugs, and other medical matters improve care or further corporatize it?

The answer to those questions is up to us.

Amazon's Latest Gambit Shows Its Ambition

On January 8, Amazon debutedopens in a new tab or window its Health Condition Programs, a new product to make it easier for consumers "to discover" the digital health benefits they need to manage chronic conditions like diabetes. Through the program, Amazon promises to "make it easy to check your coverage, apply for programs, and get started with managing your condition." Omada Health -- which works with health plans and employers to equip people with tools, resources, and support to improve their health -- is Amazon's primary partner.

This announcement is a testament to Amazon's healthcare ambitions. Indeed, it is just part of a larger strategy to define, "where healthcare happens 24/7.opens in a new tab or window" Even before this latest foray into the healthcare space, Amazon had made strides in acute and chronic care managementopens in a new tab or window, prescription drugs (through Amazon Pharmacy), men's health, and even healthcare equipment. The company also acquiredopens in a new tab or window One Medical, which gave it access to physical offices, online portals, physicians, providers, and patients. Snapping up One Medical will arguably help Amazon attract a younger, tech-savvy, financially stable demographic.

Amazon is not the only retailer to expand into healthcare, of course. The vitamin retailer GNCopens in a new tab or window recently announced plans to offer telehealth services and provide prescription drugs. CVS is no longer just a pharmacy. The company now has a pharmacy benefit manageropens in a new tab or window and provides insurance coverage through Aetnaopens in a new tab or window. Large insurers also are expanding their footprint. UnitedHealth Group employs physiciansopens in a new tab or window and even operates a hospital-based service group called Sound Physiciansopens in a new tab or window.

What does Amazon's march into healthcare mean for us? Americans are used to segmenting corporate structures into horizontally integrated monopolies and vertically integrated value chains, but Amazon challenges these categories. I believe that Amazon's previous entries into book- and grocery-selling shows that it means to reshape industries and make the company so ubiquitous that it is hard to look elsewhere for services.

A Double-Edged Sword

Amazon's venture into healthcare should not be blindly celebrated or outright condemned.

On the one hand, these developments could be game-changers. Amazon's expertise in logistics, data management, and customer service has the potential to streamline healthcare delivery, making it more accessible and efficient. Imagine a healthcare system where managing chronic conditions is as straightforward as ordering a book online.

The benefits could be enormous, especially for underserved populations.

There is, of course, another way this story could play out. The consolidation of healthcare under a few corporate giants raises serious concerns about privacy, data security, and the depersonalization of care. In fact, last year the Washington Post and NPRopens in a new tab or window reported that when patients signed up for Amazon's low-cost health service, they were asked to "essentially give up some of their federally protected privacy rights." In 2022, Timeopens in a new tab or window reported that Amazon staff admitted there are no limits on how Amazon uses this data internally, and, according to Amazon's former head of information security, the company has "no idea where our f*****g data is."

Moreover, Amazon's increasing control could stifle competition, potentially leading to higher costs and reduced innovation in the long run.

Amazon's move demonstrates how complex the healthcare landscape is, and how quickly it is evolving, and it reinforces the notion that we, as healthcare leaders, must navigate with caution, wisdom, and an unwavering commitment to the ethical practice of healthcare.

Healthcare Leaders as the Loyal Opposition

Absent a huge shift in federal antitrust policy from the Federal Trade Commission or the U.S. Department of Justice, this type of integration will continue.

Amazon's growing strength and influence in healthcare can be a force for good, but someone has to ensure the company's power is harnessed correctly.

For healthcare leaders, the critical task, then, is to navigate these developments wisely and to press for answers to difficult questions. We must leverage the potential benefits of such integrations while vigilantly safeguarding patient interests, data privacy, and the sanctity of the physician-patient relationship. We must also press policymakers, advocating for regulatory frameworks that prevent monopolistic behaviors and ensure that healthcare remains a service, not just a commodity.

As healthcare professionals, our allegiance is to our patients' well-being and our industry's integrity. We must embrace innovation while maintaining the human touch that lies at the heart of healthcare. The future of healthcare may well be in the hands of corporate giants, but its soul must always remain in the caring hands of its practitioners.

N. Adam Brown is a practicing emergency physician, entrepreneur, and healthcare executive. He is the founder of ABIG Health, a healthcare growth strategy firm, and a professor at the University of North Carolina's Kenan-Flagler Business School. Follow

https://www.medpagetoday.com/opinion/prescriptionsforabrokensystem/108550

Israel says it has struck more than 50 Hezbollah targets in Syria since Oct 7

 The Israeli military said on Saturday that since the outbreak of the Gaza war on Oct. 7 it had struck more than 50 targets in Syria linked to the Iranian-backed Lebanese movement Hezbollah.

The remarks, in a briefing by chief military spokesperson Rear Admiral Daniel Hagari that mainly discussed efforts to beat back Hezbollah attacks launched in solidarity with Hamas, were a departure from Israel's usual reticence about Syria operations.

"Everywhere Hezbollah is, we shall be. We will take action everywhere required in the Middle East," Hagari said.

Israeli forces have attacked 3,400 Hezbollah targets in Lebanon, including 120 border surveillance outposts, 40 caches of missiles and other weaponry and more than 40 command centres, Hagari said. He put the number of enemy dead at more than 200.

Hagari said Israel had deployed three army divisions along its side of the Lebanese border in anticipation of Hezbollah getting involved after Palestinian Hamas launched a shock cross-border attack on Oct. 7, triggering the war in the Gaza Strip.

With tens of thousands of its northern residents having evacuated, Israel has threatened to escalate the Lebanon fighting unless Hezbollah backs off from the border - and has sought Western help in finding a diplomatic solution in Beirut.

https://news.yahoo.com/israel-says-struck-more-50-192013011.html