America spends over $3.8 trillion a year on healthcare (2019)—and more per capita than any other country in the world, despite that our life expectancy is 76.1 years at birth – the lowest level since 1996. BTW South Korea boosts 83.5! So you will not be surprised as you read on – more spending!
Amazon Has A Plan For Your Healthcare
Amazon continues inroads in healthcare delivery with a stated objective to make medical care more affordable. It had launched and closed down recently a healthcare project targeting corporations (in 2021, after 3 years). So now they will go directly to patients, not insurance billing. You pick from a list of conditions and then choose from a list of providers. As expected there is a questionnaire to complete. You will use a non-video message-based portal to contact a licensed physician for consultation. Encounters may even end in prescriptions!
Elsewhere, the Cleveland Clinic says it will start to charge as much as $50.00 for messages in ‘My Chart‘™. patient portals when a message requires physician time and opinion. Up to now, this has been a free interaction. Relax, as refills requests, making appointments, and informing your physician of a healthcare update are still gratis. But you will see a bill if there is a medication change needed or forms to be completed. Note the fine print in your plan, some healthcare plans do not cover messaging. Cleveland Clinic plans to bill insurance companies for any interaction requiring five or more minutes of the medical provider’s time. Medicare patients with secondary insurance will not have co-pays, but some Medicare beneficiaries may see a $3 to $8 fee. Some privately insured patients will not have a copay, but if they have a deductible or their plan doesn’t cover messaging, bills might be $33 to $50 per message.
Thankfully patient portals have circumvented the Health Insurance Portability and Accountability Act of 1996 aka HIPAAconcerns. You may recall one of the many papers you sign anytime you receive any healthcare. This law exists to ensure patient information privacy.
Well, it was great while it lasted but now everyone wants in!
Alzheimer’s is a neurodegenerative disease that affects approximately 6.5 million Americans who happened to be over 65 years. Senility is sometimes used by the uninformed. Sadly, the number just continues to grow. This makes me wonder if there is something in our lifestyle or environment that accumulates and contributes to such a high number. Basically, one in nine people over 65 are living with Alzheimer’s (2022 report from the Alzheimer’s Association). Seems with increasing age the numbers do increase. As women, on average, live longer than men, there are now, more women approximately 4 million in 2022 living with Alzheimer’s.
With the stresses on the healthcare system and caregivers during COVID, those living with Alzheimer’s had an increased mortality rate of 17%. That translates to an increase of 44,700 deaths.
Actually, the numbers aren’t projected down. By 2050, unless there is a tremendous medical breakthrough, think either a preventive or slowing measure, or outright reversal innovation, 12.7 million Americans will suffer from Alzheimer’s disease.
Bad news for all of us using artificial sweeteners to try and keep the pounds off. Artificial sweeteners are present in thousands of food and beverage brands worldwide, however, they remain a controversial topic and are currently being re-evaluated by the European Food Safety Authority, and the World Health Organization. FDA states ” Based on the available scientific evidence, the agency has concluded that the high-intensity sweeteners approved by FDA are safe for the general population under certain conditions of use.” But they do not go on to specify ‘certain conditions of use. “For each of these sweeteners, FDA determined that the estimated daily intake even for a high consumer of the substance would not exceed the acceptable daily intake (ADI). Generally, an additive does not present safety concerns if the estimated daily intake is less than the ADI. That word ‘generally’ to me is worrisome. Same as used in regards GMO foods.
There have been many investigational experiments both in the laboratory and prospective observed patient on studies so I’m even human randomized controlled studies to investigate early markers of cardiovascular health for example wade hypertension inflation gut microbes but many also in association with using artificial sweeteners or artificial sweetener beverages most of these studies have suggested adverse effects. Artificial sweeteners are not good for cardiovascular or cerebrovascular health. The leading cause of death worldwide is cardiovascular disease. And this study below in-depth should put to rest the controversies. Now if only the FDA and world health in the EU food safety authority will take a position to caution the public on the use of these high sugar additives.
TheWHO 2022 reporton the health effects of artificial sweeteners observed ” an association between consumption of beverages with artificial sweeteners (used as a proxy) and some intermediate markers of CVD, including a modest increase in the unfavourable total cholesterol to HDL cholesterol ratio (meta-analysis of four randomized control trials), and an increased risk of hypertension (meta-analysis of four prospective studies)”.
In a prospective study, carried out in France, the records of 100,000 people focused on diet and activity and do use of artificial sweeteners. The British Medical Journallooked at dietary artificial sweeteners to see if it was a risk factor for cardiovascular diseases (heart and brain). Artificial sweeteners they included were: aspartame (NutraSweet™, Equal®, and in UK Canderel®), acesulfame potassium (Ace K trade names Sunett and Sweet in EU), and sucralose (aka Splenda®). Analyzing 900,000 person-years of data (2009-2021) revealed a distinct association between the two. Researchers actually took food additive composition data and matched with consumption date to account for possible industrial reformulations and changes in the additive composition. The mg/day for each participant was measured. The patient population included diverse breakdown however none were obese average BMI was 23.6. Varying cholesterol and glucose levels, hypertension, education level, also smokers and non-smokers were included.
Noteworthy is that the risk was greater for cerebral vascular disease (brain vessel disease). Further, the study found that not all artificial sweeteners were equally harmful, that specifically, aspartame use increased the likelihood of cerebral vascular events (ex. strokes, TIAs). Acesulfame K and sucralose were associated with increased coronary heart disease risk.
FYI: there are other sugar substitutes that are not in the high-intensity sugar substitutes. They are ‘sugar alcohols’ and include sorbitol, xylitol, lactitol, mannitol, erythritol, and maltitol. The sweetness of sugar alcohol varies greatly but they are low in calories and do not cause your teeth to rot, or pounds to be upped, and blood sugar rush. Look for them to be in sugar-free candies, cookies, and chewing gums.
Caffeine jump-starts your day and puts a bounce in your step. It can help you focus, improve your mood and maybe even help you live longer. It is a natural stimulant! Listen to Doc Handal’s latest podcast and learn more about caffeine and how it is actually used in Denmark to improve nearsightedness in children listen up!
What follows in this blog is a few medical Journal reveals I want to share with my followers. Hope you find them as interesting as I did.
AI & ECG Interpretation
At the European Society of Cardiology (ESC), in Barcelona last week, a randomized clinical trial of artificial intelligence (AI) presented that technology was superior -yes, better than humans at interpreting echocardiograms. Quite a bit to ponder! In the field of Dermatology, a recently reported study showed the accuracy of AI versus clinical specialists. AI matched or exceeded the practitioners!
AI & Arrhythmias
In Germany, smartphone-based screening for atrial fibrillation more than doubled the rate of finding the diagnosis when compared to waiting for routine medical care to find this heart rhythm problem. The eBRAVE-AF randomized trial was announced in the publication in Nature Medicine.
A few cups of tea a day might help stave off an early death, a U.K. Biobank prospective cohort study showed. Among nearly half a million middle-aged adults, those who consumed two or more cups of tea a day saw a slight but worthy lower risk for all-cause death. The follow-up was for about 11.2-year (median). No, it was not green tea which has been very studied. Individuals, 90% of them drank black tea. Importantly data was corrected (adjusted) for sociodemographic and lifestyle factors. This is important across any large studies.
Those that were drinking more than two cups of black tea a day, had an associated 14% to 24% decrease in risk for death from cardiovascular diseases. Another revelation was that among the heaviest black tea drinkers there was the most risk reductions.
When someone says heart attack you think of a dramatic pain that could possibly quickly end your life. However, the reality is twenty percent (American Heart Association 2022 data) of heart attacks are silent: there is no dramatic pain. The popularized notion of a load of bricks sitting on your chest does not always occur. Some experts expand that to fifty percent being silent heart attacks.
A Heart Attack occurs when heart muscle blood supply, bringing nutrients and oxygen, is decreased or stopped. You feel pain because of a blockage, partial or complete. Commonly silent heart attacks are written off as indigestion, sprain in the chest muscle, being tired, or just being run down. In retrospect, when you later recognized you’ve had an attack, you recall an experience such as shortness of breath and general discomfort which led to a night of poor sleep.
Often the most subtle body sensations are: not feeling quite yourself, suddenly sweating, becoming dizzy, and angina (pain from a decrease of blood to the heart muscle). For women the sensation of having a tight bra might be the only hint they’re having angina or heart attack. If these symptoms persist, they can lead to a heart attack. Angina may be reversible but the longer the lack of good blood supply, hence lower oxygen to the heart muscle, the more likely irreversible damage will kill heart muscle – that is a myocardial infarction- MI.
If you’re diabetic, recognizing your heart is talking to you may more easily be missed due to pain signals being dampened by neuropathy. Hence a diabetic person is at a greater risk for a silent heart attack.
Those with minimal symptoms, that is no warning sign, are often fooled or are misdiagnosed. The shortness of breath in a slightly obese woman is thought to be a blood clot coming from the leg to the lung or pain in the arm or shoulder is thought to be arthritis but in reality, could be a heart event. One helpful thing is that if your pain does not change with position or taking deep breaths then it is not musculoskeletal, and could be related to your heart. If you’re exerting yourself and your pain gets worse that would mean you’re not getting enough oxygen and the discomfort is related to your heart. If you feel better at rest when the need for oxygen to your heart muscle is less -then your symptoms could be related to the heart.
Past blogs discussed heart disease risk factors. Refresher – women 55 and older, men 45 and older, carrying excess weight, high blood pressure, high cholesterol, lack of exercise, positive heart history, smoker, family history, and of course Diabetes. You do not need to have a specific number to increase risk. Yes, there are young people with heart attacks because they use drugs or have a hereditary or congenital problem.
Not surprising if you have had a silent heart attack you are more likely to have a stroke, sudden death, or obviously another heart attack. Whenever a heart is stressed there is an increased risk for the heart to start beating in an irregular manner (arrhythmia) and cause blood clots to form.
Message – Pay Attention to changes in the patterns in your body. My mantra, you all know, if your body talks to you it’s important to listen. Pay attention to discomforts. their patterns, and predictability like with exertion. Note especially symptoms such as shortness of breath, weakness, fatigue, not quite feeling right, sweating, nausea, vomiting, lightheadedness, dizziness, pain in the back, arms like a sprain or pulled muscle, mild throat pain or chest discomfort,
Please consider the possibility that you are having a cardiac event. Remember they don’t have to be dramatic. Not everyone has the sensation of impending doom when they are having a heart attack. Not everyone clutches their chest like on the big screen!
Until today in this blog and in many media outlets you have read or heard ‘exercise with diet’ is the only way to lose weight. Well, I’ve got news from a group of researchers who state that eating within a specific eight-hour window can cause weight loss.
In a recently published JAMA Internal Medicine article, eating within a 12-hour time frame was compared to limiting caloric intake to an eight-hour time frame (7 AM to 3 PM in this study). Using the eight-hour window, individuals lost an additional 5 pounds over 14 weeks. The eight-hour window, however, wasn’t much help for shedding body fat specifically but a bonus was the lowering of the diastolic blood pressure (the second number in BP reading – the minimum pressure during relaxation and dilatation of the heart when the ventricles fill with blood). No other cardiovascular benefits were noted in the study details. The study include 59 participants, and as I stated above, ran for a 14-week period. I think it is especially noteworthy that an improved mood and sleep pattern were also seen. The detailed evaluation noted improved sub-scores for mood, vigor vs. activity, and fatigue vs. inertia. But this can have a subjective component, I feel. Important to note that within the study not everyone complied for seven days per week, the average was six days per week eating during the eight-hour period.
An earlier study this year (published New England Journal of Medicine), used the same concept – a time-restricted diet but adding a caloric restriction based on individuals’ activity level. In this study there were 90 participants, mean age of 43 – and 80% were women, all with BMIs from 30 to 60. All participants received weight loss counseling and energy restrictions followed by a caloric restricted diet of 500 cal per day below their energy expenditure. They were exercising 75 to 150 minutes per week depending on their baseline physical activity. They were analyzed for how much they exercised and they were restricted to eating from 8 AM to 4 PM.
However, these researchers found it didn’t result in a significantly greater amount of weight loss compared to just limiting your total caloric intake. Differing outcomes from similar studies are frequent in the medical literature. A careful review of specifics and outcomes is quite important for readers.
One difference between the two trials was the eight-hour time frame, the trial published in the New England Journal of Medicine studied it from 8 AM to 4 PM versus the 7 AM to 3 PM trial in JAMA Internal Medicine. So the question becomes does timing matter when it comes to eating? It matters. Regardless of the study differences, I believe the existence of benefits from adherence to a consistently limited eating time is best for our bodies.
Having your caloric intake limited according to energy expenditure appears to be relevant for weight loss. Hope this blog arms you with insights to help in your diet.
More than two-thirds of Americans are considered overweight or obese. What directly results is an increase in heart (cardiovascular) disease, diabetes, and cancer. Per the CDC data, more than 2/3 of Americans are considered overweight that being obese. The US spends the most per GDP on healthcare, approx. 3.6 trillion a year. Per capita, the highest worldwide spent than many countries with a longer life expectancy and better medical outcomes. So what’s up? What are we doing wrong?
A recent study, published in Nutrients, shows it’s our diet. Americans have a poor quality diet, which authors state is the primary cause of death in the United States. Fact is the majority of deaths per year are related to cardiovascular disease and other bad health conditions related to poor eating habits and obesity.
Many have tried to solve problems with fad diets, they are everywhere, with complex rules and schedules which some find nearly impossible to adhere to. Bottom line many studies have shown that eating whole foods and placing them in the center of your diet will benefit nutritional intake. Actually having a whole fruit that has high vitamins is better than having a supplement of high nutrient content.
Findings suggest eating a Whole Foods diet helps and promotes weight loss. It refers to acquiring nutrients through a diet with large amounts of non-starchy vegetables like carrots and string beans, fruits either frozen or fresh, whole-grain, and plant-based drinks (unsweet and soy or nut beverage, green tea decaf coffee, and tea).Look to seeds rich, in omega-3, (chai and flaxseed) to acquire this important body nutrient.Also recommended is to limit the amount of high-fat plant foods like nuts seeds coconut and avocado, dried fruit, and refined flours. Wheat, gluten foods like tofu, and soy protein are to be limited. Seriously noted is attention to moderate alcohol intake.
Absolute avoidance of refined flours added oils and solid fats, no sweets – you know that means candies, cookies, and pastries are recommended. Also absolutely, no artificially sweetened beverages, This diet ‘outlaws’ eating animal products such as poultry seafood eggs, and dairy.
This really is a new approach, incorporating some old well-known aspects. You all by now, know about the negative health impact of consuming processed foods, studies abound about the ultra-processed risk for heart disease. One study I am thinking of collected data from over 100,000 individuals, 18 and older, and tracked them for 5 1/half years. Findings that those consuming ultra-processed foods were at higher risk of cardiac disease, coronary artery, and also cerebral vascular all were statistically significant. Many other studies are available in the literature.
Please consider incorporating this regimen, especially a plant-based diet.
Doc Handal’s new podcast talks about our skin, the largest organ, and special considerations, if like 2/3 of all Americans, you bathe every day. Listen to this podcast to find out more about the ecosystem, the balance, the need for body odor removal, the presence of bacteria viruses, and fungus as well as the dangers of antibacterial soaps. She explains the need not to upset the process that our skin serves as a barrier and a defense.