0 Whats The Right Diabetes Disease Management Program For Your Patients

The answer is "it depends."

For a good example of why thats true, check out this hot-off-the-presses Health Affairs article that describes two parallel approaches to disease management.  Both were offered side by side to a largely Hispanic and socioeconomically disadvantaged population in Los Angeles (LA). 

One program was provided in the LA Department of Health Services primary care health centers. Patients with poor diabetes control were erred to a separate turn-key "one stop" care program with non-physician educators under the direction of an endocrinologist. Using a combination of in-person and telephonic management, patients were put through a six to nine month protocol designed to optimize their medication treatment plan, foster better living habits and improve self-care.  Nurse case loads averaged 125 patients.

In LAs independently-run community clinics (many of which are federally qualified health centers), case managers and clinical pharmacists were available on-site for lifestyle counseling, education on self-care and medication management that included initiating insulin and adjusting other drugs. Nurse case loads numbered 400 patients, while the pharmacists had about 200 patients.

Based on pre-post measurements involving hundreds of patients, both the LA health centers and community clinics patients experienced impressive improvements in blood glucose control and cholesterol levels.  Thats typical in disease management programs. 

However, there were some differences.  In the LA health clinics, the program was separate, overseen by a specialist, limited to patients with poor glucose control and involved a more intense program of patient education.  In the community health clinics, the nurses and pharmacists were "part" of the clinic and, based on the caseloads, were less labor-intensive.

Despite the differences, the DMCB couldnt really tell if one approach to diabetes care management was "better" than another.  There was little information on the content of the care plans and no information  on costs.  Yet, all things being equal, the DMCB suspects that architects of similar programs nationwide are ultimately selecting from a menu of care and staffing options based not only on patient need but highly subjective (or yet-to-be-investigated) perences based on local physician culture (sometimes specialist leadership is important), access to special resources (like pharmacists) and local budgetary realities.

The key lesson in this article is how two parallel clinic systems in the same population serving a similar population decided to deploy different disease management programs.  Both resulted in patient betterment.  Both had relative strengths and weaknesses.  Deciding which approach is "better" remains a matter of local judgement based on a complex number of factors.

In other words, it depends.

Image from the Kentucky Diabetes Resource Directory

0 CDC Diabetes And Prediabetes Risk Tests

The US Centers for Disease Control and Prevention (CDC) says that 25% of Americans with diabetes don’t know they have it, and that approximately 1 in 3 have prediabetes but only 7% of them know it. They developed these tests to help users learn whether they are at risk for prediabetes and type 2 diabetes.

________

0 Prevent dandruff with this food

Prevent dandruff with this food - In addition to keeping the hair and scalp, dandruff, it also can be prevented by eating nutritious food. What is it? Listen more, as reported by the following 3 Fat Chicks.

Fresh food

Fresh fruits and vegetables rich in antioxidants that prevent disease and maintain healthy hair, skin, and nails as a whole. So do not be lazy to eat fresh vegetables and fruits that dandruff is not easy to come by.

Fish oil

Fish oil has a specific effect on the skin, which prevents dryness and dandruff coming ward. Fish oil can be obtained by eating salmon and other oily fish or through supplements.

Milk substitute products

Several studies have shown that dairy products are not suitable if taken by people who have problems with dandruff. Because the combination of fat and other ingredients in dairy products actually aggravate dandruff. So find a milk substitute products is low or non-fat at all.

Vitamin B

Vitamin B complex also includes a powerful food to prevent dandruff. This vitamin can be found in fruits and vegetables that should be consumed every day indeed.

Lean meat

According to experts, in order to minimize the appearance of dandruff, the body needs a lot of protein. So do not forget to enter the menu of meat, especially lean, in order to obtain the maximum protein intake.

Those are some foods that can prevent dandruff. May be useful.

0 Top Secrets of Super Healthy Peoples Secrets of People Who Never Get Sick

‘Health is wealth’ but often people consider it luck to enjoy better health. Some people never seem to get sick. Well, it is not about luck. Simple lifestyle changes can do wonders for your body. What super healthy peoples are doing, the rest of us arent to keep illness at bay? Despite centuries of scientific advances, doctors still can’t tell us definitively how to stay well. So why not look for solutions from the people for whom the common cold is, well, uncommon? 

Here, 10 surprising habits of those people who never get sick—and how you can adapt them to your lifestyle for a better healthy living. These are easy ways that can help maintain a balance within your body and keep illnesses at bay.

Here are the top 10 secrets of people who never get sick.

1) Follow Proper Sanitizing Habits

The Centers for Disease Control and Prevention says that proper hand washing is one of the easiest ways to avoid becoming sick often. Try to wash your hands with regular soap and warm water for at least 20 seconds. This simple habit lowers your chances of contracting serious colds and the common flu.Take a bath daily and clean all parts of your body well. Regularly check your fingernails for trapped dirt. Also, keep your home and surrounding area clean and free of germs.

2) Detox regularly
Many chemicals used commonly today—such as phthalates, dioxins and PCBs—were absent from our environment a century ago. That might be why the rates of diseases (including cancer and liver disease) linked to toxic exposures are increasing, say experts. 

Although no long-term studies on the benefits of detoxification have been done, chances are good that your health will improve if you lower the level of synthetic chemicals present in your body. Digestive issues, fatigue, breakouts or muscle pain are often signs that you could benefit from a detox program, most of which require you to limit meats and avoid wheat, sugar, dairy, caffeine and alcohol.

3. Keep a Positive Attitude

Another secret to living a healthy life is feeling positive about your life, your surroundings and different situations that we all face in life. Having a positive attitude toward life will help you feel more happy, enthusiastic, and calm.

Research done at Carnegie Mellon University found that those with positive outlooks become less sick and are more resistant to developing upper respiratory illnesses. Also, those who don’t always think positively and have a negative attitude toward things suffer from more stress and tension. Too much tension and stress are factors that contribute to many life-threatening diseases such as hypertension, diabetes, heart problems and others.

4) Have an Active Social Life

Studies show that people who are active socially tend to have more robust immune systems and are less likely to suffer from infectious diseases. Harvard University did a study in 2008 that found that positive social attachments might protect against memory loss and other cognitive disorders.

Also, those with few friends were more likely to suffer from heart disease, depression and anxiety. So, to remain healthy you need to take time out of your busy schedule and see your family members or friends. If your friends live far away, you can call them up or chat online with them.

5) Dont Worry, Conquer Stress

Happy people who can easily manage stress very rarely get sick. A Duke University study showed that stress damages the immune system and the heart. Stop worrying, the fear and expectation of having something adverse happen actually lowers immunity. Other studies also suggest that too much stress increases your chances of contracting bacterial infections, such as tuberculosis. Hence, it is essential to learn relaxation techniques from early childhood and try to manage stress as much as possible.

Whenever you are tense or stressed, take a vigorous walk for about a half an hour. This will help you feel more relaxed. A diet rich in fruits and vegetables and sleeping seven to eight hours at night also helps. Finally, laughing often helps release endorphins in the body that act as natural stress busters.

6) Stay Hydrated

As the human body is made up of 60% water, it is true that staying well hydrated can immensely minimize your risk of becoming ill frequently. Staying hydrated helps your body maintain the proper harmony in cellular functioning, which plays a key role in transferring nutrients to different parts of the body. It also helps flush out excess toxins that enter our systems through pores and the blood stream.

The easiest way to keep your body hydrated is to drink plenty of water throughout the day. Try to drink 10 to 12 glasses of water daily to avoid dehydration. Also, eat more fruits and vegetables that are high in water content. Experts also recommend limiting your alcohol consumption because alcohol weakens the immune system and can cause dehydration.

7) Keep a Balanced pH Level

The body remains healthy when its systems are functioning midway between completely acidic and completely alkaline. In simple terms, it means a balanced pH level. When pH levels fall below the midpoint, the body suffers from a condition called acidosis, which can cause fatigue, rapid breathing, stomach problems and confusion. Acidosis can happen when you consume more meat and sugar. 

But eating more vegetables and fruits with alkalizing properties can resolve the imbalance.Include a lot of dark leafy greens, green beans, asparagus, carrots, cucumbers, coconuts and avocados in your diet. Also, avoid eating processed foods as much as possible.

8) Strive for a Well-Balanced Diet

A properly designed diet plan can lower your risk of becoming sick often. Food provides substances that keep us strong and healthy. Eat foods high in nutrients such as vitamin A and C, protein, carbohydrates, iron, essential fatty acids and so on. Eat fresh and seasonal fruits and vegetables and avoid processed food items.

One of the most important aspects of a healthy diet is eating a variety of fruits and vegetables in their natural, uncooked state. Brightly colored fruits and vegetables are excellent sources of vitamins and minerals along with antioxidants that boost your immune system to fight off diseases and keep you fit.

Research also suggests that onions, garlic, ginger and honey have antimicrobial and antiviral effects which can help prevent illness. Also, lowering your daily calorie intake can help you stay healthy and lower your risk of aging-related diseases such as cardiovascular disease, diabetes and possibly even Alzheimer’s disease.

9) Exercise

It has been found that those who spend at least a half an hour daily doing physical exercise do not get sick often. Exercise boosts your immune system and provides many other health benefits. If you do not have time or money to go to a gym, then try walking, running, jogging or cycling for about half an hour daily.

For better health, aerobic exercise is the best option because it gets your heart rate up and pushes nutrient-rich blood throughout the body. It also helps reduce the number of molecules in the body that lead to inflammatory conditions that weaken the immune system. Studies also have found that exercise reduces the risk of health problems like cancer, heart disease, type 2 diabetes, stroke, dementia and depression. Exercise also slows down the aging process.

10) Get Enough Rest and Sleep

Proper rest and sleep can do wonders for your body. When you enjoy at least eight hours of peaceful sleep every night, your body will reach a perfect harmonious balance and you will feel your best. Ample sleep and rest is one of the first steps to staying healthy. Sleep deprivation can have a degenerative effect on your mental as well as physical health.

A sound sleep of six to eight hours allows you to handle the day’s stress easier, boosts your memory power, helps keep blood pressure and cholesterol levels in normal ranges, helps reduce inflammation, prevents depression, helps manage body weight and more. It also boosts your immune system to ward off viruses and bacteria that make you ill.

These tips can make a huge difference for your body by boosting your immunity and helping you to stay fit and healthy disease free. Also, They are very easy to incorporate into your lifestyle. 

0 Ask the Internet Food Funny

Today’s question is a spinoff of yesterday’s post, and could be a nice diversion on this rainy, April showers kind of day:

Q: What is your favorite food-related comedy?

A: For about a year here on CHG, we had Favorites of the Week, which usually included a song, sketch, or piece of standup based on food. It was super fun to compile, and often yielded genius like:

Jim Gaffigan on Bacon


Monty Python’s “Spam”


Readers, what’s your favorite food comedy? Is it standup, sketch, or improv? Maybe a song? Or a simple quote?

If you have a link, please include! (Extra points for Vimeo and Youtube URLs, as Canadians can’t see Hulu. It’s kind of like their Snuffleupagus.)

Want to ask the interweb a question? Post one in the comment section, or write to Cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net

0 Ask the Internet Favorite Processed Food

Sweet readers! Husband-Elect and I had a Bridal/Groomal Shower this weekend! And it was a surprise! And it was awesome! And pretty! And huge! And generous! And my in-laws flew in! And we got an OXO Salad Spinner that is basically the best thing that’s ever existed! It has a brake button! Who knew?

We’re just starting to recover from the busy-ness, so today is all about getting things back up to speed. Please accept this Ask the Internet question in the meantime…

Q: A few weeks ago, we asked readers what food-type item you can’t believe exists. The answers were funny and overall, pretty shocking, with the clear-and-away winner being pre-made peanut butter and jelly sandwiches. This week, we thought we’d go in the other direction: What’s your favorite processed food?

A: I have four:

1. Kraft Macaroni and Cheese: Powdered cheese is a crime against nature and good sense, but I would give up a limb for this stuff.
2. CoffeeMate: in almost every flavor.
3. Aunt Jemima’s Butter Lite Syrup. Someday, they will discover that Aunt Jemima is the core component of nuclear payloads. Meanwhile, leave me be when Im huddled in a corner, chugging this straight from the bottle.
4. Breakfast cereals. Honey Nut Cheerios. Crispix. Special K Red Berries. Cinnamon Toast Crunch. Kix. Honey Bunches of Oats. The list goes on. I cant help it. There are Grape Nuts embedded in my DNA.

So readers, how bout you? What processed food would you fight to the death for?

Want to ask the interweb a question? Post one in the comment section, or write to cheaphealthygood@gmail.com. Then, tune in next Tuesday for an answer/several answers from the good people of the World Wide Net.

0 Best Exercises for Weight Loss Improved Health

(Article first published as Choosing the Right Exercise for Weight Loss and Health on Technorati.)
People choose many different types of exercise programs, depending on the goal they intend to accomplish. Some choose cardio aerobic activities such as walking and running in an effort to lose weight, while others gravitate toward resistance forms of exercise to build muscle and improve health. It’s important to combine the proper intensity with an appropriate fitness routine to achieve the proper end result that’s right for you.

Choosing Your Fitness Goal

Physical activity guidelines have been established by the US Department of Health and Human Services which are helpful in determining the proper exercise routine to follow, depending on your fitness level and ultimate goal. Individuals trying to lose weight and body fat will want to hit the treadmill with a moderate intensity level for at least 60 minutes on most days of the week.

Many people understand that it’s important to choose some type of exercise to improve health and retain muscle mass, while strengthening the most important muscle in the body, the heart. Here you’ll want to concentrate more on short burst, high intensity resistance exercises with 10 to 20 reps working all major muscle groups. At least 20 to 30 minutes is needed each day to maintain muscle tone and optimal body conditioning.

Top Exercises for Weight Loss
Always combine regular exercise with a well balanced, reduced calorie diet for maximum results. The best weight loss exercises will combine both an aerobic aspect as well as a toning element to drive your metabolism and burn fat.

Step Aerobics:

The main point behind cardio aerobic conditioning exercises is to raise the heart rate into the training zone which increases metabolism and triggers fat release. Step aerobics is an ideal form of fitness training that targets the hips, legs and belly, prime targets for toning and weight reduction. Step aerobics can burn up to 800 calories per hour and qualifies as an inexpensive and highly effective conditioning method to burn fat.

Bicycling:
Whether you choose to ride around the neighborhood on a traditional bike, or opt for a stationary trainer, biking provides an excellent way to burn between 500 and 1000 calories per hour, depending on intensity and terrain. Biking is easy to do and is one of the best exercises to boost metabolism and promote weight loss.

Exercises to Promote Health
Health promoting exercises typically involve improved blood circulation and enhanced metabolic function. Although these forms of physical activity aren’t as intense as those which target weight loss, they lower disease incidence by improving critical bio-markers such as blood pressure, blood glucose and heart rate.

Walking:

Walking is the perfect exercise for virtually everyone. It requires nothing more than a good pair of shoes and a safe place to stretch your legs, while strengthening the heart and influencing metabolic markers such as improved cholesterol ratios, lowered blood sugar levels and blood pressure. Plan to walk at least 30 minutes a day every day of the week for maximum benefits.

Swimming:
Swimming ranks among the best forms of exercise to improve and maintain health because it conditions every key muscle group in the body. There’s no impact to joints, so there’s little risk of injury which can sideline your efforts. Swimming strengthens the heart and lungs, and has been shown to improve insulin resistance as the muscles become metabolically conditioned for peak efficiency.

Health conscious people understand the importance of regular exercise and need to make the proper choices when determining their ultimate goal. Exercises which are meant to burn fat and lower body weight require more intensity and longer training periods. Training to improve your health demands a shorter session, completed on most days of the week. Regardless of your goal, exercise is the key to sustainable weight loss and optimal health.

0 8 Benefits cabbage unknown

8 Benefits cabbage unknown - Cabbage is one vegetable that is full of nutrients. Although cabbage sometimes cause increased gas production in the stomach, but cabbage can also provide health benefits. Here are some of the health benefits of cabbage, as reported by Mag for Women.

1. Green and red cabbage known low in calories and contain lots of vitamins and minerals. It is suitable for those who are on a diet do not do not want to consume too many calories.

2. Cabbage can prevent the aging process. Cabbage contains vitamin C and keep the skin to remain young, and slow the aging process. In addition, cabbage is also a good source of vitamin E.

3. The study revealed that cabbage contains ant - cancer substances. Eating cabbage can give the body flavonoids that can protect the body from cancer.

4. Vitamin A in cabbage helps nourish the eyes and maintain eye health. Eating cabbage since childhood will reduce the likelihood of a person wearing glasses as an adult.

5. Cabbage is rich in vitamin E, which served as a key element in the repair of cells and tissues in the body. Not only that, the vitamin E in cabbage could also accelerate metabolism. Cabbage can also increase more antibodies.

6. For a long time, has been used as a drug cabbage canker sores on the body. This is because the substance glutamine in cabbage and can be obtained by eating cabbage juice.

7. Cabbage is also rich in sulfur and other minerals function as the human digestive system cleanser. Eating cabbage will prevent constipation.

8. Eating cabbage can also ward off diseases such as Alzheimers brain. The study revealed that the substances in cabbage could prevent Alzheimers disease and can even cure patients affected by Alzheimers.

Those are some of the health benefits of cabbage. During the red cabbage is considered healthier than green cabbage . But do not eat too much cabbage because it can cause excess gas.

0 Positive outlook reduction in cardiac events such as heart attacks

People with cheerful temperaments are significantly less likely to suffer a coronary event such as a heart attack or sudden cardiac death, new Johns Hopkins research suggests.

Previous research has shown that depressed and anxious people are more likely to have heart attacks and to die from them than those whose dispositions are sunnier. But the Johns Hopkins researchers say their study shows that a general sense of well-being — feeling cheerful, relaxed, energetic and satisfied with life — actually reduces the chances of a heart attack.

A report on the research is published in the American Journal of Cardiology.

"If you are by nature a cheerful person and look on the bright side of things, you are more likely to be protected from cardiac events," says study leader Lisa R. Yanek, M.P.H., an assistant professor in the Division of General Internal Medicine at the Johns Hopkins University School of Medicine. "A happier temperament has an actual effect on disease and you may be healthier as a result."

Yanek cautioned that cheerful personalities are likely part of the temperament we are born with, not something we can easily change. While some have suggested its possible that people lucky enough to have such a trait are also more likely to take better care of themselves and have more energy to do so, Yanek says her research shows that people with higher levels of well-being still had many risk factors for coronary disease but had fewer serious heart events.

She emphasized that the mechanisms behind the protective effect of positive well-being remain unclear. She also noted that her research offers insights into the interactions between mind and body, and could yield clues to those mechanisms in the future.

For the study, Yanek and her colleagues first looked at data from GeneSTAR (Genetic Study of Atherosclerosis Risk), a 25-year Johns Hopkins project sponsored by the National Institutes of Health to determine the roots of heart disease in people with a family history of coronary disease. They analyzed information gathered from 1,483 healthy siblings of people who had coronary events before the age of 60 and who were followed for five to 25 years. Siblings of people with early-onset coronary artery disease (CAD) are twice as likely of developing it themselves.

Among other things, study participants filled out well-being surveys and received a score, on a scale of 0 to 110, which gauged cheerful mood, level of concern about health, whether they were relaxed as opposed to anxious, energy level and life satisfaction. Over the course of an average 12-year follow-up, the researchers documented 208 coronary events — heart attacks, sudden cardiac death, acute coronary syndrome, and the need for stents or bypass surgery — in the sibling group.

The researchers found that participants positive well-being was associated with a one-third reduction in coronary events; among those deemed at the highest risk for a coronary event, there was nearly a 50 percent reduction. The findings took into account other heart disease risk factors such as age, smoking, diabetes, high cholesterol levels and high blood pressure.

To validate their result, the researchers then looked at similar information in a general population using data from 5,992 participants in the first National Health and Nutrition Examination Survey (NHANES). In this population, over an average 16-year follow-up, there were 1,226 coronary events (20.5 percent). They found that this group also benefitted from a cheerful temperament, which reduced their risk of a coronary event by 13 percent.

The findings held whether the participants were white or African-American, men or women.

0 Top 10 Links of the Week 1 29 10 – 2 4 10

This week, its exploding soup, C3PO cereal, and lessons learned, all around. Have a wonderful Super Bowl Sunday, sweet readers. Have a beer or five.

1) The Kitchn: Why Does Soup Explode Out of My Blender?
I can’t tell you how often I’ve done this. How many more long-sleeved t-shirts must die?

2) Dark Roasted Blend: Weird Festivals and Strange Celebrations
From tomato tossing to cheese rolling to the Great Belgian Orange Throw of ’09, this collection of bizarre carnivals will amaze your friends, impress your parents, and possibly shoop.

3) Lifehacker: Store Brand Foods that Save You Money Without Sacrificing Taste
Consumer Reports just did a study comparing brand named groceries to generics. And? The generics, which cost an average of 27% less, did as well or better in most tests (except barbecue sauce, which … granted).

4) LA Times: With Master Cleanse, Clarity Gained – With a Twist
The Master Cleanse (for which you eat nothing but maple-and-cayenne spiked lemonade for ten days) supposedly clears your mind, revs up your appetite, and helps you lose weight. Writer Jessica Gelt tried it. This is her light-headed, calorie-deprived story.

5) Money Saving Mom: Lessons I’ve Learned from the Pantry Challenge
Recently, MSM readers took the Pantry Challenge, in which they cooked for a week using their pre-existing stocks of food. Guest poster Jennifer learned a ton in the process, and her observations should help any burgeoning frugalist.

6) New York Times: Six Meaningless Claims on Food Labels
In which the Gray Lady confirms that “All Natural” (and five other dastardly claims) mean absolutely nothing, like a Kate Hudson movie or promises from your landlord.

7) Ellen: Ellen is Sugar-free - Day 4
Ms. DeGeneres and one of her writers are going sans sugar for an entire week, and keeping a video diary about the ordeal. Ellen’s a vegan, so I don’t expect this to affect her too much, but the writer is having headaches and sleeping issues. Writers: oh, how we suffer.

8) Cavalcade of Awesome: The Grocery Aisle of Long Forgotten Breakfast Cereals
Go for the sweet pics of vintage cereal boxes like Waffle-Os and C3POs, but stay for the best blog banner EVAH.

9) Casual Kitchen: Mindful Chewing – How to Cut Your Calorie Intake in Half Without Feeling Hungry
Remember the olden days of yore, when your grandparents told you to chew each piece of food 20 to 30 times before you swallowed? Turns out, they were right. They were right about EVERYTHING. (Except the War of the Worlds debacle. Oh, New Jersey. You so crazy.)

10) MSN Smart Spending: Would you pay more for less Coke?
You know those new mini Coke cans? The 8-ounce dealies that supposedly restrict your calorie intake by restricting portion sizes? According to MSN, they’re “50% to 140% more per ounce than the regular 12-ounce cans,” not to mention TERRIBLE for birds and trees and such. And your health. There is no upside here.

HONORABLE MENTIONS

Bon Appetit: The 10 Rules of Making Nachos
Who loves ya, baby?

Hide Your Arms: 200 T-Shirts for Food Lovers
Just in time for V-day! (Thanks to the Kitchn for the link. Speaking of which...)

The Kitchn:

Making Smoothies Easy – Tips from Alton Brown
Raw to Sweet – How to Change the Intensity of Onions
What are Light and Savory Ways to Use Canned Pumpkin?
Another week, another spectacular collection of posts from the Kitchn. These are but a few of mah favorites.

Lifehacker: Repurpose Your Rice Cooker to Make Tasty One Pot Meals
Short, sweet starter article on the beauty of the rice cooker, The Husband-Elect loves his more than he loves Batman. Which is a lot.

New York Post: Manhattan Snack Lack
Big Apple-ites are thin because we/they don’t snack. I thought it was from the constant beatings.

Slashfood: Budweiser Launches 55-calorie Beer
Yay?

AND ALSO

Axecop
Written by a five-year-old and drawn by his 29-year-old brother, Axecop is the story of a cop with an axe. Also, Unibaby, the baby with a unicorn head. Hilarious and excellent. If you read nothing else this week...

Thank you so much for visiting Cheap Healthy Good! (We appreciate it muchly). If you’d like to further support CHG, subscribe to our RSS feed! Or become a Facebook friend! Or check out our Twitter! Or buy something inexpensive, yet fulfilling via that Amazon store (on the left)! Bookmarking sites and links are nice, too. Viva la France!

0 Carotenoids in Diet from Fruits and Vegetables May Help Prevent or Delay the Onset of ALS

Amyotrophic lateral sclerosis, better known as ALS, is a devastating degenerative illness that incapacitates its victims in a manner similar to those suffering from Alzheimer’s disease. At present, there is no known cure or effective treatment for the illness, believed to be the result of oxidative stress caused by decades of poor diet, stress, environmental toxins and poor physical conditioning. Researchers have now discovered that increased consumption of foods containing colorful carotenoids, particularly beta-carotene and lutein, may prevent or delay the onset of ALS.

Natural Sources of Fruits and Dark Leafy Vegetables Help Lower Risk of Developing ALS

ALS, or Lou Gehrig’s disease, is a progressive neurological disease that attacks nerve cells in the brain and spinal cord known to be responsible for the control of voluntary muscles. As the motor neurons degenerate, the muscles they control gradually weaken and waste away, leading to paralysis. A research team from the Harvard School of Public Health has published the results of their research in the Annals of Neurologythat builds on prior studies showing that carotenoids, the natural compounds that give fruits and vegetables their bright orange, red, or yellow colors, provide critical antioxidant support to help fight this devastating disease.

Scientists evaluated five large studies comprising more than one million participants to develop a basis for evaluation. Researchers reviewed food intake for the group and further broke consumption down to determine carotenoids eaten in the form of fruits and vegetables. Lead study author Dr. Alberto Ascherio noted “Understanding the impact of food consumption on ALS development is important. Our study is one of the largest to date to examine the role of dietary antioxidants in preventing ALS.”

Add Five to Nine Daily Servings of Fruits and Vegetables to Your Natural Food Diet

A total of 1093 cases of ALS were identified across the cohort of subjects. The team found that those with the highest intake of carotenoids from any source had the lowest risk of developing ALS. They also determined that individuals who consumed more carotenoids in their diets were more likely to exercise, have an advanced degree, have higher vitamin C consumption, and take vitamin C and E supplements. Participants with the highest dietary consumption of beta-carotene and lutein, most commonly found in dark green vegetables had a reduced risk of developing ALS.

Interestingly, the researchers found that diets high in lycopene, beta-cryptoxanthin, and vitamin C did not reduce disease incidence, and long-term vitamin C supplement intake was also not associated with lower ALS risk. Dr. Ascherio concluded“Our findings suggest that consuming carotenoid-rich foods may help prevent or delay the onset of ALS.” This study acts to support a large volume of prior works that reinforce the critical importance of a natural food diet consisting largely of fruits and vegetables to thwart diseases ranging from cancer and diabetes to Alzheimer’s disease and ALS.

0 Friday Quips

Occasionally, I glimpse a truer Truth, hiding in imperfect simulacrums of itself, but as I approach, it bestirs itself and moves deeper into the thorny swamp of dissent.

from Cloud Atlas, by David Mitchell

plus......

From a short inteview with Jesses Café Américain:

Q. If you could travel back in time and change something in the financial world that would benefit society, what would it be?

A. I would help Alan Greenspan achieve a wonderfully rewarding career as a professional clarinetist.

0 Exposure to Traffic Linked to Heart Attack

In June I posted an article that cited research describing how exposure to traffic and air pollution was especially unhealthful for people with diabetes:

Another Reason to Clean the Air

Heres a related study that appeared in the New England Journal of Medicine last October. It found that exposure to traffic just about tripled their subjects risk for heart attack within an hour.

Time spent in cars, motorcycles, bicycles, or on public transportation consistently increased the risk for heart attack. Again, people with diabetes were found to be more susceptible.

It may not be possible to change your commuting routine. But in light of research that suggests traffic and poor air quality can compromise cardiovascular health, coupled with the recent need for energy conservation, it may be wise to consolidate errands and limit trips when you can.

Also, as one commenter said:

"We cant avoid all pollution, but sufficient use of antioxidants and a healthy diet with proper exercise should help."

________
For a summary of the study:
Sitting in Traffic Ups Risk of Heart Attack

For the study itself (abstract only, subscription required for full article):
Exposure to Traffic and the Onset of Myocardial Infarction

0 Flu Vaccine Associated With Lower Risk of Cardiovascular Events

Receiving an influenza vaccination was associated with a lower risk of major adverse cardiovascular events such as heart failure or hospitalization for heart attack, with the greatest treatment effect seen among patients with recent acute coronary syndrome (ACS; such as heart attack or unstable angina), according to a meta-analysis published in the October 23/30 issue of JAMA.

“Among nontraditional cardiovascular risk factors, there remains interest in a potential association between respiratory tract infections, of which influenza and influenza-like illnesses are common causes, and subsequent cardiovascular events,” according to background information in the article. Several epidemiological studies have suggested a strong inverse relationship between influenza vaccination and the risk of fatal and nonfatal cardiovascular events.

Jacob A. Udell, M.D., M.P.H., F.R.C.P.C., of the University of Toronto, and colleagues conducted a meta-analysis of all randomized clinical trials (RCTs) of influenza vaccine that studied cardiovascular events as efficacy or safety outcomes to determine if influenza vaccination is associated with prevention of cardiovascular events. The researchers identified five published and 1 unpublished RCTs of 6,735 patients (average age, 67 years; 51 percent women; 36 percent with a cardiac history; average follow-up time, 7.9 months) that met inclusion criteria for the study. Analyses were stratified by subgroups of patients with and without a history of acute coronary syndrome (ACS) within 1 year of randomization.

In the 5 published RCTs, 95 of 3,238 patients treated with influenza vaccine (2.9 percent) developed a major adverse cardiovascular event compared with 151 of 3,231 patients (4.7 percent) treated with placebo or control within 1 year of follow-up, an absolute risk difference favoring flu vaccine of 1.74 percent. The addition of the unpublished data did not materially change the results (2.9 percent influenza vaccine vs. 4.6 percent placebo or control).

0 The eyes look sunken and black This is why!

The eyes look sunken and black? This is why! - Lack of sleep is not a trivial matter that can be ignored. Sunken eyes indicate that you do not sleep well for a period of time. And trouble sleeping can cause a variety of health problems such as memory loss, high blood pressure and even diabetes. Before its too late, here are four medical cause why the eyes appear sunken, as reported Boldsky.

1. Unbalanced diet or extreme

If youre on an extreme diet to lose weight, you may begin to realize that your eyes look very haggard. When you lose the layer of fat in the face, the eyes will appear sunken. This is not a sign of good health. You should look for a more balanced way to weight loss.

2. dehydration

Loss of large amounts of water from the body also causes sunken eyes. Drink plenty of water every day, which is at least 8-10 glasses a day.

3. recovery

If you are recovering from serious illnesses such as dengue fever or malaria, you will have dark circles under the eyes and the eyes will look very concave. That means you need a lot of rest and a healthy diet to make eyes look healthy again.

4. Lack of vitamin

Malnutrition is responsible for the presence of dark circles under the eyes and sunken eyes. Lack of Vitamin C and K can make the eyes look sunken and tired. Even iron deficiency can make you look tired and dull.

Here are four medical cause for the eyes that look sunken. Remember, lack of sleep and dehydration is not a trivial problem that you can ignore. Health problems that might be simple if left unchecked can also be dangerous and life-threatening.

0 Aerobic exercise improves memory brain function and physical fitness

A new study conducted by researchers at the Center for BrainHealth at The University of Texas at Dallas published online in the open-access journal Frontiers in Aging Neuroscience found that engaging in a physical exercise regimen helps healthy aging adults improve their memory, brain health and physical fitness. This finding is significant considering that among adults 50 and older, "staying mentally sharp" outranks social security and physical health as the top priority and concern in the United States.

"Science has shown that aging decreases mental efficiency and memory decline is the number one cognitive complaint of older adults," said Sandra Bond Chapman, Ph.D., founder and chief director of the Center for BrainHealth, Dee Wyly Distinguished University Chair and lead author of the paper. "This research shows the tremendous benefit of aerobic exercise on a persons memory and demonstrates that aerobic exercise can reduce both the biological and cognitive consequences of aging."

For the study, sedentary adults ages 57-75 were randomized into a physical training or a wait-list control group. The physical training group participated in supervised aerobic exercise on a stationary bike or treadmill for one hour, three times a week for 12 weeks. Participants cognition, resting cerebral blood flow, and cardiovascular fitness were assessed at three time points: before beginning the physical exercise regimen, mid-way through at 6 weeks, and post-training at 12 weeks.

"By measuring brain blood flow non-invasively using arterial spin labeling (ASL) MRI, we can now begin to detect brain changes much earlier than before," said Sina Aslan, Ph.D., founder and president of Advance MRI and collaborator on the study. "One key region where we saw increase in brain blood flow was the anterior cingulate, indicating higher neuronal activity and metabolic rate. The anterior cingulate has been linked to superior cognition in late life."

Exercisers who improved their memory performance also showed greater increase in brain blood flow to the hippocampus, the key brain region affected by Alzheimers disease. Chapman pointed out that, using noninvasive brain imaging techniques, brain changes were identified earlier than memory improvements, implicating brain blood flow as a promising and sensitive metric of brain health gains across treatment regimens.

"Physical exercise may be one of the most beneficial and cost-effective therapies widely available to everyone to elevate memory performance," says Dr. Chapman. "These findings should motivate adults of all ages to start exercising aerobically."

Chapman cautioned that while physical exercise is associated with a selective or regional brain blood flow, it did not produce a change in global brain blood flow.

"In another recent study, we have shown that complex mental training increases whole brain blood flow as well as regional brain blood flow across key brain networks," Chapman said. "The combination of physical and mental exercise may be the best health measures to improve overall cognitive brain health. We have just begun to test the upper boundaries of how we can enhance our brains performance into late life. To think we can alter and improve the basic structure of the mature brain through aerobic exercise and complex thinking should inspire us to challenge our thinking and get moving at any age."

0 Medicares Expenses Increased by 0 4 Really And Its All Because of the Affordable Care Act

If youre the head of Google and you want to teach about the internet, North Korea is a swell place to visit.  If your goal is air travel safety, the 787 Dreamliner is the plane for you.  If you would like to get the puck from an opposing professional hockey player, saying "please" helps.  And if Medicare costs dip, the Affordable Care Act (ACA) obviously deserves the credit.

Writing on an HHS website, Richard Kronick and Rosa Po announce that 2012 Medicare expenditures per beneficiary grew only by 0.4% over the 2011 baseline.  They credit the ACAs value-based payment (VBP) system, attacks on fraud and abuse, reduced payments to Medicare Advantage plans, cutting hospitals payments and "innovation."

The Disease Management Care Blog isnt too sure about that.

1. This Kaiser Health News article notes the VPB program withholds 1% of hospital payments and uses that fund to award bonuses in what is really a zero sum game.  And this Health Affairs article suggests the overall financial impact of VPB on hospitals is quite minimal anyway. 

2. While there have certainly been some big fraud and abuse busts, theres plenty of reason to still be skeptical about the ability of Medicares ossified bureaucracy to catch up with the sophisticated criminal enterprises that are routinely fleecing billions from the U.S. taxpayer.

3. As for the one-time payment cuts to providers and insurers, the DMCB is confident that theyll figure out ways to get their money back.  They always do.

4. The innovations are in demonstration phase.  Its too early to tell.

In addition, the DMCB is surprised that Medicares 2012 insurance claims were ready to be rolled up and quantitated in early 2013. Check out this telling quote from the website:

"2010 and 2011 statistics are calculated on a calendar year incurred-basis. 2012 statistics are calculated on a fiscal year cash-basis, because calendar year incurred-basis data are not yet available." (bolding from the DMCB).

Last but not least, the DMCB believes the lackluster economy has probably had the biggest impact on consumers willingness to use their Medicare benefit.  While Kronick and Ro state" Medigap" insurance benefits have protected the beneficiaries from the financial pain of Medicares out-of-pocket expenses, the expense of using a hospital or seeing a doctor is more than the sum of all those medical bills.

Is the DMCB being too skeptical?  Perhaps, but this particular HHS spin is built on assumptions that are backed by associations that are biased by partisan loyalty.  Taxpayers deserve better.

Image from Wikipedia

0 Medicare Accountable Care Organizations Medical Homes Experimental Potential or Essential

Time to measure some
new Medicare office drapes?

One major and longstanding criticism of CMS numerous innovation and demonstration projects is that they seldom lead to any meaningful orm of the core Medicare program.  In response, the Affordable Care Act created an "Innovation Center."  Despite legions of lobbyists, a third rail dread afflicting our political class and a powerful Medicare voting bloc, the intrepid folks in the Center promise to deliver insights that will advance quality, lower costs, increase access and spare all sacred cows.

Naturally, the thousands of health care experts who regularly read the Disease Management Care Blog have their doubts.  As a result, theyre unlikely to be moved by Karen Davis and colleagues "Medicare Essential" proposal appearing in the May issue of Health Affairs.

Assuming that the most wildly optimistic Accountable Care Organization (ACO) and medical home pilot programs projections are fulfilled, Dr. Davis et al propose the creation of a new "Medicare Essential" program that would co-exist with standard Medicare and Medicare Advantage.

"Essentials" essential purpose would be to finance ACOs and medical homes.  Given the authors enthusiasm, the DMCB is surprised that their Health Affairs paper isnt also recommending measuring drapes for the programs new offices.
 
In "Medicare Essential," Parts A (hospital), B (providers) and D (drugs) would be combined. There would be a single overall deductible, followed by low co-pays for primary care and higher co-pays for specialty and emergency room care Preventive care would have first dollar coverage. Pharmaceuticals would be governed by a single national formulary with low co-pays for generics as well as for perred brands and condition-specific/value-based drugs. Persons in the "Essential" program who are receiving care in ACOs or medical homes (financed with capitation, bonuses, gain sharing and monthly fees) would naturally have even lower co-pays.
 
Using "modeling by the Actuarial Research Corporation" and, as the DMCB understands it, transferring all savings back to the beneficiary, monthly out-of-pocket costs for the average Medicare enrollee could be reduced from the currently level of $427 to $354.  As an added bonus, if the patient used an ACO/Medical Home, the out of pocket would be further reduced to $254.

Case closed, right?

The DMCB isnt too sure.

Dont Measure Those "Essential" Medicare Program Office Drapes Quite Yet: While Davis et al should be commended for sending the savings back to the patient instead of Uncle Sam, their optimistic actuarial "research" projections cant be based on any consistent, statistically significant and real-world published proof.  Thats because there is no consistent, statistically significant and real-world published proof that ACOs and medical homes save money.  Come back, says the DMCB, when you have an analysis based on some real numbers.

Behavioral Economics: Furthermore, we dont know if monthly beneficiary savings of $73 to $173 are enough to move market share away from Medicare and Medicare Advantage to "Essential."  Thats doubly true if ACOs and medical homes, despite their quality, are viewed by patients as another way to impose a restricted network.

Disease Management Playbook: Advocates for the earliest versions of disease management likewise used official sounding projections to confidently project huge benefits for the Medicare program. When reality rudely intruded, the industrys fall was spectacular and almost fatal.  With friends like Dr. Davis similarly doubling down with huge ACO and medical home promises, who needs enemies?

Reinventing A 3rd Wheel? Many Advantage plans have similar co-pay arrangements and are already investing in ACO-like and medical home programs in their networks. They are likewise more than able to leverage out-of-pocket expenses to incent beneficiary behavior.

Suppose You Gave An ACO Party and Nobody Came? The last time the DMCB looked, many parts of the country lacked fully functional ACOs and medical homes. Dr. Davis says beneficiaries will respond by demanding local access to the Essential program and theore turbocharge additional health orm. The DMCB is unaware of any published data that supports that notion and, furthermore, wonders if the local lack of these programs will translate into even more variation in the U.S. health care system.

0 The Dilemma of Medicare Coverage of Reasonable and Necessary Care and Why Its Important

If you get sick, health insurance should cover all the "stuff" necessary to make you better, right?

While that sounds good in principle, Uncle Sam has made it a lot more complicated than that.  As we continue to struggle with health orm, this New England Journal article on "Medicares Enduring Struggle to Define Reasonable and Necessary Care" is very timely.

According to Drs. Neumann and Chambers, Medicare has always covered medical services that are "reasonable and necessary." As new approaches, drugs and medical technologies have been released, youd think coverage would be based on an objective analysis of outcomes and cost effectiveness.

Youd be wrong.

Years of differing interpretations, patient advocacy, Congressional meddling, regulatory carve-outs and case law have generated a miasma of bureaucratic complexity that will guarantee the incomes of thousands of lawyers for years to come.

Not that CMS hasnt tried to be reasonable about "reasonable and necessary." According to the article, in 1989 CMS specifically proposed that the words "cost effective" could be used to assess new technology. That proved too controversial. It later tried "least costly alternative language" for coverage of durable medical equipment and Part B medications.  This too was dismantled by the courts when plaintiffs argued that the term "reasonable and necessary" could only be applied to medical services, not to the costs of those services.

How ironic. Even though CMS is making "value-based purchasing" judgements for hospital payments and costs can be factored in the coverage of preventive services, that still doesnt apply to new technologies and drugs.

The latest dysfunction is CMS pretzel logic of "coverage with evidence  development" approach to medical devices, essentially agreeing to coverage that is conditional on CMS evaluation of additional outcomes data.  Unfortunately, CMS ability to collect and interpret these kinds of data in the current political environment remains an open question.

Outside of Medicares cost travails, why is all of this important?

1) Medicares price tag was $509 billion in 2010, taking 12% of the federal budget. While there are other drivers of cost, such as aging, coverage arrangements, income, pricing, administrative costs and defensive medicine, technology could account from 38% to more than 65% of the current growth (inflation) in spending.  Medicares historic inability to control this does not bode well for future cost projections.

2) This is not a partisan issue and there are no partisan solutions.

3) Commercial insurers generally use Medicares coverage criteria to define their own benefit structure.  Medicares problems are everyone elses.

4) This is another reason why Medicare is banking on ACOs.  By delegating management and the associated risk of all these thorny coverage issues, theyre hoping ACOs can do within three years what CMS couldnt do in three decades. Well see.

0 Shes got Diabetes now Yall!

I love observing people. People are an interesting societal experiment of contrasts, paradoxes, and dichotomies. If you are a lover of the observational art of human interaction and behavior, then there are two places you probably, secretly, enjoy: the mall, and the internet.

I love the mall, because frankly, Im visually amused. Its like TV, really. (Except, well, I still dont want to see your boxer shorts, or your g-string, so please, pull up your pants.)

The internet... is a little more complex. Its like TV, in many ways, except that you actually get to SEE the end results of people being told how to think and feel (and often, with the added boost of anonymity). And believe me, there are plenty of influential forces on the internet, just like on TV, trying to tell us how to think and feel. 

So... all of this being said, it came as no surprise to me when yesterday, everyone became the judge and jury of Paula Deen, when a rumor broke out that she would soon be announcing that she has Type 2 Diabetes, and would be signing a major endorsement deal with big pharma corporation, Novartis. Tweeterers, and folks commenting on articles, let their disgust be loudly, and well known. Even certain entities in the diabetes online community, which I will leave unnamed, immediately and openly expressed their disgust, with expressions like "Ugh!," and "Really? Ya think?," only to delete those tweets later. My fellow pals at The Blue Heel Society have been working OVERTIME just trying to put out some of the fires. 

Why are people getting so worked up? 

Well, sadly, some of the backlash from this will BE that people will use her as an example and an excuse to ridicule, bully, and belittle others, especially Type 2 Diabetics, and spread misinformation that diabetes is caused by too much consumption of sugar, butter, lard, or fried foods. Theres just no getting around that. 

I do think, however, that people just love to hate Paula Deen, for the sake of hating Paula Deen. Lets look at some facts. 

1. Paula Deen is annoying as *&%#.  I cant sit through much of her show without her little terms of endearment, expressions, and actual pitch and tone of her voice, getting on my very last nerve. Frankly, shes a little annoying to look at, too. I cant really put my finger on it... but theres just something about her hair, and what she wears, and how she carries herself... She doesnt have the most razzle/dazzle personality out there. This alone makes perfect fodder for being the SCAPEGOAT to anything we can possibly hate, and what is more vilified in our current decade than apparent unhealthful eating? Am I right? 

I know, I know what youre saying...! I can read your mind. You are an HONEST, unbiased person... and you would NEVER hate someone for just what they look like, or their personality -- its that horrible lifestyle shes promoting, and you are raising your voice loudly against it.  

Let me ask you this, then... where is your anger for Adam Richmans "Man vs. Food Nation?" I mean, come on... that show makes me PUKE. If anyone glorifies gluttony, its Adam Richman. But, really, to everyone... Hes a star. Everyone loves Adam Richman, and he can do no harm. At least Paula Deens show was never about "how much can I eat before I bust my guts, attempting it, while Im on vacation." (Vacation is always the excuse, by the way. Only try killing yourself with food, while on vacation.) 

Where is your anger for Sunny Anderson? Yeah, she has some healthy recipes... But so does Paula Deen! Sunny Anderson is basically, a younger, black Paula Deen, cooking Southern Soul Food. Why is she not the Queen of Evil? She obviously has a few pounds to lose, as well... 

"Oh, but Paula Deen cooks with butter, and lots of sugar, and lard...!" -- Ummm... Remind you much of Julia Child? Wheres your hate for her? Shes considered the QUEEN of cooking! And she also BRAGGED about  it... and a little more boisterously than Paula Deen.

Oh, wait, I know why... Because shes that annoying woman, with the southern drawl, that reminds you of your redneck aunt who always came and pinched your cheeks, and called you "dumplings." THATS WHY. 

2. Paula Deen endorses bad eating. Paula Deen has a very overacted, dramatic show, showcasing the southern cuisine she grew up with, just like anyone else who has a show on holiday foods and eating, is showcasing that. If you think her food is bad, then guess what, YOURE the one endorsing it when you watch it. In fact, when you watch almost any of the shows on the Food Network, youre endorsing bad eating, AND telling the network you want to keep watching such shows about bad eating. (Let me tell you, for all his bitching, Anthony Bourdain had NO reservations about eating that really fatty, roasted hog on a rod, the last time he visited Puerto Rico...) You cant really pick and choose which particular brand of CRAP cooking you watch is actually crap. That being said... Not any single cuisine or style of eating is going to make you obese, or make you get any disease. Hey, people say it all the time... They say "back in the 50s, you never saw many obese people..." Well, back in the 50s, people ate butter, lard, sugar covered lard butter... whatever. Understand? Food doesnt make anyone, in itself, unhealthy... It is overeating that potentially does.  Do I expect Paula Deen to be eating this type of food at home, every day, just because she has a show about it? Well, not anymore than anyone who has a show on holiday food. That would get old, and annoying fast, dont you think? And many of the recipes on her site are actually quite light, lean, and decidedly not southern. 

Also... and this might be controversial... but Paula Deens food, for all its caloric, sugar, and lard content is probably a LOT healthier than what America currently eats, and buys, on a daily basis. Its at least HOME MADE, and wont sit on a shelf like that burger you ate at McDonalds last night, for 6 months or more, without decomposing!  

3. Paula Deen wants to profit from her Diabetes.  Well, so far, we really dont know if she has Diabetes. Shes going to make an announcement on Tuesday, and its very likely she might admit to it. (Though, for the future, Id like to caution any one of you against using sources like The Daily Mail, and The National Enquirer as credible sources of news.) As of yesterday, afternoon,  Novartis had told CBS that Paula Deen had not yet signed a deal with them.  

All of this being said, if she did... who cares? Why does it anger anyone if she does? Just what exactly are the inferences here? Are you inferring shes going to just use pills as an excuse to keep eating like crap, and pushing bad food? Or are you inferring needing medication as a Type 2 Diabetic is a shameful thing? Or... perhaps you are inferring that people with Diabetes who take big pharma endorsements are amoral, or have sold out? Is this, somehow, any different than Omnipod, Roche, Sanofi Aventis, etc, sponsoring some of the biggest diabetes bloggers out there, right now, paying for all their supplies, and just flying them all over the place? "Yeah, but we spread awareness..." How do you know shes not going to spread awareness? How do you know all shes going to do is ask people to consider a new drug alternative thats actually working for her? Isnt that what you do, as well? Furthermore, how do you know this is actually not a good, extra tool, people with diabetes could benefit from hearing about? How do you even know she might not turn around, and make a show showcasing how you can still eat with flare, and with passion, WHILE managing diabetes? 

4. Paula Deen knowingly hid her Diabetes, so she could keep hawking her show. How dare she! How can she sleep at night! Look, lets face it. A lot of people are a bunch of judgmental jerks. These days, everyone weighs any kind of life altering event very caully before announcing it to the public. Even things like getting married, or getting pregnant, are career enders for many women in the spotlight. I know Paula Deen is no Beyoncé, but folks... If you loved something, with a passion, and suddenly someone gave you some drastic, dramatic, life altering news, you would need some time to think back, and re-evaluate your life. You want to regroup yourself, and your thoughts, before speaking to anyone. And have you stopped to think that she was also probably under contract with the Food Network? Im sure she couldnt have stopped, mid season, and been like "F it! I got Diabetes now, so I cant go on..." Things like the menu, style, and theme of the show, are likely contractual stipulations. Besides... her health is really her own damn business. Not yours... and certainly not mine.  

5. Paula Deen brought this on herself. 

"Theres no place for sympathy for type 2 diabetics, because factual scientific evidence has shown that it is brought on by themselves. " -- John Sampso, commenting on an MSNBC story.

And herein lies the rub of the matter. 

We, as a society, have decided Type 2 Diabetics deserve no sympathy. We have decided that Type 2 Diabetics are subhuman. Undeserving of sympathy, of support, of compassion, and worthy of our judgment, scorn, and policing. We have decided that Type 2 Diabetics, are basically, everything we hate about ourselves, or about the worlds injustice toward our loved ones. How dare we lack self control, how dare we cant stay on our diet, how dare we dont lose weight, how dare we eat junk food, how dare we cook unhealthy food. How dare we EXIST. 

We can debate ourselves to the moon and back if someones behavior contributed, or not, to their disease... (And when it comes to Paula, I honestly dont know. She is, after all, 65. Age is a huge contributing factor for Type 2 Diabetes. I dont know how long shes had it, but if shes kept it at bay until now, hell... GOOD FOR YOU, PAULA.) 

But, let me ask you this... If someone really did give themselves any disease (which I think we all know life is a little bit more complicated than that)... Does it really matter? 

Do they stop being worthy of our humanity? Or is it more... a projection of our OWN inhumanity?

Paula, honey... If you are a diabetic, WELCOME, and I am so sorry. With tears for the future journey ahead of you, I welcome you... Team Paula, all the way, baby. 

For Further Reading:

"Lessons from the Butter Incident," Saturday, January 21st, 2012. 

0 Omega 3 Fats are Essential to Prevent Nerve Damage after Traumatic Injury

People that have suffered a traumatic injury face an uphill battle as they attempt to regain their health and fight the risk of depression as a long term consequence of the event. British researchers from Queen Mary at the University of London have published the result of a studyin the Journal of Neuroscience that explains how omega-3 fatty acids play a significant role in preventing and protecting nerves from injury.

The research focused on peripheral nerve cells which transmit signals between the brain and the spinal cord to the rest of the body. Omega-3 fats from food sources including sardines, salmon, walnuts and flaxseeds provide for decreased cell death from injury and may offer significant protection against future damage.

Omega-3 Fats Help Prevent Nerve Damage and Assist the Repair Process

Current research indicates that our nerves do have a limited capacity to regenerate, but recovery is severely limited depending on the extent of the injury. Omega-3 fatty acids are essential for the bodys normal growth and development and have been well researched for their health benefits, largely focused on brain and heart health. The body is unable to manufacture its own Omega-3 fat supply, so it is necessary to obtain sufficient intake from foods such as oily fish, nuts and seeds or through supplementation.

Researchers studied the effect of Omega-3 fats on isolated mice nerve cells, known to parallel human nerve responses. They simulated nerve damage caused from an accident or injury by either stretching the cells or starving them of oxygen. Both types of damage can kill a significant portion of nerve cells, but enrichment with omega-3 fatty acids in cells gave them significant protection and decreased cell death.

EPA and DHA Fats Lower Sciatic Nerve Injury Damage and Prevent Muscle Wasting

The study also examined sciatic nerve damage in the mice. They found that a high level of omega-3 fatty acids helped mice to recover from sciatic nerve injury more quickly and more fully, and that their muscles were less likely to waste following nerve damage. The team leader, Dr. Adina Michael-Titus, Professor of Neuroscience concluded“Our previous research has shown that these fatty acids could have beneficial effects in a number of neurological conditions. This new study suggests that they could also have a role in treating peripheral nerve injuries.”

The findings from this research should come as no surprise to integrative health followers. The Omega-3 fats EPA and DHA are essential building blocks to all cellular structures in the body and are particularly dominant in the brain and nervous system. A healthy supply of Omega-3 fatty acids allows for natural cell repair and the effective chemical and electrical communications that are important to optimal nerve function. Consuming fatty fish three to four times a week or supplementingwith molecularly distilled fish oil (1 to 2.4 grams total EPA/DHA) supports the nervous system and regeneration process after injury.

0 Although never ill with cancer she had a chance to get pregnant

Although never ill with cancer, she had a chance to get pregnant - A study says that women who have had cancer as a child and was successfully recovered at high risk of experiencing infertility. But they still have a chance of getting pregnant.

Research in the journal Lancet Oncology was also found about two-thirds of women whove had cancer once was able to get pregnant.

According to researchers from Brigham and Womens Hospital in Boston, a chance to get pregnant for the ex the same amount of cancer patients with healthy women undergoing infertility treatment.

As reported by Medical News Today, a total of 3,531 women aged 18-39 years involved in the study. Researchers also found 64 percent of respondents managed to get pregnant despite never once had cancer while still a child.

"This is the first study to discuss the chances of getting pregnant for women who previously had cancer as a child," said Dr. Sara Barton, the head researcher.

Counsel and infertility treatment is one way to increase the chances of getting pregnant, according to investigators.

0 Dietary supplements

Dietary supplements are foods marketed as capsules, tablets, ampoules , capsules, teas , oral solutions ... whose purpose is to supplement the normal diet . They are concentrated sources of nutrients or other substances with a nutritional or physiological effect. They are designed to meet a specific need : digestion, sleep , weight loss, tone ...
These are not drugs so they do not heal . Their goal is to improve the well-being and maintain good health. Dietary supplements are not essential in sports nutrition . A varied diet can ensure complete intake of nutrients essential to good physical condition. The problem often comes from deficiencies in the quality of our food , which is often depleted or unbalanced diet. The frequency and intensity of training sessions and competitions can theore increase the risk of disability.

Are there a risk to consume dietary supplements ?
It is recommended to take these supplements on a defined period following employment recommendations on the label length . The choice of supplements should also be based on demonstrated need . Consuming dietary supplements in excessive doses , without a healthy supply of basic or no real need is certainly not without health consequences . This is the problem of self -medication ...

0 Today is World Heart Day

Visit the World Heart Days site for news and activities in your region. (They have a section on diabetes that includes a number of recent news articles.)

The World Health Organization (WHO), a major sponsor of World Heart Day, is warning that the rapid increase in weight seen globally forecasts a daunting burden in caring for chronic diseases linked to weight. They estimate there are a billion people worldwide who are currently overweight; and they predict that number to rise by 50% over the next 10 years if trends continue.

Overweight and obesity are risk factors for many chronic conditions, including type 2 diabetes.

Yet, according to Dr. Robert Beaglehole, WHO Director of Chronic Diseases and Health Promotion, many chronic diseases attributable to weight are preventable:

"Approximately 80% of heart disease, stroke, and type 2 diabetes, and 40% of cancer could be avoided through healthy diet, regular physical activity and avoidance of tobacco use."

One method of determining overweight or obesity is by assessment of a persons Body Mass Index (BMI).

BMI Categories:
Overweight is a BMI ≥ 25
Obesity is a BMI ≥ 30

Do you know your BMI?

If not, you can calculate it here. Just enter your height and weight.

________
Links:

World Heart Day - Sunday, September 25

The World Health Organization Warns of the Rising Threat of Heart Disease and Stroke as Overweight and Obesity Rapidly Increase

National Institutes of Health - BMI Calculator

0 Vegan Barley Chocolate Cake

I really want to bake a super moist and rich chocolate cake with barley flour and finally i baked some two weeks back for a friends birthday. As she is a vegan foodie, i really checked few sites to get an interesting chocolate cake,but finally i got hooked to Madhus Vegan Barley Chocolate Cake. Thanks to Madhu for giving us this beautiful,super moist cake and my friend simply loved this cake.Initially i was bit skeptical about the barley flour in cake, also i have read somewhere that barley flour are not glutenous like wheat flour or all purpose flour,while i went through this cake post at Madhus place,she also shared the same thought, thank god she also had the same thought like me. After reading her post, i was very much confident and tried my hands with homemade barley flour.

This cake turned out extremely spongy and i was very much happy with the final result. You can try ur hands in making cakes with barley flour in case if you want to experiment like me. A wonderful alternative to those who dont want to make bakes with all purpose flour or wheat flour. As am running my third week of blogging marathon with baking with wholegrains as theme, am posting this beautiful chocolate cake.Check out the Blogging Marathon page for the other Blogging Marathoners doing BM#25.

2cups Barley flour
1cup Sugar
1/4tsp Salt
1tsp Baking soda
1/2tsp Baking powder
1/4cup Unsweetened cocoa powder
1tbsp Vanilla extract
1/3cup Canola oil
1tbsp Apple cider Vinegar
1cup Cold water

Preheat the oven to 350F for few minutes.

Grease generously the bottom and sides of a round baking pan and line it with parchement paper.

Sift together the barley flour,cocoa powder,baking soda,baking powder,sugar and salt, keep aside.

Mix the vanilla extract,canola oil,vinegar,cold water in a another bowl and gradually add it to the dry ingredients,dont overmix the batter.

Pour now this batter to the prepared pan and bake for 25-30minutes or until a skewer inserted comes out clean.

Cool it completely, remove the parchement paper and slice the cake as you desire.

You can frost this cake very well or dust it with powdered sugar.

0 Vitamin D deficiency increases risk of heart disease

New research from the University of Copenhagen and Copenhagen University Hospital shows that low levels of vitamin D are associated with a markedly higher risk of heart attack and early death. The study involved more than 10,000 Danes and has been published in the well-reputed American journal Arteriosclerosis, Thrombosis and Vascular Biology.

Vitamin D deficiency has traditionally been linked with poor bone health. However, the results from several population studies indicate that a low level of this important vitamin may also be linked to a higher risk of ischemic heart disease, a designation that covers heart attack, coronary arteriosclerosis and angina. Other studies show that vitamin D deficiency may increase blood pressure, and it is well known that high blood pressure increases the risk of heart attack.

"We have now examined the association between a low level of vitamin D and ischemic heart disease and death in the largest study to date. We observed that low levels of vitamin D compared to optimal levels are linked to 40% higher risk of ischemic heart disease, 64% higher risk of heart attack, 57% higher risk of early death, and to no less than 81% higher risk of death from heart disease," says Dr. Peter Brøndum-Jacobsen, Clinical Biochemical Department, Copenhagen University Hospital.

The scientists have compared the 5% lowest levels of vitamin D (less than 15 nanomol vitamin per litre serum) with the 50% highest levels (more than 50 nanomol vitamin per litre serum). In Denmark, it is currently recommended to have a vitamin D status of at least 50 nanomol vitamin per litre serum.

The higher risks are visible, even after adjustment for several factors that can influence the level of vitamin D and the risk of disease and death. This is one of the methods scientists use to avoid bias.

Blood samples from more than 10,000 Danes
The population study that forms the basis for this scientific investigation is the Copenhagen City Heart Study, where levels of vitamin D were measured in blood samples from 1981-1983. Participants were then followed in the nationwide Danish registries up to the present.

"With this type of population study, we are unable to say anything definitive about a possible causal relationship. But we can ascertain that there is a strong statistical correlation between a low level of vitamin D and high risk of heart disease and early death. The explanation may be that a low level of vitamin D directly leads to heart disease and death. However, it is also possible that vitamin deficiency is a marker for poor health generally," says Børge Nordestgaard, clinical professor at the Faculty of Health and Medical Sciences, University of Copenhagen and senior physician at Copenhagen University Hospital.

Long-term goal is prevention
The scientists are now working to determine whether the connection between a low level of vitamin D and the risk of heart disease is a genuine causal relationship.

If this is the case, it will potentially have a massive influence on the health of the world population. Heart disease is the most common cause of adult death in the world according to the World Health Organization (WHO), which estimates that at least 17 million people die every year from heart disease.

"The cheapest and easiest way to get enough vitamin D is to let the sun shine on your skin at regular intervals. There is plenty of evidence that sunshine is good, but it is also important to avoid getting sunburned, which increases the risk of skin cancer. Diet with a good supply of vitamin D is also good, but it has not been proven that vitamin D as a dietary supplement prevents heart disease and death," says Børge Nordestgaard.

0 Laugenbrezel German Style Soft Pretzels We Knead To Bake 8

As per wiki,A pretzel is a type of baked bread made from dough most commonly found in a unique knot-like shape. Pretzels originated in Europe,the traditional pretzel shape is a distinctive symmetrical looped form, with the ends of a long strip of dough intertwined then, twisted back into itself in a certain way.Pretzels are often seasoned and flavoured with various salts,sugars or seeds or with nuts.For this months We Knead To Bake, Aparna chosed both soft and hard pretzels, pretzels are in my to do list since a long and seriously i was longing to do them at home since we tasted them during our visit to Strasbourg.

I chosed to baked Aparnas Soft Pretzels, this authentic German pretzel aka Laugenbrezel has a dark brown, crispy,salty crust and inside a soft dough. Its has a plump body and thin crispy but not dry crossed arms while the hard or crunchy pretzels are an American invention.Usually Pretzels goes an egg wash after the soda bath, to give them more shine, but i left the egg wash here and sprinkled the sesame seeds. These pretzels are egg free,if dont have or dont like sesame seeds you also sprinkle sea salt as like the authentic pretzels. Am running my fourth week of blogging marathon with Kids delight-After school bites, and pretzels suits incredible pect for evening snacks when served with a cream cheese,my kids enjoyed thoroughly these soft pretzels. Check out the Blogging Marathon page for the other Blogging Marathoners doing BM#31.. Sending to Bake fest hosted by Manjula,event by Vardhini.

Recipe Source: My Recipes
2 +1/4 tsp Dried active yeast
1+ 1/2 tsp Sugar
1cup Warm milk
3 + 1/4 cups All-purpose flour
1tsp Salt
6cups Water
2tbsp Baking soda
1tsp Cornmeal
2tbsp Milk
2tbsp White sesame seeds
2tbsp Black sesame seeds

In a large bowl, dissolve the yeast and sugar in warm milk and allow that to stand for about 5 minutes.

Add the 3 cups flour and salt to the proofed yeast and stir until a soft dough forms.

Turn dough out into a lightly floured surface and knead until smooth and elastic.

The dough will feel slightly sticky, so add a bit of flour as and when necessary while kneading. This should take about 8-10minutes.

Form the dough into a ball and place in a large oiled bowl, turning to coat the dough with oil.

Cover and allow the dough to rise for about 40 minutes or until doubled in size. (Gently press two fingers into dough. If indentation remains, the dough has risen enough.)

Deflate the dough, cover and let it rest 5 minutes. Divide dough into 12 equal portions.

Work with one portion at a time and cover remaining dough to prevent it drying.

Roll each portion into an 18-inch-long rope with tapered ends. Cross one end of rope over the other to form a circle, leaving about 4 inches at end of each rope.

Twist the rope at the base of the circle. Fold the ends over the circle and into a traditional pretzel shape, pinching gently to seal.

Place pretzels on a lightly greased baking sheet. Cover and let rise 10 minutes,pretzels will rise only slightly.

Put the 6 cups of water and baking soda in a non-aluminium pan and bring to a boi.

Turn down the heat and simmer. Gently lower a pretzel into the simmering water.

Cook on each side for about 15 seconds. The pretzel will  puff up a bit.

Remove from the water with a slotted spoon and place on a greased wire rack.

This will prevent the pretzel from sticking to the rack. Repeat with the remaining pretzels.

Place the pretzels on a baking sheet sprinkled with cornmeal or semolina. Brush with milk and sprinkle with sesame seeds.

Bake at 425F for 12 minutes or until pretzels are deep golden brown.

Transfer to a wire rack to cool.

Serve warm with a dip of your choice or just plain.

They are best to eat fresh on the same day.