A community for people who want to remain as healthy as possible as we age.

America’s big spending on health care doesn’t pay off

(The Economist) AMERICA remains the world’s most profligate spender on health care, according to a report published on November 4th by the OECD, a club of 34 mostly rich countries. In 2013 America spent, on average, $8,713 per person—two and a half times as much as the OECD average. Yet the average American dies 1.7 years earlier than the average OECD citizen. This longevity gap has grown by a year since 2003. Americans have the same life expectancy as Chileans, even though Chile spends less than a fifth of what America spends on health care per person.
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Health care law results in $2.4 billion in consumer rebates on premiums since 2011

(Centers for Medicare & Medicaid Services) The Centers for Medicare & Medicaid Services (CMS) released a new report … showing that consumers have received more than $2.4 billion premium rebates  since 2011 because the Affordable Care Act requires that health insurance companies spend at least 80 percent of premium dollars on health care.  For 2014 alone, over 5.5 million consumers received nearly $470 million in rebates, for an average of $129 per family. Those rebates are in addition to improvements in quality and affordability savings consumers have received as the share of insurance companies in compliance with the requirements has increased.
“Thanks to the Affordable Care Act, there are now programs in place to give consumers maximum value for their premium dollar,” said Kevin Counihan, CEO of the Health Insurance Marketplace.  “We are pleased that the tools created under the health care law are working as intended to give consumers access to high-quality health insurance coverage and keep cost affordable.”…
[The newly announced] results show that an increasing number of consumers are in plans where they are receiving more value for their premium dollars up front because their premium rates were set to reasonably reflect insurers’ spending on medical care and quality improvement activities.
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Study: Health Plan Buyers Will Save Money If They Shop

(Kaiser Health News) Millions of consumers who are enrolled this year could pay higher rates if they stay in the same health plan next year, according to a study released [last] Wednesday by the Kaiser Family Foundation.
The KFF analysis found that in nearly three-quarters of counties in 36 states served by healthcare.gov, the lowest-priced silver plan this year will not be the lowest priced next year. People in those plans could save money on premiums by switching to a different silver plan in 2016. (KHN is an editorially independent program of the foundation.)
If they don’t switch, their premium would increase an average of 15 percent before any tax credit is included. More than 80 percent of consumers on the federal marketplace receive a tax subsidy to lower their costs.
Most consumers who previously enrolled on healthcare.gov who don’t actively shop by Dec. 15 will be automatically renewed in the same or a similar plan beginning Jan. 1. Open enrollment on the marketplaces began Nov. 1 and ends Jan. 31.
The lowest-cost silver plan is the most popular selection in the Affordable Care Act marketplaces.
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Continuing the shift from volume to results in American healthcare

(Centers for Medicare & Medicaid Services) Almost a year ago, the Administration announced a vision for the future of the Medicare program, including clear goals and a timeline for shifting Medicare payments from volume to value. CMS is continually working to turn this vision into reality through annual rulemaking and the CMS Innovation Center, building on bipartisan ideas, initiatives and legislation from both Congress and the states…
We have seen some positive results from models that the Innovation Center is testing. Savings in the Pioneer ACO Model were so significant – and coupled with positive results on improved quality of care and better patient experience – that the independent CMS Office of the Actuary certified that expansion of the model as it was tested in the first two years would reduce net program spending under Medicare. We have also incorporated elements of the Pioneer ACO Model into the Medicare Shared Savings Program, which reaches more beneficiaries in more areas of the country. We are actively evaluating other models to see if they meet this bar and have applied lessons and feedback from the Innovation Center models throughout the Medicare program.
One of the most promising trends we’re seeing is the significant improvement in patient safety and decreased adverse incidents in the hospital setting.
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Health insurance now ranks with America's most hated industries

(CBS News) When it comes to America's most-hated industries, there are a few perennial favorites. Cable guy, anyone?
But one much-maligned industry is dipping ever further in Americans' estimation, slipping to where it's neck-and-neck with two other poorly regarded businesses, the U.S. Postal Service and fixed-line phone service. It's so bad that this industry has only two others ranked below it, pay-TV providers and Internet service providers.
Which industry is slipping farther down the list? That's health insurance, according to the American Customer Satisfaction Index, which interviews about 70,000 consumers annually to get their views on everything from soft drinks to gas stations. To be sure, the health insurance industry has been through a turbulent year as the rollout of the Affordable Care Act divided Americans over issues ranging from government costs to high deductibles.
"The usual suspects have been plaguing the industry, but it's getting worse," ACSI director David VanAmburg said. "High premiums -- no one likes paying high premiums -- slow claims processing and higher deductibles" are among the issues that get consumers upset…
The parts of health insurance that consumers most dislike include call centers, which receive the lowest ratings out of all customer experience benchmarks, and choice of plans.
The latter may be one area where people covered by the ACA are coming out better than Americans covered by their employer's plan. That's because the ACSI found customers who have bought individual plans -- and have picked from one of several choices -- have a higher satisfaction level than group policy holders.
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Barriers to Health Care Increase Disease, Death Risk for Rural Elderly

(Oregon State University) A new study of adults ages 85 or older has found that rural residents have significantly higher levels of chronic disease, take more medications, and die several years earlier than their urban counterparts…
The research confirms some of the special challenges facing older populations in rural or remote areas, who often have less access to physicians, long distances to travel for care, sometimes a lower socioeconomic and educational level, and other issues. It also reflects health problems that might have been reduced if they were treated earlier or more aggressively, researchers say.
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How the Affordable Care Act is Helping to Build a Stronger, Healthier Rural America

(Norah Deluhery, Director, Center for Faith-Based and Neighborhood Partnerships) Keeping our rural communities healthy is key to building a stronger America. That’s why … I’m proud of the new affordable health insurance options that are available because of the Affordable Care Act, helping to give rural families piece of mind across the country…
Before the ACA, many rural Americans struggled to find affordable healthcare, paying nearly half of all medical costs out of their own pockets. Many self-employed farmers, ranchers, and rural small business owners—some of the most critical contributors to strong rural economies—did not have access to the affordable insurance options that many people get through their employers. Too often, getting quality care in a rural community came with a hefty price tag. But today, more than 70% of all Marketplace enrollees can get covered for $75 a month or less with tax credits.
If you live in rural America, you’re now less likely to have to go far for quality care. Since 2011, this Administration has made innumerable investments in rural health, and thanks to the ACA, Americans have better access to doctors, nurses and comprehensive prevention and wellness services close to their homes.
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Some health-care systems want to sell you insurance as well as treat you

(Washington Post) In addition to treating what ails you, a number of health-care systems aim to sell you an insurance plan to pay for your medical expenses. With some of the most competitively priced policies available on the marketplaces, “provider-led” plans can be popular with consumers. But analysts say it remains to be seen how many will succeed long-term.
It’s not surprising that health systems are getting into the insurance business. Doing so funnels more patients to the organization’s hospitals and doctors. And it makes sense that combining clinical and claims data under one roof could lead to better-coordinated, more-cost-efficient patient care…
The provider-led marketplace plans are priced very competitively, says John Holahan, a fellow at the Urban Institute’s Health Policy Center. A forthcoming study by the center that looked at 63 areas in 21 states found provider-led plans to be the least expensive in a number of places.
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How Pfizer has shifted U.S. profits overseas for years

(Reuters) Drugmaker Pfizer's plans to take over Allergan have faced a political backlash in the United States over fears a deal would lead to the company shifting its headquarters and taxable profits to Ireland…
Ireland's tax rate is 12.5 percent, a fraction of the 35 to 40 percent levied in the United States.
President Barack Obama has described inversions as unpatriotic and last year changed some tax rules to make inverting less attractive. Allergan investors fear the U.S. treasury department may scupper a deal with additional measures…
Pfizer has used transactions between companies within its group to allow an Irish subsidiary based in Ringaskiddy - Pfizer Ireland Pharmaceuticals - to buy the rights to patents developed in the United States and then use them to make drugs which are sold back to U.S. affiliates.
Even though the Irish and other overseas units pay $3.2 billion a year in royalties to use such patent rights, the higher prices at which Pfizer in the United States imports manufactured drugs from affiliates means almost all the profits from these drugs are reported overseas.
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AstraZeneca's Tagrisso to cost $12,750 for a month's supply

(Reuters) AstraZeneca's new lung cancer pill Tagrisso, which won early U.S. approval on Friday, will cost $12,750 for a month's supply.
A company spokeswoman said on Tuesday the wholesale acquisition cost was comparable to other targeted oral lung cancer therapies, such as Pfizer's Xalkori and Novartis' Zykadia.
AstraZeneca has previously said it believes Tagrisso could generate peak sales of $3 billion a year, making it a key product in the group's growing oncology portfolio.
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J&J nabs an early OK for 'breakthrough' multiple myeloma blockbuster contender Darzalex

(FierceBiotech) Johnson & Johnson ($JNJ) scored an early FDA approval for its "breakthrough" blockbuster contender daratumumab, earning a swift OK as a new treatment for multiple myeloma four months ahead of the PDUFA date. The drug will be marketed as Darzalex…
Daratumumab is given once a week for the first two months of treatment, then the infusions wind down to once monthly in the second 6 months of the year, says a spokesperson for J&J. For the first full year--with a total of 23 doses given at a cost of $5,850 per infusion--the average monthly wholesale acquisition cost is $11,212, says J&J, or $135,550 for the first year. In year two, and any year thereafter, patients receive a total of 13 doses, for a monthly wholesale cost of $6,337, or $76,044 annually. J&J also offers programs to limit patient's out-of-pocket costs and will be offering payers discounts during price negotiations.
Focusing on the group of patients getting the top dose, investigators reported … last August that the drug scored an impressive 36% overall response rate among 42 patients with late-stage multiple myeloma--a step up from the 29% overall rate that was reported at ASCO earlier in the year.
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Global drug spending to hit $1.4 trillion in 2020: IMS

(Reuters) Global spending on medicines will reach $1.4 trillion in 2020, driven by increased healthcare access in emerging markets and high-priced new drugs for cancer and other diseases, according to a forecast by IMS Health released on Wednesday.
That is up from about $1.07 trillion this year, representing a compound annual growth rate of 4 to 7 percent over the next five years, the "Global Medicines Use in 2020" report compiled by IMS Institute for Healthcare Informatics found.
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Expensive new Hep C drugs may be cost-effective even for early disease

(Reuters Health) Treating hepatitis C with expensive new medicines at the earliest signs of liver damage improves patients' health and is also cost-effective, a new computer simulation suggests.
"Going into this, I expected to find it did make sense to wait until there was a limited amount of liver disease, but what we found to our surprise is that it makes sense to start treatment at the earliest change in the liver," said senior author Dr. James Kahn, of the University of California, San Francisco…
While other studies found the new drugs to be cost effective, the new study looked at whether that's true at each stage of liver damage. Some insurers won't let patients take the drugs until their liver disease is advanced.
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Value-Based Pricing Will Help With High Prescription Drug Costs

(MedPage Today)  Value-based drug payments are one part of the solution to the rising price of prescription drugs, several speakers said at a forum on drug pricing hosted by the Department of Health and Human Services.
The Centers for Medicare and Medicaid Services (CMS) would like to hear more ideas about how to implement value-based payments for this kind of treatment, according to CMS Acting Administrator Andy Slavitt.
"As a purchaser, the logical question for us is 'Are we getting good value for consumer and taxpayer dollars?" Slavitt said at the forum here last Friday. "Just as we pay for quality in care delivery, how should we create incentives which take the entire health and outcome of the individual into account? What's the best way to pay for targeted therapies when they work for some patients and not for others?"
Under value-based payments, insurers and other payers reimburse for drugs based on patient outcomes and similar factors, rather than paying a set price.
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Docs, and patients, should remember to use generics

(Reuters Health) Prescribing generic medicines instead of brand name drugs whenever possible cuts costs, improves patient adherence and improves health outcomes, according to a new recommendation from the American College of Physicians.
“Generic medications are cheaper and patients are more likely to get those prescriptions filled,” said Dr. Amir Qaseem of the American College of Physicians, who coauthored the recommendation.
“This is for both physicians and patients,” Qaseem told Reuters Health by phone.
Despite what some patients and even doctors may believe, generics are consistently as effective and safe as their brand-name counterparts, he said.
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Doctors Call for an End to Prescription Drug Ads

(Adweek‎) American Medical Association has called for an end to direct-to-consumer advertising of prescription drugs and medical devices.
The AMA, which represents about 250,000 physicians nationwide, reversed its previous stance on the issue following a vote at the group's annual meeting in Atlanta.
"Today's vote in support of an advertising ban reflects concerns among physicians about the negative impact of commercially-driven promotions, and the role that marketing costs play in fueling escalating drug prices," said AMA board chair-elect Patrice Harris in a statement. "Direct-to-consumer advertising also inflates demand for new and more expensive drugs, even when these drugs may not be appropriate."
The AMA's vote has no binding power. Such a ban would require congressional authorization. Still, the AMA maintains a powerful lobbying presence in Washington, and today's vote is seen as the first salvo in an effort to turn prescription drug ads into an election issue in 2016.
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Overcooking Starchy Foods Like Potatoes And Bread Increases The Levels Of Acrylamide, A Cancer-Causing Toxin: Study

(Medical Daily) The UK’s Food Standards Agency (FSA), a food safety watchdog, measured amounts of acrylamide — a cancer-causing substance — in popular UK breakfast foods and found making these foods even a little crispy could increase their levels and pose health risks. “The risk assessment indicates that at the levels we are exposed to from food, acrylamide could be increasing the risk of cancer.” said Professor Guy Poppy, the FSA’s chief scientific adviser, in a report accompanying the study…
Though it may be interpreted that the study is telling us to quit eating overcooked food, Poppy says instead we should be more mindful of how long we cook them for…
Scientists haven’t yet established safe levels of acrylamide in food, but both the FDA and FSA are looking into regulations that will set a maximum amount. Until then, hold off on the extra-cooked starchy foods and just make them a little crispy.
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Study Finds More Evidence Coffee Can Be a Life-Saver

(NBC News) Researchers have found even more evidence that coffee can be good for you. People who drink regular, moderate amounts of coffee are less likely to die from a range of diseases, from diabetes to heart disease…
"The main message is that regular consumption, meaning three to five cups of coffee a day, is associated with lower risk in total mortality and mortality from several causes like diabetes, cardiovascular disease and suicide," Frank Hu, a professor of nutrition and epidemiology who helped lead the study, told NBC News.
"In previous studies on that issue, most of the coffee was caffeinated coffee. In our study, both caffeinated and decaffeinated coffee showed a lower mortality risk but there is no final conclusion yet."
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Is bacon actually bad for you? It may depend on your DNA.

(Washington Post) In a study published last year with little fanfare, researchers found that genetics - a simple difference in your DNA - may determine how dangerous processed meats are for you.
For people with one genetic variant, eating more processed meat was associated with more colorectal cancer, according to the research, just as the WHO scientists have asserted. But for people with the other genetic variant, eating more processed meat did not appear to raise the risk of getting colorectal  cancer…
[B]y highlighting an interaction between diet and genes, the research foreshadows a day when broad dietary guidelines - that is, rules that apply to everyone - may be combined with information tailored to a person's genetic background.
Read more.                              
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Tracing Activity of Cancer-Fighting Tomato Component

(University of Illinois College of Agricultural, Consumer and Environmental Sciences) Years of research in University of Illinois scientist John Erdman's laboratory have demonstrated that lycopene, the bioactive red pigment found in tomatoes, reduces growth of prostate tumors in a variety of animal models. Until now, though, he did not have a way to trace lycopene's metabolism in the human body.
"Our team has learned to grow tomato plants in suspension culture that produce lycopene molecules with a heavier molecular weight. With this tool, we can trace lycopene's absorption, biodistribution, and metabolism in the body of healthy adults. In the future, we will be able to conduct such studies in men who have prostate cancer and gain important information about this plant component's anti-cancer activity," said John W. Erdman Jr., a U of I emeritus professor of nutrition.
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Home Cooking Means Lower Type 2 Diabetes Risk

(MedPage Today) Cooking meals at home was associated with a slightly lower risk of developing type 2 diabetes, said researchers at the annual conference of the American Heart Association here.
Those who ate 11-14 lunches or dinners prepared at home per week -- or about two meals per day -- faced a lower risk of diabetes compared with those who ate only six or fewer homemade meals a week…
The authors also found that in 8 years of follow-up, those who ate more meals prepared at home had lower weight gain and risk of obesity (HR 0.87 for obesity), which could have accounted for the lower diabetes risk, said [Geng Zong, PhD].
"We tried to analyze the differences in the diets of these people, and we also found that those with more meals prepared at home have a slightly lower sugar sweetened beverage intake," said Zong. "This could be another bridge that links homemade meals and diabetes risk."
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Cholesterol-Lowering 'Portfolio Diet' Also Reduces Blood Pressure

(St. Michael's Hospital) A diet developed for reducing cholesterol also lowers blood pressure, a St. Michael's Hospital study has found…
The portfolio diet lowered blood pressure by an average two per cent, when compared with another diet recommended to reduce hypertension.
The portfolio diet includes foods that are scientifically-proven to lower cholesterol including mixed nuts, soy protein, plant sterols (found in vegetable oils and leafy vegetables) and viscous fiber (found in oats, barley and eggplant). The comparison method, a dietary approach to stopping hypertension, or DASH diet, emphasizes fruit, vegetables and whole grains, reduced meat and dairy intake, and eliminating snack food…
The modest, two per cent reduction in blood pressure on the portfolio diet is in addition to the five to ten millimeter blood pressure improvement associated with a DASH-type diet. Although the DASH diet had higher compliance rates, the portfolio diet was more effective in reducing blood pressure.
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To Lower Cholesterol, Try a Foray Into the Mediterranean Diet

(Well, New York Times) Many Americans, when faced with a serious health risk like high cholesterol, opt to take a pill rather than adopt healthier living habits…
Dr. Philip Greenland, a cardiologist and epidemiologist at Northwestern University Feinberg School of Medicine, said, “People should be following a heart-healthy diet, keeping their weight under control and exercising regularly. This would be a highly preferable approach. Unfortunately, it’s not the direction we’re going in.”
Admittedly, swallowing a little pill every day is simpler than changing one’s behaviors — and especially one’s eating habits.
Yet experts like Dr. Greenland say that even when taking a statin or some other cholesterol-lowering drug, changes in diet and exercise habits are needed to maximize the drug’s benefits. He and others insist that drugs should be a last resort, after lifestyle changes fail to lower serum cholesterol adequately…
According to Dr. Stephen L. Kopecky, a preventive cardiologist at the Mayo Clinic in Minnesota, one of two states in which heart disease is not the No. 1 killer (Colorado is the other), there is no better approach to healthful eating than the Mediterranean diet.
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Keeping Warm with the Mediterranean Diet

(Mediterranean Foods Alliance) As the temperature drops and the days get shorter, we crave comfort foods that keep us feeling warm and satisfied for the winter ahead. It's time to cook up fresh, hardy cold-weather vegetables like winter squash and sweet potatoes, and break out the frozen, canned, and pickled forms of out-of-season favorites. For healthy, cold-weather comfort food ideas, look no further than the Mediterranean diet. Unlike in summer, spending a few hours over the stove or in the kitchen with the oven on these days is a much-needed way to warm up. Below, we provide a broad overview of some winter vegetables, and examples of how to prepare them, Mediterranean style.
Poblano and Zucchini Bucatini with Shrimp
Bucatini is a thick, spaghetti-like pasta with a hole in the center, perfect for trapping all of the comforting flavors of the vegetable-based sauce in this dish. A whole wheat ziti would also work well.
Creamy Potato Soup with Herb Oil Swirl and Migas
It's difficult to believe that this smooth and creamy potato soup is dairy-free. A panko variation of migas, a sautéed breadcrumb condiment popular in Spain, adds a bit of flavor and texture.
Portobello with Roasted Winter Root Vegetables
Paired with winter vegetable all-stars - parsnips, turnips, and rutabagas - portobello mushrooms add a meaty, warming quality. Using jarred mushrooms and peppers simplifies the recipe without sacrificing Mediterranean flavors.
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Researchers Identify Liver Pathway Linked to Negative Impacts of High-Fat, High-Cholesterol Diet

(University of Michigan) It's no secret that a high-fat, high-cholesterol "junk food" diet has been linked to major health problems, including high blood cholesterol and the buildup of plaques in the arteries, known as atherosclerosis.
Research led by the University of Michigan Life Sciences Institute has identified a pathway in the liver, controlled by a protein known as BAF60a, that contributes to these negative effects by stimulating the production of bile -- which helps the body to absorb more cholesterol and other fats from the foods we eat…
From an evolutionary perspective, it makes sense that our ancestors' bodies would want to kick into high gear to take full advantage of a rare source of fat, said Zhuo-Xian Meng, the study's lead author and a research investigator in Lin's lab.
"But now the environment has changed, fatty foods are everywhere and this adaptive response becomes maladaptive," Meng said.
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Changing Americans' Diets Requires Efforts on Many Fronts

(MedPage Today) Physician discomfort with counseling for and treating obesity may be part of the reason that obesity costs continue to go up, Y. Claire Wang, MD, ScD, said at a briefing Thursday sponsored by Health Affairs and the Robert Wood Johnson Foundation.
"Many physicians may be more comfortable treating obesity-related disease such as hypertension and high cholesterol than providing counseling and treating obesity," said Wang, who is associate professor of health policy and management at the Mailman School of Public Health at Columbia University, in New York City..
The researchers found that severe obesity costs state Medicaid programs almost $8 billion a year, from $5 million in Wyoming to $1.3 billion in California. "These costs are likely to increase following Medicaid expansion and enhanced coverage of weight loss therapies in the form of nutrition consultation, drug therapy, and bariatric surgery," they noted.
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Changing Habits to Improve Health: New Study Indicates Behavior Changes Work

(Oregon State University) Improving your heart health may be as simple as making small behavioral changes -- a new study of behavioral health interventions suggests that they are effective at helping people alter their lifestyles and lead to physical changes that could improve overall health.
The findings also indicate a shift is needed in the way such interventions are evaluated by researchers and used by health care providers, said Veronica Irvin of Oregon State University, a co-author of the study…
Behavioral treatments such as individual counseling or group training to improve nutrition or physical activity, reduce or stop smoking, or adhere to a drug treatment plan, often are overlooked because medical care providers tend to believe it is too difficult for people the make changes to their established lifestyles, said Irvin…
"This research suggests that behavioral interventions should be taken more seriously," Irvin said. "It indicates that people are able to achieve realistic behavioral changes and improve their cardiovascular health."
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Counseling Helps Patients Adhere to Lifestyle Change

(MedPage Today) Counseling-based approaches had a beneficial impact, albeit modest, on decreasing unhealthy behavior in adults at risk for cardiovascular disease, according to the results of two small late-breaking clinical trials presented here.
Participants in Fifty Fifty, a peer-group-based intervention program in Spain, were associated with overall improvement in mean cardiovascular risk scores compared with controls, with a difference of 0.75 points … on a 15-point scale, Valentin Fuster, MD, of the Icahn School of Medicine at Mount Sinai Hospital in New York City, reported…
Fuster said that peer support is a proven beneficial strategy for substance abuse, so a similar peer support strategy for modifying global risk factors and behavior deserved consideration.
"This group met every month for about a period of 12 months and obviously they helped each other, exactly like [what] happens with Alcoholics Anonymous," he said.
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Virtual Selves Can Help Boost Better Real World Health, Exercise Habits

(Penn State) Customizing an avatar to better resemble its human user may lead to improved health and exercise behaviors, according to a team of researchers…
The act of customizing an avatar seems to create a personal connection between people and their virtual alter egos and sticks with them in real life, said [S. Shyam Sundar, Distinguished Professor of Communications and co-director of the Media Effects Research Laboratory].
"Perhaps more important, there is the sense of agency we get from being able to shape our online persona," added Sundar. "This agentic feeling transfers over to our offline motivations and actions."
Waddell said that online health and diet counselors could one day use this avatar customization technique to reinforce advice and treatment for their clients.
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Food Policy: Cutting Waste, Broadening Systems

(Johns Hopkins Bloomberg School of Public Health) In two separate articles, researchers detail strategies aimed at cutting food waste and broadening approaches to food policy, moves that the researchers say would ultimately improve public health and food security…
Previous studies indicate that Americans waste as much as 40 per cent, or 133 billion pounds, of the food that is produced or purchased. Globally, the figure is about 30 per cent of the food supply…
The authors describe three examples of a food systems approach to food policy: farm-to-school programs, incorporating sustainability into the Dietary Guidelines for Americans and antibiotic use in food animal production.
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Urban Gardens and Human Health

(Universidad Politécnica de Madrid) Urban agriculture is a socioeconomic growing movement worldwide that promotes a sustainable model of agricultural production, urban development and food safety. Diverse studies have proved that this activity presents multiple environmental, economic and cultural benefits. However, urban soils are often contaminated by diverse sources and historical usages, thus there is a potential risk for human health associated with agricultural performance, consumption of seeded products and the usage of these spaces for children with recreational purposes, being necessary to study soil conditions in order to guarantee safety.
Researchers from the School of Mining and Energy Engineering at UPM collected samples of arable soil layers of different urban gardens and assessed the metal content and the physicochemical properties of the soil…
Considering two scenarios of exposure -agricultural scenarios for adults and recreational scenarios for children- and applying bioaccessibility, the estimated risk does not exceed the maximum permissible for human health, although some elements (chromium and lead) and routes of exposure (soil ingestion and agricultural products) significantly contribute to the overall experienced by receptors in urban environments.
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This is how gullible General Mills thinks Americans are

(Wonkblog, Washington Post) General Mills, the maker of Cinnamon Toast Crunch, Lucky Charms, Fiber One, and Cheerios, has a clever new trick, according to a lawsuit brought against the company this week by consumer group Center for Science in the Public Interest (CSPI). The suit alleges that the cereal maker has been selling a new product called Cheerios Protein, which the company introduced last year, under false pretenses.
"The overall impression of the box is that the cereal has a lot more protein than traditional Cheerios, but when you look at the nutrition label, it's clear that Protein Cheerios has only a little bit more protein, and a lot more sugar," said Michael Jacobson, president of CSPI. "We think that's very deceptive."
A glance at nutritional information for the two cereals, which is available on General Mills's Web site, reveals that a single serving of Cheerios Protein has seven grams of protein and seventeen grams of sugar. A serving of the original Cheerios, meanwhile, has three grams of protein and only a single gram of sugar.
The 4-gram difference in protein makes it hard to argue that that necessarily merits adding big bold letters to the packaging that spell the word PROTEIN. 
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University Returns $1 Million Grant to Coca-Cola

(Well, New York Times) The University of Colorado School of Medicine announced … that it was returning a $1 million gift from Coca-Cola after it was revealed that the money had been used to establish an advocacy group that played down the link between soft drinks and obesity.
Coca-Cola donated the money in 2014 to help establish the Global Energy Balance Network, a nonprofit group of scientists that urged people to focus more on exercise and worry less about what they eat and drink. Coke’s financial ties to the group prompted criticism that the soft drink giant was supporting scientists as a way to shape obesity research, an issue reported by The New York Times in August…
In a statement…, the University of Colorado said it was returning the $1 million seed money that Coke had provided to set up the Global Energy Balance Network because “the funding source has distracted attention from its worthwhile goal.”
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The Latest from The People’s Pharmacy

Readers Favor Both Classic and Unusual Hiccup Remedies
We’ve heard of numerous hiccup remedies over the years. A wedge of lemon or lime with Angostura bitters is a bartenders’ favorite. A spoonful of granulated sugar is another old-fashioned option for getting rid of hiccups. More recently we have heard from people who favor chocolate for hiccups.
Coconut Cookies and Peppermint Oil Ease Irritable Bowel
Enteric-coated peppermint oil can calm digestive tract spasms, while coconut helps discourage diarrhea.
Skeptical Aussie Embraces Vicks VapoRub on the Soles of the Feet for Cough
Smearing Vicks VapoRub on the soles of the feet may be able to calm a troublesome nighttime cough and allow the sufferer to get some sleep.
Marseille Soap For Leg Cramps Thanks to French Grandmothers
What did French grandmothers know about putting soap in bed to ease leg cramps? Find out the secret behind Marseille soap and why it is popular in France.
How to Get Rid of Persistent Lice
Suffocating persistent lice instead of killing them with pesticides may get around the problem of resistance.
Are TV Commercials Pushing People To Take Too Many Pills?
Americans are exposed to a stream of prescription drug commercials for everything from ED and arthritis to cancer and psoriasis. Have you had enough?
Does Your Drug Contain Lactose?
DailyMed is an online database that lists active and inactive ingredients of pills; it is a good way to learn if a medicine contains lactose as a filler.
What Your Doctor May Not Tell You About the Statin and Diabetes Connection
It came as a shock to many cardiologists to learn statins could raise blood sugar or cause diabetes. Many still don't warn patients about this side effect.
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Mind-Body Practice Results in 43% Reduction in Use of Healthcare Services

(The Integrator Blog) [A research] team took a retrospective look at healthcare utilization of more than 4000 patients in the Relaxation Response Resiliency Program (3RP) and compared them to a usual care cohort. The finding: "At one year, total utilization for the intervention group decreased by 43%, clinical encounters decreased by 41.9%, imaging by 50.3%, lab encounters by 43.5%, and procedures by 21.4%.  Measured by dollar, reduction was estimated as "on the order of $2360/patient/year." The authors note that "this reduction is on the order of that found by 3 other groups in "other similar time-limited interventions."
Their Policy Recommendation: "The data suggests that the intervention should be applied to all at risk populations, since the intervention has minimal risk, minimal cost and yields substantial benefits for patients with a wide variety of illnesses. The long-term effect of these interventions on healthy populations is unclear, but the data suggests that mind body interventions should perhaps be instituted as a form of preventative care similar to vaccinations or driver education. Such interventions are likely to be useful in population management and supported self-care, have negligible risk and cost and may help reduce the demand curve in healthcare. While the risk benefit ratio of this intervention is very favorable to further elucidate the effect size a prospective evaluation is called for."…
Comment: This is a very important paper showing a huge reduction with tremendous potential personal and socio-economic benefits. Imagine the headlines if a pharmaceutical was found to have this impact. Given the cost crisis in US medicine, a network of trials should immediately begin with multiple populations in diverse social and cultural settings to see how well these findings can be replicated.
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Americans who practice Yoga report better wellness, health behaviors

(National Center for Complementary and Integrative Health) People who practiced yoga or took natural products (dietary supplements other than vitamins and minerals) were more likely to do so for wellness reasons than to treat a specific health condition, according to analysis of data from the 2012 National Health Interview Survey (NHIS). Yoga users reported the most positive health benefits, compared to users of natural products and spinal manipulation. The analysis by the National Center for Complementary and Integrative Health (NCCIH) was published in a National Health Statistics Report by the National Center for Health Statistics.
“Though yoga seems to play the biggest role, people who use a variety of complementary health approaches reported better wellbeing,” said Josephine P. Briggs, M.D., director of NCCIH. “This may suggest that people perceive more wellness benefit when they are actively involved in their health, for example by practicing yoga. More research is needed to better understand the ways yoga and other approaches impact overall health.”
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Simple Steps to Improving Your Well-Being

(Andrew Weil, M.D.) Following through on the right resolutions about your health and lifestyle choices doesn't have to be difficult, especially if you have a firm idea of areas you want to improve, and remember that small, gradual steps typically have better results than cold-turkey or all-or-nothing approaches.
Take some time today to consider areas of your life you would like to improve. You may want to be healthier, more generous, less stressed, or just more optimistic. Once you determine your goals, create a timeline and attach some simple steps to get there. Consider your strengths and how they can help you on your path, as well as your weaknesses and ways you can work around and with them. If, during your progress, you take a step backward, keep looking forward. Most goals are reached with both good and bad days playing a part!
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6 Ways to Be Happier

(WebMD) Give Thanks
Happy people aren’t smarter or richer than their peers, but they are more grateful and often have these characteristics.
Focus on Physical Activity
You don’t need to run marathons to reap the benefits of exercise. Even short workouts release certain brain chemicals that create feelings of joy and contentment.
Eat Feel-Good Foods
While there’s no "happiness diet," some foods -- like Thanksgiving turkey -- can give your mood a lift and may help ward off depression.
Snuggle Up
Touching and hugging can release your body’s natural “feel-good hormone.” Plus, sex and intimacy can boost your self-esteem and happiness, among other health perks.
Give Back
As little as 2 hours of volunteering a week can give you that happy glow known as the “helper’s high.”
Tune In
Listening to music can provide an emotional pick-me-up, but choose wisely. Some songs may bring you down.
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More Information and Recent Research on the Brain and Mental Function

(University of Melbourne) People with a certain type of gene are more deeply affected by their life experiences, a new study has revealed… The research … focused on a particular gene, known as SERT, that transports the mood-regulating chemical, serotonin… "Our results suggest some people have a genetic makeup that makes them more susceptible to negative environments, but if put in a supportive environment these same people are likely to thrive," [lead investigator Dr. Chad] Bousman said.
(Duke University) A Duke University-led study … found that early stress, specifically between kindergarten and grade three, was most strongly associated with muted responses to rewards in adulthood. Previous studies have identified this type of brain activity as a marker for increased risk of depression and anxiety. "In participants with the greatest levels of early stress, we saw the lowest levels of activity in the ventral striatum in response to a reward," [Study lead author Jamie] Hanson said.
(Paul Krugman) There has been a lot of comment, and rightly so, over a new paper by the economists Angus Deaton (who just won a Nobel) and Anne Case, showing that mortality among middle-aged white Americans has been rising since 1999… Basically, white Americans are, in increasing numbers, killing themselves, directly or indirectly. Suicide is way up, and so are deaths from drug poisoning and the chronic liver disease that excessive drinking can cause…
I know I’m not the only observer who sees a link between the despair reflected in those mortality numbers and the volatility of right-wing politics.
My message to Dr. Krugman - Caro:
I agree with you that right-wing “volatility”, as you put it, is at least partly responsible for the despair causing so many self-inflicted deaths in one way or another among middle-aged American whites.
But it’s more than anger-mongering that is causing the problem. It’s mainly, I think, due to the furtherance of the belief that we’re all on our own and are worth less as human beings if we can’t find a way, without any help, to get out of the economic morass caused by income inequality—which causes so much influence inequality.
Millions of years of evolution living in hunter-gatherer tribes molded us into creatures whose feelings of security and well being depend on being members of a cooperative group. But today’s right wingers want us to believe that we’re all on our own, and any cooperative effort to increase the common good is a catastrophic mistake. We’re just not built that way, and trying to pretend we are or should be is apparently very detrimental to our mental health.
I’d write a book about it, if I could find a publisher.
(Center for BrainHealth) A first of its kind study … shows that depressive thoughts are maintained for longer periods of time for people with depressed mood, and this extended duration may reduce the amount of information that these individuals can hold in their memory… The authors suggest that this greater dedication of memory resources to depressive thoughts and consequently, an impoverished ability to hold positive thoughts in memory, might be the key to understanding how depression develops and continues throughout an individual's lifespan.
(Shots, NPR) Multiple studies have linked depression with elevated markers of inflammation, including two analyses from 2010 and 2012 that collectively reviewed data from 53 studies, as well as several postmortem studies. A large body of related research confirms that autoimmune and inflammatory activity in the brain is linked with psychiatric symptoms… The idea that inflammation — whether stirred up by infection or by other factors — contributes to or causes mental illness comes with caveats, at least in terms of potential treatments. Trials testing anti-inflammatory drugs have been overall mixed or underwhelming.
More . . .

Smoking rates in America are now the lowest they've been in more than 50 years

(Vox) Smoking in America is now at its lowest point in more than 50 years.
That's according to newly released data from the Centers for Disease Control and Prevention showing that the percentage of adults who smoke cigarettes has continued to decline… 21 percent of Americans smoked regularly in 2005 (about 45 million people), and in 2014 that number was down to 17 percent (about 40 million people).
It's a remarkable shift. In 1964, when the surgeon general first began a public health campaign on cigarettes, nearly half of the adult population smoked.
But thanks to tobacco taxes, smoking bans, and public awareness campaigns, cigarette use has been on a downward trajectory for decades.
This major public health success story hasn't been a total victory, either. Cigarette smoking remains the leading cause of preventable disease and death in the US, contributing to some 480,000 early deaths and more than $300 billion in health care expenditures and productivity losses every year. The push to eradicate smoking has been especially slow going among poorer Americans.
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Acetium lozenge - a promising novel method to assist smoking cessation

(Reuters) * Smoking intervention study of Biohit Oyj of nearly two years of duration using Acetium lozenge has been completed
* Says Acetium lozenge is considered to be a promising novel intervention method to assist in smoking cessation
* In intervention group, 42.9 percent could stop smoking as compared to 31.1 percent in placebo group (i.e. Acetium was 37.9 percent more effective)
* Compared to placebo, likelihood of smoking cessation among acetium users during trial was up to1.65-fold (i.e., 65 percent higher probability)
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Some Gut Microbes May Be Keystones of Health, Study Suggests

(University of Oregon) University of Oregon scientists have found that strength in numbers doesn't hold true for microbes in the intestines. A minority population of the right type might hold the key to regulating good health.
The discovery, based on research using zebrafish raised completely germ free, is reported in a paper published in the Nov. 11 issue of Cell Host & Microbe. The findings provide a path to study the function of each bacterial species in the gut and to eventually, perhaps, predict and prevent disease, says lead author Annah S. Rolig…
Low counts of a bacterial species generally have been discounted in importance, but slight shifts in the ratios of abundant microbe populations have been thought to have roles in obesity, diabetes and inflammatory bowel diseases such as Crohn's disease.
That thinking is now changing, Rolig said. "The contribution of each bacterium is not equal. There is a per-capita effect that needs to be considered."
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Competition between 'good bacteria' important for healthy gut

(University of Oxford) The vital ecosystem of bacteria in the human gut operates like a jungle, with competition between microbes helping maintain the stability necessary to keep us healthy.
That's according to scientists at Oxford University, who have used mathematical modelling to work out how hundreds of bacteria species are able to co-exist successfully.
In their report, the researchers show that -- contrary to popular assumption -- cooperation between species has the effect of destabilizing the system. Instead, a competitive environment between 'good bacteria' helps to maintain stability via negative feedback loops that counteract the destabilizing effect of high species diversity.
The researchers go on to speculate that people -- or hosts -- may help maintain this natural stability in the gut by acting as 'ecosystem engineers' who intervene in a number of ways.
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The Gut Microbiota Can Influence the Effectiveness of Dietary Treatments

(University of Gothenburg) Dietary interventions can be used to improve the metabolism of humans, and they also have a major impact on the gut microbiota. Previous studies at the Sahlgrenska Academy have shown that the gut microbiota is altered in metabolic diseases such as type 2 diabetes, and that the gut microbiota contributes to obesity, diabetes and cardiovascular disease.
In a new study, 39 subjects ate barley kernel bread for three days followed by control bread made from white flour for three days (with a break between the two diets). The results showed that barley kernel bread improved the control of blood sugar, but only in some individuals.
Prevotella, a group of bacteria previously shown to be associated with high fiber intake, was present in higher proportions in those who responded beneficially to barley kernel bread than in those who did not respond to this dietary intervention.
By transferring the gut microbiota of these individuals to germ-free mice, the research group could demonstrate that the altered gut microbiota contributed to the beneficial effects of the barley kernel bread.
"Our findings clearly show the importance of the interaction between the gut microbiota and the diet and contribute to our understanding of metabolism in health and disease. The results may help to explain why responses to different dietary treatments are so individual," says Professor Fredrik Bäckhed at the Sahlgrenska Academy, University of Gothenburg.
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Controlling Levels of Specific Gut Bacteria Could Help Prevent Severe Diarrhea

(Michigan State University) Everyone has suffered from it. It's ranged from mild to severe. It's a condition that's most-often described in a whisper.
Diarrhea.
Severe cases of diarrhea, however, are no joking matter. Research led by Michigan State University and published in a recent issue of the journal Microbiome may offer patients suffering from acute cases new treatments that focus on intestinal microbial communities to prevent the disease…
In the MSU study, most of the patients had an increase in the level of Escherichia, bacteria that are commonly found in the intestines that can sometimes be pathogenic…
These findings are important because new treatments could be developed to control the levels of Escherichia in cases of severe diarrhea and/or to promote the growth of microbial populations that are important for healthy gut function [said Shannon Manning, MSU Foundation Professor of microbiology and molecular genetics and leader of the study].
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Gut Bacteria Can Dramatically Amplify Cancer Immunotherapy

(University of Chicago Medical Center) By introducing a particular strain of bacteria into the digestive tracts of mice with melanoma, researchers at the University of Chicago were able to boost the ability of the animal's immune systems to attack tumor cells. The gains were comparable to treatment with anti-cancer drugs known as checkpoint inhibitors, such as anti-PD-L1 antibodies.
The combination of oral doses of the bacteria and injections with anti-PD-L1 antibody nearly abolished tumor outgrowth, the researchers report…
"Our results clearly demonstrate a significant, although unexpected, role for specific gut bacteria in enhancing the immune system's response to melanoma and possibly many other tumor types," said study director Thomas Gajewski, MD, PhD, professor of medicine and pathology at the University of Chicago.
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Researchers Want to Turn Acid-Loving Microbes Into Safe Drug-Carriers

(University of Southern Denmark) Usually the microbe S. islandicus is found in hot and acidic volcanic springs, but now the microbe has also found its way to the labs of University of Southern Denmark. Here researchers have for the first time showed that the exotic microbe is capable of delivering drugs to the human body.
The microbe S. islandicus has a strange and unique talent for thriving in acidic environments. This talent would allow the microbe to safely pass through the human stomach, where harsh acidic conditions rule, and this makes the microbe interesting for scientists working with delivering drugs to the human body.
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Supersized scanner to explore the body and hunt down disease

(Reuters) When they were kids, Simon Cherry and Ramsey Badawi both wanted to be astronomers, unlocking mysteries in far off galaxies. That didn't work out for them. The pair still plan on unlocking mysteries but this time inside the human body. 
They've received a $15.5 million grant to build the world's first full body PET scanner. Unlike X-Rays and MRI's that image structure in the body. Positron emission tomography, or PET, images function on a molecular level.   
"We are able to say something about what the cells in the body are doing," said Simon Cherry a professor of radiology and biomedical engineering at the University of California, Davis.
"How actively they are metabolizing, for example, or how quickly they are dividing. So taking cancer for example that could be tremendously powerful to see when you give a drug whether that shuts down the metabolism of a tumor," he added.
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Another Dimension: 3D Cell Growth Opens New Pathway for Spinal Cord Repair

(Griffith University) Griffith University researchers have opened a new avenue to advance a therapy to repair the paralysed spinal cord.
A paper … presents a novel technique to grow cells in three dimensions, without the traditional restrictions of matrix or scaffolds.
By using floating liquid marbles, cells can freely associate and form natural structures as they would normally within the human body.
"Allowing cells to grow in this 3D format dramatically increases their growth and function and is particularly useful for spinal transplantation repair in which cells are transplanted into the injury site," says research supervisor Dr James St John, from Griffith's Eskitis Institute for Drug Discovery.
The technique was developed when neurobiology merged with microfluidic engineering technology.
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