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

Boomers to change culture and attitudes on aging

(Asheville Citizen-Times) It's a quiz none of us wants to take, but it's one Michael Faulkner insists we all at least consider.
How many of you think you'll ever end up in a nursing home? How many think you'll have to use a wheelchair? How many believe you'll spend your last years with dementia?
Invariably, Faulkner says, Americans want to answer, "Not me." But that's just not realistic, especially with an onslaught of baby boomers poised to enter the ranks of the elderly in America…
Faulkner, through his company, Engaged Behavioral Health, has been leading a push to change attitudes toward aging and health care among those who work in the field — and among the elderly themselves.
The gist of the idea is that older people and their families must become engaged in their care and more vocal about what they want that care to look like, and nursing home employees have to look at the care they give from the residents' point of view.
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110-Year-Old Woman Reveals Secret To Her Long Life

(BuzzFeed) Agnes Fenton of Englewood, New Jersey … just turned 110 years old…
Fenton hears and sees well, she reads the paper and listens to the radio, and hangs out with friends.
She likes chicken wings, green beans, and sweet potatoes. She sleeps a lot and she prays. By all accounts she’s doing great with no serious health problems.
Also, every single day for 70 years she drank three beers and a shot of whiskey.
Community: Yes, well, the research shows that her prescription for a long life won’t work for most of us.
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Novelist Pat Conroy was ‘dying’ three years ago. Here’s how he got healthy.

(Washington Post) Three years ago, life caught up with the novelist Pat Conroy. After decades of eating and drinking pretty much whatever he wanted, the best-selling novelist found himself lying in a hospital bed, bloated with fluids as his organs floundered. He had Type 2 diabetes, high blood pressure and a failing liver…
Following his release from the hospital, Conroy, now 69, quit drinking. He has since lost about 25 pounds. His blood pressure is now at a normal level, without medication. He has worked with a nutritionist, who happens to be his next-door neighbor. “She actually comes to my house and opens the refrigerator door and starts throwing away things she doesn’t want me to eat,” he says.
The ever-self-deprecating Conroy may not see himself as a fitness inspiration, but he has nonetheless shown that no matter your age or how far you’ve fallen, there are still ways to regain your health.
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Testosterone Therapy May Lower Death Risk in Older Men

(MedPage Today) Testosterone replacement therapy (TRT) appeared to lower the risk for myocardial infarction, stroke and death in androgen-deficient older men whose testosterone levels were normalized by the treatment, a retrospective study found…
Compared to TRT-treated men who did not achieve testosterone normalization, those who did saw a 47% mortality benefit, a 18% MI benefit and a 30% stroke benefit … researcher Rajat Barua, MD, of the Kansas City VA Medical Center told MedPage Today
All-cause mortality, MI, and stroke rates were also significantly lower in men with normalized testosterone levels following TRT, compared to men with hypogonadism who did not receive testosterone therapy.
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Belly Fat Is Worst for Well-Being in Older Men

(Sharecare) When you think about health problems that can affect your life the most as you age, what comes to mind? Heart issues or prostate problems? Low testosterone? One study points out it’s actually a spare tire that gives men the most trouble.
Researchers from Odense University Hospital in Denmark polled 598 Danish men between the ages of 60-74, using a questionnaire that asked about quality-of-life factors such as physical ability, vitality, and social and emotional health. The researchers also measured the men’s body composition and testosterone levels. The study found that a big belly had the biggest impact on a man’s general health, and that as men’s waistlines grew, their quality of life and sense of well-being tumbled. Low testosterone, by comparison, had little effect on the men’s lives.
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Getting to the Bottom of Aging

(Forschungsverbund Berlin) The question of why we age is one of the most fascinating questions for humankind, but nothing close to a satisfactory answer has been found to date. Scientists at the Leibniz-Institut für Molekulare Pharmakologie in Berlin have now taken one step closer to providing an answer.
They have conducted a study in which, for the first time, they have shown that a certain area of the cell, the so-called endoplasmic reticulum, loses its oxidative power in advanced age. If this elixir of life is lost, many proteins can no longer mature properly. At the same time, oxidative damage accumulates in another area of the cell, the cytosol. This interplay was previously unknown and now opens up a new understanding of aging, but also of neurodegenerative diseases such as Alzheimer's or Parkinson's…
The researchers also demonstrated the decline of the oxidative milieu of the ER after stress. When they synthesised amyloid protein fibrils in the cell, which cause diseases such as Alzheimer's, Parkinson's or Huntington's disease, they set the same cascade in motion. Apart from this, they were able to show that amyloids that are synthesised in a certain tissue also have negative effects on the redox equilibrium in another tissue within the same organism. "Protein stress leads to the same effects as aging," explains Kirstein. "Our findings are thus not only interesting with regards to aging, but also concerning neurodegenerative diseases such as Alzheimer's."
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Scientists Discover Rejuvenation Factors in Eggs

(A*STAR) Scientists from A*STAR's Genome Institute of Singapore (GIS) have discovered metabolic rejuvenation factors in eggs. This critical finding furthers our understanding of how cellular metabolism changes during aging, and during rejuvenation after egg fertilisation…
A new study from GIS suggests that old mitochondria -- the oxygen-consuming metabolic engines in cells -- are roadblocks to cellular rejuvenation. By tuning up a gene called Tcl1, which is highly abundant in eggs, researchers were able to suppress old mitochondria to enhance a process known as somatic reprogramming, which turn adult cells into embryonic-like stem cells…
Cracking the mystery of reprogramming factors in oocytes is an important milestone. These new insights could boost efficacy of the alternative, non-oocyte-based iPSC techniques for stem cell banking, organ and tissue regeneration, as well as further our understanding of how cellular metabolism rejuvenates after egg-sperm fertilisation. This could help address both the aging and the fertility problems of modern societies.
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Cell Aging Slowed by Putting Brakes on Noisy Transcription

(Perelman School of Medicine at the University of Pennsylvania) Working with yeast and worms, researchers found that incorrect gene expression is a hallmark of aged cells and that reducing such "noise" extends lifespan in these organisms…
"We used budding yeast, a single-cell organism, to study the epigenetic regulation of aging and this simple model turned out to be quite powerful," explained [first author Payel Sen, PhD]…
"We have started investigating whether such a longevity pathway can also be demonstrated in mammalian cells," says [senior author Shelley Berger, PhD]. "However, these investigations are confounded by the complexity of the genome in more advanced organisms. One of our long-term goals is to design drugs that can help retain these beneficial histone modifications and extend healthy lifespan in humans."
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The Latest from The People's Pharmacy

Pineapple Juice Postpones Joint Pain
Pineapple juice contains bromelain, which appears to have anti-inflammatory activity.
High Glycemic Index Diets Trigger Depression
High glycemic index diets full of sugar and refined starches like cakes, cookies, bagels and bread can make women more susceptible to depression.
The Inside Story on the Female Sex Pill Flibanserin (Addyi)
What's the straight and skinny on the new sex pill for women? Flibanserin (Addyi) has gotten a lot of headlines but what is the real story on pros and cons?
How Accurate Is the Cardiac Risk Calculator?
Flaws in the risk calculator for heart disease could lead to overprescribing of statin-type cholesterol-lowering drugs.
Better Cleaning of Hospital Rooms Could Reduce Infections
Inadequate cleaning of hospital rooms contributes to infections being shared among patients; unfortunately, there is no consensus on how best to clean.
Are You Listening to The People’s Pharmacy Podcast?
It is easy to listen to a podcast of The People's Pharmacy radio show. Every download will empower you to take control of your own health.
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Role of Intra-Abdominal Fat in IBD Uncovered

(American Gastroenterological Association) Intra-abdominal fat cells may contribute to the development and progression of inflammatory bowel disease (IBD), according to a study…
"A well-appreciated feature of IBD, especially longstanding Crohn's disease, is intra-abdominal fat, also known as 'creeping fat,' which wraps around the intestine. However, it's not clear whether this fat is protective or harmful," said study author Charalabos Pothoulakis, MD, from the University of California, Los Angeles. "Our study offers insight into this phenomenon. We found that intra-abdominal fat cells may normally be programmed to dampen inflammation but, in fact, have acquired a tendency to promote inflammation in IBD."
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How Beneficial Bacteria Protect Intestinal Cells

(Emory Health Sciences) Research on a helpful part of the microbiome -- beneficial intestinal bacteria -- is moving from "what is there" to "how they help."
Scientists at Emory University School of Medicine have shown how an ancient cellular regulatory circuit called Nrf2, present in both insects and mammals, responds to beneficial bacteria and gears up a protective response to environmental stresses.
The findings could potentially lead to advances in the use of bacteria to treat intestinal diseases or mitigate the effects of radiation therapy for cancer…
While many types of bacteria that live in our intestines are inert or even harmful to intestinal cells, a small subset -- lactobacilli -- can stimulate increased motility, proliferation and ability to withstand stress, Neish says.
"Lactobacilli are present in yogurt, and they're also the first kind of bacteria that will colonize a baby's system after the baby is born," he says.
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Scientists Uncover Surprising Mechanism Behind Antibiotic-Resistant Bacteria

(The Scripps Research Institute) Every year, more strains of bacteria develop resistance to the antibiotics we use to treat deadly infections. At The Scripps Research Institute (TSRI) scientists have been working to develop new forms of these drugs, including an antibiotic called arylomycin—but tests have shown that it is possible for bacteria to become resistant to arylomycin, too.
Now, scientists at TSRI have discovered that the important human pathogen Staphylococcus aureus, develops resistance to this drug by “switching on” a previously uncharacterized set of genes.
“This explains why antibiotic resistance rates in some bacteria are higher than in others,” said TSRI Professor Floyd Romesberg, senior author of the new study. “Resistance depends on this little set of genes that no one knew could contribute to tolerating the arylomycins.”…
Romesberg said this discovery shows the built-in redundancies that help bacteria survive in many environments. He said the next step in this research is to figure out how the AyrA- and AyrBC-producing genes are switched on in the first place.
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Wireless, implantable device stimulates nerves in mice

(UPI) Scientists developed a wirelessly powered device that can stimulate nerves in the brain, spinal cord or limbs of mice using light, allowing mice to move much more freely during experiments with multiple mice or that involve burrowing or tunnels.
Optogenetics -- using light to control brain activity -- typically involves wires attached to the mice's heads in order for scientists to stimulate their nerves and provide power for the light. The new device is implanted in a mouse, powered by energy transferred from a specially designed power source using the mouse's own body.
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Cost Of Diabetes Drugs Often Overlooked, But Shouldn’t Be

(Kaiser Health News) Cost increases for both old and new drugs alike are forcing many consumers to scramble to pay for them.
"Every week I see patients who can't afford their drugs," says Dr. Joel Zonszein, an endocrinologist who's director of the clinical diabetes center at Montefiore Medical Center in New York City.
Many people with diabetes take multiple drugs that work in different ways to control their blood sugar. Although some of the top-selling diabetes drugs like metformin are modestly priced generics, new brand-name drugs continue to be introduced that act in different ways. They may be more effective and have fewer side effects, but it often comes at a price. For the fourth year in a row, spending on diabetes drugs in 2014 was higher on a per member per year basis than it was for any other class of traditional drug, according to the Express Scripts 2014 Drug Trend Report. Less than half of the prescriptions filled for diabetes treatments were generic.
"The cost of diabetes treatment has been increasing pretty rapidly," says Dr. Glen Stettin, senior vice president for clinical, research, and new solutions at Express Scripts.
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How health care reform adds to Wal-Mart’s pharmacy woes

(Wonkblog, Washington Post) A footnote in Wal-Mart's second quarter earnings release this week highlighted one of the many effects of more people gaining health insurance under the Affordable Care Act: its pharmacies are no longer as profitable.
The retail giant blamed weak quarterly earnings that underperformed expectations partly on challenges facing its U.S. pharmacy business.
"Let’s talk about pharmacy," Greg Foran, president and chief executive of Wal-Mart U.S., said during the call. The company is seeing lower reimbursement rates from drug insurance plans and a decline in high-margin cash transactions, he said, "reflecting a marketplace shift in which more customers are now benefiting from greater drug insurance coverage."
Wal-Mart reported in the call that its  health and wellness business was growing, including an increase in prescriptions filled, but that the profit margins are lower than expected.
Community: I feel REAL sorry for them.
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Special Report: Investors profit by funding surgery for desperate women patients

(Reuters) In July 2013, California urogynecologist Andrew Cassidenti received an email from an entrepreneur named Otto Fisher, who had a proposition. Fisher was looking for surgeons to perform operations to remove pelvic mesh implants from women…
Medical funders, often working through go-betweens like Fisher or doctors’ billing services, purchase medical bills at a deep discount from physicians, hospitals and others who have provided care to patients involved in personal injury litigation. Some medical funders also provide “concierge care” to these patients, fronting them travel and expense money at a high rate of interest.
Patients who rely on medical funders tend to be poor. They either lack private insurance or can’t afford to pay cash deductibles or out-of-network fees charged by their doctors.
When a patient’s lawsuit settles, the medical funder stakes a claim to part of the settlement by placing a lien for the full amount of the surgical bill. The funder’s profit lies in the difference between what it pays the medical provider to buy the bill and what it is able to recover from the patient’s settlement.
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The Fee-For-Service Addiction: Let’s Move To A Comprehensive Primary Care Payment Model

(Rushika Fernandopulle, Health Affairs) With much fanfare earlier this year, the Obama administration announced an aggressive goal to process half of all Medicare payments by the end of 2018 through alternative payment models as opposed to traditional fee-for-service (FFS). Primary care is one of the most urgent sectors needing such payment reform. As Bob Berenson succinctly put it, “Fee-for-service, the predominant physician payment scheme, has contributed to both the continuing decline in the primary care workforce and the capability to serve patients well.”
Unfortunately the alternative payment models for primary care currently offered or being proposed by Medicare involve additional payments on top of fee-for-service. Like an addict, we seem unable to go “cold turkey” and instead insist on just a little of our drug.
But this approach is bound to fail. If we truly want to move to a value-driven world and support a value-based payment model, we need to be willing to drop fee-for-service entirely.
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Why the GOP presidential candidates can’t reform health care

(Paul Waldman, Plum Line, Washington Post) In the last few days, Scott Walker and Marco Rubio released health care plans, and other Republican candidates are sure to follow soon. Most will probably be pretty similar, even if some are more fully fleshed out than others.
But they’ll all share one feature, the thing that tells you that they aren’t even remotely serious about this issue: they will take as their starting point that the entire Affordable Care Act should be repealed.
I say that that shows they aren’t serious not because I think the ACA has done a great deal of good, though I do think that. I say it because it shows that they’re completely unwilling to grapple with both the health care system as it exists today, and how incredibly disruptive the wholesale changes they’re proposing would be. Walker’s plan even says, “unlike the disruption caused by ObamaCare, my plan would allow for a smooth, easy transition into a better health care system.” This is the health care equivalent of thinking the Iraq War would be a cakewalk.
The reality is that repealing the ACA now that it has been implemented would mean a complete and utter transformation of American health care.
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Cost of Obesity 'Will Wipe Out Healthcare'

(Christopher Cheney, HealthLeaders Media) Obesity weighs heavily on American health and wealth.
Carrying extra pounds undermines several major weight-bearing pillars of value-based healthcare, including disease prevention, population health management, and cost control…
Jay H. Shubrook Jr., DO, a diabetes specialist and professor at Touro University College of Osteopathic Medicine in Vallejo, CA, says the societal costs of obesity are becoming too great to bear. "Our public health is at stake," he says. "We will not make meaningful headway on the prevention and treatment of chronic disease until we change the infrastructure that supports unhealthy habits…"
"Obesity is a crisis for two reasons," Shubrook says. "We are seeing lower life expectancy rates among our children, and we already know we can't handle the economic impact of diabetes. It will wipe out healthcare."…
Shubrook says … public service announcements and high-shock-value communication techniques need to be deployed as soon as possible to help reduce obesity… [Other researchers say that] education, particularly for children, will play a decisive role in whether the country can contain the obesity epidemic…
Last week I reached out to these food industry companies and associations, but did not receive responses to my requests for comment: the American Beverage Association, Coca-Cola, The Food Institute, and Little Caesar Enterprises Inc.
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The Weight Loss Menu: Surgery with a Side of Meds?

(MedPage Today) U.S. consumers now have a veritable fast-food menu of options when it comes to treatments for obesity: bypass surgeries, gastric sleeves, and lap bands; vagal nerve stimulators and balloons; and, of course, a growing list of weight loss drugs.
Yet this full plate of available therapies doesn't seem to have had a major impact on the obesity epidemic -- nearly 35% of Americans are obese, according to current figures on the CDC website, and the estimated annual medical cost of obesity in the U.S. was $147 billion in 2008…
It's possible that the options for treating obesity just aren't advanced enough yet -- there are not enough skilled surgeons, not enough reliable drugs, and not enough devices. But experts told MedPage Today that unless there are significant changes to the environmental factors in modern society that make it easy to sit all day and to overeat, there's little hope of beating the obesity epidemic…
"The importance of a healthy lifestyle cannot be forgotten regardless of potential breakthrough treatments," commented Suzanne Griggs, MS, RD, a dietitian at Boston Children's Hospital. "Positive lifestyle changes that are measurable over time, and more importantly, do-able in day-to-day life are often the ones that stick."
David Katz, MD,MPH, of Yale University School of Medicine in New Haven, Conn., wrote that the temptation to turn to medical solutions and technologies is fueled in part by the failure of clinical counseling…
"But we need cultural supports. We need prevailing opportunities for our patients to find and choose wholesome food, and fit activity into every day. Those opportunities need to be incorporated as a matter of routine into work places and schools, restaurants and cafeterias and supermarkets," he wrote.
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Healthy eating made easier

(Consumer Reports) You might attribute your failure to choose fruit over a doughnut or tofu over a burger to poor willpower. But relying on self-control is tough when unhealthy foods are heavily promoted. Fortunately, researchers have learned how simple changes in our environment and habits can help us to eat smarter without a great deal of extra effort.
Customize dishes and cups
The benefit:
 Control portion sizes…
Color-code your meals
The benefit:
 Improve nutrition and tempt your palate…
Make healthy foods visible
The benefit:
 Eat more good-for-you foods…
Make it look nice
The benefit:
 Healthy foods with visual appeal taste better…
Eat only at the table
The benefit:
 You'll eat less and feel satisfied.
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Study: Playing Tetris can help ease cravings

(UPI) Playing the block-stacking video game Tetris can ease cravings for food and drugs by about one-fifth, researchers found in a study of people in natural settings outside a laboratory.
Previous research had found that Tetris effectively reduced cravings in a lab setting. Most studies also were focused on food cravings, but researchers from Plymouth University and Queensland University of Technology found the method to be effective for smoking, alcohol, coffee, sex and sleeping, as well.
"We think the Tetris effect happens because craving involves imagining the experience of consuming a particular substance or indulging in a particular activity," said Dr. Jackie Andrade, a professor of psychology at Plymouth University, in a press release. "Playing a visually interesting game like Tetris occupies the mental processes that support that imagery -- it is hard to imagine something vividly and play Tetris at the same time."
Community: There are many practical things we can do to improve impulse control.
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Garcinia cambogia weight-loss pill is no miracle

(Consumer Reports) Garcinia cambogia, also known as tamarind, is a fruit that grows in Southeast Asia. Manufacturers claim that it boosts weight loss by, among other things, "slowing the body's ability to absorb fat," "replacing fat with toned muscles," and even improving your mood and suppressing "the drive to react to stressful situations with food." How, you may ask? It's mostly pinned on hydroxycitric acid (HCA), a substance found in garcinia cambogia that appears to inhibit an enzyme called citrate lyase and interferes with fatty acid metabolism.  
“HCA does do that—but in a petri dish," says Steven Heymsfield, M.D., the former head of the Pennington Biomedical Research Center in Baton Rouge, La. "Converting that to actual weight loss in humans would take 1,000 steps beyond that," he says…
Heymsfield, who continues to study the topic of weight-loss supplements at Pennington, says that about a dozen negative studies have since been published about garcinia cambogia. But that has not stopped marketers of the supplement, he says, from “weaving a story with obscure facts. Maybe each fragment has some validity, but if you wind it together it makes no sense at all.”
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Weight Loss May Be Fleeting With Lap Sleeve Gastrectomy

(MedPage Today) A long-term follow-up of laparoscopic sleeve gastrectomy (LSG) patients showed significant weight regain and a decrease in remission rates of diabetes.
Researchers reviewed 443 cases of LSG from 2006 to 2013 by the same surgery team and found that within 5 years, the percentage of excess weight loss declined from 77% to 56%, and "complete remission of diabetes was maintained in only 20% of patients."…
[R]emission of hypertension was maintained in 45.5% of patients, and there were significant differences in levels of high-density lipoprotein cholesterol levels and triglyceride levels, according to the authors.
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Teatox diets: a nasty way to lose weight

(Chatelaine) The latest way to cleanse your body is the “teatox,” which supplements a low-calorie diet with large amounts of herbal tea. (The #teatox hashtag has over 300,000 posts on Instagram.) Proponents say teatoxing improves energy, clears up skin, boosts metabolism and promotes weight loss…
Teatoxing might cause weight loss because the prescribed teas include senna, says Dr. Esther Konigsberg, medical director for Integrative Medicine Consultants in Toronto. “Senna is a laxative that works by irritating the bowels,” she says. This can result in diarrhea, which causes weight loss through dehydration – a dangerous condition that can lead to malnutrition. Popular teatox programs come in 7-, 14- and 28-day packs, extended periods which can prolong diarrhea, leading over time to electrolyte imbalances, depleted potassium levels, and heart irregularities.
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Is grazing good for you?

(Consumer Reports) The advice to eat small meals throughout the day has penetrated our healthy-eating mindset. About a quarter of snackers believe it’s healthier to eat several snacks throughout the day vs. larger meals. The rationale for grazing is that it keeps you from getting too hungry and then overeating. But when it comes to weight control, there’s no clear advantage to eating frequent smaller meals over fewer larger ones. If you don’t pay attention, you run the risk of taking in too many calories, especially if your version of grazing is constant nibbling over several hours. And small meals might not truly satisfy you; you may end up eating more.
In fact, there has been some research showing a benefit to fewer meals…
The bottom line
There’s no single eating strategy that’s best for all. Whether you graze during the day or limit yourself to a few set meals, be sure to eat mindfully.
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Whole Grain Recipes

Chilled Avocado and Red Quinoa Soup
This refreshing summer soup mixes two great Latin American flavors: avocados and quinoa.
Yellow Squash Stuffed with Saffron Rye Berries
This stuffed squash is elegant enough for a special dinner yet simple enough for weeknights
Summer Veggies, Sausage, and Brown Rice Spaghetti
This flavorful pasta meal makes great use of the summer garden bounty.
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Scientists Scan the Brain To See How Stress Undermines Your Diet

(Sci-Tech Today) If you're trying to lose weight, kick off your diet by relaxing. Stress tinkers with your brain chemistry in ways that make it hard to make healthful food choices and maintain self-control, a new study finds.
Study volunteers who endured a somewhat stressful experience were 24% more likely to choose unhealthful snacks afterward compared with volunteers who hadn't experienced stress. And researchers think they know why: Brain scans showed that the stressed people had altered neurological connectivity between regions of the brain that process tastiness, make value judgments and plan for long-term goals…
The results are in line with previous research, which has shown that stress leads people to eat more high-calorie foods. They are also highly relevant to the way Americans now live, experts said.
"So many Americans are under chronic stress," said Stephanie Preston, a behavioral neuroscientist at the University of Michigan who was not involved with the research. "People are working more and more hours, and their vacation time is getting smaller and smaller. They're also getting rapidly more obese."
The findings underscore that resolving to eat better without changing your lifestyle probably won't help, she said.
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For fat loss, calories may matter more than fat or carbs

(Reuters Health) Want to lose body fat? At least initially, a diet low in fat may be better than one that limits carbohydrates, a U.S. study suggests…
For the current study, [National Institutes of Health researcher Kevin] Hall and colleagues set out to test a popular belief that drives many people to try low-carb diets – that reducing foods like pasta, white bread and sugary treats can curb supplies of the hormone insulin, which in turn limits the body’s ability to accumulate fat. With less insulin, the body may also burn existing fat stores for energy and lose weight…
[T]he results … offer solid evidence that low-carb diets aren’t superior for fat loss, Susan Roberts, a nutrition researcher at Tufts University, notes in an editorial accompanying the study. “Basically what the results say is that overall energy balance is the biggest factor – how do you cut calories in what you eat,” Roberts said by email.
To help answer this question, more research is needed that explores how consumption of fat, carbohydrates and protein influences how many calories people eat, she said.
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Drug improves weight loss in type 2 diabetes patients

(Nursing Times) The drug liraglutide appears to aid weight loss in patients with type 2 diabetes, according to an international trial led by UK researchers.
Compared with placebo, a daily injection of liraglutide with a modified insulin pen device – plus diet and exercise – led to greater weight loss among overweight and obese patients with diabetes.
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Eat food, not nutrients: why healthy diets need a broad approach

(The Conversation) The most important aspect of any diet is that it should be practical and healthy enough to follow for the rest of your life…
Choices based only on macronutrients (foods required in large amounts in the diet, such as fats, carbohydrates and protein) miss important aspects of many foods and open the diet to imbalance. Carbohydrate foods, for instance, include nutritionally worthy choices – such as legumes, wholegrains, fruits, milk and yoghurt – but also a huge range of items high in sugar or refined starches with little or no nutritional attributes. “Cutting carbs” doesn’t distinguish between the good and bad foods in this category.
The same thing happens with fats. Sources of unsaturated fat – such as nuts, seeds, avocado or extra virgin olive oil – have proven health benefits. But there’s no evidence for any benefits of lard, dripping, cream, fast foods or any of the fatty snack foods that account for much of our saturated fat intake. And no long-term study shows sustained weight loss or other health benefits from a diet high in saturated fats…
Consider the dozens of studies on Mediterranean diets, including randomised trials, where the fat and carbohydrate content vary but the health value depends on particular foods: extra virgin olive oil, nuts, vegetables, fruits, grains and legumes and a low intake of highly processed products. The take-home message from these is that we need to stop fussing over macronutrients and think about foods.
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Sugar supplants salt as new food villain

(NewHope360.com) When the old food guide pyramid got a facelift five years ago, it was notable not just for the shape of the guidelines – out with the pyramid, in with the actual plate just like the one people eat food off of – but also for taking action to reduce outside sodium consumption that leads to high blood pressure.
The new food guidelines – in a preliminary 571-page scientific report, the Dietary Guidelines for Americans 2015, which should be released early next year – now are taking aim at sugar consumption. Added sugars are associated with increased risk of diabetes and excess body weight…
The proposed regulations recommend added sugar intake get to less than 10 percent of total energy intake--it’s currently at 16 percent, so that’s a tall order indeed. But the 2010 guidelines recommending reduced sodium intake have had an effect on sodium consumption, with research validating that consumers do not notice sodium reductions of up to 20 percent, depending on the food product.
Because of that, expect a new, prominently printed, line on the Nutrition Facts panel that reads, “Added sugars.”
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Scientists Say The Original Paleo Diet Had A Large Dose Of Carbs

(John McQuaid, Author of "Tasty: The Art and Science of What We Eat") We know that the evolution of Homo sapiens, with our big brains and upright bodies, depended a great deal on what our ancestors ate. But we’re still learning about that process and what it might mean for people today.
This week an international team of scientists published a paper that adds an important layer to this understanding. One apparent secret to the original paleo diets was that scourge that the modern version views with the most skepticism: carbs…
Our big brains consume more energy than other organs. We walk upright and can cover long distances by walking or running, which also consumes a lot of energy. Yet we have small guts compared to many other creatures, including our closest relatives, chimps…
Our ancestors solved this problem with a series of dietary innovations – specifically adding in meat – and the scientists argue, cooked carbohydrates, mainly from roots and tubers.
Many scientists theorize that a virtuous circle emerged between hunting, gathering, and food preparation on the one hand, and bigger brains and smaller guts on the other. (Central to this dynamic, as I argue in my book, is that the ancestral talent for pounding, cutting, chopping, and cooking made food taste better than it ever had in the history of life on earth.)
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Food insecurity and high healthcare costs go hand in hand

(Reuters Health) People with severe food insecurity, who struggle the most to put food on the table, have healthcare costs more than twice as high as people who are food secure, according to a new Canadian study.
People who have food insecurity, meaning inadequate or insecure access to food due to low income, “have poorer (physical and mental) health, this is documented extensively for adults and children,” said lead author Valerie Tarasuk of the University of Toronto.
“We finally have been able to quantify the healthcare expenditures associated with it,” Tarasuk told Reuters Health by phone.
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Humans may face malnutrition if birds and bees disappear

(Reuters Health) If all the birds, bugs, bees and other creatures that pollinate our food crops were to disappear from the planet, humans could face a sharp increase in malnutrition, disease and death in many parts of the world, scientists estimate.
Researchers analyzed supplies of 224 types of food in 156 countries, quantified the vitamins and nutrients in foods dependent on animal pollinators, and then calculated what nutritional deficits people could face if pollinators ceased to exist.
Globally, dietary changes forced by the extinction of pollinators might increase deaths from non-communicable diseases and malnutrition-related problems by about 1.4 million, or a 2.7 percent gain in mortality, the researchers estimate.
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A Vaccine to Shield Threatened Honeybees from Disease

(ChemistryWorld) Although honeybees are commercially important pollinators, populations are in decline and stress, illness and pesticides have been blamed for the current crisis. Their disappearance has become an increasingly urgent issue and several new pesticide policies have been enacted in response. Similarly, research into the bee immune system has gathered pace. Specifically insects’ ability to prime their offspring’s immune system despite having no antibodies has long been a mystery. Now, a team from University of Helsinki seem to have the answer.
‘We were dancing in the lab,’ Dalial Freitak, main author of the paper, says of the day the results came in. ‘It was like winning the lottery!’ The team had discovered that vitellogenin, a protein also found in egg yolk, finds and binds the signature molecules of pathogens eaten by the queen bee. These signature molecules are then carried by vitellogenin into the queen’s eggs, where they work as primers for future immune responses. The breakthrough has allowed researchers to start working on bee vaccines.
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A Little Exercise Goes a Long Way for Older Adults

(MedPage Today) Even a little exercise was associated with reduced mortality for adults over 60, according to a meta-analysis of nine cohort studies.
In about 122,000 patients with an average follow-up period of 9.8 years, only 15 minutes of moderate to vigorous physical activity was associated with a 22% reduction in mortality … when compared with those who did no activity. Participants who exercised for 150 minutes a week at a moderate intensity or for 75 minutes at vigorous intensity, the amounts recommended by the Physical Activity Guidelines Advisory Committee Report, had a risk reduction of 28%..., reported David Hupin, MD, at CHU Saint-Etienne in France, and colleagues.
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The Right Dose of Exercise for the Aging Brain

(Well, New York Times) We all know that working out is good for us. But precisely how much or how little exercise is needed to gain various health benefits, and whether the same dose of exercise that bolsters heart health, for instance, is also ideal for the brain has remained unclear…
[In a study,] most of the exercisers showed improvements in their thinking skills, especially in their ability to control their attention and to create visual maps of spaces in their heads, two aspects of cognition that are known to decline with age.
But these gains were about the same whether people had exercised for 75 minutes a week or 225 minutes. Those volunteers who had exercised the most scored slightly better on some cognitive tests at the end of the study period than those exercising less, but the difference was barely significant.
Over all, “a small dose of exercise” may be sufficient to improve many aspects of thinking and more sweat may not provide noticeably more cognitive benefit, Dr. [Jeffrey] Burns said.
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Out-of-Home Activities May Promote Older Persons' Physical Activity

(Academy of Finland) It is beneficial to stimulate older people to leave home to increase their level of physical activity, suggests the study of postdoctoral researcher Erja Portegijs. The study, conducted at the Gerontology Research Center of the University of Jyväskylä, showed that older people were more physically active on the days when they left home and went further away.
Physical activity is important to maintain health and function in old age. Walking is the main form of physical activity for older people. "As we expected, persons were more physically active on the days when they moved in a larger area compared to when they stayed at home or within their neighborhood," Portegijs says.
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Create a Healthier TV Habit

(Michael Roizen, MD, and Mehmet Oz, MD) Current research is showing that watching too much is a major health hazard…
TV’s dangerous because long periods of sitting mess with your metabolism, interfering with your body’s ability to burn fat and sugar for energy. If you snack while you sit, you’re piling on calories and pounds, too. And if you trade an hour or two of sleep to catch late-night TV, you’re creating a sleep deficit that boosts risk for obesity and diabetes.
Build a healthy TV habit, with these steps:
Move while you watch…
Pick something funny…
Watch something healthy…especially if you love TV recipes.
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Many Seniors Overestimate Their Mobility

(American College of Emergency Physicians) Many seniors who visit emergency departments require more assistance with physical tasks than they think they do, which may lead to hospital readmission later on…
"Ensuring that older adults discharged from the emergency department are able to safely function in their home environment is important because those who are unable to function safely at home are at risk for falls and return ER visits," said lead study author Timothy Platts-Mills, MD, MSc, of the University of North Carolina Chapel Hill in Chapel Hill, N.C. "Accurately determining the ability of these patients to care for themselves at home is critical for emergency physicians as they make decisions about whether to discharge patients home or elsewhere. A patient who reports they can walk with an assistive device but actually requires human assistance to walk is likely to be bed-bound or to fall if they go home alone."
Overall, only 77 percent of patients in the study accurately assessed their ability to perform tasks.
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Fitness fundamentals still challenge Americans, poll finds

(Reuters) Despite an explosion of fitness advice from TV shows, blogs, books and online experts, a basic knowledge of health and exercise still eludes most Americans, according to a poll.
It showed that almost three-quarters of more than 1,000 people questioned did not know that they had to burn 3,500 calories to lose a pound of fat, according to the poll by fitness equipment maker Nautilus Inc. The results were posted online, along with an interactive quiz.
Only 39 percent grasped that an egg is a healthy source of protein and a mere 13 percent understood that women who weight train will not bulk up like a man. (bit.ly/1IXYeJ1)
The average score was 42 percent out of 100.
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Sedentary Workers Increased Physical Activity Using Office Chairs with Pedals

(Medical Research News) Office employees are exposed to hazardous levels of sedentary work which is now known to contribute negatively to both physical and mental health. This study tested the effect of retrofitting standard office desks with portable elliptical machines for the purpose of increasing the physical activity levels of sedentary office workers while they are at work.
This approach is slightly different that traditional approaches which ask employees to be more active during non-working hours.  We found employees provided the pedal devices became more active while at work and pedaled an average of 50 minutes per day over four months. These findings suggest this approach was successful at increasing physical activity levels of employees while at work and over a fairly long period of time.
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Why Your Boss Wants to Track Your Heart Rate at Work

(Bloomberg) The future of the high-performance workplace is taking shape behind closed doors and kept quiet by non-disclosure agreements.
Across the U.K., hedge funds, banks, call centers and consultancies are installing tracking systems to link biosensing wearable devices with analytics tools once the preserve of elite sports.
“There isn’t a competitive sports team in the world that doesn’t adopt high-end analytics tracking the athletes on the field, off the field, at home, when they’re sleeping, when and what they're eating,” says Chris Brauer, Director of Innovation at Goldsmiths, University of London. “The workplace is heading towards that model.”
The new tools help link human behavior and physiological data to business performance.
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Exercise-Induced Hormone Irisin Is Not a 'Myth'

(Cell Press) Irisin, a hormone linked to the positive benefits of exercise, was recently questioned to exist in humans. Two recent studies pointed to possible flaws in the methods used to identify irisin, with commercially available antibodies… [T]he Harvard scientists who discovered irisin address this contentious issue by showing that human irisin circulates in the blood at nanogram levels and increases during exercise.
Senior study author Bruce Spiegelman of Dana-Farber Cancer Institute and Harvard Medical School says that the confusion over irisin comes down to disagreement over how irisin protein is made in skeletal muscle cells and the detection limits of protocols. He and co-author Steven Gygi turned to state-of-the-art quantitative mass spectrometry techniques to show that the human hormone uses a rare signal ATA (start codon) to initiate its production (translation) rather than the usual ATG.
The use of the ATA, rather than the more common ATG, had led some investigators to conclude that the human gene was a pseudogene--a gene that serves no function. But alternative start codons account for a few of all genes and are usually an indication of complex regulation. The authors show that human irisin is similar to the mouse hormone and that it circulates in the range previously reported. Although irisin circulates at low levels (nanograms), this range is comparable to that observed for other important biological hormones such as insulin. Furthermore, the investigators developed a protocol, that does not rely on antibodies, to precisely measure how much irisin increases in people after exercise.
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Patients don’t realize smoking worsens inflammatory bowel disease

(Reuters Health) Doctors know smoking can increase the risk for certain common inflammatory bowel diseases (IBD), but many patients haven’t gotten the message, a new study suggests.
Out of 239 patients with two common types of IBD - Crohn’s disease and ulcerative colitis - only half were aware of the smoking risks associated with these conditions.
“The take-home message for patients with IBD is that smoking can affect their disease,” lead study author Dr. Stephanie Ducharme-Benard of the University of Montreal Hospital Center said by email.
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The Latest from The People’s Pharmacy

Reader Dismisses Mustard for Leg Cramps as Junk Science
Reader is convinced that mustard for leg cramps is bogus at best and junk science at worst. Do we always need an explanation for why something works?
Brain Freeze Saved the Day By Stopping Migraine In Its Tracks
It seems counterintuitive that causing brain freeze could stop a migraine cold. We have heard from lots of headache sufferers that it works really well.
Will Supplement Ward Off Macular Degeneration and Vision Loss?
A randomized controlled trial found that a specific multi-vitamin and mineral supplement could slow moderate or advanced macular degeneration.
Can Older People Benefit from Less Blood Pressure Medicine?
New guidelines suggest that older people may need less aggressive treatment of hypertension and might benefit from less blood pressure medicine.
Drugs That Are More Dangerous in Hot Weather
Drugs that limit sweating are dangerous in hot weather. They could lead to heat stroke, which can be life threatening. Know the signs.
Medicines that Shift Serotonin Levels Can Cause Catastrophe
Combining drugs that alter serotonin levels in the brain can lead to serotonin syndrome. The reaction can be terrifying or even life threatening.
Prednisone Side Effect Led to Hip Replacement
This reader suffered a serious prednisone side effect, avascular necrosis. When it destroyed the hip, a surgical replacement was required.
What Are the Risks of Tooth Whitening?
Are tooth whitening kits safe? They can be helpful in improving the appearance of teeth but may also make teeth more sensitive.
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Coffee Aids Colon Cancer Recovery, Study Finds

(NBC News) Colon cancer patients who enjoy a few cups of coffee a day appear to survive their cancer better and they're less likely to die early than non-coffee drinkers, researchers reported Monday.
It's the latest in a series of studies showing the benefits of coffee, which can lower the risk of diabetes, Parkinson's and cancer. This is the first one to show it may help patients recover better, and should come as welcome news to colon cancer patients who worry if they can safely enjoy coffee.
"What we found in this slightly less than 1,000 patients is that those who drank coffee regularly had a better disease-free survival, meaning they had a lower rate of having their cancer recur or of dying," said Dr. Charles Fuchs.
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Side effects may lead breast cancer patients to skip drugs

(Reuters Health) Breast cancer patients who report more side effects of their hormone therapy drugs and less confidence communicating with their doctors are more likely to intentionally or unintentionally miss a dose, according to a new study…
“We were surprised that so many women admitted to nonadherent medication-taking behaviors,” said lead author Gretchen Kimmick of Duke Cancer Institute at Duke University Medical Center in Durham, North Carolina.
“There are many reasons that women may choose not to take the medicine,” she told Reuters Health by email. “The most common reason is probably because they notice side effects.”
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FDA warns makers of superbug-prone devices over testing violations

(Reuters) Manufacturers of medical devices linked to recent superbug outbreaks at U.S. hospitals skirted a host of testing, manufacturing and reporting requirements, the U.S. Food and Drug Administration said in warning letters to the companies released on Monday…
Violations range from not properly evaluating cleaning, sterilization and testing procedures to failure to report infections and other problems. Fujifilm and Pentax were also cited for violations in their marketing applications for the devices, known as duodenoscopes. 
"The FDA takes these violations very seriously and will continue to monitor these firms to ensure they take appropriate corrective action," the agency said in a statement. "However, currently available information indicates that the benefits of these devices continue to outweigh the risks in appropriately selected patients."
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New heroin response strategy will span 15 states

(CBS News) The White House's Office of National Drug Control Policy (ONDCP) on Monday announced it's spending $2.5 million to launch the Heroin Response Strategy, a partnership between federal, government and local forces that the White House and other lawmakers call unprecedented…
Under the Heroin Response Strategy, the five HIDTAs will choose two regional coordinators -- one with a public health focus and one with a public safety focus.
The public health coordinator will oversee reporting on overdoses and will issue alerts to health authorities regarding dangerous batches of heroin and similar threats. Those alerts will help health officials quickly prepare to distribute naxolene, an antidote to opioid overdoses, or take other steps to reduce overdose deaths.
Meanwhile, the public safety coordinator will ensure law enforcement officials have the resources and intelligence they need to disrupt heroin trafficking.
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Picking a home health agency just got a bit easier

(Consumer Reports) The federal government's recent introduction of a new, 5-star ratings system judging home health agencies could help ease the decision that millions of Americans make each year regarding home health care for an older or disabled person.
The new, free ratings, called Home Health Compare, hosted by the federal Centers for Medicare and Medicaid Services, judges about 9,300 private and public home health care providers (about 2,900 are not included). The five-star rating is based on nine measures. Another 20 measures are judged, but aren't included in the rating.
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